The Comprehensive School Health Program (CSHP) is a national program in the United States that makes efforts in schools to improve the health of children. Since schools profoundly influence the health of young people, the CSHP is very important. The program is supported by a national health organization, the American School Health Association (ASHA), which is actively involved in improving the health of school-age children.
The major causes of death in America, such as cardiovascular disease and cancer, are greatly related to lifestyle, behavior, education, and prevention efforts are best focused on physical activity and diet. School-age children often have poor diets, making this a critical area for CSHPs to focus on. Few students are meeting the Dietary Guidelines for Americans. Their diets generally lack fruit and vegetables and contain an excess of foods that are high in fat. Childhood obesity has reached epidemic proportions, with greater numbers of people becoming affected earlier in their lives. This is an important issue for school health programs, since it has been well documented that the health of school-age children is directly related to their educational success.
American School Health Association
The American School Health Association (ASHA) recognizes that schools can do more than any single agency to help young people. This national organization unites the many professionals who are committed to improving the well being of school-age children. With more than 2,000 members, ASHA is comprised of counselors, health educators, physical educators, school nurses, school physicians, and administrators. Over half of members practice in K-12 schools or advise and oversee health-services programs or health education. The ASHA's mission is to protect and improve the wellbeing of children. To achieve this mission, ASHA members support the CSHP.
The Comprehensive School Health Program
The CSHP is an "organized set of policies, procedures, and activities designed to protect and promote the health and well-being of students and staff" (Cottrell, Girvan, and McKenzie, p. 67). This program traditionally includes three components: health education, a healthful school environment, and health services. It was expanded in 1987 (see Allensworth and Kolbe) to include physical education, nutrition services, counseling services, community and family involvement, and health promotion for faculty. These eight components promote the health of students, faculty, and the
Physical education is one component of the Comprehensive School Health Program. The benefits of regular physical activity are numerous, and include enhanced bone, joint, and muscle fitness, weight control, and stress relief.
community. Since students spend a major part of their lives in school, schools are a good place to influence healthful living before harmful habits are established.
The first component, health education, suggests a planned health curriculum for students in grades K-12. The major content areas suggested for instruction are: community health, consumer health, environmental health, family life, mental and emotional health, injury prevention and safety, nutrition, personal health prevention, control of disease, and substance use and abuse. The individual states and local districts decide the actual content to be taught. Teachers are encouraged to teach healthful behaviors and provide students with skills to live healthier lives.
The second component, a healthful school environment, promotes a healthful physical and emotional environment. It is important that schools are safe and secure for all those who attend and work there. This component includes issues regarding safety, school security, a school's emotional and social atmosphere, the physical environment, and sexual harassment. Each year, many children are hurt on playgrounds, are exposed to environmental hazards, and witness violence among peers. The CSHP works towards making schools as safe as possible.
The third component, school health services, encourages promoting and protecting the health of every child. This may include on-site health clinics, school nurses, school physicians, and providing immunizations and screenings for vision, hearing, healthy weight, and head lice. With clinics and medical professionals located in schools, students have the opportunity for convenient medical care. Many clinics provide both treatment and educational services. For families who cannot afford medical care, this may be their only means to health care.
The fourth component, physical education, promotes regular exercise in schools as part of a healthful lifestyle. Approximately 75 percent of all junior high schools and high schools offer physical education classes lasting twenty minutes or more, three times per week. Physical education is important to develop strength and improve body image.
The fifth component, nutrition services, encourages balanced, appealing, and varied meals and snacks for students. The CSHP realizes the importance of good nutrition to prevent future illnesses.
The sixth component, counseling services, supports evaluations and counseling for students. By including services from guidance counselors and social workers, students' mental and emotional health is addressed.
The seventh component, community and family involvement, encourages the involvement of parents and the community in the schools. This program recognizes the need for schools to have good relationships with parents and community groups, which can be very beneficial in assisting schools and students with making decision and providing resources.
The final component, health promotion for faculty and staff, promotes a healthy staff. The many benefits of a healthy staff include less sick days, increased productivity, and positive role models for students.
The CSHP encourages all schools to address their students' health on various levels. The program's mission is to promote wellness, motivate health improvement, and offer educational opportunities for students, families, and community members. By implementing the planned, ongoing services of the CSHP, schools have the ability to improve both education and the health of students and school personnel.
Elise M. Howard-Barr
Allensworth, Diane D., and Kolbe, Lloyd J. (1987). "The Comprehensive School Health Program: Exploring an Expanded Concept." Journal of School Health 57(10):409–412.
Butler, J. Thomas, ed. (2001). Principles of Health Education and Health Promotion, 3rd edition. Belmont, CA: Wadsworth.
Cottrell, Randal R.; Girvan, James T.; and McKenzie, James F., eds. (2002). Principles and Foundations of Health Promotion and Education, 2nd edition. San Francisco: Benjamin Cummings.
American School Health Association. "About ASHA." Available from <http://www.ashaweb.org/>