New Directions in Health Education

School Health Education and the Community in Western Europe and the United States

George Campbell

• Publisher: Routledge
• Year: 2022
• Print ISBN:
  9781032252988
• eBook ISBN:
  9781000574234
• Topic: Medicine
• Subtopic: Health Care Delivery

Originally published in 1985, this book is a detailed study of the ways of harmonizing school and community policies, strategies and methods in health education, with examples of work achieved in most countries of Western Europe and the USA. It is primarily a guide to ways of overcoming a piecemeal approach to health education in schools and replacing it with more coherent, coordinated and valid forms in which community agencies can play their part.

Part 1. Understanding the Constraints on School-Community Interaction

Introduction

Trefor Williams and George Campbell present joint chapters on the topic, ‘Towards a Model of School-Community Interaction’, Williams taking a school standpoint, Campbell a community standpoint, both essentially raising and clarifying issues.

Williams identifies three basic concepts which can serve to provide a context for a model of school and community interaction:

1. The Health Career which provides a means of reviewing the many influences which help shape values, attitudes, skills and behaviour having a bearing upon health.
2. The Spiral Curriculum which has largely been used in the context of the school curriculum. Briefly it is based upon the belief that if certain ideas or concepts are valued by a community/society they can be taught and are relevant to every age group. It is arguable that what is true for the school curriculum is also highly relevant for the school-community interface.
3. Coordination, a concept which has been explored at some depth by the Schools Council Health Education Project (SCHEP) as a means of harnessing the human and material resources available in a school to the task of planning and implementing a programme of health education for its pupils.

The concepts of Health Career and Spiral Curriculum as discussed in the context of school-community interaction imply — indeed demand — a high level of coordination of the skills and knowledge possessed by many professional groups. They imply the drawing together of various professions which are not normally in close communication with each other and which sometimes do not even understand each other’s functions. Who is to take responsibility for such coordination — should the locus for it be inside or outside the school, should the initiative rest with education or health authorities?

The paper concludes by considering some of the factors which might influence the nature and level of coordination.

Campbell’s chapter examines the obstacles to ‘the common understanding’, in particular the boundary problems between school and community which prevent or limit productive collaboration. These are interpreted as differences in perception of critical issues: what health education is, and what are the necessary tasks, roles and skills required to achieve its goals. Examples of local empirical work are drawn upon to indicate the importance of task-centred activities as a means of developing interagency understanding and, ultimately, cooperative action. The emergence of key management principles is noted, and the paper concludes with a discussion of the ‘coordination’ role.

A discussion of the points raised in these chapters is set out in the Appendix pp. 211–3.

Health Education and the School-Community Interface: Towards a Model of School-Community Interaction: I: A School View

Trefor Williams

Because the health related behaviours of young people are largely practised outside the classroom in the wider school and community environment it follows that the teaching of health education should seek to link these areas of operation more closely together. For example, if as a matter of principle a school accepts the importance of teaching about human and personal relationships, this will have implications for its own organization, structure and internal relationships. If what is learned in the classroom is not seen to be supported in practice by the school environment it will have little validity in the eyes of the students. Such teaching and learning will also need to demonstrate the validity of the principle to the lives of people in the wider community if it is to hold credence as an important and relevant area of human concern.

This issue of school and community interface emerged as an area of central importance in the 1980 World Health Organization European Region Symposium held in Gent, Belgium. The Symposium, ‘Constraints in the Education for Health of Schoolchildren and Parents’, brought together representatives from sixteen European countries for five days of intensive discussion. The Summary Report of the Symposium offered three specific recommendations:

1. Consideration should be given to the development of a theoretical model which would serve to illustrate the dynamic relationship between different elements and components in society which interact to determine the quantity, nature and persistence of constraints affecting education for health.
2. All necessary measures should be taken to create openness and dialogue between schools and their communities.
3. Investment should be concentrated on integrating the principles of health education into the preparation and training of all professional groups involved with community work.

The present Seminar in Southampton partly arises out of the challenge implicit in these three recommendations — a challenge, it is felt, which needs to be taken up and developed by a continuing and dynamic dialogue, research and action in Europe and in other countries. The purpose of this and the following chapter is to begin this dialogue by offering some basic ideas and concepts for consideration. This contribution is intended to serve as a frame of reference for a model of school-community interaction and is based upon several concepts which have become, for me, basic and essential to a personal construct of health education.

The first concept is that of the health career line which provides an outline review of the chief influences on the health behaviour of individuals in a given community or society (see Figure 1). For the purpose of this paper the term ‘community’ refers to a social group of people, subjected to the same general laws and customs and also to certain categories of experiences, referred to as its culture, which influence thinking, behaviour and lifestyle. It is possible, for example, to demonstrate the influences exerted by the home, friends and community upon the emergent smoking behaviour of young people or upon attitudes to alcohol. It is possible to view the resultant behaviour as a product of the interaction between a growing/developing personality and these social influences. It is also possible to take snap shots of the possible dominant influences at any one time, so that, for example, when a child has just started school it seems reasonable to postulate the main influences as stemming from home and school, while later during pre-pubescence the influence of friends can be added. Similarly at mid/late adolescence there will be the added influence of the community environment and possibly the work situation (see Figure 2).

Figure 1. Health Education

Figure 2. The Timing of Various Social influences

The important question is what messages about health or health behaviour are transmitted both formally and informally by each of these influences. Are the formal and informal messages stemming from a single influence contradictory or complementary? Are the messages coming from the major influences complementary or contradictory? Are there ways in which the various categories of health messages could be recognized, classified and coordinated? Are we indeed confident that we know what the messages should be at any one stage of development?

The second concept is that of the spiral curriculum which is well-known and understood in the context of the school. I feel that it has application also to school-community interaction. The basic idea is straightforward: if an idea or concept is thought important enough and is valued by a community then it is possible to relate it to any level of understanding from early childhood to late adolescence and beyond. Once a decision has been taken concerning the concept it is feasible to repeat it at an increasing level of complexity commensurate with the level of understanding and of relevance to the recipients. In this way the same concept can be considered and related to the needs and aspirations of all groups — including children and young people — in the community (see Figure 3).

Figure 3. The Spiral Curriculum

The mechanism by which the spiral curriculum operates in the community is largely through socialization where what is ‘valuable’ or ‘permissible’ is made clear through a system of formal and informal messages reinforced by rewards, punishments and other sanctions. The spiral curriculum operates in schools by the choosing of areas of study which are seen to be ‘worthwhile’ educationally. These can be divided into the two facets of school life, generally referred to as the ‘academic’ and the ‘pastoral’. ‘Academic’ refers here to those traditional subject areas of the school curriculum which form the ‘backbone’ of teaching in the school. ‘Pastoral’ is used as an all-embracing term for those areas of school life which encourage the social and personal development of pupils. They are not mutually exclusive — indeed they ought, as Hamblin argues, to be seen as partners in the same educational process. Marland points out that where they are treated as separate parts of the life of a school the ‘pastoral’ is in danger of being seen as inferior by both staff and pupils. In terms of the operation of the spiral curriculum for pastoral care/health education it is then first necessary for the school itself to value this area of work sufficiently to accord it an important place in the curriculum. Secondly, it would be necessary for a school to think through the real implication of this for the way in which the curriculum, both in terms of content and methods of teaching, is organized for its pupils.

What, in terms of the spiral curriculum which in theory can link schools to the community, are the health messages or concepts which are valued or seen as educationally worthwhile? Is it possible to establish some basic concepts related to health which can be used as focal or starting points for the community-school spiral curriculum? One of the obstacles to reaching such basic concepts is the difficulty in establishing a common understanding, amongst those professional and lay persons involved, of health and health education; a common understanding which could provide a sense of common purpose. There have been attempts to make a conceptual analysis of the health education field, notably that of the American School Health Education Study which produced its excellent A Conceptual Approach to Curricular Design in the 1960s and which has been a wellspring of other significant developments both in the United States and elsewhere. The concepts needed as a base line for a shared understanding must, however, be related to ideas implicit in the professional training and work of community workers and teachers and must also make sense to parents and other involved lay persons.

For a school-community model I find it expedient to use three basic concepts:

1. Relationships — both personal and interpersonal;
2. Self-management — caring for and looking after self;
3. Community — caring for and interacting with the environment.

Each of these will need to be developed into sub-concepts relating to the level of understanding and development of the recipients. I am suggesting that the three concepts could form a common base line for school-community interaction (see Figure 4).

Figure 4. Three Basic Concepts of Health Education Related to the Spiral Curriculum and How They Interrelate.

The third concept I wish to explore is that of coordination. It is possible to argue that health education can be seen primarily as an orchestration of the many influences to which individuals are exposed. Indeed, given the broad-based nature of health education itself it is difficult to conceive of how a programme of health education could succeed in either school or community without a degree of cooperation and coordination between the personnel and agencies involved.

The later of two Schools Council Projects in Health Education — concerning secondary schools — recognized the importance of a coordinated approach to health education across the curriculum. At a very basic level, for example, the health teaching which occurs across the many subject areas can be made more effective by coordinating their content and timing. From the pupils’ point of view it is important to ensure that the many messages stemming from various subject areas are consistent with each other and provide coherent, clear and relevant health education messages. Of course, much more than this is involved in a properly planned and coordinated programme of health ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Original Title Page
• Original Copyright Page
• Table of Contents
• Acknowledgements
• Introduction: New Directions in Health Educations
• 1 Understanding the Constraints on School-Community Interaction
• 2 Policies, Strategies and Methods of Achieving Understanding and Cooperation
• 3 Professional Training
• 4 Cooperative Health Education: Ideas and Initiatives
• 5 Cooperative Health Education in the United Kingdom: Case Studies
• Appendix The International Seminar on School Health Education
• Notes on Contributors
• Index