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School Health Index (SHI)
Use of the SHI
Since the release of the first edition of CDC’s School Health
Index: A Self-Assessment and Planning Guide (SHI) in 2000, this tool
has been widely implemented across the nation to improve school health
policies and programs. Many groups have used creative approaches to
promote, modify, and evaluate the SHI, leading to thousands of schools
using it to make a significant impact in the lives of young people.
This list is a sampling of the SHI-related activities that are occurring
across the country. But we want to know more! We know that many of you are
doing great things with the SHI, so please
tell us about your successes.
Who uses the School Health Index?
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Reports of use in at least 46 states (plus adaptations
in Mexico, Canada, and Saudi Arabia).
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“SHI” is one of the most searched terms on CDC's Division
of Adolescent and School Health (DASH) Healthy Youth Web site, and often
more copies of the SHI are ordered than any other DASH publication.
Examples of usage
|
State |
Usage |
|
Delaware |
All 19 school districts. |
|
Florida |
700 schools have been trained on using the SHI. |
|
Georgia |
About 200–250 schools statewide; all DeKalb
County schools (142) and Cobb County schools (113) are required to use
the SHI annually. |
|
Kansas |
109 schools have used it in 59 districts. |
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Louisiana |
644 schools have used Louisiana's version. |
|
Maine |
All schools within 54 administrative units. |
|
Missouri |
At least 303 schools. |
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Pennsylvania |
In 2005, 1,133 schools from 66 of 67 counties participated in
Pennsylvania's
version. |
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Tennessee |
All 130 Metropolitan Nashville schools. |
|
Texas |
93 schools in Austin area; more than 50% of middle schools in Houston. |
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Promoting the SHI
State Departments of Health, State Departments of Education,
universities, and other groups are promoting the use of the SHI in a variety
of ways. They are—
- Creating policies or mandates to
require or encourage schools to use the SHI.
- Arkansas: The State Board of
Education passed a policy in August 2005 stating that all schools are
required to develop School Nutrition and Physical Activity Advisory
Committees that are responsible for completing the SHI annually and
incorporating results into School Improvement Plans.
- Cobb County, Georgia: County
policy states that all schools are required to use the SHI annually
(113 schools).
- DeKalb County, Georgia: County
policy states that all schools are required to use the SHI annually
(142 schools).
- Tennessee: The State Board of
Education passed a policy in August 2005 stating that all schools are
required to use SHI and implement Coordinated School Health Programs
(CSHP).
- Offering $1,000–$25,000 in
mini-grants to schools to implement the SHI assessment and action
plans (Arkansas, California, Connecticut, Georgia, Hawaii, Kansas, Kentucky, Michigan,
Mississippi, Missouri, Montana, New Hampshire, New York, North Carolina,
Oklahoma, Pennsylvania).
- Offering trainings or workshops (Alaska,
Arkansas, Arizona, California, Connecticut, Delaware, Florida, Hawaii, Kansas, Louisiana, Massachusetts,
Michigan, Minnesota, Missouri, Mississippi, Montana, New Jersey, New York, Ohio,
Oklahoma, Oregon, Rhode Island, South Carolina, Tennessee, Texas, Vermont, West Virginia).
- Providing copies or sending out bulk mailings
(Connecticut, Delaware, Louisiana, Massachusetts, Michigan, New Jersey, New Mexico, New York,
Oklahoma, Pennsylvania, Washington).
- Creating healthy school awards
programs using the SHI to develop their criteria (Louisiana, New York, Ohio, Pennsylvania, Utah, Wisconsin).
- Training teachers and other school
staff to use the SHI through pre-service education (Adelphi University,
Georgia State University, Morehead State University, Purdue University,
Southeastern Louisiana, University of Arizona, University of Florida,
University of Tennessee-Chattanooga, Youngstown State University).
- Encouraging or requiring schools
to incorporate the SHI results into overall School Improvement Plans (Alabama,
Alaska, Arkansas, Florida, Indiana, Tennessee).
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Impact on Policies and Programs
Schools across the country have made many changes in their health and
safety policies and programs after implementing the SHI. Examples of some of
the changes that have been made include the following:
- Physical Activity
- Developed walking clubs and adopted Kids Walk to School programs
- Increased time for
physical education
- Installed fitness stations for student and community use
- Nutrition
- Offered cooking classes or cooking clubs
- Incorporated vegetable gardening into science classes
- Removed unhealthy food choices from vending machines
- Tobacco
- Made schools tobacco-free
- Offered tobacco cessation programs
- Unintentional Injury and Violence Prevention
- Offered CPR training for staff
- Revised and update school crisis response plans
- Provided training on conflict resolution
- Asthma
- Offered in-service asthma training to staff
- Used Open Airways curriculum to educate families about asthma
- Started Power Breathers club for support and asthma education
- Cross-Cutting
- Sponsored Healthy Activity Nights
- Provided health tips of the day to students and periodically in
school newsletters
- Created a school health team
- More...
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Modifying and Adapting the SHI
The SHI’s science-based approach has inspired others to modify the tool
to fit their state or local needs. Modifications include adding health
topics and offering the SHI in different forms, such as online or in
Spanish. Examples of modifications include the following:
- Topics added—
- Mental health (Alabama, Michigan,
Oregon)
- HIV/AIDS prevention, sexual risk behaviors, and blood borne
pathogens (Kentucky, Montana, Massachusetts, Maine)
- Substance abuse (Maine)
- Fruit and vegetable promotion (California)
- Safe Routes to School (New York)
- Spanish version (Arizona, California)
- Online versions or customized version for state (Delaware,
Louisiana, Indiana, Maine, Michigan,
New York, Pennsylvania, Texas)
- District-level SHI (Kentucky,
North Carolina, South Carolina)
- Student version (Massachusetts)
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Evaluating the SHI
Early efforts to evaluate the SHI focused on process evaluations (North
Carolina, Michigan, Arizona, Georgia) and compilations of success stories
(Kansas, Michigan, Oregon). Several articles have been published in
scientific journals that have evaluated the SHI implementation process and
described the results of the process.1-5
The Massachusetts Department of Public Health developed a school-based
overweight prevention initiative, 5-2-1 Go! (eat 5 servings of fruits and
vegetables daily, limit screen time to no more than 2 hours a day, and get
at least 1 hour of physical activity daily). The program has two main
components, the SHI and Planet Health, that work together to make positive
changes in both individual behaviors and organizational decision making. The
intervention has been shown to be effective in preventing disordered
weight-control behaviors in early adolescent girls.6 Items from the SHI are
also being used as indicators of best practices. CDC/DASH applied the SHI to
a nationally representative sample of schools using data from the
School
Health Policies and Programs Study (SHPPS) to assess the percentage of
schools nationwide achieving the school health recommendations described in
the SHI.7
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Feedback from the Field
See what others have said about the School Health Index in
Feedback from the Field.
References
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Austin SB, Fung T, Cohen-Bearak A, Wardle K, Cheung LWY.
Facilitating change in school health: a qualitative study of schools’
experiences using the School Health Index.
Prev Chronic Dis [serial
online] 2006 Apr.
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Pearlman DN, Dowling E, Bayuk C, Cullinen K, Thacher AK.
From
concept to practice: using the School Health Index to create healthy
school environments in Rhode Island elementary schools.
Prev Chronic Dis [serial
online] 2005 Nov.
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Staten LK, Teufel-Shone NI, Steinfelt VE, Ortega N, Halverson K, Flores
C, et al.
The School Health Index as an impetus for change. Prev Chronic Dis
[serial online] 2005 Jan.
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Sherwood-Puzzello CM, Miller M, Lohrmann D, Gregory P. Implementation of
CDC's School Health Index in 3 midwest middle schools: motivation for
change. J Sch Health. 2007; 77: 285-293.
- 5. Geiger BF, Petri CJ, Barber C. A university-school
system partnership to assess the middle school health program. American
Journal of Health Studies 2004; 19(3):158-163.
- Austin SB, Kim J, Wiecha J, Troped PJ, Feldman HA,
Peterson KE. School-Based Overweight Preventive Intervention Lowers
Incidence of Disordered Weight-Control Behaviors in Early Adolescent
Girls. Arch Pediatr Adolesc Med 2007; 161(9):865-869.
- Brener N, Pejavara A, Barrios L, Crossett L, Lee SM, McKenna M, Michael
S, Wechsler H. Applying the School Health Index to a Nationally
Representative Sample of Schools. J Sch Health 2006;76(2):57–66.
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