title: Health impact assessment as an instrument to examine the health implications of education policies.
abstract: OBJECTIVE
  Health impact assessment (HIA) is a systematic process that can be used by public health professionals to examine the potential health effects of a policy, plan, program, or project that originates outside of the health sector. This article presents a case study of how an interdisciplinary team utilized an HIA to analyze the potential health impact of full-day kindergarten (FDK) on communities in Nevada.
  
  
  METHODS
  Case study.
  
  
  METHODS
  With stakeholder and community engagement, we conducted a multistage HIA that included qualitative and quantitative data collection and analysis, a review of existing literature, and projections. The team considered several pathways through which FDK could impact health in Nevada: (1) school performance; (2) physical development (physical activity and nutrition education); and (3) access to school-based meals and health screenings.
  
  
  RESULTS
  Findings indicated that access to FDK could enhance opportunities for Nevada's children to harness school-based services, increase physical activity, and promote nutrition education. In addition, based on existing research that suggests relationships between (1) FDK attendance and 3rd and 5th grade math and reading standardized test scores and (2) 3rd and 5th grade test scores and high school graduation, as well as available state and national data, we estimated that access to FDK could increase high school graduation in Nevada by 499-820 students per year.
  
  
  CONCLUSIONS
  This HIA demonstrated that access to FDK could impact both student and adult health in Nevada. Our engagement of public health professionals along with stakeholders and the community in the HIA process demonstrated that HIAs can be an important tool for public health professionals to examine the effects on community health of policies, programs, plans or projects that arise outside of the health sector.
authors.affiliation: School of Community Health Sciences, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV 89154, USA. Electronic address: Jennifer.pharr@unlv.edu.
authors.forename: J
authors.initials: J
authors.lastname: Pharr
authors.affiliation: School of Community Health Sciences, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV 89154, USA. Electronic address: maxim.gakh@unlv.edu.
authors.forename: M
authors.initials: M
authors.lastname: Gakh
authors.affiliation: School of Community Health Sciences, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV 89154, USA. Electronic address: courtney.coughenour@unlv.edu.
authors.forename: C
authors.initials: C
authors.lastname: Coughenour
authors.affiliation: School of Community Health Sciences, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV 89154, USA. Electronic address: Sheila.clark@unlv.edu.
authors.forename: S
authors.initials: S
authors.lastname: Clark
mesh_terms: D002648:Child; D018672:Community Health Planning / Q000379:methods*; D003299:Cooperative Behavior; D062489:Health Impact Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D019982:Organizational Case Studies; D057766:Policy; D011050:Policy Making; D011634:Public Health; D012111:Residence Characteristics; D012572:School Health Services; D012574:Schools; D011795:Surveys and Questionnaires
keywords: Community health; Education policy; Health impact assessment; Kindergarten; School health