Voices from the Field -- A Qualitative Analysis of Classroom, School, District, and State Health Education Policies and Programs
Pateman, Beth, Grunbaum, Jo Anne, Kann, Laura, Journal of School Health
The Centers for Disease Control and Prevention (CDC) conducted the first national School Health Policies and Programs Study (SHPPS) in 1994. SHPPS was designed to measure policies and programs at the state, district, school, and classroom levels across five components of a comprehensive school health program: health education, physical education, health services, food service, and health policies related to tobacco use, alcohol and other drug use, and violence. SHPPS examined the current status of these five components, responsibility for each component, the relationship between state and district policies and school programs and services, and factors that facilitated and prevented the delivery of quality school health programs. The results have provided data relevant to 14 national health objectives that can be obtained by schools as described in Healthy People 2000 and to goal seven of the National Education Goals.
The rationale, methodology, and quantitative findings from SHPPS were first reported in the SHPPS Summary Report. This article presents qualitative data from the study obtained by analyzing responses to open-ended questions about health education. These data provide insight into the thoughts of educators and administrators who work in classrooms, schools, districts, and state education agencies about actions that could improve the status of health education at each of these levels.
Data Collection and Respondents
Health education data were collected at four levels. Respondents in each of the 50 states and the District of Columbia provided state-level data, while nationally representative samples were selected at the district, school, and classroom levels. For the state- and district-level data collections, respondents who administered health education (sometimes in addition to other programs) throughout an entire state or district answered mailed questionnaires. School- and classroom-level data collections involved site visits to middle or junior high and senior high schools, whereby trained data collectors interviewed selected health education teachers. School respondents were lead teachers selected by their administrators to represent the health education program in their schools. Classroom respondents were randomly selected from persons who taught required health education in any course across the school curriculum.
The SHPPS state- and district-level questionnaires assessed health education policies and programs for grades K-12. The school- and classroom-level interviews asked about health education practices in the middle or junior high and senior high schools. The questionnaires and interviews included five open-ended questions related to health education: 1) What would you like to do in health education that you have not been able to do? 2) What has prevented you from doing those things you just described? 3) What needs to happen so you can do those things? 4) What has been most helpful in improving health education? 5) What are your recommendations for improving health education?
All state-level administrators (50 states and the District of Columbia) completed the state- level health education questionnaire. At the district level, 413 of the 502 (82%) sampled districts completed at least one of the five district questionnaires. At the school level, 607 of the 766 (79%) sampled schools completed at least one of the five school interviews. At the classroom level, 1,040 of the 1,643 (63%) sampled health education teachers completed the interview.
Responses to the open-ended questions were analyzed using the constant comparative method of qualitative analysis for key issues and recurrent themes. Because classroom teachers directly provided health education for students, the analysis began by searching these teachers' responses for key issues that enabled or limited the effectiveness of day-to-day provision of health education. …