This session will provide highlights from the North Carolina School Health Education Profile Survey that was published by the Department of Public Instruction in 2013. School health and physical education, tobacco use, STDs, and other important health issues at the middle and high school levels will be discussed.

1. North Carolina Association for Middle Level
Education’s Annual Conference
3:30 pm – Biltmore Room
March 17, 2014

2. Presented by:
Dr. Terri Mitchell
mitchlltd@appstate.edu
Dr. Melanie Greene
greenemw@appstate.edu
Appalachian State University
Boone, North Carolina

3. What do you know…
about health behaviors among North
Carolina middle school students?
Find a partner and see if you can
answer the following questions from
the 2011 NC Middle School YRBS.
(2013 should be available within the
next few months)

4. 2011 NC MS YRBS
1. __% reported ever having been in a physical fight
(__% of males, __% of females).
2. __% rarely or never wore a bicycle helmet (of
those who reported riding a bike).
3. __% describe themselves as slightly or very
overweight.
4. __% have ever been bullied on school property
(highest among white students at __%).
5. __% ever drank alcohol.
6. __% of students consider themselves to have a
disability.

5. 2011 NC MS YRBS
1. 55% reported ever having been in a physical fight
(69% of males, 41% of females).
2. 77% rarely or never wore a bicycle helmet (of
those who reported riding a bike).
3. 25% describe themselves as slightly or very
overweight. Hispanic/Latino overall: 32%
4. 42% have ever been bullied on school property
(highest among white students at 46%).
5. 29% ever drank alcohol. 8th grade: 44%
6. 9.8% of students consider themselves to have a
disability.

6. Presentation Outline
•Introductions
•Background of the Profiles Study
•Current Study
•Research Findings
•Questions and Discussion

7. School Health Profiles
• Developed by the Centers for Disease
Control and Prevention.
• Profiles is a system of surveys
assessing school health policies and
practices in states, large urban school
districts, territories, and tribal
governments.
• Profiles surveys are conducted every 2
years by education and health agencies
among middle and high school
principals and lead health education
teachers.

8. The Study
• Two questionnaires are used to collect data - one
for school principals and one for lead health
education teachers.
• Questionnaires were mailed to 432 regular
secondary public schools containing any of grades
6 through 12 in North Carolina during spring 2012.
• Response rate: principals 71%, teachers 70%
(weighted and representative date).

9. Coordinated School
Health Programs

10. Areas Included in Profiles
• Coordinated School Health and Health Education
• HIV Prevention and Sexual Orientation
• Physical Education and Physical Activity
• Tobacco-Use Prevention Policies
• Nutrition-related Policies and Practices
• Health Services
• Family and Community Involvement in School
Health Programs
• Collaboration
• Professional Development and Preparation

11. Reporting Procedures
• An Executive Summary of 2012 findings is
presented in the report.
• All findings from 2004, 2006, 2008, 2010,
and 2012 are included to give an indication
of changes that have occurred in the past
six years.
• Trend data is not available for all items.

12. Highlights of 2012 Findings

13. Coordinated School Health
• 2012 saw an increase in the use of assessment
tools for policies, activities, and programs in all
areas. New to 2010 was injury and violence
prevention, with 38% of schools reporting the
assessment of policies, activities, and programs for
this program area in 2012.
• 44% of schools report using YRBS or fitness data
as part of the school’s improvement planning (SIP)
process.
• 80% of schools report coordinators for all school
activities (decline from 84% in 2010)

14. What do you know…
• About SHACs (School Health
Advisory Councils)?
• Healthy Active Children Policy, Section 1. LOCAL SCHOOL
HEALTH ADVISORY COUNCIL
• Each school district shall establish and maintain a local School
Health Advisory Council to help plan, implement, and monitor this
policy as well as other health issues as part of the coordinated
school health plan.
• The local School Health Advisory Council shall be composed of
community and school representatives from the eight areas of a
coordinated school health program mentioned in Section 4 (a),
representatives from the local health department and school
administration.

15. HIV Prevention and Sexual
Orientation
• 31% of Middle Schools provide professional
development for staff on HIV, STD , or pregnancy
prevention issues and resources for ethnic/racial
minority youth at high risk.
• MS: 11% report a Gay Straight Alliance (32% at
HS level)
• 97% report teaching HIV prevention (83% in 2010)
• 46% identify “safe spaces” where LGBTQ youth
can receive support from administrators, teachers,
or other school staff.

16. What do you know…
about the NC School Violence
Prevention Act?
List at least three groups that are
explicitly protected from bullying.
• real or perceived race, color, religion,
ancestry, national origin, gender,
socioeconomic status, academic status,
gender identity, physical appearance, sexual
orientation, or mental, physical,
developmental, or sensory disability.

17. Physical Education & Activity
• Physical education is required for grades six
through eight in 96% of schools, 99% of high
schools.
• 91% of middle schools report that physical
education teachers received some type of
professional development within the past two
years.
• 59% of middle schools provide opportunities for
students to participate in activities such as
Intramurals or physical activity clubs (a 8% point
decline from 2010).

18. What do you know…
• The number of minutes of physical
activity a school is required to provide
weekly to children is _______.
150
(according to the Healthy
Active Children Policy)

19. Tobacco Policies and Programs
• 98% of middle schools have a policy that prohibits
tobacco use on campus.
• 92% of middle schools include instruction on
Identifying tobacco products and the harmful
substances they contain.
• 97% of all schools report having a tobacco
prevention policy that specifically prohibits the use
of cigarettes, smokeless tobacco, cigars and pipes
by visitors during any school-related activity.

20. What do you know…
What does it mean if a school is 100%
tobacco free?
A 100% Tobacco-Free school has a policy
that prohibits the use of tobacco products
by anyone, including students, staff, and
visitors, on school grounds or at school
events at all times. This tobacco-free zone
includes school premises, school vehicles,
and school events, both indoors and
outdoors, and both on and off school
property. (www.nctobaccofreeschools.org)

21. Nutrition Policies/Practices
• 35% of schools report that they almost always or
always provide fruits or non-fried vegetables during
school celebrations. Thirteen percent report that
they never or rarely offer these healthier food items
during school celebrations.
• 77% of high schools and 49% of middle schools
allow students to purchase snack foods or
beverages at various places on the school
campus. This reflects a steady decline for both
middle and high schools since 2004.
• 43% of middle schools allow students to have a
water bottle during the school day in all locations.
• 91% of middle schools report teaching about the
benefits of health eating.

22. What do you know…
• What are some common diseases
associated with childhood obesity?
•Type II Diabetes
•High Blood Pressure
•High cholesterol
•Sleep apnea
•Asthma
(from the CDC)

23. Health Services
• In 2012, 28% of schools had a full-time registered
nurse to provide health services to students.
• 33% of high schools report having a full-time nurse
compared to 24% of middle schools, a slight
increase since 2010.
• 93% of schools report that all or most students with
known asthma have an action plan on file with the
school.
• Less than half of all middle schools report referral
services for reproductive healthcare to their
students (ie, HIV and other STD testing, pregnancy
testing, condom and other contraception access)

24. What do you know…
• What is the Healthy People 2020
objective for school nurse to student
ratio?
Recommended:
1 nurse per 750 students by 2020
Currently:
1 nurse per 1,200 students in a
school district

25. Family and Community
Involvement
• Only 13% of schools report that families help
develop or implement policies and programs
related to HIV, STD, or teen pregnancy prevention.
• 21% of schools report that community members
have helped develop or implement policies and
programs related to HIV, STD, or teen pregnancy
prevention.

26. Required Health Education
• At the middle school level health is a required
subject with 87% of 6th graders, 88% of 7th graders,
and 88% of 8th graders required to take the course.
This reflects a 9% increase since 2010.
• 92% of teachers at the middle school level report
that students take one or more health courses at
their respective schools.

27. What do you know…
• In a classroom of 30 children about
___ are likely to have asthma.
3…
and is the leading cause of
school absences

28. Required Health Education
• At the middle school level, attention is given to
nutrition and dietary behavior (98%), physical
activity and fitness (98%), and tobacco-use
prevention (96%), very similar to 2010 results.
• Ninety-three percent of lead health teachers report
that middle school students are taught how HIV and
STDs are transmitted, a 17% increase since 2010.
• Lead health education teachers in grades 6, 7, or 8
reported an increase from 34% (2010) to 69% on
teaching the importance of using condoms correctly
and consistently.
New items in 2012

29. What do you know…
• What percentage of NC parents would
like their children to receive sexuality
education from the school?
91.8%...
and more than 2/3 of parents
thought sexuality education
should start by the 6th grade
(from the NC Parent Opinion Survey of
Public School Sexuality Education)

30. HIV Prevention
• 93% of middle school students are taught how HIV
and STDs are transmitted, up from 76% in 2010.
Ninety-three percent are taught the differences
between HIV and AIDS, up from 87% in 2008 and
74% in 2010.
• 13% of lead MS health teachers report providing
curricula or supplementary materials on the topics of
HIV, STD, or pregnancy prevention that are relevant
to lesbian, gay, bisexual, transgender, and
questioning youth.

31. What do you know…
About House Bill 88?
• State legislation for sexuality education in
NC (signed into law 2009)
• Changed from “Abstinence Until Marriage”
to “Reproductive Health and Safety
Education”
– Sexually Transmitted Diseases,
contraception, sexual assault/abuse
• Grades 7, 8, 9
• Implemented Fall 2010

32. Collaboration
• 36% of middle school lead health education
teachers work with food service staff and 87% of
work with physical education staff.
• Middle school teachers were somewhat more likely
to provide health information to parents and
families in the areas of physical activity (48%) and
HIV prevention (42%) than in nutrition (38%) or
asthma (24%).

33. Professional Development
Middle school teachers have received a variety of
workshops, conferences, continuing education or in-
service programs in
– physical activity(68%),
– HIV prevention (60%),
– violence prevention (53%),
– human sexuality (49%),
– and alcohol or other drug use prevention (40%).
• Middle school teachers were much more likely to
receive professional development on HIV prevention
(60%) and human sexuality (49%) in 2012 than in
2010.

34. What do you know…
• About % of teens report online
harassment (cyberbullying), with more
girls/boys being targets.
~Pew Internet and American Life Project
33

35. Professional Development
• Middle school lead health education teachers have
a strong interest in staff development for
– violence prevention (80%), Same as 2010
– physical activity and fitness (74%), - since 2010
– nutrition and dietary needs (80%), + since 2010
– suicide prevention (71%), - since 2010
– alcohol and drug use prevention (71%), - since 2010
– emotional and mental health (73%) + since 2010

36. Questions
and Discussion

37. Resources
• North Carolina Healthy Schools:
www.nchealthyschools.org
• Profiles, 2002, 2004, 2006, 2008,
2010, and 2012:
http://www.nchealthyschools.org/data/
profiles/
• North Carolina Department of
Public Instruction:
www.ncpublicschools.org