1. “Building the Case for Coordinated School Health”: The Cuyahoga County Board of Health Coordinated School Health Initiative Presented by: Martha Halko, MS, RD, LD Carol Inniss, BSN, RN

2. Cuyahoga County Demographics The population in the health district served by the Cuyahoga County Board of Health (CCBH), is the largest in the state of Ohio. The City of Cleveland, Shaker Heights and Lakewood have their own health departments. The county population is ~1.3 million. It is a diverse, multi-cultured, urban county. There are 31 Public School districts in Cuyahoga County & 343 school buildings.

3. CCBH at a Glance Our Mission…Prevent Disease and Injury, Promote Positive Health Outcomes and Provide Critical Services to Improve the Health Status of the Community.

4. Health Commissioner Terrance Allan, R.S., M.P.H The 4 service areas are: Community Health Nursing Environmental Health Epidemiology and Surveillance

5. Building the Case for Coordinated School Health The CCBH identified the need for a Coordinated School Health (CSH) initiative. The CCBH programs which address the needs of schools and school districts include: –School health services –Tobacco avoidance & cessation –Teen pregnancy prevention –School environmental health services –Cardiovascular Health –Child & Family Health Services – Wellness Policy Technical Assistance Program

6. CSH Strategic Priority The CCBH programs which provide interventions in the schools were not coordinated. To better serve the local school districts: –CCBH set a strategic priority to “Broaden the Scope of the Comprehensive School Health Program.” –The CCBH Performance Goals are: 1. Establish a School Health Council 2. Host a Comprehensive School Health Conference.

7. CSH Best Practices Utilize the Eight Component Coordinated School Health Model (Allensworth and Kolbe, 1987) Utilize a Best Practices Model Institute policy and environmental changes to enable the use of a population-based approach. Healthy People 2010 objectives

8. CSH Resources “School Health Index for Physical Activity, Healthy Eating & a Tobacco- Free Lifestyle”; A self assessment & planning Guide. –February 2000, U.S. Department of Health & Human Services, Centers for Disease Control & Prevention. Healthy Ohioans- Buckeye Best Healthy School Awards Program –Goal: To achieve positive school-based environmental and policy changes. –Focuses on tobacco, nutrition and physical activity.

9. Identifying the Foundations for Coordinated School Health The CCBH School Health Program: –Contracts with 10 public school districts –Contracts with14 private school system –Serves more than 60,000 students annually. The School Health Nurses play an integral role in the development & implementation of a (CSH) program.

10. Existing Support for CSH The CCBH Cardiovascular Health Grant –Administered by the Ohio Department of Health –Focus on Coordinated School Health. The CCBH Child & Family Health Services Grant has a focus on wellness policy. Community Partners supported the need for a Coordinated School Health Initiative.

11. Supporting Data Local childhood obesity rates and tobacco usage data provided a strong basis for promoting a healthy school environment. –Local survey revealed that 35%, or 1 in 3 of the children enrolled in kindergarten were overweight or obese. –A 2004 Youth tobacco Survey revealed that 28% of students report current use of some type of tobacco product. More students report current use of cigars, cigarillos, and little cigars, than cigarettes.

12. Fostering Collaboration Coordination & collaboration among CCBH service areas and programs. Utilize the Ohio Department of Health CVH project consultant as a resource and a “team member.” Build on existing partnerships with Cleveland Department of Public Health, Children’s Hunger Alliance, American Cancer Society & other’s. Coordinate with Ohio Action For Healthy Kids. Form new partnerships to assure that there is representation on the council from all branches of the coordinated school health model.

13. Steps in the Planning Process CCBH school advisory committee formed. A county-wide AFHK advisory council formed. American Cancer Society recommended merging the two committees. The new Coordinated School Health Council formed a planning committee to plan & present a CSH conference.

14. Steps in the Planning Process During the conference planning process the CSH council was expanded. The council met for the first time on May 3 rd prior to the May 25 th CSH conference. Both the council meeting & conference were used to introduce coordinated school health to the county.

15. CSH Funding Sources CCBH in-kind contributions Cardiovascular Health Grant –4 year cycle, began Jan. 05 United Parcel Service Mini-Grant, administered by Children’s Hunger Alliance American Cancer Society Child & Family Health Services Grant –5 year cycle, began July 05 Seeking additional funding

16. Coordinated School Health Implementation Plan Mission: The Cuyahoga County Coordinated School Health Council will work in partnership with the school districts of Cuyahoga County to promote healthy lifestyle choices in a healthy school environment. Goal: To assist school districts with creating a healthy school environment which gives students & staff consistent, reliable health information and ample opportunity to use it.

17. Implementation Plan Develop communications plan which will include: –Developing a countywide newsletter and brochure. –CSH speakers bureau to present the CSH model. Partner with the Youth Tobacco Survey to gather baseline data.

18. Academics + Health = A Winning Combination May 25 th, 2005Conference objectives: –To develop an action plan to improve student health, leading to increased academic proficiency. –To develop an action plan to create wellness policies & environmental conditions in the school & community Providing technical assistance to school districts represented at the CSH conference.

19. Outcomes/Successes CSH conference was successful! –84 attendees –16 school districts represented. Great collaboration with ODH and community partners. The CSH council has grown from ~15 members to 32 since its inception.

20. Challenges Serving all public and private schools in the county. Incorporating the school districts which are not in the CCBH health jurisdiction. Short and long term funding. Forming relationships with school administrators. Coordinating programs and services within CCBH & within a large urban community.

21. Next Steps….. Next CSH meeting scheduled for September. –Establishing council overall goals and objectives. –Creating active subcommittees for newsletter/brochure development, wellness policy implementation and marketing. –Create a CSH link on the CCBH web site.

22. Contact Information Deborah Weisbarth, BSN, RN Supervisor, School Health Program Chair, Coordinated School Health Program (216) 201-2001 x1304 dweisbarth@ccbh.net Martha Halko, MS, RD, LD Program Manager, Cardiovascular Health Grant (216) 201-2001 x1535 mhalko@ccbh.net Carol Inniss, BSN, RN Program Manager, School Health Program (216) 201-2001 x1309 cinniss@ccbh.net