To address childhood obesity, more and more dietetic professionals are employed in or consulting to schools in a health promotion capacity. Like most health promotion issues, reducing obesity at a population level requires interventions aimed at changing social structures as well as health knowledge and practices. In a previous Practice article, Graves and Murphy (2006) discussed the need for frameworks to guide school interventions, so that health knowledge gained through programs will be applied as self-care both in and out of school. Here I discuss my experience with the Health Promoting Schools (HPS) approach as one potential framework.
The HPS approach, sometimes known as Comprehensive School Health, began as a WHO-sponsored framework in 1986 based on a social model of health. The HPS approach aims to take a 'whole school' approach to promoting the physical, social, spiritual and emotional well-being of all students, staff and broader community. Schools that work with the model integrate health promotion efforts across the curriculum, and consider health in planning and management practices, as well as when developing school policy. Health-promoting schools also consult, negotiate with and involve their communities to create healthy policy at school, school board and government levels. The HPS approach creates a highly supportive environment that influences the health perceptions of all those who learn, work and play in the school (WHO, 2006).
My experience with the HPS approach began in Australia where the concept has been widely embraced, implemented and evaluated since the mid 1990s (Lynagh et al., 1999). In the Australian Capital Territory, school health committees are trained in the HPS framework. Participating schools then choose to focus on one or two health issues at a time, usually after mapping issues and surveying parents and community members to determine priorities. Examples of priority health issues include bullying, drugs and alcohol, sun protection, sexual health, healthy school canteens, and smoking prevention.
As a member of an out-of-school health agency, I was involved in two long-term health promotion efforts within HPS: a smoking prevention project aimed at girls in grades 7 and 8, and a project aimed at improving the nutritional quality of foods offered in school canteens. Both of these projects were successfully implemented in a number of HPS, due in large part to the priority-setting process that created an immediate 'buy-in'. Schools and their communities were poised to embrace health promotion efforts and to support projects because they themselves had chosen these issues as the top priorities for their schools. With health promotion efforts being curriculum driven, we found teachers were also highly supportive of the projects as they continued to meet curriculum requirements without the projects being considered an additional responsibility. Integration across the curriculum also allowed students adequate time to reflect on health issues, to transition through stages of change, and to test new behaviours in a supportive environment. All of these factors working synergistically gave students the confidence to apply new information in self-care practices, and gave parents a supportive network of teachers and other parents, better equipping them to support their children.
The HPS framework is grounded in the notion that healthy, well educated young people ultimately go on to become productive citizens who reduce inequalities in society, and thus contribute to the health and welfare of the population at large (WHO, 2006). This framework set a positive stage for implementing health promotion efforts, became a roadmap at times when new ideas were being tested and served as a collective vision when consensus-building was required. Dietetic professionals working in schools will find their efforts have an extended reach when they work within an HPS approach or other evidence-based framework.
Contact Information:
Nicole Druhan-McGinn, MPH, PDt
Project Consultant
The Cancer Council of the Australian
Capital Territory
(609) 683-5156
ndruhanmg@yahoo.com
Nicole currently resides in the United States and consults to several Australian agencies.
[Reference]
References:
Graves K, Murphy A. (2006). Taking food seriously, in and out of school. Practice, 34:4.
World Health Organization (WHO). European Network of Health Promoting Schools. Last accessed June 2006 at: www.euro.who.int/ENHPS
Lynagh M, Knight J, Schofield MJ, Paras L. (1999). Lessons learned from the Hunter Region Health Promoting Schools Project in New South Wales Australia. Journal of School Health, 69(6):227-32.
Resources:
Canada
Health Canada, Public Health Agency, Comprehensive School Health
www.phac-aspc.gc.ca/dca-dea/ 7-18yrs-ans/comphealth_e.html
Communities and Schools Promoting Health
www.safehealthyschools.org/
Australia
Victoria
(www.sofweb.vic.edu.au/hps/index.htm)
Australian Capital Territory (http://activated.det.act.gov.au/hps/)
United Kingdom
www.healthpromotingschools.co.uk/
