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7. Findings on Provincial/Territorial Capacity
The findings regarding national and provincial/territorial capacity are as follows. For more information on the sources used for this summary, contact dmccall@cash-aces.ca
Key Findings from Surveys of School Health Policies/Programs at Provincial/Territorial Level
The data from two national surveys done in the last decade indicate that we are making progress in school health promotion. (Note: The data from these two surveys is not directly comparable, so these observations should be considered to be only an indication.) A regular, reliable system for reporting on the status of policies and programs in Canada is required.
| Capacity Questions | Canada |
| A General and Brief History/Context 1. What are the key events (conferences, studies, reports, public events etc) in the development of school health programs and policies in the nation and in states/provinces? 2. Has research and knowledge development influenced the development of school health in the country or state/province? 3. Have practitioner organizations (either school health associations, professional groups or voluntary health/social groups) played an important role in the development of school health in the country or states/provinces? 4. What can be said about the general nature or philosophy of the SH approach being used in your jurisdiction? | NationalThe first national conference on CSH was held in 1988 and brought together national health and education organizations with Health Canada funding. A 1990 Consensus Statement signed by over 25 organizations extended the US-led emphasis on curriculum to a “comprehensive approach” that involved multiple professionals, agencies and systems at all levels. This comprehensiveness (of seeking links among health issues, partners, interventions, agencies and systems) is likely the most significant contribution from Canada to the field of SH promotion. A memorandum was signed in 1990 between Health Canada and the Council of Ministers of Education, Canada (There is no federal department of education in Canada.). However, this MOU was never really implemented in any systematic way. Several national projects involving a variety of partners increased stakeholder and government awareness of the CSH concept but most activities were issue-specific and project driven. In the 1990’s, Health Canada support for CSH waned with budget cutbacks and the CSH movement was kept alive through ad-hoc projects and the ongoing efforts of the Canadian Association for School Health (CASH) and the consulting firm that works with the Association. A 1999 survey of health and education ministries, local agencies and schools reported that about a third of the agencies supported the CSH concept and most health and education ministries included references (but not support) for CSH in their curriculum and policy documents. In 2003, the School Health Research Network was formed and there are now several SH research projects and programs underway in Canada. However, research evidence was not often a factor in the major decisions about CSH at the national or provincial/territorial levels until recenty. Some exceptions to this general rule are:
In more recent times, the Canadian Institutes for Health Research have funded large scale projects investigating the impact of the social and physical environment of the school. As well, several intervention research projects have been started. Hopefully the results of these studies will consolodate the gains made in earlier years. In 2004, the Canadian Association for School Health (CASH), working with the Council of Ministers of Education, Canada (CMEC), brought together the provincial/ territorial deputy ministers of education and health to form the Joint Consortium for School Health (JCSH). Education and health ministers as well as the country’s first ministers endorsed this new intergovernmental mechanism. A small budget and secretariat have been formed with all but oneprovincial jurisdictions participating. One of the federal health departments is also a member of the JCSH. A national network of NGO’s, the Canadian School Health NGO Network, was also formed in 2005 and is beginning its collaborative advocacy for CSH. In 2007, this NGO Network adopted a Revised Consensus Statement on Comprehensive School Health. In 2005, a federally funded agency, the Canadian Council on Learning, established a Knowledge Centre on Health & Learning that includes a big focus on CSH. The 1990 consensus statement on "Comprehensive School Health" advocating action in four areas (instruction, services, social environment and physical environment) was similar to the eight specfic programs recommended in the "Coordinated SH Programs" in the US and the values-laden 1997 Declaration of the European Network on "Health Promoting Schools". The Canadian statement placed more emphasis on inter-agency and multi-level cooperation. The current Canadian approach includes more emphasis on systems capacity and change. The intergovernmental FPT consortium on SH has explicitly adopted eight key capacities. The revised NGO Consensus Statement preceeded this evolution and researchers have begun to investigate capacity related issues such as the role of the SH coordinator. |
| Provincial/Territorial The SH movement in Canada began with coalitions in three provinces for three different reasons. The Manitoba association was developed by a health NGO in order to coordinate input being delivered to the education ministry about curriculum. The Nova Scotia association was developed by educators returning from a US conference on health education. The third, in BC, was developed through the efforts of the health consultant in the Vancouver School Board. Federal funding in the 1980’s created coalitions in all jurisdictions but several went dormant when that funding was cut. Most provincial SH activities were issue specific and project-based. Education and health ministry cooperation was sporadic and usually driven by crisis issues or external funding. At the turn of the century, however, several jurisdictions had recognized the need for a more coordinated approach. A variety of health related initiatives were started with slightly different names and focal points. At the same time, most education ministries were responding to concerns about bullying and crime with programs as well as coordinators assigned on safe and caring schools. All education ministries have a safe schools plan and had named a provincial coordinator by the late 1990's. This approach is often described as "safe & caring" emphasizing positive youth development as well as seeking to prevent crime, delinquency and bullying. Most PT jurisdictions are now developing healthy school plans and programs. All jurisdictions as well as one of the federal health departments have jointly named a SH Coordinator. The approaches being used in PT jurisdictions vary slightly. Saskatchewan is building from a tradition of inter-agency work on coordinated health and social services in its “schools plus” approach. Manitoba is developing its “healthy schools” approach from a comprehensive policy on children that started first with early childhood. Several jurisdictions such as Newfoundland, New Brunswick and British Columbia are developing their school health programs within a “chronic disease/healthy living/wellness” context. Nunavut is developing its school health plans within the context of its culturally relevant promise to children. Ontario is focused on physical activity and healthy eating. Quebec’s approach is based on a comprehensive inter-ministry agreement and plan on prevention for youth. School Health coalitions are now being re-involved in the work in some PT jurisdictions. In the late 80’s, many government officials were actually on the national SH Association Board of Directors because this group provided the best access to national information. Research evidence has been used in several Canadian PT jurisdictions to develop specific school programs in physical activity but much less so on other issues. Most PT responses have been ad-hoc, with officials gradually learning the value of comprehensive approaches as they worked through activities and programs. School health research networks and resource centres have recently been started in PEI, New Brunswick, Quebec, Ontario, Alberta and BC. SH email lists are operated in three jurisdictions by various organizations. |
| Systems Capacities | |
| 1. Comprehensive, coordinated policies, a) Does the national and/or state/provincial governments have an explicit policy statement on: - school health promotion? - a holistic approach to child/youth health (rather than just a series of policy responses to health and social problems)? - recognition that health and learning are interdependent and need joint action b) Are national or state/provincial initiatives, programs or policies on specific health and social issues required or encouraged to include a comprehensive school health approach? c) To what extent are national and state/provincial SH policies comprehensive and coordinated? d) Does the national and/or state/provincial governments have a policy or priority that SH programs should address the needs of at-risk students as a priority within SH programs? e) Are these school health policies actively supported by senior managers and policy-makers? How? | NationalCanada’s two health departments have provided implicit support and project funding to support SH promotion, but this has usually been done on an ad-hoc, piece-meal fashion. There is no federal policy requirement to use a comprehensive approach to SH promotion, nor to use a holistic approach to the health of children nor to coordinate initiatives that relate to health and learning. However, recently, Canada’s First Ministers have committed their governments to work intersectorially through healthy schools as part of a 2004 Health Care Accord. The country’s education ministers and health ministers have endorsed the creation of the federal-provincial/territorial Joint Consortium for School Health but joint policy-making is specifically excluded from that organization’s mandate. There are several similar FPT and inter-provincial committees addressing specific health and learning issues that seek to promote cooperation and communication without having a policy coordination mandate. These committees overlap with the mandate of the Joint Consortium for School Health and their cooperation with JCSH is not required, nor yet evident. These difficulties related to policy coordination are reflective of the structure of the federal system in Canada, where there is no federal mandate for education or health delivery but there is a federal spending power that is used to respond to health and education issues and often overlaps with provincial/territorial activity. Sometimes this is helpful, when such projects create a consensus on better practices. Other times federal project funding is duplicative of PT efforts. At the same time project activity within provinces and territories with larger jurisdictions spending funds on the same research and development activities and smaller jurisdictions following along with adaptations. Provincial/TerritorialProgress is being made in policy coordination in some jurisdictions in Canada, notably Manitoba (a child-centered policy framework), Quebec (an inter-ministry agreement), British Columbia (jointly developed ministry service plans), Saskatchewan (Schools Plus) and to a lesser degree in Nova Scotia and Ontario (where a Ministry of Health Promotion is mandated to coordinate policy development.)However, all Canadian jurisdictions do not have the mandate, nor influence except in times of crisis or financial largesse, to require their local education and health agencies to adopt comprehensive SH policies, programs or initiatives. These semi-autonomous agencies therefore need to be persuaded of the value of SH programs if they are to support their schools and staff in a sustained SH approach. Nevertheless, progress has been made recently with comprehensive SH approaches being recommended (but not required) as part of government initiatives on health issues such as nutrition and physical activity. However, this trend is not necessarily being used in responses to other health issues such as drugs, tobacco, mental health, safety/bullying, infectious diseases, and injury prevention. |
| 2. Formal mechanisms for coordination such as inter-ministry agreements and committees as well as informal mechanisms for cooperation such as shared vision statements, networks with NGO’s, shared PD activities, etc a) Does your country and/or states have a formal definition/goal statement of school health promotion? Have governments adopted that definition? Have NGO’s adopted that definition? b) Do your national and state/provincial governments have formal inter-departmental and inter-ministry agreements on school health promotion? c) Do your national government and state/provincial governments have inter-departmental or inter ministry committees on school health (either as SH, or on youth that includes SH or on issues that have a specific SH components)? d) Do you have SH coalitions (composed of NGO’s) at the national or state/provincial level? Or, do coalitions on specific health issues address SH regularly as part of their mandate? e) Is there a regular conference on SH that brings together practitioners, researchers and officials on a regular basis? | NationalCanadian NGO’s developed a consensus statement on “Comprehensive School Health” (emphasizing a holistic multi-system, multi-level, multi-intervention approach rather than selected programs or values) in 1990. This statement has been revised and endorsed again by over 25 national organizations. Various other national statements and declarations on various health issues have included this CSH approach as part of their terms. These statements have been adopted by a variety of organizations. The federal government, including several specific programs within the two federal health departments, has supported the development of these SH and SH related statements and declarations but has not adopted these statements as policy. There are several national networks concerned with health issues at the national level. Many of these national networks implicitly or explicitly support SH promotion in their activities. The Canadian Association for School Health has existed since 1988 but has only recently led the development of a national network of NGO’s that share a concern for SH promotion. The Public Health Agency of Canada is attempting to create an informal network of program level staff concerned with SH promotion within the federal government. A regular national SH conference has been started and has occurred in 2005, 2006 and 2007. A fourth conference is planned for April 2008 in Ottawa. School health is also a regular feature at the annual conference of the Canadian Association for Health, Physical Education, Recreation and Dance, usually in the form of workshop; sessions organized by a CAHPERD Advisory Committee on Quality School Health. Provincial/TerritorialIn recent years, provincial/territorial SH conferences have been organized or are being planned by the SH coalitions in Ontario, Alberta and Nova Scotia. |
| 3. Assigned staff and dedicated infrastructure at all levels to ensure coordination and communication. a) Are there national, state/provincial programs on school health? b) Is there an office or government official named to coordinate the SH program at the - national level? - state/provincial level? - local level? | NationalThe Public Health Agency of Canada has named a SH coordinator who is part of the Joint Consortium for School Health. Other parts of the PHAC and the other federal health department, Health Canada, tend to have program staff assigned to youth aspects of their health issue. It is these atff members who tend to respond to or plan SH initiatives as part of their youth work. Provincial/TerritorialEach province and territory has named a SH Coordinator. In most cases, this appointment has been a joint position of their health and education ministries. Nine of those appointments are full time and four are part time. Three jurisdictions (New Brunswick, Nova Scotia and Newfoundland) have established and funded local SH Coordinators. In two of these jurisdictions, these ate public health personnel embedded in school board offices. In the other case, the coordinators are responsible for school and community coordination. There are several local health authorities across Canada that have assigned staff to SH programs, usually pas part of a public health or youth health program. Three jurisdictions (Manitoba, British Columbia and Ontario) are considering or developing financial incentives programs to encourage local schools to become healthier. |
| 4. Procedures and processes to develop, translate, disseminate and exchange knowledge. a) Are there research centres that include SH as an explicit part of their mandate? b) Is there an ongoing SH research program or initiatives? c) Is there a national SH journal? d) Are there web sites and regular email lists devoted to SH? | National In 2003, the School Health Research Network was formed and there are now several SH research projects and programs underway in Canada. A SH Research Agenda has been developed, along with specific mini-agendas for various health topics. The SHRN web site also maintains links to SH research reviews and landmark studies/reports on various health topics. The Canadian Institutes for Health Research funded two national projects on the impact of social and physical environments on health. These grants led to two SH projects. The University of PEI Centre on Comprehensive School Health is focused on knowledge transfer, specifically on data. The University of Calgary has a major research study on school-based mental health promotion. The National Institute for Public Health in Quebec has a research program on school health. The CRISP centre at the University of New Brunswick has taken an interest in school health promotion. Researchers at the University of Waterloo have been developing a program on school-based physical activity and healthy eating programs. In 2005, a federally funded agency, the Canadian Council on Learning, established a Knowledge Centre on Health & Learning that includes a big focus on CSH. Its knowledge broker activities include a national teachers magazine, distribution of journal inserts to public health professionals, networking of local agencies, a documentation centre, national conference, consultation on surveillance/monitoring needs, research RFP’s, an international SH research seminar and informal networks on CSH applied to aboriginal students and French-language minority students. A small documentation centre/library is being maintained at a university with an accompanying comprehensive SH web site that seeks to be a central reference point for school health in Canada. A national SH email list is maintained currently by volunteers. Provincial/TerritorialOne PT jurisdiction (Ontario) has funded a Resource Centre in SH promotion. That same province has included SH promotion in reviews of best practices in public health done by another centre.Occasionally, the resources centres that are funded in health promotion create a report, research review or resource on how schools can address a particular health topic, but rarely is there a sustained and organized and ongoing plan to exchange, analyze or disseminate SH knowledge. |
| 5. Sustained workforce development through both pre-service and in-service staff development in all sectors (not just teachers? a) Are there any statements on the pre-service training that teachers, nurses, social workers, police officers, school principals, guidance counsellors should have in preparation for SH practice? b) Has there been any studies of the pre-service training or qualifications or current practices/attitudes of these same categories of professionals needed for school health? c) Is there any sustained program to offer SH in-service training to these same categories of professionals to support their SH practice? d) Is there any on-going program to train SH coordinators? | National There have been occasional studies done by university-based researchers on the readiness of teachers to teach health education, physical education and sexual health education. But these studies have had no decision-maker audience and Canadian universities guard their academic freedom. There have been very few Canadian studies of the qualifications, training, practices, attitudes or skills of the different categories of personnel involved in SH promotion. The only national study was done in 1999 as part of a larger policy/program study on sexual health and school health. Further, while provincial/territorial governments in Canada have the right to impose requirements on universities, they have not done so in relation to health education or health promotion. There are several initiatives underway in Canada that may have an indirect impact on the readiness of educators and public health professionals to work in school health promotion. Shortages of health care professionals have prompted a federal study on supply and demand in health professions. As part of a renewal strategy in public health capacity, several national organizations are examining public health competencies and post-graduate programs. On the education side, education ministries are working to improve the accountability of post-secondary institutions and there are FPT discussions underway on increased federal funding for post-secondary education. All national agencies shy away from sustained funding on in-service programs because of the costs involved. There is no program to train SH coordinators in Canada but there may be a study on the role and impact of such coordinators in the near future. Provincial/TerritorialNo PT jurisdiction in Canada has defined or required any ratio, qualification, training or preferred set of practices for any of the categories of personnel that are involved in SH promotion. Some jurisdictions have done studies of heath education teacher practices (Saskatchewan) and public health nurses activities in schools (Niunavit and Ontario). Like their federal counterparts, most PT governments shy away from funding in-serve training programs because of their costs.Occasionally, as part of a high profile initiative, funding will be provided to train teachers in a prevention program or to orient teachers to a new curriculum but this is usually not done in a sustained way. |
| 6. Explicit procedures to identify priority and emerging issues and trends and to focus system attention on those issues in advance of a crisis. a) Is there a regular report on emerging issues and trends in the health and/or health learning of children/youth or in school health promotion? b) Does the national and/or state/provincial governments have an explicit statement on their health issue priorities? | NationalA recent report on child/youth health was the first government agency analysis of child/youth health in many years. Prior to that, non-governmental organizations received sporadic project funding to publish such analyses. Provincial/TerritorialTwo jurisdictions (BC and Manitoba) have inter-ministry statements identifying selected health priorities. Two provinces, Alberta and Quebec, now publish a regular report on child health. Other PT jurisdictions have recently begun inter-ministry work on identifying relevant data sources on child health and school health in response to a CCL project funded through the Joint Consortium for School Health. |
| 7. Explicit, systematic means to monitor and report on: a) Are there regular reports a the national and state/provincial levels on: - the health/social development of children and youth? - the status and capabilities of local agencies and professionals in their policies, programs and practices? - the health/social development learning outputs for students (including basic health literacy, optimal health knowledge/skills and preliminary exploration & training related to health, PE, and social services professions such as Home Ec, Nursing) as well as periodic assessments and analyses of local needs and resources b) Is there regular analysis of the data sources relevant to SH that is published and disseminated? c) Are local agencies receiving, analyzing and using data in their program planning? d) Are there readily available self-assessment tools for schools and agencies to use in planning their SH programs or comprehensive responses to various health, social development and learning issues? | There is a patchwork of national and international surveys and data sources on the health status of children and youth that is being addressed by separate task forces and initiatives, a unit within the Public Health Agency of Canada and various FPT committees. Informal discussions have begun within federal departments on how to coordinate data collection from schools, as many schools are now refusing to participate in health surveys. A 2006 project report has once again raised this as a problem for consideration by senior decision-makers and it is hoped that several subsequent steps will result. . The education ministries in Canada do not report on the health literacy and learning of their students. A 2004 review of the Pan-Canadian Assessment Program of the Council of Ministers of Education, Canada decided to not add to other subjects to its roster of reading, mathematics and science education testing. No regular reporting is done in Canada on the status of SH policies and programs. One of Canada’s national newspapers will be publishing the results of its survey of school boards in August 2006. This will be the first national report of this type since 1999, when the Council of Ministers of Education, Canada did a study on sexual health and school health programs that reported on health and education ministries, agencies and school/nursing staff. Most of the self-assessment tools are aimed at school staff and school only actions (often excluding assessments of the role of the other SH partners). The Public Health Agency of Canada has funded the development of a web-based student health survey and planning tool (Voices and Choices). The Joint Consortium for School Health is developing a school-based self-assessment tool that can help schools assess their nutrition, physical activity, tobacco and mental fitness programs. The University of Waterloo has published a self-assessment tool on tobacco and schools and is developing similar tools on nutrition and physical activity. The Canadian Public Health Association has published a self-assessment tool on school safety and violence. Provincial/TerritorialMany Canadian jurisdictions are considering an adapted version of the ASCD Healthy Schools Report card. Many have also looked at the SMART Tool from Adelaide, Australia. Several Canadian jurisdictions are now actively considering how health concerns can be integrated within the mandatory plans and procedures for school improvement, development t and accountability. Newfoundland and Quebec have developed questions and scenarios for use in their jurisdictions. |
| 8. Explicit plans to ensure evaluation, evolution and sustainability of policies and programs a) Is there an explicit plan to evaluate the impact of national and state/provincial SH plans and programs? b) Is there an explicit plan to ensure the sustainability of national and state/provincial SH programs? | National There is no national plan or program for school health promotion in Canada. Further, accountability measures at the federal level relate solely to project management and financial procedures rather than program impact in areas such as prevention, promotion or learning. Consequently, various national “initiatives” on specific health issues rarely, if ever, have evaluation components that assess their impact on child/youth health or on school health policies or programs at any level. There is no sustainability plan for the FPT Joint Consortium for School Health but there is a draft long-term evaluation plan being developed to assess its impact on inter-governmental cooperation. Provincial/TerritorialOnly one jurisdiction in Canada (British Columbia) has published its plan to evaluate the impact of its SH program (as part of its ministry service planning). Others are developing their respective plans in 2006-07. |
Key Findings from Surveys of School Health Policies/Programs at Provincial/Territorial Level
The data from two national surveys done in the last decade indicate that we are making progress in school health promotion. (Note: The data from these two surveys is not directly comparable, so these observations should be considered to be only an indication.) A regular, reliable system for reporting on the status of policies and programs in Canada is required.
| Principle/Capacity | 1999 CMEC-Health Canada Survey | 2006 SHRN Survey |
| 1. Whole child, not just part | Most MOH had chronic disease focus for SH plans. All MOEs had designed curricula to address knowledge, skills, attitudes and behaviours for an extensive list of health and social issues. | |
| 2. All children, especially vulnerable children and disadvantaged children. | No MOH had plan for vulnerable disadvantaged, children. About half of MOEs funded school meal programs and higher student services ratios. Most MOEs have programs and structures for aboriginal students. | |
| 3. Understand and address local context | One MOH had plan for settings-based approach, one had commissioned research on settings | |
| 4. Comprehensiveness - build multi-level, integrate with other health issues | No PT had a tri-level (ministries, local agencies, schools) plan for SH. Some MOHs had linked healthy weight, overeating and physical activity. Some MOEs linked safety, violence, bullying. | |
| 5. Select evidence-based programs, | One MOH has defined early identification services. | |
| 6. Use evidence-based Implementation process | No questions were asked in relation to this key point. | |
| 7. Coordinate programs across five domains (policy, instruction, services, social and physical; environment) | One third of MOEs and one third of MOHs had explicitly stated support for CSH approaches. Over 60% said that they required coordination on sexual health programs from local agencies. All MOE’s reported that Health Education was mandatory. (About 75% of school boards said so. About 50% of school principals said so.) About one third of MOHs said that youth health service delivery was mandatory. (About 60% of health units said that such serves were required. About 90% of nurses said they were delivered. ) Three quarters of MOEs said they had required policies on universal hygiene precautions in schools. | All PTs have declared a CSH approach, vision. However, most initiatives are issue-specific, not coordinated and project orientated. Most MOH initiatives link education programs to public awareness campaigns but not to services, policy, work in other settings etc |
| 8. Seek congruence with primary education mandate and constraints of schools | No MOE reported on health education results in their annual reporting. | Most MOHs review or publish curriculum supplements or instructional programs on health. Most MOE’s review and authorize instructional programs and materials. No PT had integrated health within school improvement planning procedures. No MOE required that school improvemenht plans address health. All MOEs had explicitly recognized the link between health status and learning. All MOEs had explicitly adopted an effective schools approach which includes attention to a safe, orderly school environment. Most MOEs had made similar statements about healthy schools, safe schools or community schools. Most of these statements were contained in curriculum documents. |
| 9 Build capacity in eight areas (coordinate policy, staff for coordination, mechanisms for cooperation, workforce development, knowledge exchange, monitoring & reporting, issue management and sustainability | One third of MOEs reported that there was an inter-ministry agreement on HIV-AIDS and sexual health. Fewer MOHs reported such a agreement. About one third of both groups of ministries reported that there was an active inter-ministry committee on health issues. About one-half of MOHs had published a document on inter-ministry cooperation. About one-quarter of MOHs reported that they assigned staff to support cooperation with other ministries. One MOE had described the role of counsellors in health. One-third of MOHs reported that they had guidelines on the role of the nurse when working with schools. One-quarter of MOHs said they had a staffing ratio of PH staff to youth or schools. Most schools reported nurse presence for less than one day per month. Half of the MOEs and MOHs were reviewing their health curriculum or promotion assignments in 1999. Most MOEs had a full time health curriculum specialist, most has a PE specialist as well. About half of MOHs had assigned a person within their health promotion team to youth health. No MOH had assigned a person to SH. About half of MOHs reported that they encouraged different forms of knowledge exchange. About half of MOHs reported that they monitored the number of youth receiving health services. No MOE kept track of that type of data. About one third of MOHs reported periodically on sexual health status/behaviours of youth. (There was and is no national reporting) All MOEs reported health as being a lower priority than reading, math, science, social studies and vocational education. Sexual health/AIDS was reported as a higher priority than nutrition and injuries, and the same priority as drugs and tobacco by MOHs. Most MOHs and MOEs reported that they passed along data and studies about child/youth health to local agencies. | All MOHs and all MOE’s were developing SH action plans. Two MOHs included references to these plans in annual reports. Most MOEs reported SH as a priority within internal planning documents. 2-3 PT had have inter-ministry agreements on SH or preventio Half of MOHs require coordination with education at local agency level. No MOEs had a similar requirement for school boards. One MOH has described mandate of Health Authority to work with schools in a written document. Two MOHs have described role of nurse. No MOH has defined staffing ratio for such nurses. Few MOEs had described the role of counselors, psychologists and others related to health. All MOEs and MOHs had named SH Coordinators (usually half position in each, one jointly named) Most MOEs had a full time health curriculum and a full time PE curriculum specialist. Most MOEs had a full time student services specialist. Three MOHs have funded SH Coordinators within school boards. About 30% of Health Authorities have assigned staff explicitly to SH. n Most MOHs had investigated evidence on CSH program effectiveness. All MOHs have identified a list of priority health issues. Most MOEs had not identified an explicit list of health issues. No MOH had plan to report on all aspects of child/youth health. Some were tracking some health issues. No MOE was monitoring health literacy/health education results. No PT has monitoring system for SH policies and programs. Most MOHs were not revising their health monitoring systems. There was no coordination between ministries on data use and collection. No MOE was reporting on its implementation of SH action plans, nor did they require local school boards to do so. Most MOEs required school boards to report on numbers of students taking optional senior high school courses relating to health, PE and family studies but did not report that information to the public. |
| 10. Address system & organizational characteristics | Two MOHs had conducted surveys of nurses on working with schools. One MOE had done a survey on teacher and principal practices re health. |
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