Student+Health

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toc = = = by Team Awesomesauce =



= = = = =Physical Activity in Schools=



Introduction
For the past several years there has been a significant increase in the level of interest in the effects of physical activity on academic performance. A paradigm shift has occurred, with the old school of thought that time spent on physical activities was time not spent on academic endeavors and thus a waste. Now, however, more and more research is showing that physical activity increase the potential and efficiency of learning, and that a lack of physical activity is detrimental to students.(Bailey, Armour, Kirk, Jess, Pickup, Sandford & BERA Physical Education and Sport Pedagogy Special Interest Group 2009). Beyond physical activity, it has been found that participation in school sports is also very beneficial to students (Bailey et al., 2009). These benefits extend beyond mere academic performance and also help students develop respect for their bodies, integrate the body and mind, understand aerobic and anaerobic exercise and positively enhance self-confidence and esteem as well as facilitating cognitive and social development.

Historical Context
Since the founding of public education, the role of physical activity has changed several times, and the amount has waxed and waned. When physical activity was first being incorporated into public schools it was to provide a sound physique and to prevent physical defects such as poor posture (Bailey et al., 2009). If these two things were accomplished then physical activity was doing its job. In addition, the educational effects were viewed to be mostly moral and mental, pertaining to instilling the students with self-discipline and increasing their ability to concentrate and their manual dexterity. The first real shift in the expectations of physical activity in schools was after World War II when a large concern for physical fitness trumped the previous concerns with a lack of defects (Bailey et al., 2009). The activities were also of a much more rigorous and militaristic nature preparing students for the possibility of another war. Now the contemporary focus is more on childhood obesity and the children's perceptions of their own bodies, opposed to previous eras when the concern was more on preventing malnourishment and prevention of physical defects (Bailey et al., 2009). Also the educational benefits are now viewed as being cognitive and social, as opposed to being moral and mental(health).

Physical Activity and Academic Performance
Lately research has shown that physical activity is positively correlated with students' academic performance. In a study of North Carolina high school students during the years of 1993-1996, researchers found that athletes performed significantly better than non-athletes (Whitley, 1999). The average GPA of the athletes was 2.86 (4.0 scale) while non-athletes had an average GPA of 1.96 (4.0 scale). In a separate study of middle and high school students in Minnesota, a relationship was apparent between the intensity of the physical activity that students underwent and significant positive benefits on their GPA. "Specifically for high school boys participating in 0, 1, 2, and 3 or more sports teams, their respective mean GPA's were 2.50, 2.69, 2.79, 2.94 and similarly for high school girls their respective mean GPA's were 2.73, 2.85, 3.06, 3.20" (Fox, Barr-Anderson, Neumark-Sztainer, & Wall, 2010, p. 34). Athletes also missed, on average, half the number schools days throughout the year and got in trouble less (Whitley, 1999). Students participating in athletics also had a 99.56% graduation rate, while non-participating students graduated at a rate of 94.66% (Whitley, 1999). Also, in numerous studies it has been shown that a reduction in classroom time to incorporate physical activity in the school day does not have detrimental academic effects but actually increases performance in many instances (Bailey et al., 2009).

Physical Activity and Social Benefits
 Physical activity has been shown to﻿ be related to positive social behaviors, such as cooperation, personal responsibility and empathy. Through participation in physical activities, young people develop these abilities facilitating positive interaction with others. Data has also shown a correlation between physical activity and social issues dealing with reducing problematic youth behavior, including depression, crime and alcohol or drug abuse (Bailey et al., 2009).

**Relevant Organizations**
These organizations are dedicated to improving physical activity and education across the country:

[|American Alliance for Health, Physical Education, Recreation and Dance] (AAHPERD)is an organization that promotes and supports leadership, research, education and best practices for health and active lifestyles.

[|PE2020] is a project looking to solicit as many statements as possible that imagine what physical education should look like by the year 2020.

[|National Association of Kinesiology and Physical Education in Higher Education] is an organization for professionals, particularly to foster leadership in teaching, administration and policy.

Connection to Policy and Funding
[|National Coalition for Promoting Physical Activity] is a group of associations, health organizations, and private corporations that advocate for policies that encourage physical activity for Americans all of all ages

[|Elementary and Secondary Education Act of 1965, as amended, Title V, Part D, Secs. 5501-5507]

[|Education Department General Administraive Regulations (EDGAR) - 34 CFR Parts 74, 75, 76, 77, 79, 80, 81, 82, 84, 85, 86, 97, 98, 99]

[|Carol M. White Physical Education Program] is a government program that provides grants to initiate, expand or enhance physical education programs.

[|AAHPERD Grants] offers a list of funding sources from the AAHPERD.

**Relevant Resources (Best Practices & Action Opportunities)**
Michelle Obama's "[|Let's Move] " initiative. America's Move to Raise a Healthier Generation of Kids'.

[|PE Central] provides an avenue to share high quality practices and compiles innovative ideas for best practices.

=**Mental Health in Schools**=



**Introduction**
Mental health affects the overall well being of a child. Academic performance and behavior are affected by a student’s mental health. Although mental health issues can be a concern for any student, the focus of this section is on students dealing with mental health issues who do not have disabilities. In classrooms students live with untreated or, in some cases, treated mental health disorders. Students deal with adjustment issues, social interpersonal dilemmas, anxiety, stress, phobias, depression, aggression, behavioral problems, eating disorders, suicidal thoughts, etc. (Office of Surgeon General). These mental health problems directly shape students’ self-concept and self-esteem (Mann, Hosman, Schaalma, & Vries, 2004). Methods of prevention and offering intervention will benefit students’ mental status, which will not only enrich their self-concept and self-esteem, but also improve academic performance and behavior (Mann et al., 2004). Providing proper programs and promoting awareness for students’ mental health will present students with the means to perform academically and behave appropriately (Student Mental Health).

**Incidence and Consequences of Mental Health Issues**
• Approximately 20 percent of children and adolescents in the U.S. reported experiencing symptoms of a mental health problem and 5 percent reported experiencing “extreme functional impairment.” • Nearly 60 percent of the 2.2 million adolescents who reported a major depressive episode in the past year did not receive treatment. • Untreated mental illness can result in a lack of vocational success, substance abuse, violence and even suicide. • The dropout rate for students with severe emotional and behavioral problems is nearly two times higher than it is for other students. (Council of State Governments) Further details found by visiting [|healthystates.csg.org] (Search for ‘school mental health' then click on the first link ‘School Mental Health Services").

**Historical Context (content drawn from** [|**http://tiny.cc/mentalhygiene**]**)**
In 1893, Isaac Ray, a founder of the American Psychiatric Association, provided a definition of the term //mental hygiene// as:

"The art of preserving the mind against all incidents and influences calculated to deteriorate its qualities, impair its energies, or derange its movements. The management of the bodily powers in regard to exercise, rest, food, clothing and climate, the laws of breeding, the government of the passions, the sympathy with current emotions and opinions, the discipline of the intellect—all these come within the province of mental hygiene." (Mandell, W., Realization of an Idea, 2010, [] )

Mental health was first referred to as mental hygiene from the 1900’s until about the 1960’s. The National Committee for Mental Hygiene (founded 1909) was the first committee to take a look at improving mental health facilities, developing preventions, providing awareness of psychological perspectives and furthering the research. Mental hygiene was originally based on the beliefs of psychiatrist Adolf Meyer, who in the 1900’s deemed “mental illness and mental disorder were the outcome of the dynamic interaction of individuals with their environments.” He was of the conviction that prevention would be valuable. Although mental hygiene stems from psychiatry, it quickly became a focal point for teachers.

In the 20’s, Sigmund Freud using Meyer’s ideas, focused on specifically on the impact of an individual's childhood environment. This discovery influenced more teachers to recognize the significance of their students’ mental health. Freud went on to report the need for adults (teachers) to help develop children’s (their students’) mental health. Keeping the importance of childhood in an individual’s mental outcome in perspective, William Healy, introduced “child guidance” clinics into the juvenile system. He then presented ideas of having a team of professionals probe multiple dimensions of the individual’s life. With this information the team would construct a treatment plan to assist said individual.

In the 30’s “child guidance” clinics found their way out of the juvenile system, where the guidance was forced upon the delinquents, and instead became a source of support for parents and children of the middle-class, who would seek out their own help personally and privately. Through funding from the Laura Spelman Rockefeller Memoria, research shifted from the study of development of students with mental illness to the development of //average// students. This research brought into focus educational programs with goals of promoting mental health to all students. From here many researchers and professionals who benefit from psychology started to engulf themselves with looking for the most effective programs and models for increasing the mental health of all students. The progress of mental health reform is increasing as a community based issue, but currently the progress is moving to involve both the school’s mental health services and community’s mental health services for the best possible results.

**General Trends** []
Sources: Morrissey & Goldman, 1984; Goldman & Morrissey, 1985. []
 * ** Reform movement ** || ** Era ** || ** Setting ** || ** Focus of Reform ** ||
 * Moral Treatment || 1800-1850 || Asylum || Humane, restorative treatment ||
 * Mental Hygiene || 1890-1920 || Mental hospital or clinic || Prevention, scientific orientation ||
 * Community Mental Health || 1955-1970 || Community mental health center || Deinstitutionalization, social integration ||
 * Community Support || 1975-present || Community support || Mental illness as a social welfare problem (e.g., housing, employment) ||

**Mental Health Connections to Research**
//Prospective Reciprocal Relations between Physical Activity and Depression in Female Adolescents// Jerstad, Ness, Boutelle, and Stice's (2010) literature review revels previous findings that depression is common among adolescents, much more prevalent among females, and that physical activity has been shown to help the situation. This study took the current research further by not only looking at how physical activity affects depression, but also how depression affects physical activity. The authors used about 500 female adolescents over a six-year period, and gathered information regarding their mental health and physical activity status. Jerstad et al. (2010) found that for each additional physical activity the relative risk for depressive symptoms decreased by 1%, 8% for minor depression, and 16% for major depression. Girls with major depression were 35% less likely to participate in one more physical activity per year. Those with minor depression were 18% less likely to participate in one additional sport along with 21% of those with depressive symptoms. The results report level of depression and amount of physical activity can be predictors for one another, however the correlation is moderate. To address this concern would be to offer many opportunities for physical activity and to provide extra encouragement to depressed adolescents to participate.

//Identifying Trajectories of Adolescents' Depressive Phenomena: An Examination of Early Risk Factors// Mazza, Fleming, Abbott, Haggerty, Catalano (2010) suggest a need for identifying possible predictors for depression. With this knowledge the authors look to produce beneficial information that will help develop proper preventions and intervention strategies. The authors followed about 950 adolescents from grades second to eighth. Those six years were closely compared with the purpose of identifying any patterns of early behaviors with later depression. Common risk factors found for depression were anxiety, antisocial behavior, and attention problems. Such knowledge of these risk factors will help direct prevention programs at an early age.

//Adolescents' Suicidal Thinking and Reluctance to Consult General Medical Practitioners// This study examined the likelihood that if an adolescent was experiencing a mental health issue, they would seek out professional help. The focus being on help with suicidal thoughts due to the fact that 20% of Australian adolescents, where the study was done, and 10% of American adolescents deaths are suicide. Wilson, Deane, Marshall, and Dalley (2010) focused on ‘‘the refusal to accept or access available helping resources,’’ which they defined as help-negation (p.344). Studying close to 500 adolescents their statistics found that adolescents with suicidal thoughts and/or psychological distress are more likely not to seek help. It has been previously found that 75% of mental health problems in adolescents are untreated. There are a high number of adolescents who need, but do not seek professional help. The authors suggest a need to bring about help-negation awareness, to encourage those who need help.

//Bullying and Stress in Early Adolescence: The Role of Coping and Social Support// Konishi and Hymel (2009) studied both boys and girls to further discover a connection between the amount of stress experienced, the coping strategy employed with said stress, social support received, and those who report bullying behavior. A positive correlation between the amount of stress experienced and those who participated in bullying behavior was found. The study further found that those adolescents who used distraction as a coping strategy were more likely to bully, when under stress. This leads the authors to suggest, that effective coping strategies for stress should be taught at a young age. Proper coping strategies can help reduce stress, which can help reduce bullying. This study brings to light that bullies may be experiencing high amounts of stress, and do not know how to cope.

**Policy Information**
//President’s New Freedom Commission on Mental Health Vision Statement:// "We are committed to a future where recovery is the expected outcome and when mental illness can be prevented or cured. We envision a nation where everyone with a mental illness will have access to early detection and the effective treatment and supports essential to live, work, learn and participate fully in their community.” Find the New Freedom Commission on Mental Health: []

//The Current Status of Mental Health in Schools: A Policy and Practice Analysis.// Here is the executive summary of an in-depth look at the past, present and possible future policies. Read it at: []

//Federal Focus on School-Based Mental Health:// Visit: [] Click on Chapter 5 to download a ‘pdf’ file.

**Legislation**
Legislation Related to Student Support & Mental Health in Schools []

**Models and Best Practices**
//Three Models of health services//**:** ( [] ) 1. //School-supported mental health models:// • Social workers, guidance counselors, and school psychologists are employed directly by the school system. • Separate mental health units exist within the school system. • School nurses serve as a major portal of entry for students with mental health concerns. 2. //Community connections models:// • A mental health agency or individual delivers direct services in the school part-time or full-time under contract. • Mental health professionals are available within a school-based health center or are invited into after-school programs. • There is a formal linkage to an off-site mental health professional and/or to a managed care organization. 3. //Comprehensive, integrated models:// • A comprehensive and integrated mental health program addresses prevention strategies, school environment, screening, referral, special education, and family and community issues and delivers direct mental health services. • School-based health centers (SBHC) provide comprehensive and integrated health and mental health services within the school environment.

//Conceptual Models of School-Based Mental Health:// Visit: [] Click on Chapter 3 to download a ‘pdf’ file.

//Report on// //Comprehensive, Integrated Model:// The public schools in D.C. implemented a comprehensive integrated model and researched its effects. They found improvements in students’ mental health, overall. The link provides a comprehensive view of the integrated model, which consist of combining school-based and community based mental health programs. Visit: http://www.healthinschools.org/Health-in-Schools/Health-Services/School-Based-Mental-Health.aspx Click on: [|School Mental Health Services for the 21st Century: Lessons from the District of Columbia School Mental Health Program]

**Resources**
// Caring for Every Child’s Mental Health Campaign // • Increase public awareness about the importance of protecting and nurturing the mental health of young people. • Foster recognition that many children have mental health problems that are real, painful, and sometimes severe. • Encourage caregivers to seek early, appropriate treatment and services. []

// Comprehensive Community Mental Health Services Programs for Children // • Expand the service capacity in communities that have developed an infrastructure for a community-based, interagency approach to serving children and adolescents in the target population. • Provide a broad array of mental health services that are community-based, family-centered and tailored to meet the needs of the child or adolescent through an individualized service planning process. • Ensure the full involvement of families in the development of local services and in the care of their children and adolescents. []

// National Strategy for Suicide Prevention // The NSSP lays out a suicide prevention framework for action and guides development of an array of services and programs. []

• For a quick, one page guide on responding to a student in crisis click here for ‘psychological first aid.’ [] • Current research and past research on mental health can be located on the Substance Abuse and Mental Health Administration website. [] • UCLA developed a website with the focal point being on mental health in schools. New policies and research along with ideas on how to deal with mental health problems can be found at this easy to navigate site. [] • Comprehensive approaches to school mental health is a wiki-source where teachers post information about different techniques and models they have tired. It’s a way to collaborate with more than just your colleague next door. []

**Organizations**
National institute of Mental Health (NIMH) is part of the U.S. Department of Health and Human Services. Their objective is reducing the hindrance of behavioral and mental health problems through research on the connections of genetics, brain, behavior and mind. Check it out: []

//Organizations of Mental Health Professionals** : **// []

“SparkAction is an online journalism and advocacy center by and for the child and youth field. Through our site and e-newsletters, we work to: 1. Connect concerned adults and young people—whether they’re new to the issues or already activists—to compelling stories, context and accurate information on children’s issues, as well as tools to take action, from volunteering to advocate for better policies and programs. 2. Help child- and youth-focused organizations effectively reach a broad audience (the public, professional peers, and policymakers) with their content and materials. 3. Elevate the voices and perspectives of young people themselves. Break down silos in the broad child and youth field and strengthen connections among organizations and agencies to create a stronger, unified voice for children and youth.” Check it out: [|http://sparkaction.org/action]

**Funding** []
// Grants to Improve the Mental Health of Children. // The means provided here would be for the intended ends of increasing access to quality mental health care by developing innovative programs linking schools’ mental health programs with community mental health facilities. Criteria for the grants focus on integrating community and school-based mental health care. • Submit description of program • Measure and report the quality increase of mental health services • Establish crisis intervention programs • Explain how your new program will be combined with the current school policy. • Further explain how said program establishes support and learning for students. []

• // Grant for Elementary and Secondary School Counseling Programs // [] • // Grant to Prevent Youth Substance Abuse and Violence // [] [] • // Grant to Implement Mentoring Programs // [] • // The Health, Mental Health, Environmental Health and Physical Education // (HMHEHPE): provides opportunities for financial assistance to foster the overall well being of students. []

**Action Opportunities**
For chances to be proactive check out: [|http://takeaction.mentalhealthamerica.net/site/PageServer] This website provides ideas and ways to participate in reform in the form of educational programs, annual conferences, and advocacy programs.

Introduction
Sleep duration affects the health of children and adolescents. Shorter sleep durations have been associated with poorer academic performance, unintentional injuries, and obesity in adolescents ( Noland, Price, Dake, & Telliohann, 2009). Inadequate sleep time may be contributing to adolescent health problems such as increased stress and obesity. A variety of factors affect the quantity and quality of adolescents' sleep, including stress, obstructive sleep apnea, caffeine consumption, alcohol consumption, exercise behaviors, jobs, homework, sports, poor time management skills, and school start times (Pope, 2010). The most obvious factors affecting the quantity of sleep in youths are when they go to bed and when they arise.

Students who are sleepy are not able to work to their fullest potential in school ( Walker, Brakefield, Hobson, & Stickgold, 2003). There are direct connections between rapid eye movement sleep, sleep occurring later at night, and learning ( Golombek & Cardinali, 2008). Middle and high school students who consistently get less than eight hours of sleep miss out on the most important sleeping stage for storing new information. Early morning school start times in middle school and high school are not conducive to student sleep health because students at this age are on an opposite sleep-wake cycle. They are biologically and socially inclined to sleep in later and go to bed later. This conflict, as well as less parental involvement in sleep schedules and an increase in academic responsibility, leads to poor sleep health. Secondary school students typically display more interests in later time activities, such as watching TV, using the computer, dating, meeting friends, working jobs, or going to parties.

Most adolescents need slightly more than nine hours of sleep each night for optimal daytime functioning. The most significant signs that indicate that an adolescent probably had insufficient sleep include changes in mood and decreased motivation, which often result in emotional and behavioral difficulties. Most adolescents go to bed after 11 P.M. Because most adolescents must rise between 6:00 and 6:30 A.M. to prepare for school, they are getting a maximum of seven hours of sleep on school nights.

Sleep Deprivation and Physical Consequences
Early morning school schedules impose earlier wake-up times on secondary school students, who have a later inclination toward wakefulness. One consequence of this is that adolescents are requested to increase academic performance when they would most likely prefer to sleep. Furthermore, later bedtimes and earlier wake-up times reduce sleep duration on school days, resulting in longer and later sleep on the weekends. It is not clear whether this modification on weekends is due to a compensation for sleep loss during school days or the expression of the natural circadian rhythm characteristic of that age group, free of social pressures of school schedule or some combination of the two (Noland et al., 2009). These modifications promote a reduction–extension sleep pattern between week and weekend days. This irregular pattern and the associated daily sleep loss are related to increased reports of diurnal sleepiness, tiredness, bad mood, concentration and attention difficulties, and reduction in school performance ( Wolfson, A. R., & Carskadon, M. A., 2003).

Sleep Deprivation Connections to Research
[|Mind, Brain, Education, and Biological Timing] This article summarizes the biology behind adolescent sleep schedules. Golombek and Cardinelli (2008) explain that secondary school students, who are typically vespertine chronotypes, confront a conflict between their school schedules and their sleep preferences. Research stresses the importance of synchronizing sleep preferences with student schedules in order to maximize their health and academic performance. Students are often shifting their sleep schedules due to the difference in their schedules during the week versus the weekend and vacation. The circadian system will adjust to a delay in bedtime and wake time within one to two days, but the hormone and temperature readjustment back to an early wake time during the school week requires several days. The circadian rhythm can more easily shift forward to accommodate staying up late and sleeping in, which explains why it is less painful to stay up late than it is to wake up early and also to travel westbound instead of eastbound. This sleep issue is infringing upon human quality of life, resulting in poorer adolescent academic performance. A proper solution to this problem would align chronobiology with school day structure.

[|Sleep After Learning Aids Memory Recall] In a quantitative research study, Born, Gais, and Lucas (2008) ask the question, is high school students’ ability to remember vocabulary, an instance of declarative memory, improved when sleep follows learning? Is the beneficial effect of evening learning attributable to sleep following learning or is it related to the time of day? Results indicate that sleep following learning has a beneficial effect on declarative memory consolidation in humans and that this effect is present when retrieval is postponed until after recovery sleep in the sleep deprivation condition. Results also indicate that sleep is most effective in terms of memory consolidation when it follows shortly after the learning takes place instead of after a long period of wakefulness. The authors hypothesize that having a no-interference period shortly after learning might enhance encoding. If sleep happens within a certain window after learning, subjects may have lower incidences of forgetting.

[|Adolescents' Sleep Behaviors and Perceptions of Sleep] Most students go to sleep around 11:00 PM and need to wake for school between 6:00 and 6:30 AM. Fewer hours of sleep correlate with poorer academic performance, unintentional injuries, and obesity in adolescents. This quantitative research study by Noland, Price, Dake, and Telliohann (2009) focuses on how adolescents perceive and negotiate their sleep issues. Low rapid eye movement levels associated with fewer hours of sleep preclude the storing of new information. Most subjects slept longer hours on the weekends than they did on weekdays in a potential effort to make up for sleep lost during the week. Because wake and rise times differ so dramatically during the week compared to the weekend, the authors surmise that students may feel extreme tiredness, mood swings, feelings of jet lag, lack of motivation, and difficulty concentrating as their sleep schedule readjusts during the week. Students were largely aware of healthy sleep behaviors despite the fact that they did not always engage in them. In order for sleep education programs to be successful, they will need to extend beyond providing information to students and will have to use alternate means to motivate students to obtain adequate sleep.

[|“Beyond ‘Doing School:’ From ‘Stressed Out’ to ‘Engaged in Learning.’] The results from research found that students are sleeping much less than the recommended nine hours nightly and that there is not enough time in the day for everything the student needs to accomplish. Another outcome of such a rigorous schedule is that students are either disengaging from their studies and only accomplishing what is minimally required or choosing to not do their work. Pope (2010) seeks to explain the nature of the Challenge Success initiative: Stanford coaches from the School of Education worked closely with administrators, instructors, parents, students, and counselors to figure out what each school needs in terms of reform efforts. Students often do not have the time or the opportunity to process information during the school day because they are jumping from short class to short class. Each school decided upon an arrangement that best suited their needs; schools commonly adopted block schedules, late starts, study periods, and tutorials, as well as calendar systems that prevented multiple exams within a certain period and created an easier exam schedule around vacation time. Studies have revealed that students who feel cared for are less likely to engage in unethical and unhealthy behaviors and are more likely to learn in school. Certain schools implemented the Jared Project, which devises a system so that every student has an advocate at the school and feels cared for. The program stressed the understanding of concepts and main ideas as opposed to memorization of facts and details. Challenge Success emphasized a multitude of assessment tools, an inspection of current grading policies, and a shift away from public recognition and emphasis on numerical scores.

Best Practices for Schools and Students
Sleep hygiene is the practice of several behaviors that optimize and promote good sleep and daytime functioning. The components include ensuring regular bedtimes and rise times, limiting napping during the day, avoiding lying in bed waiting to fall asleep, winding down before bed, being relaxed, restricting caffeine and nicotine throughout the day, avoiding alcohol and sleep aids, and providing for a favorable sleeping environment. A positive environment is one free of excessive noise and light, extreme temperatures, pets, and even a bed partner. Other disruptions to the sleep environment include activities that may take place in bed such as watching television, eating, working on schoolwork, or talking on the phone.

One of the most significant factors affecting adequate sleep time and quality of sleep is a consistent sleep and wake schedule. Previous studies have determined that people who go to bed and rise at the same time each day, including the weekend, have higher quality of sleep and are less likely to report sleep deprivation. Adolescents may not realize that they cannot make up for lost sleep during the week by sleeping more on the weekends or by napping (Noland et al., 2009). The four most common items that students indicated kept them from getting sleep were homework, stress, TV, and socializing.

Although parents may be involved with the sleep schedules of chil dren, it is likely that they become less involved as their offspring enter secondary school. Therefore, it might bene fit adolescents if parents remain involved in their middle schooler’s or high schooler’s sleep schedule and if parents are well informed about factors that interfere with the sleep of their children.

Adolescents also need to be educated regarding the importance of adequate sleep, the components of good sleep hygiene, and strategies such as time management to facilitate healthy sleep behaviors (Noland et al., 2009). Although education may be necessary to improve sleep hygiene of students, it is probably not sufficient. A long-term solution to chronic sleep deprivation in adolescents that others conducting research on adolescent sleep behaviors support may mean that high school start times should be no earlier than 8:30 A.M.

Resources and Organizations for Sleep and Education
[|American Academy of Sleep Medicine]

[|Teachers' Guide to Information about Sleep]

[|Information about Sleep Health and Safety]

[|Start Later for Excellence in Education Proposal]

[|Sleep Education Blog] =Nutrition in Schools=

Introduction
Childhood obesity has become a national epidemic. In the past three decades, obesity rates have tripled for young people; currently one in three children in the U.S. is considered overweight or obese. ( CDC __[|http://www.cdc.gov/obesity/childhood/index.htm)l]__ Numerous studies have shown that overweight children are more prone to have risk factors associated with diabetes, high blood pressure and cholesterol, and cancer. The majority of children do not exercise enough and consume too much fat content in their daily diet. (CDC)

Obese children in most instances become unhealthy adults. There is an eighty percent likelihood that overweight children aged 10 - 15 will be obese at age 25. ( CDC __[|http://www.cdc.gov/obesity/childhood/index.htm)l]__ ) A recent study conducted by the New England Journal of Medicine and cited in the New York Times found that “the heaviest youngsters were more than twice as likely as the thinnest to die prematurely, before age 55, of illness or a self-inflicted injury.” (NYT, Feb 10, 2010) Youngsters can also develop negative self-images which often plague them throughout their adult lives.

Since 2000, the media have increased coverage of health issues, particularly those of America’s youth, and thus nutrition has become a more prevalent topic. Some state and local agencies have begun to establish nutritional standards for schools. In Michigan, the Department of Education [] is currently developing a new set of guidelines for nutrition in schools. Further, they are utilizing Federal grant dollars to test a program in four school districts, which includes more fresh fruits and whole grain products than typically found in school cafeterias. Empirical data are being collected, and results will be available in 2012. Because most schools offer breakfast, lunch and after-school snack programs, the potential is great to increase awareness of better eating habits and to affect children’s behavior. Research has shown a strong link between diet quality and student performance. (Florence, Asbridge, & Geugelers, 2008)

Historical Context
The school lunch program began in 1946 with the signing of the //National School Lunch Act// (NSLA) by President Harry Truman. Within one year the program was reaching out to over 7 million children. In 1966, with the school lunch program serving over 3 billion meals annually, Congress passed the //Child Nutrition Act,// which established the School Breakfast Program, established a food service equipment assistance program, and increased funding for meals to students in need. In 1969 President Richard Nixon established the free and reduced price lunch program for low income students. Nineteen seventy-seven saw the establishment of the Nutritional Education Training (NET) program. A full history of the National School Lunch Program can be found [|here.]

Since 1980, a number of behavioral and environmental factors have influenced children’s dietary intake: ([]) - direct link to site listed below.
 * Less physical exercise - from reduced gym and sports programs at school
 * More sedentary lifestyle - more time spent watching television and playing video games
 * Increased food intake - larger portions resulting in a 31% increase in calories per day (letsmove.gov)
 * Poor eating habits - more snacking, more food and drinks containing higher sugar and fat content, more meals on the “go”
 * Omnipresence of snack foods - available in most schools and where children congregate (shopping malls, sporting events, even exercise facilities)
 * Increased advertising - from millions of broadcast impressions (radio, tv) and now on the internet too

The Center for Disease Control (CDC) has become a crucial voice to counteract the alarming trends in America toward obesity. Their efforts to study the effects of nutrition on obesity and to make their research available publicly have contributed to a new culture of awareness and action. Increased media coverage, celebrity nutritional campaigns, and national, state and local educational programs are all beginning to yield results.

Connections to Research
[] The purpose of this study was “...to ensure that children have access to healthy, well-balanced meals.” (p.1) This is the third study commissioned by the United States Department of Agriculture (USDA) to measure the effectiveness of school-provided breakfast and lunch programs.

Recent data analysis suggest that schools have made nutritional improvements to the School Breakfast Program (SBP) and National School Lunch Program (NSLP) that they offer 36 million students every day. However, the authors from the USDA (Gordon & Fox, 2007) note that these programs still provide fat and saturated fat levels that exceed USDA standards. The main obstacle to meeting these standards appears to be competitive foods, which are often cheaper and more attractive to students than healthy alternatives. (USDA)

Health Education and Behavior @http://heb.sagepub.com/content/37/1/51.abstract

"This study tested a structural equation model to estimate the relationship between health behaviors, body mass index (BMI), and self-esteem and the academic achievement of adolescents. The authors analyzed survey data from the 2000 study of Youth in Iceland, a population-based, cross-sectional sample of 6,346 adolescents in Iceland. The model demonstrated good fit with chi-square of 2685 (n = 5,810, df = 180), p < .001, Comparative Fit Index value of .94, and a root mean square error of approximation of .049. Lower BMI, physical activity, and good dietary habits were all associated with higher academic achievement; however, health behavior was positively and robustly associated with greater self-esteem. Self-esteem was positively influenced both through physical activity (β = .16) and the consumption of fruits and vegetables (β = .14). In contrast, poor dietary habits negatively influenced self-esteem and academic achievement, and self-esteem was negatively influenced by increasing levels of BMI (β = –.05)."

Teen Obesity @http://eric.ed.gov/ERICWebPortal/search/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=EJ793442&ERICExtSearch_SearchType_0=no&accno=EJ793442

"Objective: A school-based nutrition education minimal intervention (MI) was evaluated. Design: The design was experimental, with random assignment at the school level. Setting: Seven schools were randomly assigned as experimental, and 7 as delayed-treatment. Participants: The experimental group included 551 teens, and the delayed treatment group included 329 teens. Intervention: The minimal intervention was Present and Prevent, a commercially available Power-Point program presented in two 30-minute time slots over 1 week. Main Outcome Measures: The dependent variables were nutrition knowledge, attitudes, peer and family influences, behavioral intentions, and program satisfaction. The independent variable was group assignment. Analysis : A matched-pairs and 2-sample t test were used respectively to assess within-group and between-group changes. Results: Significant experimental posttest improvements occurred in the following: knowledge (P .001); intention to maintain a healthy body weight because of importance to friends (P .001);and intention to eat fewer fried foods, eat fewer sweets, look more at food labels, and limit TV watching (all P .001). Program satisfaction measures were significantly associated with each of the healthy weight maintenance behavioral intentions. Conclusions and Implications: The MI teen obesity prevention program made an impact on nutrition knowledge and positive behavioral intentions in only 2 classroom sessions and was well received by participants."

Dietary Patterns Relating To Academic Performance @http://jech.bmj.com/content/62/8/734.full?rss=1

"Objectives: To empirically test the impact of dietary intake at several time points in childhood on children’s school attainment and to investigate whether any differences in school attainment between children who ate packed lunches or school meals was due to who these children were, their pre-school dietary patterns, or to what they ate at school. Design: Using longitudinal data available in the Avon Longitudinal Study of Parents and Children (ALSPAC), multivariate linear regression was used to assess the relative importance of diet at different ages for school attainment. Main outcome measures: Three indicators of school attainment were used: at ages 4–5 entry assessments to school, at ages 6–7 Key Stage 1 national tests and at ages 10–11 Key Stage 2 national tests. These outcome variables were measured in levels as well as in changes from the previous educational stage. Results: The key finding at age 3 was that ‘‘junk food’’ dietary pattern had a negative association with the level of school attainment. A weak association remained after controlling for the impact of other dietary patterns at age 3, dietary patterns at ages 4 and 7 and other confounding factors. The authors did not find evidence that eating packed lunches or eating school meals affected children’s attainment, once the impact of junk food dietary pattern at age 3 was accounted for in the model. Conclusions: Early eating patterns have implications for attainment that appear to persist over time, regardless of subsequent changes in diet."

Diet Quality vs Academic Performance @http://www3.interscience.wiley.com/journal/119393960/abstract?CRETRY=1&SRETRY=0

"BACKGROUND: Although the effects of nutrition on health and school performance are often cited, few research studies have examined the effect of diet quality on the academic performance of children. This study examines the association between overall diet quality and academic performance. METHODS: In 2003, 5200 grade 5 students in Nova Scotia, Canada, and their parents were surveyed as part of the Children's Lifestyle and School-performance Study. Information on dietary intake, height, and weight and sociodemographic variables were linked to results of a provincial standardized literacy assessment. Diet Quality Index-International was used to summarize overall diet quality. Multilevel regression methods were used to examine the association between indicators of diet quality and academic performance while adjusting for gender and socioeconomic characteristics of parents and residential neighborhoods. RESULTS: Across various indicators of diet quality, an association with academic performance was observed. Students with decreased overall diet quality were significantly more likely to perform poorly on the assessment. Girls performed better than boys as did children from socioeconomically advantaged families. Children attending better schools and living in wealthy neighborhoods also performed better. CONCLUSIONS: These findings demonstrate an association between diet quality and academic performance and identify specific dietary factors that contribute to this association. Additionally, this research supports the broader implementation and investment in effective school nutrition programs that have the potential to improve student access to healthy food choices, diet quality, academic performance, and, over the long term, health."

**Resources**
[|http://www.letsmove.gov]/ Michelle Obama has set up a website that represents White House policy on Health and Nutrition for children. The website is composed of five components and the one most relevant to this topic is //Eat Healthy: Food and Nutrition, which// gives advice on healthy eating and seeks involvement from pregnant moms to entire communities.

**Relevant Legislation**
These are the current school nutrition bills passing through congress.
 * [|H.R. 5504 - Improving Nutrition for America's Children Act] - House Child Nutrition Reauthorization Bill - June 2010
 * Will improve the access of nutritional food to many young children across the country. It aims to improve the nutritional quality of meals in schools and child care.
 * S. 3307 - Healthy, Hunger Free Kids Act of 2010 - Senate Child Nutrition Reauthorization Bill - March 2010
 * This bill focuses on nutritional programs that are specifically designed to protect young children, such as: The Special Supplemental Nutrition Program for Women, Infants, and Children, The Child and Adult Care Food Programs, and the school breakfast and lunch programs.
 * [|S. 934 The Child Nutrition Promotion and School Lunch Protection Act of 2009] April 2009
 * This bill will amend the Child Nutrition Act of 1966 to improve the nutrition and health of schoolchildren and update the national school nutrition standards for foods and beverages sold outside of school meals to conform to current nutritional research.
 * [|HR 1324 The Child Nutrition and School Lunch Protection Act of 2009] March 2009
 * The version of the previous bill in the House of Representatives.

**Relevant Organizations**
These organizations are dedicated to improving school nutrition across the country:

[|American School Health Association]

[|ASHA Advocacy Network]

[|School Nutrition Association]

[|Farm to School]

[|National School Lunch Program-USDA] References

Bailey, R., Armour, K., Kirk, D. Jess, M., Pickup, I., Sandford, R. & BERA Physical Education and Sport Pedagogy Special Interest Group (2009). The educational benefits claimed for physical education and school sport: An academic review. //Research Papers in Education 24//(1) 1-27.

Born, J., Gais, S., & Lucas, B. (2006). Sleep after learning aids memory recall. //Learning & Memory, 13//(3), 259-262.

Burt, J.J. (1998). The role of kinesiology in elevating modern society. //Quest 50,// 80-95

Department of Health and Human Service, Substance Abuse and Mental Health Service Administration, Center for Mental Health Services. (4578). //Mental health: A report from the surgeon general.// Washington, DC: http://surgeongeneral.gov/library/mentalhealth.chapter2/sec7.html

Florence, M.D., Asbridge, M, & Veugelers, P.J. (2008). Diet quality and academic performance. //Journal of School Health//, 78(4), 209-215.

Fox, C., Barr-Anderson, D., Neumark-Sztainer, D., & Wall, M. (2010). Physical activity and sports team participation: Associations with academic outcomes in middle school and high school students. //Journal of School Health, 80// (1), 31-7.

Goldman, H.H., Morrissey, J.P. (1985). The alchemy of mental health policy: Homelessness and the fourth cycle of reform. //American Journal of Public Health, 75, 727-731.//

Golombek, D. A. & Cardinali, D. P. (2008). Mind, brain, education, and biological timing. //Mind, Brain, and Education, 2//(1), 1-6.

Gordon, A., & Fox, M.K., (2007). School Nutrition Dietary Assessment Study-III: Summary of findings. Washington, D.C.; United States Department of Agriculture. Retrieved from http://www.fns.usda.gov/OANE/menu/published/CNP/FILES/SNDAIII-SummaryofFindings.pdf

Jerstad, S., Ness, K., Boutelle, K., & Stice, E. (2010). Prospective reciprocal relations between physical activity and depression in female adolescents. //Journal of Consulting and Clinical Psychology, 78(2), 268-272.//

Konishi, C., & Hymel, S. (2009). Bullying and stress in early adolescence: The role of coping and social support. //Journal of Early Adolescence//, //29//(3), 333-356.

Mann, M., Hosman, C., Schaalma, H., & Vries, N. D. (2004). Self-esteem in a broad-spectrum approach for mental health promotion. //Health Education Research//, //19//(4), 357-372.

Mazza, J., Fleming, C., Abbott, R., Haggerty, K., & Catalano, R. (2010). Identifying trajectories of adolescents' depressive phenomena: An examination of early risk factors. //Journal of Youth and Adolescence, 39(6), 579-593.//

Mental Health: A Report of the Surgeon General - Chapter 2. (n.d.). //Office of the Surgeon General (OSG).// []

Morrissey, J.P., & Goldman, H. H. (1984). Cycles of reform in the care of the chronically mentally ill. //Hospital and Community Psychiatry, 35, 785-793.//

Noland, H., Price, J.H., Dake, J., & Telliohann, S. K. (2009). Adolescents' sleep behaviors and perceptions of sleep. //Journal of School Health, 79//(2), 224-230.

Pope, D. (2010). Beyond 'doing school:' From 'stressed out' to 'engaged in learning.' //Education Canada, 50//(1), 5-8.

Student Mental Health. (n.d.). //Student Mental Health Manual.// Lancaster University. http://www.studentmentalhealth.org.uk/chap5.html

The Council of State Governments, Healthy States Initiative (CDC, HHS), (2007). School mental health. Legislator policy brief.

Walker, M.P., Brakefield, T., Hobson, J.A., & Stickgold, R. (2003). Dissociable stages of human memory consolidation and reconsolidation. //Nature, 425//, 616-620.

Wilson, C., Deane, F., Marshall, K., & Dalley, A. (2010). Adolescents' suicidal thinking and reluctance to consult general medical practitioners. //Journal of Youth and Adolescence//, //39//(4), 343-356.

Whitley, R. L. (1999). Those “dumb jocks” are at it again: A comparison of the educational performances of athletes and non-athletes in North Carolina high schools from 1993 to 1996. //The High School Journal, 82,// 223-233.

Wolfson, A. R., & Carskadon, M. A. (2003). Understanding adolescents’ sleep patterns and school performance: A critical appraisal. Sleep Medicine Reviews, 7, 491–506.