Health Protection Fund - Year V: 1998
Adolescent Behavior and School Performance
Schools have a vested interest in preventing risk behaviors that negatively impact on health. This is founded on the link between risk behavior and impaired cognitive functioning 1 and the link between good health and better school performance.2 Resilient factors derive from individual characteristics, family, community, and the school. The findings in this report focus on school-related health education program practices described in the Massachusetts Health Curriculum Framework, Building Resilience that are associated with the ability to "maintain a positive attitude and healthy body."3
Health Protection Fund
The Health Protection Fund (HPF) was created by a 1992 state legislative referendum that directs tax revenue on tobacco products to the Department of Elementary and Secondary Education. These funds are used for tobacco prevention education and cessation in the context of comprehensive school health education. Comprehensive health education meets the complex and extensive needs of today's youth through a broad-based approach that includes school, family, and community, and consists of many related health components in order to create effective programs, services, and education. An average of 24 million dollars a year of Health Protection Fund monies has been distributed through grants to Massachusetts school districts over the last four years, totaling approximately $96,000,000.
Budget Allocations and Health Education Programs and Services
€As shown in the figure below, the majority of the Health Protection Fund monies have been used for personnel. Instructional and professional staff account for the largest portion of the spending, followed by contractual services
(e.g., consultants to do training, stipends paid to regular staff for duties outside their regular contract).
€75% of the health coordinators' duties are in the area of facilitating health programs and activities for students, as well as parents, and the community; trainings for other health educators to provide services; and teaching health courses.
€90% of health education teachers are currently certified to teach health education in the grade they now teach, a significant increase from 1994.
€85% of high schools report a graduation requirement for health.
€Students in middle school (6th - 8th grade) receive approximately 30 hours per year of health education. A sharp decrease occurs at eleventh grade with just 10 hours of health education and less than 10 hours per year of health education for seniors.
Tobacco Prevention Education and Cessation
Findings
€100% of Massachusetts districts have Tobacco-Free School Policies.
€The greatest amount of tobacco prevention education is received by middle school students.
€Students who have more hours per year of required middle school health education (including tobacco prevention education) appear less likely to use tobacco compared to students who have fewer hours per year of required middle school health education (including tobacco prevention education). 
€There has been a significant increase from 1994 to 1996 in the percentage of health educators teaching tobacco use prevention, from 73% to 95%.
€Students appear less likely to use tobacco in districts where health education professionals perceive support from district and non-health staff for implementing the health curriculum framework, Building Resilience.
€56% of districts provide tobacco education to parents.
€Students appear less likely to use tobacco in districts that sent educational materials (including tobacco) to parents to involve them in health education.
€75% of districts' tobacco control programs (including prevention education and cessation) are linked to community programs.
€Students appear less likely to use tobacco in districts that include community-based organizations on the school health advisory council.
1998 Action Plan
€A tobacco specialist will be assigned in ESE to oversee and facilitate the school-based tobacco control programs.
€Districts will provide tobacco prevention education and cessation activities to all students
€In the 1998-99 HPF grant application, districts will be required to submit:
- tobacco-free school written policies and enforcement procedures for students and staff, including number of violations and consequences.
- a description of the current curriculum and activities for tobacco prevention education.
- the name of a representative from the American Cancer Society who serves on the community health advisory council.
€The Department of Elementary and Secondary Education and the American Cancer Society are preparing narratives about successful school-based tobacco control programs.
€The Department will collect and report specific information from districts around funding of tobacco education prevention and cessation; the amount of tobacco prevention education students receive; and the number of students, staff, parents, and community reached by cessation programs.
General Prevention Education
Findings
€Students have more required health education per year in middle school (average 31 hours) than in high school (average 22 hours).
€Compared to students with fewer hours of required middle school health education per year, students who have more hours per year of required middle school health education appear less likely to use alcohol and other drugs, and less likely to engage in violence.
€45% of middle schools and 76% of high schools use trained peer educators. Peer educators are used to teach about health in the following ways:
- discussion or support groups in 67% of middle schools and 84% of high schools.
- conflict resolution and mediation sessions in 72% of middle schools and 83% of high schools.
- assembly programs in 49% of middle schools and 66% of high schools.
€Students appear less likely to engage in violence and to use alcohol in districts that use trained peer educators to teach about health in group settings.
€67% of middle schools and 61% of high schools had parents participate in the health education curriculum development and review.
 €Students appear less likely to engage in violence in districts in which parents are involved in planning health education.
€In 65% of middle and 66% of high schools, health education teachers plan and coordinate health-related projects or activities with school counseling and psychological services.
€Students appear less likely to engage in violence in districts in which the health education teacher works with school- based mental health services.
Action Plan 1998
€In the 1998-99 HPF grant application, districts will agree to do the following:
- provide opportunities for all students to develop positive relationships with peers and adults, as well as for strong guidance and counseling programs and the coordination of health and mental health services.
- be guided by data from a student behavior needs assessment in planning the goals and timelines of their health education activities.
€In the 1998-99 HPF grant application, districts will be required to submit:
- description of the integration of local health curriculum with the health framework, Building Resilience. Districts must show how this work supports the implementation of Prek-12 health school-based tobacco control programs.
- results of a student behavior needs assessment.
- formal evaluation plan assessing the accomplishment of established goals and timelines.
€ The Department will identify model programs that exhibit effective comprehensive school health education program practices and reductions in student risk behaviors, especially around tobacco.
Endnote
The data sources for this report are the 1997 Self-Evaluation Tool for School-Based Tobacco Control Programs (SETT), the 1996 Massachusetts School Health Education Profile (SHEP), and the 1997 Health Education Telephone Interview Project (TIP). The findings discussed in this report are supported by research on effective comprehensive school health education programs that include classroom-based learning as well as peer participation, parent involvement, and community representation.4
The Department of Elementary and Secondary Education has worked with many agencies to extend the knowledge of effective comprehensive school health education programs. These agencies are the Department of Public Health, the American Cancer Society, the Tobacco Oversight Council, the Division of Adolescent School Health at the Centers for Disease Control, and the Council of Chief State School Officers.
The entire report can be viewed on the Department of Elementary and Secondary Education web site, www.doe.mass.edu
References
1. Squire, L. R. (1987). Memory and Brain. New York, NY: Oxford University Press.
2. Council of Chief State School Officers. (1989). A Concern About... Meeting the Health Needs of Children and Youth, Particularly Those at Risk for School Failure. Concerns, Issue XXVII, October.
3. Massachusetts Department of Elementary and Secondary Education. (1996). TheMassachusetts Comprehensive Health Curriculum Framework: Building Resilience Through Comprehensive Health. Publication No. 17811-51-5M-4/96-ESIS W/S.
4. Davis, R., Gonser, H., Kirkpatrick, M., Lavery, S., & Owen, S. (1985). Comprehensive School Health Education: A Practical Definition. Journal of School Health, 55, 335-339
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