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Implementing CDC’s School Guidelines:
Challenges And Opportunities
Joy LarsonUtah Department of Health
Tobacco Prevention & Control Program
Goal Explain challenges to
implementing CDC’s Guidelines for School Health Programs to Prevent Tobacco Use and Addiction at the state and local levels and identify a process to address these challenges.
Presentation Overview CDC’s School Guidelines (overview) Utah’s School Tobacco Prevention
Project (history) Challenges and Opportunities A School’s Guide to Comprehensive
Tobacco Control & The Project in Action
Lessons Learned
CDC’s School Guidelines1. Policy: Develop and enforce a school
policy on tobacco use.2. Instruction: Provide instruction about
the short- and long-term negative physiologic and social consequences of tobacco use, social influences on tobacco use, peer norms regarding tobacco use, and refusal skills.
3. Curriculum: Provide tobacco-use prevention education in grades K-12.
CDC’s School Guidelines4. Training: Provide program-specific
training for teachers.5. Family Involvement: Involve parents
or families in supporting school-based programs to prevent tobacco use.
6. Tobacco Cessation Efforts: Support cessation efforts among students and school staff who use tobacco.
7. Evaluation: Assess the tobacco-use prevention program at regular intervals.
Utah’s School Tobacco Prevention Project In the past, Utah’s Tobacco
Prevention and Control Program (TPCP) placed a strong emphasis on guidelines 2 & 3: Instruction and Curriculum.
Utah’s School Tobacco Prevention Project 2001-02
Conducted research (literature review & key informant interviews)
Implemented pilot project Contracted with Grand School District to
implement CDC’s School Guidelines, with an emphasis on policy change
Utah’s School Tobacco Prevention Project 2001-02
Decided to contract directly with school districts to implement CDC’s School Guidelines
Benefits: increased school district interest, built infrastructure and sustainability
Created A School’s Guide to Comprehensive Tobacco Control
A step-by-step guide to lead school districts and others through the process of implementing CDC’s School Guidelines
Utah’s School Tobacco Prevention Project
Contracting with School Districts: The Process
Identified target school districts to pilot the project
Informed and partnered with state and local agencies (State Office of Education, Local Health Departments, etc.)
Proposed the project to targeted school districts
Utah’s School Tobacco Prevention Project
What are the School Districts Doing?
Hire a ½ employee to oversee the project
Follow A School’s Guide to Comprehensive Tobacco Control to implement CDC’s School Guidelines
Work closely with local partners
Utah’s School Tobacco Prevention Project 2002-03
Utah’s School Tobacco Prevention Project implemented in six school districts
2003-04 Expanded project to include four
additional districts
Utah’s School Tobacco Prevention Project 3 Challenges Initially Encountered:
1. The need to find partners at the school district level
2. The need to prioritize school districts due to limited funding
3. The need for a step-by-step guide to lead school districts through the implementation process
Challenge #1Challenge: The need to find partners at the
school district level. By partnering with the school districts,
we build interest, infrastructure and sustainability of the project. But…
• Tobacco is not a top priority for schools.• Schools are busy!• Territorial issues often exist.
Challenge #1
Challenge: The need to find partners at the school district level.
Opportunities to overcome:• Educate stakeholders• Provide a plan• Utilize the project as an “umbrella”
for all who want to be involved
Challenge #2Challenge: The need to prioritize school
districts due to limited funding. 40 School Districts in Utah (more
in other states!) Initial project start-up takes time
and technical assistance Project funding increases
implementation, but is limited
Challenge #2Challenge: The need to prioritize school
districts due to limited funding. Opportunities to overcome:
Utilize a selection process rather than a competitive funding process.
• Identify indicators related to tobacco use to select target districts:• Tobacco Use Rates• Socioeconomic status• Availability of prevention programs
Challenge #2Percentage of Utah High School Students Who Smoked
Cigarettes on O ne or More of the Past 30 Days, 1991-2003
0%
10%
20%
30%
Per
cent
16.8% 17.4% 17.0% 16.4% 11.9% 8.3% 7.3%
1991 1993 1995 1997 1999 2001 2003
Source: Utah YRBS 1991- 2003
Challenge #3Challenge: The need for a step-by-step
guide to lead school districts through the implementation process.
“School people” know the school system, but often are not tobacco prevention experts.
One-on-one training and technical assistance is time intensive and can be expensive.
Challenge #3Challenge: The need for a step-by-step guide to
lead school districts through the implementation process.
Opportunities to overcome: Utilizing A School’s Guide to Comprehensive
Tobacco Control: Provides school districts with a step-by-step
resource to lead them through the process of implementing CDC’s School Guidelines
Helps to institutionalize efforts Creates a uniform process across several
districts Reduces expenses related to training and time
A School’s Guide to Comprehensive Tobacco
Control
CDC’s School Guidelines
1. Policy2. Instruction3. Curriculum4. Training5. Family Involvement6. Tobacco Cessation
Efforts7. Evaluation
A School’s Guide 1. Policy2. Community &
Family Involvement3. Instruction &
Curriculum4. Training5. Tobacco Cessation
Efforts6. Evaluation
The Project in Action Steps Challenges Successes
Utilizing A School’s Guide to Comprehensive Tobacco Control,
Component #1 Policy
The Project in Action CDC: Develop and enforce a school policy
on tobacco use.
Guide: Evaluate, update, and reinforce the school policy on tobacco use.
Currently, Utah school tobacco policies: Are not comprehensive Lack consistent enforcement Are not well-communicated
The Project in Action Step 1: Review the current policy.
Step 2: Get commitment.
Step 3: Form an advisory committee to revise the tobacco policy.
Adapted from: Creating and Maintaining a Tobacco-Free School Policy. Partnership For A Tobacco-Free Maine, Bureau of Health, Department of Human Services.
The Project in Action “T” Activity
The Project in Action “T” Activity
The Project in Action Step 4: Develop a draft of the new
policy.
Step 5: Present the new policy to the school board.
Step 6: Plan implementation strategies.
Adapted from: Creating and Maintaining a Tobacco-Free School Policy. Partnership For A Tobacco-Free Maine, Bureau of Health, Department of Human Services.
The Project in Action Step 7: Communicate the policy
throughout the school and community.
Step 8: Implement the policy.
Step 9: Conduct ongoing advocacy and evaluation of the policy.
Adapted from: Creating and Maintaining a Tobacco-Free School Policy. Partnership For A Tobacco-Free Maine, Bureau of Health, Department of Human Services.
Lessons Learned
Early findings from this project suggest:
School districts at high-risk for tobacco use are enthusiastic to implement CDC’s School Guidelines and are able to do so following A School’s Guide to Comprehensive Tobacco Control.
Lessons Learned
Early findings from this project suggest:
Directly funding school districts allows the districts to institutionalize efforts and build community and internal support to sustain tobacco prevention efforts beyond funding opportunities.
Questions?