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BACKGROUND It is important that collaborative relationships exist in a community to improve access to needed services for children. Such partnerships foster preventive services, such as immunizations, and other services that protect the health and well-being of all children. METHODS A collaborative relationship in Illinois involving an academic health center, a school district, and county health department to address noncompliance with health examination and immunization requirements was formed. Parents were additional partners. RESULTS Examinations, screenings, and immunizations increased from previous year baselines. Greater fulfillment of health exam mandates resulted in fewer students (39% fewer) excluded from admission to school. CONCLUSIONS The type of partnerships described is feasible and can result in improved health care for school-aged children who otherwise might be excluded both from health services and from school.

BACKGROUND: Given the pressure that educators and policy makers are under to achieve academic standards for students, understanding the relationship of academic success to various aspects of health is important. The international Health Behavior in School-Aged Children (HBSC) questionnaire, being used in 41 countries with different school and grading systems, has contained an item assessing perceived school performance (PSP) since 1986. Whereas the test-retest reliability of this item has been reported previously, we determined its convergent and discriminant validity. METHODS: This cross-sectional study used anonymous self-report data from Austrian (N = 266), Norwegian (N = 240), and Canadian (N = 9,717) samples. Students were between 10 and 17 years old. PSP responses were compared to the self-reported average school grades in 6 subjects (Austria) or 8 subjects (Norway), respectively, or to a general, 5-category-based appraisal of most recent school grades (Canada). RESULTS: Correlations between PSP and self-reported average school grade scores were between 0.51 and 0.65, representing large effect sizes. Differences between the median school grades in the 4 categories of the PSP item were statistically significant in all 3 samples. The PSP item showed predominantly small associations with some randomly selected HBSC items or scales designed to measure different concepts. CONCLUSIONS: The PSP item seems to be a valid and useful question that can distinguish groups of respondents that get good grades at school from those that do not. The meaning of PSP may be context-specific and may have different connotations across student populations from different countries with different school systems.

BACKGROUND: Not much is known about the academic correlates of tobacco use among students in developing countries. This study investigated associations between multiple forms of tobacco use, psychosocial risk factors, and academic failure among 10- to 16-year-old government school students in Delhi and Chennai, India. METHODS: This study was a secondary analysis of data gathered from students in 7 government schools during a larger tobacco intervention trial in India. Mixed-effects regression analyses were carried out on a cross-sectional sample of 3799 students and a retrospective cohort of 2586 students. Data on tobacco use and risk factors were collected from self-reported student surveys in 2006 and 2004. Using school records, academic failure was defined as repeating the same grade level once or twice between 2004 and 2006. RESULTS: In 2006, academic failure was significantly more prevalent among students who reported use of chewing tobacco, bidis, or cigarettes, as compared with nonusers. Students with academic failure had greater social susceptibility and intentions for future tobacco use, and poor knowledge and self-efficacy for avoiding tobacco. Cohort analyses showed that students who had reported tobacco use in 2004 were more likely to have academic failure by 2006, as compared with nonusers. CONCLUSIONS: School health programs that incorporate tobacco control measures should be offered to government school students with poor academic outcomes in India, along with remedial education efforts. School-based longitudinal research is needed to assess effects of tobacco use in early adolescence on academic, social, and behavioral outcomes in later adolescence and young adulthood.

Health assessments are required for entrance into child care, Head Start, and preschool programs. However, state and federal screening and documentation mandates vary, and programs create their own forms for keeping required data on file. Inconsistent recording formats present challenges for primary care providers who must document each child's health status and for program administrators who wish to collect data across groups of children. This article describes how the passage of new legislation in Connecticut establishing a statewide prekindergarten program presented the opportunity to develop a comprehensive early childhood health form for all early childhood programs, which promotes children's access to health services and coordination of care among health care professionals, early childhood providers, and families.

School health service programs underwent rapid changes to meet the health needs of today's students. These needs stem largely from: a) increased number of students with special health care needs attending school, b) increased stress and time pressure on families, c) rapid restructuring of the health care system serving children, and d) recognition that schools provide opportunities to identify students with health risks. This paper describes seven components of a statewide Massachusetts plan to develop school health services by: a) setting standards, b) reviewing and revising statutes and regulations, c) promoting credentialing of school health personnel, d) providing continuing education on subjects pertinent to school health, e) exploring reimbursement systems and new funding sources, including funds from the tobacco settlement, f) exploring new models of care, and g) implementing data systems. The plan focuses on developing school nurse-managed school health services within a public health model.

Health services, provided through schools for more than 100 years, increasingly have expanded to meet preventive as well as acute health care needs of children. This article reports on a survey of parents of third-grade children in an urban public school system. The authors examined what parents know about school health services, what value they place on the services, and what barriers exist to health care access. Results indicated parents place a high value on health services offered in schools, but they know little about service availability and use. Parents often were unaware their children received many of the services listed, such as review of school health records, vision and hearing screening, and health education by school nurses.

The Dallas (Texas) Public Schools established the first school-based health center in the United States in 1969. In 1993 a partnership between two school principals, a school mental health professional, and the medical director of the county mental health center was the impetus for the first comprehensive school-based mental health center in Texas. In 1995 the programs joined together as Youth and Family Centers (YFCs) to provide physical health, mental health, and other support services to students and their families. The 10 strategically located school-based centers are directed by licensed mental health professionals employed by the district who lead a multidisciplinary team of physical health and mental health providers. Students served by the YFCs have fewer discipline problems, course failures, and school absences.

The rapid expansion of managed care creates opportunities and dilemmas for those involved in school health and adolescent health promotion. Managed care organizations (MCOs), public health agencies, and school and adolescent health providers share certain common goals and priorities including an emphasis on prevention, cost-effectiveness, and quality of care — and a willingness to explore innovative approaches to health promotion and disease prevention. However, MCOs often face conflicting challenges, balancing the goals of cost containment and investment in prevention. In considering support for school health programs, MCOs will be interested in evidence about the effectiveness of services in improving health and/or reducing medical expenditures. Mechanisms for improving prevention efforts within MCOs include quality assurance systems to monitor the performance of health plans, practice guidelines from professional organizations, and the contracting process between payers and health care providers. Development of partnerships between MCOs and schools will be a challenge given competing priorities, variation in managed care arrangements, structural differences between MCOs and schools, and variability in services provided by school health programs

The definition of a comprehensive school health program changed dramatically in the 20th century. Publication of the book Health Education, in the 1920s, provided a vision of health education as an instructional experience. In the 1950s, the concept of school health programs grew with addition of components in health services and a healthy school environment. An expanded concept of comprehensive school health programs now includes the components of physical education, food services, counseling, staff health promotion programs, and involvement of parents and the community. The next step involves inclusion of a "focusing" or "integrating" component that unifies elements of the comprehensive school health model. This component provides leadership and management to ensure that potential benefits of a comprehensive school health program are fully realized.

This article reports findings from an assessment by the Office of Technology Assessment (OTA), an analytical arm of the U.S. Congress. In brief, OTA found the conventional wisdom that American adolescents as a group are so healthy that they do not require health and related services is not justified. Even more disturbing, U.S. adolescents often face formidable barriers in trying to obtain health care. OTA suggested that Congress could act to 1) increase adolescents' access to health care, most effectively by supporting school- or community-based comprehensive health services specifically for adolescents, 2) restructure and reinvigorate the federal role in adolescent health, most visibly by creating an office of adolescent health in the U.S. Executive branch, and 3) improve adolescents' social environments, by providing more support to the families of adolescents, limiting adolescents' access to firearms, supporting the expansion of recreational opportunities for adolescents, and further supporting opportunities for community service. Congressional actions taken since the release of OTA's report are summarized. (J Sch Health. 1992;62(5): 167–174)

The main roots of health care and health education for young people in the United Kingdom are described. Contributions of the National Health Service to health screening and developmental assessment are described, primarily through the function of school health services. The development and future potential for effective school health education also is considered in the light of the impending introduction of a new national curriculum. The evaluation of the concept of the “health promoting school” is highlighted as a key area for future development, together with more emphasis on achieving a balance between health enhancement and educational outcomes to school health education. Greater priority for evaluation of school health education also is advocated.

The leading health problems of children and adolescents in Chile is reviewed. The Chilean educational system and how the system addresses its principal health problems are described. A school health program is described as well as other educational programs designed and developed by nongovernmental institutions which have a smaller coverage. Current research studies regarding growth and development, child morbidity, nutritional level, and mental health studies are reviewed. In addition, principal challenges that include developing more efficient ways of referring children, enriching the curriculum and teacher training, assigning school hours for health teachers, and enlarging coverage of the health care evaluation programs are outlined. Of special importance is developing prevention programs for parents and children using school and community leaders to prevent health problems in areas such as human sexuality education, decision-making, social abilities, and alcohol and drug abuse. Main efforts should be directed toward low-income families and children to improve life conditions.The leading health problems of children and adolescents in Chile is reviewed. The Chilean educational system and how the system addresses its principal health problems are described. A school health program is described as well as other educational programs designed and developed by nongovernmental institutions which have a smaller coverage. Current research studies regarding growth and development, child morbidity, nutritional level, and mental health studies are reviewed. In addition, principal challenges that include developing more efficient ways of referring children, enriching the curriculum and teacher training, assigning school hours for health teachers, and enlarging coverage of the health care evaluation programs are outlined. Of special importance is developing prevention programs for parents and children using school and community leaders to prevent health problems in areas such as human sexuality education, decision making, social abilities, and alcohol and drug abuse. Main effort should be directed toward low-income families and children to improve life conditions. The Chilean school health program includes health screenings for high-risk schools. These are defined as those located in low socioeconomic communities. There are medical clinics for problems detected by the school health evaluation through anthropometric tests. If necessary, the student is hospitalized. Immunization is carried out in every Chilean elementary school (grades 1-8). Local health programs consist of health promotion programs, disease prevention programs, and mental health programs (including substance addiction). The greatest challenge now is to implement local, regional, and national policies, adapting the program to regional differences; creating new educational areas, and providing human resources and materials.

The scope and content of school health education research conducted from 1984-1987 in countries outside the U.S. are examined. Both published and unpublished research were requested from sources identified by the American School Health Association's Council on International Health. One hundred eighty-eight studies from 31 countries were reviewed and categorized. Countries that publish journals devoted to school health offer more opportunities for publishing research. Analysis of the studies revealed that individuals involved in school health face similar problems regardless of country. Cross-country comparative studies serve as models for future research.

News about health research findings, especially regarding controversial topics, can seem confusing and conflicting to students and the general public. Many people eventually develop a "turned-off" attitude toward all health news. Yet medical information is one of the key factors involved in health decision-making, because it influences a person's judgment about the potential health impact of a behavior choice. As part of their health education, youngsters need to learn skills to better understand and evaluate reports of research news, so the information available for health decision-making will be more complete and accurate. Such news is already abundant in television, radio, newspaper and magazine reports and will continue to increase as research advances, knowledge expands and health "facts" are revised. This article outlines concepts and skills to help teachers and students understand the changes and controversies in health news. To most effectively use new information generated by medical research, students need to: 1) understand basic concepts about the nature of research and the research process; 2) apply critical thinking approaches to health news; and 3) locate additional health information resources. Generating ways to address these needs is a high priority of the school health education work at the National Heart, Lung and Blood Institute. Comments are invited on this approach.

Eighty-eight international students enrolled at the University of Toledo were surveyed in order to ascertain their health care needs since arriving at the university. This study of the health status of international students indicated that the four leading problems experienced since arriving at the university were fatigue, homesickness, headaches and colds. Fatigue and colds were more commonly reported by students from Latin America than those from Asia or the Middle East. Both community health services and the university health service are not used by a majority of international students. Friends and the telephone book yellow pages are the most commonly used sources for finding a physician if one becomes sick. The drug store was indicated as being the place the international students would go for medicine if they became sick. The findings of this study suggest that international students must be oriented to the health services available in the community and at the university health service. A health education program needs to be conducted to inform these students about personal health practices and available services.

A pilot health education project stressing prevention and individual responsibility was developed and presented at two high schools. The health record, maintained by the individual, focuses on health maintenance and illness prevention; although it allows for recording illnesses as well. Preliminary results are encouraging. Students were interested in the course and the record and indicated their intent to continue using the record. The article describes the health record, the educational process used and directions for future research.

There is considerable concern in the United States today about the health of this nation's school children. Various plans, including the direct delivery of primary health care in the public schools, are being suggested. School health care in the United States traditionally has stressed health inspection, assessment, and first aid. However, school health programs that delivered primary health care, including dental care, always have existed, though they represented a distinctly minority tradition. Since the 1960s, the number and scope of these programs have expanded. At the present time new approaches to delivering primary health care in the public schools are being attempted. Other proposals are emerging from the federal government and from private foundations.

The following special report was developed by the staff of the Division of Maternal and Child Health, Bureau of Health Care Delivery and Assistance, U.S. Department of Health and Human Services as background material for a conference on “Health of School-age Children” conducted in March 1982 by the University of Colorado Health Sciences Center, School of Nursing in conjunction with the Division of Maternal and Child Health. The American School Health Association believes there is an urgent need to communicate the issues and concerns expressed in the special report to those members who have responsibility in the field for providing leadership in the planning and implementation of programs for school-age children and youth. The Journal of School Health is pleased to have the opportunity to present this special report to its readership.

Mental health programs which facilitate prevention and remediation within the school system are indicated by large numbers of children at risk for problems. Counseling, consultation and communication activities to promote mental health can readily be provided by school health personnel. Barriers to the development and implementation of a mental health program include problems in staffing and communication as well as a continued illness orientation of the health professional.