1. 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

2. WHAT IS THE SCHOOL HEALTH POLICIES AND PRACTICES STUDY?

3. 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

4. The 2013 YRBS data are available at www.cdc.gov/yrbs. www.cdc.gov/yrbs

6. Dissemination of SHPPS Results www.cdc.gov/shpps

7. 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 2012.  The full report is available at http://www.cdc.gov/healthyyouth/shpps/2012/ pdf/shpps-results_2012.pdf. http://www.cdc.gov/healthyyouth/shpps/2012/ pdf/shpps-results_2012.pdf

8. 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

9. 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

10. 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

11. 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?

12. 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

13. 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

14. Response Rates Questionnaire Number Sampled Number Responding Response Rate (%) State questionnaires (all)51 100.0 District Health Education104871968.6 District Physical Education104870867.6 District Health Services104866063.0 District Mental Health and Social Services 104868465.3 District Nutrition Services104866063.0 District Healthy and Safe School Environment 104869766.5 District Faculty and Staff Health Promotion 104865562.5

15. SELECTED RESULTS: Coordination

16. Percentage of States and Districts with a Coordinator for Selected School Health Program Components ComponentStates (%)Districts (%) Health education88.262.1 Physical education82.063.2 Health services74.579.2 Mental health and social services56.063.1 Nutrition services96.190.1 Faculty and staff health promotion50.040.1 All school health and safety policies and activities 66.053.7

17. Topics Addressed by School Health Committee, Council, or Team* TopicStates (%)Districts (%) Faculty and staff health promotion83.382.5 Family and community involvement90.372.5 Food service or nutrition100.094.0 Health education90.091.3 Health services90.083.7 Mental health or social services93.374.7 Physical education or activity96.891.7 Physical school environment90.077.9 Psychological and social environment or school climate 86.778.4 * 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.

18. SELECTED RESULTS: Health Services

19. 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 72.076.590.2 HIV infection or AIDS 63.368.682.4 Linking students to community healthcare providers 52.058.888.0 Procedures for administering student medications or treatment 74.084.392.2 Screening for student weight status 48.056.070.6 Sending and keeping students home from school when they are sick 72.074.588.2.

20. Percentage of States and Districts That Provided Funding for PD or Offered PD for School Nurses— Selected Topics Topic States (%)Districts (%) Administration of medications 69.452.0 Contraceptives 38.09.7 HIV counseling, testing, and referral 46.913.5 Identification, treatment of, or referral for STDs 64.017.5 Infectious disease outbreak detection and response 68.046.0 Services specifically for gay, lesbian, or bisexual students 46.08.2 Teaching self-management of chronic health conditions 77.645.8 Weight management 36.722.1

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

22.  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

23. 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

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

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

26. Health Services Trends, 2000-2012 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%

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

28. 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

29. FINAL THOUGHTS

30. 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

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

32. www.cdc.gov/shpps

33. Thank you For more information please contact : Mary Vernon-Smiley mev0@cdc.gov 404-718-8182 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