Georgia school health profiles report

2006 Georgia School Health Profiles Report
1 2006 School Health Profiles Report

Acknowledgements
Georgia Department of Human Resources B.J. Walker, Commissioner
Division of Public Health Stuart T. Brown, M.D., Director
Epidemiology Branch Susan Lance, D.V.M., Ph.D., Director
Chronic Disease, Injury, and Environmental Epidemiology Section John M. Horan, M.D., M.P.H., Chief Georgia Department of Education Kathy Cox, State Superintendent of Schools Learning Support Division Phil Hulst, Director
Georgia Health Policy Center, Andrew Young School of Policy Studies, Georgia State University
Bernette Sherman, MPA, Research Associate II Mary Ann Phillips, MPH, Senior Research Associate
Graphic Design: Jimmy Clanton, Jr. The 2006 Georgia School Health Profiles is funded in part by a grant from Healthcare Georgia Foundation. Created in 1999 as an independent, private foundation, the Foundation's mission is to advance the health of all Georgians and to increase access to affordable, quality healthcare for underserved individuals and communities. Suggested Citation: Falb M, Figueroa A, Kanny D. 2006 Georgia School Health Profiles Report. Georgia Department of Human Resources, Division of Public Health, Chronic Disease, Injury, and Environmental Epidemiology Section, March 2007. Publication Number: DPH07/027.HW.
2 2006 School Health Profiles Report

Table of Contents
Introduction................................................................................................................................................. 4 Health Education ........................................................................................................................................ 5
Required Health Education................................................................................................................ 5 Standards, Curricula, Guidelines and Framework............................................................................. 5 Content .............................................................................................................................................. 6 Teaching Methods ............................................................................................................................. 6 Coordination ...................................................................................................................................... 6 Professional Training and Staff Development ................................................................................... 7 Physical Education ..................................................................................................................................... 8 Physical Activity .......................................................................................................................................... 9 Tobacco Use............................................................................................................................................... 10 Nutrition ...................................................................................................................................................... 12 Violence...................................................................................................................................................... 14 Health Services ......................................................................................................................................... 15 Coordinated School Health......................................................................................................................... 17 Worksite Health Promotion......................................................................................................................... 17 Survey Methods.......................................................................................................................................... 18 References ................................................................................................................................................. 19 Appendix A Healthy People 2010 Tables................................................................................................. 20 Appendix B Data Tables ......................................................................................................................... 21
3 2006 School Health Profiles Report

Introduction

Over 1.5 million children in Georgia attend school, half of them in secondary education (middle and high schools) (1). They spend about 6 hours of class time per day, approximately 180 days per year (2). Schools present a unique opportunity to help improve the health status of students in Georgia. School policies and programs, including classroom training, can help school-aged adolescents establish behaviors that promote and maintain lifelong health and prevent health-risk behaviors among youth. School health education, policies, and programs 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 increase risk for human immunodeficiency virus (HIV) infection, other sexually transmitted diseases (STDs) and unintended pregnancies (3).
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 risk behaviors (i.e., tobacco use; alcohol and other drug use; imprudent dietary patterns; inadequate physical activity; sexual behaviors that result in unintended pregnancy, HIV infection, or infection by other STDs; 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. Involvement of parents, health professionals, and other
concerned community members; 8. Periodic evaluation, updating, and improvement of the
health education program.
In 1995, the CDC, in collaboration with state and large local education agencies, developed the School Health Profiles (Profiles) (4). The Profiles was designed as a schoolbased survey of principals and lead health educators in middle and high schools. The purpose of the Profiles was two-fold. One purpose was to measure the current status of comprehensive health education, policies related to school health and safety, and levels of coordination in middle and high schools. The other purpose was to monitor characteristics of health education practices and some school health policies in middle and high schools over time. The Profiles has evolved to provide a more comprehensive assessment of school health policies and programs.
This report summarizes results from the 2006 Georgia Profiles. The report is organized by topics (Health Education, Physical Education, Physical Activity, Tobacco Use, Nutrition, Violence, Health Services, Coordinated School Health, and Worksite Health Promotion). Each topic describes key findings from the principal and health education teacher perspectives. A table summarizing relevant Healthy People 2010 Goals (5) and Georgia's status are presented in Appendix A, and detailed data tables are presented in Appendix B.

4 2006 School Health Profiles Report

Health Education
Introduction
The Institute of Medicine (IOM) recommends schools to require at least one semester of health education at the secondary school level (6). Education Rule 160-4-2-.12 of the Georgia State Board of Education states that schools shall make available instruction in alcohol and drug abuse in grades K-12 and health and physical education in grades 6-12. Education Rule 160-4-2-.47 requires high school students to complete one unit of health and physical education (out of 22 units) in order to graduate (7).
The Georgia Department of Education's standards for health education aim to increase students' knowledge and skills in disease prevention, family living, growth and development, mental health, nutrition, personal health, and safety (8).
Educational programs play a key role in improving health outcomes and quality of life. Objective 7-2 of Healthy People 2010 (5) aims to increase the quality, availability and effectiveness of educational and community-based programs designed to prevent disease and improve health and quality of life.
Key Findings
Required Health Education Most middle (83%) and all high schools in Georgia required health education to be taught in any of grades 6-12 (Table 1). 38% of middle schools required their students to take 3 health education courses, while 86% of high schools required their students to take only one health education course (Table 2). Three-fourths of middle schools required health education in 6th, 7th, and 8th grades (Figure 1, Table 3) Most high schools (92%) required a health education course in 9th grade; however only about one-fourth of high schools required a health education course in 10th, 11th, and 12th grades (Figure 1, Table 3). 14% of middle schools and 98% of high schools required students who fail a required health education course to repeat it (Table 4).

Standards, Curricula, Guidelines and Framework Materials Used in Required Health Education Courses
Almost all middle (94%) and high (99%) schools required teachers to use state-, district- or school-developed curriculum (Figure 2, Table 5).

Figure 2. Percentage of schools that required teachers to use specific curriculum materials in a
health education course, by school type, Georgia, 2006

100 80

94 73 69

99 79 72

60

50

45

40

Percent

20

0 Middle school

High school

State-, district-, or school-developed curriculum Commercially-developed student textbook Commercially-developed teachers guide Commercially-developed curriculum

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Health Education

Content Alcohol or other drug use prevention, tobacco use prevention, physical activity and fitness, and nutrition and dietary behavior were the most common topics taught in health education courses in middle schools (93%) and in high schools (99%), while suicide prevention and asthma awareness were less common (Figure 3, Table 6). Health education teachers in most middle schools (85%) and high schools (85%) taught students skills related to accessing valid health information, media influence on health and wellness, communication, decision-making, goal setting, conflict resolution, and resisting peer pressure in health education courses (Table 7).
Teaching methods The most common teaching methods used in health education courses at middle schools and high schools were group discussions (94% and 98%), audiovisual media (91% and 99%), and cooperative group activities (89% and 90%) (Figure 4, Table 8). The least common teaching methods in health education courses at middle schools and high schools were making pledges for behavior change (49% and 42%) (Table 8). Modifying teaching methods to match students' learning styles, health beliefs, or cultural values was the most common method for highlighting diversity in health education courses in middle schools (92%) and high schools (85%) (Table 9). Completing projects with family members, identifying advertising in the community designed to influence health behaviors, and identifying potential injury sites were the most common community-related activities students were asked to participate in as part of health education courses at middle schools (64%-82%) and high schools (70%-84%) (Table 10).

Figure 3. Percentage of schools in which the lead health education teacher tried to increase student knowledge on
selected health topics, by school type, Georgia, 2006

Percent

100 80 60 40 20 0

93 73 65

83

84

61

Middle school

High school

Violence prevention Asthma awareness Suicide prevention

Figure 4. Percentage of schools in which the lead health education teacher used specific teaching methods
in a required health education course, by school type, Georgia, 2006

100 80

94 91 89 72 70

98 99 90 77 79

Percent

60

40

20

0 Middle school

High school

Group discussions Cooperative group activities The Internet

Audio-visual media Role play or simulations

Coordination 49% of middle schools and 46% of high schools had a health education teacher serving as the school's health education coordinator (Table 11). 62% of middle schools and 92% of high schools required health education as a combined course with physical education (Table 13). 17% of middle schools and 10% of high schools required health education as a combined course with another subject, such as science, social studies, or English (Table 13). Lead health education teachers collaborated with physical education staff on health education activities in about nine in ten middle schools and high schools, while they collaborated with nutrition or food service staff on health education activities in approximately three in ten middle schools and high schools (Figure 5, Table 14).
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Health Education

Professional training and staff development Most (97%) middle schools and high schools had lead health education teachers licensed or certified to teach health education (Table 16). 37% of middle schools and 60% of high schools had lead health education teachers with at least 15 years of experience teaching health education (Figure 6, Table 16). Most middle schools (82%) and high schools (85%) had lead health education teachers with a professional preparation in health education or a combined health and physical education (Table 17).

Percent

Figure 6. Percentage of schools in which the lead health education teacher had taught health education for a specific number of years, by school type, Georgia, 2006

100 80 60 40 20 0

37 20 25
13 5

60
11 16 11 2

Middle school

15 years or more 2 to 5 years

10 to 14 years 1 year

High school 6 to 9 years

Lead health education teachers at middle schools and high schools were more likely to have received staff development during the previous two years on physical activity and fitness, violence prevention, and alcohol or other drug use prevention and less likely to have received staff development in the previous two years on suicide prevention, nutrition and dietary behaviors, and asthma awareness (Figure 7, Table 18).

Percent

Figure 7. Percentage of schools in which the lead health education teacher received staff development on selected health topics, by school type, Georgia, 2006

100

80

60

39

40

31 30

24

20

28

31 27

17

0 Middle school

High school

Tobacco use prevention Asthma awareness Nutrition and dietary behavior Suicide prevention

Lead health education teachers at middle schools and high schools were more likely to indicate wanting to receive staff development on violence prevention, and alcohol or other drug use prevention (Figure 8), and were less likely to indicate wanting to receive staff development on asthma awareness (Table 19).

Figure 8. Percentage of schools in which the lead health education teacher would like to receive staff development
on selected health topics, by school type, Georgia, 2006

100

82 81

80

74 73

60

83 78

78

69

Percent

40

20

0 Middle school

High school

Violence prevention Alcohol or other drug use prevention Physical activity and fitness Suicide prevention

7 2006 School Health Profiles Report

Physical Education
Introduction
Physical activity is an integral component in the development and maintenance of good health. Schools are an opportune setting for promoting physical activity through instruction and programs because they reach most children and adolescents. School physical education can play an important role in helping students acquire knowledge and develop skills necessary for physically active lifestyles throughout their lifetime (3).
Education Rule 160-4-2-.12 of the Georgia State Board of Education states that each school with grades 6-12 shall make available instruction in health and physical education (7).
The Georgia Department of Education's standards for quality physical education curriculum aim to increase students' knowledge, skills, and participation in physical fitness, movement competencies, and a variety of activities (8).
In 2005, 65% of middle school students and 42% of high school students in Georgia attended a physical education course on one or more days during the week. However, only 35% of middle school students and 36% of high school students attended a daily physical education course (9).
Key Findings
Policies 76% of middle schools and 99% of high schools required students to take at least one course in physical education (Table 20). 43% of middle schools required students to attend 2 or 3 courses of physical education, while 75% of high schools required only one course of physical education (Table 21). The percentage of middle schools requiring physical education was consistent by grade (71%), while the percentage of high schools requiring physical education significantly decreased between grade 9 (96%) and grades 10 (35%), 11 (31%), and 12 (30%) (Figure 9, Table 22).
Half of middle schools required daily physical education in grades 6, 7, or 8 (48%-51%), while the percentage of high schools requiring daily physical education significantly decreased between grade 9 (83%) and grades 10 (23%), 11 (21%), and 12 (20%) (Figure 10, Table 23). Few middle schools (7%-8%) and high schools (2%8%) required 2 semesters of daily physical education for any grades 6-12 (Figure 10, Table 24).
Long-term physical or mental disabilities, religious reasons, participation in other school activities, cognitive disabilities, and enrollment in other courses were the most common exemptions from physical activity requirements in middle schools and high schools (Figure 11, Table 25). 96% of high schools required students to repeat physical education if they failed the course, while only 16% of middle schools required students to repeat physical education if they failed the course (Table 26).
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Physical Activity

Introduction
In addition to physical education, schools can encourage students to adopt and maintain active lifestyles through policies and programs providing opportunities for students to be physically active at school (3). Policies can include offering intramural activities or physical activity clubs, providing transportation home from after-school activities, and allowing use of the school's athletic facilities outside of school hours. Examples of programs can include supporting/encouraging walking or biking to and from school through promotional activities, designating safe routes or preferred routes, or having storage facilities for bicycles and helmets.
Regular physical activity prevents excess weight gain and reduces the risk for cardiovascular disease, high blood pressure, stroke, colon cancer, and type 2 diabetes (10). The physical activity recommendations for children and adolescents are 60 minutes or more of age- and developmentally appropriate physical activity from a variety of physical activities on all or most days of the week (11). In 2005, only 34% of high school students in Georgia met the physical activity recommendations (9).
Key Findings
Policies 66% of middle schools and 54% of high schools offered intramural activities or physical activity clubs (Table 27). 17% of middle schools and 12% of high schools provided transportation home for students who participated in after-school intramural activities or physical activity clubs (Table 28). 86% of middle schools and 78% of high schools allowed use of physical activity or athletic facilities for communitysponsored sports teams, classes, or lessons (Table 29). 8% of middle schools and 3% of high schools had a policy to prevent students from walking or biking to and from school (Figure 12, Table 30).
Programs 36% of middle schools and 16% of high schools supported or promoted walking or biking to and from school (Figure 13, Table 31). Traffic, no sidewalks or poorly maintained sidewalks, and lack of adult supervision were the most frequently reported barriers for students to walk or bike to and from school by middle school and high school principals (Figure 14, Table 32).

Education Most middle schools (74%) and high schools (85%) taught students about fitness, psychosocial benefits, selfefficacy, injury prevention, and performance enhancing drug use topics related to physical activity in health education courses (Table 33).

Percent

Figure 14. Barriers to students walking or biking to school by type of barrier and school type, Georgia, 2006

100

80
65 64
60
40

46 45

44 36

20

14 13

0

Traffic

No sidewalks or Lack of adult Neighborhood

poorly

supervision

safety

maintained

sidewalks

Middle Schools High Schools

9 2006 School Health Profiles Report

Tobacco use
Introduction
The Guidelines for School Health Programs to Prevent Tobacco Use and Addiction, developed by the Centers for Disease Control and Prevention (CDC), were created to help school personnel plan, implement and assess educational programs and school policies to prevent tobacco use, encourage cessation of tobacco use, and reduce exposure to secondhand smoke (12).
The Georgia Department of Education's standards for policies and laws related to the use of tobacco products, alcohol and other drugs examine school rules, system policies, and local, state, and federal laws regulating purchase, sale, use, and possession of alcohol, tobacco products, and other drugs (8).
Tobacco use remains a leading preventable cause of illness and death in this country. In Georgia, tobacco kills over 10,000 residents each year and costs $1.8 billion in health care expenditures (13). About 25,000 (7%) middle school students and 73,000 (17%) high school students in Georgia are smokers (9). Approximately 11,000 (3%) middle school students and 34,000 (8%) high school students smoked cigarettes on school property (14). By adopting policies and procedures to create safe and drug-free learning environments, schools play a key role in creating healthier communities and improving health and learning. Healthy People 2010 (5) identifies several objectives to help reduce illness, disability and death related to tobacco use and exposure to secondhand smoke.
Key Findings
Policies Almost all middle schools (99%) and high schools (99%) had a policy prohibiting tobacco use (Table 34). Most (95%) of middle schools and high schools had a policy prohibiting students, faculty, and staff from smoking cigarettes, cigars, or pipes or using smokeless tobacco during school hours and in school buildings, grounds, and property (Table 35). Middle schools (Figure 15a) and high schools (Figure 15b) were more likely to have a policy prohibiting tobacco use by students, faculty, staff, and visitors during school hours than non-school hours (Table 36). Middle schools (72%) and high schools (67%) were less likely to have a policy prohibiting visitors from using tobacco at off-campus events than to have a policy prohibiting students and staff and faculty from using tobacco in school buildings, outside of school grounds, on school buses, and at off-campus events (>91%) (Table 37). Most middle schools (80%) and high schools (87%) had procedures to inform students, parents, school faculty and staff, and visitors about the policy prohibiting tobacco use at school (Table 38). Most middle schools and high schools had procedures to inform students (98%) and school faculty and staff (88% and 93%) what happens if they do not comply with the school's policy on tobacco; however, only two-thirds of middle schools and high schools have procedures to inform visitors about non-compliance (Table 39).
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Tobacco use

Policies, cont. The majority of middle schools (99%) and high schools (97%) always referred students who were caught smoking cigarettes to the school administrator (Figure 16, Table 40). Most middle schools (97%) and high schools (94%) always notified parents when students were caught smoking cigarettes (Figure 16, Table 40). Nearly a half of middle schools (48%) and high schools (46%) always gave in-school suspension to students who were caught smoking cigarettes (Figure 16, Table 40). Few middle schools and high schools always encouraged (<13%) or required (<5%) students caught smoking to participate in a cessation program (Table 40). One-fourth of middle schools and one-fifth of high schools provided referrals to tobacco cessation programs to faculty and staff (Table 41). One-fifth of middle schools and one-fourth of high schools provided referrals to tobacco cessation programs to students (Table 41). 65% of middle and high schools posted signs indicating that the school is a tobacco-free zone (Table 42).

Figure 16. Percentage of schools that always took action when students were caught smoking cigarettes by most
frequent actions taken and school type, Georgia, 2006

Percent

100

99 97

80

60

40

20

0
Referred to school administrator

97 94
Notify parents or guardians

48 46
Give in-school suspension

Middle Schools High Schools

The Georgia Department of Education's standards for health education on tobacco use aim to analyze, recognize, and assess the effects, consequences and risk factors associated with the use of tobacco products, alcohol, and other drugs (8).
The Guidelines for School Health Programs to Prevent Tobacco Use and Addiction, recommend tobacco use prevention be taught to all students in grades Kindergarten through 12. The guidelines also recommend instruction focusing on the shortand long-term consequences of tobacco use, social influences on use, peer norms regarding use, and refusal skills (12).

Education Almost all middle schools (99%) and all high schools taught tobacco use prevention as a health education curriculum topic (Table 6). Most middle schools (84%) and high schools (81%) taught students about the health consequences of tobacco use, the social and cultural influences on tobacco use, and tobacco use cessation in health education courses (Table 43). Almost all middle schools (99%) and high schools (99%) taught students about the health effects of exposure to environmental tobacco smoke, or secondhand smoke, in health education courses (Table 43).

11 2006 School Health Profiles Report

Nutrition
Introduction According to the Centers for Disease Control and Prevention's Guidelines for School Health Programs to Promote Lifelong Healthy Eating, healthy and appealing foods should be readily available in school meals, a la carte items, snack bars, and vending machines. Schools can increase access to healthy and appealing foods by adopting a coordinated school nutrition policy that promotes healthy eating through classroom lessons and a supportive school environment (15). The Georgia Department of Education's standards for nutrition education aim to help students understand the role of nutrition in disease prevention, identify reliable sources of food and nutrition information, follow the dietary guidelines, and analyze marketing and advertising methods for influencing food choices (8). Energy excess caused by an imbalance between energy intake (nutrition) and energy expenditure (physical activity) increases the risk for chronic conditions such as obesity, type 2 diabetes, cardiovascular disease, and high blood pressure. Diets rich in fruits and vegetables can reduce the risk for cardiovascular disease and prevent excess weight gain (16,17). Despite these health benefits, few high school students (18%) in Georgia ate the recommended five servings of fruit and vegetables per day in 2005 (9).
Key Findings Policies
13% of middle schools and 19% of high schools allowed less than 20 minutes for students to eat lunch once they were seated (Table 44). Only 12% of middle schools and 10% of high schools had a policy to offer fruits and vegetables at school events (Table 45). 81% of middle schools and 96% of high schools allowed students to purchase snack foods or beverages from school vending machines, school stores, canteens, or snack bars (Table 46). Less nutritious snack food and beverages were readily available in middle schools and high schools (Figure 17a, Table 47).
More nutritious snack food and beverages were readily available in middle schools and high schools, except for fruits and vegetables (Figure 17b, Table 48).
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Nutrition
Policies, cont. 10% of middle schools and 26% of high schools restricted snack food and beverage purchases from vending machines, school stores, canteens, or snack bars before and during the school day (Figure 18, Table 49). 47% of middle schools and 59% of high schools restricted snack food and beverage purchases from vending machines, school stores, canteens, or snack bars before or during the school day (Figure 18, Table 49). 43% of middle schools and 15% of high schools did not have restrictions on snack food and beverage purchases from vending machines, school stores, canteens, or snack bars before or during the school day (Figure 18, Table 49). 40% of middle schools and 34% of high schools had nutrition standards for foods sold at school (Table 50).
Middle schools (34%) and high schools (32%) were most likely to have nutrition standards for foods sold in the cafeteria and least likely to have standards for foods sold at athletic events (11%) (Figure 19, Table 51). 10% of middle schools and 11% of high schools had a policy to prohibit foods low in nutritional value being offered at school settings (Table 52).
Education Most middle schools (85%) and high schools (89%) taught students a wide range topics related to healthy eating and nutrition in health education courses (Table 53).
13 2006 School Health Profiles Report

Violence

Introduction
In 2004, unintentional injuries, suicide, and homicide accounted for 53% (68 deaths) of all deaths among children aged 10 to 14 years and 75% (312 deaths) of all deaths among adolescents aged 15 to 19 years in Georgia (18). The No Child Left Behind Act of 2001 authorizes federal funds for school programs to prevent violence in and around schools (19). The CDC's School Health Guidelines to Prevent Unintentional Injury and Violence (20) identifies the following strategies for school health efforts to prevent unintentional injury, violence, and suicide: Establish social and physical environment that promote safety and prevent unintentional injuries, violence, and suicide. Implement health and safety education to help students adopt and maintain safe lifestyle. Establish mechanisms for short- and long-term response to crises, disasters, and injuries. Healthy People 2010 (5) Objective 15-39 calls for the reduction of weapon carrying by adolescents on school property. About 126,000 (35%) Georgia middle school students ever carried a weapon, such as a gun, knife, or club, in their lifetime. About 94,000 (22%) Georgia high school students carried a weapon, such as a gun, knife, or club, one or more times during the past month (9).
The Georgia Department of Education's standards for health education on violence prevention aim to identify threats to personal safety, such as child abuse, sexual and physical abuse, neglect and emotional abuse (in Grades 6 and 7), as well as incest, rape and date rape (from Grade 8 through high school) (8).

Key Findings

Policies All middle schools and high schools required visitors to report to the main office upon arrival to the school (Figure 20, Table 54). Nearly all middle schools and high schools maintained a "closed campus" where students were not allowed to leave school during the school day and had staff or adult volunteers to monitor hallways between and during classes (Figure 20, Table 54). 24% of middle schools and 38% of high schools used metal detectors as a safety measure (Figure 20, Table 54).
Programs Bully prevention programs were the most common safety programs implemented by middle schools (76%), while peer mediation programs were the most common safety programs implemented by high schools (61%) (Figure 21, Table 55). Safe-passage to school programs were the least common safety programs implemented by middle schools (10%) and high schools (9%) (Figure 21, Table 55).

Figure 20. Percentage of schools that implemented safety and security measures by measure and school type, Georgia, 2006

Visitors report

Closed campus

Volunteers monitor halls

Uniformed police

Security cameras

Locker searches

Use metal detectors

38 24

Students wear ID badges

19 9

Students wear uniforms 1 8

67 69
58

86 82
86

100 100 94 99 94 98

0

20

40

60

80

100

Percent

Middle Schools

High Schools

Plans Nearly all middle schools (99%) and high schools (98%) had a written plan to address crisis preparedness, response, and recovery (Table 56).

Education Most middle schools (93%) and high schools (84%) taught violence prevention as a health education curriculum topic (Table 6).

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Health Services
Introduction: General
Health Services at school provide care to students who otherwise may not have access to care. The scope of services can include providing immunization, diagnosing and treating acute illness and injury, managing and monitoring chronic diseases, dispensing medications, and offering preventive and primary dental care (21).
School nurses can assess student health and development, help families determine when medical services are needed, and serve as a professional link with physicians and community resources. A licensed practical nurse or registered nurse is an essential component of a healthy school. Healthy People 2010 (5) Objective 7-4 aims to increase the proportion of the nation's elementary, middle, and high schools with a nurse-to-student ratio of at least 1 to 750. Georgia has a ratio of one school nurse to 1,680 students.
The Georgia A+ Education Reform Act of 2000 (O.C.G.A 20-2-281) mandates the School Health Nurse Program, part of the School Health Services Program. Each local board of education is responsible for establishing the program's policies and procedures. The Georgia Department of Education recognizes the Georgia Association of School Nurses and Children's Healthcare of Atlanta as two resources for the provision of School Health Services (22).
According to the Georgia Association of School Nurses, approximately 13% of school age children in Georgia do not have healthcare insurance coverage, and approximately 30% have chronic health conditions, such as asthma, diabetes, and epilepsy, which affect their ability to learn. About 5 million doses of prescription medication are given annually at schools and about 15 million annual visits are made to the school's office or health room for illness, medication and injury in Georgia. The majority of schools in Georgia have a licensed school nurse on site during at least part of the school day (23).
Key Findings
School Nurse 91% of middle schools and 82% of high schools had a school nurse to provide standard health services (Table 57).
Health Services 78% of middle schools and 67% of high schools provided identification or school-based management of chronic health conditions, such as asthma or diabetes (Figure 22, Table 58). 69% of middle schools and 56% of high schools provided identification or school-based management of acute illnesses (Figure 22, Table 58). 68% of middle schools and 47% of high schools provided an Asthma Action Plan for all students with asthma (Figure 22, Table 58). 41% of middle schools and 32% of high schools provided assistance with enrolling in Medicaid or SCHIP (State Children's Health Insurance Program) (Figure 22, Table 58). 37% of middle schools and 33% of high schools provided immunizations (Figure 22, Table 58).
15 2006 School Health Profiles Report

Health Services
Introduction: Asthma
Asthma is a chronic illness that that has increased in prevalence since 1980 (24). In Georgia, approximately 56,000 (15%) middle school students and approximately 70,000 (16%) high school students have asthma (25). Although asthma cannot be cured, it can be controlled with proper diagnosis and appropriate care and management activities. Schools can help students manage their asthma by adopting policies and procedures to create safe and supportive learning environments for students with asthma. The CDC, in Strategies for addressing Asthma Within a Coordinated School Health Program (26), recommends obtaining a written action plan for all students with asthma and ensuring that students have immediate access to medications, including allowing students to self-carry and self-administer medications.
Key Findings
Illness Self-Management Policy 77% of middle schools and 75% of high schools permitted students to carry and self-administer a prescription quick relief inhaler (Figure 23, Table 59). 31% of middle schools and 41% of high schools permitted students to carry and self-administer an epinephrine auto-injector (e.g., EpiPen) (Figure 23, Table 59). 21% of middle schools and 27% of high schools permitted students to carry and self-administer insulin or other injected medications (Figure 23, Table 59). Few middle schools and high schools permitted students to carry and self-administer any other prescribed medications (3% and 9%) or any overthe-counter medications (2% and 16%) (Figure 23, Table 59).
Education 73% of middle schools and 61% of high schools included asthma awareness as a health education curriculum topic (Table 6). 73% of middle schools and 69% of high schools included immunizations as a health education curriculum topic (Table 6).
16 2006 School Health Profiles Report

Coordinated School Health
Introduction
The Coordinated School Health Program (CSHP) model aims to promote health and wellness through eight interactive components. Components of the CSHP include health education; physical education; nutrition services; health services; counseling, psychological and social services; healthy school environment; health promotion for staff; and family/community involvement. Schools by themselves cannot, and should not be expected to, address the nation's most serious health and social problems. Alternatively, this model identifies schools as a critical setting in which many stakeholders might work together to improve and maintain the well-being of young people (27).
Key Findings 65% of middle schools and 62% of high schools had
implemented at least one component of the Coordinated School Health Program (Table 60).
Worksite Health Promotion
Introduction
Providing health promotion opportunities for school staff can encourage them to pursue a healthy lifestyle that contributes to their improved health status, improved morale, and a greater personal commitment to the school's overall coordinated health program. This personal commitment often transfers into greater commitment to the health of students and creates positive role modeling. Health promotion activities have improved productivity, decreased absenteeism, and reduced health insurance costs (29).
Key Findings Physical activity programs, physical activity and fitness
counseling, and weight management programs were the most common types of worksite health promotion programs offered by middle schools and high schools (Figure 24, Table 61). Nutrition and dietary behavior counseling, tobacco cessation, and breastfeeding support services were the least common types of worksite health promotion programs offered by middle schools and high schools (Figure 24, Table 61). Most middle schools (86%) and high schools (87%) allowed faculty and staff to use the school's athletic facilities and equipment (Table 62).
17 2006 School Health Profiles Report

Survey Methods

Survey Methods
The 2006 Georgia School Health Profiles was conducted by the Georgia Department of Education and the Georgia Department of Human Resources.
Questionnaire Development
The 2006 Profiles consisted of two questionnaires developed by the CDC; one for principals (part I) and one for lead health education teachers. The principals' questionnaire examined health education requirements, physical education and physical activity programs, tobacco use prevention policies, nutrition-related policies and practices, violence prevention and school safety, health services, and HIV infection policies from an administrative perspective. The lead health education teachers' survey examined health education from an instructional viewpoint. The 2006 Profiles instruments consisted of 45 questions related to administration of health education, policies, and programs and 21 questions related to instruction.
In addition to the standard questionnaires, the 2006 Profiles included a second questionnaire for principals (part II) with 18 additional questions on overall health promotion, physical education, physical activity, tobacco, nutrition, and worksite health promotion. Copies of the questionnaires can be obtained at http://www.health.state.ga.us/epi/cdiee/policy. asp#schools.
Sampling and Response Rates
All public middle and high schools in Georgia having at least one of grades 6 through 12 (n=797) were included in the sampling frame. Schools were sorted by estimated enrollment in the target grades within school level before sampling. Systematic equal probability sampling with a random start was used to select a sample of schools for the survey.

Three hundred ninety-two public middle and high schools in Georgia were randomly selected to participate in the survey. Two schools were subsequently deemed ineligible for the principal sample and four schools were deemed ineligible for the lead health education teacher sample. Of the 390 sampled principals, 279 completed questionnaire part I (72% response rate) and 275 completed questionnaires part II (71% response rate). Of the 388 sampled teachers, 271 completed the health education teacher questionnaire (70% response rate).
Data Collection
Data were collected during the spring semester of 2006. The principal's questionnaires (part I and II) and the lead health education teacher's questionnaire were 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, and then returned. Follow-up telephone calls and written reminders were used to encourage school participation.
Weighting
A weight has been assigned to each questionnaire to reflect the likelihood of a principal or a lead health education teacher being selected, to reduce bias by compensating for differing patterns of non-response, and to improve precision by making school sample distributions conform to known population distributions.
Data Analysis
The weighted survey results in this report can be used to make inferences about health education in all Georgia public middle and high schools. Point estimates and 95 percent confidence intervals were calculated in SUDAAN v9.

18 2006 School Health Profiles Report

References

1. Georgia Department of Education. School Year 20052006 Enrollment. Accessed October 11, 2006 from http:// app.doe.k12.ga.us/ows-bin/owa/fte_pack_ethnicsex. display_proc.asp
2. Snyder T, Tan A, Hoffman C. Digest Educational Statistics, 2003, (NCES 2005-025). U.S. Department of Education, National Center for Education Statistics. Washington, DC: U.S. Government Printing Office; 2004.
3. Centers for Disease Control and Prevention. Guidelines for school and community programs to promote lifelong physical activity among young people. MMWR 1997;46(No. RR-6).
4. Grunbaum J, Kann L, Williams B, Kinchen S, Collins J, and Kolbe L. Characteristics of health education among secondary schools School Health Education Profiles, 1996. MMWR 1998; 47 (No. SS-4): 1 31.
5. U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health, 2 vols. Washington, DC: U.S. Government Printing Office; November 2000.
6. Institute of Medicine. Schools and Health: Our Nation's Investment. Washington, DC: National Academy Press, 1997.
7. State Board of Education. State Education Rules. Accessed November 13, 2006 from http://public.doe. k12.ga.us/pea_board.aspx?PageReq=PEABoardRules
8. Georgia Department of Education. Quality Core Curriculum Standards. Accessed October 4, 2006 from http://www.glc.k12.ga.us/qcc/
9. Kanny D. 2005 Georgia Student Health Survey Report. Georgia Department of Human Resources, Division of Public Health, May 2006. Publication Number: DPH06/076HW. http://health.state.ga.us/epi/cdiee/ studenthealth.asp
10. U.S. Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996.
11. Strong WB, Malina RM, Blimkie CJ, Daniels SR, et al. Evidence based physical activity for school-age youth. J Pediatr 2005;146(6):732-7.
12. Centers for Disease Control and Prevention. Guidelines for school health programs to prevent tobacco use and addiction. MMWR 1994; 43(No. RR-2).

13. 2006 Georgia Data Summary: Tobacco Use. Available at http://health.state.ga.us/epi/cdiee/tobaccouse.asp
14. Kanny D and Figueroa A. 2005 Georgia Youth Tobacco Survey Report. Georgia Department of Human Resources, Division of Public Health, September 2006. Publication Number: DPH06/143HW. http://health.state. ga.us/epi/cdiee/tobaccouse.asp
15. Center for Disease Control and Prevention. Guidelines for school health programs to promote lifelong healthy eating. MMWR 1996; 45(No. RR-9).
16. Hyson D. The health benefits of fruits and vegetables. A scientific overview for health professionals. Wilmington, DE: Produce for Better Health Foundation, 2002.
17. Rolls BJ, Ello-Martin JA, Carlton Tohill B. What can intervention studies tell us about the relationship between fruit and vegetable consumption and weight management. Nutrition Reviews 2004;62(1):1-17.
18. Georgia Vital statistics, 2004. http://oasis.state.ga.us/ 19. No Child Left Behind Act of 2001, Pub. L. No. 107-110,
1061, 115 Stat. 2083 (2002). 20. CDC. School Health Guidelines to Prevent Unintentional
Injury and Violence. MMWR 2001;50(RR-22):1-73. 21. National Assembly on School-Based Health Care.
Principles and Goals for School-Based Health Care. Available at http://www.nasbhc.org/app/ nasbhc%20final%20goals.pdf. 22. Georgia Department of Education, Office of Teacher and Student Support, accessed November 9, 2006 at http://public.doe.k12.ga.us/tss_learning.aspx?PageRe q=TSSLearningHealth 23. Georgia Association of School Nurses, accessed November 9, 2006 at www.gasn.org 24. Centers for Disease Control and Prevention. Surveillance for asthma United States, 1980-1999. MMWR 2002; 51(SS-1):1-13. 25. 2006 Georgia Data Summary: Asthma. Available at http://health.state.ga.us/epi/cdiee/asthma.asp 26. Centers for Disease Control and Prevention. Strategies for Addressing Asthma within a Coordinated School Health Program, with updated resources. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2005. http://www.cdc.gov/healthyyouth/ asthma/pdf/strategies.pdf 27. Centers for Disease Control and Prevention. A Coordinated School Health Program, Atlanta, GA: Centers for Disease Control and Prevention, Division of Adolescent and School Health, 1998.

19 2006 School Health Profiles Report

Appendix A -- Healthy People 2010 Tables

National Health Objectives and Leading Health Indicators from Healthy People 2010 measured by the Georgia School Health Profiles Survey, 2006

Objective No.
7-2a
7-2b 7-2c 7-2d 7-2e 7-2f 7-2g 7-2h 7-2i 7-2j 22-8a 22-8b 22-12 27-11

Objective
Increase the proportion of middle, junior high, and senior high schools that provide school health education to prevent health problems in unintentional injury; violence; suicide; tobacco use and addiction; alcohol and other drug use; unintended pregnancy, HIV/AIDS, and STD infection; unhealthy dietary patterns; inadequate physical activity; and environmental health.
Increase the proportion of middle, junior high, and senior high schools that provide school health education to prevent unintentional injuries.
Increase the proportion of middle, junior high, and senior high schools that provide school health education to prevent violence.
Increase the proportion of middle, junior high, and senior high schools that provide school health education to prevent suicide.
Increase the proportion of middle, junior high, and senior high schools that provide school health education to prevent tobacco use and addiction.
Increase the proportion of middle, junior high, and senior high schools that provide school health education to prevent alcohol and other drug use.
Increase the proportion of middle, junior high, and senior high schools that provide school health education to prevent unintended pregnancy, HIV/AIDS, and STD infection.
Increase the proportion of middle, junior high, and senior high schools that provide school health education to prevent unhealthy dietary patterns.
Increase the proportion of middle, junior high, and senior high schools that provide school health education to prevent inadequate physical activity.
Increase the proportion of middle, junior high, and senior high schools that provide school health education on environmental health.
Increase the proportion of the public and private middle schools that require daily physical education for all students.
Increase the proportion of the public and private high schools that require daily physical education for all students.
Increase the proportion of the public and private schools that provide access to their physical activity spaces and facilities for all persons outside of normal school hours.
Increase smoke-free and tobacco-free environments in schools, including all school facilities, property, vehicles, and school events.

Healthy People 2010 Target (%)

Data from 2006 Georgia School
Health Profiles (%)

70

Middle Schools: 88

High Schools: 87

90

Middle Schools: 93

High Schools: 92

80

Middle Schools: 93

High Schools: 84

80

Middle Schools: 65

High Schools: 84

95

Middle Schools: 99

High Schools: 100

95

Middle Schools: 99

High Schools: 100

90

Middle Schools: 92

High Schools: 100

95

Middle Schools: 97

High Schools: 100

90

Middle Schools: 99

High Schools: 99

80

Middle Schools: 70

High Schools: 83

25

7*

5

2*

50

Middle Schools: 85

High Schools: 78

100

Middle Schools: 53 High Schools: 51

* Proportion of schools that require students to take 2 semesters of daily physical education in every grade. Proportion of schools that allow use of physical activity and athletic facilities for community-sponsored sports teams outside of school hours. Proportion of schools that have a policy prohibiting students, faculty/staff, and visitors from using all types of tobacco during school hours and during non-school hours on school property, vehicles, and at school events.

20 2006 School Health Profiles Report

Appendix B -- Data Tables

Table 1. Percentage of schools that required health education in any of grades 6-12, by school type, Georgia, 2006

Middle School

%

95% CI

High School

%

95% CI

Required health education

82.9 (76.2-88.0) 100.0

-

Table 2. Percentage of schools that required health education in any of grades 6-12, by number of courses and school type, Georgia, 2006

Number of courses 0 courses 1 course 2 courses 3 courses 4 or more courses

Middle School

%

95% CI

17.6 (11.7-23.5)

27.0 (20.0-34.0)

9.3 (4.8-13.9)

38.3 (30.3-46.2)

7.8 (3.5-12.1)

High School

%

95% CI

0.0

-

86.3 (80.6-92.0)

9.6 (4.7-14.6)

0.0

-

4.1

(0.5-7.7)

Table 3. Percentage of schools that required a health education course, by grade, Georgia, 2006

Grade 6th 7th 8th 9th

Middle School

%

95% CI

75.0 (68.2-81.7)

75.5 (69.1-81.9)

76.0 (69.9-82.2)

High School

%

95% CI

92.1 (87.6-96.6)

10th 11th 12th

24.9 (17.1-32.7) 25.6 (18.2-33.0) 25.5 (17.3-33.7)

Table 4. Percentage of schools that required students who fail a required health education course to repeat it, by school type, Georgia, 2006

Required students who fail a required health education course to repeat it

Middle School

%

95% CI

13.9 (8.9-18.9)

High School

%

95% CI

97.5 (94.6-100.0)

21 2006 School Health Profiles Report

Table 5. Percentage of schools that required teachers to use specific curriculum materials in a required health education course, by school type, Georgia, 2006

Middle school

High school

Curriculum materials

%

95% CI

%

95% CI

State-, district-, or school-developed curriculum

94.1 (87.9-97.2) 99.2 (94.3-99.9)

Commercially-developed student textbook

72.5 (64.0-79.6) 79.0 (70.7-85.4)

Commercially-developed teachers guide

68.5 (59.5-76.3) 71.7 (63.4-78.7)

Commercially-developed curriculum

49.9 (40.1-59.7) 45.1 (36.4-54.1)

Health education performance assessment materials 47.2 (38.2-56.4) 57.1 (47.2-66.5)

Any materials from health organizations, e.g., AHA, ACS
The National Health Education Standards
Health Education Curriculum Analysis Tool (CDC)

43.8 (35.4-52.5) 50.6
38.5 (30.5-47.2) 50.1 8.6 (4.8-14.9) 14.4

(41.1-60.1)
(40.2-60.0) (8.7-23.1)

Table 6. Percentage of schools in which the lead health education teacher tried to increase student knowledge on a specific health-related topic in a required health education course, by school type, Georgia, 2006

Middle school

High school

Health education topics

%

95% CI

%

95% CI

Alcohol or other drug use prevention

99.1 (93.9-99.9) 100.0

-

Tobacco use prevention

99.1 (93.9-99.9) 100.0

-

Physical activity and fitness

99.1 (93.8-99.9) 99.2 (94.2-99.9)

Nutrition and dietary behavior

97.4 (95.1-98.7) 100.0

-

Growth and development

96.4 (91.4-98.6) 94.3 (88.1-97.4)

Violence prevention

92.5 (86.3-96.1) 83.5 (74.9-89.5)

Injury prevention and safety

93.0 (86.8-96.4) 91.7 (85.6-95.3)

Human immunodeficiency virus (HIV) prevention

93.5 (87.2-96.8) 100.0

-

Emotional and mental health

91.7 (85.2-95.4) 97.2 (91.4-99.1)

Sexually-transmitted disease (STD) prevention

88.9 (81.9-93.4) 99.3 (95.0-99.9)

Consumer health

86.1 (79.0-91.1) 93.5 (87.2-96.8)

Pregnancy prevention

88.2 (81.2-92.8) 99.3 (94.9-99.9)

Human sexuality

83.2 (75.7-88.8 93.4 (86.9-96.8)

Dental and oral health

83.9 (76.7-89.2) 70.8 (61.1-79.0)

First aid

80.4 (73.1-86.1) 88.1 (80.9-92.8)

Sun safety or skin cancer prevention

78.1 (70.2-84.4) 86.7 (79.2-91.8)

Immunizations

72.7 (63.6-80.3) 68.5 (58.2-77.2)

Asthma awareness

73.0 (65.5-79.4) 61.3 (51.6-70.2)

Environmental health

69.7 (61.5-76.8) 83.0 (75.1-88.8)

Foodborne illness prevention

66.7 (59.1-73.5) 75.4 (65.9-83.0)

Cardiopulmonary resucitation (CPR)

65.3 (56.4-73.3) 84.7 (76.5-90.4)

Suicide prevention

65.3 (56.0-73.6) 83.5 (75.9-89.1)

22 2006 School Health Profiles Report

Table 7. Percentage of schools in which the lead health education teacher tried to improve specific student skills in a required health education course, by school type, Georgia, 2006

Middle school

High school

Student skills

%

95% CI

%

95% CI

Resisting peer pressure

98.4 (93.5-99.6) 100.0

-

Goal setting

97.6 (92.6-99.3) 98.3 (93.3-99.6)

Conflict resolution

92.2 (85.7-95.9) 89.1 (82.4-93.5)

Media influence on health and wellness

90.2 (84.7-93.9) 92.8 (86.0-96.5)

Accessing valid health information or services related 89.1 (82.8-93.3) 96.7 to health and wellness

(91.3-98.8)

Decision making

85.2 (77.9-90.4) 96.0 (90.5-98.4)

Communication

84.7 (77.0-90.1) 94.0 (88.9-96.8)

Table 8. Percentage of schools in which the lead health education teacher used specific teaching methods in a required health education course, by school type, Georgia, 2006

Middle school

High school

Teaching methods

%

95% CI

%

95% CI

Group discussions

94.4 (88.6-97.4) 98.2 (92.8-99.6)

Audio-visual media

91.1 (85.0-94.9) 99.1 (93.8-99.9)

Cooperative group activities

89.1 (82.6-93.3) 90.1 (83.2-94.4)

Role play, simulations, or practice

72.4 (64.2-79.4) 76.8 (69.7-82.7)

The Internet

70.4 (61.6-77.9) 79.5 (72.0-85.4)

Peer teaching

61.1 (52.5-69.0) 63.2 (53.8-71.8)

Language, performing, or visual arts

56.1 (47.6-64.4) 53.6 (44.9-62.2)

Guest speakers

55.9 (47.9-63.7) 64.5 (54.9-73.1)

Computer-assisted instruction

53.8 (44.9-62.5) 58.5 (49.2-67.3)

Pledges or contracts for behavior change

48.6 (41.3-56.1) 42.3 (33.4-51.7)

Videoconferencing or other distance learning methods

13.5 (8.7-20.4) 13.5 (8.1-21.6)

Table 9. Percentage of schools in which the lead health education teacher used teaching methods to highlight diversity or the values of various cultures in a required health education course, by school type, Georgia, 2006

Middle school

High school

Teaching methods

%

95% CI

%

95% CI

Modifying methods to match students' learning styles, 92.0 (85.5-95.7) 85.4 health beliefs, or cultural values

(77.3-91.0)

Teaching about cultural differences and similarities 82.1 (73.9-88.2) 79.4 (70.2-86.3)

Sharing cultural experiences related to health topics 66.3 (57.8-73.9) 76.1 (66.7-83.5)

Using curricular materials reflective of various cultures

62.8 (54.8-70.2) 62.7

Using curricular materials designed for students with 35.7 (28.0-44.3) 31.5 limited English proficiency

(53.3-71.2) (23.0-41.4)

23 2006 School Health Profiles Report

Table 10. Percentage of schools in which the lead health education teacher asked students to participate in health-related community activities as part of a required health education course, by school type, Georgia, 2006

Middle school

High school

Activities

%

95% CI

%

95% CI

Complete homework or projects that involve family members

81.8 (75.0-87.0) 83.8

(76.2-89.3)

Identify advertising in the community designed to influence health behaviors

74.1 (66.1-80.8) 81.1 (72.9-87.2)

Identify potential injury sites at school, home, or in the community

63.8 (55.3-71.5) 70.0 (22.0-39.5)

Gather information about health services available in 45.6 (36.9-54.6) 67.1 the community

(57.9-75.2)

Advocate for a health-related issue

44.9 (36.8-53.3) 53.3 (44.5-61.8)

Visit a store to compare prices of health products

26.4 (19.6-34.7) 36.6 (27.8-46.3)

Participate in or attend a community health fair

25.8 (18.7-34.3) 31.1 (23.3-40.2)

Perform volunteer work at a hospital, local health department, or community organization that addresses health

12.0 (7.7-18.3) 29.6 (22.0-38.6)

Table 11. Percentage of schools with a health education coordinator, by person who coordinates health education and school type, Georgia, 2006

Middle school

High school

Coordinates health education

%

95% CI

%

95% CI

Health education teacher

48.9 (40.7-57.1) 46.4 (37.9-54.8)

School Administrator

23.6 (16.9-30.3) 24.7 (16.6-32.9)

District health education or curriculum coordinator

17.7 (16.9-30.3) 23.3 (16.5-30.0)

Someone else coordinates health educaiton

4.0 (0.8-7.2) 0.7

(0.0-2.0)

District administrator

3.3 (12.3-23.1) 3.2

(0.0-6.4)

No one

2.5

(0-6.2)

0.8

(0.0-2.5)

School nurse

0.0

-

0.9

(0.0-2.8)

Table 12. Percentage of schools with a group to offer guidance on the development of policies or coordinates activities on health topics, by school type, Georgia, 2006

Middle school

High school

%

95% CI

%

95% CI

A group offers guidance on the development of policies or coordinates activities on health topics

52.1 (43.8-60.4) 49.2 (40.5-57.9)

Table 13. Percentage of schools that required health education as a combined course or in another course, by school type, Georgia, 2006

Middle school

High school

Combined courses

%

95% CI

%

95% CI

Health education taught as a combined course with 61.6 (53.9-69.3) 91.7 physical education

(86.5-96.8)

Health education taught as a combined course such 16.7 (10.6-22.8) 10.0 as science, social studies, or English

(4.6-15.5)

24 2006 School Health Profiles Report

Table 14. Percentage of schools in which health education staff worked on health education activities with other school staff, by school type, Georgia, 2006

Middle school

High school

School staff

%

95% CI

%

95% CI

Physical education staff

89.7 (83.9-93.6) 93.2 (87.0-96.6)

School health services staff

67.3 (59.5-74.3) 62.1 (52.8-70.5)

School mental health or social services staff

53.9 (45.7-61.8) 47.9 (38.9-57.0)

Nutrition or food service staff

39.1 (32.4-46.3) 26.0 (18.6-35.1)

Table 15. Percentage of schools that engaged parents and families in specific health education activities, by school type, Georgia, 2006

Middle school

High school

Activities

%

95% CI

%

95% CI

Provided families with information on school health education

68.9 (61.4-75.5) 63.1

(54.2-71.3)

Invited family members to attend health education classes

46.4 (39.4-53.6) 36.1 (27.8-45.4)

Met with a parent's organization such as the PTA to 29.6 (22.9-37.2) 22.9 discuss school health education

(16.4-31.2)

Table 16. Percentage of schools in which the lead health education teacher is licensed or certified to teach health education and the number of years of experience teaching health education, by school type, Georgia, 2006

Middle school

High school

Teacher preparation

%

95% CI

%

95% CI

Licensed or certified

96.6 (91.9-98.6) 97.3 (91.8-99.2)

Years of experience teaching health education

15 years or more

37.4 (30.2-45.3) 59.8 (52.0-67.1)

10 to 14 years

12.7 (8.7-18.2) 10.7 (6.7-16.6)

6 to 9 years

19.6 (14.2-26.5) 16.5 (10.9-24.0)

2 to 5 years

25.1 (19.1-32.2) 11.2 (7.0-17.5)

1 year

5.1 (2.8-9.3) 1.9

(0.5-7.3)

Table 17. Percentage of schools in which the lead health education teacher had professional preparation in each specific discipline, by school type, Georgia, 2006

Middle school

High school

Discipline

%

95% CI

%

95% CI

Health and physical education combined

81.9 (74.6-87.4) 84.5 (76.2-90.2)

Physical education or kinesiology, exercise science 5.4 (2.7-10.7) 9.3 or exercise physiology

(4.9-17.1)

Biology or science

5.1 (2.4-10.5) 1.1

(0.1-7.3)

Public health

2.0 (0.6-6.2) 1.7

(0.4-6.7)

Nursing

1.4 (0.4-5.7) 2.5

(0.8-7.4)

25 2006 School Health Profiles Report

Table 18. Percentage of schools in which the lead health education teacher received staff development on specific health education topics, by school type, Georgia, 2006

Middle school

High school

Topic

%

95% CI

%

95% CI

Cardiopulmonary resucitation (CPR)

70.1 (62.2-77.0) 74.4 (66.6-80.9)

First aid

60.3 (52.0-68.1) 59.0 50.0-67.5)

Physical activity and fitness

50.4 (42.5-58.4) 50.4 (41.0-59.8)

Sexually-transmitted disease (STD) prevention

47.8 (40.1-55.5) 49.5 (40.2-58.8)

Violence prevention

48.2 (40.7-55.8) 42.2 (33.1-51.9)

Human immunodeficiency virus (HIV) prevention

47.3 (39.7-54.9) 53.7 (45.0-62.1)

Alcohol or other drug use prevention

46.8 (39.4-54.4) 52.3 (44.1-60.4)

Injury prevention and safety

41.3 (34.0-49.0) 44.4 (36.2-52.8)

Pregnancy prevention

40.7 (33.3-48.6) 37.5 (29.0-46.8)

Human sexuality

38.4 (30.6-46.7) 37.6 (30.1-45.7)

Tobacco use prevention

39.0 (31.5-47.2) 28.5 (21.1-37.3)

Growth and development

34.4 (27.6-42.0) 27.4 (20.3-36.0)

Emotional and mental health

32.1 (25.0-40.1) 31.9 (24.7-40.1)

Asthma awareness

30.7 (23.9-38.4) 17.1 (11.6-24.5)

Nutrition and dietary behavior

30.1 (22.7-38.7) 31.0 (23.2-40.1)

Suicide prevention

23.7 (18.0-30.6) 27.2 (20.1-35.7)

Consumer health

20.5 (14.9-27.6) 22.9 (16.4-31.0)

Dental and oral health

17.7 (12.3-24.8) 12.1 (7.5-19.1)

Immunizations

15.4 (10.7-21.6) 17.3 (12.2-24.1)

Foodborne illness prevention

15.3 (10.3-22.2) 15.3 (9.8-23.1)

Environmental health

15.3 (10.3-22.2) 15.0 (9.5-22.8)

Sun safety or skin cancer prevention

13.7 (9.4-19.6) 15.3 (10.1-22.5)

26 2006 School Health Profiles Report

Table 19. Percentage of schools in which the lead health education teacher wanted to receive staff development on specific health education topics, by school type, Georgia, 2006

Middle school

High school

Topic

%

95% CI

%

95% CI

Violence prevention

81.9 (74.5-87.5) 82.6 (74.7-88.4)

Alcohol or other drug use prevention

80.6 (73.2-86.4) 78.0 (68.8-85.0)

First aid

75.5 (68.0-81.7) 78.6 (69.6-85.5)

Physical activity and fitness

74.0 (67.8-79.3) 69.4 (60.4-77.1)

Suicide prevention

72.7 (64.8-79.3) 78.3 (69.0-85.3)

Nutrition and dietary behavior

73.0 (66.0-79.1) 75.8 (66.8-83.1)

Cardiopulmonary resucitation (CPR)

71.9 (64.4-78.4) 71.3 (61.8-79.3)

Tobacco use prevention

71.8 (64.9-77.8) 69.8 (60.8-77.4)

Human immunodeficiency virus (HIV) prevention

71.3 (63.2-78.2) 71.1 (62.1-78.8)

Injury prevention and safety

71.5 (63.6-78.2) 70.1 (60.9-77.9)

Sexually-transmitted disease (STD) prevention

66.0 (57.4-73.7) 72.4 (63.4-79.9)

Emotional and mental health

65.7 (57.4-73.1) 69.6 (61.8-76.3)

Growth and development

65.0 (56.9-72.2) 55.9 (47.3-64.2)

Asthma awareness

61.4 (53.2-69.0) 68.9 (60.0-76.7)

Human sexuality

61.4 (53.9-68.5) 62.8 (54.6-70.4)

Sun safety or skin cancer prevention

59.8 (52.1-67.0) 62.8 (53.6-71.1)

Pregnancy prevention

57.8 (49.4-65.8) 68.2 (59.4-75.8)

Foodborne illness prevention

56.5 (49.3-63.4) 61.4 (51.6-70.3)

Environmental health

53.1 (45.5-60.7) 59.1 (49.5-68.0)

Dental and oral health

49.8 (42.9-56.6) 48.5 (40.5-56.6)

Consumer health

48.8 (40.8-56.8) 52.5 (43.9-60.9)

Immunizations

43.9 (36.7-51.3) 49.5 (40.5-58.5)

Table 20. Percentage of schools that required physical education in any of grades 6-12, by school type, Georgia, 2006

Middle school

High school

%

95% CI

%

95% CI

Required physical education

76.3 (69.6-83.1) 99.3 (98.0-100.0)

Table 21. Percentage of schools that required physical education in any of grades 6-12, by number of courses and school type, Georgia, 2006

Middle school

High school

Number of courses

%

95% CI

%

95% CI

0 courses

24.6 (17.9-31.3) 0.7

(0-2.1)

1 course

18.2 (11.9-24.5) 74.6 (67.3-81.9)

2 or 3 courses

43.2 (35.2-51.1) 19.9 (13.5-26.4)

4 or 5 courses

8.9 (4.2-13.5) 4.8

(0.9-8.6)

6 or 7 courses

4.6 (1.7-7.5) 0.0

-

8 or more courses

0.6

(0-1.7)

0.0

-

27 2006 School Health Profiles Report

Table 22. Percentage of schools that required a physical education course, by grade, Georgia, 2006

Grade 6th

Middle school

%

95% CI

70.5 (63.0-78.0)

High school

%

95% CI

7th

70.8 (63.4-78.2)

8th

71.1 (63.5-78.7)

9th

95.8 (92.1-99.5)

10th

35.1 (26.7-43.6)

11th

30.7 (22.2-39.2)

12th

30.0 (21.5-38.5)

Table 23. Percentage of schools that required a daily physical education course, by grade, Georgia, 2006

Grade 6th 7th 8th 9th 10th 11th 12th

Middle school

%

95% CI

48.3 (40.5-56.0)

49.6 (41.8-57.4)

51.2 (43.1-59.3)

High school

%

95% CI

83.2 (76.7-89.6) 23.2 (15.2-31.2) 21.4 (14.2-28.5) 19.7 (12.5-26.9)

Table 24. Percentage of schools that required 2 semesters of physical education courses, by grade, Georgia, 2006

Grade 6th

Middle school

%

95% CI

7.3 (4.1-12.8)

High school

%

95% CI

7th

8.0 (4.8-13.0)

8th

8.0 (4.8-13.1)

9th

8.0

(4.2-14.7)

10th

2.4

(0.8-7.6)

11th

2.4

(0.8-7.6)

12th

1.5

(0.4-6.1)

28 2006 School Health Profiles Report

Table 25. Percentage of schools that allowed students to be exempted from taking a required physical education course, by exemption and school type, Georgia, 2006

Exemption

Middle school

%

95% CI

High school

%

95% CI

Long-term physical or medical disability

64.5 (57.0-72.1) 66.6 (57.6-75.5)

Religious reasons
Participation in other school activities Cognitive disability Enrollment in other courses Participation in vocational training Participation in community service activities Participation in school sports teams High physical fitness competency test score Participation in community sports teams

34.7 (27.0-42.4) 26.1

32.7 (25.2-40.2) 25.2

28.1 (20.7-35.4) 24.0

25.8 (18.6-32.9) 25.1

4.1 (0.8-7.3) 4.3

2.2

(0-4.7)

1.7

1.7

(0-3.7)

5.7

1.3

(0-3.2)

0.0

0.6

(0-1.8)

0.8

(18.2-34.0)
(17.8-32.5) (16.6-31.5) (17.0-33.3)
(0.5-8.0) (0-4.1) (1.5-10.0)
(0.0-2.4)

Table 26. Percentage of schools that require students who fail a required physical education course to repeat it, by school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Required students who fail a required physical education course to repeat it

15.8 (10.4-21.1) 96.0 (92.5-99.5)

Table 27. Percentage of schools that offered intramural activities or physical activity clubs, by school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Offered intramural activities or physical activity clubs 65.6 (58.8-72.4) 54.2 (44.7-63.7)

Table 28. Percentage of schools that provided transportation home for students who participated in intramural activities or physical activity clubs, by school type, Georgia, 2006

Middle school

High school

%

95% CI

%

95% CI

Provided transportation home

17.1 (11.3-22.8) 12.3 (6.5-18.0)

Table 29. Percentage of schools that allowed use of activity or athletic facilities, by school type, Goergia 2006

Middle school

High school

%

95% CI

%

95% CI

Allowed use of activity or athletic facility

85.5 (79.9-91.1) 77.6 (70.2-84.9)

29 2006 School Health Profiles Report

Table 30. Percentage of schools that had a policy to prohibit students from walking or biking to and from school, by school type, Georgia, 2006

Middle school

High school

%

95% CI

%

95% CI

Policy to prohibit walking or biking

8.0 (3.5-12.5) 2.5

(0-5.4)

Table 31. Percentage of schools that promoted walking or biking to and from school, by school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Promoted walking or biking

35.9 (28.3-43.4) 16.3 (10.3-22.2)

Table 32. Barriers to students walking or biking to and from school, by barrier and school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Traffic

64.7 (56.5-73.0) 63.5 (54.5-72.4)

Something else

51.9 (43.3-60.4) 57.6 (49.2-65.9)

No sidewalks or poorly maintained sidewalks

45.5 (36.8-54.1) 45.0 (36.0-53.9)

Lack of adult supervisions Concerns about neigborhood safety

44.2 (35.5-52.9) 36.1 13.5 (7.4-19.5) 13.2

(26.7-45.4) (6.7-19.7)

Table 33. Percentage of schools in which the lead health education teacher taught about physical activity topics in a required health education course, by school type, Georgia, 2006

Middle school

High school

Physical activity topics

%

95% CI

%

95% CI

The physical, psychological, or social benefits of physical activity

96.0 (90.7-98.4) 96.9 (91.8-98.9)

Health-related fitness

95.0 (89.2-97.8) 94.3 (88.6-97.3)

Dangers of using performance-enhancing drugs, such as steroids

94.3 (89.5-97.0) 96.5 (92.8-98.4)

Preventing injury during physical activity

94.5 (88.5-97.4) 94.3 (88.5-97.2)

Decreasing sedentary activities such as television watcing

89.6 (82.4-94.1) 94.2 (89.6-96.8)

Weather-related safety

91.2 (85.4-94.8) 94.9 (90.2-97.4)

How much physical activity is enough

88.0 (80.6-92.8) 92.8 (86.6-96.3)

The difference between physical activity, exercise, and fitness

88.3 (80.9-93.0) 91.6 (85.9-95.2)

Phases of a workout

86.4 (78.7-91.6) 92.7 (86.4-96.2)

Opportunities for physical activity in the community 86.5 (80.0-91.2) 85.4 (78.5-90.4)

Overcoming barriers to physical activity

82.5 (75.1-88.1) 87.7 (79.7-92.9)

Developing an individualized physical activity plan

75.2 (67.1-81.8) 86.2 (78.7-91.4)

Monitoring progress toward reaching goals in an individualized physical activity plan

74.3 (65.7-81.3) 88.4 (81.5-92.9)

30 2006 School Health Profiles Report

Table 34. Percentage of schools that had a policy prohibiting tobacco use, by school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Had a policy prohibiting tobacco use

99.4 (98.2-100.0) 99.2 (97.6-100.0)

Table 35. Percentage of schools that had a policy prohibiting tobacco use, by tobacco product, group, and school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Had a policy prohibiting cigarettes

Students

98.2 (96.2-100.0) 97.7 (95.1-100.0)

Faculty/staff

98.2 (96.1-100.0) 94.8 (90.9-98.7)

Visitors

93.9 (90.4-97.3) 90.1 (85.2-95.1)

Had a policy prohibiting smokeless tobacco

Students

97.6 (95.2-99.9) 96.9 (93.8-100.0)

Faculty/staff

96.3 (93.4-99.2) 94.8 (90.8-98.7)

Visitors

88.9 (84.4-93.3) 87.0 (81.1-92.8)

Had a policy prohibiting cigars

Students

98.2 (96.2-100.0) 97.7 (95.1-100.0)

Faculty/staff

98.2 (96.1-100.0) 95.6 (92.1-99.2)

Visitors

94.5 (91.2-97.7) 90.1 (85.2-95.1)

Had a policy prohibiting pipes

Students

98.2 (96.2-100.0) 97.7 (95.1-100.0)

Faculty/staff

98.2 (96.1-100.0) 95.6 (92.1-99.2)

Visitors

94.5 (91.2-97.7) 89.4 (84.2-94.5)

Table 36. Percentage of schools that had a policy prohibiting tobacco use, by time, group, and school type, Georgia, 2006

Middle school

High school

%

95% CI

%

95% CI

Had a policy prohibiting tobacco use during school hours

Students

99.4 (98.2-100.0) 98.5 (96.4-100.0)

Faculty/staff

98.0 (95.8-100.0) 95.6 (92.0-99.1)

Visitors

96.2 (94.3-98.0) 93.9 (90.4-97.5)

Had a policy prohibiting tobacco use during nonschool hours

Students

86.1 (80.5-91.6) 88.4 (82.3-94.5)

Faculty/staff

81.0 (74.9-87.1) 79.9 (72.4-87.5)

Visitors

76.2 (69.5-82.9) 71.3 (62.3-80.2)

31 2006 School Health Profiles Report

Table 37. Percentage of schools that had a policy prohitibing tobacco use, by location, group, and school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Had a policy prohibiting tobacco use in school buildings
Students

98.8 (97.2-100.0) 98.3 (96.0-100.0)

Faculty/staff

98.8 (97.2-100.0) 97.6 (94.9-100.0)

Visitors

96.3 (93.4-99.3) 96.0 (92.5-99.5)

Had a policy prohibiting tobacco use outside of school grounds
Students

98.8 (97.2-100.0) 98.3 (96.0-100.0)

Faculty/staff

95.6 (92.3-98.9) 93.9 (89.7-98.2)

Visitors

86.3 (80.8-91.8) 87.7 (82.0-93.3)

Had a policy prohibiting tobacco use on school buses
Students

98.8 (97.2-100.0) 98.3 (96.0-100.0)

Faculty/staff

98.8 (97.2-100.0) 97.6 (94.9-100.0)

Visitors

95.0 (91.5-98.5) 94.6 (90.5-98.6)

Had a policy prohibiting tobacco use at off campus events
Students

98.8 (97.2-100.0) 98.3 (96.0-100.0)

Faculty/staff

91.3 (86.8-95.9) 91.5 (86.5-96.6)

Visitors

71.8 (64.6-78.9) 67.3 (58.9-75.8)

Table 38. Percentage of schools that had procedures to inform specific groups about tobacco prevention policy that prohibits their use, by group and school type, Georgia, 2006

Middle school

High school

Group

%

95% CI

%

95% CI

Had procedures to inform students

99.4 (98.2-100.0) 98.4 (96.3-100.0)

Had procedures to inform faculty/staff

97.6 (95.2-100.0) 96.3 (93.0-99.6)

Had procedures to inform visitors

80.4 (74.0-86.9) 86.7 (80.6-92.7)

Had procedures to inform parents

97.4 (94.9-99.9) 96.2 (92.8-99.5)

Table 39. Percentage of schools that had procedures to inform specific groups if they do not comply with tobacco use prevention policy, by group and school type, Georgia, 2006

Middle school

High school

Group

%

95% CI

%

95% CI

Had procedures to inform students

98.7 (96.8-100.0) 100.0

-

Had procedures to inform faculty/staff Had procedures to inform visitors

87.9 (83.3-92.5) 93.2 69.3 (62.4-76.2) 64.9

(88.7-97.7) (56.6-73.2)

32 2006 School Health Profiles Report

Table 40. Percentage of schools that always took action when students were caught smoking cigarettes, by action taken and school type, Georgia, 2006

Action taken

Middle school

%

95% CI

High school

%

95% CI

Students were always referred to school administrator
Parents or guardians were always notified

98.7 (97.0-100.0) 96.9 (93.8-100.0) 97.4 (94.8-100.0) 94.3 (90.0-98.6)

Students were always given in-school suspension

48.3 (42.0-54.7) 45.6 (37.9-53.3)

Students were always suspended from school Students were always referred to school counselor

26.1 (19.0-33.3) 21.7 25.3 (18.9-31.8) 11.2

(14.2-29.2) (5.3-17.1)

Students were always allowed to participate in extra- 23.9 (16.6-31.3) 21.6 curricular activities

Students were always placed in detention

20.7 (15.3-26.1) 31.4

Students were always encouraged to participate in 12.8 (8.2-17.4) 9.1 cessation program

Students were always referred to legal authorities

5.3 (2.2-8.4) 2.4

Students were always required to participate in cessation program

4.5 (1.7-7.2) 1.5

Students were always reassigned to alternative school

1.9

(0-4.0)

0.9

Students were always expelled from school

0.6

(0-1.9)

1.6

(15.3-28.0) (23.3-39.5) (3.9-14.3)
(0-5.2) (0-3.7) (0-2.6) (0-3.8)

Table 41. Percentage of schools that provided referrals to tobacco cessation programs, by group and school type, Georgia, 2006

Middle school

High school

Group

%

95% CI

%

95% CI

Provided referrals to faculty/staff

24.6 (18.4-30.7) 21.1 (13.9-28.2)

Provided referrals to students

21.9 (16.1-27.8) 25.9 (18.6-33.2)

Table 42. Percentage of schools that posted signs marking a tobacco-free school zone, by school type, Georgia, 2006

Posted signs marking a tobacco-free school zone

Middle school

%

95% CI

65.1 (57.4-72.7)

High school

%

95% CI

65.1 (56.7-73.6)

33 2006 School Health Profiles Report

Table 43. Percentage of schools in which the lead health education teacher taught about tobacco use prevention topics in a required health education course, by school type, Georgia, 2006

Middle school

High school

Tobacco use prevention topics

%

95% CI

%

95% CI

Short- and long-term health consequences of

99.1 (93.9-99.9) 100.0

-

cigarette smoking

Benefits of not smoking cigarettes

99.1 (93.9-99.9) 100.0

-

Addictive effects of nicotine in tobacco products

99.1 (93.9-99.9) 100.0

-

The health effects of environmental tobacco smoke (ETS) or secondhand smoke

99.1 (93.9-99.9) 99.1

(93.9-99.9)

Resisting peer pressure to use tobacco

97.5 (92.4-99.2) 100.0

-

Short- and long-term health consequences of using 97.6 (92.7-99.2) 99.2 smokeless tobacco

(94.4-99.9)

Influence of the media on tobacco use

97.7 (92.8-99.3) 99.2

(94.2-99.9)

Benefits of not using smokeless tobacco

98.4 (93.5-99.6) 98.2

(92.9-99.6)

Influence of families on tobacco use

97.7 (92.9-99.3) 98.2

(92.9-99.6)

How students can influence or support others in

95.9 (90.3-98.4) 100.0

-

efforts to quit using tobacco

How many young people use tobacco

96.7 (91.3-98.8) 98.0

(92.4-99.5)

How students can influence or support others to prevent tobacco use

94.4 (88.5-97.4) 99.2

(94.2-99.9)

Social or cultural influences on tobacco use

91.4 (84.6-95.3) 97.6

(92.5-99.2)

Short- and long-term health consequences of cigar smoking

89.7 (82.5-94.1) 95.7

(89.7-98.2)

How to find valid information or services related to tobacco use prevention or cessation

86.3 (78.9-91.4) 87.1

(79.9-92.0)

Making a personal commitment not to use tobacco 84.2 (76.1-89.9) 81.8

(73.6-87.9)

Table 44. Percentage of schools in which students usually had less than 20 minutes to eat lunch once they were seated, by school type, Georgia, 2006

Middle school

High school

%

95% CI

%

95% CI

Students had less than 20 minutes to eat lunch

12.8 (8.2-17.4) 18.7

(11.9-25.5)

Table 45. Percentage of schools that had a policy to offer fruits and vegetables at school settings, by school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Had a policy to offer fruit and vegetables at school events

11.8 (6.5-17.2) 9.8

(4.3-15.3)

34 2006 School Health Profiles Report

Table 46. Percentage of schools that allowed students to purchase snack foods or beverages from vending machines, school store, canteen, or snack bar, by school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Allowed students to purchase snack foods or beverages

81.3 (75.3-87.2) 96.2 (92.9-99.5)

Table 47. Percentage of schools that allowed students to purchase less nutritious snack foods or beverages from vending machines, school store, canteen, or snack bar, by food or beverage and school type, Georgia, 2006

Food and beverages Sports drinks Soda pop or fruit drinks not 100% juice Salty snacks not low in fat Other kinds of candy Chocolate candy

Middle school

%

95% CI

74.2 (67.3-81.0)

63.0 (55.3-70.7)

49.3 (40.7-57.9)

43.1 (35.0-51.3)

39.2 (31.3-47.2)

High school

%

95% CI

94.4 (90.3-98.5)

88.9 (83.2-94.6)

74.7 (66.9-82.5)

77.8 (70.5-85.2)

77.2 (69.6-84.7)

Table 48. Percentage of schools that allowed students to purchase more nutritious snack foods or beverages from vending machines, school store, canteen, or snack bar, by food or beverage and school type, Georgia, 2006

Food and beverages

Middle school

%

95% CI

High school

%

95% CI

Bottled water

79.1 (72.7-85.5) 96.2 (92.9-99.5)

100% fruit juice Salty snacks low in fat Baked goods low in fat Fruit or vegetables

57.8 (50.1-65.5) 76.5 47.9 (39.5-56.2) 73.2 40.8 (32.3-49.2) 63.0 12.3 (7.1-17.5) 18.5

(69.6-83.3) (65.7-80.7) (54.3-71.6) (11.7-25.3)

Table 49. Percentage of schools that restricted students to purchase snack food or beverages from the vending machines, school store, canteen, or snack bar at specific times, by time and school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Restricted purchases before and during the school day

10.4 (5.4-15.4) 25.9

Restricted purchases before or during the school day 46.9 (38.8-55.0) 59.4

(18.1-33.6) (51.7-67.1)

No restrictions on purchases

42.7 (35.0-50.4) 14.7

(8.3-21.2)

35 2006 School Health Profiles Report

Table 50. Percentage of schools that had nutrition standards for foods sold at school, by school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Had nutrition standards for foods sold at school

39.7 (32.1-47.3) 34.1 (25.8-42.5)

Table 51. Percentage of schools that had nutrition standards for foods sold at school, by location and school type, Georgia, 2006

Location Cafeteria a la carte items Vending machines Snack bars Fund-raisers Class parties

Middle school

%

95% CI

34.2 (27.0-41.4)

29.2 (21.9-36.5)

19.8 (13.3-26.2)

15.3 (9.6-20.9)

14.4 (9.0-19.7)

High school

%

95% CI

31.6 (23.6-39.5)

24.5 (17.3-31.6)

19.1 (12.5-25.7)

14.0

(7.6-20.4)

13.9

(7.4-20.4)

Athletic events

11.3 (6.2-16.3) 11.1

(5.3-16.9)

Table 52. Percentage of schools that had a policy to prohibit foods low in nutritional value from being offered at school settings, by school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Had a policy to prohibit foods low in nutritional value 9.8 from being offered at school

(4.7-14.9) 10.6

(5.2-16.1)

Table 53. Percentage of schools in which the lead health education teacher taught about nutrition and dietary topics in a required health education course, by school type, Georgia, 2006

Middle school

High school

Nutrition and dietary topics

%

95% CI

%

95% CI

The benefits of healthy eating

97.5 (95.2-98.7) 99.2

(94.4-99.9)

Balancing food intake and physical activity

96.0 (92.3-98.0) 98.4

(93.6-99.6)

Eating more fruits, vegetables, and grain products

96.0 (92.2-97.9) 97.5

(92.2-99.2)

Choosing foods that are low in fat, saturated fat, and 94.4 (89.7-97.0) 98.5 cholesterol

(93.9-99.6)

Risks of unhealthy weight control practices

95.1 (90.8-97.4) 96.7

(91.2-98.8)

Accepting body size differences

94.2 (89.3-96.9) 93.5

(86.7-97.0)

Eating disorders

94.1 (89.0-96.9) 97.2

(91.3-99.1)

Using sugars in moderation

92.7 (87.2-95.9) 95.7

(89.7-98.3)

Using food labels

93.6 (89.7-96.1) 95.1

(89.2-97.9)

Using salt and sodium in moderation

91.3 (85.5-94.9) 98.5

(93.9-99.6)

Food guidance using MyPyramid

89.5 (83.0-93.8) 93.8

(87.2-97.1)

Preparing healthy meals and snacks

87.6 (81.3-91.9) 91.0

(83.9-95.1)

Food safety

85.8 (81.6-89.2) 89.4

(82.6-93.8)

Eating more calcium-rich foods

85.5 (78.5-90.5) 90.3

(82.8-94.7)

36 2006 School Health Profiles Report

Table 54. Percentage of schools that implemented safety and security measures, by school type, Georgia, 2006

Middle school

High school

Safety and security measures

%

95% CI

%

95% CI

Required visitors to report to main office or reception 100.0

-

100.0

-

area

Maintained closed campus

98.7 (96.9-100.0) 93.9 (89.6-98.1)

Used staff or adult volunteers to monitor school halls 97.5 (95.0-100.0) 94.3 (90.1-98.6)

Used police, school resources, or security guards during school day

82.2 (76.5-87.8) 86.3 (80.7-91.9)

Used security or surveillance cameras

66.8 (59.9-73.7) 86.3 (80.8-91.9)

Routinely conducted locker searches

57.7 (50.6-64.7) 68.9 (61.3-76.4)

Used metal detectors including wands

23.8 (16.6-31.0) 38.1 (29.1-47.1)

Required students to wear id badges

9.0 (5.0-12.9) 18.8 (13.0-24.5)

Required students to wear school uniforms

7.7 (3.8-11.5) 0.9

(0-2.8)

Table 55. Percentage of schools that had or participated in specific violence prevention programs, by program and school type, Georgia, 2006

Middle school

High school

Violence prevention programs

%

95% CI

%

95% CI

Had program to prevent bullying

75.5 (69.1-81.8) 53.7 (44.0-63.4)

Had peer mediation program

59.0 (51.2-66.7) 60.8 (52.1-69.4)

Had program to prevent gang violence

43.8 (36.7-50.9) 37.9 (29.1-46.7)

Had safe passages to school program

10.2 (5.4-14.9) 8.5

(4.4-12.5)

Table 56. Percentage of schools that had a plan to address crisis preparedness, response, and recovery, by school type, Georgia, 2006

Middle school

High school

%

95% CI

%

95% CI

Had plan to address crisis preparedness, response, 98.7 (96.8-100.0) 98.3 (96.0-100.0) and recovery

Table 57. Percentage of schools that had a school nurse to provide standard health services, by school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Had a school nurse to provide standard health services

90.5 (85.8-95.3) 82.1 (76.2-88.0)

37 2006 School Health Profiles Report

Table 58. Percentage of schools that provided health services, by service provided and school type, Georgia, 2006

Middle school

High school

Health services

%

95% CI

%

95% CI

Provided identification or school-based management 77.5 (71.4-83.7) 67.0 of chronic conditions

(58.0-76.0)

Provided identification or school-based management 69.2 (61.7-76.8) 55.7 of acute illnesses

(46.5-64.8)

Provided Asthma Action Plan

67.5 (60.4-74.5) 46.7 (37.9-55.5)

Provided assistance with enrolling in Medicaid or SCHIP

41.2 (33.2-49.3) 31.6 (23.6-39.6)

Provided immunizations

36.9 (29.6-44.2) 32.5 (23.8-41.2)

Table 59. Percentage of schools that permitted students to carry and self-administer medication, by medication and school type, Georgia, 2006

Middle school

High school

Medication

%

95% CI

%

95% CI

Permitted prescription quick-relief inhaler

76.7 (70.1-83.2) 75.1 (67.6-82.5)

Permitted epinephrine auto-injector

31.3 (23.7-38.8) 41.2 (33.2-49.2)

Permitted insulin or other injected medications

20.8 (14.6-27.0) 26.6 (19.6-33.5)

Permitted any other prescribed medications

3.2 (0.0.4-5.9) 9.3

(4.5-14.0)

Permitted any over-the-counter medications

2.4 (0.0-4.8) 15.8 (9.6-21.9)

Table 60. Percentage of schools that implemented at least one component of the Coordinated School Health Program, by school type, Georgia, 2006

Middle school

High school

%

95% CI

%

95% CI

Implemented some of the Coordinated School Health 65.0 (57.4-72.6) 61.9 Program

(53.1-70.7)

Table 61. Percentage of schools that offered health promotion programs to faculty/staff, by program and school type, Georgia, 2006

Middle school

High school

Health promotin programs

%

95% CI

%

95% CI

Offered physical activity programs

42.1 (34.4-49.9) 34.8 (26.5-43.0)

Offered physical activity counseling

30.1 (21.9-38.3) 26.0 (18.3-33.7)

Offered weight managment program

27.6 (20.2-35.0) 24.1 (16.8-31.3)

Offered nutrition and dietary behavior counseling

23.0 (15.8-30.2) 15.3 (9.6-21.0)

Offered tobacco cessation program

19.9 (13.4-26.5) 15.2 (9.1-21.3)

Offered breastfeeding support services

6.4 (2.4-10.3) 5.8

(1.5-10.1)

Table 62. Percentage of schools that allowed faculty/staff to use recreation facilities, by school type, Georgia, 2006

Middle school

%

95% CI

High school

%

95% CI

Allowed faculty/staff to use recreation facilities

86.4 (80.8-92.0) 86.9 (80.6-93.2)

38 2006 School Health Profiles Report

DHR
GEORGIA DEPARTMENT OF HUMAN RESOURCES
39 2006 School Health Profiles Report