L School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey tobacco use prevention physical activity nutrition violence prevention asthma management HIV prevention 0 Acknowledgements Georgia Department of Human Resources Maria Greene, Acting Commissioner Division of Public Health Kathleen E. Toomey, M.D., M.P.H., Director Chronic Disease Prevention and Health Promotion Branch Carol B. Steiner, R.N., M.N., Acting Director Family Health Branch Rosalyn Bacon, M.P.H., Director Epidemiology Branch Paul A. Blake, M.D., M.P.H., Director Georgia Department of Education Kathy Cox, State Superintendent of Schools Learning Support Division Phil Hulst, Director Suggested citation: Kanny D., Choi, HS, Hammond, DA. School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey. Georgia Department of Human Resources, Division of Public Health, February 2004. Publication number DPH04.181HW. School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey I 0 Table of Contents INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 SURVEY METHODS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 GEORGIA SHEP SURVEY RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Health Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 Required Health Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 Required Health Education Course Content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 Required Health Education Teaching Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 Health Education Coordination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 Health Education Staff Training and Professional Development . . . . . . . . . . . . . . . . . . . . . . . .8 Physical Education and Physical Activity Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-10 Tobacco Use Prevention Education and Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-13 Nutrition-related Policies and Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-15 Violence Prevention and School Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 Asthma Management Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 HIV Prevention Education and Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 CONCLUSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 APPENDIX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A1 Detailed Data Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A1-A26 School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey ii 0 INTRODUCTION School health education is one of the most effective means to reduce and prevent some of the most serious health problems in the United States (1). Classroom training can help school-aged youth establish health behaviors that promote and maintain good lifelong health and prevent health-risk behaviors among youth. School health education should focus on reducing behaviors that place youth at risk for important health problems, which include sedentary lifestyles; tobacco use; improper nutrition; intentional and unintentional injuries; and sexual behaviors that place youth at risk for HIV infection, other STDs and unintended pregnancies (2). In 1990, the Centers for Disease Control and Prevention (CDC) developed an operational definition of health education that identifies eight elements of school health education (National Commission on the Role of the School and the Community in Improving Adolescent Health, 1990): 1. A documented, planned, and sequential program of health education for students in kindergarten through grade 12; 2. A curriculum that addresses and integrates education about health problems and issues; 3. Activities that help young persons develop skills to avoid health-risk behaviors (i.e., tobacco use; alcohol and other drug use; imprudent dietary patterns; inadequate physical activity; sexual behaviors that result in unintended pregnancy, human immunodeficiency virus (HIV) infection, or infection by other sexually transmitted diseases (STD); and behaviors that result in unintentional and intentional injuries; 4. Instruction provided for a prescribed amount of time at each grade level; 5. Management and coordination by an education professional trained to implement the health education program in each school; 6. Instruction from teachers trained to teach the subject; 7. Collaboration with parents, health professionals, and other concerned community members; 8. Periodic evaluation, updating, and improvement of the health education program. In 1995, to measure the current status of comprehensive health education, safe and healthy school policies, and levels of coordination in middle and high schools, the CDC, in collaboration with state and large local education agencies, developed the School Health Education Profiles (SHEP) (4). The School Health Education Profile monitors characteristics of health education in middle and high schools. The Georgia Profile is a school-based survey conducted by the Georgia Department of Education and the Georgia Department of Human Resources as part of a cooperative agreement with the Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 1 0 INTRODUCTION continued. . . The 2002 Georgia SHEP asked school principals and lead health educators questions related to the implementation, organization, structure, and support of health education in their schools. In addition, questions were asked relating to whether health education was taught by personnel trained in health education, and if health education focused on skills necessary to avoid certain health risks. The SHEP survey consisted of two questionnaires developed by the CDC; one for principals and one for lead health education teachers. The lead health education teacher is the person who coordinates health education policies and programs within a middle or high school. The principals' questionnaire examined whether health education is required, physical education and physical activity programs, tobacco use prevention policies, nutritionrelated policies and practices, violence prevention and school safety, asthma management activities, and HIV infection prevention programs and policies from an administrative perspective, while the lead health educators' survey looked at health education from an instructional viewpoint. The 2002 SHEP survey instruments consisted of 41 questions related to administration of health education and 21 questions related to instruction. Georgia has collected data from school principals and lead health educators since 1996. The survey is administered biannually during the spring semester. Though data were collected for the first time in 1996, only in 1998 and 2002 were response rates high enough to represent all public middle and high schools in Georgia. Most of the results presented in this report are for 2002 only. When applicable, the 2002 data have been compared with the 1998 Profiles. This report summarizes the 2002 Georgia Profile data and provides cross-year comparisons with baseline data from the 1998 Georgia Profile to assess change. All analyses conducted for this report are descriptive and use the weighted data. Throughout this report, when differences are said to be significant, there is no overlap in the 95-percent confidence intervals of the percentages being compared. Ninety-five percent confidence intervals for each point estimate (percentage) are presented in the detailed data tables found in the Appendix. School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 2 3 SURVEY METHODS Sample: Selection Process and Description All public middle and high schools in Georgia having at least one of grades 6 through 12 were included in the sampling frame. Systematic equal probability sampling with a random start was used to select a sample of schools for the survey. Three hundred seventy four public middle and high schools in Georgia were randomly selected to participate in the survey. Of the 748 surveys mailed, 526 were completed and returned from 151 middle schools and 123 high schools. Usable questionnaires were received from 266 of the 374 sampled principals (71% response rate), and 260 of 374 questionnaires were received from teachers (70% response rate). Data Collection Data were collected during the spring semester of 2002. The principal's questionnaire and the lead health education teacher's questionnaire were both mailed to the principal of each sampled school. The principal then determined who the lead health education teacher was and distributed the questionnaire accordingly. Participation in the surveys was confidential and voluntary. Responses were recorded on the questionnaire booklet by the principal or teacher, then returned. Follow-up telephone calls and written reminders were used to encourage participation. Data Analysis A weighting procedure was performed to reduce bias by compensating for differing patterns of nonresponse and to reflect the likelihood of sampling each school. The weighted survey results in this report can be used to make inferences about health education in all Georgia public middle and high schools. SUDAAN, a computer software for the statistical analysis of correlated data, was used to compute point estimates (5). The estimated error rate, using a normal approximation, is less than 5 percent. School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 3 L Results tobacco use prevention physical activity nutrition violence prevention asthma management HIV prevention School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 4 L HEALTH EDUCATION Required Health Education The Institute of Medicine (IOM) recommended that schools require at least one-semester of health education at the secondary school level (1). Education Rule 160-4-2-.12, adopted by the Georgia State Board of Education in 2000, states that schools shall make available instruction in health education and physical education in grades 6 through 12, with the exception of alcohol and drug abuse, which must be covered in each grade level K-12. Education Rule 160-4-2-.47, adopted in 2002, requires high school students to complete 1 unit of Health and Physical Education (out of 22 units) in order to graduate. In 2002, 85% of middle schools and 98% of high schools in Georgia reported that health education is required for students in any of the grades in their schools. In middle schools, this is a statistically significant decline from 99% in 1998 (Table 1). Required health education classes are most likely to be taught in grades six through nine, whereas only about 20% of schools required health education in grades 10 through 12 (Figure 1, Table 2). Figure 1: Percent of schools that require a health education course by grade, Georgia, 2002 100 86 80 76 79 80 60 40 20 21 22 17 0 6th 7th 8th 9th 10th 11th 12th In 2002, 55% of middle schools required their students to take 3 health education courses, whereas 82% of high schools required their students take only one health education course. Ten percent of Georgia middle schools reported that they do not require health education courses at all (Table 3). Forty-eight percent of middle schools reported that less than 1% of their students were excused or exempted from a required health education course by parental request and 29% reported that students cannot be exempted at all. In high schools, however, 31% reported a less than 1% exemption rate while 58% cannot be exempted at all (Table 4). Georgia schools use a variety of curriculum materials for their health education courses. The most common curriculum materials used in health education courses in Georgia include state's, district's, and school's curriculum/guidelines/framework and commercially developed teacher's guide (Table 5). Percent of schools School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 5 L HEALTH EDUCATION Required Health Education Course Content Health education can be offered to students in standalone classes or integrated with other subjects. While integration of health information and skills into other subjects should not replace stand-alone health classes, such integration can reinforce and extend the health education curriculum in important ways (6). In Georgia, health education is most often delivered in a combined health education and physical education course (59% in middle schools, 72% in high schools). Middle schools are more likely than high schools to offer health education in courses other than health (28% middle school, 7% high school). In both middle and high schools, this is a statistically significant decline in health education courses offered from 1998 (50% middle schools, 43% high school) (Table 6). At both middle and high schools, lead health educators mentioned alcohol and drug use prevention, tobacco use prevention, emotional and mental health, sexually transmitted disease prevention, HIV prevention, physical activity and fitness, and nutrition and dietary behavior prevention as the most popular topics in which the schools tried to increase student knowledge. Least mentioned topics in which teachers tried to increase student knowledge were death and dying, dental and oral health, immunizations and vaccinations, suicide prevention, CPR, and sun and safety or skin cancer prevention (Table 7). Lead health educators at Georgia middle and high schools also teach students how to improve their skill and knowledge levels. In required health education courses, skills for improving decision making, goal setting, and resisting peer pressure for unhealthy behavior were the most often mentioned skills. The skills teachers rated as the least mentioned were advocating for personal, family, and community health, analysis of media messages, and access to health information (Table 8). Required Health Education Teaching Methods The most popular teaching methods used by lead health educators at both middle and high schools were group discussions and cooperative group activities. The least used teaching methods in both middle and high schools were peer educators, computerassisted instruction, and pledges or contracts for behavior (Table 9). Lead health educators were asked whether they ask students to participate in specific activities as part of their health education course. The least frequently mentioned activity was asking students to participate in out-of-class activities such as volunteer work at a hospital or other organization for health services. Completion of homework with family members and identifying and analyzing advertisements that influence health risk behaviors were the most often mentioned activities (Table 10). School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 6 L HEALTH EDUCATION Health Education Coordination Nationwide, approximately two-thirds (63%) of schools have someone to oversee or coordinate health education (7). Management and coordination by a professional who is trained in health education is a necessary component of effective health education (3). The lead health educator coordinates health education in 43% of the middle schools and 45% of the high schools in Georgia. It is rare for health education to not be coordinated by anyone (Table 11). Support from outside advisory councils often builds support for school health initiatives. Involvement of parents, community members, and other professionals is a key element of school health programs (8,9,10,11). About two-thirds of middle (60%) and high (65%) schools have a school health committee or advisory group that develops policies, coordinates activities, or seeks students and family involvement in programs that address health issues (Table 12). An integrated school and community approach is an effective strategy to promote adolescent health and well being (8). Lead health educators in Georgia middle and high schools worked most often with physical education staff. They were least likely to work with the food services staff (Table 13). Most of Georgia middle and high schools provided families with information on health education programs (77% middle school, 66% high school), but least met with parents' organizations to discuss health education (24% middle school, 30% high school) (Table 14). School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 7 L HEALTH EDUCATION Health Education Staff Training and Professional Development Effective implementation of school health education is linked directly to adequate teacher training programs. School health education designed to decrease students' participation in health-risk behaviors requires that teachers have appropriate training to develop and implement school heath education curricula (8). The most popular staff development topics for Georgia middle and high school health teachers were CPR and first aid. Although, teachers have received the most training in CPR, they have ranked CPR as one of the least taught topics in the classroom (see Required Health Education Course Content). Slightly over half of Georgia health teachers received training related to HIV in the past two years (Table 15). The highest demand for additional training for both middle and high school health teachers was in the areas of violence prevention and alcohol or other drugs prevention (Table 16). For example, 41% of the middle school teachers received some violence prevention training in the two years prior to the survey, yet 73% indicated that they would like to have additional training in violence prevention. Health education teachers need to be academically prepared and qualified specifically to teach heath education (11,3). More than half (52%) of lead middle school health educators and two-thirds (68%) of lead high school health educators have taught health education for 10 or more years (Table 17). Professional development activities for health education teachers need to focus on teaching strategies that both actively engage students and facilitate their mastery of critical health information and skills (11). Staff development on teaching methods received by lead educators in Georgia middle and high schools was highest in the area of using interactive teaching methods such as role-playing or cooperative group activities and the lowest in teaching students with limited English proficiency (Table 18). The most important area in which lead health educators at both middle and high schools wanted to receive further staff development was teaching skills for behavior change (Table 19). School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 8 L PHYSICAL ACTIVITY Physical Education and Physical Activity Programs Physical education can increase students' knowledge, physical activity in physical education class, and overall fitness (2). Nationally, 96% of schools required students to take some form of physical education (12). In Georgia, physical education is a required course at 62% of middle schools and 94% of high schools (Figure 2, Table 20). In middle schools, students can be exempted from taking required physical education course if they are enrolled in other courses (21%) or participated in school activities (15%). In high schools, students are rarely exempt from taking physical education (Figure 3, Table 21). In schools that require students to take physical education, the importance of passing the course varies by school type. Nearly all high schools (96%) but only 20% of middle schools, require their students to repeat physical education if they fail the course (Figure 4, Table 22). Figure 2: Percent of schools that require physical education by school type, Georgia, 2002 100 80 62 60 40 20 0 Middle School 94 High School Percent of schools Percent of schools Figure 3: Percent of schools that exempt students from taking required physical education by reasons for exemption and school type, Georgia, 2002 30 Middle High 21 20 15 10 5 2 1 0 Enrollment in Participation in Participation in Participation in other courses school sports other school community activities sports activities Figure 4: Percent of schools that require students to repeat physical education if they fail by school type, Georgia, 2002 100 96 80 60 40 20 20 0 Middle School High School The physical and social environment should support safe and enjoyable physical activity and discourage the use or withholding of physical activity as punishment. The use of physical activity as punishment risks creating negative associations with physical activity for young persons while withholding activity denies students the health benefits (2). Over twenty-five percent (26% middle school, 28% high school) of Percent of schools School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 9 L PHYSICAL ACTIVITY Percent of schools Percent of schools Physical Education and Physical Activity Programs cont... schools allow faculty to use physical activity as a punishment for bad behavior (Figure 5, Table 23). Less than 5% of middle schools and less than 1% of high schools make students miss a physical education course as a punishment for bad behavior in another class (Table 24). Figure 5: Percent of schools that use physical activity as a punishment for bad behavior by school type, Georgia, 2002 50 40 30 28 26 20 10 0 Middle School High School Newly hired physical education teachers in both middle and high schools are almost always certified, licensed, or endorsed by the state in physical education (Table 25). This rate is higher than nationwide findings of 73% of schools (12). Middle schools (62%) are more likely to offer intramural activities than high schools (43%) (Table 26), however, only 11% of middle school and 5% of high schools provide transportation for students who participate in after school intramural activity or physical activity clubs (Table 27). Intramural activities contribute to the physical and social development of young people (13). Lack of transportation may be a limiting factor for some to participate. Providing transportation therefore gives students the opportunity and promotes healthier behavior. Outside of school hours school spaces and facilities should be available to young people (2). The majority (86%) of middle schools and high schools (79%) allow children or adolescents to use the school's athletic facilities for community-sponsored sports teams or physical activity programs outside of school hours or when school is not in session (Figure 6, Table 28). Figure 6: Percent of schools that allow use of school's athletic facilities outside of school hours by school type, Georgia, 2002 100 86 80 79 60 40 20 0 Middle School High School CDC's Guidelines for School and Community Programs to Promote Lifelong Physical Activity Among Young People recommend that health education curricula should provide information about physical activity concepts including the physical, social and mental health benefits of physical activity, the components of health-related fitness; principles of exercise; injury prevention and first aid; physical activity and weight management; social influence on physical activity; and the development of safe and effective individualized physical activity programs (2). At both middle and high schools, in a required health education course, lead health educators taught most often about the physical, psychological & social benefits of physical activity and on the dangers of using performanceenhancing drugs, such as steroids. Teachers least taught about development of an individualized activity plan for physical activity and on monitoring progress of activity plan (Table 29). School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 10 L TOBACCO USE PREVENTION Percent of schools Percent of schools Tobacco Use Prevention Education and Policies Because tobacco is the most preventable form of mortality in the United States, the CDC established the Guidelines for School Health Programs to Prevent Tobacco Use and Addiction. The guidelines recommend that tobacco use prevention be provided to students in each grade kindergarten through 12th grade (14). In Georgia, tobacco use prevention education is most likely to be taught in grade 9 (95%), followed by grades 6 through 8 (84% to 88%). Only about half of the students in grades 10 through 12 receive tobacco use prevention education (Figure 7, Table 30). Figure 7: Percent of schools that provide information on tobacco use prevention by grade, Georgia, 2002 100 95 84 88 88 80 60 58 52 51 40 20 0 6th 7th 8th 9th 10th 11th 12th Tobacco use prevention is taught most often in physical education courses, both in middle and high schools (Table 31). The CDC guidelines further recommend instruction that focuses on particular topics, including the shortand long-term negative physiological and social consequences of tobacco use, social influences on use, peer norms regarding use, and refusal skills (14). In a required health education course lead health educators mentioned that the most taught topics in both middle and high schools were short- and long-term health consequences of smoking cigarettes, benefits of not smoking cigarettes, short- and long-term health consequences of smokeless tobacco, benefits of not using smokeless tobacco, addictive effects of nicotine in tobacco products, how to say no to tobacco use, and the health effects of second-hand smoke. The two least taught topics by Georgia middle and high schools, although still rated by over 80% of teachers, were how to find information or services related to tobacco use cessation and making a personal commitment not to use tobacco (Table 32). The CDC guidelines were created to encourage the restriction of use or exposure to cigarettes and tobacco products. Schools often develop policies in accordance to the CDC guidelines. Nearly all Georgia middle and high schools have adopted a policy prohibiting tobacco use products, including cigarette smoking, by students. Over 90% of Georgia middle and high schools prohibit faculty and staff from using tobacco products and almost 90% of schools also prohibit visitors from using tobacco (Figure 8a & 8b, Table 33). Figure 8a: Percent of middle schools with a policy prohibiting tobacco use by product and group, Georgia, 2002 Students Faculty Visitors 100 99 92 89 80 99 92 85 99 93 89 99 93 89 60 40 20 0 Cigarettes Smokeless Tobacco Cigars Pipes School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 11 L TOBACCO USE PREVENTION Percent of schools Tobacco Use Prevention and Education Policies cont... Figure 8b: Percent of high schools with a policy prohibiting tobacco use by product and group, Georgia, 2002 Students Faculty Visitors 100 99 94 88 80 98 94 88 98 93 87 99 93 87 60 40 20 0 Cigarettes Smokeless Tobacco Cigars Pipes Schools with tobacco policy prohibit the use of tobacco products during school hours for all students and nearly for all faculty/staff and visitors. However, this policy is less likely to prohibit tobacco use during nonschool hours (Figure 9a & 9b, Table 34). Figure 9a: Percent of middle schools with a policy prohibiting tobacco use by time period and group, Georgia, 2002 Students Faculty Visitors 100 99 94 91 80 86 77 75 60 40 20 0 During school hours During non-school hours Percent of schools Percent of schools Figure 9b: Percent of high schools with a policy prohibiting tobacco use by time period and group, Georgia, 2002 Students Faculty Visitors 100 100 93 86 80 84 70 60 57 40 20 0 During school hours During non-school hours At nearly all the schools, the tobacco policy prohibits tobacco use by students and faculty/staff in school buildings, on school grounds, in school buses or vehicles and at off-campus events. However, this policy is less likely to prohibit tobacco use by visitors at off campus, school sponsored events (Figure 10a & 10b, Table 35). Figure 10a: Percent of middle schools with a policy prohibiting tobacco use by location and group, Georgia, 2002 Students Faculty Visitors 100 99 99 94 80 60 99 93 84 99 99 94 99 96 66 40 20 0 In school buildings On school grounds In buses or vehicles Off-campus events Percent of schools School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 12 L TOBACCO USE PREVENTION Percent of schools Tobacco Use Prevention and Education Policies cont... Figure 10b: Percent of high schools with a policy prohibiting tobacco use by location and group, Georgia, 2002 Students Faculty Visitors 100 100 98 96 80 100 92 80 100 96 90 98 85 60 53 40 20 0 In school buildings On school grounds In buses or vehicles Off-campus events Almost all of Georgia middle and high schools have procedures to inform students and faculty/staff about the school's tobacco policy. Three-fourths of the schools also have procedures to inform visitors of the policy (Figure 11, Table 36). Nearly all schools (98% middle schools, 99% high schools) have procedures to inform parents of the policy in both middle and high schools. Figure 11: Percent of schools with procedures to inform students, faculty, and staff about tobacco prevention policy by school type and group, Georgia, 2002 Students Faculty Visitors 100 98 97 84 80 98 96 76 60 40 20 0 Middle Schools High Schools Just over half (55%) of middle and high schools have a designated individual to enforce the tobacco prevention policy. In both middle and high schools, when students are caught smoking cigarettes, they are almost always referred to the school administrator and their parents are informed. In 55% of middle schools and 47% of high schools students who are caught smoking cigarettes are given in-school suspension. Being encouraged and/or required to attend assistance/education/cessation programs and being referred to legal authorities are rarely ever used as a consequence (Table 37). Students and faculty/staff are unlikely to be given a referral to a cessation program by the school (Table 38). Over 90% of Georgia middle and high schools prohibit tobacco advertising in school buildings, on school grounds, on school buses, and in school publications (Table 39). Almost all Georgia middle and high schools prohibit tobacco advertising through sponsorship of events (Table 40) and tobacco brand-name apparel and merchandise (Table 41). However, tobacco-free zone signs are posted at just over half of the schools (63% middle school, 55% high school). Percent of schools School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 13 L NUTRITION Nutrition-related Policies and Practices Many nutrition experts believe that students are more likely to eat well if they have a pleasant dining experience in the cafeteria. Having ample time to eat without having to rush is a major component of a pleasurable dining experience. The American Food Service Association has established 20 minutes once seated as a standard for the amount of time needed to create a pleasurable dining experience (6). Nationally, 80% of schools give 20 or more minutes to eat lunch (15). More than 80% of Georgia middle and high schools allow students 20 minutes or more to eat lunch once they are seated. About 15% of both middle and high schools allow less than 20 minutes to eat lunch (Figure 12, Table 42). According to the CDC's Guidelines for School Health Programs to Promote Lifelong Healthy Eating, healthy and appealing foods should be available in meals, a la carte items, snack bars, and vending machines. Additionally, schools should discourage foods high in fat and sodium and with added sugars (16). Few schools (6% middle schools, 11% high schools) in Georgia have policies stating that fruits and vegetables will be offered at school settings such as school parties, after-school programs, staff meetings, parent's meeting, or concession stands (Figure 13, Table 43). Percent of schools Percent of schools Figure 12: Percent of schools with lunch eating practice of less than 20 minutes by school type, Georgia, 2002 50 40 30 20 15 10 0 Middle School 15 High School Figure 13: Percent of schools with a policy to offer fruits and vegetables at school settings by school type, Georgia, 2002 30 20 10 6 0 Middle School 11 High School School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 14 L NUTRITION Nutrition-related Policies and Practices cont... Most schools (83% middle school, 96% high school) offer snack foods or beverages from vending machines, school stores, canteens, or snack bars (Figure 14, Table 44). The most often mentioned foods/beverages were bottled water and drinks not 100% juice. Fruits and vegetables are the least likely to be available (Figure 15, Table 45). Beverages and snacks can be purchased at any time in the majority of high schools while in middle schools the access is mainly during lunch periods, and less often before or during school hours (Figure 16, Table 46). Nutrition education has the primary goal of helping young persons adopt healthy eating behaviors that will aid in reducing the risk for disease (16). At both middle and high schools, in a required health education course, lead health educators taught most often about the benefits of healthy eating and aiming for a healthy weight. The least taught topic in middle schools was keeping food safe to eat (Table 47). Figure 14: Percent of schools where students can purchase snack foods/beverages from vending machines by school type, Georgia, 2002 100 83 80 60 40 20 0 Middle School 96 High School Percent of schools Percent of schools Figure 15: Percent of schools where students can purchase snack foods/beverages at school by food/beverage and school level, Georgia, 2002 Middle High 100 80 79 77 80 77 64 62 60 56 54 94 94 96 96 64 54 75 74 40 22 20 15 0 ChocOotlhaeter kcianndSdsayoltfyc/annodtylowSainltyfFar/tuliotswainndfaLvtoewge-ftaatbblDeasrkinekdsgnoootd1s00%1j0ui0c%e fruit juice Bottled water Figure 16: Percent of schools where students can purchase snack foods/beverages by time period and school type, Georgia, 2002 Middle High 100 80 72 60 40 22 20 56 27 52 47 0 Before school starts During school hours During school lunch time Percent of schools School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 15 L VIOLENCE PREVENTION Violence Prevention and School Safety Effective and safe schools are well prepared for any potential crisis or violent acts (17). Nearly all middle (99%) and high (96%) schools have a written plan for responding to violence (Figure 17, Table 48). Figure 18: Percent of schools that implement safety and security measures by measure and school type, Georgia, 2002 100 99 99 98 91 94 94 Middle High 80 75 78 66 60 58 Percent of schools Percent of schools Figure 17: Percent of schools with a written plan for responding to violence at school by school type, Georgia, 2002 100 99 96 80 60 40 20 0 Middle School High School As part of a violence protection policy, nearly all Georgia middle and high schools require visitors to report to the main office upon arrival to the school, maintain a "closed campus" where students are not allowed to leave school during the school day, including during lunchtime, and use staff or adult volunteers to monitor hallways between and during classes. Twenty percent of middle schools and 36% of high schools use metal detectors as a safety measure (Figure 18, Table 49). 40 36 31 28 23 20 20 16 7 2 0 Visitors rCeVlpoooslreutdntceaemrBsapmgu,sodneitsokr,hloacllksePr rcohheibcSikttusbdaecnktpsSawctuekdaser nutnsifwoermarsUIDsebamdegteasl detUenctifoorrsmed police The Safe and Drug-Free School and Communities Act of 1994 provides federal funds for programs to prevent violence in and around schools (18). Sixty six percent of Georgia middle schools and 49% of Georgia high schools have a program to prevent bully- ing. Sixty three percent of the middle schools and 53% of the high schools have peer mediation programs (Figure 19, Table 50). Figure 19: Percent of schools that have or participate in safety programs by program and school type, Georgia, 2002 Middle High 100 80 63 60 53 40 42 34 66 49 Percent of schools 20 77 0 Peer Safe-passage to Prevent Prevent bullying mediation school gang violence School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 16 L ASTHMA MANAGEMENT Asthma Management Activities Recommendations for school health services for students from the American Lung Association and Kaiser Permanente National Conference include: having a full-time nurse, all day every day for each school; identifying and tracking all students with asthma; assuming immediate access to medications as prescribed by a doctor and approved by parents; and using standard emergency protocols for students with respiratory distress (19). Most often, implemented asthma management activities in Georgia middle and high schools were encouraging full participation in physical education and physical activity when asthma students are doing well, assuring immediate access to medication as prescribed by a physician, and providing modified physical education and physical activities as indicated by the student's Asthma Action Plan (Figure 20, Table 51). Percent of schools Figure 20: Percent of schools that implement asthma management activities by activity and school type, Georgia, 2002 100 80 70 Middle 84 86 High 88 94 83 76 60 43 40 40 20 51 39 40 36 34 45 44 40 30 27 18 0 NTurarscekAssttuhdmeantAAscccteiosns Ptolamn eCdaicsaetimonanagemeEndtucaEtedusctaaftfe AsstutEhdnmecnoatusarawgaereMPnEoedspisfaiertdicPipEataionnd activities School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 17 L HIV PREVENTION HIV Prevention Education and Policy Abstinence, the most effective method to avoid HIV infection, was one of the most often taught HIV prevention topics in required health education courses in Georgia. How HIV is transmitted and how it affects the human body were HIV prevention topics taught by 89% of the middle schools and 94% of the high schools (Table 52). When HIV prevention courses were not taught as part of health education, they were usually taught in conjunction with science courses (37%) and physical education courses (29%) in middle schools. In high schools, on the other hand, HIV prevention lessons were taught in a variety of courses: physical education (51%), science (49%), life skills (48%), home economics (42%), and special education (36%) (Table 53). Students and staff with HIV infection or AIDS need policies to protect their rights (20). About half the schools nationwide have adopted a policy to address HIV (21). In Georgia, 64% of middle schools and 68% of high schools have adopted a written policy that protects the rights of students and/or staff with HIV infection or AIDS (Figure 21, Table 54). Most school written policies that protect the rights of students and/or staff with HIV infection/AIDS covered issues such as maintaining confidentiality of HIV-infected students and staff and worksite safety (Table 55). Percent of schools Figure 21: Percent of schools that have a written policy to protect rights of students/staff with HIV/Aids by school type, Georgia, 2002 100 80 64 68 60 40 20 0 Middle School High School School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 18 L CONCLUSION The 2002 Georgia School Health Education Profile (SHEP) provides important information on Georgia public middle and high schools. Health Education is offered in nearly all schools and is required most often in grades 6 through 9. The State curricula are used in combined health education and physical education courses and a broad range of topics are covered in the courses. Students are taught a number of skills for maintaining healthy behaviors such as decision making and conflict resolution. The school health education teachers use a variety of teaching methods to present these topics and skills and also instruct students to participate in activities outside of the classroom to reinforce concepts. The SHEP examined six health areas in particular: tobacco use prevention, physical activity, nutrition, violence prevention, asthma management, and HIV prevention. Within these six areas, there were many similarities and differences between middle and high school health education. Middle schools are less stringent on physical activity but offer school facilities to students after school. Only 11% of middle schools provide transportation for students who participate in after school intramural activity or physical activity clubs. High schools require students to participate and pass physical education class. Both middle and high school students are given similar physical education lessons. Ninth grade students are the most likely to receive tobacco use prevention education, but no matter which grade tobacco education is offered, the focus is the same. Tobacco prevention policies are the same for middle and high schools and consequences for breaking school policies are also similar for the school types. Georgia schools educate students on nutrition but healthy snack alternatives such as fruits and vegetables are the least likely to be offered to students. Middle and high schools implement a variety of similar activities and procedures to ensure school safety and to assist students with asthma. Both school types also have policies in place to protect the rights of students and faculty with HIV infection and AIDS. Not only do schools have HIV policies, but they also provide students with HIV prevention education, usually in science courses. High school students are provided education about HIV/AIDS with slightly different focal points, examining issues such as drug and alcohol use more often than middle schools. Neither middle nor high schools spend much time on condom use. The 2002 SHEP also explored collaboration and coordination between schools and local partners. Health education teachers are usually held responsible for coordinating health education in the schools. Health education teachers often work alongside physical education teachers and use parental and community input when developing activities. Both middle and high school health education teachers are well trained in many topics. They receive training in many subjects and teaching methods. The health education teachers in Georgia are not only frequently attending educational training in health but are also well experienced, with the majority of the teachers having 15 years or more of teaching. School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 19 i REFERENCES 1. Institute of Medicine. Schools and health: our nation's investment. Washington, DC: National Academy Press, 1997. 2. CDC. Guidelines for school and community programs to promote lifelong physical activity among young people. MMWR 1997;46(No. RR-6). 3. National Commission on the Role of the School and the Community in Improving Adolescent Health. Code blue: uniting for healthier youth. Alexandria, VA: National Association of State Boards of Education, 1990. 4. Grunbaum, J, Kann, L, Williams, B, Kinchen, S, Collins, J, & Kolbe, L. Characteristics of health education among secondary schools School Health Education Profiles, 1996. Morbidity and Mortality Weekly Report 1998; 47 (No. SS-4): 1 31. 5. Shah BV, Barnwell BG, Bieler GS. SUDAAN user's manual, release 7.5. Research Triangle Park, NC: Research Triangle Institute, 1997. 6. Marx, E, Wooley, S, and Northrop, D. Health is academic: a guide to coordinated school health programs. New York: Teachers College Press, 1998. 7. Kann, L, Brener, N, Allensworth, D. Health education: results from the School Health Policies and Programs Study 2000. Journal of School Health 2000; 71: 266-278. 8. Allensworth, D. Health education: state of the art. Journal of School Health 1993; 63: 14-20. 9. Epstein, J. School/family/community partnerships. Phi Delta Kapaan 1995; 76: 701-712. 10. Kolbe, L. An essential strategy to improve the health and education of Americans. Preventive Medicine 1993; 22: 544-560. 11. Lohrmann, D, and Wooley, S. Comprehensive school health education. In: Marx, E, Wooley, S, eds. Health is Academic. New York: Teachers College Press, 1998: 43-66. 12. Burgeson, C, Wechsler, H, Brener, N, Young J, and Spain C. Physical education and activity: results from the School Health Policies and Programs Study 2000. Journal of School Health 2000; 71: 279-293. 13. National Association for Sport and Physical Education. Sport and physical education advocacy kit. Reston, VA: National Association for Sport and Physical Education, 1994. 14. CDC. Guidelines for school health programs to prevent tobacco use and addiction. MMWR 1994;43(No. RR-2). 15. Wechsler, H., N.D. Brener, S. Kuester, C. Miller. "Food Service and Foods and Beverages Available at School: Results from the School Health Policies and Programs Study 2000." Journal of School Health 71(7):313-323. 2001. 16. CDC. Guidelines for school health programs to promote lifelong healthy eating. MMWR 1996; 45(No. RR-9). 17. Dwyer, K., Osher, D, Warger, C. Early warning, timely response: A guide to safe schools. Washington, DC: U.S. Department of Education, 1998. 18. 20 U.S.C.S. 7101 et seq., 2001. 19. Kaiser Permanente/ American Lung Association: National Partnership on Asthma. National Asthma Conference. Asthma prevention, management, and treatment: community-based approaches for the new millennium. National Asthma Conference. November 16-17, 2000. Washington, DC. 20. National Association of State Boards of Education. Someone at school has AIDS: a complete guide to education policies concerning HIV infection. Alexandria, VA: National Association of State Boards of Education, 1996. 21. Brener, N, Burstein, G, DuShaw, M, Vernon, M, Wheeler, L, and Robinson, J. Health Services: Results from the School Health Policies and Programs Study 2000. Journal of School Health 2000; 71: 294-303. School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey 20 8 APPENDIX: DETAILED DATA TABLES Table 1: Is health education required for students in any of grades 6 through 12 in this school? Middle High % 85.0 97.6 2002 (95% CI) (78.9 91.1) (94.8 100) % 99.4 100 1998 (95% CI) (98.1 100) (100 100) Table 2: Is a required health education course taught in each of the following grades in this school? Grades 6 7 8 Middle Schools 2002 % (95% CI) 76.3 79.2 80.2 (69.2 83.5) (72.0 86.5) (73.9 86.6) Middle Schools 1998 % (95% CI) 69.8 74.6 78.6 (62.7 76.9) (67.9 81.3) (73.0 84.3) Grades 9 10 11 12 High Schools 2002 % (95% CI) 85.7 21.4 22.2 17.0 (79.0 92.4) (13.7 29.1) (15.3 29.1) (10.4 23.7) High Schools 1998 % (95% CI) 90.2 20.1 21.8 19.3 (85.4 95.1) (14.0 26.3) (15.3 28.2) (13.4 25.1) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A1 8 APPENDIX: DETAILED DATA TABLES Table 3: How many required health education courses do students take in grades 6 through 12 in this school? Courses 0 courses 1 course 2 courses 3 courses 4 or more courses Missing Values Middle Schools 2002 % 10.0 15.8 5.6 55.4 8.6 4.6 (95% CI) (4.6 15.4) (9.0 22.6) (1.5 9.8) (47.1 63.8) (3.9 13.3) High Schools 2002 Middle Schools 1998 % 1.7 81.7 6.8 2.5 3.4 3.9 (95% CI) (0.0 4.1) (74.8 88.5) (2.6 10.9) (0.0 5.3) (0.5 7.4) % 9.7 16.4 13.1 54.3 5.3 1.2 (95% CI) (5.3 14.1) (11.3 21.5) (8.0 18.1) (47.6 61.1) (2.4 8.3) High Schools 1998 % 0.6 87.0 6.4 0.0 6.0 0.0 (95% CI) (0.0 1.9) (82.4 91.7) (2.2 10.5) (0.0 0.0) (2.4 9.6) Table 4: During this school year, about what percent of students in grades 6 through 12 were exempted or excused from any part of a required health education course by parental request? % exempted Students cannot be exempted or excused Less than 1% 1% to 5% 6% or more Middle Schools 2002 % (95% CI) High Schools 2002 % (95% CI) Middle Schools 1998 % (95% CI) High Schools 1998 % (95% CI) 29.2 47.9 6.9 0.9 (20.4 37.9) (38.9 56.9) (2.4 11.4) (0.0 2.8) 58.3 31.0 3.5 0.0 (49.7 66.9) (22.8 39.1) (0.0 6.9) (0.0 0.0) 29.1 47.9 9.2 0.0 (22.8 35.4) (40.6 55.1) (4.9 13.5) (0.0 0.0) 44.5 47.3 0.7 0.0 (36.5 52.6) (39.0 55.5) (0.0 2.0) (0.0 0.0) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A2 8 APPENDIX: DETAILED DATA TABLES Table 5: Are teachers in this school required to use each of the following materials in a required health education course for students in any of grades 6 through 12? Middle Schools 2002 Material National Health Education Standards State's curriculum, guidelines or framework District's curriculum, guidelines or framework School's curriculum, guidelines or framework Materials from health organizations Commercially-developed student textbook Commercially-developed teacher's guide * = No data available % 29.0 97.8 92.6 75.1 40.5 40.5 71.0 (95% CI) (21.0 37.0) (95.3 100)) (88.0 97.1) (66.9 83.4) (32.5 48.6) (32.5 48.6) (63.0 79.0) High Schools 2002 % (95% CI) Middle Schools 1998 % (95% CI) 44.7 (35.4 54.0) * * 94.4 (89.9 98.9) 95.9 (92.9 99.0) 82.7 (75.1 90.2) 80.8 (75.4 86.2) 85.3 (78.6 92.0) 68.9 (62.4 75.4) 48.7 (39.2 58.2) * * 48.7 (39.2 58.2) 36.2 (29.2 43.2) 81.5 (74.4 88.6) 68.3 (61.9 74.7) High Schools 1998 % (95% CI) * * 95.4 (91.7 99.1) 81.5 (74.6 88.3) 73.0 (65.7 80.3) * * 31.0 (22.3 39.8) 66.8 (58.2 75.3) Table 6: Is required health education taught in each of the following ways to students in grades 6 through 12 in this school? Method In a combined health ed & PE course In a course mainly about another subject other health ed Middle Schools 2002 % (95% CI) High Schools 2002 % (95% CI) Middle Schools 1998 % (95% CI) 58.9 (50.3 67.6) 72.4 (64.0 80.8) 53.3 (46.1 60.5) 28.0 (19.6 36.4) 6.6 (2.0 11.2) 49.7 (43.6 55.8) High Schools 1998 % (95% CI) 61.8 (53.9 69.7) 43.3 (34.7 51.9) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A3 8 APPENDIX: DETAILED DATA TABLES Table 7: During the school year, have teachers in this school tried to increase student knowledge on each of the following topics in a required health education course in any of the grades 6 through 12? Middle Schools 2002 Topic Accident or injury prevention Alcohol or other drug use prevention Consumer health CPR (Cardiopulmonary resuscitation) Death & dying Dental & oral health Emotional & mental health Environmental health First Aid Growth & development HIV (human immunodeficiency virus) prevention Human sexuality Immunization & vaccinations Nutrition & dietary behavior Personal hygiene Physical activity & fitness Pregnancy prevention STD (sexually transmitted disease) prevention Suicide prevention Sun safety or skin cancer prevention Tobacco use prevention Violence prevention (such as bullying, fighting, or homicide) * = No data available % 92.2 97.7 78.2 61.3 50.9 71.4 95.7 73.7 83.9 91.5 92.3 88.5 69.1 91.0 91.0 94.5 85.7 92.4 68.6 75.5 97.7 87.6 (95% CI) (87.1 97.3) (95.1 100.0) (70.9 85.6) (53.1 69.5) (41.7 60.0) (64.0 78.9) (92.0 99.5) (66.5 80.9) (77.3 90.5) (86.6 96.4) (87.5 97.0) (83.3 93.7) (60.8 77.3) (85.7 96.3) (86.6 95.4) (90.5 98.6) (79.6 91.8) (87.6 97.1) (60.9 76.4) (67.9 83.0) (95.1 100.0) (82.6 92.7) High Schools 2002 % (95% CI) Middle Schools 1998 % (95% CI) 91.5 97.0 78.7 (86.0 97.1) (93.5 100.0) (71.2 86.2) 89.7 98.9 80.3 (85.5 93.9) (97.4 100.0) (75.0 85.6) 81.6 70.9 67.3 (73.6 89.7) (62.3 79.6) (58.5 76.0) 71.7 45.9 76.3 (65.4 78.1) (38.6 53.2) (70.0 82.5) 96.1 72.8 88.3 91.8 (92.2 99.9) (64.4 81.2) (81.8 94.8) (86.1 97.5) 93.4 79.8 87.9 95.4 (89.6 97.2) (74.0 85.6) (83.0 92.8) (92.2 98.6) 95.1 90.5 (90.8 99.4) (84.6 96.4) 93.0 84.5 (89.9 96.2) (79.9 89.1) 75.8 (67.5 84.1) * * 95.1 81.2 94.3 92.5 (90.8 99.4) (73.3 89.0) (89.7 98.9) (87.3 97.7) 96.3 96.8 94.8 83.7 (93.9 98.6) (94.2 99.4) (91.9 97.7) (79.0 88.4) 95.9 87.8 (91.9 99.9) (81.2 94.5) 92.7 65.7 (89.2 96.1) (59.2 72.1) 75.8 96.0 (67.2 84.3) (92.1 99.9) * 97.3 * (94.9 99.7) 86.7 (79.7 93.7) 86.5 (81.9 91.1) High Schools 1998 % (95% CI) 92.2 97.2 86.2 (87.9 96.5) (94.4 100.0) (81.6 90.8) 84.3 69.7 68.3 (77.9 90.7) (62.1 77.3) (60.2 76.4) 95.2 82.2 94.2 91.7 (92.1 98.2) (76.3 88.1) (90.5 97.8) (86.8 96.7) 97.0 91.1 (94.8 99.3) (86.9 95.2) * * 95.8 95.7 91.8 89.6 (92.5 99.2) (92.2 99.2) (87.1 96.5) (84.4 94.7) 94.8 85.0 (91.5 98.2) (79.5 90.5) * 94.6 * (90.6 98.6) 86.0 (80.3 91.8) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A4 8 APPENDIX: DETAILED DATA TABLES Table 8: During this school year, have teachers in this school tried to improve each of the following student skills in a required health education course in any of grades 6 through 12? Middle Schools 2002 Skill Accessing valid health information, products, & services Advocating for personal, family, & community health Analysis of media messages Communication Decision making Goal setting Conflict resolution Resisting peer pressure for unhealthy behaviors Stress management % 79.6 80.8 81.4 94.5 95.0 95.8 89.5 98.5 88.6 (95% CI) (71.9 87.4) (73.3 88.2) (74.2 88.6) (90.4 98.5) (91.0 99.0) (92.1 99.5) (83.8 95.2) (96.4 100) (82.7 94.5) High Schools 2002 % (95% CI) Middle Schools 1998 % (95% CI) 89.6 (84.0 95.2) 82.1 (76.7 87.5) 82.8 86.8 94.3 96.1 95.2 89.5 95.2 95.1 (75.2 90.4) (79.9 93.7) (89.7 98.9) (92.2 100) (91.0 99.4) (83.4 95.7) (91.0 99.4) (90.9 99.4) 79.5 81.6 88.9 95.9 94.0 85.9 97.3 87.7 (73.3 85.8) (76.9 86.3) (84.3 93.5) (92.9 98.8) (90.5 97.5) (80.6 91.3) (94.9 99.7) (82.8 92.6) High Schools 1998 % (95% CI) 86.9 (81.4 92.3) 87.0 83.7 94.8 97.0 97.0 85.8 97.7 94.6 (80.9 93.0) (77.7 89.6) (91.0 98.7) (94.8 99.3) (94.1 100) (79.9 91.6) (95.1 100) (90.6 98.6) Table 9: During this school year, have teachers in this school used each of the following teaching methods in a required health education course in any of grades 6 through 12? Middle Schools 2002 Teaching method Group discussions Cooperative group activities Role play, simulations, or practice Language, performing, or visual arts Pledges or contracts for behavior change Adult guest speakers Peer educators The Internet Computer-assisted instruction % 94.9 94.2 82.2 68.1 58.7 80.4 55.4 69.1 57.2 (95% CI) (90.8 98.9) (90.2 98.1) (75.3 89.1) (59.7 76.4) (49.8 67.5) (74.0 86.8) (46.7 64.0) (61.2 77.0) (48.3 66.0) High Schools 2002 % 92.3 (95% CI) (86.9 97.7) 90.0 (83.9 96.2) 83.2 (76.8 89.7) 70.9 (61.9 79.8) 49.0 83.9 64.5 78.5 (40.2 57.8) (76.7 91.1) (56.3 72.6) (70.2 86.8) 67.2 (58.1 76.3) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A5 8 APPENDIX: DETAILED DATA TABLES Table 10: During this school year, have teachers in this school asked students to participate in each of the following activities as part of a required health education course in any of grades 6 through 12? Activity Perform volunteer work at a hospital, local health department, or community organization that addresses health Participate in or attend a school or community health fair Gather information about health services that are available in the community Visit a store to compare prices of health products Identify potential injury sites at school, home, or in the community Identify & analyze advertising in the community designed to influence health behaviors or health risk behaviors Advocate for a health-related issue Complete homework assignments with family members Middle Schools 2002 % (95% CI) 15.9 27.5 56.7 21.8 60.6 (9.4 22.3) (19.8 35.3) (49.2 64.1) (14.0 29.5) (52.5 68.8) 72.4 40.8 74.0 (64.4 80.5) (32.3 49.2) (66.6 81.5) High Schools 2002 % (95% CI) 26.7 44.2 65.5 29.3 57.4 (17.5 36.0) (34.8 53.6) (56.1 74.9) (20.1 38.4) (48.3 66.5) 65.1 58.4 75.1 (56.1 74.2) (48.3 68.6) (68.0 82.2) Table 11: Who coordinates health education in this school? Middle Schools 2002 Coordinator No one coordinates HE in this school District Administrator District HE or curriculum coordinator School administrator Health education teacher School nurse Someone else % 2.0 10.0 19.2 19.3 43.2 0.0 3.3 (95% CI) (0.0 4.3) (5.3 14.8) (13.1 25.4) (13.1 25.5) (34.6 51.8) (0.0 0.0) (0.4 6.2) High Schools 2002 % (95% CI) Middle Schools 1998 % (95% CI) 2.5 (0.0 5.2) 1.6 (0.0 3.5) 3.4 (0.1 6.7) 0.0 (0.0 0.0) 27.5 20.3 (19.7 35.3) (12.7 27.9) 33.9 15.4 (28.3 39.5) (10.4 20.4) 44.7 0.0 0.9 (36.0 53.4) (0.0 0.0) (0.0 2.6) 28.2 0.0 16.5 (22.2 34.2) (0.0 0.0) (11.2 21.8) High Schools 1998 % (95% CI) 0.7 (0.0 2.0) 0.8 (0.0 2.4) 29.5 10.7 (21.8 37.2) (5.6 15.8) 35.1 0.0 13.7 (26.9 43.4) (0.0 0.0) (8.7 18.7) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A6 8 APPENDIX: DETAILED DATA TABLES Table 12: Does this school or school district have a school health committee or advisory group that develops policies, coordinates activities, or seeks student and family involvement in programs that address health issues? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 59.7 (52.2 67.3) 65.1 (56.8 73.4) Table 13: During this school year, have any health education staff worked with each of the following groups on health education activities? Middle Schools 2002 Course Physical education staff School health services staff School mental health or social services staff Food service staff Community members % 80.2 61.1 53.0 24.1 58.4 (95% CI) (73.7 86.8) (52.7 69.5) (45.3 60.8) (17.0 31.3) (49.9 66.8) High Schools 2002 Middle Schools 1998 % 86.1 (95% CI) (79.9 92.4) % 63.0 (95% CI) (55.9 70.0) 63.5 (54.8 72.2) 27.0 (20.2 33.8) 52.0 33.5 63.7 (44.0 60.0) (24.8 42.1) (55.6 71.8) 55.2 15.7 * (48.3 62.0) (10.3 21.1) * High Schools 1998 % 74.2 (95% CI) (66.9 81.4) 28.8 (21.2 36.3) 42.1 18.4 * (33.1 51.1) (11.0 25.8) * Table 14: During this school year, has this school done each of the following activities? Middle Schools 2002 Activity Provided families with info on HE program Met with a parents' organization to discuss HE program Invited family members to attend a HE class % 77.4 (95% CI) (70.6 843) 23.9 44.1 (16.8 30.9) (36.6 51.7) High Schools 2002 % (95% CI) 66.3 (59.1 73.6) 29.5 46.7 (20.7 38.2) (37.5 56.0) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A7 8 APPENDIX: DETAILED DATA TABLES Table 15: During the past two years, did you receive staff development (such as workshops, conferences, continuing education, or any other kind of in-service) on each of the following health education topics? Middle Schools 2002 Topic Accident or injury prevention Alcohol or other drug use prevention Consumer health CPR (Cardiopulmonary resuscitation) Death & dying Dental & oral health Emotional & mental health Environmental health First Aid Growth & development HIV (human immunodeficiency virus) prevention Human sexuality Immunization & vaccinations Nutrition & dietary behavior Personal hygiene Physical activity & fitness Pregnancy prevention STD (sexually transmitted disease) prevention Suicide prevention Sun safety or skin cancer prevention Tobacco use prevention Violence prevention (such as bullying, fighting, or homicide) * = No data available % 33.7 48.1 0.0 60.6 6.9 5.9 19.3 13.6 54.9 31.9 51.0 31.6 8.7 14.4 9.9 33.6 32.2 45.9 14.8 6.4 35.4 40.8 (95% CI) (25.9 41.6) (40.7 55.6) (0.0 0.0) (52.9 68.4) (2.7 11.0) (1.9 9.8) (12.7 25.9) (8.0 19.2) (46.3 63.4) (23.7 40.1) (42.3 59.7) (23.5 39.7) (4.2 13.3) (8.4 20.4) (5.1 14.7) (25.9 41.3) (24.0 40.4) (37.4 54.5) (9.5 20.1) (2.4 10.5) (27.7 43.1) (33.0 48.6) High Schools 2002 % (95% CI) Middle Schools 1998 % (95% CI) 49.0 (40.2 57.9) 25.0 (19.1 30.9) 54.4 0.0 (44.8 64.0) (0.0 0.0) 33.6 10.7 (27.2 40.0) (6.3 15.2) 69.2 10.2 10.3 (60.8 77.6) (5.0 15.4) (6.2 14.4) 37.2 7.6 8.5 (29.8 44.5) (3.6 11.6) (4.2 12.7) 26.4 18.3 65.6 23.0 (19.0 33.8) (11.5 25.0) (57.0 74.2) (16.0 30.1) 16.5 10.6 32.5 21.7 (11.4 21.6) (6.3 14.8) (25.4 39.6) (15.7 27.6) 58.9 41.5 (50.0 67.8) (32.5 50.6) 30.4 25.3 (23.6 37.1) (19.1 31.4) 16.0 (9.1 22.9) * * 24.1 14.5 45.0 35.4 (16.1 32.2) (8.6 20.5) (36.2 53.8) (26.9 44.0) 19.3 18.8 30.4 23.5 (13.7 24.9) (13.0 24.7) (24.0 36.9) (17.6 29.4) 50.5 29.8 (42.0 59.0) (23.9 35.7) 28.8 10.4 (22.5 35.1) (6.0 14.8) 13.1 37.6 (7.9 18.2) (28.6 46.5) * 26.5 * (20.0 33.0) 45.5 (36.9 54.1) 32.0 (24.7 39.3) High Schools 1998 % (95% CI) 31.1 (22.9 39.4) 45.7 14.2 (37.2 54.1) (7.6 20.7) 46.0 10.2 12.6 (36.2 55.8) (4.6 15.7) (6.4 18.9) 20.3 8.5 45.2 19.8 (13.2 27.5) (3.4 13.6) (35.9 54.5) (12.3 27.2) 38.5 27.1 (29.5 47.5) (18.4 35.9) * * 22.1 20.0 35.2 21.3 (14.2 30.1) (13.1 26.9) (26.2 44.3) (13.5 29.1) 31.6 13.0 (23.2 40.0) (7.1 18.9) * 22.7 * (14.7 30.7) 29.3 (21.2 37.5) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A8 8 APPENDIX: DETAILED DATA TABLES Table 16: Would you like to receive staff development on each of these health education topics? Middle Schools 2002 Topic Accident or injury prevention Alcohol or other drug use prevention Consumer health CPR (Cardiopulmonary resuscitation) Death & dying Dental & oral health Emotional & mental health Environmental health First Aid Growth & development HIV (human immunodeficiency virus) prevention Human sexuality Immunization & vaccinations Nutrition & dietary behavior Personal hygiene Physical activity & fitness Pregnancy prevention STD (sexually transmitted disease) prevention Suicide prevention Sun safety or skin cancer prevention Tobacco use prevention Violence prevention (such as bullying, fighting, or homicide) % 52.5 69.8 41.3 65.0 56.8 44.3 62.9 50.6 68.5 55.0 68.6 60.6 43.1 63.5 41.5 62.0 61.4 66.9 67.7 57.8 61.1 73.1 (95% CI) (44.6 60.4) (62.4 77.2) (33.2 49.3) (56.8 73.1) (48.4 65.2) (36.3 52.3) (55.6 70.2) (42.8 58.4) (60.4 76.5) (46.9 63.1) (61.4 75.8) (52.9 68.2) (35.1 51.1) (56.1 70.9) (33.6 49.5) (54.0 70.0) (53.6 69.2) (59.5 74.4) (60.3 75.1) (50.3 65.3) (53.1 69.1) (66.8 79.5) High Schools 2002 % (95% CI) 53.0 (43.6 62.3) 71.2 41.4 (61.7 80.6) (32.9 49.9) 63.6 53.1 44.2 (54.5 72.7) (42.8 63.4) (34.0 54.5) 58.4 49.3 63.4 51.9 (48.6 68.1) (39.6 59.1) (54.2 72.7) (42.1 61.7) 68.9 63.7 (59.8 78.0) (53.7 73.7) 50.3 (40.6 60.0) 61.1 40.6 64.0 62.9 (51.8 70.4) (31.1 50.1) (55.5 72.6) (53.7 72.2) 69.6 66.5 (60.6 78.6) (57.3 75.7) 52.0 60.6 (41.8 62.1) (50.1 71.0) 75.8 (67.6 84.1) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A9 8 APPENDIX: DETAILED DATA TABLES Table 17: Including this school year, how many years have you been teaching health education? Years teaching 1 year 2 to 5 years 6 to 9 years 10 to 14 years 15 years or more Middle Schools 2002 % 11.3 22.3 13.0 21.7 30.4 (95% CI) (5.9 16.6) (15.9 28.7) (7.1 18.8) (15.0 28.3) (22.9 38.0) High Schools 2002 Middle Schools 1998 % 2.7 17.5 12.1 18.4 49.4 (95% CI) (0.0 5.8) (10.5 24.4) (5.8 18.4) (11.3 25.5) (40.7 58.0) % 7.7 23.3 19.6 17.2 31.0 (95% CI) (3.6 11.7) (17.2 29.4) (14.1 25.1) (11.9 22.5) (24.2 37.8) High Schools 1998 % 4.1 20.0 12.3 16.6 47.0 (95% CI) (0.5 7.7) (13.2 26.9) (6.5 18.1) (10.2 23.0) (38.4 55.6) Table 18: During the past two years, did you receive staff development on each of the following teaching methods? Middle Schools 2002 Teaching method Teaching students with physical or cognitive disabilities Teaching students of various cultural backgrounds Teaching students with limited English proficiency Using interactive teaching methods Encouraging family or community involvement Teaching skills for behavior change % 32.0 37.2 24.8 54.9 25.0 39.5 (95% CI) (24.5 39.4) (29.4 45.1) (18.2 31.4) (48.0 61.8) (17.6 32.5) (32.3 46.6) High Schools 2002 % (95% CI) 41.6 (33.3 49.8) 38.4 25.4 58.1 40.8 42.9 (29.1 47.7) (18.0 32.9) (50.2 65.9) (31.7 49.9) (33.3 52.6) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A10 8 APPENDIX: DETAILED DATA TABLES Table 19: Would you like to receive staff development on each of these teaching methods? Middle Schools 2002 Teaching method Teaching students with physical or cognitive disabilities Teaching students of various cultural backgrounds Teaching students with limited English proficiency Using interactive teaching methods Encouraging family or community involvement Teaching skills for behavior change % 60.2 58.4 61.6 55.8 65.7 69.0 (95% CI) (52.4 68.0) (51.3 65.5) (53.7 69.4) (47.7 64.0) (57.5 73.8) (61.4 76.6) High Schools 2002 % (95% CI) 66.0 (57.8 74.2) 66.6 60.7 68.4 63.9 71.9 (58.3 75.0) (51.8 69.5) (59.4 77.4) (55.1 72.8) (64.0 79.8) Table 20: Is physical education required for students in any of grades 6 through 12 in this school? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 61.6 (53.6 69.7) 94.3 (90.1 98.5) Table 21: Can students be exempted from taking required physical education for any of the following reasons? Middle Schools 2002 Reason Enrollment in other courses Participation in school sports Participation in other school activities Participation in community sports activities % 21.4 0.0 15.4 0.0 (95% CI) (12.5 30.2) (0.0 0.0) (8.2 22.5) (0.0 0.0) High Schools 2002 % (95% CI) 1.6 (0.0 3.8) 0.8 (0.0 2.4) 4.9 (1.1 8.6) 0.0 (0.0 0.0) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A11 8 APPENDIX: DETAILED DATA TABLES Table 22: If students fail required physical education, are they required to repeat it? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 19.7 (11.2 28.2) 95.9 (92.3 99.5) Table 23: Are faculty and staff at this school allowed to use physical activity, such as laps or push-ups, to punish students for bad behavior in physical education? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 25.7 (18.5 32.8) 28.4 (20.1 36.7) Table 24: Are faculty and staff at this school allowed to make students miss all or part of physical education as punishment for bad behavior in another class? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 4.9 (1.5 8.3) 0.7 (0.0 2.2) Table 25: Is a newly hired physical education teacher or specialist required to be certified, licensed, or endorsed by the state in physical education? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 96.8 (93.7 100) 99.2 (97.7 100) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A12 8 APPENDIX: DETAILED DATA TABLES Table 26: Does this school offer students opportunities to participate in intramural activities or physical activity clubs? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 62.4 (55.3 69.5) 42.9 (33.5 52.3) Table 27: Does this school provide transportation home for students who participate in after-school intramural activities or physical activity clubs? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 10.9 (5.5 16.2) 4.9 (1.0 8.9) Table 28: Outside of school hours or when school is not in session, do children or adolescents use any of this school's activity or athletic facilities for community-sponsored sports teams or physical activity programs? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 85.5 (79.7 91.4) 79.0 (72.1 85.8) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A13 8 APPENDIX: DETAILED DATA TABLES Table 29: During this school year, did teachers in this school teach each of the following physical activity topics in a required health education course for students in any of grades 6 through 12? Topic The physical, psychological, or social benefits of physical activity Health-related fitness Phases of a workout How much physical activity is enough Developing an individualized physical activity plan Monitoring progress toward reaching goals in an individualized physical activity plan Overcoming barriers to physical activity Decreasing sedentary activities such as television watching Opportunities for physical activity in the community Preventing injury during physical activity Weather-related safety Dangers of using performance-enhancing drugs, such as steroids Middle Schools 2002 % (95% CI) 88.2 82.7 79.8 77.7 (82.3 94.1) (75.7 89.6) (72.8 86.8) (71.3 84.1) 62.9 (54.2 71.5) 60.6 66.2 (51.9 69.3) (57.9 74.5) 80.8 (73.6 88.1) 77.0 76.8 82.4 (69.5 84.4) (69.6 83.9) (75.6 89.3) 86.8 (80.5 93.2) High Schools 2002 % (95% CI) 91.8 87.8 86.1 85.0 (86.4 97.2) (81.7 93.9) (79.6 92.6) (78.2 91.9) 80.4 (72.4 88.4) 80.5 81.0 (72.5 88.4) (73.1 88.9) 88.1 (82.0 94.1) 79.1 88.2 88.9 (71.2 87.0) (82.2 94.1) (83.0 94.7) 91.6 (86.2 97.1) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A14 8 APPENDIX: DETAILED DATA TABLES Table 30: During this school year, in which of the following grades was information on tobacco use prevention provided? Grades 6 7 8 Middle Schools 2002 % 83.9 88.3 88.0 (95% CI) (78.1 89.7) (83.7 92.9) (83.3 92.7) Grades 9 10 11 12 High Schools 2002 % 94.9 58.1 51.5 50.7 (95% CI) (91.4 98.3) (49.3 66.8) (42.5 60.5) (41.9 59.5) Table 31: Are required tobacco use prevention units or lessons taught in each of the following courses in this school? Topic Science Home economics or family & consumer education Physical education Family life education or life skills Special education Middle Schools 2002 % 34.7 (95% CI) (28.7 40.8) 16.5 41.1 28.9 28.9 (10.0 23.1) (32.3 49.9) (21.7 36.1) (21.4 36.3) High Schools 2002 % 36.6 (95% CI) (29.2 44.1) 37.5 61.7 44.1 44.7 (29.0 46.0) (53.9 69.6) (34.8 53.3) (36.2 53.3) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A15 8 APPENDIX: DETAILED DATA TABLES Table 32: During this school year, did teachers in this school teach each of the following tobacco use prevention topics in a required health education course for students in any of grades 6 through 12? Topic Short- & long-term health consequences of cigarette smoking Benefits of not smoking cigarettes Risks of cigar or pipe smoking Short- & long-term health consequences of using smokeless tobacco Benefits of not using smokeless tobacco Addictive effects of nicotine in tobacco products How many young people use tobacco The number of illnesses & deaths related to tobacco use Influence of families on tobacco use Influence of the media on tobacco use Social or cultural influences on tobacco use How to find valid information or services related to tobacco use cessation Making a personal commitment not to use tobacco How students can influence or support others to prevent tobacco use How students can influence or support others in efforts to quit using tobacco How to say no to tobacco use Health effects of environmental tobacco smoke (ETS) or second-hand smoke Middle Schools 2002 % (95% CI) 96.8 96.8 92.4 (93.6 99.9) (93.6 99.9) (87.4 97.3) 96.8 96.8 (93.6 99.9) (93.6 99.9) 96.8 91.8 (93.6 99.9) (86.7 96.9) 93.4 95.1 94.7 (88.8 98.0) (91.1 99.0) (90.4 98.9) 90.7 (85.2 96.2) 80.7 (74.1 87.4) 79.1 (71.9 86.3) 90.3 (84.9 95.6) 91.6 96.2 (86.8 96.5) (92.8 99.5) 96.8 (93.6 99.9) High Schools 2002 % (95% CI) 93.5 94.4 92.6 (88.7 98.4) (89.9 98.9) (87.5 97.8) 94.4 94.4 (89.9 98.9) (89.9 98.9) 94.4 92.6 (89.9 98.9) (87.5 97.8) 93.5 91.7 94.4 (88.7 98.4) (86.3 97.2) (89.9 98.9) 89.8 (83.8 95.9) 81.6 (74.2 88.9) 73.5 (64.8 82.1) 87.3 (80.6 94.0) 86.3 93.5 (79.4 93.3) (88.7 98.4) 93.5 (88.7 98.4) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A16 8 APPENDIX: DETAILED DATA TABLES Table 33: Does the tobacco prevention policy specifically prohibit use of each type of tobacco for each of the following groups? Type of tobacco Students Cigarettes Smokeless tobacco Cigars Pipes Faculty Cigarettes Smokeless tobacco Cigars Pipes Visitors Cigarettes Smokeless tobacco Cigars Pipes Middle Schools 2002 % 98.8 98.8 98.8 98.8 92.1 92.1 92.8 92.8 88.6 85.1 88.6 88.6 (95% CI) (97.2 100) (97.2 100) (97.2 100) (97.2 100) (87.7 96.5) (87.6 96.5) (88.5 97.0) (88.5 97.0) (83.4 93.9) (79.2 91.0) (83.4 93.9) (83.4 93.9) High Schools 2002 % 99.2 98.4 98.4 99.2 93.9 93.8 93.0 93.0 88.0 88.0 87.2 87.2 (95% CI) (97.6 100) (96.1 100) (96.1 100) (97.5 100) (89.3 98.4) (89.3 98.4) (88.2 97.8) (88.2 97.8) (81.8 94.3) (81.8 94.3) (80.7 93.6) (80.7 93.6) Table 34: Does the tobacco prevention policy specifically prohibit tobacco use during each of the following times for each of the following groups? Time Students During school hours During non-school hours Faculty During school hours During non-school hours Visitors During school hours During non-school hours Middle Schools 2002 % 99.3 86.4 93.8 76.5 91.0 74.6 (95% CI) (97.9 100) (80.8 91.9) (89.8 97.8) (69.5 83.5) (86.3 95.8) (67.3 81.8) High Schools 2002 % 100 84.1 93.0 70.4 86.4 57.2 (95% CI) (100 100) (77.0 91.2) (88.1 97.8) (61.3 79.6) (79.7 93.0) (48.1 66.3) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A17 8 APPENDIX: DETAILED DATA TABLES Table 35: Does the tobacco prevention policy specifically prohibit tobacco use in each of the following locations for each of the following groups? Location Students In school buildings On school grounds In school buses or other vehicles At off-campus, school-sponsored events Faculty In school buildings On school grounds In school buses or other vehicles At off-campus, school-sponsored events Visitors In school buildings On school grounds In school buses or other vehicles At off-campus, school-sponsored events Middle Schools 2002 % 98.8 98.8 98.8 (95% CI) (97.2 100) (97.2 100) (97.2 100) 98.8 92.1 92.1 92.8 (97.2 100) (87.7 96.5) (87.6 96.5) (88.5 97.0) 92.8 88.6 85.1 88.6 (88.5 97.0) (83.4 93.9) (79.2 91.0) (83.4 93.9) 88.6 (83.4 93.9) High Schools 2002 % 99.2 98.4 98.4 (95% CI) (97.6 100) (96.1 100) (96.1 100) 99.2 93.9 93.8 93.0 (97.5 100) (89.3 98.4) (89.3 98.4) (88.2 97.8) 93.0 88.0 88.0 87.2 (88.2 97.8) (81.8 94.3) (81.8 94.3) (80.7 93.6) 87.2 (80.7 93.6) Table 36: Does your school have procedures to inform each of the following groups about the tobacco prevention policy that prohibits their use of tobacco? Group Students Faculty Visitors Middle Schools 2002 % 98.0 96.7 83.9 (95% CI) (95.8 100) (93.8 99.6) (77.5 90.3) High Schools 2002 % 98.3 96.3 75.7 (95% CI) (96.0 100) (92.8 99.9) (68.2 83.1) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A18 8 APPENDIX: DETAILED DATA TABLES Table 37: When students are caught smoking cigarettes, how often are each of the following actions taken? Action Parents or guardians are informed Referred to a school counselor Referred to a school administrator Encouraged, but not required to participate in an assistance, education, or cessation program Required to participate in an assistance, education or cessation program Referred to legal authorities Placed in detention Given in-school suspension Suspended from school Middle Schools 2002 High Schools 2002 Always or almost always % 98.6 21.5 98.8 (95% CI) (96.7 100) (14.7 28.4) (97.1 100) % 90.1 7.5 98.4 (95% CI) (84.9 95.2) (2.6 12.4) (96.2 100) 7.0 3.8 2.8 11.5 55.0 19.0 (2.6 11.3) (0.4 7.1) (0.7 4.9) (6.6 16.5) (47.6 62.4) (13.4 24.6) 4.9 1.6 1.6 13.4 46.9 24.1 (1.0 8.8) (0.0 3.9) (0.0 3.7) (6.9 19.9) (39.6 54.1) (15.9 32.2) Table 38: Does your school provide referrals to tobacco cessation programs for each of the following groups? Group Faculty & staff Students Middle Schools 2002 % 13.2 21.8 (95% CI) (7.3 19.0) (15.7 27.9) High Schools 2002 % 10.2 23.5 (95% CI) (5.1 15.3) (15.9 31.2) Table 39: Is tobacco advertising prohibited in each of the following locations? Location In the school building On school grounds On school buses or other vehicles In school publications Middle Schools 2002 % 92.2 91.4 90.4 91.4 (95% CI) (88.4 96.0) (87.3 95.4) (86.0 94.9) (87.4 95.5) High Schools 2002 % 93.4 92.7 93.4 92.7 (95% CI) (88.9 98.0) (88.0 97.4) (88.9 98.0) (88.0 97.5) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A19 8 APPENDIX: DETAILED DATA TABLES Table 40: Is tobacco advertising through sponsorship of school events prohibited? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 93.3 (89.2 97.3) 89.5 (84.2 94.7) Table 41: Are students at your school prohibited from wearing tobacco brand-name apparel or carrying merchandise with tobacco company names, logos, or cartoon characters on it? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 93.6 (89.4 97.8) 94.0 (90.1 97.8) Table 42: How long do students usually have to eat lunch once they are seated? Amount of time Less than 20 minutes 20 minutes or more This school does not serve lunch to students Middle Schools 2002 % 15.4 83.2 0.0 (95% CI) (9.5 21.3) (77.0 89.4) (0.0 0.0) High Schools 2002 % 15.4 80.5 2.5 (95% CI) (9.1 21.6) (73.6 87.4) (0.8 4.2) Table 43: Does this school or district have a policy stating that fruits or vegetables will be offered at school settings? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 5.6 (1.7 9.5) 10.6 (4.8 16.3) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A20 8 APPENDIX: DETAILED DATA TABLES Table 44: Can students purchase snack foods or beverages from vending machines or at the school store, canteen, or snack bar? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 82.8 (76.9 88.6) 96.0 (93.3 98.7) Table 45: Can students purchase each snack food or beverages from vending machines or at the school store, canteen, or snack bar? Food/Beverage Chocolate candy Other kinds of candy Salty snacks that are not low in fat (potato chips) Salty snacks that are low in fat (pretzels) Fruits & vegetables Low-fat cookies, crackers, cakes, or baked goods Soft drinks, sports drinks, or drinks not 100% juice 100% fruit juice Bottled water Middle Schools 2002 % 56.0 54.2 (95% CI) (47.5 64.5) (45.5 62.9) 63.7 62.4 15.4 (55.3 72.0) (53.7 71.2) (9.0 21.9) 54.0 (45.4 62.6) 94.4 74.6 95.6 (90.1 98.7) (66.8 82.4) (91.8 99.5) High Schools 2002 % 79.1 76.6 (95% CI) (71.5 86.6) (69.2 84.0) 79.7 76.9 22.4 (72.8 86.6) (69.1 84.7) (15.5 29.4) 63.9 (54.3 73.6) 94.0 74.3 95.9 (89.6 98.4) (66.2 82.4) (93.1 98.7) Table 46: Can students purchase snack foods or beverages during the following times? Time Before classes begin in the morning During any school hours when meals are not being served During school lunch periods Middle Schools 2002 % 22.0 (95% CI) (14.4 29.5) 26.7 46.5 (19.3 34.0) (37.8 55.3) High Schools 2002 % 71.9 (95% CI) (63.9 80.0) 56.0 52.4 (47.7 64.2) (43.3 61.4) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A21 8 APPENDIX: DETAILED DATA TABLES Table 47: During this school year, did teachers in this school teach each of the following nutrition and dietary topics in a required health education course for students in any of grades 6 through 12? Topic The benefits of healthy eating The Food Guide Pyramid The Dietary Guidelines for Americans Using food labels Aiming for a healthy weight Choosing a variety of grains daily, especially whole grains Choosing a variety of fruits & vegetables daily Choosing a diet low in saturated fat & cholesterol & moderate in total fat Moderating intake of sugars Choosing & preparing foods with less salt Eating more calcium-rich foods Keeping food safe to eat Preparing healthy meals & snacks Risks of unhealthy weight control practices Accepting body size differences Eating disorders Middle Schools 2002 % 91.0 86.2 81.1 83.8 88.8 (95% CI) (85.7 96.3) (80.3 92.1) (74.5 87.8) (77.3 90.4) (82.9 94.7) 80.2 (73.2 87.1) 83.3 (76.5 90.1) 86.4 84.0 77.5 81.5 74.0 81.1 86.1 83.0 86.0 (80.2 92.5) (77.4 90.6) (70.1 84.9) (74.5 88.4) (65.8 82.2) (74.6 87.6) (80.2 92.0) (76.9 89.1) (80.4 91.7) High Schools 2002 % 94.3 90.8 90.8 88.6 94.3 (95% CI) (89.8 98.9) (85.1 96.5) (85.1 96.5) (82.2 95.1) (89.8 98.9) 89.3 (83.0 95.6) 91.7 (86.2 97.2) 92.6 91.7 91.7 89.1 82.3 88.0 93.5 91.7 93.4 (87.4 97.8) (86.2 97.2) (86.3 97.1) (83.4 94.9) (74.5 90.2) (81.5 94.5) (88.6 98.3) (86.2 97.2) (88.6 98.3) Table 48: Does your school have a written plan for responding to violence at the school? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 99.4 (98.1 100) 96.3 (92.8 99.9) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A22 8 APPENDIX: DETAILED DATA TABLES Table 49: Does your school implement each of the following safety and security measures? Measure Require visitors to report to the main office or reception area upon arrival Maintain a "closed campus" where students are not allowed to leave school during the school day, including during lunchtime Use staff or adult volunteers to monitor school halls during & between classes Routinely conduct bag, desk, or locker checks Prohibit students from carrying backpacks or book bags at school Require students to wear school uniforms Require students to wear identification badges Use metal detectors Have uniformed police, undercover police, or security guards during the regular school day Middle Schools 2002 % (95% CI) 99.4 (98.1 100) 98.1 93.7 58.0 30.8 6.7 15.7 19.9 65.5 (95.9 100) (89.6 97.9) (50.3 65.7) (22.9 38.7) (3.2 10.1) (9.5 21.9) (13.7 26.1) (57.2 73.7) High Schools 2002 % (95% CI) 99.1 (97.5 100) 90.9 94.3 74.6 28.2 1.7 22.9 35.9 77.9 (86.0 95.7) (90.1 98.5) (67.3 81.9) (20.8 35.6) (0.0 3.9) (15.4 30.4) (28.3 43.5) (70.8 84.9) Table 50: Does your school have or participate in each of the following programs? Program A peer mediation program A safe-passage to school program A program to prevent gang violence A program to prevent bullying Middle Schools 2002 %% 62.8 7.3 42.1 65.8 (95% CI) (55.6 70.0) (3.4 11.2) (33.6 50.7) (58.3 73.3) High Schools 2002 % 53.0 6.5 33.9 49.0 (95% CI) (43.5 62.5) (2.0 11.1) (24.9 42.8) (38.8 59.2) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A23 8 APPENDIX: DETAILED DATA TABLES Table 51: Does your school implement each of the following school-based asthma management activities? Activity Provide a full-time registered nurse, all day every day Identify & track all students with asthma Obtain & use an Asthma Action Plan for all students with asthma Assure immediate access to medication as prescribed by a physician Provide intensive case management for students with asthma who are absent 10 days or more per year Educate school staff about asthma Educate students with asthma about asthma management Teach asthma awareness to all students in at least one grade Encourage full participation in physical education & physical activity when students with asthma are doing well Provide modified physical education & physical activities as indicated by the student's Asthma Action Plan Middle Schools 2002 % (95% CI) 42.7 70.3 (35.2 50.1) (63.3 77.2) 38.9 (31.2 46.7) 83.7 (77.7 89.7) 35.6 44.6 39.9 17.8 (28.3 42.9) (37.0 52.1) (31.6 48.1) (11.9 23.6) 93.6 (89.6 97.6) 82.5 (77.2 87.8) High Schools 2002 % (95% CI) 39.9 51.1 (31.1 48.7) (41.8 60.3) 39.7 (31.1 48.2) 85.5 (78.8 92.2) 34.2 43.6 29.9 27.4 (26.3 42.0) (36.2 50.9) (22.6 37.1) (19.6 35.2) 88.4 (82.4 94.4) 75.7 (67.9 83.4) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A24 8 APPENDIX: DETAILED DATA TABLES Table 52: During this school year, did teachers in this school teach each of the following HIV prevention topics in a required health education course for students in any of grades 6 through 12? Topic Abstinence as the most effective method to avoid HIV infection How HIV is transmitted How HIV affects the human body Condom efficacy Influence of alcohol & other drugs on HIV-related risk behaviors Social or cultural influences on HIV-related risk behaviors Number of young people who get HIV How to find valid information or services related to HIV or HIV testing Compassion for persons living with HIV or AIDS Middle Schools 2002 % (95% CI) 90.1 89.3 89.0 63.8 (84.6 95.6) (83.7 94.9) (83.2 94.8) (55.2 72.4) 86.5 (80.2 92.8) 80.7 84.3 (73.4 88.0) (77.5 91.2) 68.7 (59.9 77.4) 73.5 (64.9 82.1) High Schools 2002 % (95% CI) 95.1 94.2 94.2 78.1 (90.8 99.4) (89.6 98.9) (89.6 98.9) (69.7 86.4) 95.1 (90.8 99.4) 92.2 91.6 (86.7 97.6) (86.1 97.1) 86.9 (80.1 93.8) 89.6 (83.4 95.8) Table 53: Are required HIV prevention units or lessons taught in each of the following courses in this school? Course Science Home Ec or family & consumer education Physical education Family life education or life skills Special education Middle Schools 2002 % 36.7 10.3 28.7 18.7 19.1 (95% CI) (28.6 44.8) (5.4 15.2) (20.8 36.5) (12.8 24.6) (12.4 25.8) High Schools 2002 % 49.4 41.9 50.8 48.3 36.3 (95% CI) (41.6 57.2) (33.3 50.6) (41.8 59.9) (39.1 57.4) (28.4 44.2) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A25 8 APPENDIX: DETAILED DATA TABLES Table 54: Has this school adopted a written policy that protects the rights of students and/or staff with HIV infection or AIDS? Middle Schools 2002 High Schools 2002 % (95% CI) % (95% CI) Yes 64.0 (56.8 71.3) 67.6 (58.8 76.4) Table 55: Does that policy address each of the following issues for students and/or staff with HIV infection or AIDS? Middle Schools 2002 Issue Attendance of students with HIV infection Procedures to protect HIV-infected students Maintaining confidentiality of HIV-infected students & staff Worksite safety Confidential counseling for HIV-infected students Communication of the policy to students, school staff, & parents Adequate training about HIV infection for school staff Procedures for implementing the policy % 87.0 89.8 94.2 94.2 84.9 84.6 80.0 83.2 (95% CI) (79.5 94.5) (83.9 95.8) (89.1 99.3) (89.1 99.3) (77.8 92.0) (76.6 92.5) (71.0 89.0) (75.3 91.0) High Schools 2002 % (95% CI) Middle Schools 1998 % (95% CI) 86.7 (79.6 93.8) 84.9 (79.0 90.7) 91.4 (84.9 97.8) 86.9 (81.4 92.3) 96.3 95.1 82.0 (92.1 100) (90.3 99.9) (74.6 89.5) 89.0 89.6 62.8 (83.9 94.0) (84.4 94.8) (55.0 70.5) 90.3 (83.5 97.0) 73.2 (66.7 79.6) 79.7 84.4 (70.9 88.5) (76.1 92.6) 80.0 82.6 (73.4 86.7) (75.8 89.4) High Schools 1998 % (95% CI) 86.8 (79.8 93.8) 91.0 (85.3 96.7) 91.8 84.9 69.2 (86.1 97.4) (78.0 91.7) (60.8 77.6) 79.6 (71.7 87.6) 82.9 85.6 (76.3 89.4) (79.2 92.0) School Health Education in Georgia: Results from the 2002 School Health Education Profile (SHEP) Survey A26