Coordinated School Health
Tennessee Coordinated School Health connects physical, emotional and social health with education through eight inter-related components. This coordinated approach improves students' health and their capacity to learn through the support of families, communities and schools working together. Coordinated School Health works with many partners to address school health priorities.
Education reforms have not succeeded in improving the performance of all students, particularly those who do not arrive at school ready to learn. Coordinated School Health encourages healthy lifestyles, provides needed supports to at-risk students and helps to reduce the prevalence of health problems that impair academic success.
Coordinated School Health is an effective approach designed to connect health (physical, emotional and social) with learning. CSH improves children’s health and their capacity to learn through the support of families, communities and the schools working together.
The involvement of parents, families and community is the glue that binds the CSH. Full involvement of these entities as partners in the educational process provides valuable input, increases the commitment of all partners and ensures positive educational and health outcomes.
Coordinated School Health is not a program, but is a systematic approach to promoting student health that emphasizes needs assessment; planning based on data, sound science and analysis of gaps and redundancies in school health programming; and evaluation.
The CSH approach consists of eight major components. By definition, all Coordinated School Health Components work together to improve the lives of students and their families. Although these components are listed separately, it is their composite that allows CSH to have significant impact. The eight components include: health education, health services, counseling, psychological and social services, nutrition, physical education/physical activity, school staff wellness, healthy school environment and student/parent/community involvement.
The Office of Coordinated School Health (OCSH) was established by the Tennessee Department of Education in February 2001. The primary mission of the office is to improve student health outcomes as well as support the connection between good health practices, academic achievement and lifetime wellness. The OCSH partners with the Tennessee Department of Health, Office of School Health. With the passage of T.C.A. Section 49-1-1002 in 2000, authorization and funding for CSH was established. Additional funding has been provided by a grant from the Centers for Disease Control and Prevention (CDC).
Coordinated School Health is a national model that is making an impact on children’s health. The coordinated school health model was developed by the Centers for Disease Control and Prevention (CDC) in 1988. The CDC has funded over 20 states to support the development of coordinated school health initiatives.
With the passage of T.C.A. 49-1-1002, The Coordinated School Health Improvement Act of 2000, authorization and funding for CSH was established in Tennessee. State funding provided support for ten pilot sites. In 2006, Public Chapter 1001, the Coordinated School Health Expansion and Physical Activity Law, established authority and funding ($15 million) to expand CSH statewide. The law created a Physical Education Specialist and a Coordinator of School Health position within the Tennessee Department of Education and mandated 90 minutes of physical activity in grades K-12. By July 1, 2007, all Tennessee public school systems implemented coordinated school health for the 2007-08 school year.
Additional funding has been provided to the Office of Coordinated School Health by a grant from the Centers for Disease Control and Prevention (CDC).
Although these components are listed separately, it is their composite which allows CSH to have significant impact. Click on each component below for additional information and resources.
Health education is a planned, sequential, pre K-12 curriculum and program that addresses the physical, mental and emotional, and social dimensions of health. The activities of the curriculum and program are integrated into the daily life of the students and designed to motivate and assist students to maintain and improve their health, prevent disease and reduce health-related risk behaviors. It allows students to develop and demonstrate increasingly sophisticated health-related knowledge, attitudes, skills, and practices. The curriculum and program include a variety of topics such as personal health, family health, community health, consumer health, environmental health, family living, mental and emotional health, injury prevention and safety, CPR, nutrition, prevention and control of disease and substance use and abuse. Qualified professionals such as health educators, teachers, school counselors, school health nurses, registered dietitians, and community health care professionals provide health education.
Key Elements of a Comprehensive Health Education Program*
Lifetime Wellness is a holistic approach to health and physical education in Tennessee high schools. The course addresses Nutrition, Substance Use and Abuse, Mental Health, Human Growth and Development, First Aid and Safety, and Personal Fitness and Related Skills. Each content area is addressed in a classroom setting while allowing opportunity to explore how one content area affects and is affected by other content areas. Students participate in cooperative learning instructional methods and physical activities that can be practiced throughout a person’s lifespan. Instruction emphasizes prevention as well as intervention with regard to the health practices of students.
The following are key elements of comprehensive health education, which itself are part of an overall coordinated school health program:
- A documented, planned, and sequential program of health instruction for students in grades kindergarten through twelve.
- A curriculum that addresses and integrates education about a range of categorical health problems and issues at developmentally appropriate ages.
- Activities that help young people develop the skills they need to avoid: tobacco use; dietary patterns that contribute to disease; sedentary lifestyle; sexual behaviors that result in HIV infection, other STDs and unintended pregnancy; alcohol and other drug use; and behaviors that result in unintentional and intentional injuries.
- Instruction provided for a prescribed amount of time at each grade level.
- Management and coordination by an education professional trained to implement the program.
- Instruction from teachers who are trained to teach the subject.
- Involvement of parents, health professionals, and other concerned community members.
- Periodic evaluation, updating, and improvement.
*Source: CDC, Coordinated School Health Program, www.cdc.gov/HealthyYouth/about/
Related Resources & Links
- EverFi: Connections & Community
- EverFi Character Playbook
- Health Education Standards
- We Can! Initiative
- CDC – Characteristics of an Effective Health Education Curriculum
- Nemours Foundation – Health Education Lesson Plans and Teacher’s Guide
- Stanford Medicine – Tobacco Prevention Toolkit
Health services are provided and/or supervised by school health nurses to appraise, protect, and promote the health of students. These services include assessment, planning, coordination of services and direct care for all children, including those with special health care needs. Health services are designed and coordinated with community health care professionals to ensure early intervention, access and referral to primary health care services; foster appropriate use of primary health care services; prevent and control communicable disease and other health problems; provide emergency care for student and staff illness or injury; provide daily and continuous services for children with special health care needs; promote and provide optimum sanitary conditions for a safe school facility and school environment; and provide educational and counseling opportunities for promoting and maintaining individual, family and community health. Qualified professionals such as school health nurses, physicians, psychiatrists, psychologists, dentists, health educators, registered dietitians, school counselors, and allied health personnel including speech therapists and occupational or physical therapists provide these services.
Student Immunization Requirements
The Tennessee Department of Health has new immunization requirements for children attending schools. .
Related Resources & Links
- CDC Flu Planning Resources
- CDC - Head Lice Information
- CDC Headlice Information Page
- CDC - Information for School Nurses and Health Professionals in a School Setting
- CDC Meningitis Information
- Chronic Health Conditions Toolkit
- COVID-19 & Asthma Toolkit for Schools
- Guidelines for Health Care in a School Setting
- HHS Flu Vaccination Information
- HHS Meningococcal Vaccine Information
- MRSA Guidance
- NASN - Food Allergy and Anaphylaxis Tools and Resources
- NASN – Immunizations Tools and Resources
- National Association of School Nurses
- National Meningitis Association
- Return to Learn/Return to Play: Concussion Management Guidelines
- School Health Screenings Guidelines
- TDOH Healthy Schools Headlice Information
- Teacher Acute Concussion Tool
- Tennessee Association of School Nurses
- TN Disability Coalition Toolkit
- TN Chapter of the American Academy of Pediatrics
- Traumatic Brain Injury (tn.gov)
Nutrition services assure access to a variety of nutritious, affordable and appealing meals in school that accommodate the health and nutrition needs of all students. School nutrition programs reflect the U.S. Dietary Guidelines for Americans and other criteria to meet the complete nutrition needs of students.
Each school's nutrition program also offers a learning laboratory for classroom nutrition and health education that helps students develop skills and habits in selecting nutritionally appropriate foods, and serves as a resource and link with nutrition-related community services and educational programs. Qualified professionals such as experienced, knowledgeable school food supervisors and registered dietitians provide these services.
For more information about the department's nutrition program, visit the School Nutrition page.
Related Resources & Links
Physical education is a planned, sequential pre-k -12 curriculum program that follows national standards in providing developmentally appropriate, cognitive content and learning experiences in a variety of physical activity areas such as basic movement skills; physical fitness; rhythm and dance; cooperative games; team, dual, and individual sports; tumbling and gymnastics; and aquatics. Quality physical education promotes, through a variety of planned individual and cooperative physical activities and fitness assessments, each student's optimum physical, mental, emotional and social development; and provides fitness activities and sports that all students, including students with special needs, can enjoy and pursue throughout their lives. Qualified professionals such as physical education teachers and physical activity specialists provide physical education and related fitness activities.
Related Resources & Links
- Active Students, Active Learners
- Considerations for Classroom Physical Activity During COVID-19
- Physical Education Standards
- CDC – Comprehensive School Physical Activity Programs: A Guide For Schools
- Nemours Foundation - Let’s Move! Child Care
- Physical Education Portfolio
- SHAPE America
- Springboard to Active Schools
The Healthy School Environment component relates to the quality of the physical and aesthetic surroundings; the psychosocial climate, safety, and culture of the school; the school safety and emergency plans; and the periodic review and testing of the factors and conditions that influence the environment.
Factors and conditions that influence the quality of the physical environment include the school building and the area surrounding it; transportation services; any biological or chemical agents inside and outside the school facilities that are detrimental to health; and physical conditions such as temperature, noise, lighting, air quality and potential health and safety hazards.
The quality of the psychological environment includes the physical, emotional and social conditions that affect the safety and well being of students and staff. Qualified staff such as facilities and transportation supervisors, principals, school and community counselors, social workers, psychologists, school health nurses, health educators, and school safety officers assess and plan for these factors and conditions in the school environment.
See the School Climate page for related information.
Related Resources & Links
- Planning for the Next Normal at School Playbook
- Reducing Lead in Drinking Water
- Tools for Schools: Air Quality
- NASN – School Environmental Health Tools and Resources
Child Abuse & Sexual Abuse Prevention
- Keeping Students Safe during Covid
- Warning Signs of Child Abuse (English)
- Warning Signs of Child Abuse (Spanish)
- Child Abuse Reporting Steps for Teachers
- Practice Guidelines and Resources for Erin’s Law
- Mandated Reporter Training
- Child Abuse Coordinator Training
- Human Trafficking for Tennessee Educators
Counseling, mental health, and social services are provided to assess and improve the mental, emotional, and social health of every student. All students receive these services, including developmental classroom guidance activities and preventative educational programs, in an effort to enhance and promote academic, personal, and social growth. Students who may have special needs are served through the administration and interpretation of psychometric and psychoeducational tests, observational assessments, individual and group counseling sessions, crisis intervention for emergency mental health needs, family/home consultation, and/or referrals to outside community-based agencies when appropriate. The professional skills of counselors, psychologists, and social workers, along with school health nurses, are utilized to provide coordinated "wrap around" services that contribute to the mental, emotional, and social health of students, their families and the school environment. Qualified professionals such as school and community counselors, school and community psychologists, school health nurses, social workers, and qualified staff from community agencies provide these services.
Related Resources & Links
- Comprehensive School-based Mental Health Supports
- National Child Traumatic Stress Network
- Mental Health Guidelines
- Tennessee Model for Comprehensive School Counseling
- Jason Foundation Youth Suicide Prevention
- TDOE School Counseling
- TN School Counselors Association
- NASN – Mental Health Tools and Resources
- NASN – Violence in Schools Tools and Resources
Involvement of students, parents, community representatives, health specialists, and volunteers in schools provides an integrated approach for enhancing the health and well being of students both at school and in the community. School health advisory councils, coalitions, and broadly-based constituencies for school health can build support for school health programs. School administrators, teachers, and school health staff in all components actively solicit family involvement and engage community resources, expertise, and services to respond effectively to the health-related needs of students and families. Qualified professionals such as principals, teachers, and school health staff, along with students, parents and volunteers, provide leadership in this area.
Related Resources & Links
- American Academy of Pediatrics, Healthy Children
- CDC – Parent Engagement in Schools
- Harvesting A Future ~A Comprehensive Garden Resource Guide
- Helping Parents understand Remote Learning
- Getting Involved in Your Community
- Kidcentral tn
- Parent Zone
- TDOH - Tennessee Parent to Parent Support Program
- Tennessee State Park Adventure Challenge
- U.S. Department of Education-Family and Community Engagement
- U.S. Department of Education - Parent & Family Digital Learning Guide
Teachers and other school employees are charged with educating and caring for one of our most precious assets – our students. Therefore, it is imperative that school employees are supported in their efforts to stay healthy and active so that they can do their job most effectively. Wellness opportunities such as health assessments, health education and physical fitness activities are provided to all school staff, including the administrators, teachers and support personnel, to improve their health status. These opportunities encourage staff to pursue a healthy lifestyle that contributes to their improved health status, improved morale, and greater personal commitment to the overall coordinated school health program. This personal commitment often transfers into greater commitment to the health of students and serving as positive role models. Health promotion activities conducted on-site improve productivity, decrease absenteeism, and reduce health insurance costs. Qualified professionals such as principals, supervisors, health educators, school health nurses and school personnel/human resources directors provide leadership in this area.
Related Resources & Links
- AHA-Get Moving: Easy Tips to Get Active!
- AHA-To Stress or Not to Stress?
- Alliance for a Healthier Generation, Employee Wellness
- CDC - School Employee Wellness Resource
- Coping With the COVID-19 Crisis: Importance of Care for Caregivers Tips for Administrators and Crisis Team
- Get Connected: Creative Ideas for Building Staff Relationships
- Healthier Tennessee
- Stress Management-Tips for Better Management of Your Stress