title: A retrospective examination of the relationship between implementation quality of the coordinated school health program model and school-level academic indicators over time.
abstract: BACKGROUND
  Although models such as the coordinated school health program (CSHP) are widely available to address student health needs, school professionals have been unconvinced that scarce resources should be allocated to improving student health. Concern that attention may be diverted from meeting academic accountability goals is often seen as a reason not to attend to student health. Despite continuing calls for the study of multicomponent health programs in relation to educational achievement, the understanding of the extent to which adherence to the characteristics of CSHP contributes to or compromises academic outcomes over time remains incomplete.
  
  
  METHODS
  A retrospective study was conducted of CSHP implementation across 158 public schools in Delaware, serving grades K-12. Using a doubly multivariate design, this study examined 3 levels of CSHP implementation across 5 school-level academic indicators for 3 years. Indicators included school performance, school progress, and aggregated student performance in 3 content areas--reading, mathematics, and writing. Data for the years prior to, during, and following implementation of CSHP were analyzed.
  
  
  RESULTS
  Multivariate main effects of year by implementation level were detected. CSHP schools with high levels of implementation had better school-level performance and progress ratings. CSHP implementation did not have an effect on reading, math, and writing indicators, though all groups showed significant improvements over time in these areas.
  
  
  CONCLUSIONS
  Results of this study suggest that quality implementation of CSHP does not adversely impact school-level academic indicators over time. Moreover, findings suggest a better fit with school-wide accountability indicators than with specific content-based achievement indicators.
authors.affiliation: Concept Systems, Inc., 136 E State St, Suite 402, Ithaca, NY 14850, USA. srosas@conceptsystems.com
authors.forename: Scott
authors.initials: S
authors.lastname: Rosas
authors.forename: Jane
authors.initials: J
authors.lastname: Case
authors.forename: Linda
authors.initials: L
authors.lastname: Tholstrup
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002669:Child Welfare; D004521:Educational Measurement; D004522:Educational Status; D006304:Health Status; D006801:Humans; D016730:Program Development; D015397:Program Evaluation; D011787:Quality of Health Care; D012189:Retrospective Studies; D012572:School Health Services / Q000458:organization & administration / Q000592:standards*; D012574:Schools / Q000592:standards*