Development of the COMPASS School Health Profile...Development of the COMPASS School Health Profile...

Cohort study evaluating how changes in school programs, policies, and resources impact youth health behaviours

Development of the COMPASS School Health Profile COMPASS Technical Report Series, Volume 1, Issue 1 April 2013

i

University of Waterloo

Waterloo, Ontario

April 2013

©COMPASS

www.compass.uwaterloo.ca

ii

Dana Church, PhD1 Scott Leatherdale, PhD2

1 - Propel Centre for Population Health Impact, University of Waterloo, Waterloo, ON Canada. 2 - School of Public Health and Health Systems, University of Waterloo, Waterloo, ON Canada.

Report funded by:

The COMPASS study was supported by a bridge grant from the Canadian Institutes of Health Research (CIHR) Institute of Nutrition, Metabolism and Diabetes (INMD) through the “Obesity – Interventions to Prevent or Treat” priority funding awards (OOP-110788; grant awarded to ST. Leatherdale) and an operating grant from the Canadian Institutes of Health Research (CIHR) Institute of Population and Public Health (IPPH) (MOP-114875; grant awarded to ST. Leatherdale).

Suggested citation:

Church D, Leatherdale ST. Development of the COMPASS School Health Profile. COMPASS Technical Report Series. 2013;1(1). Waterloo, Ontario: University of Waterloo. Available at: www.compass.uwaterloo.ca

Contact: COMPASS Research Team University of Waterloo 200 University Ave West, BMH 1038 Waterloo, ON Canada N2L 3G1 [email protected]

ACKNOWLEDGEMENTS

http://www.compass.uwaterloo.ca/

mailto:[email protected]

iii

Table of Contents Acknowledgements ........................................................................................................................................ ii

Introduction .................................................................................................................................................. 1

Methods ........................................................................................................................................................ 2

Length of the School Health Profile .......................................................................................................... 2

Visual Appearance of the School Health Profile ....................................................................................... 3

Evidence-Based Recommendations, Curriculum Supplements, and Public Health Unit Information ...... 4

Final version of the Compass School Health Profile ..................................................................................... 5

References .................................................................................................................................................... 5

Appendix ....................................................................................................................................................... 6

Example of a generic COMPASS School-Specific Feedback Report .......................................................... 6

1

Introduction COMPASS is a longitudinal study (starting in 2012-13) designed to follow a cohort of grade 9 to 12 students attending a convenience sample of Ontario secondary schools for four years to understand how changes in school environment characteristics (policies, programs, built environment) are associated with changes in youth health behaviours. COMPASS originated to provide school stakeholders with the evidence to guide and evaluate school-based interventions related to obesity, healthy eating, tobacco use, alcohol and marijuana use, physical activity, sedentary behaviour, school connectedness, bullying, and academic achievement. COMPASS has been designed to facilitate multiple large-scale school-based data collections and uses in-class whole-school sampling data collection methods consistent with previous research [1-4]. COMPASS also facilitates knowledge transfer and exchange by annually providing each participating school with a school-specific feedback report that highlights the school-specific prevalence for each outcome, comparisons to provincial and national norms or guidelines, and provides evidence-based suggestions for school-based interventions (programs and/or policies) designed to address the outcomes covered in the feedback report. (Refer to: www.compass.uwaterloo.ca) The provision of a customized feedback report to participating schools is an important knowledge transfer (KT) component of COMPASS. Each school-specific report provides data on the various student health behaviours or outcomes of interest, makes comparisons to provincial and/or national norms or guidelines, and offers: (a) evidence-based suggestions for interventions, programs, or policies aimed at improving the health of the student population; (b) evidence-based suggestions for curriculum supplements aimed at improving student awareness and knowledge to encourage and enable them to make healthier lifestyle choices; and (c) local public health unit contact information specific to each content domain, in case the school wishes to contact their local public health unit for support in taking action on the findings. These reports essentially allow school stakeholders to quickly see, “at a glance,” what is happening at their school and how they should plan for future school programs and intervention activities. The reports are generated using an automated, quality-controlled system that accurately scans data from the student questionnaires, inputs the data into analysis programs, and exports these data into a format that can be inputted into an existing feedback report template. The time between completion of the student questionnaire and generation of the COMPASS feedback report is less than 4 weeks. Thus, the COMPASS feedback reports provide schools with up-to-date school-specific evidence pertaining to the student health behaviour(s) or outcomes of interest for their student population. Moreover, aside from the feedback reports being used by participating schools, COMPASS also engages a Knowledge Broker (to connect schools with resources for taking action on the findings), who uses these reports when acting as a link between schools and local public health professionals, should schools wish to have linkages formed to assist with making changes to their policies and/or programs after viewing the data. As such, the school-specific report needs to reflect these unique aspects of the COMPASS project. This technical report outlines the development of the COMPASS school-specific feedback report, referred to in the COMPASS study as the School Health Profile (SHP).

http://www.compass.uwaterloo.ca/

2

Methods The COMPASS School Health Profile (SHP) was intended to be a KT tool for schools. The principal of a participating school would be given the SHP and then s/he would be encouraged to (a) use the data for informing and guiding health promotion activities within their school, and (b) share the student data and evidence-based recommendations in the report with the school community (i.e., school board, school staff, parents, and students) and/or their local public health unit. The COMPASS student questionnaire contains 65 questions measuring a number of different items. The COMPASS research team decided how the data from the questionnaire would be used (i.e., which items would be presented in the SHP), as well as which comparisons would be made between the student data and existing guidelines or national benchmarks. To increase the probability that principals would read and use the SHP, and share it with their community, it was decided the SHP must be brief, visually attractive, and easy to read with minimal text.

Length of the School Health Profile The SHP would be provided to schools in both a hard copy booklet format and as a pdf. Taking physical printing parameters into account, it was decided that a 16-page booklet format would allow for a brief yet comprehensive summary of the student data. The 16 pages would be assigned accordingly:

Page 1: Front cover with title and COMPASS logo Page 2: Inside front cover (blank) Page 3: Introduction and description of Profile, contact information, partner logos Pages 4-13: Presentation of student data Page 14: Information for contacting the COMPASS Knowledge Broker (mostly blank) Page 15: A message from COMPASS Leadership (inside back cover, mostly blank) Page 16: Back cover with COMPASS logo and web address (mostly blank)

This format provides 10 pages for presenting the student data and the inclusion of blank or mostly blank pages allow space additional data comparisons to be added in subsequent years, showing schools in which areas they have improved (or digressed). Please refer to the Appendix of this report to see the generic template used for the SHP. Using this 16-page format, the question arose as to how to summarize the student data in 10 pages. To be consistent with the COMPASS priority topics, it was decided that one full page would be devoted to each of the original priority topic areas:

• Obesity • Marijuana Use • Physical Activity • Alcohol Use • Smoking • Sedentary Behaviour

3

Given that healthy eating and bullying are issues that have been identified by schools as priorities, they would also receive their own full page. Due to their similarity, it was decided that school connectedness and academic achievement would be presented jointly on the same page. This resulted in there being one remaining page in the SHP and it was decided that it would be used to show schools their data broken down into gender comparisons. Thus, the last page of student data presented in the SHP would be a comparison of the outcomes for males and females for each of the health behaviours listed above.

Visual Appearance of the School Health Profile We wanted to ensure that the COMPASS SHP was visually appealing, easy to comprehend, and not overly ‘text’ heavy. As such, the first consideration to maximize visual appeal of the SHP was to include the same COMPASS logo and colour scheme that is used for other COMPASS correspondence (i.e., letterhead, project brochure, and website). This would provide consistency and branding for the overall project, as well as make the Profile easily recognizable by school stakeholders as a component of the COMPASS study. The second consideration was to develop a standard or “master” template for the entire SHP. This template would be used for each participating school such that the layout, text, and style would be consistent across schools yet each school’s specific data (percentages) could be easily inserted into the SHP without needing to modify surrounding graphics or text. The specific school name would also appear on the SHP cover and each page that presents student data in case school stakeholders wanted to share the entire SHP or only results specific to particular topics they deem as priorities. Such a template would also allow for ease of SHP generation by COMPASS staff. The COMPASS research team decided that to make the SHP visually distinct from more traditional school-specific feedback reports that are used in similar school-based projects [for instance, the National Youth Smoking Survey (www.yss.uwaterloo.ca), SHAPES (www.shapes.uwaterloo.ca), or the New Brunswick Student Health Survey (www.unbf.ca/education/herg/wellness/example-reports.php)]. We wanted the SHP to incorporate eye catching graphics and simple text, rather than lots of text, charts, and graphs. To do this we conducted a large online search for different information graphics or “infographics,” resources, as these presented us with a variety of different options for thinking about how to visually present data in a clear, simple, and eye catching ways (for instance, http://visual.ly/). When these websites were searched, any infographic that presented data in a particularly appealing way was printed and included in a portfolio, organized according to COMPASS topic areas. We then used these as templates for developing a unique storyboard for the COMPASS SHP. This draft storyboard was presented to a local graphics design company (green dot design; www.greendotdesign.ca), who created the unique look and style for the COMAPSS SHP based on our design requests and the draft storyboard. In order to maximize knowledge transfer of the school-specific student data to principals, and to ensure ease of comprehension is shared with a variety of external school stakeholders, it was decided that the SHP would use minimal text and present results in percentages. This would allow readers to easily see and understand the important school-specific results “at-a-glance.” In order to help readers put those school-specific results into the appropriate context, we also provided benchmarks for comparison in terms of the percentage of students at that school meeting specific national/provincial guidelines (e.g., eating the appropriate number of servings listed in Canada’s Food Guide) or the percentage of students at that school performing a particular behaviour compared to the national/provincial norms (e.g.,

http://www.yss.uwaterloo.ca/

http://www.shapes.uwaterloo.ca/

http://www.unbf.ca/education/herg/wellness/example-reports.php)

http://visual.ly/

http://www.greendotdesign.ca/

4

smoking or binge drinking rates). The following sources were used for the guidelines or comparison data presented in the SHP:

• Obesity o BMI Classification system provided by the International Obesity Task Force [5], based on

age and sex adjusted BMI cut-points • Physical Activity

o The Canadian Society for Exercise Physiology (www.csep.ca/guidelines) • Healthy Eating

o Health Canada’s Eating Well with Canada’s Food Guide (http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php)

• Sedentary Behaviour o The Canadian Society for Exercise Physiology (www.csep.ca/guidelines)

• Tobacco Use o The 2010-2011 Youth Smoking Survey (www.yss.uwaterloo.ca)

• Alcohol Use o The 2010-2011 Youth Smoking Survey (www.yss.uwaterloo.ca)

• Marijuana Use o The 2010-2011 Youth Smoking Survey (www.yss.uwaterloo.ca)

The COMPASS team decided that all comparisons of student data to these guidelines and comparison data would be presented in visually distinct boxes so that they stood out as “take home” messages to the reader.

Evidence-Based Recommendations, Curriculum Supplements, and Public Health Unit Information A critical component of the COMPASS project is to work with schools after they receive their SHP, should they wish to make any changes to their health-related policies and/or programs after viewing their school-specific data. To this end, the COMPASS team decided it would be helpful to schools if each page of the SHP also provided a topic-specific evidence-based programming recommendation and topic-specific curriculum supplement recommendation. In addition, we also decided to include the contact information for their local public health unit representative responsible for that topic/domain, should the school wish to contact them, as they would have expertise and/or access to resources to implement changes. The recommendations, curriculum supplements, and contact information could also act as points of discussion for when the COMPASS Knowledge Broker contacts the school during follow-up. Evidence-based recommendations for school programming and curriculum supplements were found by online searches of the following organizations:

• The Public Health Agency of Canada Canadian Best Practices Portal (http://cbpp-pcpe.phac-aspc.gc.ca/learn-more/listservsnewsletters/)

• Cancer Control P.L.A.N.E.T. (http://cancercontrolplanet.cancer.gov/) • The Centre for Addiction and Mental Health (CAMH) (www.camh.ca) • Ontario Physical and Health Association (OPHEA) (www.ophea.net)

http://www.csep.ca/guidelines

http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php

http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php

http://www.csep.ca/guidelines




http://cbpp-pcpe.phac-aspc.gc.ca/learn-more/listservsnewsletters/

http://cbpp-pcpe.phac-aspc.gc.ca/learn-more/listservsnewsletters/

http://cancercontrolplanet.cancer.gov/

http://www.camh.ca/

http://www.ophea.net/

5

Programs and curricula supplements were selected for the SHP if they were age appropriate (i.e., developed for students in grades 9-12), and had been previously implemented and evaluated with positive outcomes. Contact information for a school’s local public health unit was obtained by first consulting the local public health unit’s website. The Recruitment Coordinator (Dana Church) first searched the site for any information pertaining to public health nurses assigned to schools, school health teams, or school health management. If no such person was found, the health unit’s general contact information was used. The COMPASS Recruitment Coordinator contacted the individual by email or phone, explained the COMPASS study and asked whether they would agree to be indicated as the health unit’s contact person in the SHP, or asked who would be the appropriate person to be listed in the SHP. The Recruitment Coordinator also inquired whether the same individual should be listed for each of the COMPASS priority topics, or whether different staff with specific expertise should be indicated for specific priority topics.

Final version of the Compass School Health Profile A sample of the COMPASS School Health Profile that is currently being used in the COMPASS study for our baseline sample can be found in the Appendix.

References

1. Leatherdale ST, Burkhalter R: The substance use profile of Canadian youth: exploring the prevalence of alcohol, drug and tobacco use by gender and grade. Addict Behav 2012, 37:318-322.

2. Leatherdale ST, Manske S, Faulkner G, Arbour K, Bredin C: A multi-level examination of school programs, policies and resources associated with physical activity among elementary school youth in the PLAY-ON study. Int J Behav Nutr Phys Act 2010, 25;6. doi: 10.1186/1479-5868-7-6.

3. Leatherdale ST, McDonald PW, Cameron R, Brown KS: A multi-level analysis examining the relationship between social influences for smoking and smoking onset. Am J Health Behav 2005, 29:520-530.

4. Leatherdale ST, Papadakis S: A multi-level examination of the association between older social models in the school environment and overweight and obesity among younger students. J Youth Adolesc 2011, 40:361-372.

5. Cole, TJ, Bellizzi, MC, Flegal, KM, Dietz, WH: Establishing a standard definition for child overweight and obesity worldwide: International survey. British Medical Journal 2000, 320(7244):1240-1243.

6

Appendix

Example of a generic COMPASS School-Specific Feedback Report

C ohort study O besity M arijuana use P hysical activity A lcohol use S moking S edentary behaviour

Anyplace School

Thank you for participating in the 2012/2013 COMPASS survey.

This is your school’s customized School Health Profi le.

This report shows the 2012/2013 COMPASS survey results from participating students

enrolled at your school. Please note that in some cases results may not add up to 100%

due to rounding.

The information contained in this profi le will not be shared with any third party.

However, we encourage you to share these results with your school community

(teachers, parents, and students), your school board, and local health and community

organizations in order to take action on these fi ndings.

Examples of action steps can be found in the Recommendations section at the bottom of

each page. All recommendations are community interventions that have been evaluated,

shown to be successful, and have the potential to be adapted and replicated in your school.

For more information about this profi le or the COMPASS project, visit www.compass.uwaterloo.ca or contact:

Dr. Dana Church Chad Bredin COMPASS Recruitment Coordinator COMPASS Project Manager

Propel Centre for Population Health Impact Propel Centre for Population Health Impact

University of Waterloo University of Waterloo

519-888-4567 ext. 35679 519-888-4567 ext. 33317

1-800-667-1804 1-800-667-1804

[email protected] [email protected]

Dr. Scott LeatherdaleCOMPASS Principal Investigator

Associate Professor

Cancer Care Ontario Research Chair

School of Public Health and Health Systems


Obesity Outcomes at Anyplace school

RECOMMENDATIONSTeens Eating for Energy and Nutrition at School (TEENS)

• A school-based intervention intended to reduce obesity through healthy eating

• Includes classroom, school-wide, and family components

• Trained peer leaders deliver segments of the curriculum

• http://rtips.cancer.gov/rtips/programDetails.do?programId=246210

CURRICULUM SUPPLEMENTS• Centre for Addiction and Mental Health (CAMH): http://knowledgex.camh.net/educators/secondary/Pages/default.aspx

• MediaSmarts.ca: http://mediasmarts.ca/teacher-resources/fi nd-lesson

PUBLIC HEALTH UNIT CONTACT:Jane Doe: Public Health Nurse, Anyplace Health UnitP: (555) 555-5555E: [email protected]

Among Students at your school:

68% are of healthy weight

20% are overweight

9% are obese

54% describe themselves as being about the right weight

40% are trying to lose weight

29% of students at your school are overweight or obese

Physical Activity Outcomes atAnyplace school

54% reported they were enrolled in PE class this year

55% reported strength training at least 3 days/week

18% reported that they usually walk or bike to school

36% reported participating in varsity sports

38% reported participating in intramural sports

49% are meeting the National guidelines of 60 min/day of physical activity

RECOMMENDATIONSThe Physical Activity and Teenage Health (PATH) Program

• Curriculum is designed to be taught by physical education teachers in fi ve 30-minute sessions per week over 12 weeks

• http://rtips.cancer.gov/rtips/programDetails.do?programId=781968

CURRICULUM SUPPLEMENTS• Ontario Physical and Health Association (OPHEA): http://www.ophea.

net/programs-services/health-physical-education-hpe/grade-11/12-hpe-supplementary-course-materials



RECOMMENDATIONS

Gimme 5 - www.gimme5.ca

• A school-wide program that encourages and assists students to consume 5 or more servings of fruits and vegetables each day

• Targets changes in knowledge, attitudes, and behaviours of students towards fruits and vegetables

• Achieved through a school media-marketing campaign, classroom

workshops, family involvement, and environmental changes at school

CURRICULUM SUPPLEMENTSCentre for Addiction and Mental Health (CAMH): www.knowledgex.camh.net/educators/secondary/Pages/default.aspx

MediaSmarts.ca: http://mediasmarts.ca/teacher-resources/fi nd-lesson


Healthy Eating Outcomes atAnyplace school

*Food groups and serving recommendations are provided by Health Canada’s Eating Well with Canada’s Food Guide: http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php/

8% eat the recommended 7-8 servings of fruits & vegetables per day

11% eat the recommended 6-7 servings of grains per day

59% eat the recommended 3-4 servings of dairy products per day

73% eat the recommended 2-3 servings of meat & alternatives per day

54% buy their lunch at school at least once per week

19% buy snacks from school vending machines at least once per week


3% of students are eating the recommended number of servings from all 4 food groups

RECOMMENDATIONSEncouragement to increase physical activity outside of school can be integrated into school health related programs and curricula. Please refer to the physical activity page for suggestions.


Sedentary Behaviour Outcomes atAnyplace school

Surfi ng the internet: 1.7 hours/day

Watching/streaming TV shows or movies: 1.6 hours/day

Playing video/computer games: 1.2 hours/day

Talking on the phone, texting, messaging, emailing: 1.5 hours/day


Average total daily hours of recreational screen time: 6.0 hours/day

Average time spent doing homework: 1.4 hours/day

7% are meeting the National guideline of 2 hrs or less of recreational screen time/day

Tobacco Use Outcomes atAnyplace school

RECOMMENDATIONSNOT on Tobacco

• Involves 10 one-hour long weekly sessions and four booster sessions, delivered to males and females separately by same-gender, trained facilitators

• Major programs goals are to help participants:

o Quit smoking or reduce the number of cigarettes smoked by those youth unable to quit

o Improve life skills such as stress management, decision-making, coping, and interpersonal skills

• http://www.notontobacco.com/





8% are occasional smokers

36% have never smoked but are susceptible to begin smoking in the future

9% are current smokers

9% National average*

7% Provincial average*

1% are daily smokers

74% of smokers have made a quit attempt

18% have used other forms of tobacco besides cigarettes (e.g., hookah, smokeless tobacco) in the past 30 days

*2010-2011 Youth Smoking Survey

Alcohol Use Outcomes atAnyplace school

RECOMMENDATIONSSchool Health and Alcohol Harm Reduction Project (SHAHRP)

• Uses a harm reduction approach: aims to reduce the levels of alcohol related harms in students who drink alcohol, and to reduce the harms experienced by those students who do not drink alcohol but who interact with others who drink

• Program includes three phases: (1) eight lessons in Year 1; (2) fi ve booster lessons in Year 2; (3) four additional booster lessons in Year 2

• http://ndri.curtin.edu.au/research/shahrp/



• National Institutes of Health: http://science.education.nih.gov/supplements/nih3/alcohol/guide/nih_alch_curr-supp.pdf



16% reported consuming alcohol mixed with an energy drink in the last year

22% reported binge drinking in the last month



Marijuana Use Outcomes atAnyplace school

55% think it would be easy to get marijuana if they wanted some

RECOMMENDATIONSLifeSkills Training (LST)

• Main purpose of the program is to facilitate the development of personal and social skills, with particular emphasis on the development of skills for coping with social infl uences to smoke, drink, or use drugs

• One of the most extensively researched and e! ective prevention programs available

• http://www.lifeskillstraining.com/

CURRICULUM SUPPLEMENTS• Centre for Addiction and Mental Health (CAMH): http://

knowledgex.camh.net/educators/secondary/Pages/default.aspx


19% reported using marijuana in the past month



6% reported using marijuana daily



RECOMMENDATIONSThe Olweus Bullying Prevention Program

• Uses a whole school approach, and its goals are to reduce and prevent bullying problems among school children and to improve peer relations at school

• The program has been found to reduce bullying among children, improve the social climate of classrooms, and reduce related antisocial behaviors such as vandalism and truancy

• http://www.clemson.edu/olweus/index.html

CURRICULUM SUPPLEMENTS• Centre for Addiction and Mental Health (CAMH):

http://knowledgex.camh.net/educators/secondary/Pages/default.aspx



Bullying Outcomes at Anyplace school

14% have been verbally attacked

16% have been bullied

11% have taken part in bullying other students

3% have been physically attacked

3% have been victims of cyber-attacks

Among Students at your school, within the last month:

RECOMMENDATIONSLevels of school connectedness may be improved by focusing on any of the other areas covered in this report. Please see the recommendations made for other domains of student health.


School Connectedness and Academic Achievement Outcomes at Anyplace school

79% feel close to people at school

78% think they will complete a post-secondary education

77% feel they are a part of their school

82% would like to complete a post-secondary education

89% feel safe at school


89% feel that teachers treat them fairly

Getting good grades is important to 95% of students

Gender Di! erences at Anyplace school

20% are overweight

or obese

37% are overweight

or obese

3% eat the recommended number of servings from all 4 food groups

3% eat the recommended

number of servings from all 4 food

groups

45% meet the National guidelines for daily physical activity

54% meet the National

guidelines for daily physical

activity89% exceed the National guidelines for daily recreational screen time

94% exceed the National guidelines

for daily recreational screen time

10% are current smokers 7% are current

smokers

21% reported binge drinking within the last month

24% reported binge drinking within the last

month

17% have used marijuana within the last month

20% have used marijuana within

the last month

17% have been bullied within the last month

15% have been bullied within the

last month





Among Males at your school:Among Females at your school:

For more information about how to implement any of the recommendations

made in this report, please contact our COMPASS Knowledge Broker:

Rachel Laxer: [email protected]

A Message from COMPASS Leadership

Thank you again for participating in the

2012/2013 COMPASS survey. We hope you

fi nd this report informative and useful.

We look forward to continuing to work with

your school in the upcoming years, and

to working with your local public health

professionals to help make your school the

healthiest environment possible for students.

Dr. Scott LeatherdaleCOMPASS Principal Investigator

Associate Professor

Cancer Care Ontario Research Chair

School of Public Health and Health Systems


www.compass.uwaterloo.ca

University of Waterloo 200 University Ave. W., Waterloo, Ontario, Canada N2L 3G1

Telephone: (519) 888-4567 www.compass.uwaterloo.ca

Development of the COMPASS School Health Profile...Development of the COMPASS School Health Profile...

Documents

Transcript of Development of the COMPASS School Health Profile...Development of the COMPASS School Health Profile...