Teachers play critical role in adolescent health promotion efforts

Teachers are among the most important influences in the lives of school-aged children, yet relatively little emphasis has been placed on examining the potential role general academic teachers may play in facilitating adolescent health promotion efforts, according to a study conducted by researchers at Columbia University's Mailman School of Public Health and published in the Journal of School Health.

The study results indicate that teachers provide valuable information to school personnel about what health issues are important to adolescents, in particular, because they hear feedback from adolescents on a daily basis.

“We found that teachers agreed that schools were an important venue for discussing and providing health messages,” says Alwyn T. Cohall, MD, associate professor of clinical Sociomedical Sciences, director of the Harlem Health Promotion Center, and lead author. “However, they expressed concern about their ability to handle mental health, behavioral health, and reproductive health problems, and desire additional staff development workshops to address these needs.”

More than half (52%) of those surveyed overheard student discussions about health once a week or more in classrooms, hallways, cafeterias, and playgrounds. Seventy percent of teachers stated they were actively approached by students one to three times per semester or more with personal problems or health concerns. “Our study shows that relying solely on certified health education teachers to impart health messages and facilitate referrals for services would appear rather limiting given these contextual realities,” noted Dr. Cohall.

While approximately 90% of U.S. school districts require health education in public schools, relatively little emphasis has been placed on examining the role that non-health teachers play in facilitating adolescent health promotion efforts. Yet, teachers are among the most important influences in the lives of school-aged children ages six to 18.

“It is conceivable that almost all teachers have opportunities, both formal and informal, to influence adolescent health behavior. However, to our knowledge, there have been few studies that examine the extent to which general academic teachers are involved in interactions with students about health,” observed Dr. Cohall.

The survey was conducted among academic teachers and administrators working in four schools in the Northern Manhattan community of New York City. These schools had a cumulative enrollment of approximately 4,600 students, and an active school-based health clinic on site, providing a wide range of free physical and mental health services to students during school hours, including primary and reproductive healthcare.

The teachers surveyed believe that schools are an appropriate place for discussion and dissemination of health information. Yet, the data indicates that fewer than 20% of the teachers had provided formal classroom material on a health topic such as nutrition (19.8%), tobacco, drugs or alcohol (19.0%), reproductive health (17.2%), mental health (15%); less than 8% planned to provide such material in the future.

In general, teachers described themselves as being reasonably comfortable addressing many of these problems. They were less comfortable discussing problems at home, emotional or mental health, and medical problems or illness. Sixty-three percent of teachers surveyed indicated they had referred a student to the school-based clinic, suggesting that teachers play an important role in facilitating care for youth.

More than three quarters of teachers were interested in receiving staff development on problems with peers (77.5%) and emotional or mental health (77.3%). The other two areas where more than half of the teachers were interested in receiving staff development were problems at home and reproductive health issues related to sex, pregnancy, and sexually transmitted infections.

Teachers were approached by students regardless of race/ethnicity. The implied impression of teachers as approachable, credible sources of information, regardless of race/ethnicity, has important implications. For example, research has consistently shown that students who feel connected to their schools are less likely to engage in risky behavior.

“Our findings suggest the need for closer and more consistent interactions between school-based clinic staff and school personnel throughout the year, and points out the need for further research to develop cost-effective and time-efficient strategies to enhance the health literacy of all school personnel,” said Dr. Cohall.