Jeffrey K. Clark

Promoting Mental Health and Preventing Substance Abuse and Violence in Elementary Students: A Randomized Control Study of the Michigan Model for Health

BACKGROUND In elementary grades, comprehensive health education curricula mostly have demonstrated effectiveness in addressing singular health issues. The Michigan Model for Health (MMH) was implemented and evaluated to determine its impact on multiple health issues, including social and emotional skills, prosocial behavior, and drug use and aggression. METHODS Schools (N = 52) were randomly assigned to intervention and control conditions. Participants received 24 lessons in grade 4 (over 12 weeks) and 28 more lessons in grade 5 (over 14 weeks), including material focusing on social and emotional health, interpersonal communication, social pressure resistance skills, drug use prevention, and conflict resolution skills. The 40-minute lessons were taught by the classroom or health teacher who received curriculum training and provided feedback on implementation fidelity. Self-report survey data were collected from the fourth-grade students (n = 2512) prior to the intervention, immediately after the intervention, and 6 weeks after the intervention, with the same data collection schedule repeated in fifth grade. RESULTS Students who received the curriculum had better interpersonal communication skills, social and emotional skills, and drug refusal skills than the control group students. Intervention students also reported lower intentions to use alcohol and tobacco, less alcohol and tobacco use initiated during the study and in the past 30 days, and reduced levels of aggression. CONCLUSION The effectiveness of the MMH in promoting mental health and preventing drug use and aggression supports the call for integrated strategies that begin in elementary grades, target multiple risk behaviors, and result in practical and financial benefits to schools.

A Qualitative Analysis of Success Stories From Michiana Coordinated School Health Leadership Institute Participants

BACKGROUND The purpose of this study was to detect and document common themes among success stories, along with challenges, as related by participants in the Michiana Coordinated School Health Leadership Institute. Four-member teams from 18 Michigan and Indiana school districts participated in semiannual Institute workshops over a 3-year period and were tasked with implementing Coordinated School Health Programs (CSHPs). METHODS Qualitative methods were used to generate themes from interviews. Data were gathered through a combined survey/interview process related to programmatic successes, evidence of success, and implementation challenges. One participant from 11 of 18 participating school districts completed the survey/interview. RESULTS Each participant reported at least 1 success that had a positive effect on students and/or staff, many of which were related to the federally mandated wellness policy. With some notable exceptions, success was based on subjective judgments rather than systematically collected data. Unanimous expression of time constraints and being overworked in their current positions constituted major challenges. CONCLUSIONS Although the Institute required only process evaluation, some participants collected outcome data, a task that is important in validating the benefits of CSHPs. Most districts were not able to hire the recommended coordinator to ensure implementation of health program planning initially developed during the institute. Encouragingly, at the time of data collection many teams were still acting to ensure health programming remained a priority. Nevertheless, without the network of social support provided by the Institute, some respondents struggled to maintain momentum.

Where Public Health Educators are Working: A National Study of the Hiring Practices and Manpower Needs of Local Health Departments

This study collected data typically included in professional manpower reports for the purpose of establishing a manpower profile of health educators in local health departments (LHD) in the United States. Using a table of random numbers, a nationally representative sample of 670 LHD was mailed a 43-item questionnaire which assessed four basic areas: geographic jurisdiction, personnel, attitudes toward health education credentialing, and demographics of each agency top executive. Usable questionnaires were received from 279 LHD, a return rate of 41.6 percent. The data reveal that a tight job market for health educators exists in LHD. While a large majority (84 percent) of LHD are known to provide health education/risk reduction services, fewer than 60 percent of LHD in the sample employed a health educator. Among those LHD who did employ health educators, less than one-half had a full-time health educator on-staff. Using a weighting formula and interpolation as methods to make projections, there are betwee...

Beyond controversies: sexuality education for adolescents in India.

Sexuality education for adolescents is one of the most controversial topics in the field of child health. In the past decade, policymakers in India have also struggled with the issue and there has been greater public discourse. However, policymaking and public discussions on adolescent sexuality education are frequently fueled by religious, social, and cultural values, while receiving scant scientific attention. To meet the needs of an expanding young population in India, scientific evidence for best practices must be kept at the core of policymaking in the context of sexuality education for adolescents.

Attitudes and Perceptions about Health Education Credentialing: A National Study of Top Agency Executives in Local Health Departments

Increasing numbers of health educators are being certified as health education specialists (CHES). This study investigated the attitudes of top agency executives toward the credentialing of health educators. Each state identified their LHDs by providing a mailing list. A sample of 670 LHDs was selected using a table of random numbers, and a 43-item instrument was mailed. Responses from 279 sites were analyzed using descriptive statistics. Results indicated that 45 percent (127) of the respondents were aware of the credentialing process for health educators. The attitudes and beliefs that top agency executives possess toward credentialing were analyzed in 10 different areas. Top agency executives possessed favorable attitudes toward credentialed practitioners in seven of the 10 areas, while negative or undecided in the remaining three areas. A majority (51 percent) of the top agency executives who were aware of the credentialing process believed that credentialed health educators enhance the profession to ...

The Delivery of Sexuality-related Patient Education to Adolescent Patients: A Preliminary Study of Family Practice Resident Physicians

Background: Risky sexual behavior among adolescents is one of the leading health behaviors most associated with mortality, morbidity, and social problems. Adolescents need reliable sources of information to help them promote healthy sexual behaviors. Physicians in the United States are often seen by adolescents as a reliable and trustworthy source of accurate sexual information. However, many physicians feel uncomfortable or ill-prepared to deal with sexuality issues among their adolescent patients. Purpose: This study examined the impact of family resident physicians’ sexual attitudes, knowledge, and comfort, on the delivery of sexuality-related patient education to their adolescent patients. Materials and Methods: Pre-post-test scales were administered to 21 physicians. Data were also collected for patient (n=644) charts. Factors that determined the delivery of sexuality-related patient education were analyzed. Results: Results indicate that sexuality-related patient education was rarely provided to adolescent patients. Conclusions: Adolescent sexuality education is not a high priority for physicians. Professional medical organizations should play a leadership role in training physicians on delivering sexuality education to adolescent patients.

Expanding the Role of Community Centers for Health Education

Abstract Community centers for health education have been in existence for a quarter of a century. Each center reflects the direction and concerns of its respective communities and is an expression of commitment toward educating the community about health. Most centers have traditionally provided programming for elementary school students that is a highly stimulating onetime exposure. The limited exposure of students to such programs has made it difficult to evaluate the impact a center has upon its community. This article provides suggestions on how community health education centers can expand their role in the community and broaden their impact.

Clarifying Prescriptive Messages about HIV: The Case of Long-Term Mutually Monogamous Relationships.

Abstract Prescriptive messages about HIV and AIDS should be precise and well-grounded in science. Throughout the epidemic, the language used in AIDS education has been modified or changed as needed to be more effective, avoid confusion and misperception, and dispel fear about the disease. The word “monogamy” has traditionally been used to describe the act of being married to only one person, but has taken on a broader meaning in the age of AIDS and is now used to characterize sexual behavior. This article examines the appropriateness of using the word “monogamy” in this way. The authors identify the basic concepts found in prescriptive messages about HIV, review ways in which “monogamy” is defined, applied, and interpreted in the literature, present a content analysis of top-selling sexuality and AIDS/HIV textbooks, and discuss strategies to more effectively deliver this prescriptive health message.

Promoting Fitness and Safety in Elementary Students: A Randomized Control Study of the Michigan Model for Health.

BACKGROUND In elementary grades, comprehensive health education curricula have demonstrated effectiveness in addressing singular health issues. The Michigan Model for Health (MMH) was implemented and evaluated to determine its impact on nutrition, physical fitness, and safety knowledge and skills. METHODS Schools (N = 52) were randomly assigned to intervention and control conditions. Participants received MMH with 24 lessons in grade 4 and 28 more lessons in grade 5 including material focusing on nutrition, physical fitness, and safety attitudes and skills. The 40-minute lessons were taught by the classroom teacher who received curriculum training and provided feedback on implementation fidelity. Self-report survey data were collected from the fourth-grade students (N = 1983) prior to the intervention, immediately after the intervention, and 6 weeks after the intervention, with the same data collection schedule repeated in fifth grade. Analysis of the scales was conducted using a mixed-model approach. RESULTS Students who received the curriculum had better nutrition, physical activity, and safety skills than the control-group students. Intervention students also reported higher consumption of fruits; however, no difference was reported for other types of food consumption. CONCLUSION The effectiveness of the MMH in promoting fitness and safety supports the call for integrated strategies that begin in elementary grades, target multiple risk behaviors, and result in practical and financial benefits to schools.

An Assessment of Health Education Responsibilities and Competencies Addressed in Continuing Education Contact Hour Articles

Abstract For more than a decade the health education profession has used the seven responsibilities, outlined from the 1978–1988 Role Delineation Project, as the foundation for credentialing, curricular structure in professional preparation programs, and continuing education. The purpose of this study was to investigate the extent to which the seven responsibilities and corresponding competencies were addressed in continuing education articles found in the professional literature. The method included using the Health Competency Assessment form to code responsibilities and competencies found in all continuing education articles (n=148) published between 1997 and 2000. The census of articles was found in four peer-reviewed journals and on web sites that published such articles for Certified Health Education Specialists. All articles offered for continuing education contact hours were selected and divided equally among the five researchers to read and evaluate (interrater reliability Pi=0.76 − 0.87). Results were tabulated and analyzed using descriptive statistics. The results indicated that the responsibilities are not addressed uniformly in the continuing education articles. Responsibilities I (assessing needs) and IV (evaluating programs) were most frequently addressed. Responsibility VI (acting as a resource person) was addressed in the literature the least often. As a result of this study it can be concluded that competencies are not addressed uniformly in continuing education articles. Based on the studys findings it is suggested that editorial boards of professional journals may want to clarify the role of their respective journals in continued professional development of their readers.