Using Organization Development Concept to Conduct Administrative Assessment of Health Promoting Schools in Taiwan – A Preliminary Study.

Introduction The children and adolescent health problems including smoking, teenage pregnancy, HIV infection, drug abuse, accidents, nutrition and mental health problems are major concerns in Taiwan as well as around the world. Available data showed the adolescent smoking rate had increased to 6.5% in Taiwan. (1) Teenage pregnancy among girls between fifteen to nineteen years old was getting worse. The rate had increased to 8.5%. (2) It was also reported that one out of every twenty-five AIDS patients were teenagers under nineteen years old. (3) Rate of drug abuse in high school students was 1.6%1 , and 12[degrees]% of the elementary school students were overweight. (4,5) These data indicated that there were increased health problems among adolescents in Taiwan. Along with this statistics, there also was a reduction of required hours of health instruction in both elementary and middle schools due to major change in curriculum structure in Taiwan in 2001. The merge of health and physical education curriculum resulted in reduction of health instruction from 2 hours to one hour a week for elementary schools. For the middle schools, the change resulted in an increase of health instruction on the surface, but in reality the increase was not adapted and implemented because of the academic pressure for middle school students. Only first year in middle school had implemented health instruction for students, but there were no health instruction for second and third year students. As a result of these curriculum changes, there were insufficient hours of health instruction to influence students' health knowledge, attitudes, and behaviors and students' health problems were further deterioriated. (6) How to reduce health risk factors and promote health among school aged children is a major concern of professionals in health education in Taiwan. Health Promoting School (HPS) has been suggested as one of the strategies for addressing these problems. A health-promoting school is where all members of the school community work together to provide students with integrated and positive experiences and structures which promote and protect their health. (7) Health Promoting Schools in Taiwan School health programs had been implemented for many years in Taiwan. There have been solid foundations set in policy, legislative support, organizations, government budgets, researches, and preliminary evaluation.8 These improvements have made significant contribution to the health of students and employees in every level of school. In 1997, Ministry of Education (MOE) of Taiwan issued "Guidelines for School Health Programs" as the framework of school health works and launched the School Health Promotion Program in 2001. In 2002, the School Health Acts was approved and published. In the same year, Department of Health (DOH) of Executive Yuan of Taiwan also started the Health-Promoting School Program. In 2003, DOH published the similar version of Guidelines for Health-Promoting School. One year later, the Health-Promoting School Program funded by both DOH and MOE recruited 50 elementary and middle schools to participate in the phase I of the HPS. By the World Health Organization's (WHO) definition, a health promoting school is one that consistently strengthens its capacity for living, learning and working, which engages health and education officials, teachers, students, parents, health providers and community leaders in efforts to make the school a healthy place. (8) The heart of a HPS program is to connect the school and community, and to promote the health of community residents. (9) Although health promoting actions can also be implemented in hospitals, communities, work places, and schools, but schools are thought to be different from others by many health promotion researchers. (11) Schools can conveniently coordinate all activities in the same time. School is the place that all important skills of life are incubated. …