OPHEA - Ontario Physical and Health Education Association

An Overview of the Ophea Public Health Support Needs Assessment

In many ways, public health and public education make a perfect pair. After all, both institutions share a goal of using education and awareness-building to foster strong, healthy communities. And with Ontario’s Ministry of Education and Ministry of Health Promotion’s Foundations for a Healthy School Framework calling for an integrated, community-based approach to school health province-wide, there’s never been a better time to build partnerships that will help to ensure today’s children and youth are instilled with healthy habits to last a lifetime.

Furthermore, not only do the majority of public health units want to work with school boards and/or schools, they are also all mandated to do so by the Ontario Public Health Standards (OPHS), released in January of 2009. Likewise, the revised Health & Physical Education (H&PE) Grades 1 – 8 (2010) Curriculum places a strong emphasis on collaboration between school staff, families, community partners and other stakeholders, including public health.

But while anyone would be hard-pressed to argue that public health and public education working in partnership is not a great idea, it may not be as easy as it sounds. How should public health approach schools? What types of support should they offer? How can public health and public education—two institutions with similar goals, but different cultures, languages and understandings—come together for the greater good of the physical, mental and academic well-being of students?

In September of 2009, Ophea—a not-for-profit organization led by the vision that all kids value, participate in and make a lifelong commitment to healthy active living—began to work with an external evaluation consultant, Ishan Angra, from Brock University to conduct an extensive needs assessment of all Ontario’s public health units. The goal was to identify the types of support public health must receive in order to work effectively with school boards and schools as they fulfill their OPHS mandate during the implementation of the revised H&PE Grades 1-8 (2010) Curriculum and beyond.

The Questions: ‘What Do You Need?’ & ‘How Can We Help?’

When Ophea set out to talk to public health units about their needs, they had two main questions in mind: first, what support did public health staff think they needed in order to effectively support the implementation of the revised H&PE Grades 1-8 (2010) Curriculum and, second, how could Ophea help to provide this support?

From there, it was decided that the best way to gather information was by using a three-pronged approach. This consisted of one in-person, facilitated roundtable discussion; five teleconference focus groups and ten individual follow-up interviews with health units. Through these three data-collection methods, all health units in Ontario were able to make their voices heard.

The Results: 7 Strategies for Supporting Public Health

The information gathered at the roundtable discussion was condensed into a summary document that was shared with public health staff to ensure accuracy. Meanwhile, the information from the teleconferences and interviews was transcribed and analysed. What emerged were seven key themes that paint a picture of what Ophea, government agencies and even public health units themselves can do to help make the most of their mandate to work with schools.

1. Advocacy: Finding a Champion

It is difficult to build support for your cause when people do not understand the value of what you can bring to the table. For this reason, participants expressed the need for an agency or organization, such as Ophea, that could champion the cause of public health. This group or agency would raise awareness of what public health can bring to schools and would solicit increased funding, specialized staffing and greater program and resource development from the Ministry of Education and the Ministry of Health Promotion. They could also play a role in opening doors for public health by advocating for their involvement in schools to both boards of education and schools themselves.

2. Communication: Sharing Challenges & Successes

Clear and consistent communication—not only between public health and school boards and schools, but also between the various health units themselves, and between health units and government agencies—was also identified as a need. Participants felt this was important for identifying and addressing the priorities of schools as well as for sharing challenges and successes amongst themselves.

“If there are other health units in the province who are in a similar situation,” commented one public health nutritionist, “if they could also share their learnings with us, what’s working, how they’re progressing, I think that would help us as well.”

And while the OPHS document does provide direction for the work of public health units in schools, the need for clearer, more specific ‘scope of service guidelines’ about what should be expected from public health (developed by the Ministries of Education and Health Promotion) was also noted.

3. Inter-Professional Dynamics: Getting Everyone on Board

Finding ways to work together effectively was a theme that surfaced again and again in the research—not only when it came to collaborations between school boards/schools and public health, but also within and between the health units themselves. To make the greatest contribution possible to promoting school health, participants felt that all public health staff (regardless of their specific program or team mandate) needed to get on board and work collaboratively to serve school boards in their region.

4. Knowledge Transfer: Providing the Right Information in the Right Format

Likewise, sharing knowledge about research, policies, programs and/or government priorities within health units (as well as with school boards and schools) was seen as vital. Public health staff expressed the need to have access to the latest information, and they stated a desire to receive it in the format that will be best suited to their needs and to the needs of the schools they will be serving. For example, participants reported relying heavily on a two-page summary that described the differences between the old H&PE curriculum and the revised policy. However, while this summary was useful as a starting point, a more comprehensive resource was needed to help public health staff explore the topic in greater depth.

The need for a ‘knowledge broker’—an organization, such as Ophea, that could establish and support relationships and facilitate knowledge exchange between stakeholders—was also noted. By acting as a link (in this case, between public health and schools, as well as between public health and the Ministries of Education, Health Promotion and Health and Long Term Care) this knowledge broker would help all parties to better understand each other’s needs and goals.

5. Outlook: Coming to a Common Understanding

Many participants felt there was a lack of clarity surrounding their roles and responsibilities. They wanted clearer direction on what school boards, schools and other stakeholders (non-governmental organizations, community agencies, etc.) expected from them. There was also concern about a lack of common understanding when it came to what health means in a school context. “We need to stop looking at health as just being physical... [W]e need to focus on the psychosocial aspects,” commented one public health nurse.

The need to build strong relationships with school boards, schools and other community stakeholders was also identified, not only because it is central to the philosophy of the Healthy Schools approach, but also because these relationships will be key to public health’s success in fulfilling its mandate to partner with and support school boards and/or schools. Some public health units reported having already experienced great success in this regard, and it was suggested that it would be beneficial to have these groups share their best practices in partnership development with other health units. Some health units also expressed the desire for consultative support to help them build partnerships with school boards.

Participants also raised concerns about the fact that, while public health is mandated to work with schools, schools are not mandated to work with public health. They pointed out that it would be helpful if the Ministries of Education & Health Promotion made the partnership compulsory for both parties with specified roles, responsibilities and protocol for each.

6. Resources: Updating & Standardizing Materials

This theme includes professional development, instructional materials, staffing and funding requirements—all of which participants felt were essential to the success of their work with schools. Public health staff requested ongoing training and consultation on the Healthy Schools approach and the new Health & Physical Education curriculum, as well as on how to connect with school boards and administrators.

They also recognized the need to update and standardize their instructional and promotional materials and to develop these materials collaboratively (with other public health units, with the Ministries of Education & Health Promotion and/or with community partners and organizations like Ophea) in order to avoid unnecessary duplication. A significant need for French-language resources was also noted, as was a need for ongoing research and evaluation including a possible needs assessment of schools to find out which public health initiatives are working, which are not working, and what priorities schools want to see public health address.

Additional government-based funding was also seen as essential—both for hiring more staff to take on the increased workload, as well as for the development of new programs and resources, evaluation strategies and additional supports that might be necessary.

7. School Culture: Learning to Speak the Same Language

Although both public health and public education share similar concerns for the welfare of Ontario’s children and youth, the participants in the needs assessment expressed that they sometimes felt that the two institutions, quite literally, spoke different languages. “What is a rubric?” one public health nurse wondered aloud. “Health literacy. What exactly does that mean?’” asked another. Likewise, public health staff expressed a desire to understand the practices and norms of schools in order to better support them.

Next Steps:

Thanks to the careful research conducted by Ophea, and the thoughtful, honest feedback of the public health staff who gave of their time to participate in the needs assessment, Ophea is now able to move forward with a clear idea of how best to help health units deliver on their mandate to work with schools. The organization will strive to address many of the identified concerns during the 2010–2011 school year, and will communicate with public health units on a regular basis to inform them of new initiatives.

“We’re looking forward to continued collaboration with public health units to support their work with schools across the province,” says Chris Markham, Executive Director for Ophea. “Providing public health staff with quality program supports as well as assistance with partnership-building and advocacy is just another way we can enable children and youth to lead healthy active lives.”

But just as Ophea is preparing to do their part, so too must public health, schools, government agencies and other community partners. After all, an improved quality of life for Ontario’s children and youth is what all stakeholders are aiming for… and it’s only by supporting one another’s efforts, ensuring open lines of communication, fostering shared understandings and finding effective ways to build partnerships that we are sure to have an impact, ensuring both healthier kids and stronger communities.

Visit www.ophea.net/healthyschools to learn more about the Healthy Schools approach.