Association Between Health-Risk Behaviors and Academic Grades

I was checking my e-mail this afternoon and opened the latest message from NASPE. After scrolling through some P.E. news, the big link that caught my eye was entitled, "New Health and Academic Achievement Resources from DASH." I'm always interested in reading about how health education, physical education, etc. can help improve academic learning.

The information provided by the CDC is based on the just released 2009 results of the national Youth Risk Behavior Survey. If you're unaware, the goal of the YRBS is to monitor priority risk-behaviors among adolescents across the country. The amount of information this provides health educators is incredible; in addition to a national breakdown, data can be broken down on the state and local level. This data has been used in my district to adapt our health curriculum to fit the needs of our students. One could argue that changes might be too late to have an impact by the time we see trends, and identifying future trends is something I would like to try to improve on by talking with the students, etc. But, when it comes down to it we are using the data in a way that can help create positive changes among the youth we serve.

I haven't yet looked at all the data (this frequently happens when I blog about something I just read about), but the Overview provided enough information for me to post here. When it comes down to it, after controlling for sex, race/ethnicity, and grade level, data showed "a negative association between health-risk behaviors and academic achievement among high school students."

Students with higher grades are less likely to engage in risk behaviors! Are there outliers? Of course there are. This data can't be applied in every situation. I'm sure that we can all think of someone we went to high school with that partied hard or engaged in some of the other risk behaviors and somehow managed to get decent grades, or vice versa. But, how much did they learn? That in itself, the reflection of grades on student learning, is another can of worms to open up. I'm getting off track here, but as you can see I try to see the whole picture behind the numbers. Learning disabilities, AP classes, and a host of other items are not taken into account.

I would be further interested to see how these numbers correlate to results of standardized test scores. We already know that physical activity can help increase scores on standardized tests (among other things, like improving classroom behavior) but do engagement in risk behaviors affect them too? It's easy to generalize, or make assumptions, about the potential result of this. I would love to look at some data from which I could draw conclusions. However, some people don't perform well on standardized test scores and some people ace them while maintaining below average grades. Too many controls for a study, I think!

The CDC themselves has said that these numbers require further research to determine what exactly leads to low grades, or to engaging in risk-behaviors, or what else could lead to either of the above. My excitement with this is that now we have the possibility for future research into this area. And, in an economic climate where health and physical education are placed on the chopping block quickly and often without justification, these numbers give those of us in the field concrete evidence of the importance of what we teach children. It also helps support the argument for incorporating a well developed, interactive, coordinated school health program in as many school districts as possible.

I'm going to use some of this new data during my brief presentation during back to school night. Actually, as part of our department's professional development before school begins, we are spending a day with our community prevention coalition discussing the new data from our own, district-wide version of the YRBS. So, I'll be able to apply even more specific data during back to school night.

I'll also use it when I finally get my chance to present in front of the School Committee, Governor, President (whoever!) when I argue my case for increasing the amount of sexuality education we teach in our middle school. But that, my friends, is another topic for another time!

Check out the actual reports and information here.

Phoebe Prince

It appears school lunches and bullying are both hot topics this year, especially with the local, highly publicized story regarding the suicide of 15 year old Phoebe Prince. This media firestorm first occurred back in January and with the recent news that charges have been made, it's back again.

Nine teenagers have been charged with various crimes relating to the death of Prince, which are explained in detail in the linked articles below. The articles share the same common information: unrelenting bullying of Phoebe, kids and teachers who were aware of what was going on, and a fired up public. If you haven't figured it out by now, I don't rehash articles that already have the information for you. So, they're linked below. If a study or article comes out on its own, I'll do a more in depth review (like the New England Journal of Medicine article on salt) but when so many articles appear in a certain amount of time, I just add my thoughts.

Here's an editorial by Boston Globe columnist Kevin Cullen. It's more, uh, blunt than the other reports. Next, the actual articles in the Boston Globe, the Washington Post, and the New York Times. A brief story also appeared in the Springfield Republican.

It's no secret that bullying happens. In order for bullying to stop, students need to learn the skills of how to properly handle a bullying situation. What should someone do if they are being teased or bullied? What can they do as a bystander who witnesses bullying happening? Why do kids bully anyway? To me, this might be the most important question. Part of our sixth grade curriculum includes Aggressors, Victims, and Bystanders. It's a little dated, but my favorite part deals with what students can do as a bystander to a bullying situation, and how they can either prolong the bullying or help end it. We also discuss that choosing not to do anything at all is a decision that has its consequences, as many people in South Hadley have found out. Students should also learn other important life skills, such as self-esteem, communication skills, goal setting, decision making, support networks...all of which can tie into anti-bullying units.

I'm up in the air about the new legislation in Massachusetts regarding bullying because it places most of the blame in one place. Parents are still responsible for their kids, and administrators have so much on their plate already. I'm not saying teachers and administrators should not report bullying behavior (they NEED to do something about it) but I think there are more proactive ways to handle this issue, which is another post in itself! I do like the part about attempting to change the climate of a school, and ultimately, teachers need to be aware of what constitutes bullying versus simple teasing (many may argue there is no such thing as simple teasing). However, so much of bullying can occur outside of school, where teachers and administrators are not responsible for the behavior of their students. I read a report about a parent who paid two boys fifty dollars each to "take care" of someone bullying his daughter. What kind of example does this set? When bullying does occur in school, it's often (not always) very subtle. Teenagers are masters at keeping their behavior discrete. By the time it's being taken care of, another incident is probably occurring. It's a never ending battle; at least it will be until we start changing the culture of a school and community. It is going to be a multi-faceted effort, involving schools, parents, community organizations, and more. Sounds like a great opportunity for schools to work within their coordinated school health programs!

NOTE: I picked up Queen Bees and Wannabes at Borders this weekend, along with a few other books. I'm hoping to start it this week, but with middle school, track, and class all very busy right now, it might have to wait until the weekend.

Cough Medicine Abuse

This post is all over the place. At the end I have numerous links; links to articles and resources. For all I know, this issue will result in ongoing commentary from me right here on Middle School Health Esteem. I should be reading about standard deviation and z scores for my grad class, but this is important for me to post about.

Over the last month or so I've heard a lot about DXM, dextromethorphan. I was attending a district wide professional development class when a teacher from the high school in my district informed me about the increasing trend among our community of students abusing cough medicines. Last week, while in the middle of our seventh grade ATOD unit, I covered DXM and numerous other drugs in class. Then, an article appeared in the town newspaper, which was shortly followed by an article in the local, regional paper. The next logical step was for television media to get involved. This week the local ABC affiliate, WCVB in Boston, had a story on the evening news. The media was reporting on an increase in teenagers abusing cough medicines containing DXM.

Well, it's no secret now that I teach in Danvers, Massachusetts. Originally, I didn't want that to come out on here simply because anyone can read whatever I type here, and I don't have tenure yet. But, then I realized I really have nothing to hide, I'm promoting what I do in the classroom, and if anything, maybe we can get some conversations flowing about this issue and other issues too.

Abusing cough medicines with DXM has many negative health effects: impaired judgement, vomiting, hallucinations, dizziness, disorientation, etc. More information on DXM is linked below. Many medicines contain other ingredients that can be deadly in excess amounts as well. This post isn't really about DXM itself, but more about how Danvers is approaching this issue.

After I read the article in the regional paper, I e-mailed the director of Danvers CARES, a prevention coalition that always gets two huge thumbs up from me. I asked the director if she had any additional resources I could share with all of my students to educate them about DXM and prescription drug abuse in general. We only touch upon substance abuse in general terms in the seventh grade curriculum; they go more in depth in high school health (we focus on tobacco and alcohol). She responded with some great information that I've included below. I'm using them in some "teachable moments" coming up with all grade levels, because whenever a teachable moment exists I snag that opportunity!

It's also important to remember that DXM abuse is only one part of prescription drug and OTC drug abuse. It falls under that general umbrella, which encompasses abuse of anything from Oxycontin to diet pills. So, abuse of one drug is only one small part of a much larger issue.

We also don't really know how long this has been going on. National data about this type of behavior, according to the director of Danvers CARES, only goes back to 2006. What I do know is that we in Danvers are very lucky to have an organization like Danvers CARES to spearhead community involvement over this issue. Our police department visited all the local pharmacies to talk to the managers recently, and there is a round table discussion scheduled for next month with police officers, school officials, Danvers CARES representatives, and more. The purpose is to educate parents and citizens about the dangers of DXM abuse. I'm a big believer in involving parents in what goes in within a child's education, and I'm trying to add a little more of that each year in my own teaching. Providing these opportunities for parents to hear from people who know what they're talking about and to ask those questions is a great thing! Parents: please talk to your kids, and get them the facts.

Basically, many parts of the coordinated school health program that I'm a huge proponent of are working together on this issue. In order for any change to happen a huge effort is required; it looks like we're seeing that becoming reality here. Will it work? I hope so. Ultimately, it's up to the kids themselves to change their own behaviors. Ideally, it would be great to identify trends with risk behaviors before they happen. Unfortunately, that's not always realistic, and I'm not sure where that would even start. A reader comment I read on one of the newspaper articles online mentioned that when kids start using these types of drugs, that they have surpassed marijuana and are looking for something else. I don't know if that has any truth to it or not (anything posted online like that needs to be taken with a grain of salt), but if it is true than I'm scared to think about what could come next.

Check out the following resources below.

Resources:

DXM Stories: Make Up Your Own Mind About Cough Medicine. Provides factual information, stories from former users, and news about cough medicine abuse. The site says all information is from reliable, medical research or from first hand accounts of former users.

Above The Influence: OTC Drugs. From the "abovetheinfluence" website.

*Note: The director of Danvers CARES mentioned that some of the following are produced by pharmaceutical companies. They have great information, but remember the course as you browse them. I used the Kids Health reference sheet in class this week, as an FYI.

Tip Sheet for Giving Oral OTC Cough and Cold Medicines to Children.

Check The OTC Label.

Preventing Teen Cough Medicine Abuse: A Parent's Guide.

Cough and Cold Medicine Abuse: KidsHealth.org

"Good Food in the City"--Baltimore Public Schools

After opening the most recent issue of Educational Leadership, I took a look at the article, "Good Food in the City" by Anthony Geraci, Director of Food and Nutrition Services for Baltimore City Schools, Baltimore, Maryland. Instead of reviewing the entire article with citations and all that "official" stuff, here are some thoughts as I read through the article.

The best part about this program? They get the most out of it. A farm provides fresh fruit and vegetables and so much more, as I mention in more detail below. I think that this program in Baltimore should be a model used in other cities across the country. The other big plus from my end is that this program is aiming to change the perception of students in their school district while providing them with the tools, skills, and information needed to make healthy decisions. They don't just serve fresh food. At the risk of sounding cheesy, this isn't simply a food program: it's a movement!

• This program guarantees that every school lunch served in Baltimore city schools will come with at least one piece of fresh fruit. This is only the beginning.

• "Today, 'peach' more often refers to a flavor for candies and frozen desserts than to the actual food. That's what we need to change for kids in Baltimore and all over the United States." Don't get me started on high-fructose corn syrup. Yes, I do consume foods with HFCS, but not intentionally. My consumption is far lower than most people my age.

• Geraci explains that in the 1970s, many school districts felt the need to operate in a similar fashion to the McDonald's corporation; not in the food they provide but in the way they operate their business and individual franchises. Scares about contaminated food led to frozen, ready-to-eat meals that also reduced labor costs. However, as he explains, "But with every level of convenience comes a level of the process that dilutes food to something unrecognizable." I'm sure we can all remember our first mystery meat experience. What exactly was that anyway?!

• A major problem today has to do with the kitchen facilities in schools. The school I work in was renovated about five years ago. It's a stunning building, serving as the unofficial flagship school for our district. When the kitchens were designed, they set them for small prep work (for sandwiches, etc) and mainly for reheating and serving food from the freezer. So, how is a school without the facilities supposed to create fresh meals? Baltimore's schools faced this problem, with only 20 out of 200 schools with fully operational kitchens. Due to budget issues and the size of a lot of schools, simply renovating was out of the question. Their eventual goal for Baltimore is to create a central kitchen and many subkitchens that can create fresh made meals that can be delivered to schools without facilities. The example Geraci gives is the central kitchen making chicken the sub-kitchens can put into burritos or the beef for a stew, etc. More school districts should consider kitchen space when they design plans for a new school. Adequate meal preparation space and a wellness center for student/staff use would be great additions to any school!

• As I mentioned in my last post, companies and organizations that decide to help public schools promote health and wellness are extremely important for districts without a lot of money. Baltimore was lucky enough to receive gifts worth a staggering $1.3 million from the Mid-Atlantic Dairy Association: nine refrigerated trucks, milk coolers for all 200 schools, and a technology grant to help keep track of everything. Further proof that companies or organizations can, and will, help out their communities.

• The Baltimore City Schools now contracts to obtain all of its fruits and vegetables locally.

• A local supply program has numerous benefits! Less fuel for delivery and fewer man hours for manning those deliveries create cost savings. Because less fuel is used, fewer greenhouse emissions are created. Supporting local farmers contributes to the local economy. In Baltimore, a contract to supply only locally grown fruits and vegetables means over half a million dollars stays in state. I could go on and on!

• Geraci and his colleagues knew that changing the perception of fruits and vegetables among students was not going to be easy, especially in urban areas filled with easily accessible fast food restaurants and convenience stores. So, he set out to see what the kids liked with a "No Thank You Bite" program in the elementary schools. This is based on an old mom's trick! Students were given a small cup (about a bite and a half of food) of different ingredients to try out. If they liked it, they could have more. If they didn't like it, they tried something else. Kids tracked what they liked and the more they tried, the better chances they had at winning prizes. A reward system works well for younger kids, especially when they are stepping out of their comfort zone in trying something new.

• Geraci even combined forces with the Baltimore Ravens and Orioles for a separate breakfast program. A reward for participation was a breakfast with stars of either team; this also created a perfect opportunity for role-models to speak about the importance of good nutrition. Purchases of breakfast boxes ("containing 100% fruit juice; a carton of milk; and a whole-grain, high protein snack with no artificial colors or preservatives") increased from 8,500 to 35,000 in less than two months!

• Baltimore also created the Great Kids Farm. This farm is 33 acres of organic farmland that is owned and operated entirely by the Baltimore Public Schools! This farm provides HUGE benefits for the community: selling produce to the community (restaurants, farmers' markets, etc), thereby serving as another source of income for the district; providing vocational training for students; service-learning opportunities, etc. It was also the site of an eight week summer internship program!

• At one point, Geraci explains the well-known phenomenon that people living in urban areas are disproportionally affected by diseases that are diet related. Baltimore itself finds approximately 37% of their high school students are obese; higher than the state and national average. Because these rates also fall in line with the city's poverty rates, he writes, "It only makes sense that doing right by children's health can help them perform better in the classroom."

I clearly have difficulty being terse, but there's so much going on here! The Baltimore City Schools has a great thing going with this program. If you teach health or anything related to nutrition, I urge you to check out this article!

Article: Obesity won't improve without reforming PE

I came upon an article today while checking out AAHPERD's Facebook page. The article, written by NASPE board member Bryan McCullick, is short, to the point, and effective. Although I do not teach PE, I'm obviously a big advocate for anything health/PE related in schools.

Click here for the article.

McCullick writes that,"PE is at the core of promoting healthy choices. A comprehensive school program includes PE, health education, healthy food options, recess for elementary school students, intramural sport programs and physical activity clubs, and interscholastic sports for high school students. Ideally, schools would also include physical activity breaks, walk/bike to school programs, appropriate physical activity in after-school child care programs, and staff wellness programs."

Many choices listed here tie into a coordinated school health program. Each unit operates in support of one other. Tennessee has made funding available statewide for development of a CSHP in each district. Will this set a precedent for other states? We'll find out (more on the Tennessee thing later this week).

I also like McCullick's point that, "The days of the ball-rolling, coffee-swilling, game-prepping PE “coach” have contributed to the current obesity rate increase." Today's physical education classes should focus on lifestyle activities and participation in physical activity, and are no longer for the "jocks" or athletes. Anyone is capable of moving their bodies and finding an activity they enjoy doing, and exposure to those activities in physical education classes is one way for students to find that out!

On a side note, a great example of an after school program is ING's Run For Something Better. Here a company is offering 50 $2,000 grants to either begin a school-based running program or to enhance one that already exists. Financial assistance from major corporations is a great way to fund programs for cash strapped districts.

"If schools are places where responsible citizenship is fostered, they should also have an obligation to help children develop the skills, knowledge and confidence necessary to maintain a healthy lifestyle that can prevent or reduce costly future health care."I

Jay Mathews Says PE Is a Bad Idea

I enjoy reading a blog entitled, "Class Struggle" by Jay Mathews of the Washington Post. It mainly deals with issues in the DC area, but his posts often have implications beyond DC. I like a lot of his writing and his conversations with blog readers via his comments section. He is not afraid to push buttons and talk about equality (or the lack of) in education, and the fact that he actually responds to readers gives him big points in my book. When I saw Mathews critique the recently introduced Healthy Schools Act in Washington, DC schools, alarm bells went off. Maybe it's the Springfield undergrad in me resurfacing, but anytime anyone tries to say physical education or health education are not important, I get fired up.

Before I begin, I would encourage you to read the article and the comments written from readers and Mathews himself. There is a lot of great insight going on, and Mathews does respond, keeping a relatively open mind and providing clarifying points when needed. He even admits when he makes a bad statement or compliments someone who proves him wrong.

The Healthy Schools Act would require, as Mathews writes, the following: "The new bill would require every public school student in kindergarten through fifth grade to have 150 minutes of P.E. (30 minutes a day). Sixth- through eighth-graders would be required to take 225 minutes (45 a day)."

These new physical education guidelines fit in with the guidelines set by the American Heart Association for most healthy people of at least 30 minutes of physical activity most days of the week. The 150 minutes per week also fits the guidelines set by the American Alliance for Health, Physical Education, Recreation, and Dance. AAHPERD consists of professionals involved in the fields of health education, physical education, fitness, recreation, sports and coaching, etc. The organization is a huge advocate for anything promoting health and fitness, and a great organization to be involved in.

Mathews argues that DC school children need to spend more time in the classroom due to underachieving test scores. However, physical education is important in learning. As pointed out on Ed Burke's The Slow Cook, many studies have been done showing that physical education classes can improve academic performance. This was drilled into our heads at Springfield as a way to advocate for our profession as physical or health educators. I won't repeat the stats from the other blog, but the information provided by Ed Burke is spot on.

The schools also provide a location for students to work out in gym class. Students living in urban areas may have difficulty finding space to play/exercise in or may not have the resources needed for programs that their suburban counterparts enjoy. The food section of the bill would serve local fruits and vegetables to elementary school students one to three times a week, depending on the season. Why is this a bad thing? This saves in fuel costs, contributes to the local economy, and will taste better too.

I'm not sure if Mathews understands the role of the coordinated school health program (CSHP) in education today. For basic information on the CSHP, see an earlier post I wrote last year. Ideally, a CSHP contains multiple parts working in conjunction with each other in order to help maintain healthy young people. Two critical portions of this model, physical education and food services, are positively affected by the proposed Healthy Schools Act. Hopefully, the other components are active in the DC schools as well.

Has Mathews spent time in a classroom with middle school students who simply need time to run around and burn off some energy? It can be very hard to control kids who have no outlet for their energy. I would prefer an odiferous, post-phys. ed class any day of the week over a class that has too much energy to handle. They're not focused if they have built up energy. I strive to set an example by my own physical activity, and I know in my district, the kids would be very upset if their physical education classes were cut.

Much of education has nothing to do with what students learn in classes they may not use in their entire life. This is the importance of physical education and health education: providing tools for a lifetime of healthy living. The long term, positive effects of this is for another post, but they are numerous.

My next post will have something to do with the classroom. Check back within the week!

As always, please leave comments telling me what you think. I, like Mathews, want to hear the whole side of the story.

Recommended Read: Health Is Academic: A Guide to Coordinated School Health Programs. Edited by Eva Marx and Susan Frelick Wooley with Daphne Northrop.

Brief Description from the EDC (Education Development Center): "Health Is Academic: A Guide to Coordinated School Health Programs describes the growing understanding that piecemeal, competitive, or uncoordinated efforts to address the intertwined social, educational, psychological, and health needs of young people are inefficient and ineffective. Developed in collaboration with more than 70 national organizations, it discusses how the eight components of a CSHP can work together to support students and help them acquire the knowledge and skills they need to become healthy, productive adults. Published in 1998 by Teachers College Press, the 346-page book provides action steps for schools, districts, state and national organizations, and colleges and universities.

The content is based on the knowledge and experiences of teachers, principals, administrators, school board members, nurses, psychologists, counselors, and other health and education experts around the country. Top researches in the field wrote the chapters, and more than 300 professional educators reviewed them."

What I Say:

This book examines in detail the eight component Coordinated School Health Program that was developed by the Centers for Disease Control (CDC). Many people are unaware that the CSHP model even exists, instead viewing each component as a separate entity, when all are in fact related. The eight components are as follows: Health Education, Physical Education, Health Services (nursing, etc), Nutrition Services, Counseling, Psychological, & Social Services, Healthy School Environment, Health Promotion for Staff, Family/Community Involvement.

The book begins by looking at the undeniable link between health and student learning, and then explains how a district can look into implementing the CSHP in their district; an action plan is given at the school level and the district level. Each of the eight components are then explained individually; lastly the CSHP at the state and nationwide level is discussed.

"A school health program is 'comprehensive' and 'coordinated' when it:

• focuses on key risks to health and learning
  
• receives support from students, family, friends, and adults within the school community
• draws on the thoughts and efforts of many disciplines, community groups, and agencies
• uses multiple programs or components
• provides staff development programs
• uses inclusive and broadly based program planning"

This book was used in one of my health education classes during the fall of my senior year, Organization, Administration, and Assessment of the School Health Program. I actually took this course one-on-one with Dr. McDiarmid, and she had me take a hard look at some programs in local school districts. I was able to apply what I learned from the book to what was in the real world, finding gaps where improvements could be made. This positively affected my student teaching in semester two, and my knowledge of the CSHP was one of the reasons I was hired for my first teaching job.

Health Is Academic was published in 1998, so some of the contact information of the organizations listed have changed. However, the book is very applicable to any school because the "action steps" listed give districts a place to start. The CDC's webpage linked at the start of this post is also very imformative. As a side note, the EDC mentioned develops curricula for school such as the Aggressors, Victims, and Bystanders anti-bullying curriculum that is popular in schools across the country.

I'm not going to go into too much depth about the CSHP here, that's why I want you to read the book! It's a must-read for anyone in physical education or health education, and I would highly suggest it to administrators as well.

As always, please feel free to e-mail me with questions or comments.