The Role of the Federal Government in Promoting Health Through the Schools: Report from the Department of Education
Statement of Diane Ravitch, PhD, Assistant Secretary f o r the Office of Educational Research and Improvement, U.S. Department of Education, and Counselor to the Secretary on the Federal Government’s Role in Child Health Promotion and Disease Prevention, before the Subcommittee on Oversight of Government Management. Committee of Governmental Affairs, U.S. Senate, November 14, 1991.
T
he Department of Education plays an important role in encouraging health education in our nation’s schools. For the nation to offer its children an excellent education, we must help ensure that they have the healthy minds and bodies to learn. The Elementary and Secondary School Improvement Amendments of 1988, P.L. 100-297, authorized the Comprehensive School Health Education Program under the Fund for Innovation in Education (FIE), most of which is administered by the Office of Educational Research and Improvement (OERI). This program provides grant assistance to state and local educational agencies for various activities related to improving comprehensive health education for elementary and secondary students. Activities include implementation of training programs for school personnel in health education, development of a comprehensive school health program, assessment of school health programs, demonstration of model programs, and dissemination of information to schools related to nutrition, personal health and fitness, disease prevention, and other urgent health problems affecting students. Additionally, the 1988 law authorized establishment of an Office of Comprehensive School Health Education in the Office of the Secretary. The department considered this issue and concluded that enlarging the Office of the Secretary to administer this grant program was not desirable. The Office of Educational Research and Improvement provides the leadership necessary to administer the program and to coordinate the Department’s health-related programs and activities with other agencies.
COMPREH E NSlVE SCHOOL HEALTH EDUCATION PROGRAM ACTIVITIES The Comprehensive School Health Education Program has completed its third year of operation. Program highlights include: In 1989, the first competitions were held for awards under the Comprehensive School Health Education Program, and grants totaling $3 million were made to a variety of organizations, school systems, universities, and state agencies. Several supported innovative, interDiane Ravitch, PhD, Assistant Secretary for the Office of Educational Research and Improvement, US. Dept. of Education, 555 New Jersey Ave., NW, Room 600, Washington, DC 20208.
disciplinary projects and focused on disadvantaged students in grades K-12. In 1990, approximately $1.5 million was awarded to 10 new applicants. Most of these projects focused on training teachers and involved parents in the planning and implementation of comprehensive school health education programs. An additional $2.3 million was awarded for the second year of funding for projects awarded in 1989. In 1991, $1 million was awarded for 10 new grants. More than one-half of these projects train teachers and administrators in health, fitness, nutrition, disease prevention, and safety. An additional $3.6 million was used for the second and third year of funding for projects initiated in 1990 and 1989. The following four examples represent innovative projects funded the past three years: The National School Boards Association (NSBA) will collaborate with national education, health, and community organizations to train local school board members in how to plan, implement, and improve comprehensive school health education programs. The NSBA also plans to collect national data on programs and promote health education at national and state conventions. The National Association of School Nurses and the non-profit Education Development Center, Inc., will seek ways to improve the training of school nurses. Two teaching models, one using regional workshops and one using home study, will be tested. The University of Mississippi will develop a series of live, interactive television programs for fifth and sixth graders on various health and fitness topics. The programs will be delivered through a Star Schools Satellite Network funded through another Department program. Satellite programs also will be developed for teachers and parents. The South Dakota Department of Health will expand a health education program to include Indian students attending public and private schools on eight reservations. The grant also will be used to train teachers and develop additional curriculum materials relevant to Indian cultures. The Department places a high priority on evaluating these and all projects it funds. Project evaluation is promoted by requiring carefully designed evaluations in all applications and providing technical assistance to funded projects. To support this priority, the Department conducts technical assistance workshops for all grantees
Journal of School Health
Aprll 1992, Vol. 62, No. 4
141
to help them implement their evaluation plans. In addition, every effort is made to coordinate this evaluation effort with the Department of Education’s Program Effectiveness Panel, which determines whether a project is effective and eligible for dissemination through the National Diffusion-Network.
OTHER DOE INITIATIVES In addition to the Comprehensive School Health Education Program, administered by OERI, the Department administers other programs that support school health-related activities. These include: Drug-Free Schools and Communities Act Programs (DFSCA) support drug and alcohol abuse education and prevention activities. Under the Early Childhood DrugPrevention Education Program, the Department supports development and dissemination of education and prevention materials for prekindergarten children. Contractors are developing print and multi-format materials, curricula, and training programs for children and their caretakers designed to promote knowledge and behavior necessary to resist drugs. The scope of activities supported by DFSCA is limited to alcohol and drug education and prevention. However, these components are significant for child health education. The most promising practice in drug prevention seems to be comprehensive, community-wide programs the kind of programs advocated by the Department of Education since the publication of Schools Without Drugs in 1986. Support for such comprehensive programs comes from an evaluation of Project Star, currently being implemented in Kansas City. Evaluation of that program, which focuses on a broad range of prevention programs and activities implemented in every phase of community life, demonstrates a short-term reduction in drug use among students exposed to the program. The evaluation continues, and we are anxious to learn whether or not this prevention strategy will translate into reduced drug use as students enter high school. The Department has undertaken several evaluations of DFSCA Programs. In a study of the implementation of DFSCA, state and local grants programs, state education agencies reported increases in the following: the number of local educational agencies with formal prevention programs; teacher/administrator awareness of problems; student knowledge of alcohol and drug use hazards; involvement of parents in drug education efforts; and identification of and referral to treatment of students with drug and alcohol problems. Recent surveys, including the National High School Senior Survey and the Household Survey, indicate drug use is decreasing. Just as the Department has difficulty in isolating the impact of DFSCA funds from the impact of state and community-funded programs, it is difficult to isolate the cause of the downward trend in use. Evidence and experience indicate we are taking the right approach. State and Local Programs under Chapter 2 of Title I of The Elementary and Secondary Education Act support, at the discretion of state and local educational agencies, projects to enhance personal excellence of students and student achievement in physical fitness and comprehensive school health education.
142
Journal of School Health
Aprll 1992, Vol. 62, No. 4
Compensatory Education Programs support education-related health activities under Chapter 1 of Title I of the ESEA, including Even Start. The Follow Through and Education for the Homeless Children and Youth programs, can support health-related activities. Vocational Education - Basic State Grants support services and activities related to training youth and adults for health-related ,careers. Special Education Programs are authorized t o support research, demonstrations, models, training, technical assistance, and other activities related to providing special education and related services for children with disabilities. The National Diffusion Network (NDN) promotes dissemination of exemplary educational programs, including school health education and physical education. The Comprehensive School Health Education Program and NDN work together to increase the number of school health education applications approved by the Program Effectiveness Panel. The Education Resources Information Centers (ERIC) Clearinghouse on Tpacher Education collects and disseminates materials on school health education. This clearinghouse is administered by the American Association of Colleges for Teacher Education in Washington, D.C.
CONCLUSION The Comprehensive School Health Education Program has taken the lead in coordinating all health-related programs in the Department of Education. Staff share information on program accomplishments and develop plans and priorities for future health initiatives. Staff also coordinate by sending program announcements to all Department components for all new grant competitions. Plans also are underway to establish in the Department a School Health Education Working Group to improve communication among programs with health-related components and to establish an information system to provide current information on the Department’s programs and exemplary projects. A program staff member co-chairs the Ad Hoc Committee on Health Promotion Through the Schools with the Office of Disease Prevention and Health Promotion in the Department of Health and Human Services t o facilitate communication among all government agencies with responsibilities for health in the schools. The Office of Elementary and Secondary Education, the Office of Educational Research and Improvement, and the National Institutes of Health cooperate on asthma education by developing strategies for strengthening school-level education about asthma and publishing a booklet on the subject for dissemination to all the nation’s schools. Program staff also maintain cooperative efforts with the Centers for Disease Control to strengthen efforts to support and improve comprehensive school health education. The Department takes seriously its important role in encouraging health education in our nation’s schools. We will continue t o emphasize improving health education for elementary and secondary students through the Fund for Innovation in Education. We also will continue to support health-related activities through other Department programs, as appropriate.
Statement of Diane Ravitch, PhD, Assistant Secretary f o r the Office of Educational Research and Improvement, U.S. Department of Education, and Counselor to the Secretary on the Federal Government’s Role in Child Health Promotion and Disease Prevention, before the Subcommittee on Oversight of Government Management. Committee of Governmental Affairs, U.S. Senate, November 14, 1991.
T
he Department of Education plays an important role in encouraging health education in our nation’s schools. For the nation to offer its children an excellent education, we must help ensure that they have the healthy minds and bodies to learn. The Elementary and Secondary School Improvement Amendments of 1988, P.L. 100-297, authorized the Comprehensive School Health Education Program under the Fund for Innovation in Education (FIE), most of which is administered by the Office of Educational Research and Improvement (OERI). This program provides grant assistance to state and local educational agencies for various activities related to improving comprehensive health education for elementary and secondary students. Activities include implementation of training programs for school personnel in health education, development of a comprehensive school health program, assessment of school health programs, demonstration of model programs, and dissemination of information to schools related to nutrition, personal health and fitness, disease prevention, and other urgent health problems affecting students. Additionally, the 1988 law authorized establishment of an Office of Comprehensive School Health Education in the Office of the Secretary. The department considered this issue and concluded that enlarging the Office of the Secretary to administer this grant program was not desirable. The Office of Educational Research and Improvement provides the leadership necessary to administer the program and to coordinate the Department’s health-related programs and activities with other agencies.
COMPREH E NSlVE SCHOOL HEALTH EDUCATION PROGRAM ACTIVITIES The Comprehensive School Health Education Program has completed its third year of operation. Program highlights include: In 1989, the first competitions were held for awards under the Comprehensive School Health Education Program, and grants totaling $3 million were made to a variety of organizations, school systems, universities, and state agencies. Several supported innovative, interDiane Ravitch, PhD, Assistant Secretary for the Office of Educational Research and Improvement, US. Dept. of Education, 555 New Jersey Ave., NW, Room 600, Washington, DC 20208.
disciplinary projects and focused on disadvantaged students in grades K-12. In 1990, approximately $1.5 million was awarded to 10 new applicants. Most of these projects focused on training teachers and involved parents in the planning and implementation of comprehensive school health education programs. An additional $2.3 million was awarded for the second year of funding for projects awarded in 1989. In 1991, $1 million was awarded for 10 new grants. More than one-half of these projects train teachers and administrators in health, fitness, nutrition, disease prevention, and safety. An additional $3.6 million was used for the second and third year of funding for projects initiated in 1990 and 1989. The following four examples represent innovative projects funded the past three years: The National School Boards Association (NSBA) will collaborate with national education, health, and community organizations to train local school board members in how to plan, implement, and improve comprehensive school health education programs. The NSBA also plans to collect national data on programs and promote health education at national and state conventions. The National Association of School Nurses and the non-profit Education Development Center, Inc., will seek ways to improve the training of school nurses. Two teaching models, one using regional workshops and one using home study, will be tested. The University of Mississippi will develop a series of live, interactive television programs for fifth and sixth graders on various health and fitness topics. The programs will be delivered through a Star Schools Satellite Network funded through another Department program. Satellite programs also will be developed for teachers and parents. The South Dakota Department of Health will expand a health education program to include Indian students attending public and private schools on eight reservations. The grant also will be used to train teachers and develop additional curriculum materials relevant to Indian cultures. The Department places a high priority on evaluating these and all projects it funds. Project evaluation is promoted by requiring carefully designed evaluations in all applications and providing technical assistance to funded projects. To support this priority, the Department conducts technical assistance workshops for all grantees
Journal of School Health
Aprll 1992, Vol. 62, No. 4
141
to help them implement their evaluation plans. In addition, every effort is made to coordinate this evaluation effort with the Department of Education’s Program Effectiveness Panel, which determines whether a project is effective and eligible for dissemination through the National Diffusion-Network.
OTHER DOE INITIATIVES In addition to the Comprehensive School Health Education Program, administered by OERI, the Department administers other programs that support school health-related activities. These include: Drug-Free Schools and Communities Act Programs (DFSCA) support drug and alcohol abuse education and prevention activities. Under the Early Childhood DrugPrevention Education Program, the Department supports development and dissemination of education and prevention materials for prekindergarten children. Contractors are developing print and multi-format materials, curricula, and training programs for children and their caretakers designed to promote knowledge and behavior necessary to resist drugs. The scope of activities supported by DFSCA is limited to alcohol and drug education and prevention. However, these components are significant for child health education. The most promising practice in drug prevention seems to be comprehensive, community-wide programs the kind of programs advocated by the Department of Education since the publication of Schools Without Drugs in 1986. Support for such comprehensive programs comes from an evaluation of Project Star, currently being implemented in Kansas City. Evaluation of that program, which focuses on a broad range of prevention programs and activities implemented in every phase of community life, demonstrates a short-term reduction in drug use among students exposed to the program. The evaluation continues, and we are anxious to learn whether or not this prevention strategy will translate into reduced drug use as students enter high school. The Department has undertaken several evaluations of DFSCA Programs. In a study of the implementation of DFSCA, state and local grants programs, state education agencies reported increases in the following: the number of local educational agencies with formal prevention programs; teacher/administrator awareness of problems; student knowledge of alcohol and drug use hazards; involvement of parents in drug education efforts; and identification of and referral to treatment of students with drug and alcohol problems. Recent surveys, including the National High School Senior Survey and the Household Survey, indicate drug use is decreasing. Just as the Department has difficulty in isolating the impact of DFSCA funds from the impact of state and community-funded programs, it is difficult to isolate the cause of the downward trend in use. Evidence and experience indicate we are taking the right approach. State and Local Programs under Chapter 2 of Title I of The Elementary and Secondary Education Act support, at the discretion of state and local educational agencies, projects to enhance personal excellence of students and student achievement in physical fitness and comprehensive school health education.
142
Journal of School Health
Aprll 1992, Vol. 62, No. 4
Compensatory Education Programs support education-related health activities under Chapter 1 of Title I of the ESEA, including Even Start. The Follow Through and Education for the Homeless Children and Youth programs, can support health-related activities. Vocational Education - Basic State Grants support services and activities related to training youth and adults for health-related ,careers. Special Education Programs are authorized t o support research, demonstrations, models, training, technical assistance, and other activities related to providing special education and related services for children with disabilities. The National Diffusion Network (NDN) promotes dissemination of exemplary educational programs, including school health education and physical education. The Comprehensive School Health Education Program and NDN work together to increase the number of school health education applications approved by the Program Effectiveness Panel. The Education Resources Information Centers (ERIC) Clearinghouse on Tpacher Education collects and disseminates materials on school health education. This clearinghouse is administered by the American Association of Colleges for Teacher Education in Washington, D.C.
CONCLUSION The Comprehensive School Health Education Program has taken the lead in coordinating all health-related programs in the Department of Education. Staff share information on program accomplishments and develop plans and priorities for future health initiatives. Staff also coordinate by sending program announcements to all Department components for all new grant competitions. Plans also are underway to establish in the Department a School Health Education Working Group to improve communication among programs with health-related components and to establish an information system to provide current information on the Department’s programs and exemplary projects. A program staff member co-chairs the Ad Hoc Committee on Health Promotion Through the Schools with the Office of Disease Prevention and Health Promotion in the Department of Health and Human Services t o facilitate communication among all government agencies with responsibilities for health in the schools. The Office of Elementary and Secondary Education, the Office of Educational Research and Improvement, and the National Institutes of Health cooperate on asthma education by developing strategies for strengthening school-level education about asthma and publishing a booklet on the subject for dissemination to all the nation’s schools. Program staff also maintain cooperative efforts with the Centers for Disease Control to strengthen efforts to support and improve comprehensive school health education. The Department takes seriously its important role in encouraging health education in our nation’s schools. We will continue t o emphasize improving health education for elementary and secondary students through the Fund for Innovation in Education. We also will continue to support health-related activities through other Department programs, as appropriate.
