Penni Cushman NHPRC 2013

Addressing health issues in New Zealand schools

Penni CushmanUniversity of CanterburyNew Zealand

7th Nordic Health Promotion ConferenceVestfold University College, Norway. 17-19 June, 2013

Where is New Zealand?

New Zealand

“No curriculum is brilliant enough to compensate for a hungry stomach or distracted mind.” (American Cancer Society, 1992)

“Children experience more positive learning and achievement outcomes when they are well-nourished, engage in physical activity and experience school as a caring and supportive social and learning environment. (Dickinson, 2005)

“There is a clear and consistent relationship between nutrition and academic outcomes in the long term.” (Quigley and Watts, 2005)

“A lack of sleep puts adolescents at risk of cognitive and emotional difficulties and poor school performance.” (Carpenter, 2001)

“Physical activity has been found to improve cognitive performance and promote on-

task classroom behaviour.” ( Mahar et al., 2006)

Why the school is important as a health promotion setting – links between health and academic achievement

• If New Zealand teachers perceive students’ learning to be affected by health issues

• Whether schools implement strategies to address health issues, and if so, which strategies

• If strategies reflect the HPS approach

• Teachers’ understanding of HPS

We set out to investigate:

• 1000 surveys sent to randomly selected schools across NZ. Final return rate 305. Late responders analysed. (Uuskula, 2011)

Key questions: 1. What health issues in your school do you see as impacting on students’ learning?2. Do you have strategies in place to address these issues?3. What is your understanding of a ‘health promoting school’?4. Do you consider your school to be a HPS school? If ‘yes,’ what do you see as the

benefits?5. Do you see a relationship between HPS and educational outcomes?6. Do you have a HPS team and if yes, who is on it?

Quantitative data was coded, entered into Excel and transferred to SPSS. Qualitative data analysed and coded according to identified themes.

Methodology

School location response distribution

School type response distribution

Decile level

What health issues do you see as impacting on students’ learning? (% of 858 issues)

Mental health:• Effective Behaviour Support (EBS), other behaviour management and

education programmes• Workshops• Monitoring of at-risk students • Support from, or referral to helping (outside) agencies • ‘Cool School’ approach for conflict resolution • Pastoral care (e.g. deans, tutors, teachers, counselors, school therapist,

psychologist, social worker)• Work closely with Resource Teacher Learning Behaviour (RTLB) and Social

Worker in School (SWIS) • Teacher works with individual students and families • Peer support and safe room for students • Life skill activities (cooking, gardening, community experiences)

What strategies have you put in place to address these issues?

Food Choices:• ‘Fruit in Schools’ Programme (or just offering fruit) • Water only school• Offering healthy food (for school bought lunch and snacks) • Supplying healthy food, lunch and/or snacks ('brainfood')• Breakfast Club/breakfast programmes, school fruit break • School garden (grow veges and/or fruit) • Cooking classes promoting healthy eating (e.g. education programmes

and workshops in school, awards) • Communication, talks, information for parents (e.g. newsletter)

monitoring eating behaviour, • WAVE Programme • Student health council/team • School survey on canteen fizzy drinks - energy drinks banned

What strategies have you put in place to address these issues?

The HPS framework has been widely promoted in NZ – but are schools using it?

Do you consider your school to be a health promoting school?

• “Nil” (school 51)

• “A school that promotes healthy nutrition … and students are involved in daily fitness.” (school 74)

• “A school that promotes the total wellbeing of individuals – physically, mentally, spiritually.” (school 163)

• “One that has a committee of representatives from staff, parents, pupils and/or BOT to deal with health issues and find resolutions.” (school 160)

• “A school that is proactive around the issues they identify as barriers to learning. Educating parents, promoting outside agencies/groups. Usually has a committee made up of teachers/parents/children.” (school 289)

What is your understanding of a ‘health promoting school’?

The benefits of being a health promoting school?

• “Creates a safe, caring and supportive learning environment. Enables students to develop lifelong skills, and health behaviours that can increase their potential to live healthy lives.” (school 57)

• “Students respect themselves/others in a far greater way. Students think more about making safe choices and the consequences of any decisions they make.” (school 47)

• “Better pastoral care, more resilient students, happier learning environment, more effective relationships between student to student and staff.” (school 234)

• “A shared community approach to healthy living. Greater learning engagement and reduced attendance issues. (school 8)

What do you see as the benefits of being a health promoting school?

• 81% of schools considered themselves an HPS school yet only 53% had an HPS team.

Do you have an HPS team?

Do you see a relationship between HPS and educational outcomes?

•“Healthy students are more confident and more ready to learn. They are not held back by health issues.” (school 38)

•“Healthy, active, positive children are more able to make the most of their opportunities, take risks, meet challenges and bounce back from setbacks.” (school 181)

•“Safe, positive environment supports high expectations and outcomes.” (school 170)

•“Too many to mention!” (school 42)

The relationship between HPS and educational outcomes

– Participants identified a number of issues that impacted negatively on learning, with issues around food seen as particularly important.

– Participants’ understanding of HPS varied from no understanding to a comprehensive understanding.

– Despite the variation in an understanding of HPS almost 90% of respondents saw a relationship between HPS and educational achievements.

There is a need for:

– Further research around best practice.

– More professional development regarding schools as health promotion settings, especially in regards to developing community links and parental partnerships.

Conclusions and challenges