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ISHA Spring 2014 Newsletter


April 9, 2014

Introduction It is my privilege to begin this newsletter of the Independent School Health Association (“ISHA”) by thanking Becky Smith for her service as President. During Becky’s tenure, ISHA faced numerous challenges, including funding and changes in how ISHA goes about acquiring and keeping its members. Despite these challenges, Becky was able to maintain much of the structure of ISHA that its founders established. Becky remains at The Hill School (PA) as their school counselor and is spending much of her free time making progress towards finishing her doctorate. As it is the tradition of ISHA that the most recent president remains a part of ISHA’s organizational structure, Becky has accepted my invitation to be a member of ISHA’s new

steering committee. I’d also like to thank Becky for making this transition as seamless as possible and for ensuring that all of ISHA’s records (many of which we have scanned) were in good order. I am also extraordinarily grateful for the continued commitment of Ben

Thompson of Williston Northampton School in Massachusetts (our Vice President) and Penny Aham of Governor’s Academy in Massachusetts (our Treasurer). Both Ben and Penny have helped immensely to keep ISHA afloat during its challenging time. Their commitment to (Continued on page 2)

ISHA Friends and Steering Committee Members at Horace Mann School, Fall 2013 Inside this issue:

Upcoming Workshop: Charting the Future of School Intro. & Upcoming Workshop Health in Independent Schools (New England) The first issue of the ISHA newsletter was published in spring 1981. On the front page of the issue was an article by David Connell, M.D., titled, “ISHA: Past and Present”. Dr. Connell reflected on his time at Choate Rosemary Hall (“CHR”) and the somewhat isolated life of a fulltime school physician. The outcome of his reflection was a letter that he sent to a

number of member schools in 1978. With brevity, Dr. Connell inquired whether school personnel, such as physicians, school nurses, psychologists, school counselors, and Deans involved with counseling would be interested in an “experimental” medical meeting at CHR. The result of Dr. Connell’s letter was that twenty-two people (Continued on page 2)


Looking Ahead


ISHA’s History


Recent Research


Indoor Tanning for Minors


Coordinated School Health


Health-Related News


About the Interim Director


VP’s Corner


Letter from Interim Director


Spotlight: First School Nurse


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Introduction (cont’d)

Upcoming Workshop: Charting the Future of School Health in Independent Schools (cont’d) (Continued from page 1)

School , ISHA, AISNE,. Please RSVP here.

(Continued from page 1)

came from a variety of boarding schools in New England and spent an exciting day together. The result of the meeting, however, was much greater. Six of the attending persons had agreed to start conversations to form an association that eventually became ISHA. In the first of what we hope will be several regional conferences around school health, let’s see if we cannot reignite ISHA’s flame together! Please join us at the Dana Hall School’s Shipley Center for Athletics, Health, and Wellness, Friday, April, 25, 2014. The event is free of charge Students practicing dance at Dana Hall’s Shipley Center for Athletics Health and Wellness and jointly hosted by Dana Hall spring of 2012. Since retiring, Nancy has kept busy. In addition to being ISHA’s secretary, she is enjoying traveling, consulting, and pursuing many interests, secretary. We are fortunate to have her. Last, but certainly not least, I would like to thank Michele Grethel and Peggy Hartmann, whose passion for health in independent schools and coordination enabled ISHA to meet for two very important meetings in 2013. Michele graciously coordinated our event at The Spence School and Peggy graciously coordinated our event at Horace Mann School. Without further ado, I would like thank and introduce the members of ISHA’s Steering Committee, whose passion for school health and commitment to ISHA’s mission we could not do without: 

Becky Smith, Past President of ISHA and School Counselor at the Hill School (PA)

Cathy Cramer, Director of New York Interschool Association (NY)

ISHA and its mission is indicative of the importance of our organization. I would also like to take this opportunity to introduce and thank Nancy Drago (our new Secretary). Nancy was most recently the school counselor at The Brearley School in New York City. Her work at Brearley included bringing health educators together from other schools to establish a K-12 template that served as a foundation for the development of Brearley’s and other schools’ health curricula. Prior to her tenure at Brearley, Nancy served as school counselor and Dean of Students at the Millbrook School in Dutchess County, NY. She retired from Brearley in the

School Counselor at the Riverdale School (NY) 

Michele Grethel, Director of Psychological Services at The Spence School (NY)

Debbie Roffman, Health and Sexuality Educator at The Park School (MD)

Nancy Drago, Secretary of ISHA and Retired Independent School Counselor (NY)

Jefferson Burnett, VP for Government and Community Relations at the National Association of Independent Schools (DC)

Peggy Hartmann, Health Education Coordinator at the Horace Mann School (NY)

John Suby, Director of Athletics, Health, and Wellness at the Dana Hall School (MA)

Penny Aham, Treasurer of ISHA and Director of Finance at The Governor's Academy

Kathleen Murdock, Consultant for Community Wellbeing at the Dana Hall School (MA)

 Ben Thompson, VP of ISHA and Director of Psychological Counseling Services at The Williston Northamp ton School (MA)

Several of our steering committee members also have health/wellness blogs, which I have listed below and invite you to visit.

Karen Brandt, Health Education Department Chair, The Packer Colle-  giate Institute (NY)  KC Cohen, Middle and Upper

Ben Thompson’s Blog Kathleen Murdock’s Blog (Continued on page 3)


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Introduction (cont’d) (Continued from page 2)

Looking Ahead ideas, recommendations, conferences, and membership questions. Please do not hesitate to contact him via email at

KC Cohen’s Blog As we look to be inclusive locally and geographically, we invite members representing all facets of independent school communities that are involved or Miguel G Marshall Interim Executive Director interested in all areas of school health, including, but not limited to: (a) health education; (b) physical education; (c) health services; (d) nutrition services; (e) counseling, psychological, and social services; (f) school safety and school environment; (g) health promotion for staff, and; (h) family/community involvement. Accordingly, we are considering this newsletter as a first step in reconnecting with ISHA members, former ISHA members, and soliciting new ones. To that end, Ben Thompson will serve as a primary conduit for sharing of

Over the summer of 2013, several members of ISHA’s steering committee (Becky Smith, Ben Thompson, Debbie Roffman, John Suby, Kathleen Murdock, and Miguel Marshall) met with John Chubb, President of NAIS, and Jefferson Burnett, NAIS’ VP of Government and Community Relations. The meeting was groundbreaking! ISHA was able to solidify a relationship with NAIS where communication channels are open and support in the form of time and guidance is available. As ISHA continues to develop its membership, John said that NAIS is committed to supporting ISHA and organizations like it. He is eager to see how ISHA can best serve independent schools in the arena of school health and looks forward to (Continued on page 4)

“ISHA was officially founded in 1979, but was originally called the Independent Schools Health Society (‘ISHC’)”

A Brief Look at ISHA’s History As this is the first newsletter from ISHA since the fall of 2010 and we are now beginning to broaden our reach to schools beyond New England, it is appropriate to dedicate a portion of this newsletter to ISHA’s founding purpose and history. ISHA was officially founded in 1979, but was originally called the Independent Schools Health Society (“ISHC”). ISHC was the culmination of meetings and correspondence among members of several independent boarding schools in New England. The “original six” members of ISHC were:  David Connell of Choate Rosemary Hall  Ellie Drury of Choate Rosemary Hall

 John Anderson of Deerfield Academy  John Bermon of LoomisChaffee  Sprague Hazard of Deerfield Academy  Zanda Kubler-Merrill of Philips Academy ISHC’s first meeting was held at Deerfield Academy on April 29, 1979, where it identified its founding members as:  David Connell of Choate Rosemary Hall  Gretchen Thornton*  John Anderson of Deerfield Academy  John Bermon of LoomisChaffee (Continued on page 10)

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Looking Ahead (cont’d) (Continued from page 3)

our proposal of principles of good practice for school health in independent schools. Now could not be a more momentous occasion to celebrate health in schools as well as reflect on some of the challenges or barriers we have experienced in pursuit of school health. Several important milestones are being made with respect to school health and more seem to be on the way. Recently: 

“even if health factors had no effect on education outcomes, they clearly influence the quality of life for youth and their ability to contribute and live productively in a democratic society”  ASCD has devoted a webpage to learning and health with several useful resources related to school health. In light of these milestones and milestones achieved by many of our schools, ISHA aims to promote health through:

ISHA Members with new President of NAIS, John Chubb and NAIS A Joint Statement VP of Government and Community Relations, Jefferson Burnett form the American Cancer Society, the  partnerships with American Diabetes Association, independent school communities; “Even if health factors had no effect on and the American Heart Association support the notion that, education outcomes, they clearly influence  creation and sustainability of a “quality health education programs the quality of life for youth and their ability forum dedicated to the discussion delivered in the nation’s schools of healthy schools and health educan improve the well-being and to contribute and live productively in a cation; health of our children and youth”. democratic society”. Dr. Charles Basch The statement goes on to say that: The health and well-being  professional development of our nation’s young peothrough conference coordination,  appropriate nutrition. ple is not a matter of luck. active website, listserv, social meIt is not a chance or ran The first encyclopedia on school dia, and a newsletter; dom event. It must be a health has been published; no compaplanned outcome. rable work exists. The Encyclopedia of School Health (2013), which  providing a resource library with A recent report by the Center on the content related to health curricuoffers quick access to health and Developing Child at Harvard Unilum and health program developwellness information most relevant to versity (“CDCHU”) highlights the ment; children in America’s K-12 school importance of how developing setting, is the product of a collaborahealthy lifestyles earl-on in life inflution of 200-plus professional contrib-  creating awareness around social ences children’s health and developutors. Its organization follows the ment across the lifespan. CDCHU causes of health and disease, and; framework of Coordinated School states that science supports the folHealth (“CSH”), covering areas on lowing foundations of health, all of each of CSH’s eight components.  promotion of evidence-based and which can be influenced by schools: other best practices.  stable and responsive rela-  Dr. Charles Basch of Teachers College, Columbia University recently tionships; published a report titled, “Healthier  safe, supportive environStudents are Better Learners”. In ments, and; his evidence-based report, he argues:


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Recent Research: Adolescents and Sleep Study Boergers, J., Gable, C. J., & Owens, J. A. (2014). Later School Start Time Is Associated with Improved Sleep and Daytime Functioning in Adolescents. Journal of Developmental & Behavioral Pediatrics, 35(1), 11-17. Study Background Chronic insufficient sleep has become a virtual epidemic among adolescents in the United States. Contributing to chronic sleep deficits include environmental influences such as, homework, jobs, extracurricular activity, and use of technology. Potential consequences of deficient sleep in adolescents include the following adverse health outcomes: 

Drowsy driving-related crashes


serving students in grades nine through twelve. The school had three terms, fall,  Metabolic dysfunction winter, and spring. During the fall and Further, the study writes, “adolescents spring terms, the school began at 8:00 AM achieving insufficient sleep are vulnerable and ended at 6:00 PM, Mondays, Tuesto impairments in mood, behavioral condays, Thursdays, and Fridays. On trol, attention, memory, and executive Wednesdays and Saturdays, school began function” (p. 11). Moreover, changes in at 8:00 AM, but ended at 12:35 PM. Duradolescents’ circadian rhythms associated ing the winter term only, researchers imwith their development through puberty plemented an “experimental schedule”. contribute to “significant difficulty falling The experimental schedule changed the asleep at an earlier bedtime” (p. 11). start times on all days from 8:00 AM to According to the National Sleep Foun- 8:25 AM. On Wednesdays Saturdays, dation, adolescents need about eight hours school still ended at 12:35 PM, but on all and thirty minutes to nine hours and fifteen other days ended at 5:35 PM. minutes of sleep each night to function Researchers used a modified version optimally during the day. of the School Sleep Habits Survey (SSHS), which is an adolescent self-report survey. Study Summary Researchers also collected data on student The study was conducted at an independent coeducational boarding school (Continued on page 6) Cardiovascular disease

Recent Research: Playground Design for Physical Activity Study Escalante, Y., García-Hermoso, A., Backx, K., & Saavedra, J. M. (2014). Playground Designs to Increase Physical Activity Levels During School Recess A Systematic Review. Health Education & Behavior, 41(2), 138-144. Study Background

With school being an environment in which children spend the most of their time, schools are also places where they have the opportunity to be physically active. The present study builds of previous research demonstrating associations between certain attributes of playground design and their influence on or associations with child physical activity during recess.

Study Summary Researchers conducted a systematic review of the literature, which included searching several bibliographic databases, going as far back as 1900 and as recent as 2012. For each of the databases, the search was limited to studies that involved children two to five years of age (Continued on page 7)

Current Resources Related to Energy Drinks, Soft Drinks, and Substance Use

“Teens who consume

Wolters Kluwer Health: Lippincott Williams & Wilkins. (2014, February 4). Teens who consume energy drinks more likely to use alcohol, drugs. ScienceDaily. Retrieved April 2, 2014 from

energy drinks more likely to use alcohol, drugs,” study shows.

Radiological Society of North America. (2013, December 2). Cardiac MRI reveals energy drinks alter heart function. ScienceDaily. Retrieved April 2, 2014 from Rutgers Biomedical and Health Sciences. (2013, September 4). Why energy drinks are harming children, adolescents. ScienceDaily. Retrieved April 2, 2014 from

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Recent Research: Adolescents and Sleep (cont’d)

(Continued from page 5)

use of all caffeinated items. Out of 432 boarding school students who received parental permission and were eligible to participate in the study, 197 of them completed surveys at end of the fall term (after the normal school schedule) and at the end of the winter term (after the experimental school schedule). Students were fairly evenly distributed across grade levels nine through twelve and “all students reported the goals of attaining at least a college-level degree” (p. 13). Analyses of the data produced numerous results, including (“Time 1” refers to data recorded at the conclusion of the fall term; “Time 2” refers to data recorded at the conclusion of the winter term):  51.2% of students reported that they rarely or never got enough sleep at Time 1; however, after the experimental schedule was implemented, a smaller amount of students (35.5%) reported rarely or never getting enough sleep.

 Although minimized, researchers acknowledge that it is possible that there are other variables that could explain the association between school start time delay and the observed benefits for students Potential Application(s) of Study to Independent Schools There is a paucity of peerreviewed literature on independent schools. Although one cannot infer from this study that the school was a member of caffeine declined. NAIS and accredited by a state or region Schedule changes did not have an al association of independent schools, the impact on self-reported grades; 93% fact that the researchers use the term at Time 1 and 91% at Time 2 report- “independent” to describe the research ed receiving mostly Bs or better in setting distinguishes this school from their classes. generic settings, such as “private” or “nonpublic”, which are often used in re Students reported no change in the number of hours they spent engaged search. With that said, this study is parin athletics, extracurricular activities, ticularly pertinent to boarding schools and homework after the experimental serving students in grades nine through twelve who wish to consider the impact schedule was implemented. their schedules have on adolescent sleep,  When compared to Time 1, signifihealth, attention, and time for homework. cantly fewer students reported feeling too tired to do their homework at Time 2.

 Avg. school night bedtimes did not significantly change.

Overall, the researchers concluded that, “insufficient sleep duration was as The duration of school night sleep sociated with higher levels of depressed increased by 29 minutes after the mood, sleepiness, and caffeine consumpexperimental schedule was impletion, both before and after the schedule change, but…there were significant immented. provements in all of these parameters  Girls awoke slightly earlier (14 after the start time delay” (p. 16). Furmins.) than boys did at Time 1, but ther, they argue that their study “adds to not at Time 2. the growing body of evidence suggesting  At both Time 1 and Time 2, students compelling health benefits with even a who reported getting less than eight very modest delay in school start time” hours of sleep on school nights also (p. 16). reported more depressed mood and Study Limitations weekly caffeine consumption than students who achieved at least eight  Based on self-report data hours of sleep on school nights.  No information on duration of naps

 After the change in school start time,  Unique sample, in that students were scores on the depression sub-scale of enrolled in a “highly competitive the SSHS decreased and total weekly independent boarding school”

Additional Info and Resources For more detailed information this topic, please see, Sleep Deprivation May be Undermining Teen Health, published in the Monitor on Psychology, October 2001. Also see the Harvard School of Public Health’s webpage highlighting the associations between sleep and obesity.


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Recent Research: Playground Design for Physical Activity (cont’d) (Continued from page 5)

and children five to twelve years of age. Additionally, there were four other selection criteria: (a) study had to be a randomized controlled trial or controlled clinical trial; (b) the intervention did not include structured activities during recess, nor could there have been playground markings, game equipment, and/ or physical structures prior to any intervention; (c) children had to be assessed using objective measurements, such as heart rate monitors, pedometers, and/or accelerometers; (d) the type of physical activity studied had to be vigorous physical activity (“VPA”) or moderate-tovigorous physical activity (“MVPA”). Researchers identified a total of 477 articles through their search and an additional seven articles from a manual search of those articles. Of those 484 articles identified, eight were determined to be eligible given their selection/inclusion criteria. Researchers grouped the eight studies into four categories according to the “redesign” characteristics of the studies’ intervention: 1) playground markings (two studies); 2) game equipment (two studies); 3) playground markings plus physical structures (three studies); 4) playground markings plus game equipment (one study). Throughout all of the studies, “the schools had no playground markings at the beginning of the study (only field marks) and had only a limited quantity of game equipment” (p. 140). Duration of recess varied among the studies from a minimum of sixteen minutes to a maximum of forty-two minutes. The study found the following results with regard to each type of intervention in relation to physical activity:  Playground Markings: inconclusive (i.e., “simply providing playground markings is insufficient to increase

levels of activity and decrease levels of sedentary behavior during playtime” (p. 142))  Game Equipment: insufficient to increase the amount of MVPA and VPA  Playground Markings Plus Physical Structures: short-term improvement in MVPA and VPA  Playground Markings Plus Game Equipment: Only one study was reviewed and the finding was that, “neither the availability of toys nor the presence of play equipment or of markings was associated with more [physical activity]” (p. 143).

Provided their review of the eight studies meeting their selection/inclusion criteria, researchers concluded that, “the strategies analyzed do have the potential to increase PA levels during recess” (p. 143); however, more research is needed to identify which specific strategies may contribute significantly to increased student physical activity and to meeting minimum recommended levels of daily MVPA and VPA. Study Limitations  Only three studies were random controlled trials  Although grouped by their characteristics, the interventions of each study were uniquely different (e.g., “playground markings” represented a

range of different types of “markings” or delineations)  Certain extraneous factors not discussed in the studies reviewed may have influenced the results of those studies.  Four studies did not distinguish between the physical activity outcomes of boys and the physical activity outcomes of girls  Studies reviewed “did not analyze the possible influence of the teacher in stimulating the child’s use of the equipment” (p. 143). Possible Application(s) of Study to Independent Schools Elementary schools considering the influence of playground/courtyard design on the physical activity of their students may wish to consider having a variety of options that help to stimulate physical activity. However, given the results of the present study, considerations to only the aspects of the playground design may not be sufficient to stimulate MVPA or VPA in elementary school children. Thus, if a goal is to stimulate physical activity, factors beyond the design of a school’s playground/ courtyard should also be considered.

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Indoor Tanning for Minors (Society of Behavioral Medicine Position Statement) (“SBM”) joins the American Academy of Dermatology, the American Academy of Pediatrics, and a host of other national and international organizations in support of a total ban on indoor tanning for minors under the age of eighteen. SBM’s support for this ban comes in light of numerous studies showing that indoor tanning increases risk for both nonmelanoma and melanoma skin canPosition Statement cers. Pagoto, S., Hillhouse, J., Heckman, C., Further, the statement provides that, Coups, E., Stapleton, J., Buller, D., “according to the International Agency . . . Geller, A. (2014). Society of for Research on Cancer, artificial sources behavioral medicine (sbm) position of ultraviolet radiation are in the highest statement: Ban indoor tanning for category of carcinogens, joining tobacco minors. Translational Behavioral and asbestos” (p. 124). The statement Medicine, 4(1), 124-126. doi: cites research demonstrating that expo10.1007/s13142-013-0240-1 sure to UV radiation in early life increases the risk for developing skin cancer, and Position Statement Summary The Society of Behavioral Medicine that (in some tanners) tanning can devel-

op into “tanning dependence”, which is “a pattern of tanning that bears resemblance to other substance dependencies” (p. 124). In addition to stating its position on banning indoor tanning for minors, the SBM shares that eleven countries ban indoor tanning in all minors, and although home tanning bed ownership is banned in several European countries and Australia, “home indoor tanning is legal in the USA and wholly unregulated” (p. 126). Possible Application(s) of this Position Statement to Independent Schools If they have not already, schools may want to consider incorporating into their science or health curricula information about the harmful effects that UV rays (especially artificial UV rays) can have on human beings.

You can read and/or download the full -text of this SBM position statement by clicking here.

Coordinated/Comprehensive School Health (Commentary) Commentary Hoyle, T.B., Todd Bartee, R., & Allensworth, D.D. (2010). Applying the process of health promotion in schools: A commentary. Journal of School Health, 80(4), 163-166. doi: 10.1111/j.17461561.2009.00483.x Commentary Summary A commentary published recently in the Journal of School Health, to which Diane Allensworth (co-contributor to the development of the Coordinated School Health model) was a contributor, stated, “no longer must we limit the perceived capability of school health educators by advocating for health ‘programs’—even coordinated school health programs” (p.

165). Rather, future, efforts, the authors argue, should be directed at finding a niche in the health promotion process that is compatible with ongoing school improvement efforts and “positions the

health-promotion process into the fabric of schooling” (p. 165) Possible Applications of this Commentary to Independent Schools Independent schools have understood for a long time that any programmatic or curricular changes are best made with thoughtful consideration to a school’s mission and unique community. Reading statements such as those quoted above from scholars who have studied the development and impact of school health, reminds us that all components of the Coordinated School Health model are best applied as part of a process that is woven “into the fabric of schooling”.


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Other Areas of Interest and Updates Related to Health From the Robert Wood Johnson Foundation

From the New York Times

50 Years of Tobacco Control An interactive history and timeline with videos, pictures, and illustrations of data reporting on the highlights of fifty years of tobacco control since the first Surgeon General’s Report on smoking and health in 1964

What Your Activity Tracker Sees and Doesn’t See This is a fascinating article that reports and illustrates the advantages and limitations of activity trackers.

From the Harvard School of Public Health The Benefits of Physical Activity An evidence-based summary of the health benefits of physical activity. Sections include: “The Cost of Inactivity”, “Exercise Intensity: What’s Moderate, What’s Vigorous?”, and “The Bottom Line: Move More, Sit less”. Physical Activity [in relation to obesity] More evidence-based reporting of the role of physical activity as it relates to weight management rends across developed nations, and obesity prevention. New School Meal Standards Significantly Increase Fruit, Vegetable Consumption A brief press release regarding the new federal standards requiring schools to offer healthier meals that include increased fruit and vegetable consumption. See also: Eating Fruits, Vegetables Linked to Healthier Arteries Later in Life

From the Los Angeles Times Mindful Meditation at School Gives Kids Tools for Emotional Expression This article reports on the state of mindfulness meditation programs in California, where “hundreds of schools” have such programs in effect.

A Concussion Monitor to Measure Hard Knocks This article reports on the Reebok CHECKLIGHT™, which is designed to measure the severity of impacts one experiences while engaged in sports or other athletic activities. This topic was also featured last year in Boston Magazine. Also related to concussions: Vision Test on Sidelines May Help Diagnose Concussion: More Evidence Does Porn Hurt Children? Research suggesting that teenagers and pornography are a hazardous mix is far from definitive.

From the Robert Wood Johnson Foundation Unlocking the Potential of School Nursing: Keeping Children Healthy, In School, and Ready to Learn

From Johns Hopkins School of Public Health Johns Hopkins has a slew of health information useful to schools. The most recent issue of their magazine is titled: The Food Issues: What we Grow – What We Eat – What We Seek. The full issue can be viewed and downloaded here. Other web-resources from Hopkins include: Food Teaching the Food System Center for a Livable Future

From the University of Michigan, School of Kinesiology PE Evolves Into Health and Fitness In 2012, the School laid the foundations for strategic directions, and one of the key emphases that emerged was a focus on physical activity, health and wellness, and nutrition. As a result, the University discontinued its PE program and launched a new health and fitness major in the fall 2013.

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About the Interim Executive Director Miguel G. Marshall is currently a doctoral student of health education in the department of health and behavior studies at Teachers College, Columbia University. His dissertation proposal is titled: Achieving Consensus on Principles of Good Practice for School Health in Independent Schools: A Delphi Study. He was most recently the Associate Head of School at The Caedmon School in New York City, where he served as the school’s first health director, developed and taught its first health education curriculum for fifth grade students, and coordinated efforts that led to the creation of Caedmon’s first nursery for faculty children. He earned a B.A. in Philosophy from Muhlenberg College and a M.A. in Health Education and Health Behavior from Columbia University. He is also a volunteer Emergency Medical Technician for the Central Park Medical Unit and holds a certificate in Advanced Project Management from the Stanford Center for Professional Development. As a former independent school student himself, Miguel believes passionately in the capacity of independent schools to be leaders in school health and to help students be active participants in their own health, as well as in the health of others. Miguel can be reached via email at:

A Brief Look at ISHA’s History (cont’d) (Continued from page 3)

 Maria Van Dusen*  Nancy Hander*  Pete Harris*  Sprague Hazard of Deerfield Academy  Stuart Bicknell of Deerfield Academy  Zanda Kubler-Merrill of Phillips Academy *A more extensive review of ISHA’s literature is needed to learn the affiliations of these founders. If you recall their affiliations or know someone who may, please email Together, ISHC’s founding members formulated the following definition of “good health”. Good health is a state of well being arising out of the harmonious integration of an individual’s physical, psychological, social, and spiritual sides. Around this definition, ISHC’s founders wove the purposes of the organization, namely that, “good health can be

achieved within a school by conscious teamwork of those involved in health care and health education” (Connell, D., ISHA Spring 1981 Newsletter, p. 1). Similar to today’s ISHA, ISHC considered members from several different disciplines as part of a collective approach to school health. Among those involved in health care and health education in independent schools, ISHC considered, “psychological counselors, physical therapists, trainers, chaplains, and teachers involved in class teaching of health knowledge and health values” (Connell, D., ISHA Spring 1981 Newsletter, p. 1). Among the first topics of discussion and programming were counseling and anorexia nervosa. ISHC soon became ISHA when members of ISHC became aware of a parallel organization, called Health Education Associates (“HEA”). “After attending a stimulating meeting at Walter St. Goar’s house in Boston, it was decided that HEA should be included in the larger framework of the Independent School Health Association” (Connell, D., ISHA Spring 1981 Newsletter, p. 1). From 1979 to 1989 and again from 2006 to 2010, ISHA had strong membership among boarding schools in New England and a few day schools across the East Coast. They organized conferences garnering attention from independent school health practitioners representing

different areas of school health, as well as from school administrators who had an investment in furthering efforts around the “whole child”. Previous conference titles included: “Perspectives on the Health and Healing of Young Women”; Building Programs in Health Education”; “Some Practical Issues in the Health Services”; “Sexuality Issues, Education, and Health Care”; “Issues in Adolescent Sports Medicine”, and; “Pathways to Spiritual Growth in Independent Schools”. Then, in 2012, ISHA met with a group of health educators representing several independent schools in New York City. This group of health educators, like ISHA’s founders, was inspired by the need to fill the school health void in terms of professional development opportunities, idea-generation and -exchange, and remaining current on health issues affecting independent schools. At the time, the NYC group of health educators had sent a letter to then president of NAIS, Pat Bassett, outlining how it thought NAIS could support the missions of independent school health programs. NAIS’ gift was sharing the efforts of ISHA with this group of health educators, some of whom are (at the time of this publication) members of ISHA’s steering committee. The rest is left to be written…


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VP’s Corner: Psychological Wellness Articles by Ben Thompson Taking Control of Test Anxiety When Julie (not her real name) came to talk with me a couple of years ago, she was becoming increasingly upset about her level of anxiety and poor performance whenever she had to take a test. While she knew the material, as she sat down to take the test her heartbeat increased, she experienced “butterflies” in her stomach, her thoughts began to race, and she couldn’t concentrate on the task at hand. Inevitably, she did poorly and ended up feeling like a failure. The worst part, she told me, was that she knew the answers both before and after the test, but not during it. Julie was experiencing a bad case of test anxiety—a problem that occurs when feelings of extreme nervousness interfere with our ability to recall previously learned information during a testing situation. When in the midst of severe test anxiety, we can blank out or “forget” what we’ve learned, become overly focused on negative outcomes, and, as a result, underperform— sometimes in a big way. A certain degree of anxiety during a performance situation can be a good thing. It “gets the juices flowing” and can help to sharpen our concentration and focus. When the level of anxiety goes beyond a certain point, however, it has the opposite effect, resulting in feelings of mental paralysis and inhibiting performance. Those of us who worry a lot or who are perfectionists are more likely to have trouble with test anxiety. At times, we may find ourselves in a vicious cycle: We imagine ourselves doing poorly, causing our anxiety to escalate. The higher level of anxiety, in turn, increases the possibility that we will do worse on the test, leading to even more worry and negative thoughts down the line. The good news is that there are several things that you can do to take control of test anxiety: 1) If possible, prepare for the test well ahead of time. Don’t cram, and don’t study in the hour or so before the test begins. 2) Learn as much you can about the test. For example, how many and what kinds of questions will there be? What topics will be covered? How much time will you have? 3) Stay focused on the task at hand—successfully taking the test—rather than on getting a certain grade. 4) When you first sit down to take the test, center yourself and take a couple of long, deep belly breaths, exhaling very slowly. Wright State University psychologist Rob-

ert Rando encourages anxious test-takers to picture themselves in the ”eye of the hurricane”—that calm and focused place around which the anxiety and worries swirl. 5) Counter negative self-statements such as “If I don’t pass this test, I’m a failure” with more realistic ones such as “I’ve improved my study plan this time and will probably do better, but if I don’t I can still bounce back.” 6) Get plenty of sleep before the test. Lack of sleep can contribute to memory loss and decreased concentration. 7) Don’t consume coffee or other caffeinated drinks before taking the test. While caffeine, a stimulant, can be beneficial to some people in such situations, it is likely to greatly exacerbate symptoms in the already anxious individual. 8) On multiple choice tests, first read the instructions for each item, then read each item. If you know the answer, go ahead and complete it. If you are 50% sure of the answer, put a dash next to the question and move on. If you are less than 50% sure of the answer, put a circle next to the question and move on. When you’ve finished your first run through all of the questions, go back and complete the ones with the dashes in front of them. When finished with those, go back and complete the ones with the circles in front of them. With practice, patience, and time, you really can get a handle on your test anxiety. The skills used to overcome your testrelated fears can also be helpful in a wide variety of performance-related situations, such as public speaking, athletics, and acting. If you’ve tried some of the suggestions in this column and still feel like you are “losing the battle,” don’t hesitate to seek additional help. Williston’s counseling services can be a good place to start. I’m happy to report that Julie’s anxiety decreased and her performance increased over a period of a few months. By revising her anxious (and sometimes catastrophic) thinking, employing a few simple relaxation strategies, and preparing for tests well ahead of time, she was able to reverse the negative cycle that had been making her school experience so upsetting.

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I S HA S PR I N G 20 1 4 N E W S LE T T E R

A Letter from the Interim Executive Director

We’re excited to bring back ISHA’s newsletter!

school members interested in ISHA’s mission to sign up for updates. Over 100 people responded to Ben and Becky’s letter by signing up for updates and about a quarter to half of those people indicated they would like to be contacted to learn how I hope that this issue finds they can best help ISHA achieve its mission and goals. Altyou well and stimulates your hough we are still organizing around our new mission and dethoughts around some of the veloping some pilot conferences, here are some things you or exciting and critical topics others at your school can do to support ISHA’s mission: related to the health of inde Tell us what you’d like to see or read about. pendent school communities.  If you do anything related to school health, please say so publicly. Advocate for it to be listed on your website, in your admissions materials, and etc. There are too many As this newsletter is the first ISHA newsletter published schools that are doing wonderful things around school over quite some time, the structure, prose, and diction of my health, but only few publish with detail their approach. letter to you reflects my eagerness to update you on recent Your website acts as a conduit not only for prospective changes and inspire momentum. I hope that future letters from parents, but also for other schools who may be me will give you a more accurate sense of my looking to learn about or develop school health character and my passion for school health. programs at their school. “The fact that there is no If this is the first time you have received our organization for professional  Forward this newsletter along and share our newsletter, you will notice that we have transilink so that peotioned to a new format. Yet, whether it is your exchange and dialogue at the ple interested can subscribe to updates. first time reading a newsletter from ISHA or you independent school level led  Consider publishing an article on work that have read newsletters in the past, we want to hear to the decision to try to fill you have done at your school or on something from you. The format you see here and the content contained herein is only as good as its readthe obvious void”. Former ISHA that you think is particularly poignant in relation to school health in independent schools. Please ers think it is. Please share your thoughts by President, Dr. Sprague Hazard. don’t hesitate to send your thoughts to Ben contacting me ( or Thompson. Ben ( NAIS is now accepting applications to present at its 2015 conference! The 2015 conference is scheduled to take Also, through recent discussions with members of both boarding and day schools, we have amended our mission state- place in Boston, February 25 to 27. Please email Ben if you ment. Please take the opportunity to access and read a PDF of have an idea or would like to collaborate on a presentation. The more interest we receive on a certain topic can help us put our new mission statement at your leisure you in touch with someone who is equally interested. Last year Now is a unique time for health in independent schools. Becky Smith coordinated a fabulous presentation to which Many independent schools are at different places with respect members of other independent schools participated and presentto their approaches to school health, and although we have known for long the importance and impact of consciously inte- ed. A PowerPoint of her presentation is accessible here. grating health into the fabric of schools, reflections of 21st century education and the roles of schools have re-emphasized the importance of school health and the need for it to have a permanent place in our schools. To showcase these reflections, I created a brief PowerPoint that highlights health-related excerpts from recently published books on the topic of education in the 21st century. A link to that PowerPoint, which I also presented to a small group of health educators at Horace Mann School, is accessible here. As I shared it with the group at Horace Mann, I share this presentation with you because I think it may be useful in supporting the notion that school health has a permanent place in all schools. In a recent letter from our vice president Ben Thompson and former president Becky Smith, we asked independent

Our website (with the new domain, remains under development. However, thanks to Rob Ambrose of Paragon Technology Solutions, we have successfully migrated from the previous domain to our new domain. We hope that with time and with some funding we can upload content and design it to be an accessible, relevant, and useful resource for independent schools. Lastly, as former ISHA president Sprague Hazard, MD, wrote, “the fact that there is no organization for professional exchange and dialogue at the independent school level led to the decision to try to fill the obvious void”. Unfortunately, it (Continued on page 13)


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A Letter from the Interim Executive Director (cont’d) (Continued from page 12)

would seem that this void still exists today. Nonetheless, I am extremely confident that, through working together, we and ISHA can continue to fill that void as it has been filled in the past. To that end, if you are interested in: 

publishing an article in ISHA’s newsletter;

planning or hosting a school health-related event;

becoming a member of ISHA’s Steering Committee;

sharing about your school’s approach to health, and/or;

simply sharing your opinion on school health in inde-

pendent schools, please contact Ben Thompson via email. I hope to see many of you at the Dana Hall School for an informal workshop Friday, April 25. The workshop is free and you can RSVP by clicking here. May living healthfully be enabling and liberating, not restricting or overwhelming. Salveo, Miguel G. Marshall Interim Executive Director

Historical Spotlight: Lina Rogers Struthers, “the First School Nurse” “Above all other things the school nurse must have a deep, human love for children, a charity and kindliness that embraces all children in its sympathy, the dull and the bright, the dirty and the clean, the sulky and the cheerful, the repulsive and the attractive, the insolent and the obedient, the quarrelsome and the loving, the rebel and the follower and admirer.” Lina Rogers Struthers The above quote is from the first textbook on school nursing, authored by Lina Rogers Struthers, R.N. Published in 1917, Nurse Struthers’ text was titled, “The School Nurse: A Survey of the Duties and Responsibilities of the Nurse in the Maintenance of Health and Physical Perfection and the Prevention of Disease among School Children”3. Beginning her role in New York City, Nurse Rogers (maiden name) arrived at a time when she was needed most. With a burgeoning population, “New York hired 150 doctors for an hour a day to inspect school children for contagious diseases”4. However, this approach turned out to be less successful than the city had hoped. In light of this outcome, a group of nurses came up with a different approach. Rather than solely inspecting children for disease(s), nurses suggested to “actually treat the students in the school setting”4. The city agreed to test this approach with a group of nurses for one month, serving 10,000 students2, 4. From using a board atop a radiator as an examining table to using a narrow empty closet as a “health room”, Lina Rogers lead and participated in the treatment of numerous NYC Public School students. Beyond treating children, Ms. Rogers implemented preventative innovations including, “wellness and illness prevention programs”, “training and inspiring teachers to present lessons in hygiene”, “nutrition, and physical development programs”, “introducing paper towels for hand-drying”, and “dental and audiologic screenings”. ISHA recognizes Lina Rogers Struthers, R.N. for her instrumental and seminal work in school health services and school health education, and for her understanding of the needs of the “whole child”. School nurses today play a critical role in our schools, and this is no doubt due in part to the work of nurse Struthers nearly 100 years ago. Thank you, Lina Rogers Struthers, R.N.!





References Book review: The school nurse. (1917). The American Journal of Nursing, 18(2), 172. doi: 10.2307/3406112 Hanink, E. (n.d., n.d.). Lina rogers, the first school nurse: Spearheading an intervention to keep kids in school. Profiles in Nursing. Retrieved April 3, 2014, from http:// -first-school-nurse Struthers, L.R. (1917). The school nurse; a survey of the duties and responsibilities of the nurse in the maintenance of health and physical perfection and the prevention of disease among school children. New York London: G. P. Putnam's sons. The ‘Experiment that Endured: The Beginnings of School Nursing. (1999). School Nurse News, March 1999. Retrieved April 3, 2014, from BackIssues/1999/SNMarch99history.pdf

The Independent School Health Association (“ISHA”) aims to support the development and sustainability of health and health education in independent schools. Our mission is to equip independent school communities with the information, skills, and resources to navigate emotionally,

cally, spiritually, mentally, and socially their health and well-being. We are also committed to illuminating the relevant associations between health and academic achievement, and how they influence student motivation and potential. active website, listserv, social media, and a newsletter;

ISHA is dedicated to promoting health through: 

partnerships with independent school communities;

creation and sustainability of a forum dedicated to the dis-

curriculum and health program development; 

cussion of healthy schools and health education; 

providing a resource library with content related to health

professional development through conference coordination, 

creating awareness around social causes of health and disease, and; promotion of evidence-based and other best practices.

Have something to share or write about? Please email ISHA’s VP, Ben Thompson:

2015 NAIS Annual Conference Conference Registration is Now Open! February 25 - 27 | Boston Conference Theme: Design the Revolution: Blending Learning, Leading, and Innovation At the 2013 NAIS Annual Conference, former ISHA President, Becky Smith, presented a presentation on resilience with members from other independent schools. The presentation was well-organized, insightful, and a hit among attendees! Email Ben Thompson ( if you’re interested in collaborating on a proposal.

ISHA Spring 2014 Newsletter  
ISHA Spring 2014 Newsletter