Implementing CDC’s School Guidelines: Challenges And Opportunities

1. Implementing CDC’s School Guidelines: Challenges And Opportunities Joy Larson Utah Department of Health Tobacco Prevention & Control Program

2. 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.

3. 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

4. CDC’s School Guidelines • Policy: Develop and enforce a school policy on tobacco use. • 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. • Curriculum: Provide tobacco-use prevention education in grades K-12.

5. CDC’s School Guidelines • Training: Provide program-specific training for teachers. • Family Involvement: Involve parents or families in supporting school-based programs to prevent tobacco use. • Tobacco Cessation Efforts: Support cessation efforts among students and school staff who use tobacco. • Evaluation: Assess the tobacco-use prevention program at regular intervals.

6. 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.

7. 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

8. 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

9. 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

10. 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

11. 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

12. Utah’s School Tobacco Prevention Project • 3 Challenges Initially Encountered: • The need to find partners at the school district level • The need to prioritize school districts due to limited funding • The need for a step-by-step guide to lead school districts through the implementation process

13. Challenge #1 Challenge: 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.

14. 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

15. Challenge #2 Challenge: 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

16. Challenge #2 Challenge: 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

17. Challenge #2 Source: Utah YRBS 1991- 2003

18. Challenge #3 Challenge: 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.

19. Challenge #3 Challenge: 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

20. CDC’s School Guidelines Policy Instruction Curriculum Training Family Involvement Tobacco Cessation Efforts Evaluation A School’s Guide Policy Community & Family Involvement Instruction & Curriculum Training Tobacco Cessation Efforts Evaluation A School’s Guide to Comprehensive Tobacco Control

21. The Project in Action • Steps • Challenges • Successes Utilizing A School’s Guide to Comprehensive Tobacco Control, Component #1 Policy

22. 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

23. 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.

24. The Project in Action • “T” Activity

25. The Project in Action • “T” Activity

26. 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.

27. 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.

28. 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.

29. 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.

30. Questions?