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“No curriculum is brilliant enough to compensate for a hungry stomach or distracted
mind.” (American Cancer Society, 1992)
“Children experience more positive learning and achievement outcomes when they
are well-nourished, engage in physical activity and experience school as a caring
and supportive social and learning environment. (Dickinson, 2005)
“There is a clear and consistent relationship between nutrition and academic
outcomes in the long term.” (Quigley and Watts, 2005)
“A lack of sleep puts adolescents at risk of cognitive and emotional difficulties and
poor school performance.” (Carpenter, 2001)
“Physical activity has been found to improve cognitive performance and promote on-
task classroom behaviour.” ( Mahar et al., 2006)
Why the school is important as a health promotion setting
– links between health and academic achievement
• If New Zealand teachers perceive students’ learning to be affected by
• Whether schools implement strategies to address health issues, and if
so, which strategies
• If strategies reflect the HPS approach
• Teachers’ understanding of HPS
We set out to investigate:
• 1000 surveys sent to randomly selected schools across NZ. Final return rate
305. Late responders analysed. (Uuskula, 2011)
1. What health issues in your school do you see as impacting on students’ learning?
2. Do you have strategies in place to address these issues?
3. What is your understanding of a ‘health promoting school’?
4. Do you consider your school to be a HPS school? If ‘yes,’ what do you see as the
5. Do you see a relationship between HPS and educational outcomes?
6. Do you have a HPS team and if yes, who is on it?
Quantitative data was coded, entered into Excel and transferred to SPSS. Qualitative
data analysed and coded according to identified themes.
What health issues do you see as impacting on
students’ learning? (% of 858 issues)
• Effective Behaviour Support (EBS), other behaviour management and
• Monitoring of at-risk students
• Support from, or referral to helping (outside) agencies
• ‘Cool School’ approach for conflict resolution
• Pastoral care (e.g. deans, tutors, teachers, counselors, school therapist,
psychologist, social worker)
• Work closely with Resource Teacher Learning Behaviour (RTLB) and
Social Worker in School (SWIS)
• Teacher works with individual students and families
• Peer support and safe room for students
• Life skill activities (cooking, gardening, community experiences)
What strategies have you put in place to
address these issues?
• ‘Fruit in Schools’ Programme (or just offering fruit)
• Water only school
• Offering healthy food (for school bought lunch and snacks)
• Supplying healthy food, lunch and/or snacks ('brainfood')
• Breakfast Club/breakfast programmes, school fruit break
• School garden (grow veges and/or fruit)
• Cooking classes promoting healthy eating (e.g. education programmes
and workshops in school, awards)
• Communication, talks, information for parents (e.g. newsletter)
monitoring eating behaviour,
• WAVE Programme
• Student health council/team
• School survey on canteen fizzy drinks - energy drinks banned
What strategies have you put in place to
address these issues?
The HPS framework has been widely
promoted in NZ – but are schools using it?
Do you consider your school to be a health
• “Nil” (school 51)
• “A school that promotes healthy nutrition … and students are involved in
daily fitness.” (school 74)
• “A school that promotes the total wellbeing of individuals – physically,
mentally, spiritually.” (school 163)
• “One that has a committee of representatives from staff, parents, pupils
and/or BOT to deal with health issues and find resolutions.” (school 160)
• “A school that is proactive around the issues they identify as barriers to
learning. Educating parents, promoting outside agencies/groups.
Usually has a committee made up of teachers/parents/children.” (school
What is your understanding of a
‘health promoting school’?
The benefits of being a health promoting school?
• “Creates a safe, caring and supportive learning environment. Enables students to
develop lifelong skills, and health behaviours that can increase their potential to
live healthy lives.” (school 57)
• “Students respect themselves/others in a far greater way. Students think more
about making safe choices and the consequences of any decisions they make.”
• “Better pastoral care, more resilient students, happier learning environment,
more effective relationships between student to student and staff.” (school 234)
• “A shared community approach to healthy living. Greater learning engagement
and reduced attendance issues. (school 8)
What do you see as the benefits of being a
health promoting school?
• 81% of schools considered themselves an HPS school yet only 53% had an
Do you have an HPS team?
Do you see a relationship between HPS and
•“Healthy students are more confident and more ready to learn. They are
not held back by health issues.” (school 38)
•“Healthy, active, positive children are more able to make the most of their
opportunities, take risks, meet challenges and bounce back from
setbacks.” (school 181)
•“Safe, positive environment supports high expectations and outcomes.”
•“Too many to mention!” (school 42)
The relationship between HPS and educational
– Participants identified a number of issues that impacted negatively
on learning, with issues around food seen as particularly important.
– Participants’ understanding of HPS varied from no understanding to
a comprehensive understanding.
– Despite the variation in an understanding of HPS almost 90% of
respondents saw a relationship between HPS and educational
There is a need for:
– Further research around best practice.
– More professional development regarding schools as health promotion
settings, especially in regards to developing community links and parental
Conclusions and challenges