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CSH Priority Areas - PANT
Physical Activity, Nutrition, Tobacco

 

Establishing healthy behaviors during childhood is easier and more effective than trying to change unhealthy behaviors during adulthood. Health-promoting schools help young people establish lifelong healthy behaviors.

Risk Behaviors Established Early in Life
According to the Centers for Disease Control (CDC), six priority health risk behaviors contribute to the leading causes of death, disability, and social problems in the United States. These behaviors, often established during childhood and early adolescence, are -

  • Tobacco use
  • Unhealthy dietary behaviors
  • Inadequate physical activity
  • Alcohol and other drug use
  • Sexual behaviors that may result in HIV infection, other sexually transmitted diseases and unintended pregnancies
  • Behaviors that contribute to unintentional injuries and violence.

Schools can most effectively and efficiently meet the health needs of young people by focusing their efforts on these six priority health risk behaviors, in addition to addressing other important health problems such as asthma, obesity, and infectious diseases. The priority of CDC’s CSH programs focus on PANT - physical activity, nutrition and tobacco.

 

Click on the following topics to view the information below:

You can also click on "Back to the Top" after each topic to return to the list.

Physical Activity

Physical activity reduces the risk of premature mortality, coronary heart disease, hypertension, colon cancer, and diabetes. Positive experiences with physical activity at a young age are the foundation for being regularly active throughout life. In 2007, only 48% of high school students had participated in at least 60 minutes per day of physical activity for more than 5 of the last 7 days. Participation in physical activity tends to decline as children age. (CDC National Data)

Benefits of Regular Physical Activity

  • Helps build and maintain healthy bones and muscles, and control weight
  • Helps reduce the risk of developing obesity and chronic diseases such as diabetes and cardiovascular disease
  • Reduces feelings of depression and anxiety, increases self-esteem, and promotes psychological well-being
  • May improve blood pressure and cholesterol levels

Long-Term Consequences of Physical Inactivity

  • Overweight and obesity, influenced by physical inactivity and poor diet, are significantly associated with an increased risk of diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status.
  • Physical inactivity increases the risk of dying prematurely, dying of heart disease, and developing diabetes, colon cancer, and high blood pressure.

North Dakota's Plan for Physical Activity

What can be done to increase Physical Activity for school-age youth?

To strive towards the CDC standard for:
A planned, sequential K-12 curriculum that provides cognitive content and learning experiences in a variety of activity areas such as basic movement skills; physical fitness; rhythms and dance; games; team, dual, and individual sports; tumbling and gymnastics; and aquatics. Quality physical education should promote, through a variety of planned physical activities, each student's optimum physical, mental, emotional, and social development, and should promote activities and sports that all students enjoy and can pursue throughout their lives. DPI Coordinated School Health and partners promote physical activity in schools by …

  • Updating the ND Physical Education standards;
  • Advocating for district policy changes to maintain or increase recess and Physical Education time as well as incorporating Physical Education and physical activity concepts into health curriculum;
  • Partnering with other state and local initiatives to provide information and strategies to schools, parents and communities to increase options for more physical activity time for school-age youth;
  • Providing professional development of Physical Education and physical activity teaching and classroom strategies at the annual Roughrider Health Promotion Conference.

What can schools do to promote physical activity?

  • Align local curriculum with the North Dakota Physical Education standards;
  • Obtain grants to improve the local Physical Education program;
  • Encourage Physical Education instructors to obtain professional development at the Roughrider Conference and join PE organizations such as NDAHPERD;
  • Individual physical activity – up to 30 minutes a day of moderate-to-vigorous physical activity during the school day;
  • School-based physical education classes for all grades, K-12 which promote life long physical activity and exercise in groups and individual sports which contribute to each student’s physical, motor and behavioral development;
  • Expansion of physical activity opportunities by providing clubs, lessons, intramural sports, and interscholastic sport programs that meet the physical activity needs and interests of all students;
  • Promotion of walking and bicycling to school and assurances of safe routes for both;
  • Recess for elementary students of no less than 20 minutes during each school day;
  • Knowledge of the benefits of physical activity as part of evidence-based health education programs which focus on increasing physical activity and decreasing sedentary and risk behaviors;
  • Work with community partners and parents to provide information, resources and professional development.

North Dakota & National Resources

Health Education Standards
The North Dakota Health Content and Achievement Standards document provides a framework for the skills and knowledge that students in grades K-12 are expected to attain in health. Based on its predecessor, the 2000 North Dakota Health Content Standards; the current standards and benchmarks define levels of achievement at each grade level. In addition to referencing previous state content standards, the current state standards reference the National Health Education Standards 2006 as well as standards documents from other states.

The health education standards and benchmarks address the six dimensions of health (i.e., physical, emotional, social, spiritual, intellectual, occupational, and environmental) and serve as a guide to districts in developing their health curriculum. Furthermore, consideration is given to the following, as advocated by the Center for Disease Control (CDC). The six priority health behaviors that contribute to the leading causes of death, disability, and social problems in the United States are:

  • Tobacco use
  • Unhealthy dietary behaviors
  • Inadequate physical activity
  • Alcohol and other drug use
  • Sexual behaviors that may result in HIV infection, other sexually transmitted diseases and unintended pregnancy
  • Behaviors that contribute to unintentional injuries and violence

Health instruction should reflect what both educational research and best practices reveal about the teaching and learning of health.  It should include hands on experiences and innovative health technology.

Physical Education Standards
The North Dakota Physical Education Content and Achievement Standards were written to provide physical education teachers and school districts with a guide for quality physical education programs. Physical education and wellness is evolving to provide a more comprehensive lifestyle management approach, encouraging physical fitness and activity, sound nutritional practices, and assessment through the use of the latest technology.

The standards are organized around a core of fundamental physical education standards for all students in the state of North Dakota. Grade level expectations are identified for kindergarten through senior high school. These statements reflect a comprehensive approach to combating inactivity, obesity, and a lack of physical fitness of children in schools and local communities. In addition, the standards and benchmarks reflect what a student should know and be able to do, as well as what should be assessed at each grade level.

PEP Grants
Program Description

This program provides grants to initiate, expand, and improve physical education programs for K–12 students in order to help them make progress toward meeting state standards for physical education.

Types of Projects
Funds may be used to provide equipment and support to enable students to participate actively in physical education activities. Funds also may support staff and teacher training and education.

Through the US Department of Education, the Carol M. White Physical Education Program (PEP) provides grants to local educational agencies and community-based organizations to pay 90 percent of the total cost of initiating, expanding, and improving physical education programs designed to assist students in making progress toward meeting State standards for physical education. Grant funds may be used to provide equipment and support to enable students to participate actively in physical education activities and to train teachers and staff.
Web: http://www.ed.gov/programs/whitephysed/2006-215f.doc

North Dakota PEP Grant Award Recipients:

2009: Warwick School District ($435,368)
2009: Grafton Public Schools ($308,246)
2008:  West Fargo  ($490,601)
Grand Forks  ($575,518)
Cavalier  ($54,920)
2007: Park River School District ($257,778)
2007: Grafton Public Schools ($256,000)
2006: Fargo Public Schools ($259,453)
2005: Bismarck Diocese Catholic Schools ($448,506)
2004: Hillsboro Public School #9 ($219,333)
May-Port CG School District ($126,900)
2003: Bismarck Public Schools ($457,628)
Fargo Public Schools District #1 ($323,015)
Richardton-Taylor Public School District ($374,888)

North Dakota Alliance for Health, Physical Education, Recreation and Dance
NDAHPERD/AAHPERD's mission is to promote and support creative and healthy lifestyles through high quality programs in health, physical education, recreation, dance and sport, and to provide members with professional development opportunities that increase knowledge, improve skills, and encourage sound professional practices.
Web: http://www2.edutech.nodak.edu/ndahperd/index.html .

School Health Policies and Programs Study (SHPPS)
The School Health Policies and Programs Study is conducted every six years by the Centers for Disease Control and Prevention (CDC).  This national study is completed with every state to assess school health policies and programs at the state, district, school, and classroom levels.

On October 19, 2007, the SHPPS webpage www.cdc.gov/SHPPS was updated with new information and resources, including a link to the Journal of School Health articles, fact sheets, a state-level summaries document, questionnaires, analytic data files and technical documentation, and archives of previous SHPPS studies. 

Youth Risk Behavior Surveillance System
The YRBS monitors behaviors that contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the United States. Follow this link to view the report.

School Health Index
The School Health Index (SHI) (external link) can help schools implement school health guidelines and related strategies. This self-assessment and planning tool enables schools to identify the strengths and weaknesses of health promotion policies and programs and assists schools in developing an action plan for improving the school environment.

Physical Activity: School and Community Guidelines
This document (external link) includes strategies most likely to be effective in promoting physical activity among young people.

Physical Education Curriculum Analysis Tool
The PECAT (external link) can help school districts conduct a clear, complete, and consistent analysis of written physical education curricula, based upon national physical education standards. The PECAT is customizable to include local standards. The results from the analysis can help school districts enhance existing curricula, develop their own curricula, or select a published curriculum, for the delivery of quality physical education in schools.

The Center for Disease Control and Prevention (CDC) is pleased to announce that Physical Education Curriculum Analysis Tool (PECAT) Workshops are now available to all DASH-funded CSH states. Thirteen individuals from across the country attended the PECAT Training of Trainers (TOT) and became equipped with the skills and materials to conduct state-level PECAT Workshops for a minimum of 4 hours and a maximum of 8 hours. The purpose of the PECAT Workshops is to train school district and school-level physical education and physical activity staff in the implementation of the PECAT.

Each PECAT trainer will be paid by the CDC for his/her time to plan, travel, train, and provide follow-up support. Any additional costs (e.g., facility space, materials, meals, participant travel) will be the responsibility of the site coordinator. Workshops can be scheduled for any time between November 1st, 2006 and October 31st, 2007. Contact Anu Pejavara (APejavara@cdc.gov or 770-488-6214) or Sarah Lee (skeuplee@cdc.gov or 770-488-6126) to be connected to a PECAT Trainer in your region.

For more information on the PECAT, visit: http://www.cdc.gov/HealthyYouth/PECAT/

Physical Activity Brochures
Brochures (exernal link) designed to help parents, teachers, and principals increase physical activity among elementary and middle school-aged youth.

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Nutrition

Healthy eating is associated with reduced risk for many diseases, including the three leading causes of death: heart disease, cancer, and stroke. Healthy eating in childhood and adolescence is important for proper growth and development and can prevent health problems associated with obesity, dental caries, and iron deficiency anemia. Most young people are not following the recommendations set forth in the Dietary Guidelines for Americans. In the U.S.,67% of youth aged 6-19 exceed dietary guidelines recommendations for fat intake and 72% exceed recommendations for saturated fat intake. Only 17% of ND high school students reported eating fruits and vegetables five or more times during the past 7 days (ND YRBS 2007).

Diet & Disease

  • Overweight and obesity, influenced by poor diet and inactivity, are significantly associated with an increased risk of diabetes, high blood pressure, high cholesterol, asthma, joint problems, and poor health status.
  • As rates of overweight and obesity rise, Type 2 diabetes, formerly known as adult onset diabetes, has become increasingly prevalent among children and adolescents. A CDC study estimated that one in three American children born in 2000 will develop diabetes in their lifetime.
  • Overweight children and adolescents are more likely to become overweight or obese adults.

Overweight Among Youth

Nationally, the prevalence of overweight among children aged 6-11 years has more than doubled in the past 20 years and among adolescents aged 12-19 has more than tripled.

The North Dakota Youth Risk Behavior (YRBS) shows an increase in the number of overweight students from 1999 to 2007.

7 - 8 grade

9 – 12 grade

10.3% in 1999 to 12.8% in 2005

7.2% in 1999 to 10% in 2007

North Dakota’s Plan for Nutrition

What can be done to improve Nutrition for school-age youth?
To strive towards the CDC standard for:
Access to a variety of nutritious and appealing meals that accommodate the health and nutrition needs of all students. School nutrition programs reflect the U.S. Dietary Guidelines for Americans and other criteria to achieve nutrition integrity. The school nutrition services offer students a learning laboratory for classroom nutrition and health education, and serve as a resource for linkages with nutrition-related community services. DPI Coordinated School Health and partners promote healthy nutrition in schools by …

  • Updating the ND Health Education standards;
  • Advocating for district policy to include standards for all foods available in schools;
  • Partnering with other state and local initiatives to provide information and strategies to increase and improve reliable nutrition information;
  • Developing effective nutrition strategies resources;
  • Providing nutrition best practice strategies and professional development opportunities at Roughrider Health Promotion Conference.

What can schools do to promote healthy nutrition?

  • Implement an effective wellness policy;
  • Provide nutrition education professional development opportunities for all staff;
  • Promote and provide healthy nutrition choices for staff and students;
  • Utilize local nutrition experts (Public Health, Extension, Healthcare, etc);
  • Implement wellness policies which include standards for all foods available in schools;
  • Offer breakfast programs in all schools;
  • Provide healthy snack options in the classroom and at school events;
  • Incorporate lunches that meet the USDA guidelines;
  • Include staff and students in choosing healthy vending options;
  • Ensure that school-based health education curriculum for all grades, K-12 include nutrition education;
  • Align Health curriculum with the ND Health Education Standards;
  • Work with community partners to extend the nutrition education, training and information to parents.
  • Consider a SCHOOL GARDEN OR GREENHOUSE new project;

North Dakota & National Resources

North Dakota Healthy School Nutrition Alliance
The NDHSNA combines the efforts of Healthy North Dakota, Action for Healthy Kids, Team Nutrition and Coordinated School Health to promote healthy nutrition environments in schools. This collaborative effort by dietitians, nutritionists, school food service professionals, teachers, administrators, school nurses and physicians, provides schools and communities with reliable nutrition information, consistent messages, human resources and other services. Together, the Alliance members encourage and promote healthy nutrition environments so all students in North Dakota have the opportunity to learn nutrition in the classroom, learn skills to make healthy choices and have healthy choices available throughout the school so the can practice those skills. Alliance members are available to provide districts with resources, technical assistance and information regarding healthy school nutrition environments. Contact: Loris Freier at DPI (328-2664) to connect with local members.
Healthy North Dakota: http://www.health.state.nd.us/healthyND
Action for Healthy Kids: http://www.actionforhealthykids.org
Team Nutrition: http://www.fns.usda.gov/tn/Default.htm
Coordinated School Health – CDC DASH: http://www.cdc.gov/HealthyYouth/CSHP

ND Child Nutrition and Food Distribution
The North Dakota Department of Public Instruction, under agreement with the Food and Nutrition Service of the United States Department of Agriculture (USDA), administers child nutrition and food distribution programs. A partnership of federal, state, and local agencies provides nutrition services and food assistance to students, young children and adults. Students in K-12 public and private schools, and those in residential facilities, are served by these programs and initiatives: National School Lunch Program, School Breakfast Program, Special Milk Program, Afterschool Snacks, Summer Food Service Program and Team Nutrition.

Visit DPI's Child Nutrition & Food Distribution website for more information

Local Wellness Policies
Team Nutrition - USDA
Assistance to schools and school districts in meeting the Local Wellness Policy requirement, Team Nutrition has compiled some existing resources on developing and implementing a Local Wellness Policy that promotes healthy eating and physical activity.

Local Wellness Policy Development Tools
Providing links to tools and resources for schools to assist with the development of local wellness policies in accordance with the June 2004 Child Nutrition and WIC Reauthorization Act (Sec 04). pdf icon

School Health Policies and Programs Study (SHPPS)
The School Health Policies and Programs Study is conducted every six years by the Centers for Disease Control and Prevention (CDC).  This national study is completed with every state to assess school health policies and programs at the state, district, school, and classroom levels.

On October 19, 2007, the SHPPS webpage www.cdc.gov/SHPPS was updated with new information and resources, including a link to the Journal of School Health articles, fact sheets, a state-level summaries document, questionnaires, analytic data files and technical documentation, and archives of previous SHPPS studies. 

Youth Risk Behavior Surveillance System
The YRBS monitors behaviors that contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the United States. Follow this link to view the report.

School Health Index
The SHI can help schools implement school health guidelines and related strategies. This self-assessment and planning tool enables schools to identify the strengths and weaknesses of health promotion policies and programs and assists schools in developing an action plan for improving the school environment.

The National Association of State Boards of Education (NASBE) includes general school health policies plus policies to encourage healthy eating and physical activity.

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Tobacco

Tobacco use, including cigarette smoking, cigar smoking, and smokeless tobacco use, is the single leading preventable cause of death in the United States. Every day, approximately 4,000 American youth aged 12-17 try their first cigarette. If current patterns of smoking behavior continue, an estimated 6.4 million of today's children can be expected to die prematurely from a smoking-related disease (CDC).

Health Effects of Tobacco Use by Young People

  • Cigarette smoking by young people leads to immediate and serious health problems including respiratory and non-respiratory effects, addiction to nicotine, and the associated risk of other drug use.
  • Smoking at an early age increases the risk of lung cancer. For most smoking-related cancers, the risk rises as the individual continues to smoke.
  • Teenage smokers suffer from shortness of breath almost three times more often as teens who don't smoke, and produce phlegm more than twice as often as teens who don't smoke. Not surprisingly, smoking also hurts young people's physical fitness in terms of both performance and endurance---even among young people trained in competitive running.
  • Smoking causes mild airway obstruction, reduced lung function, and slowed growth of lung function among adolescents.

Nicotine Addiction Among Young People

The younger people begin smoking cigarettes, the more likely they are to become strongly addicted to nicotine. Young people who try to quit suffer the same nicotine withdrawal symptoms as adults who try to quit.
Several studies have found nicotine to be addictive in ways similar to heroin, cocaine, and alcohol. Of all addictive behaviors, cigarette smoking is the one most likely to become established during adolescence.

Tobacco Sales and Promoting to Youth

All states have laws making it illegal to sell cigarettes to anyone under the age of 18. Unfortunately, according to the ND 2007 Youth Tobacco Survey, 63.3% of current smokers under the age of 18 who purchased or attempted to purchase cigarettes in a store during the 30 days preceding the survey were not asked to show proof of age. Children and teenagers constitute the majority of all new smokers, and the industry’s advertising and promotion campaigns often have special appeal to these young people.

Health Effects in Youth of Secondhand Smoke

Every day, more than 15 million kids are exposed to secondhand smoke at home, with millions also exposed to secondhand smoke in schools and other places, as well. That exposure increases the chances that the children will suffer from smoke-caused coughs and wheezing, bronchitis, asthma, pneumonia, potentially fatal lower respiratory tract infections, eye and ear problems, and other health problems. Each year, 280 children actually die from respiratory illness caused by secondhand smoke.

North Dakota’s Plan for Tobacco Prevention

What can be done to prevent and reduce tobacco use among school-age youth?
The goal of tobacco prevention is to reduce disease, disability and death related to tobacco use by a) preventing the initiation of tobacco use among young people, b) promoting quitting among young people and adults, c) eliminating nonsmokers' exposure to secondhand smoke, and d) identifying and eliminating tobacco-related disparities among specific population groups. In order to reduce tobacco use among school-age youth, a comprehensive approach is necessary. DPI Coordinated School Health and partners work to prevent and reduce tobacco use among school-age youth by …

  • Updating the ND Health Education Standards;
  • Advocating for district policy to include tobacco free grounds policies in all schools and property;
  • Partnering with other state and local initiatives to provide information and strategies to increase knowledge and awareness about the dangers of tobacco;
  • Providing best practice and policy strategies to educators and partners at the Roughrider Health Promotion Conference.

What can you do to promote a tobacco free lifestyle?

  • Work with parents regarding the dangers of second hand smoke;
  • Implement the CDC Guidelines for School Health Programs to Prevent Tobacco Use and Addiction;
  • Implement evidence-based tobacco prevention curricula;
  • Implement and enforce comprehensive tobacco free school policy.
  • Work with community partners to prohibit the sale of tobacco products to underage youth;
  • Support local and statewide policies to protect people from secondhand smoke in all workplaces and public places;
  • Collaborate with local and state partners to provide information and strategies to keep youth tobacco free.

North Dakota & National Resources

The North Dakota Department of Health - Division of Tobacco Prevention and Control provides comprehensive information and materials about tobacco, cessation, and local programs available as described below. Refer to http://www.ndhealth.gov/tobacco/

School Health Policies and Programs Study (SHPPS)
The School Health Policies and Programs Study is conducted every six years by the Centers for Disease Control and Prevention (CDC).  This national study is completed with every state to assess school health policies and programs at the state, district, school, and classroom levels.

On October 19, 2007, the SHPPS webpage www.cdc.gov/SHPPS was updated with new information and resources, including a link to the Journal of School Health articles, fact sheets, a state-level summaries document, questionnaires, analytic data files and technical documentation, and archives of previous SHPPS studies. 

Youth Risk Behavior Surveillance System
The YRBS monitors behaviors that contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the United States. Follow this link to view the report.

School Health Guidelines: Tobacco Use
Includes strategies most likely to be effective in preventing tobacco use and addiction among young people.

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North Dakota Department of Public Instruction
Dr. Wayne G. Sanstead, State Superintendent
600 E. Boulevard Avenue, Dept. 201
Bismarck, North Dakota 58505-0440
701/328-2260

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