ASCD's Health in Education Initiative: School-Community Partnerships for Problem-Based Learning

Presenters: Theresa C. Lewallen, ASCD, Alexandria, VA; Kay Kinsey, LaSalle University and LaSalle Neighborhood Nursing Center, Philadelphia, PA; Ann Walker, LaSalle University, Philadelphia, PA

This session is presented in separate parts. Use the buttons at the end of the transcription to navigate between each part.

II. Healthy Me + Healthy You = Healthy Schools + Healthy Neighborhoods — Philadelphia, Pennsylvania

THERESA LEWALLEN: Thank you, Julie. Now I want to introduce, from LaSalle University and LaSalle Neighborhood Nursing Center, Kay Kinsey, who is one of the co-directors of the project in Philadelphia, Pennsylvania. And she has with her Ann Walker, one of the other directors of the project, who works in the school with the students.

KATHERINE KINSEY: Thank you. This presentation reviews findings of the ASCD proposal Healthy Me + Healthy You = Healthy Schools + Healthy Neighborhoods middle school health career program. LaSalle Neighborhood Nursing Center and the School District of Philadelphia jointly submitted the proposal. The program specifically targets 7th and 8th grade students enrolled in a K-8 public school that is a Title I school in inner-city Philadelphia. In this particular neighborhood, fewer than 60 percent of the children graduate from high school, and between one and five percent may pursue health careers post-graduation — and I'm speaking about perhaps being a nursing aide versus going on to university study.

The 2000-2001 program involved 210 youths, 150 7th and 8th graders, and 60 K-1 graders. The 2001-2002 program involves 90 8th graders and between 30 and 60 kindergarten children. The total will probably be about 360 at the end of the spring. And also, about 300,000 Philadelphia cable television subscribers have the benefit of the public service announcements that our youth produced during the summer camp. Although we can't show the video today, they targeted radon.

Student involvement and performance teacher and principal feedback, school system factors, and Nursing Center contributions are highlighted. Opportunities and challenges for future work are shared. This program is an example of what can be offered to high-risk students. However, the interplay of family, social, educational, economic, and environmental dynamics continue to vex public health professionals who truly want bright futures for these students. So we want to bring you up close and personal with our program in Philadelphia. And the first thing you need to know is something about our school population and why we chose this particular school.

Our university is in this Olney-Logan neighborhood. Eighty-six percent of the children come from low-income families, meaning that they are at or below the federal poverty guidelines. All the children are at high-risk for asthma, lead poisoning, and many of them have not been adequately vaccinated. This is particularly important because Ann had to experience this over the last two years, and what the School District of Philadelphia did not share with us until we got into the school was that, of the 8th graders, 58 percent showed below what the standards would be for reading and 80 percent of them scored below basic in math. And we have to give you alert that the 5th, 8th, and 11th grades are always tested in the spring of the year.

So our environment really was not only the school, but also the neighborhood in which they lived, their home, the city in general — and you'll understand why we're identifying that — as well as the university, which is less than 10 minutes walk from the school. Although it's perhaps not clear in this particular overhead, this particular display demonstrates the inner-city blight that we have in the city of Philadelphia, and all the red dots there represent abandoned houses. So you can see the corridor of where we, in fact are located. It's in the upper part of where those red dots are. Another portrayal is that this particular area of the city has about 150 urban brownfields, which means their housing stock has been torn down because of sinking homes — they were built on a landfill over a stream, and there are multiple blocks of abandoned housing. And all these children walk to school from this neighborhood. The next one portrays some of housing stock. This is an abandoned home, and it would be next to a residential home.

The goals of the initiative are to improve the well being of at-risk children and youth, educate middle school children about health careers, and introduce unique neighborhood opportunities to become caring, competent public health professionals. Our objectives were to learn more about public health issues — and we could the neighborhoods as real-life case studies, both positive and what were still challenges. That they would be able to conduct a personal health assessment, conduct an environmental health assessment, develop a strategy to deal with a public health topic, learn how to share learning with their peers and lower-grade children, be able to identify one or more professionals who keep their neighborhoods healthy, and know one or two more education or health resources in their immediate neighborhood. Therefore, the students would work with others at the end of their year on a project and a public health topic that they have identified, and the teaching staff would learn more about neighborhood health threats to their student population and identify community resources available to the students. Examples of some of the other sessions that the children and the youth were involved in were: All About Drugs — they were provided information on physical and mental effects of drugs; Dangers of Tobacco; a community service clean-up project; a research paper on childhood asthma.

We have the good fortune to have in-student nurses at LaSalle University, and Ann is their faculty member, particularly during the spring semester. Last year in the spring, and this year, right now, we have students, senior nursing students, who are working with the 7th grade and 8th grade last year and the 8th graders this year on educational topics. They also are beginning to introduce roles for the students that have to do with nursing and other related health professional careers. So last year, the 7th grader did a program to the younger students on dental health, and you saw the tooth on the slide and we had a puppet show on dental care and a skit on good nutrition. This is one of our students who was presenting during that particular project during the first year.

Ann, do you want to talk about the camp?

ANN WALKER: The camp happened during the summer last year at LaSalle University, and I want to say that none of the students had been at the university, even though it was a 10-minute walk. We had the students on campus for a week. We had a van that picked them up every morning, and they got a gold card, a university card, which they really liked, and they could use that to buy food. They ate in the student cafeteria for breakfast and lunch, and we worked on a project, an environmental health project. We used a variation of a program that had been used at Rutgers University about carbon monoxide poisoning. And the students learned about carbon monoxide poisoning, the health effects of it, and they made their own — produced and wrote — their own video, and it ended up being a two-minute public service announcement that is being shown on a cable TV station. In addition to that, they had a tour of the university from the admissions people. They learned what it would take to get into the university, what the requirements were. We were able to use all the university facilities, the track — several of the kids were really interested in the track — and tennis, we played tennis, swimming, and a lot of other activities. We took a field trip. So it was really an action-packed five days.

KATHERINE KINSEY: Thank you. Also, Ann did an abbreviated forum about "What's Wrong With the Johnson Family?" that was included in the Rutgers content. And we wanted to introduce you to LaSalle. It's a changing urban neighborhood, so 3 years ago, if you came to Philadelphia, you would not have had the same environmentally distressed area. It is within view of Center City, Philadelphia. And that's the president of our university with the children that were at the summer camp. Ann had to form many, many partnerships — with the school nurse, with the technology teacher, the art teacher, the kindergarten, and we should probably say teachers — particularly the classroom teachers. There are many teachers in that particular school. The school has over 800 children in it.

Now we want to introduce you up close and personal what happened to us in the city of Philadelphia between the time we wrote the project and what occurred concurrently as we tried to implement this program. They were facing a teachers' strike. The teacher union constraints meant that teachers did not want to stay after school. The superintendent resigned. They had a cluster system. There are between 210,000 and 250,000 children in a school district. You can never get your hands around how many children there really are, because there are children who go to parochial schools and charter schools and other types of private schools. But there was a cluster system in the city of Philadelphia, which was dissolved this year. So what you're used to is no longer … instead of having 10 schools in a cluster, now you have 20 schools in a different kind of configuration. You have principal politics and constraints, and we learned the personality of a school really has a great deal to do with the principal that's in that school. An inadequate funding of schools — for example, among the children there, each child receives $4,500 a year. And the suburban … what was it Ann, you said that your school district is $9,500. So there's a very different variation in the kid of funding support that's for each child.

Obviously, children who live in poverty and also have social chaos come to school with many other responsibilities and burdens — some of which are truly underestimated by the school population, including the teachers and the administrators there, who leave the school and go someplace else to live. And really what we discovered was there was a parental lack of appreciation or support for education. Maybe it's not what you and I think. It could be that they're so involved having two jobs, or having to meet the TANF [Temporary Assistance For Needy Families] requirements, that they can't be involved in education. Or maybe they themselves were not successful in school, so therefore the value of education for their children is very different.

And last but not least, if you've been following Philadelphia, you know that the state took it over this year. So we're still waiting to find out what the administration's going to, and what are the fiscal constraints, and whether there's going to be a for-profit company administering the School District of Philadelphia.

We wanted to give you some of the challenges, because we wanted to tell you how difficult it was and how I particularly feel that Ann Walker, who did this project, really overcame some significant obstacles. One was that 50 percent of the students — although we were told that 100 percent of the students we worked with could go to the technology class — only half of them could use the computers. And then the students erased a month's worth of work, so you had to start over again. And then the technology teacher designed the class was unable to work in the lab because they were not self-disciplined enough to remain at their computers. And then they had to rewire the technology lab. So all your timelines and all your plans of how you were going to use the school resources ended up being something that you had to go back to ground one. Now in public health you've always learned to be flexible, but this required a different kind of flexibility than we anticipated.

And then we found out that you not only had to be the politician and you had to deal with the school system, you also had to be the communicator — so the public health nurse is put in the unique position of communicating with all the other staff and giving them the messages that perhaps the principal should have given. Then we discovered that no matter we thought as far as teaching would go, and how we could involve all the students in public health topics, and how we enhanced the science requirements of 7th and 8th graders, there were a lot of interruptions. What it really suggests is that there were a lot of interruptions to academic learning, too — for field trips, assemblies, and the bomb scare. Then also the concept that they could work independently, but not necessarily get access to computers. You also could see that the students' computer disks seemed to disappear, and that although we assumed they had skills, we really had to work on basic skills. The public health nurse had to learn how to do the Mac format, how to develop the booklets. The design was that they were going to use computers to develop booklets that they could share with the kindergartners and first graders. So in the first year, only seven percent of the students completed their booklets. Sixteen percent of them have completed them this year. New strategies have been put into place for second year, and Ann decided immediately how to do them. At the beginning of the year you had to start producing them.

We did a CDC school health index and we shared that with the principal using the student nurses — so that tells the principals exactly some of the characteristics of the student body as well as the surrounding neighborhood. The students learned in careers that we thought they might be interested in. Now, why did we do high school students? There's a majority of students that drop out before they finish high school. So let's do something early to them so that they might have a different aspiration and complete high school.

The student outcomes — although we are still evaluating this, I think the informative way in which they've received information about health options … They're more aware of the university presence. They value those role models and mentors that have been working them, and predominately those have been nursing students and our public health nurse. They recognize the neighborhood, both the challenges and some of the resources that might be available to them. And they have received basic knowledge about three public health issues that are really prevalent in our community: lead poisoning, asthma, and air pollution.

The teacher enjoyed our public health nurse, because none of these topics would have been in the regular science curriculum. And there was the value of the leadership of the public health nurse. The reality was, there were two people in the classroom — the teacher had 30 students, and now you had two teachers with 30 students. However, we found that the student project represented the contributions of the highly motivated and some of the less engaged lower achievers. But the challenges are still with students who did not read at level or do math. The kindergarten teachers reported that books would be valuable teaching resources and references tools for the classes, and the computer teacher, despite all the obstacles, thought that the real life application had students learn more about how to use the computer and gave them a motivation. It wasn't simply learning something, that they would be able to produce a product. And the CDC school health index would be able to provide information to the principal to argue, preferably, for more money for the school.

Now this is what the youth told us — not the little children, kindergartners or 1st graders — but what the youth told us after they came to the camp after the first year. They wanted to learn more about getting into college. And, of course, what would you think — they wanted to sleep over at the university. They did everything else. You want to have the university appear to be fun to students and to have them want to do it, and to have them want to come to our school. And more interactive activities. For 7th and 8th graders — what was it, Ann? — one child learned how to swim. So maybe they'll remember that. More city tours, more camp, not to have the program end, and a concept of reunions — getting back together. They also wanted ongoing contact with the public health nurse as they enter high school, and to have video copies of their public service announcement. And we included this one, because one student, as Ann describes, told proudly that both of his parents have "paycheck jobs." And that's what he wanted to do. He wanted to have a paycheck job.

Changes in our school community. The teacher particularly recognized us as being resources, and particularly the public health nurse. The students had interaction with younger students, and that is atypical in this school. The students are on a different floor, they don't have lunch at the same time — so there's no interaction between younger students and older students. They had the product that they could take home to their families about their health topic, the book. And they participated in environmental days, clean-up days.

Now what would happen, because we were asked to say if there would be replication? We would say that if you had more resources available, we thought we could do it. If our politicians and bureaucrats — particularly in this uncertain time with the school district — put children and public education first we feel it would have more opportunities. If the school district was not bankrupt — that's why the state took the school district over. And if they students were on grade level. They need more community role models. And also, what we really recognize, they need more culturally and racially diverse health professionals who can mentor them as they go through their school experience.

These are the lessons that we learned, and this is what we think would be a good mantra: Reaching some is better than none, and we feel that we have done that. What we would have done if we had only known — and sometimes it's better not to know, it's better just to do it. We can make differences, but we feel only over time. And the legacy of this program may only be measured in the year 2010, which would be a target college graduation date. And now we want to introduce you to all the kindergarten children at the end of the first year, who listened attentively to all 7th and 8th graders who produced the work [shows photo]. Thank you.

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