Awards get the message across

John Barron & Alison Cockerill

Drugs, sexual health, family and safety are important topics. But they often get pushed to the bottom of the pile in schools as health education falls victim to other curriculum pressures.

To combat this, health-promoting school award schemes have been set up across the country, mainly in the past three years, in areas such as Leeds, Leicester and Lincolnshire. Some set goals that every child must reach, others help schools aim for targets that reflect their own needs.

For these schemes to succeed, they should not be viewed in isolation from the rest of the school. They should ensure that health education is an integral part of its ethos.

One advantage of these schemes is the commitment it requires from senior management ensuring that health permeates all aspects of school life. Only where this occurs can schools claim to be "health promoting". As Noreen Wetton and Jenny McWhirter say in Health for life: a guide for health promoting schools (Forbes Publications, 1995), schools must be places where "what is offered, taught and learned in the health education curriculum is practised, extended and reinforced in the wider curriculum by the ethos of the school, the relationships within the school and with the community".

Several National Health Service trusts are running a health promoting scheme with Kingston-upon-Hull, East Yorkshire, North and North-East Lincolnshire local authorities. Yorkshire Water also joined the scheme through Education Business Partnership, supporting it financially and giving advice.

The scheme aims to help and encourage schools to adopt a "built-in and not bolted-on" approach to health education and promotion, starting from whatever stage the school has reached. This means that all schools, rural and inner city, can take part, whatever their circumstances and needs.

So how does it work? The scheme consists of nine broad criteria, including health education curriculum, health promotion policy, healthier eating, safety, community links, environment and well-being. Members of the school community are invited to look at each area and agree with the scheme consultant (usually a health promotion specialist) their own targets.

They must demonstrate a balanced commitment to all aspects of health - physical, mental and social. Once they have been agreed, the scheme consultant and other members of the wider school community offer advice and help to enable their achievement. When all nine have been accredited, the school co-ordinator is asked to do a short informal presentation to the scheme management group, explaining what they have done for each criteria and the impact it has had on the school.

Targets set have been varied. Many schools have set up healthy eating tuckshops. Others, such as Neasden primary school in Hull, introduced playground markings and training for lunchtime supervisors. Freshney Park infants school in Grimsby built a scented garden for the visually impaired.

Other targets schools set themselves included a no smoking policy in buildings and grounds, a mentoring scheme between older and younger pupils to reduce bullying, first aid classes for parents, pupils and teachers and a workshop on asthma for all staff.

Jo Johnson, the then head of Freshney Park infants school, says: "Schools automatically deal with the 'whole' child and so are already concerned with health issues. The award scheme helped us to lift the profile of health education and health promotion in our school and gave us recognition for some of the things we were planning to do."

The pupils benefited from a raised awareness of health and lifestyle. It made them think more about others and their needs and they had a greater self-esteem.

When considering a scheme, teachers are often concerned about the time factor. With an overloaded curriculum and other pressures, they can be reluctant to take on what could seem to be more work.

However, those that have embarked on it have found that it need not be a burden. Schools have developed ways of managing the achievement of targets, but most have found that a steering group is pivotal.

Individual teachers are automatically concerned with certain targets and the school co-ordinator's role can be one of supporting, keeping track of progress and collecting the evidence.

South Holderness secondary school in Kingston-upon-Hull found that staff were so busy that the best way to keep things going was to write memos and produce a news sheet. Parents and pupils were kept up-to-date with progress through regular articles in the school's magazine. Other schools have found that regular short up-dating sessions work best for them. The flexibility of the scheme and the autonomy it allows participants enables each to adopt whatever system suits them best.

Health promoting schemes can be a positive experience for everyone. They provide a valuable opportunity for schools to focus on getting health messages across, for putting ideas into practice and for getting the community involved.

Above all, they help to dispel the myth that health promotion and health education are all about negative messages and telling people to stop this or that. Instead, they help schools to "celebrate health".

John Barron is a health promotion specialist with Scunthorpe Community Health Care NHS Trust. Alison Cockerill is a health promotion specialist with Hull and Holderness Community Health NHS Trust

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