Health promoting schools network in Lombardia Region (Italy) – Innovative approaches to school-based health promotion Liliana Coppola, Bruna Baggio, Morena Modenini, Danilo Cereda, Maria Vezzoni, Maria Gramegna

Who are we? state schools private schools schools 5.379 2.578 7.957 11 bilions of inhabitants state schools private schools schools 5.379 2.578 7.957 students 3-18 yr 1.160.414 259.590 1.420.004 teachers 92.926 nd not teachers workers 26.912

Italian school system Italian health system Italian school system 3-5 yr Children school 6-10 yr Primary school 11-13 yr lower secondary school 14-18 yr upper secondary school Italian health system Regions have the task to organize its own health system Health System in Lombardia is organized in 15 health territorial agencies (Asl) Founding principles Universality Equality Equity

Why did you choose to do this? . In Lombardy for several years, schools and health system worked together on health promotion. Guidelines IHUPE 2009 Vilnius 2009 1980 1990 2000 2010 The strategy of health promotion at school has undergone a change, it is passed through more stages: - health education centered on the figure of health professional - health education centered on the figuer of teacher - in health education centered on the figure of students Nowadays these strategies are all still presents in our system. After the publication of Vilnius resolution “better schools through health” and Guidelines for Promoting Health in Schools (IUHPE 2009) we understood that we need a new systematic approach to health promoting at school. Schools and health territorial agencies need a guideline to work together about “health promoting schools” approach

What did you do? Agreement between school authorities and health authorities Formal institution of «Health promoting schools network in Lombardia “ 14/7/2011 3/5/2012 School authorities and health authorities worked together to promote a health promoting school network In 2011, they signed an agreement that provides the foundation and support of a regional health promoting school network. The agreement is inspired by the Vilnius charter principles; an agreement that aims to make the Schools leaders in the governance of their own health care.

Health promoting schools network in Lombardia Who were the participants? 365 schools (75 school boards) ; 1 regional school office ; 12 provincial school office territorial health agencies; 1 regional health office What actually happened? Collaborative planning of the network (involved more than 150 teachers and health professionals): focus group, brainstorming . Contextualization of documents of the network “School for Health in Europe” (IUHPE) Health promoting schools network in Lombardia systemic model , integrated and scientifically based

School coordinator (IS dell’acqua di Legnano) 1 Regional board School coordinator (IS dell’acqua di Legnano) provincial board 1 school coordinator provincial board 1 school coordinator provincial board 1 school coordinator provincial board 1 school coordinator … 12 provincial groups School School School School School School

What actually happened? The network developed a procedure (web based) to analyze ’health profile’ and health promoting interventions, schools could describe carefully their own health profile, they have to do a self-evaluation about 4 areas: • individual life skills • social environment • school organization • community collaboration. Every school could see its results and benchmark with regional or national standards. Furthermore the network organized many meetings to define its structure and many interventions to promote teacher’s education about: • Life skills training • Security at schools

Which aspects went particularly well? . Web based software (http://accesso.requs.it/ ) is very interesting because in accordance with the new health promotion let the schools to analyze outputs and outcomes. data Self evaluation

http://www.scuolapromuovesalute.it/

What difficulties were encountered? The principal difficulty was the traditional view that health promotion was an activity of health professionals. To overcome this difficult, in accordance with the new model of health promotion, schools and health authorities organized many training events for teachers and health professionals to inform and educate them about the new model of health promotion.

After more than 1 year of life, the network continues to grow: many schools want to enter in the network School and Health authorities could work together to develop a sustainable model of health promoting school network where schools become leaders in health promoting and health system could assist them. What can we learn? What will you do? For 2013, the network aims are: • support the process of empowerment of every school in the network (nowadays more than 400 schools joined); • help the schools in the network to define their ’health profile’; • contribute to the definition of ”improvement plans” based on evidence-based interventions or best practices; • spread the network by sharing evidence-based interventions and best practices with schools not belonging

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