The purpose of this study was to examine the effects of the three most popular comprehensive health education programs in Michigan including each program's curricular content, student outcomes, and cost effectiveness. The three programs were cross-referenced with the Michigan Essential Performance Objectives for Health (MEPO). Student outcome data were gathered and analyzed utilizing a health education instrument derived from the Michigan Educational Assessment Program. Instruments were administered to 377 third-graders and 595 sixth-graders participating in the three health programs. While each of the three programs met the Michigan Essential Performance Objectives for Health, the programs differed in areas of teacher training time, materials cost, and length of time for implementation. Third graders showed some very positive effects from health instruction based upon a comparison of their composite scores and scores for 10 health topic areas. Sixth graders showed some gains in several health topic areas, but few significant gains in composite scores.
The rapid expansion of managed care creates opportunities and dilemmas for those involved in school health and adolescent health promotion. Managed care organizations (MCOs), public health agencies, and school and adolescent health providers share certain common goals and priorities including an emphasis on prevention, cost-effectiveness, and quality of care--and a willingness to explore innovative approaches to health promotion and disease prevention. However, MCOs often face conflicting challenges, balancing the goals of cost containment and investment in prevention. In considering support for school health programs, MCOs will be interested in evidence about the effectiveness of services in improving health and/or reducing medical expenditures. Mechanisms for improving prevention efforts within MCOs include quality assurance systems to monitor the performance of health plans, practice guidelines from professional organizations, and the contracting process between payers and health care providers. Development of partnerships between MCOs and schools will be a challenge given competing priorities, variation in managed care arrangements, structural differences between MCOs and schools, and variability in services provided by school health programs.
This study surveyed all Michigan public school principals regarding the current status of comprehensive school health education being provided in Michigan public schools. A 32-item survey was developed, pretested, revised and mailed to all public school principals in Michigan. Followup letters were sent to nonrespondents. A phone survey was conducted to nonrespondent principals after the cut-off date to verify survey responses. All data was analyzed by elementary, junior high school and high school population. The areas of professional preparation, inservice education, application and utilization of the Essential Performance Objectives for Health Education in Michigan, the content and time allotted for health education, and the lack of a well-developed organizational structure for health education have been articulated as deficit areas in the current status of comprehensive school health education. This survey provided much information for future consideration by educators, public and private health organizations, and other individuals and groups interested in school health in Michigan.
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