Healthy and Safe School Environment, Part I: Results From the School Health Policies and Programs Study 2006
By Jones, Sherry Everett Fisher, Carolyn J; Greene, Brenda Z; Hertz, Marci F; Pritzl, Jane
ABSTRACT BACKGROUND: Policies set at the state, district, and school levels can support and enhance a healthy and safe school environment.
METHODS: The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of school districts (n = 461). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 1025).
RESULTS: Most districts had adopted a policy on the inspection and maintenance of school facilities and equipment, and most schools had inspected and provided appropriate maintenance for each type of school facility and equipment during the 12 months preceding the study. Nearly all districts and schools had a comprehensive crisis preparedness, response, and recovery plan. Nearly all districts and schools prohibited tobacco, alcohol, and illegal drug use; fighting; weapons use; and weapon possession; but when students broke rules related to those behaviors, punitive measures were taken more often than provision of supportive services. Most schools did not reschedule outdoor activities to avoid times when the sun was at peak intensity, nor did they encourage the use of sunscreen before going outside.
CONCLUSIONS: To provide students with a truly healthy and safe school environment in which learning can take place, more schools need to promote a positive school climate and reduce violence, injuries, and the use of tobacco, alcohol, and other substances. States and districts need to continue to provide policy and technical assistance in support of school efforts.
Keywords: injury prevention; substance use; schools; school policy; surveys.
A healthy and safe school environment is an integral component of a school health program, in addition to health education, physical education and activity, health services, mental health and social services, nutrition services, faculty and staff health promotion, and family and community involvement. A healthy and safe school environment encompasses the physical surroundings and the psychosocial, learning, and health-promoting environment of the school. Policies set at the state, district, and school levels can support and enhance health- and safety-promoting behaviors. Further, students attending schools with a safe, positive physical and psychosocial school environment may be less likely to experience unintentional injuries and violence, to use tobacco, alcohol, or other drugs, or to experience school failure.1
The school environment is regulated by laws and policies instituted at the national, state, district, and school levels. For example, at the national level, the Gun-Free Schools Act requires that states receiving federal funds under the No Child Left Behind Act2 have a state law requiring mandatory 1-year expulsions for students who bring a firearm to school (on a case-by case basis, a local education agency may modify the expulsion requirement).3 Another federal law, subject to some exceptions, makes it a crime to possess a firearm or knowingly or recklessly discharge a firearm in a school zone.4 The Pro-Children Act of 1994 prohibits smoking within any indoor facility that receives federal funds and provides routine or regular kindergarten, elementary, or secondary education services to children.5 The Safe and Drug-Free Schools and Communities Act provides federal funds for programs to prevent violence in and around schools and to prevent the illegal use of alcohol, tobacco, and drugs.6 Programs or activities funded under this Art must “be based on scientifically based research that provides evidence that the program to be used will reduce violence and illegal drug use … [and] include meaningful and ongoing consultation with and input from parents in the development of the application and administration of the program or activity.”7 In addition, states receiving funds under this Art must “establish a uniform information management and reporting system.”8
Although many state- and district-level policies directly mandate school-level policies and programs, many other state and district policies provide only general guidelines and leave the specific elements of a policy or implementation of a policy up to individual schools. Also, schools may implement additional policies and programs not required by the state or district.
To assess the status and characteristics of a wide range of healthy and safe school environment policies and practices at the state, district, and school levels, the Centers for Disease Control and Prevention (CDC) conducted the School Health Policies and Programs Study (SHPPS) 2006. It expands upon the healthy and safe school environment component of SHPPS 2000.9 Specifically, SHPPS 2006 included for the first time questions about sun safety; student drug testing; crisis preparedness, response, and recovery; and school climate.
Skin cancer is the most common preventable cancer in the United States and has been shown to be related directly to sun exposure.10- 13 In fart, ultraviolet radiation has been classified as a human carcinogen.14 School policies (eg, requiring the use of hats, long- sleeved shirts, and sunscreen) can play an important role in protecting students and staff from ultraviolet radiation and may ultimately reduce the risk of skin cancer.15,16
Drug-testing requirements for students engaged in competitive extracurricular activities, though controversial, have been upheld by the US Supreme Court in Vernonia School District, 47J versus Acton in 199517 and in Board of Education of Independent School District No. 92 of Pottawatomie County versus Earls in 2002.l8 These cases limit the nature and scope of drugtesting programs to protect students’ constitutionally protected Fourth Amendment rights against unreasonable searches and seizures, but do support drugtesting programs in certain situations. SHPPS 2006 is the first national study to examine district-level drug-testing policies and school- level drug-testing programs, including how students are chosen for drug testing, the drugs for which students are tested, and the testing methods used.
Since SHPPS 2000, the expectation that districts and schools will have developed crisis preparedness, response, and recovery plans has grown appreciably. The US Department of Education provides state and local education agencies with guidance on mitigation and prevention, preparedness, response, and recovery.19 In addition, the CDC’s School Health Guidelines to Prevent Unintentional Injuries and Violence recommends that schools “establish mechanisms for shortand long-term responses to crises, disasters, and injuries that affect the school community. “20(p39) In times of crisis, schools are often used as shelters, community meeting places, and even command centers. Thus, recommendations from the National Advisory Committee on Children and Terrorism suggest that to adequately address the needs of students, in addition to the planning which occurs at the national and state levels, local-level coordination is critical.21 SHPPS 2006 examined the extent to which districts and schools have crisis preparedness, response, and recovery plans and what is included in those plans; with whom district and school staff collaborated in developing the plans; and crisis preparedness training for staff, students, and families.
Increasingly, studies are supporting the concept that students who feel connected to their school are less likely to engage in a variety of health-risk behaviors such as alcohol and illegal drug use and violent and deviant behaviors, and are less likely to experience emotional distress.22-25 SHPPS 2006 examined the extent to which states, districts, and schools promote a positive school climate through policies and programs, faculty and staff development, prosocial codes of conduct, and family and community involvement.
This article describes findings from SHPPS 2006 about state- and district-level policies and practices related to school health councils and school health coordinators; keeping the school environment safe and secure; sun safety; violence prevention; unintentional injury prevention; tobacco-use prevention; alcohol- use and illegal drug-use prevention; crisis preparedness, response, and recovery; school climate; and assistance to districts and schools. At the school level, this article describes school health councils and school health coordinators, as well as policies and practices related to keeping the school environment safe and secure; sun safety; violence prevention; unintentional injury prevention; tobacco-use prevention; alcohol-use prevention; illegal drug possession and use prevention; crisis preparedness, response, and recovery; and school climate. In addition, this article describes changes in key policies and practices from 2000 to 2006. While this article is primarily descriptive in nature, the CDC intends to conduct more detailed analyses and encourages others to conduct their own analyses using the questionnaires and public-use data sets available at www.cdc.gov/shpps. METHODS
Detailed information about SHPPS 2006 methods is provided in “Methods: School Health Policies and Programs Study 2006″ elsewhere in this issue of the Journal of School Health. The following section provides a brief overview of SHPPS 2006 methods specific to the healthy and safe school environment component of the study.
SHPPS 2006 assessed the healthy and safe school environment at the state, district, and school levels. State-level data were collected from education agencies in all 50 states plus the District of Columbia. District-level data were collected from a nationally representative sample of public school districts. School-level data were collected from a nationally representative sample of public and private elementary schools, middle schools, and high schools.
Questionnaires
The state-level healthy and safe school environment questionnaire assessed policies on the prevention of violence and tobacco use and on injury prevention and safety; the physical school environment; crisis preparedness, response, and recovery; school climate; and assistance to districts and schools.
Because the entire district-level questionnaire took longer than 20-30 minutes to complete and covered such a wide range of topics that a single respondent might not have sufficient knowledge to complete it, the questionnaire was divided into 4 modules: (1) district configuration; general school environment; violence, tobacco-use, alcohol-use, and illegal drug-use prevention; and injury prevention and safety; (2) physical school environment; (3) crisis preparedness, response, and recovery; and (4) school climate; foods and beverages sold outside of the school meal program; and district assistance to schools, including model policies, staff development, school health councils, and school health coordinators.
The school-level questionnaire also was divided into modules: (1) general school environment; violence, tobacco-use, alcohol-use, and illegal drug-use prevention; and injury prevention and safety; (2) physical school environment; and (3) crisis preparedness, response, and recovery; school climate; physical activity; foods and beverages sold outside the school meal program; and school health councils.
Data from the state-level questionnaire and from module 2 in both the district- and school-level questionnaires on the physical school environment are reported in “Healthy and Safe School Environment, Part II, Physical School Environment: Results From the School Health Policies and Programs Study 2006″ elsewhere in this issue of the Journal of School Health. Data from module 4 in the district-level questionnaire and module 3 in the school-level questionnaire on foods and beverages sold outside the school meal program are reported in “Nutrition Services and Foods and Beverages Available at School: Results From the School Health Policies and Programs Study 2006″ elsewhere in this issue of the Journal of School Health.
Data Collection and Respondents
State- and district-level data were collected by computer- assisted telephone interviews or selfadministered mail questionnaires. Designated respondents for each of 7 school health program components (ie, health education, physical education and activity, health services, mental health and social services, nutrition services, healthy and safe school environment, and faculty and staff health promotion) completed the interviews or questionnaires. At the state level, the state-level contact designated a single respondent to complete each component. At the district level, the district-level contact could designate a different respondent for each module. All designated respondents had primary responsibility for, or were the most knowledgeable about, the policies and programs addressed in the particular questionnaire or module.
After a state- or district-level contact identified respondents, each respondent was sent a letter of invitation and packet of study- related materials. Each packet contained a paper copy of the questionnaire(s) so that respondents could prepare for the interview and provided a toll-free number and access code that respondents could use to initiate the interview. Respondents were told that the questionnaire(s) could be used in preparation for their telephone interview or completed and returned if self-administration was preferred. One week after packets were mailed to respondents, trained interviewers from a call center placed calls to them to schedule and conduct telephone interviews. In April 2006, telephone interviewing ceased and most of the remaining state- and district- level data collection occurred via a mail survey. All remaining respondents were mailed paper questionnaires and return envelopes; however, interviewers remained available for any respondents who chose to contact the call center.
At the end of the data collection period (October 2006), 80% of the completed state-level healthy and safe school environment questionnaires had been completed via telephone interviews and 20% as paper questionnaires. For the completed district-level questionnaires, module 1 was completed via telephone interview 47% of the time; module 3, 51%; and module 4, 47%.
School-level data were collected by computerassisted personal interviews. During recruitment, the principal or other school-level contact designated a faculty or staff respondent for each questionnaire or module, who had primary responsibility for or the most knowledge about the particular component. The principal or school-level contact could designate a different respondent for each module. For modules 1 and 3, the most common respondents were principals and assistant principals or other school administrators.
Response Rates
One hundred percent (n = 51) of the state education agencies completed the state-level healthy and safe school environment questionnaire. District eligibility for each module was determined before interviews began; 720 districts were eligible for each of modules 1, 3, and 4. Of the 720 districts eligible to complete any school policy and environment module, 64% (n = 461) completed at least 1 module. School eligibility for each module also was determined before interviews began; 1416 schools were eligible for each of modules 1 and 3 and 72% (n = 1025) completed at least 1 module.
Data Analysis
Data from state-level questionnaires are based on a census and are not weighted. District- and schoollevel data are based on representative samples and are weighted to produce national estimates.
Because of missing data, the denominators for each estimate vary slightly. Figures 13 and 14 in Appendix 1 in this issue of the Journal of School Health show the estimated standard error associated with an observed estimate from the district- and school- level healthy and safe school environment questionnaires.
To analyze changes between SHPPS 2000 and 2006, many variables from SHPPS 2000 were recalculated so that the denominators used for both years of data were defined identically. In most cases, this denominator included all states, districts, or schools, rather than a subset of states, districts, or schools. As a result of this recalculation, percentages previously reported for SHPPS 20009 might differ from those reported in this article. Only estimates from 2000 and 2006 based on this same denominator should be compared.
Because state-level data are based on a census, statistical tests for differences between 2000 and 2006 are not appropriate. Therefore, this article highlights changes over time meeting at least 1 of 2 criteria: (1) the difference was greater than 10 percentage points or (2) the 2006 estimate increased by at least a factor of 2 or decreased by at least half as compared with the 2000 estimate. At the district and school levels, t tests were used to compare SHPPS 2000 and SHPPS 2006 prevalence estimates. However, to account for multiple comparisons, this article only highlights changes over time meeting at least 2 of 3 criteria: (1) a p value less than .01 from the t test, (2) a difference greater than 10 percentage points, or (3) the 2006 value increased by at least a factor of 2 or decreased by at least half as compared with the 2000 estimate. Note that not all variables meeting these criteria are presented in this article.
RESULTS
Healthy and Safe School Environment at the State and District Level
School Health Councils and School Health Coordinators. A school health council, committee, or team (defined as a group that offers guidance on the development of policies or coordinates activities on health topics and called a school health council for the purposes of this article) is an integral part of any school health program. Most (85.7%) states had a school health council that was formally charged with coordinating state-level school health activities.
Nationwide, 72.9% of districts had 1 or more school health councils at the district level that offered guidance on the development of policies or coordinated activities on health topics. School health councils addressed a wide variety of school health program components and topics. More than half of the 72.9% of districts with a school health council addressed each of the school health program components or topics listed in Table 1. Most district- level school health councils had broad representation. Half or more of the 72.9% of districts with a district-level school health council included in their group a representative from all of the school and community groups listed in Table 2 except for local social service agencies and local health organizations (eg, the local Red Cross Chapter). Among the 72.9% of districts with a school health council, 5.6% met less than 1 time, 30.3% met 1 or 2 times, 32.7% met 3 or 4 times, 15.8% met 5 or 6 times, and 15.6% met more than 6 times during the 12 months preceding the study. During the 2 years preceding the study, 85.7% of states provided funding for or offered to help districts or schools, and 50.5% of districts provided funding for or offered to help schools, establish a school health council.
At the district level, 67.8% of districts had someone who oversees or coordinates school health (eg, a school health coordinator), but only 36.6% of respondents held that position. Among those district respondents who were the district’s school health coordinator, only 20.7% had received any training in their role as a school health coordinator.
Keeping the School Environment Safe and Secure. Districts adopted a variety of policies to help keep the school environment safe and secure (Table 3). Almost all districts had adopted a policy stating that elementary, middle, and high schools will have visitors report to the main office or reception area upon arrival. At least two thirds of districts had adopted a policy stating that elementary, middle, and high schools will assign staff or adult volunteers to monitor school grounds and halls between classes. At least half of districts had adopted a policy stating that elementary, middle, and high schools will assign staff or adult volunteers to monitor bathrooms and school halls during classes. Nationwide, 91.4% of districts had adopted a policy stating that elementary schools will assign staff or adult volunteers to monitor playgrounds while they are in use.
Nationwide, two thirds or more of districts had adopted a policy requiring that visitors to elementary, middle, and high schools wear identification badges, and one third of districts had adopted a policy requiring faculty and staff in elementary, middle, and high schools to do so (Table 3). Few districts had adopted a policy requiring students in elementary, middle, and high schools to wear identification badges or school uniforms. Most districts, however, had adopted a policy stating that elementary, middle, and high schools will enforce a student dress code.
Nationwide, more than two thirds of districts had adopted a policy stating that elementary, middle, and high schools will maintain closed campuses (ie, students are not allowed to leave school during the school day, including during lunchtime) (Table 3). More than half of districts had adopted a policy stating that middle and high schools will routinely conduct locker searches (general, random, or by the use of drug-sniffing dogs). Less than half of districts had adopted a policy stating that elementary, middle, and high schools will use police, school resource officers, or security guards during the regular school day. Few districts had adopted a policy stating that elementary, middle, or high schools will use metal detectors, including wands; more than one fourth of districts had adopted a policy stating that schools will use security or surveillance cameras, either inside or outside the building; and almost two thirds or more of districts had adopted a policy stating that schools will use communication devices (eg, cell phones, 2-way radios, walkie-talkies, or intercoms).
Sun Safety. School policies can play an important role in protecting children and adolescents from ultraviolet radiation.1516 Two percent of districts required and 35.9% recommended that schools schedule outdoor activities to avoid times when the sun is at peak intensity, and 4.0% of districts required and 32.5% recommended that schools establish procedures to encourage students to use sunscreen before going outside.
Violence Prevention. Nationwide, 68.6% of states and 98.6% of districts had adopted a policy prohibiting physical fighting by students on school property; 62.0% of states and 96.6% of districts had adopted a policy prohibiting physical fighting by students at off-campus, school-sponsored events; and 76.5% of states required districts or schools to report to the state on the number of times students were caught fighting.
Nationwide, 96.1% of states and 100% of districts had adopted a policy prohibiting both weapon (eg, a gun, knife, or club) use and weapon possession by students on school property; 84.0% of states and 98.9% of districts had adopted a policy prohibiting weapon use by students at off-campus, school-sponsored events; and 84.0% of states and 99.3% of districts had adopted a policy prohibiting weapon possession by students at off-campus, schoolsponsored events. Most states required districts or schools to report to the state on the number of times students were caught using (94.1%) or possessing (98.0%) a handgun or other firearm and using (88.2%) or possessing (92.2%) any other weapon.
Nationwide, 31.2% of states and 78.5% of districts had adopted a policy prohibiting gang activity (eg, recruiting or wearing gang colors, symbols, or other gang attire), and 26.5% of states required districts or schools to report to the state on the number of times students were caught violating any rule on gang activity.
Bullying was defined as repeated infliction or attempted infliction of injury, discomfort, or humiliation of a student by 1 or more other students. Nationwide, 60.8% of states and 94.8% of districts had adopted a policy prohibiting bullying on school property, and 53.1% of states and 90.3% of districts had adopted a policy prohibiting bullying at offcampus, school-sponsored events.
School-associated violent deaths can include homicides or suicides at school or school-sponsored events among students, faculty and staff, and visitors. Nationwide, 70.0% of states required districts or schools to report to the state on the number of school-associated violent deaths. Less than half (42.9%) of states had adopted a policy stating that schools will have a plan for the actions to be taken when a student at risk for suicide is identified. Among the 86.0% of districts that had adopted such a policy, 96.4% required that the student’s family be informed, 78.8% required the student be referred to a mental health provider, and 49.2% required a visit with a mental health provider be documented before the student returned to school.
Unintentional Injury Prevention. Routine inspection and maintenance of school facilities and equipment can help prevent injuries among students, faculty and staff, and school visitors. More than two thirds of all states had adopted a policy on the inspection or maintenance of fire extinguishers, smoke alarms, sprinkler systems, and special classroom areas (eg, chemistry labs, workshops, and art rooms) (Table 4). Three fourths or more of all districts had adopted policies on the inspection or maintenance of all the school facilities and equipment about which districts were questioned except for inspection or maintenance of sprinkler systems. Nationwide, 46.7% of districts had adopted a policy stating that elementary schools will use the safety checklist and equipment guidelines published in the Handbook for Public Playground Safety by the US Consumer Product Safety Commission.26
Wearing protective gear can reduce the number and severity of injuries to students. Nationwide, 76.1% of states and 94.9% of districts had adopted a policy requiring students to wear appropriate protective gear when engaged in classes such as wood shop or metal shop, and 76.1% of states and 94.6% of districts had adopted policies requiring students to wear appropriate protective gear when engaged in lab activities for photography, chemistry, biology, or other science classes.
Nationwide, 33.0% of districts had ever been sued because of an injury that occurred on school property or at an off-campus, school- sponsored event. This included any claim filed with a court, regardless of the outcome, but did not include suits against individual staff members.
Tobacco-Use Prevention. States and districts were asked whether they had policies prohibiting cigarette smoking, smokeless tobacco use, or cigar or pipe smoking among students, faculty and staff (during any school-related activity), and school visitors. Visitors were defined as anyone other than students or faculty and staff, including family members, community members, and repair workers who might visit the school during or outside of school hours. Most states had adopted a policy prohibiting cigarette smoking (92.2%), smokeless tobacco use (83.7%), and cigar or pipe smoking (90.2%) among students. Fewer states had adopted a policy prohibiting cigarette smoking (74.5%), smokeless tobacco use (56.9%), and cigar or pipe smoking (70.6%) among faculty and staff. Similarly, fewer states had adopted a policy prohibiting cigarette smoking (86.3%), smokeless tobacco use (64.7%), and cigar or pipe smoking (86.3%) among visitors.
Nationwide, 100% of districts had adopted a policy prohibiting cigarette smoking among students, 94.3% had adopted a policy prohibiting smokeless tobacco use among students, and 94.4% had adopted a policy prohibiting cigar or pipe smoking. Most districts also had adopted a policy prohibiting cigarette smoking (94.8%), cigar or pipe smoking (89.8%), and smokeless tobacco use (87.8%) among faculty and staff, and most had adopted a policy prohibiting cigarette smoking (92.5%), smokeless tobacco use (82.6%), and cigar or pipe smoking (88.4%) among visitors.
As part of a tobacco-use prevention effort and to promote a healthy school environment, school policies should prohibit students, faculty and staff, and visitors from using any form of tobacco anywhere under the control of school authorities.27 Thus, states and districts were asked the location where cigarette smoking and smokeless tobacco use was prohibited (schools were not asked where cigar or pipe smoking were prohibited) (Table 5). In general, states and districts were more likely to have adopted policies applying to students than to faculty and staff and visitors that prohibited cigarette smoking and smokeless tobacco use in school buildings, outside on school grounds (including parking lots and playing fields), on school buses or other vehicles used to transport students, and at off-campus, school-sponsored events. While most states and districts had adopted policies prohibiting some tobacco use in some locations, only 38.0% of states and 55.4% of districts had adopted policies that (1) prohibited cigarette smoking and smokeless tobacco use among all students, all faculty and staff, and all school visitors in school buildings; outside on school grounds; on school buses or other vehicles used to transport students; and at off-campus, school-sponsored events and (2) prohibited cigar or pipe smoking by all students, all faculty and staff, and all school visitors.
In addition to prohibiting tobacco use, states and districts also may adopt policies prohibiting tobacco advertisements, sponsorship of events, and wearing of tobacco brand-name apparel or merchandise to reinforce their commitment to tobacco-use prevention and tobacco- free environments (Table 6). Less than half of all states, but more than three fourths of all districts, had adopted policies prohibiting tobacco advertisements in school buildings, outside on school grounds, on school buses or other vehicles used to transport students, in school publications, and through sponsorship of school events and prohibiting students from wearing tobacco brand-name apparel or carrying merchandise with tobacco company names, logos, or cartoon characters on it.
Alcohol- and Illegal Drug-Use Prevention. Nationwide, 99.9% of districts had adopted a policy prohibiting alcohol use by students on school property, and 98.8% had adopted a policy prohibiting alcohol use by students at off-campus, school-sponsored events. All districts had adopted a policy prohibiting illegal drug possession or use by students on school property, and 99.3% of districts had adopted a policy prohibiting illegal drug possession or use by students at off-campus, school-sponsored events.
Nationwide, 25.5% of districts containing middle schools or high schools had adopted a student drug-testing policy. Among the 25.5% of districts that had adopted a student drug-testing policy, 56.1% conducted student drug testing randomly among members of specific groups of students (eg, athletes, students who participate in other extracurricular activities, or student drivers), 63.9% conducted student drug testing when it was suspected that a student was using drugs at schools (ie, for cause), 37.6% had voluntary drug testing for all students, 3.6% had voluntary drug testing for specific groups of students, and 13.4% used some other unspecified criteria. Among the 25.5% of districts that had adopted a student drug- testing policy, the policy specified that students will be tested for amphetamines (eg, methamphetamine or ecstasy) (48.8%), marijuana (48.8%), opiates (eg, heroin or morphine) (48.8%), cocaine (48.0%), phencyclidine (ie, PCP) (47.0%), alcohol (33.7%), steroids (20.3%), and nicotine (18.4%).
Crisis Preparedness, Response, and Recovery. Planning ahead facilitates a rapid, coordinated, and effective response when a crisis occurs.19 Nationwide, 92.2% of states had adopted a policy requiring districts or schools and 84.2% of districts had adopted a policy requiring schools to have a comprehensive plan to address crisis preparedness, response, and recovery in the event of a natural disaster or other emergency or crisis situation. Two thirds or more of all states had adopted a policy requiring districts or schools to have plans that included evacuation plans, requirements to conduct regular emergency drills other than fire drills, procedures to stop people from leaving or entering school buildings (ie, lockdown plans), and requirements to periodically review and revise emergency response plans (Table 7). Three fourths or more of all districts had adopted a policy requiring schools to have plans that included evacuation plans, requirements to conduct regular emergency drills, procedures to stop people from leaving or entering school buildings, requirements to periodically review and revise emergency response plans, provisions for students and staff with special needs, mechanisms for communicating with school personnel, establishment of an incident command system, and procedures for responding to media inquiries.
Nationwide, 10.2% of states and 32.4% of districts had adopted a policy that all schools must have a National Oceanic and Atmospheric Administration-approved (NOAA-approved) weather radio, a radio that provides continuous weather information directly from a nearby National Weather Service office and broadcasts warning and postevent information for all types of hazards.
Nationwide, 95.3% of districts had their own comprehensive district-level plan to address crisis preparedness, response, and recovery in the event of a natural disaster or other emergency or crisis situation. More than three fourths of all districts had crisis preparedness, response, and recovery plans that included mechanisms for communicating with school personnel; procedures for responding to media inquiries; protocols for communicating with building-level managers during a crisis; requirements to periodically review and revise emergency response plans; evacuation protocols for crises involving more than 1 school; establishment of an incident command system; plans for serving as a community shelter or coordinating center during a community-wide crisis; provision of mental health services for students, faculty, and staff after a crisis has occurred; and requirements to conduct district-level crisis response drills (Table 8).
Among the 95.3% of districts with a comprehensive district-level plan, districts were most likely to have worked with staff or members from a local law enforcement agency and a local fire department, and least likely to have worked with the FBI when developing the plan (Table 9). Three fourths (74.6%) of these districts had evaluated or assessed the plan during the 12 months preceding the study.
Most (87.8%) state education agencies were members of the state emergency planning committee (ie, a group of agencies that coordinate crisis preparedness, response, and recovery efforts). Few (10.2%) states required and 75.5% recommended that districts or schools serve as members of a group of local agencies that coordinated crisis preparedness, response, and recovery efforts (eg, a local emergency planning committee or an emergency management team). Nationwide, 56.3% of districts were members of a group of local agencies that coordinated crisis preparedness, response, and recovery efforts, 27.2% were not members of such a group, and 16.5% reported no such group existed in their community.
School Climate. A positive school climate was defined as a sense of community and welcome within the school, exemplified through caring student-teacher relationships, high teacher morale, student involvement and leadership in activities and programs, and family involvement. Nationwide, 70.6% of states and 77.0% of districts had adopted policies that explicitly promoted a positive school climate. In addition, 42.0% of states and 66.7% of districts had adopted a policy stating that schools will adopt a prosocial code of conduct that addresses such concepts as cooperation, conflict resolution, and helping others.
Assistance to Districts and Schools. States and districts can help foster the development and implementation of policies through the provision of model policies, staff development, and funding. Model policies were defined as an example of what an actual policy on a particular topic or issue might address. The content might be based on scientific evidence, best practices, or state law or policy. Model policies are recommendations, not mandates. During the 2 years preceding the study, more than three fourths of states provided model policies on crisis preparedness, response, and recovery; bullying prevention; and tobacco-use prevention. Three fourths or more of districts provided schools with model policies on these same 3 topics plus violence prevention, illegal drug-use prevention, and alcohol-use prevention (Table 10).
Staff development was defined as workshops, conferences, continuing education, graduate courses, or any other kind of in- service. During the 2 years preceding the study, 98.0% of states provided funding for staff development or offered staff development to districts or schools on how to implement policies and programs related to at least 1 of the topics listed in Table 10. In addition, 96.4% of districts provided funding for or offered staff development to schools on how to implement policies and programs related to any of these topics.
Among the 95.3% of districts with a crisis preparedness, response, and recovery plan, 81.5% provided funding for training or offered training on the plan to school faculty and staff, 51.5% to students, and 15.4% to students’ families during the 2 years preceding the study. Among all districts, 22.2% offered general education (ie, not specific training on the district’s crisis plan) on crisis preparedness, response, and recovery to students’ families during the 2 years preceding the study.
Changes Between 2000 and 2006 at the State and District Levels. The percentage of states with tobacco-use prevention policies for students, faculty and staff, and visitors increased between 2000 and 2006. Specifically, the percentage of states that had adopted a policy prohibiting cigar or pipe smoking among students increased from 80.0% to 90.2%. In addition, an increase was detected in the percentage of states that had adopted a policy prohibiting cigarette smoking among faculty and staff in school buildings (from 64.0% to 74.5%) and on school buses or other vehicles used to transport students (from 61.2% to 72.5%). The percentage of states that had adopted a policy prohibiting faculty and staff from cigar or pipe smoking during any school-related activity also increased from 58.3% to 70.6%. The percentage of states that had adopted a policy prohibiting cigarette smoking among school visitors increased from 71.4% to 86.3%. Further, an increase was detected in the percentage of states that had adopted a policy prohibiting cigarette smoking among visitors in school buildings (from 69.6% to 86.3%), on school buses or other vehicles used to transport students (from 67.4% to 84.0%), and at off-campus, school-sponsored events (from 37.0% to 52.0%). In addition, the percentage of states that had adopted a policy prohibiting smokeless tobacco use by visitors at off-campus, school-sponsored events increased from 30.6% to 48.0%, and the percentage of states that had adopted a policy prohibiting cigar or pipe smoking among school visitors increased from 70.0% to 86.3%.
As a result of these increases in the percentage of states with policies prohibiting some tobacco use in some locations, an increase from 24.5% in 2000 to 38.0% in 2006 occurred in the percentage of states that (1) prohibited cigarette smoking and smokeless tobacco use among students, faculty and staff, and school visitors in school buildings, outside on school grounds, on school buses or other vehicles used to transport students, and at off-campus, school- sponsored events and (2) prohibited cigar or pipe smoking by students, faculty and staff, and school visitors.
Between 2000 and 2006, the percentage of both states and districts that adopted policies prohibiting tobacco advertisements increased. Specifically, the percentage that had adopted a policy prohibiting tobacco advertisements in school buildings increased from 28.0% to 38.8% among states and from 71.9% to 84.2% among districts. Similarly, the percentage that had adopted a policy prohibiting tobacco advertisements on school buses or other vehicles used to transport students increased from 30.0% to 40.8% among states and from 71.2% to 81.9% among districts, and the percentage that had adopted a policy prohibiting tobacco advertisements in school publications increased from 26.0% to 36.7% among states and from 70.8% to 82.1% among districts. The percentage of districts that prohibited tobacco advertisements outside on school grounds increased from 71.0% to 83.3%, and the percentage of districts that prohibited tobacco advertising through sponsorship of school events increased from 64.2% to 79.8%.
Some changes in violence prevention policies between 2000 and 2006 also were detected. At the state level, the percentage of states that had adopted a policy prohibiting physical fighting by students increased from 46.9% to 68.6%, and the percentage of states that required districts or schools to report to the state on the number of times students were caught using weapons other than handguns or firearms increased from 74.5% to 88.2%. In addition, the percentage of states that provided model policies on violence prevention to districts or schools during the 2 years preceding the study decreased from 83.7% in 2000 to 72.0% in 2006.
At the district level, the percentage of districts that had adopted a policy requiring schools to use security or surveillance cameras increased from 2000 to 2006 for all school levels (elementary schools, from 11.0% to 29.1%; middle schools, from 16.4% to 37.2%; high schools, from 19.2% to 46.4%), as did the percentage of districts that had adopted a policy requiring schools to use communication devices (elementary schools, from 42.4% to 65.3%; middle schools, from 48.1% to 71.6%; high schools, from 49.5% to 70.7%) and the percentage of districts that had adopted a policy requiring schools to enforce a student dress code (elementary schools, from 62.0% to 81.4%; middle schools, from 75.1% to 91.2%; high schools, from 77.5% to 90.4%). In addition, the percentage of districts that had adopted a policy requiring routine locker searches increased from 35.4% to 57.1% for middle schools and from 44.0% to 63.4% for high schools. From 2000 to 2006, the percentage of districts that had adopted a policy prohibiting gang activity increased from 62.5% to 78.5%.
Two changes in district-level policies related to intentional injury prevention were detected. From 2000 to 2006, the percentage of districts that had adopted a policy on the inspection or maintenance of smoke alarms increased from 72.2% to 89.8%, and the percentage of districts that had adopted a policy requiring elementary schools to use the safety checklist and equipment guidelines published in the Handbook for Public Playground Safety by the US Consumer Product Safety Commission26 increased from 29.7% to 46.7%.
From 2000 to 2006, an increase was detected in the percentage of districts that had provided model policies to schools during the 2 years preceding the study on illegal drug-use prevention (from 64.0% to 76.2%) and on alcohol-use prevention (from 64.9% to 75.4%).
Healthy and Safe School Environment at the School Level
School Health Councils and School Health Coordinators. Nationwide, 39.5% of schools had a school health council that offered guidance on the development of policies or coordinated activities on health topics. School health councils addressed many school health program components and many health topics (Table 1). Among the 18 topics listed in Table 1, only human immunodeficiency virus prevention, management of chronic health conditions such as asthma or diabetes, other sexually transmitted disease prevention, and pregnancy prevention were addressed by less than two thirds of the 39.5% of schools with a school health council. Representation on school health councils varied, but more than half of the 39.5% of schools with a school health council included district or school administrators, physical education teachers, health education teachers, health services staff, community members, and nutrition or food service staff (Table 2). Among the 39.5% of schools with a school health council, 4.3% of the councils met less than 1 time, 29.8% 1 or 2 times, 32.4% 3 or 4 times, 9.4% 5 or 6 times, and 24.2% more than 6 times during the 12 months preceding the study. Nationwide, 60.8% of schools had someone at the school to oversee or coordinate school health (eg, a school health coordinator).
Keeping the School Environment Safe and Secure. Most schools at each school level required visitors to report to the main office or reception area upon arrival (Table 3). With 1 exception, more than half of all schools at all levels assigned staff or adult volunteers to monitor school halls during classes and between classes, bathrooms, and school grounds, and among elementary schools, to monitor playgrounds while they were in use. Across all school levels, more than two thirds of schools required identification badges for visitors, but less than half of schools required identification badges for faculty and staff. Few schools required identification badges for students. Less than one third of schools required students to wear school uniforms, but almost two thirds or more of schools had a dress code. Nearly all elementary and middle schools maintained a closed campus, while almost three fourths of high schools had closed campuses. Nationwide, 36.5% of middle schools and 43.2% of high schools routinely conducted locker searches.
Nationwide, 25.7% of elementary schools, 36.4% of middle schools, and 50.0% of high schools used police or school resource officers during the regular school day, whereas only 5.2% of elementary schools, 9.3% of middle schools, and 19.4% of high schools used security guards during the regular school day (Table 3). Nationwide, 9.2% of elementary schools, 23.8% of middle schools, and 29.6% of high schools had armed security staff.
Less than half of all elementary and middle schools used security or surveillance cameras, but more than half of high schools did so. Few schools at any level used metal detectors. Most schools across all levels used communication devices.
Sun Safety. During the 12 months preceding the study, 41.6% of schools never, 18.8% rarely, 26.1% sometimes, and 13.5% almost always or always scheduled outdoor activities to avoid times when the sun was at peak intensity. Further, 29.3% of schools never, 24.1% rarely, 29.8% sometimes, and 16.7% almost always or always encouraged students to use sunscreen before going outside.
Violence Prevention. Nationwide, 88.1% of schools had a plan for the actions to be taken when a student at risk for suicide was identified. Among these schools, 98.1% of the plans required the student’s family be informed, 81.6% of the plans required the student be referred to a mental health provider, and 52.4% of the plans required a visit with a mental health provider be documented before the student returned to school.
Nationwide, 98.7% of schools had adopted a policy prohibiting physical fighting by students on school property, 92.7% of schools had adopted a policy prohibiting physical fighting at off-campus, school-sponsored events, and 97.9% of schools had a policy that also included guidelines on what actions the school should take when students were caught fighting.
Nationwide, 49.9% of schools had 4 or more incidents where students were caught fighting during the 2004-2005 school year. Incidents was defined as the number of occurrences, not the number of students, officially reported or witnessed by an adult. Among these schools, the effect or severity of the violation, repeat offender status, and zero tolerance were the most common criteria used to determine what actions the school took in response (Table 11). When students were caught fighting, 97.7% of these schools almost always or always notified students’ families, and 95.4% almost always or always referred students to a school administrator (Table 12). Nationwide, 33.3% of schools posted signs marking a weapons-free school zone (ie, a specified distance from school grounds where weapons are not allowed). Further, 99.2% of schools had adopted a policy prohibiting weapon use by students on school property; 98.9% of schools had adopted a policy prohibiting weapon possession by students on school property; 94.6% of schools had adopted a policy prohibiting weapon use by students at off-campus, school-sponsored events; and 94.9% of schools had adopted a policy prohibiting weapon possession by students at off-campus, school- sponsored events. Most schools had a policy that also included guidelines on what actions the school should take when students were caught using (98.2%) or possessing (97.8%) weapons.
Only 7.6% of schools had 4 or more incidents where students were caught possessing weapons during the 2004-2005 school year. Among these schools, zero tolerance was the most common criterion used to determine what actions the school took in response (Table 11). When students were caught possessing a weapon, more than half of these schools almost always or always referred students to a school administrator, notified students’ families, suspended students from school, did not allow students to participate in extracurricular activities or interscholastic sports, and referred students to legal authorities (Table 12). The percentage (1.0%) of schools reporting 4 or more incidents of weapon use was too small for meaningful analysis of the data on criteria used to determine what actions the school took and the actions taken in response.
Nationwide, 73.1% of schools had adopted a policy prohibiting gang activity such as recruiting or wearing gang colors, symbols, or other gang attire. Almost one third (30.6%) of schools had or participated in a program to prevent gang violence, and 10.1% of schools had or participated in a safe passages to school program, defined as a program that develops safe routes to school so students do not have to go through dangerous areas.
Nationwide, 95.4% of schools had adopted a policy prohibiting bullying on school property, and 89.6% had adopted a policy prohibiting bullying at off-campus, school-sponsored events. In addition, 73.9% of schools had or participated in a program to prevent bullying, and 34.1% of schools had or participated in a peer mediation program.
Most schools had procedures to inform all students about violence- related rules (98.4%) and what happens if they break the rules (98.0%) and procedures to inform the families of all students about violence-related rules (98.1%) and what happens if students break the rules (97.8%). During the 2 years preceding the study, 50.2% of all schools involved students, 44.7% involved students’ families, and 52.5% involved community members in developing, communicating, or implementing violence prevention policies or activities (Table 13).
Unintentional Injury Prevention. Schools implemented a variety of injury prevention and safety procedures related to sports or playground activities, school lab or workshop activities, and fire safety. Three fourths or more of all schools had inspected and provided appropriate maintenance during the 12 months preceding the study for each type of school facility and equipment listed in Table 4. Almost half (48.7%) of elementary schools used the safety checklist and equipment guidelines published in the Handbook for Public Playground Safety by the US Consumer Product Safety Commission.26 Further, 94.6% of the 32.7% of schools with classes such as wood shop or metal shop required students to wear appropriate protective gear when engaged in those classes, and 97.6% of the 64.6% of schools with lab activities for photography, chemistry, biology, or other science classes required students to wear appropriate protective gear when engaged in those activities.
Most schools had procedures to inform all students (93.6%) and the families of all students (88.9%) about rules related to school safety and injury prevention. However, one third or less of all schools involved students, students’ families, and community members in developing, communicating, or implementing injury prevention and safety policies or activities during the 2 years preceding the study (Table 13). Nationwide, 11.8% of schools had ever been sued because of an injury that occurred on school property or at an off-campus, school-sponsored event. This included any claim filed with a court, regardless of the outcome, but did not include suits against individual staff members.
Tobacco-Use Prevention. Most schools had adopted a policy prohibiting cigarette smoking (96.9%), smokeless tobacco use (91.3%), and cigar or pipe smoking (90.2%) among students; prohibiting cigarette smoking (92.6%), smokeless tobacco use (88.4%), and cigar or pipe smoking (89.9%) among faculty and staff; and prohibiting cigarette smoking (90.5%), smokeless tobacco use (84.8%), and cigar or pipe smoking (87.3%) among school visitors. Schools were asked if they had a policy that prohibited cigarette smoking and smokeless tobacco use among students, faculty and staff, and visitors in a variety of locations (Table 5). Only 63.6% of schools (65.5% of elementary schools, 58.7% of middle schools, and 66.1% of high schools) had policies that (1) prohibited cigarette smoking and smokeless tobacco use among all students, all faculty and staff, and all school visitors in school buildings, outside on school grounds, on school buses or other vehicles used to transport students, and at off-campus, school-sponsored events and (2) prohibited cigar or pipe smoking by all students, all faculty and staff, and all school visitors.
Nationwide, most schools prohibited tobacco advertisements in school buildings, outside on school grounds, on school buses or other school vehicles used to transport students, and in school publications; through sponsorship of school events; and by prohibiting tobacco brand-name apparel or merchandise (Table 6). Further, 54.1% of schools posted signs marking a tobacco-free school zone (ie, a specified distance from school grounds where tobacco use is not allowed), and 37.8% of middle schools and high schools had or participated in a youth empowerment or advocacy program related to tobacco-use prevention.
Most (95.0%) schools had a policy that included guidelines on what actions the school should take when students were caught smoking cigarettes, and 90.2% had a policy on what actions the school should take when students were caught using smokeless tobacco. Nationwide, 11.9% of schools had 4 or more incidents where students were caught smoking cigarettes and 6.4% of schools had 4 or more incidents where students were caught using smokeless tobacco during the 2004-2005 school year. Among these schools, zero tolerance was the criterion most commonly used to determine what actions the school took in response to both cigarette smoking and smokeless tobacco-use incidents (Table 11). When students were caught smoking cigarettes, 95.9% of these schools almost always or always referred students to a school administrator, and 93.4% almost always or always notified students’ families (Table 12). Similarly, when students were caught using smokeless tobacco, 95.3% of these schools almost always or always referred students to a school administrator, and 93.1% notified students’ families.
Most schools had procedures to inform all students about tobacco- related rules (94.9%) and what happens if they break the rules (95.5 %) and procedures to inform the families of all students about tobacco-related rules (95.6%) and what happens if students break the rules (95.1%). Most schools also had procedures to inform faculty and staff about tobacco-related rules (90.0%) and what happens if they break the rules (86.9%) and procedures to inform school visitors about tobacco-related rules (77.0%) and what happens if visitors break the rules (65.7%). During the 2 years preceding the study, 43.5% of all schools involved students, 29.4% involved students’ families, and 43.8% involved community members in developing, communicating, or implementing tobacco-use prevention policies or activities (Table 13).
Alcohol-Use Prevention. Most schools had adopted a policy prohibiting alcohol use by students on school property (97.2%) and at off-campus, school-sponsored events (94.4%). Most schools (96.4%) had a policy that also included guidelines on what actions the school should take when students were caught drinking alcohol. Nationwide, 4.5% of schools had 4 or more incidents where students were caught using alcohol during the 2004-2005 school year. Among these schools, zero tolerance was the criterion most commonly used to determine what actions the school took in response (Table 11). When students were caught drinking alcohol, 97.5% of these schools almost always or always notified students’ families, 97.4% almost always or always referred students to a school administrator, 80.4% almost always or always did not allow students to participate in extracurricular activities or interscholastic sports, and 73.6% almost always or always suspended students from school (Table 12).
Most schools had procedures to inform all students about alcohol use-related rules (95.0%) and what happens if they break the rules (95.5%) and procedures to inform the families of all students about alcohol use-related rules (95.8%) and what happens if students break the rules (95.6%). During the 2 years preceding the study, 43.9% of all schools involved students, 35.1% involved students’ families, and 47.0% involved community members in developing, communicating, or implementing alcohol-use prevention policies or activities (Table 13). Nationwide, 38.5% of schools had or participated in a community- based alcohol-use prevention program, such as SADD (Students Against Destructive Decisions). Illegal Drug Possession and Use Prevention. Most schools had adopted a policy prohibiting illegal drug possession or use by students on school property (97.8%) and at off- campus, school-sponsored events (96.0%). Most (97.4%) schools also had a policy that included guidelines on what actions the school should take when students were caught possessing or using illegal drugs. Nationwide, 9.7% of schools had 4 or more incidents where students were caught possessing or using illegal drugs during the 2004-2005 school year. Among these schools, zero tolerance was the criterion most commonly used to determine what actions the school took in response (Table 11). When students were caught possessing or using illegal drugs, 98.9% almost always or always referred students to a school administrator, 98.7% almost always or always notified students’ families, 87.7% almost always or always suspended students from school, 79.4% almost always or always referred students to legal authorities, and 77.2% almost always or always did not allow students to participate in extracurricular activities or interscholastic sports.
Nationwide, 11.4% of middle schools and 19.5% of high schools conducted drug testing on students. Among the 11.3% of private middle and high schools that conducted testing, 81.4% conducted tests when it was suspected that a student was using drugs at school, 35.0% conducted tests randomly among the entire student population, 7.7% used voluntary testing for all students, and 11.5% used some other unspecified criterion. Among the 15.9% of public middle and high schools that conducted testing, 71.9% conducted tests when it was suspected that a student was using drugs at schools, 53.4% conducted tests randomly among members of specific groups of students, 45.8% used voluntary testing for all students, and 11.2% used some other unspecified criterion.
Among the 14.6% of public and private middle schools and high schools that conducted drug testing on students, 85.6% tested for marijuana, 78.1% tested for opiates (eg, heroin or morphine), 77.3% tested for amphetamines (eg, methamphetamine or ecstasy), 74.7% tested for cocaine, 70.7% tested for phencyclidine (ie, PCP), 49.7% tested for alcohol, 27.0% tested for steroids, and 16.3% tested for nicotine. Urine tests were used in 83.9% of these schools, a breathalyzer (breath alcohol test) in 39.5%, hair in 15.2%, saliva in 7.9%, and sweat in 2.9%.
Among the 14.6% of public and private middle schools and high schools that conducted drug testing on students, 14.4% had 4 or more incidents where students had a positive drug test during the 2004- 2005 school year. This was too few to conduct meaningful analysis of the data on criteria used to determine what actions the school took and the actions taken in response.
Most schools had procedures to inform all students about illegal drug use-related rules (94.5%) and what happens if they break the rules (95.0%), and procedures to inform the families of all students about illegal drug use-related rules (95.2%) and what happens if students break the rules (95.2%). During the 2 years preceding the study, 46.9% of all schools involved students, 36.9% involved students’ families, and 49.9% involved community members in developing, communicating, or implementing alcohol-use prevention policies or activities (Table 13). Nationwide, 46.8% of schools had or participated in a community-based illegal drug-use prevention program (defined as programs that target latchkey children, dropouts, or other high-risk populations and that may provide safe havens after school or alternative activities for children), and 54.4% posted signs marking a drug-free zone (ie, a specified distance from school grounds where illegal drugs are not allowed).
Crisis Preparedness, Response, and Recovery. Nationwide, 41.4% of schools had their own plan to address crisis preparedness, response, and recovery in the event of a natural disaster or other emergency or crisis situation, 41.2% used a district-level plan that had been adapted to meet the school’s needs, 14.5% used a plan provided by the district, and 2.9% of schools did not have a plan. At least 90% of all schools had plans that included evacuation plans, procedures to stop people from leaving or entering school buildings, mechanisms for communicating with school personnel, and requirements to periodically review and revise emergency response plans (Table 7). Nationwide, 57.3% of schools had a NOAA-approved weather radio.
Among the 97.1% of schools with a comprehensive crisis preparedness, response, and recovery plan, schools were most likely to have worked with staff from a local law enforcement agency and a local fire department and least likely to have worked with the FBI to develop their plan (Table 9). During the 12 months preceding the study, 82.1% of the schools with a plan had evaluated or assessed it.
Among the 97.1% of schools with a crisis preparedness, response, and recovery plan, 87.1% of schools provided training on the plan to school faculty and staff, 71.5% provided training to students, and 25.2% provided training to students’ families during the 2 years preceding the study. Among all schools during the 2 years preceding the study, 27.7% offered general education on crisis preparedness, response, and recovery to students’ families (ie, not including training on the school’s crisis plan).
Nationwide, 46.9% of schools were members of a group of local agencies that coordinated crisis preparedness, response, and recovery efforts; 46.6% were not members of such a group; and 6.5% reported there was no such group in the community. Nationwide, 50.2% of schools were designated to serve as staging areas or community shelters during local emergencies.
School Climate. Schools were asked about efforts to promote a positive school climate. Nationwide, 85.7% of schools had adopted school-wide practices or programs that explicitly promoted a positive school climate. During the 2 years preceding the study, faculty and staff received staff development on topics explicitly related to school climate in 86.9% of schools. In addition, 88.8% of schools had a prosocial code of conduct that addressed such concepts as cooperation, conflict resolution, and helping other