Even though we know that an unhealthy child cannot learn and an uneducated child can be a drain on society, too little is being done to provide comprehensive health education to youngsters. Most hospital-sponsored programs provide periodic health education activities or speakers for schools, with no systematic effort to instill the fundamentals necessary for healthy living.
The Coordinated School Health Program (CSHP), Los Angeles, is different. CSHP is a 12-year-old program that has provided a mix of acute care services, such as school nurses and health aides; health education special events for students from kindergarten through high school; direct classroom instruction; and in-service training for health and physical education teachers.
CSHP is a collaborative effort of four public school districts; a local hospital district; and Hospital Home Health Care Agency of California, a not-for-profit cooperative that includes a number of Catholic hospitals and is responsible for administering the program. CSHP is funded by the Beach Cities Health District of Redondo Beach, CA.
Moving Children
CSHP's school-based programs were initiated when staff at Hospital Home Health Care Agency became concerned about inactivity among area youth and its impact on their health. One of CSHP's most innovative programs is the Moving Children Project, which trains elementary schoolteachers to foster physical, mental, and social health during physical education classes.
"Today's parents often are in better shape than their sons and daughters," explains Jim Tehan, a Hospital Home Health Care executive and CSHP director. "This trend is aggravated by an absence of daily physical education classes at the elementary level and lack of qualified PE specialists. In California, where less than 5 percent of elementary schools employ these specialists, teachers with little or no PE coursework are responsible for movement education."
The lack of teacher training means many students receive no instruction in physical fitness or related skills. "During PE classes, students are relegated to playing school yard games that promote competitive activities and allow only the most athletic student to excel," Tehan notes. "Physical education then becomes a time of embarrassment or avoidance."
A Skill-building Program
The Moving Children Project (whose motto is, "If you're not moving, you're not getting healthy") trains and supports elementary teachers in implementing a skill-building physical education program appropriate for their students' grade level.
The curriculum integrates social skills (e.g., cooperation, communication) and mental skills (e.g., goal setting, decision making) with physical fitness. Most important, it focuses on teamwork and personal development rather than athletic superiority.
The Moving Children Project trains teachers to structure a physical education program and sequence lessons to build skills progressively. The training consists of four major components with lesson plans for each. For example, first graders learn the following, in sequence:
- Body movement: personal space and how their limbs and muscles function
- Object control: body control using objects such as large, inflatable balls and parachutes; also, coordination and object control while exercising legs, arms, and heart
- Implement control: how to use rackets and scoops as extensions of their bodies
- Game structure
Each physical education class is followed by a classroom discussion (e.g., on what muscles they just used) and study of related health topics. Students then write down their progress and fitness goals in a journal.
The Training Process
The teacher training process is designed to assist teachers as much as possible without disrupting a school or district's schedule. Teachers participate in large- and small-group training sessions and schedule time with the Moving Children trainers every other week for follow-up assistance.
Group sessions familiarize teachers with the major components and offer experiential activities to illustrate the concepts being introduced. At the body movement session, for example, activities demonstrate the concepts of spatial awareness, locomotor activities, nonlocomotor activities, and physical fitness. In addition, each teacher receives a set of lesson plans appropriate for the grade level taught. And physical education specialists and trainers visit schools to coteach some of the lessons with teachers.
When CSHP began, teachers were skeptical that an outside organization could effectively involve the entire school in an activity-based, educationally valuable health promotion event. But 12 years later they agree that community health organizations can play a valuable role in building healthy communities. In addition to the benefits for hundreds of teachers and thousands of students, CSHP has met the expectations of participating organizations. School districts receive specialized resources to supplement their health and physical education curriculums. The funding agency benefits from visibility and community good will. And CSHP has received new foundation support to implement successful programs at new school districts.
Ms. Weiss is a Santa Monica, CA-based healthcare consultant.