Transcultural validation of CDC’s School Health Index in Italian context

Schools promote health if they are healthy as organizations. Unfortunately, this comprehensive concept of Health Promoting School (HPS) is more advanced than its practice. So, there is a need of assessment methods: indices and indicators of HPS implementation. The WHO outlined 8 areas for HPS: Health Services; Health Education (HE); Physical and social environment; Health Promotion (HP) for staff; Community involvement; Nutrition; Physical education and recreation; Mental health, counselling and social support. Based on this framework, the USA’s Centers for Disease Control and Prevention published since 2000 the School Health Index (SHI) composed of 8 modules with a scoring system. The objective of our work was to validate an Italian version of SHI for Middle-High schools. SHI modules have been translated, integrated and adapted to Italian schools organisation and characteristics (i.e. safety laws, HE activities, nutrition services). 12 schools of Abruzzo Region have been involved: their staff filled in all questionnaires and answered a validation form on the utility, completeness and well-balanced aspects investigated. The main results are: the staff appreciated this evaluation system and completed nearly all modules; many items have to be reformulated due to specific differences between the Italian and American context; the system needs to be integrated with student and staff wellness assessment, learning experience and more deepened physical environment evaluation. The validated scoring system will enable Italian schools to identify strengths and weaknesses of HP policies and programs.