Results from the School Health Policies and Practices Study 2012: How it relates to the work of state school nurse consultants Mary Vernon-Smiley, MD, MPH Senior Medical Officer Division of Adolescent and School Health June 26, 2014 National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of Adolescent and School Health

WHAT IS THE SCHOOL HEALTH POLICIES AND PRACTICES STUDY?

What is SHPPS?  SHPPS is a national survey periodically conducted to assess school health policies and practices at the state, district, school, and classroom levels  SHPPS was conducted in 1994, 2000, and 2006  SHPPS 2012— results were released on August 26, 2013  SHPPS 2014 School and classroom data collection began in February 2014

The 2013 YRBS data are available at

Dissemination of SHPPS Results

24 Fact Sheets  Present highlights of results on particular school health components and topics published in Results from the School Health Policies and Practices Study  The full report is available at pdf/shpps-results_2012.pdf. pdf/shpps-results_2012.pdf

Fact Sheets  7 fact sheets report national results on the following components of school health:  Faculty and staff health promotion  Health education  Health services  Mental health and social services  Nutrition services  Physical education  Physical school environment

Fact Sheets  17 fact sheets report national results on the following topics across all components of school health:  Alcohol- or other drug-use prevention  Asthma  Crisis preparedness  Food safety  Human immunodeficiency virus (HIV) prevention  Infectious disease prevention and control  Injury prevention and safety

Fact Sheets (Con’t)  17 fact sheets report national results on the following topics across all components of school health:  Nutrition  Physical activity  Pregnancy prevention  School health coordination  School nutrition environment  Sexually transmitted disease (STD) prevention  Students with disabilities  Suicide prevention  Tobacco prevention and control  Violence prevention

SHPPS Purpose  What are the characteristics of each component of school health at the state, district, school, and classroom levels and across elementary, middle, and high schools?  Are there persons responsible for coordinating and delivering each component of school health, and what are their qualifications and educational backgrounds?  What collaboration occurs among staff from each component of school health and with staff from outside agencies and organizations?  How have key policies and practices changed over time?

Healthy and Safe School Environment Health Promotion for Staff Health Promotion for Staff Physical Education Health Education Health Services Mental Health and Social Services Nutrition Services Nutrition Services Family and Community Involvement SHPPS Components

Sample and Data Collection Methods State education agencies in all 50 states and the District of Columbia A nationally representative sample of public school districts Data collection – Web-based questionnaires 100% of state questionnaires 85.4% of district questionnaires – Mailed self-administered paper-and-pencil questionnaires 14.6% of district questionnaires

Response Rates Questionnaire Number Sampled Number Responding Response Rate (%) State questionnaires (all) District Health Education District Physical Education District Health Services District Mental Health and Social Services District Nutrition Services District Healthy and Safe School Environment District Faculty and Staff Health Promotion

SELECTED RESULTS: Coordination

Percentage of States and Districts with a Coordinator for Selected School Health Program Components ComponentStates (%)Districts (%) Health education Physical education Health services Mental health and social services Nutrition services Faculty and staff health promotion All school health and safety policies and activities

Topics Addressed by School Health Committee, Council, or Team* TopicStates (%)Districts (%) Faculty and staff health promotion Family and community involvement Food service or nutrition Health education Health services Mental health or social services Physical education or activity Physical school environment Psychological and social environment or school climate * Among the 68.8% of states and 65.4% of districts with one or more groups that that offer guidance on the development of polices or coordinate health-related activities.

SELECTED RESULTS: Health Services

Percentage of States That Provided Assistance to Districts and Schools—Selected Topics Topic % Developed/ Revised Model Policies % Distributed/ Provided Model Policies % Provided Technical Assistance Chronic health conditions HIV infection or AIDS Linking students to community healthcare providers Procedures for administering student medications or treatment Screening for student weight status Sending and keeping students home from school when they are sick

Percentage of States and Districts That Provided Funding for PD or Offered PD for School Nurses— Selected Topics Topic States (%)Districts (%) Administration of medications Contraceptives HIV counseling, testing, and referral Identification, treatment of, or referral for STDs Infectious disease outbreak detection and response Services specifically for gay, lesbian, or bisexual students Teaching self-management of chronic health conditions Weight management

Percentage of Districts Providing Professional Development to School Nurses, 2000−2012* *During the 2 years before the study.

 10.6% of districts had a policy specifying a maximum student-to-school nurse ratio  More than 75% of districts had adopted a policy stating that schools will provide:  Administration of medications  Case management for students with disabilities  CPR  First aid  Violence prevention  12.5% of districts had at least one school- based health center (SBHC) that provided both health services and mental health and social services to students, and an additional 6.8% had at least one SBHC that offered only health services

Sexual Health Services Requirements 1.9% of districts require middle or high schools to make condoms available 3.4% require schools to provide contraceptives 15.2% require schools to provide identification, treatment of, or referral for STDs 15.0% require schools to provide HIV counseling, testing, and referral

Percentage of Districts Requiring Schools to Provide Specific Health Services, 2000−2012* *During the 2 years before the study.

Percentage of Districts Requiring Schools to Provide Specific Health Services, 2000−2012* *During the 2 years before the study.

Health Services Trends, The percentage of districts that required newly hired school nurses to have:  an RN’s license decreased from 95.6% to 86.1%  state school nurse certification decreased from 67.8% to 39.5% The percentage of districts that required schools to obtain and keep information on dietary needs or restrictions increased from 69.9% to 88.5% The percentage of districts with arrangements to provide health services to students at other sites not on school property decreased from 37.5% to 24.3%

Percentage of Districts That Permitted Students to Carry and Self-Administer Medications, 2000 – 2012

Attendance or Absenteeism Information 26.0% of states and 77.0% of districts had real-time access to student attendance or absenteeism information 60.8% of states and 88.2% of districts recommended that districts or schools use a specified electronic system for reporting student attendance or absenteeism information 30.4% of districts require schools to close or dismiss all students when the percentage of absent students or staff reaches a specified level

FINAL THOUGHTS

How Can State School Nurses Use SHPPS Data?  Celebrate where great improvements have occurred  Identify areas where state agencies might need to provide additional technical assistance and professional development  Identify areas where CDC and others can target resources to develop key tools and materials for states and districts

Future of SHPPS  SHPPS 2014  Data collection began in February 2014  Results available in 2015

Thank you For more information please contact : Mary Vernon-Smiley The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of Adolescent and School Health