www.schoolhealthpromotion.org
An Online Workbook for
countries, states, agencies, practitioners and researchers
to support Continuous Improvement
  • Home
  • About
    • Introduction to this workbook and new SHP Paradigm
    • How to Use, Contribute to this Workbook >
      • Format of Better Practices Pages
    • SH Promotion in the 21st Century
    • List of Better Practices in this Workbook
    • List of Partners, Contributors & Sponsors
    • Be the Lead on a topic/Contact Us/Sign-Up for Updates
    • Brief History, Key Aspects of SHP
    • Key Definitions & Terms
  • Better Practices (A-F)
    • Before You Start: Shared Vision & Goals
    • A. Understand Your Context >
      • A-1 Defined Country, Community Contexts
      • A-2 Conduct a Situation Analysis >
        • A-2-1 Understand the Organization, Structures, Laws for Education Systems
      • A-3 Exchanges with similar countries
    • B. Better Data, Focus Your Resources >
      • B-1 Agree on Priority Issues >
        • B-1 (i) Issues documented, Agreed, Communicated
        • B-1 (ii) Local, School Priorities Enabled
      • B-2 Focus Your Resources on these Issues
      • B-3 Select/Develop/Use Surveys on Child Health & Behaviours
      • B-4 Select/develop/use a SH Policy/Program Survey
      • B-5 Select/develop/use a HPSD student learning survey
      • B-6 Establish Reporting Format, Frequency
    • C Whole Child, All Children, Esp. Disadvantaged >
      • C-1 Define, Describe, Publish Your Values
      • C-2 Describe Impact on Access, Achievement in school
      • C-3 Describe Impact on Disadvantaged Students
    • D Choose Interventions, Build Multi-Interventions (MIP's) >
      • D-1 Select Populations to be served by priority interventions
      • D-2 Select core sets of interventions
      • D-3 Build Multi-Intervention Progrtams (MIP's)
      • D-4 Control Proliferation of Projects, Issues
    • E. Select & Align Multi-Component Approaches >
      • E-1 Select, descrtibe your Multi-Component Approach (MCA)
      • E-2 Align MCA's Used in your country
    • F Build, Maintain Core Components >
      • F-1 Over-arching SH Policy >
        • F-1 (i) The Policy-Making Cycle
        • F-1 (ii) Encourage/require multiple components/interventions
        • F-1 (iii) Emphasize Equity within the policy
        • F-1 (iv) Support the Policy with an Action Plan
      • F-2 Develop, maintain a strategic action plan >
        • F-2 (i) Health, Education, Other Ministry Service Plans
        • F-2 (ii) Local Health, Education, Other Agency Service Plans
        • F-2 (iii) School, Clinic, Professional Service Plans, Guidelines
      • F-3 Maintain a core HPSD Education Program >
        • F-3 (i) Core HPSD Curriculum/Class Instruction
        • F-3 (ii) Consider core Home Ec/Financial Literacy Curriculum
        • F-3 (iii) Consider Core PE Curriculum
        • F-3 (iv) Vocational Prep for Health Careers
        • F-3 (v) Planned, sequenced cross-curricular instruction
        • F-3 (vi) Use of school routines, organization
        • F-3 (vii) Correlate with School Climate, Discipline Practices
        • F-3 (viii) Use of Co-Curricular Activities
        • F-3 (ix) Use of Extra-curricular Activities
        • F-3 (x) School-linked Web Learning
        • F-3 (xi) School-linked Family/Parent Education
        • F-3 (xii) School Participation in Community Education Programs
        • F-3 (xiii) Teacher Education & Development
        • F-3 (xiv) Teacher Wellness
      • F-4 Define Set of SH Services, Waiting Times >
        • F-4 (i) Defined set of school-based/linked services
        • F-4 (ii) School Health Services Quality, Delivery
        • F-4 (iii) School-based Clinics
        • F-4 (iv) School-based Vaccinations/Immuization
        • F-4 (v) School Management of Students with Chronic Diseases
        • F-4 (vi) School Management of Students with Disabilities
        • F-4 Role, Training of School Nurses
        • F-4 (viii) Role, Training of School Psychologists
        • F-4 (ix) Role, Training of School Physicians
        • F-4 (x) Role, Training of Donor Funded Aid Workers
        • F-4 Role, Training of SH Coordinators
      • F-5 Social Environmnet, Support, Engagement >
        • F-5 (i) Maintain positive school social climate
        • F-5 (ii) School discipline/codes of conduct
        • F-5 (iii) Consult, engage students
        • F-5 (iv) Inform, educate, involve, support parents
        • F-5 (v) Inform, involve community
        • F-5 (vi) Awareness, safety, use of social media
      • F-6 Physical Environment, Practical Resources >
        • F-6 (i) School Construction, Retro-fitting
        • F-6 (ii) Clean Water
        • F-6 (iii) Clean, safe bathrooms, latrines
        • F-6 (iv) School Meals, Food Services
        • F-6 (v) Safe Routtes to School
        • F-6 (vi) Disaster/Emergency Risk Reduction
        • F-6 (vi) Strategy to "Green" School Grounds, Facilities
      • F-7 Reciprocal, Strategic Partnerships
      • F-8 Country/Community Ownership
      • F-9 Youth/Student Engagement
  • Better Practices (G-J)
    • G Implementing, Scaling Up, Sustaining Programs >
      • G-1 Are you distributing, disseminating or institutionalizing?
      • G-2 Scaling Up, Succession Planning
      • G-3 Intervention Mapping
      • G-4 Interventiion Fit with your Situation
      • G-5 Use of Effective Planning Mechanisms
      • G-6 Use a Tested Implementation Model
      • G-7 Anticipate local Barriers, Drivers
      • G-8 Identify Threshold/Levers for Sustaining Programs >
        • Calculate & plan for scale up/ongoing costs
    • H Build System/Organizational Capacity >
      • H-1 Start=up & Baseline Funding, Staffing >
        • H-1 (i) Transition from Project to Ongoing Program/Budget
        • H-1 (ii) Adequate Time in Curriculum/School Day
        • H-1 (iii) Minimum Waiting Times for Services
      • H-2 System & Organizational Capacities >
        • H-2 (i) Coordinated Policy & Leadership
        • H-2 (ii) Assigned Staff as Coordinators at all Levels
        • H-2 (iii) Mechanisms for Cooperation, Coordination
        • H-2 (iv) Ongoing Knowledge Exchange & Development
        • H-2 (v) Pre-service education, In-service development of workforce
        • H-2 (vi) Regular monitoring, reporting, evaluation, improvement
        • H-2 (vii) Identify, jointly manage emerging issues
        • H-2 (viii) Explicit plan for sustainability
    • I Integrate Health & Social Programs in Core Business of Education System >
      • I-1 New Partnership Models to Better Integrate Within Education >
        • I-1-(i) Negotiated roles, resources in SH partnership
        • I-1 (ii) All initiiatives through one SH structure/team
        • I-1 (iii) First Consider Learning Needs
      • I-2 Align SH work within education structures, concerns, routines >
        • I-2 (i) Understand constraints on schools
        • I-2 (ii) Understand teacher beliefs, norms, work lives, concerns
        • I-2 (iii) Recognize, support teacher autonomy in lessons
        • I-2 (iv) Use updated pedagogical models
        • I-2 (v) Build teams in constrained conditions
        • I-2 (vi) Fit within stages, models of teacher education./development
        • I-2 (vii) Invest in education/development of non-educators in SH
      • I-3 Avoid silos on diseases/problems >
        • I-3 (i) Be guided by integrative paradigms
        • I-3 (ii) Deliver interventions within your multi-component approach (MCA)
        • I-3 (iii) Advocate for HPSD education in a broad core curriculum
      • I-4 Re-align Health, Other Sectors Within Education >
        • I-4 (i) Use "no-blame", shared responsibility, incremental change strategies
        • I-4 (ii) Address the characteristics of education systems
        • I-4 (iii) Use systems change models used by educators
        • I-4 (iv) Work within education consultative, decision-making & management structures
        • I-4 (v) Describe how core health/other sector structures, functions will relate to education counterparts
        • I-4 (vi) Maintain long-term perspective when building partnership with education sector
        • I-4 (vii) Develop, maintain a joint monitoring & reporting system
      • I-5 Health/Other Sectors should commit to providing on-going financial & human resources within schools >
        • I-5 (i) Health/other sectors should build capacity within their system that work with schools
        • I-5 (ii) Be specific about outputs from your partnership with the education sector
        • I-5 (iii) Health/other sectors should define minimum service levels related to schools
    • J Use concepts/tools from systems science/organizational development >
      • J-1 Policies, practice guidelines require Ecological Approach, Systems-focused Actions >
        • J-1 (i) Discourage use of settings as way to reach captive audience, encourage strategies to build capacity, modify conditions
        • J-1 (ii) Position linear logic models for programs within complex, ecological models
        • J-1 (iii) Select or adapt a model of continuous improvement/quality management
        • J-1 (iv) Review, select concepts/tools from systems science
      • J-2 Address implications of systems characteristics >
        • J-2 (i) Address implications of Open Systems
        • J-2 (ii) Addresss imlications of decision-making in loosely-coupled systems
        • J-2 (iii) Address implications of "professional bureaucracies"
      • J-3 Address complexities of working across & within several systems, agencies >
        • J-3 (i) Address inter-organizational cooperation & competition
        • J-3 (ii) Plan for different types of cooperation
        • J-3 (iii) Implement, maintain a "whole of government" strategy
        • J-3 (iv) Understand contradictions of "Health in All Policies" initiatives
    • Addendum: Developing a SHP Knowledge Development/Research Agenda
  • Approaches & Contexts
    • Different Approaches
    • Different Contexts >
      • Low Resource Countries
      • Conflict/Disaster Affected Countries
      • High Resource Countries
      • Indigenous Communities
      • Disadvantaged Communities
      • Small Island Developing States
  • Calendar School Health & Development
  • New Page
Introduction to this Workbook
There are many examples of standards, checklists and self-assessment tools available for countries, agencies and schools to use in monitoring their progress. Many of these documents focus on one of a few selected issues. Others are tied directly to one organization or model or they are so general, so the results not easily compared with similar countries.

Most are based on the notion that schools (and often only the educators) should be able to “account” for the status and effectiveness of their health policies and programs. In other words, the implicit goal is to identify what is going wrong rather than identify things that can be improved. Many assessments are divorced from decisions about budgets, staffing and improvement planning. Most are focused at the school level rather than recognizing that individual schools are part of large organizations. Many seek yes/no answers to complex questions that have been reduced to a few specific indicators so that senior managers will read them. Many try to publish a simple score card for the same reason. This workbook does not try to reduce or avoid the complexity of the real world.

This workbook, with its accompanying consensus statement, e-book, essential criteria, online resources and related modules for MOOC’s/online courses is different.

First, we are using a systems-based approach where we ask participants to reflect on the progress that they are making at the national/state, local agency and not only at the school/neighbourhood levels. Most of the research, policy and program development has focused on the school as the unit of analysis and action. Although individual schools have some autonomy and capacity to implement small scale projects/activities and specific policies on issues like in-school food sales and menus, the decisions about core curricula, the training of teachers, the role & numbers of nurses and other personnel providing services, and most other human resource, funding and policy decisions are made at much higher levels within the education, health and other agencies and government ministries.

As education policy makers have learned a long time ago, small scale “innovations” are relatively easy to adopt in the front-lines of large, complex “professional bureaucracies”, but large scale “reforms” that change the balance among the custodial, intellectual, vocational, social placement/accreditation and socialization functions of schooling are exceedingly difficult. Consequently, the underlying strategy and philosophy for this workbook reflects the “continuous improvement” strategies now used in most modern education systems. Indeed, this “total quality management” strategy is widely used in the private and other public sectors such as health care, where employees and teams are encouraged and supported to identify and implement specific improvement objectives that they see as relevant and achievable. This is a stark departure from traditional approaches to “accountability” where external experts and auditors seek to identify where “things are going wrong”, rather than how things could be improved. 

Consequently, we have tried to link the standards and their related criteria/indicators to evidence-based or experience-tested improvement strategies. Indeed, in accordance with systems science and quality management practices, we encourage actors at all levels to identify specific improvement objectives in accordance with their needs and opportunities. Reflecting this, we most of the questions and space for reporting in tis are formatted in a rubric format, thereby allowing for nuanced responses more in keeping with the real world and its complexities.
More importantly, this online guide provides web links directly to the research, reports, good examples and resources that can be used to improve the practice on each point. As well, we try to identify qualitative and specific steps or improvements on each practice. We have grouped these materials by three different types of contexts (high, low and conflict/disaster-affected) as best we can. We are asking researchers and practitioners if they would respond to email inquiries about the practices they have studied or are working on in their own programs.

Second, this workbook is not only intended for educators or the education sector. We believe that school health promotion (SHP) is a shared responsibility for many sectors, including health, child protection, municipalities, law enforcement/civil protection and others which have their own sectorial mandate but share a concern for the health of young people. Each of these sectors, but especially health, must commit ongoing, substantive human and financial resources to all levels of school health promotion approaches and programs. Providing technical advice, planning guides or educational materials is not sufficient.
Many more performance criteria, qualitative improvements and related collections of research, reports and resources could have been added to this online workbook if we had added the massive amount of information that has been published on a topic by topic basis. There are many other web sites that focus on these topics, issues and types of prevention programs, so we have simply listed them on one of the pages herein. We think that the criteria and better practices represent the core set of activities that need to be maintained in a multi-component approach such as healthy schools.

For many of us, there is a temptation to ensure that our issue or at least the rationale for our program is included in any assessment tool. There is a time and place for detailed and applied versions of this continuous improvement approach to the many, many health and social issues and behaviours that challenge young people and schools today. This type of work needs to be done. Or more accurately, the work of adapting and applying these ten dimensions of our new paradigm (see below) needs to be done. But it will not be done in this workbook, except for a better practice how a multi-intervention program (MIP) can and should be developed for such broad issues.
Although the list of better practices in this workbook are numerous, they are not yet complete. The ten dimensions used in this new school health promotion paradigm are not yet fully explored and explained by practitioners, officials and researchers. So they will evolve and these pages/better practices will be modified as they occurs.

We should also keep in mind that this workbook represents a wide universe of better practices that will never be within the reach of any of us. Please do not attempt to do everything described herein. Please look at the big picture described in the ten dimensions and then select the items that your organization or team can work on in a defined time frame. This is the essence of continuous improvement.

Th list of ten dimensions in the new paradigm suggest that we look beyond our traditions of selecting an issue and implementing a program to address it. But we are not suggesting that we abandon this focus on effective programs. This traditional health promotion research and practice has helped us to understand much about dimension number 4 (see below) which entails:

 “4. Choosing evidence-based and experience-tested interventions (specific policies, programs, services, practices) that are suited to the local context and capacities and then combining several into multiple intervention programs (MIP’s) addressing broad education, health and social issues and conditions.

However, we have much more to learn regarding the other dimensions such as contextualization, better data/monitoring to focus our resources, high quality implementation strategies that lead to easy scaling up, maintenance and sustainability, building organizational and system capacity, truly integrating health & social programs within the core business of education systems, acting on new ecological thinking by using system science and organizational development tools and, even about truly building/monitoring the core infrastructure pf SHP policies, curriculum, services, social support and physical environments.

We believe that these quality improvements can be addressed by all countries, health, education & other ministries states/provinces, local education & health agencies/authorities and by schools and the relevant professionals working in their respective neighbourhoods. . They represent a core set of goals around which comprehensive approaches to school health promotion can be built and maintained. However, we suggest that these standards will be achieved in different ways in different contexts. Consequently, we will provide examples and applications to low resource, high resource and conflict/disaster-affected countries in the “pathways to improvement” sections. 
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