Implementing CDC’s School Guidelines:

Challenges And Opportunities

Joy LarsonUtah Department of Health

Tobacco Prevention & Control Program

Goal Explain challenges to

implementing CDC’s Guidelines for School Health Programs to Prevent Tobacco Use and Addiction at the state and local levels and identify a process to address these challenges.

Presentation Overview CDC’s School Guidelines (overview) Utah’s School Tobacco Prevention

Project (history) Challenges and Opportunities A School’s Guide to Comprehensive

Tobacco Control & The Project in Action

Lessons Learned

CDC’s School Guidelines1. Policy: Develop and enforce a school

policy on tobacco use.2. Instruction: Provide instruction about

the short- and long-term negative physiologic and social consequences of tobacco use, social influences on tobacco use, peer norms regarding tobacco use, and refusal skills.

3. Curriculum: Provide tobacco-use prevention education in grades K-12.

CDC’s School Guidelines4. Training: Provide program-specific

training for teachers.5. Family Involvement: Involve parents

or families in supporting school-based programs to prevent tobacco use.

6. Tobacco Cessation Efforts: Support cessation efforts among students and school staff who use tobacco.

7. Evaluation: Assess the tobacco-use prevention program at regular intervals.

Utah’s School Tobacco Prevention Project In the past, Utah’s Tobacco

Prevention and Control Program (TPCP) placed a strong emphasis on guidelines 2 & 3: Instruction and Curriculum.

Utah’s School Tobacco Prevention Project 2001-02

Conducted research (literature review & key informant interviews)

Implemented pilot project Contracted with Grand School District to

implement CDC’s School Guidelines, with an emphasis on policy change

Utah’s School Tobacco Prevention Project 2001-02

Decided to contract directly with school districts to implement CDC’s School Guidelines

Benefits: increased school district interest, built infrastructure and sustainability

Created A School’s Guide to Comprehensive Tobacco Control

A step-by-step guide to lead school districts and others through the process of implementing CDC’s School Guidelines

Utah’s School Tobacco Prevention Project

Contracting with School Districts: The Process

Identified target school districts to pilot the project

Informed and partnered with state and local agencies (State Office of Education, Local Health Departments, etc.)

Proposed the project to targeted school districts

Utah’s School Tobacco Prevention Project

What are the School Districts Doing?

Hire a ½ employee to oversee the project

Follow A School’s Guide to Comprehensive Tobacco Control to implement CDC’s School Guidelines

Work closely with local partners

Utah’s School Tobacco Prevention Project 2002-03

Utah’s School Tobacco Prevention Project implemented in six school districts

2003-04 Expanded project to include four

additional districts

Utah’s School Tobacco Prevention Project 3 Challenges Initially Encountered:

1. The need to find partners at the school district level

2. The need to prioritize school districts due to limited funding

3. The need for a step-by-step guide to lead school districts through the implementation process

Challenge #1Challenge: The need to find partners at the

school district level. By partnering with the school districts,

we build interest, infrastructure and sustainability of the project. But…

• Tobacco is not a top priority for schools.• Schools are busy!• Territorial issues often exist.

Challenge #1

Challenge: The need to find partners at the school district level.

Opportunities to overcome:• Educate stakeholders• Provide a plan• Utilize the project as an “umbrella”

for all who want to be involved

Challenge #2Challenge: The need to prioritize school

districts due to limited funding. 40 School Districts in Utah (more

in other states!) Initial project start-up takes time

and technical assistance Project funding increases

implementation, but is limited

Challenge #2Challenge: The need to prioritize school

districts due to limited funding. Opportunities to overcome:

Utilize a selection process rather than a competitive funding process.

• Identify indicators related to tobacco use to select target districts:• Tobacco Use Rates• Socioeconomic status• Availability of prevention programs

Challenge #2Percentage of Utah High School Students Who Smoked

Cigarettes on O ne or More of the Past 30 Days, 1991-2003

0%

10%

20%

30%

Per

cent

16.8% 17.4% 17.0% 16.4% 11.9% 8.3% 7.3%

1991 1993 1995 1997 1999 2001 2003

Source: Utah YRBS 1991- 2003

Challenge #3Challenge: The need for a step-by-step

guide to lead school districts through the implementation process.

“School people” know the school system, but often are not tobacco prevention experts.

One-on-one training and technical assistance is time intensive and can be expensive.

Challenge #3Challenge: The need for a step-by-step guide to

lead school districts through the implementation process.

Opportunities to overcome: Utilizing A School’s Guide to Comprehensive

Tobacco Control: Provides school districts with a step-by-step

resource to lead them through the process of implementing CDC’s School Guidelines

Helps to institutionalize efforts Creates a uniform process across several

districts Reduces expenses related to training and time

A School’s Guide to Comprehensive Tobacco

Control

CDC’s School Guidelines

1. Policy2. Instruction3. Curriculum4. Training5. Family Involvement6. Tobacco Cessation

Efforts7. Evaluation

A School’s Guide 1. Policy2. Community &

Family Involvement3. Instruction &

Curriculum4. Training5. Tobacco Cessation

Efforts6. Evaluation

The Project in Action Steps Challenges Successes

Utilizing A School’s Guide to Comprehensive Tobacco Control,

Component #1 Policy

The Project in Action CDC: Develop and enforce a school policy

on tobacco use.

Guide: Evaluate, update, and reinforce the school policy on tobacco use.

Currently, Utah school tobacco policies: Are not comprehensive Lack consistent enforcement Are not well-communicated

The Project in Action Step 1: Review the current policy.

Step 2: Get commitment.

Step 3: Form an advisory committee to revise the tobacco policy. 

Adapted from: Creating and Maintaining a Tobacco-Free School Policy. Partnership For A Tobacco-Free Maine, Bureau of Health, Department of Human Services.

The Project in Action “T” Activity

The Project in Action “T” Activity

The Project in Action Step 4: Develop a draft of the new

policy.

Step 5: Present the new policy to the school board.

Step 6: Plan implementation strategies.

Adapted from: Creating and Maintaining a Tobacco-Free School Policy. Partnership For A Tobacco-Free Maine, Bureau of Health, Department of Human Services.

The Project in Action Step 7: Communicate the policy

throughout the school and community.

Step 8: Implement the policy.

Step 9: Conduct ongoing advocacy and evaluation of the policy.

Adapted from: Creating and Maintaining a Tobacco-Free School Policy. Partnership For A Tobacco-Free Maine, Bureau of Health, Department of Human Services.

Lessons Learned

Early findings from this project suggest:

School districts at high-risk for tobacco use are enthusiastic to implement CDC’s School Guidelines and are able to do so following A School’s Guide to Comprehensive Tobacco Control.

Lessons Learned

Early findings from this project suggest:

Directly funding school districts allows the districts to institutionalize efforts and build community and internal support to sustain tobacco prevention efforts beyond funding opportunities.

Questions?