Development of the COMPASS school health profile (PDF)
COMPASS technical report series, volume 1, issue 1, April 2013
Table of contents
Acknowledgements
Introduction
Methods
Length of the school health profile
Visual appearance of the school health profile
Evidence-based recommendations, curriculum supplements, and public health unit information
Final version of the COMPASS school health profile
References
Appendix
Acknowledgements
Authors
Dana Church, PhD (Propel Centre for Population Health Impact, University of Waterloo, Waterloo, ON)
Scott T. Leatherdale, PhD (School of Public Health and Health Systems, University of Waterloo, Waterloo, ON)
Report funded by
The COMPASS study was supported by a bridge grant from the Canadian Institutes of Health Research (CIHR) Institute of Nutrition, Metabolism and Diabetes (INMD) through the “Obesity – Interventions to Prevent or Treat” priority funding awards (OOP-110788; grant awarded to ST. Leatherdale) and an operating grant from the Canadian Institutes of Health Research (CIHR) Institute of Population and Public Health (IPPH) (MOP-114875; grant awarded to ST. Leatherdale).
Suggested citation
Church D, Leatherdale ST. Development of the COMPASS School Health Profile. COMPASS Technical Report Series. 2013;1(1). Waterloo, Ontario: University of Waterloo. Available at: www.compass.uwaterloo.ca Contact: COMPASS Research Team University of Waterloo 200 University Ave West, BMH 1038 Waterloo, ON Canada N2L 3G1 compass@uwaterloo.ca.
Introduction
COMPASS is a longitudinal study (starting in 2012-13) designed to follow a cohort of grade 9 to 12 students attending a convenience sample of Ontario secondary schools for four years to understand how changes in school environment characteristics (policies, programs, built environment) are associated with changes in youth health behaviours. COMPASS originated to provide school stakeholders with the evidence to guide and evaluate school-based interventions related to obesity, healthy eating, tobacco use, alcohol and marijuana use, physical activity, sedentary behaviour, school connectedness, bullying, and academic achievement. COMPASS has been designed to facilitate multiple large-scale school-based data collections and uses in-class whole-school sampling data collection methods consistent with previous research [1-4]. COMPASS also facilitates knowledge transfer and exchange by annually providing each participating school with a school-specific feedback report that highlights the school specific prevalence for each outcome, comparisons to provincial and national norms or guidelines, and provides evidence-based suggestions for school-based interventions (programs and/or policies) designed to address the outcomes covered in the feedback report. (Refer to: www.compass.uwaterloo.ca)
The provision of a customized feedback report to participating schools is an important knowledge transfer (KT) component of COMPASS. Each school-specific report provides data on the various student health behaviours or outcomes of interest, makes comparisons to provincial and/or national norms or guidelines, and offers: (a) evidence-based suggestions for interventions, programs, or policies aimed at improving the health of the student population; (b) evidence-based suggestions for curriculum supplements aimed at improving student awareness and knowledge to encourage and enable them to make healthier lifestyle choices; and (c) local public health unit contact information specific to each content domain, in case the school wishes to contact their local public health unit for support in taking action on the findings. These reports essentially allow school stakeholders to quickly see, “at a glance,” what is happening at their school and how they should plan for future school programs and intervention activities. The reports are generated using an automated, quality-controlled system that accurately scans data from the student questionnaires, inputs the data into analysis programs, and exports these data into a format that can be inputted into an existing feedback report template. The time between completion of the student questionnaire and generation of the COMPASS feedback report is less than four weeks. Thus, the COMPASS feedback reports provide schools with up-to-date school-specific evidence pertaining to the student health behaviour(s) or outcomes of interest for their student population. Moreover, aside from the feedback reports being used by participating schools, COMPASS also engages a knowledge broker (to connect schools with resources for taking action on the findings), who uses these reports when acting as a link between schools and local public health professionals, should schools wish to have linkages formed to assist with making changes to their policies and/or programs after viewing the data. As such, the school-specific report needs to reflect these unique aspects of the COMPASS project.
This technical report outlines the development of the COMPASS school-specific feedback report, referred to in the COMPASS study as the School Health Profile (SHP).
Methods
The COMPASS School Health Profile (SHP) was intended to be a KT tool for schools. The principal of a participating school would be given the SHP and then s/he would be encouraged to (a) use the data for informing and guiding health promotion activities within their school, and (b) share the student data and evidence-based recommendations in the report with the school community (i.e., school board, school staff, parents, and students) and/or their local public health unit.
The COMPASS student questionnaire contains 65 questions measuring a number of different items. The COMPASS research team decided how the data from the questionnaire would be used (i.e., which items would be presented in the SHP), as well as which comparisons would be made between the student data and existing guidelines or national benchmarks. To increase the probability that principals would read and use the SHP, and share it with their community, it was decided the SHP must be brief, visually attractive, and easy to read with minimal text.
Length of the school health profile
The SHP would be provided to schools in both a hard copy booklet format and as a pdf. Taking physical printing parameters into account, it was decided that a 16-page booklet format would allow for a brief yet comprehensive summary of the student data. The 16 pages would be assigned accordingly:
Page 1: front cover with title and COMPASS logo
Page 2: inside front cover (blank)
Page 3: introduction and description of Profile, contact information, partner logos
Pages 4-13: oresentation of student data
Page 14: information for contacting the COMPASS knowledge broker (mostly blank)
Page 15: a message from COMPASS leadership (inside back cover, mostly blank)
Page 16: back cover with COMPASS logo and web address (mostly blank)
This format provides 10 pages for presenting the student data and the inclusion of blank or mostly blank pages allow space additional data comparisons to be added in subsequent years, showing schools in which areas they have improved (or digressed). Please refer to the appendix of this report to see the generic template used for the SHP.
Using this 16-page format, the question arose as to how to summarize the student data in 10 pages. To be consistent with the COMPASS priority topics, it was decided that one full page would be devoted to each of the original priority topic areas:
- obesity
- marijuana use
- physical activity
- alcohol use
- smoking
- sedentary behaviour
Given that healthy eating and bullying are issues that have been identified by schools as priorities, they would also receive their own full page. Due to their similarity, it was decided that school connectedness and academic achievement would be presented jointly on the same page. This resulted in there being one remaining page in the SHP and it was decided that it would be used to show schools their data broken down into gender comparisons. Thus, the last page of student data presented in the SHP would be a comparison of the outcomes for males and females for each of the health behaviours listed above.
Visual appearance of the school health profile
We wanted to ensure that the COMPASS SHP was visually appealing, easy to comprehend, and not overly ‘text’ heavy. As such, the first consideration to maximize visual appeal of the SHP was to include the same COMPASS logo and colour scheme that is used for other COMPASS correspondence (i.e., letterhead, project brochure, and website). This would provide consistency and branding for the overall project, as well as make the Profile easily recognizable by school stakeholders as a component of the COMPASS study.
The second consideration was to develop a standard or “master” template for the entire SHP. This template would be used for each participating school such that the layout, text, and style would be consistent across schools yet each school’s specific data (percentages) could be easily inserted into the SHP without needing to modify surrounding graphics or text. The specific school name would also appear on the SHP cover and each page that presents student data in case school stakeholders wanted to share the entire SHP or only results specific to particular topics they deem as priorities. Such a template would also allow for ease of SHP generation by COMPASS staff.
The COMPASS research team decided that to make the SHP visually distinct from more traditional school-specific feedback reports that are used in similar school-based projects [for instance, the national Youth Smoking Survey, school health action planning and evaluation system (SHAPES), or the New Brunswick Student Health Survey. We wanted the SHP to incorporate eye catching graphics and simple text, rather than lots of text, charts, and graphs. To do this we conducted a large online search for different information graphics or “infographics,” resources, as these presented us with a variety of different options for thinking about how to visually present data in a clear, simple, and eye catching ways (for instance, visual.ly.com). When these websites were searched, any infographic that presented data in a particularly appealing way was printed and included in a portfolio, organized according to COMPASS topic areas. We then used these as templates for developing a unique story board for the COMPASS SHP. This draft story board was presented to a local graphics design company, green dot design, who created the unique look and style for the COMPASS SHP based on our design requests and the draft story board.
In order to maximize knowledge transfer of the school-specific student data to principals, and to ensure ease of comprehension is shared with a variety of external school stakeholders, it was decided that the SHP would use minimal text and present results in percentages. This would allow readers to easily see and understand the important school-specific results “at-a-glance.” In order to help readers put those school-specific results into the appropriate context, we also provided benchmarks for comparison in terms of the percentage of students at that school meeting specific national/provincial guidelines (e.g., eating the appropriate number of servings listed in Canada’s Food Guide) or the percentage of students at that school performing a particular behaviour compared to the national/provincial norms (e.g., four smoking or binge drinking rates). The following sources were used for the guidelines or comparison data presented in the SHP:
- obesity
- Body mass index (BMI) classification system provided by the International Obesity Task Force [5], based on age and sex adjusted BMI cut-points
- physical activity
- healthy eating
- sedentary behaviour
- tobacco use
- alcohol use
- marijuana use
The COMPASS team decided that all comparisons of student data to these guidelines and comparison data would be presented in visually distinct boxes so that they stood out as “take home” messages to the reader.
Evidence-based recommendations, curriculum supplements, and public health unit information
A critical component of the COMPASS project is to work with schools after they receive their SHP, should they wish to make any changes to their health-related policies and/or programs after viewing their school-specific data. To this end, the COMPASS team decided it would be helpful to schools if each page of the SHP also provided a topic-specific evidence-based programming recommendation and topic specific curriculum supplement recommendation. In addition, we also decided to include the contact information for their local public health unit representative responsible for that topic/domain, should the school wish to contact them, as they would have expertise and/or access to resources to implement changes. The recommendations, curriculum supplements, and contact information could also act as points of discussion for when the COMPASS Knowledge Broker contacts the school during follow-up.
Evidence-based recommendations for school programming and curriculum supplements were found by online searches of the following organizations:
- The Public Health Agency of Canada Canadian Best Practices Portal
- Cancer Control plan, link, act, network with evidence based tools (P.L.A.N.E.T).
- The Centre for Addiction and Mental Health (CAMH)
- Ontario Physical and Health Association (OPHEA)
Programs and curricula supplements were selected for the SHP if they were age appropriate (i.e., developed for students in grades 9-12), and had been previously implemented and evaluated with positive outcomes.
Contact information for a school’s local public health unit was obtained by first consulting the local public health unit’s website. The recruitment coordinator (Dana Church) first searched the site for any information pertaining to public health nurses assigned to schools, school health teams, or school health management. If no such person was found, the health unit’s general contact information was used. The COMPASS recruitment coordinator contacted the individual by email or phone, explained the COMPASS study and asked whether they would agree to be indicated as the health unit’s contact person in the SHP, or asked who would be the appropriate person to be listed in the SHP. The recruitment coordinator also inquired whether the same individual should be listed for each of the COMPASS priority topics, or whether different staff with specific expertise should be indicated for specific priority topics.
Final version of the COMPASS school health profile
A sample of the COMPASS School Health Profile that is currently being used in the COMPASS study for our baseline sample can be found in the appendix.
Reference
- Leatherdale ST, Burkhalter R: The substance use profile of Canadian youth: exploring the prevalence of alcohol, drug and tobacco use by gender and grade. Addict Behav 2012, 37:318- 322.
- Leatherdale ST, Manske S, Faulkner G, Arbour K, Bredin C: A multi-level examination of school programs, policies and resources associated with physical activity among elementary school youth in the PLAY-ON study. Int J Behav Nutr Phys Act 2010, 25;6. doi: 10.1186/1479-5868-7-6.
- Leatherdale ST, McDonald PW, Cameron R, Brown KS: A multi-level analysis examining the relationship between social influences for smoking and smoking onset. Am J Health Behav 2005, 29:520-530.
- Leatherdale ST, Papadakis S: A multi-level examination of the association between older social models in the school environment and overweight and obesity among younger students. J Youth Adolesc 2011, 40:361-372.
- Cole, TJ, Bellizzi, MC, Flegal, KM, Dietz, WH: Establishing a standard definition for child overweight and obesity worldwide: International survey. British Medical Journal 2000, 320(7244):1240-1243.
Appendix
Example of a generic COMPASS School-Specific Feedback Report
Title page
COMPASS
- Cohort study
- Obesity
- Marijuana
- Physical activity
- Alcohol use
- Smoking
- Sedentary behaviour
Anyplace school
Inside cover page
Thank you for participating in the 2012/2013 COMPASS survey.
This is your school’s customized School Health Profile.
This report shows the 2012/2013 COMPASS survey results from participating students enrolled at your school. Please note that in some cases results may not add up to 100% due to rounding.
The information contained in this profile will not be shared with any third party. However, we encourage you to share these results with your school community (teachers, parents, and students), your school board, and local health and community organizations in order to take action on these findings.
Examples of action steps can be found in the Recommendations section at the bottom of each page. All recommendations are community interventions that have been evaluated, shown to be successful, and have the potential to be adapted and replicated in your school.
For more information about this profile or the COMPASS project, visit www.compass.uwaterloo.ca or contact:
Dr. Dana Church
COMPASS Recruitment Coordinator
Propel Centre for Population Health Impact
University of Waterloo
519-888-4567 ext. 35679
1-800-667-1804
dchurch@uaterloo.ca
Chad Bredin
COMPASS Project Manager
Propel Centre for Population Health Impact
University of Waterloo
519-888-4567 ext. 33317
1-800-667-1804
cbredin@uaterloo.ca
Dr. Scott Leatherdale
COMPASS Principal Investigator
Associate Professor
Cancer Care Ontario Research Chair
School of Public Health and Health Systems
University of Waterloo
Obesity Outcomes and Anyplace school
Among students at your school:
- 68% are of a healthy weight
- 20% are overweight
- 9% are obese
- 54% describe themselves as being about the right weight
- 40% are trying to lose weight
29% of students at your school are overweight or obese!
Recommendations
Teens Eating for Energy and Nutrition at School (TEENS)
- A school-based intervention intended to reduce obesity through healthy eating
- Includes classroom, school-wide, and family components
- Trained peer leaders deliver segments of the curriculum
- TEENS
Curriculum supplements
Public health unit contact:
Jane Doe: Public Health Nurse, Anyplace Health Unit
P: (555) 555-5555
E: jane.doe@aphu.com
Physical activity outcomes at Anyplace school
Among students at your school:
- 54% reported they were enrolled in PE class this year
- 55% reported strength training at least 3 days/week
- 18% reported that they usually walk or bike to school
- 38% reported participating in intramural sports
- 36% reported participating in varsity sports
49% are meeting the national guidelines of 60 mins/day of physical activity.
Recommendations
The Physical Activity and Teenage Health (PATH) Program
- Curriculum is designed to be taught by physical education teachers in fi ve 30-minute sessions per week over 12 weeks
- Program details
Curriculum supplements
• Ontario Physical and Health Association (OPHEA)
Public health unit contact:
Jane Doe: Public Health Nurse, Anyplace Health Unit
P: (555) 555-5555
E: jane.doe@aphu.com
Healthy eating outcomes at Anyplace school
Food groups and serving size recommendations are provided by Health Canada's Eating Well with Canada's Food Guide.
Among students at your school:
- 8% eat the recommended 7-8 servings of fruits and vegetables per day
- 11% eat the recommended 6-7 servings of grains per day
- 59% eat the recommended 3-4 servings of dairy products per day
- 73% eat the recommended 2-3 servings of meat and alternatives per day
- 54% buy their lunch at school at least once per week
- 19% buy snacks from a school vending machine at least once per week
3% of students are eating the recommended number of servings from all 4 food groups.
Recommendations
- A school-wide program that encourages and assists students to consume 5 or more servings of fruits and vegetables each day
- Targets changes in knowledge, attitudes, and behaviours of students towards fruits and vegetables
- Achieved through a school media-marketing campaign, classroom workshops, family involvement, and environmental changes at school
Curriculum supplements
Public health unit contact:
Jane Doe: Public Health Nurse, Anyplace Health Unit
P: (555) 555-5555
E: jane.doe@aphu.com
Sedentary behaviour outcomes at Anyplace school
Among students at your school:
- Average total daily hours of recreational screen time: 6.0 hours/day
- surfing the Internet: 1.7 hours/day
- talking on the phone, texting, messaging, emailing: 1.5 hours/day
- Watching/streaming TV shows or movies: 1.6 hours/day
- Playing video/computer games: 1.2 hours/day
7% are meeting the national guideline of 2hrs or less of recreational screen time/day.
-
Average time spent doing homework: 1.4 hours/day
Recommendations
Encouragement to increase physical activity outside of school can be integrated into school health related programs and curricula. Please refer to the physical activity page for suggestions.
Public health unit contact:
Jane Doe: Public Health Nurse, Anyplace Health Unit
P: (555) 555-5555
E: jane.doe@aphu.com
Tobacco use outcomes at Anyplace school
Among students at your school:
- 36% have never smoked but are susceptible to begin smoking in the future
- 9% are current smokers (7% Provincial average, 9% national average)
- 8% are occasional smokers
- 1% are daily smokers
- 74% of smokers have made a quit attempt
- 18% have used other forms of tobacco besides cigarettes (e.g. hookah, smokeless tobacco) in the past 30 days
Recommendations
- Involves 10 one-hour long weekly sessions and four booster sessions, delivered to males and females separately by same-gender, trained facilitators
- Major programs goals are to help participants: o Quit smoking or reduce the number of cigarettes smoked by those youth unable to quit o Improve life skills such as stress management, decision-making, coping, and interpersonal skills
Curriculum supplements
Public health unit contact:
Jane Doe: Public Health Nurse, Anyplace Health Unit
P: (555) 555-5555
E: jane.doe@aphu.com
Alcohol use outcomes at Anyplace school
Among student at your school:
- 22% reported binge drinking in the last month (25% national average)
- 16% reported consuming alcohol mixed with an energy drink in the last year
Recommendations
School Health and Alcohol Harm Reduction Project (SHAHRP)
- Uses a harm reduction approach: aims to reduce the levels of alcohol related harms in students who drink alcohol, and to reduce the harms experienced by those students who do not drink alcohol but who interact with others who drink
- Program includes three phases: (1) eight lessons in Year 1; (2) fi ve booster lessons in Year 2; (3) four additional booster lessons in Year 2
Curriculum supplements
Public health unit contact:
Jane Doe: Public Health Nurse, Anyplace Health Unit
P: (555) 555-5555
E: jane.doe@aphu.com
Marijuana use outcomes at Anyplace school
Among students at your school:
- 19% reported using marijuana in the past month (19% national average)
- 6% reported using marijuana daily (5% national average)
- 55% think it woudl be easy to get marijuana if they wanted some
Recommendations
- Main purpose of the program is to facilitate the development of personal and social skills, with particular emphasis on the development of skills for coping with social influences to smoke, drink, or use drugs
- One of the most extensively researched and effective prevention programs available
Curriculum supplements
Public health unit contact:
Jane Doe: Public Health Nurse, Anyplace Health Unit
P: (555) 555-5555
E: jane.doe@aphu.com
Bullying outcomes at Anyplace school
Among students at your school, within the last month:
- 14% have been verbally attacked
- 16% have been bullied
- 11% have taken part in bullying other students
- 3% have been physically attacked
- 3% have been victims of cyberattacks
Recommendations
The Olweus Bullying Prevention Program
- Uses a whole school approach, and its goals are to reduce and prevent bullying problems among school children and to improve peer relations at school
- The program has been found to reduce bullying among children, improve the social climate of classrooms, and reduce related antisocial behaviors such as vandalism and truancy
Curriculum supplements
Public health unit contact:
Jane Doe: Public Health Nurse, Anyplace Health Unit
P: (555) 555-5555
E: jane.doe@aphu.com
School connectedness and academic achievement outcomes at Anyplace school
Among students at your school:
- 8% think they will complete a post-secondary education
- 77% feel they are a part of their school
- 82% would like to complete a post-secondary education 89
- 89% feel safe at school
- 89% feel that teachers treat them fairly
- 79% feel close to people at school
Getting good grades is important to 95% of students
Recommendations
Levels of school connectedness may be improved by focusing on any of the other areas covered in this report. Please see the recommendations made for other domains of student health.
Public health unit contact:
Jane Doe: Public Health Nurse, Anyplace Health Unit
P: (555) 555-5555
E: jane.doe@aphu.com
Gender differences at Anyplace school
| Among females at your school: | Among males at your school: |
|---|---|
| 20% are overweight or obese | 37% are overweight or obese |
| 3% eat the recommended number of servings from all 4 food groups | 3% eat the recommended number of servings from all 4 food groups |
| 45% meet the national guidelines for daily physical activity | 54% meet the national guidelines for daily physical activity |
| 89% exceed the national guidelines for daily recreational screen time | 94% exceed the national guidelines for daily recreational screen time |
| 10% are current smokers | 7% are current smokers |
| 21% reported binge drinking within the last month | 24% reported binge drinking within the last month |
| 17% have used marijuana within the last month | 20% have used marijuana within the last month |
| 17% have been bullied within the last month | 15% have been bullied within the last month |
| 75% feel they are a part of their school | 80% feel they are a part of their school |
| 76% think they will complete a post-secondary education | 78% think they will complete a post-secondary education |
For more information about how to implement any of the recommendations made in this report, please contact our COMPASS Knowledge Broker: Rachel Laxer.
A message from COMPASS leadership
Thank you again for participating in the 2012/2013 COMPASS survey. We hope you fi nd this report informative and useful. We look forward to continuing to work with your school in the upcoming years, and to working with your local public health professionals to help make your school the healthiest environment possible for students.
Dr. Scott Leatherdale
COMPASS Principal Investigator
Associate Professor
Cancer Care Ontario Research Chair
School of Public Health and Health Systems
University of Waterloo
Back cover of report
University of Waterloo 200 University Ave. W., Waterloo, Ontario, Canada N2L 3G1 Telephone: (519) 888-4567 www.compass.uwaterloo.ca