Better schools through health: learning from practice

2. “MY DEAR PINOCCHIO”: THE ITALIANWAY TO THE HEALTH PROMOTINGSCHOOLMaria Vezzoni, Cristina Morelli, Antonella Calaciura,Chiara Mariani, Luigi Acerbi, Roberta Tassi,Marina Penati, Maurizio Bonaccolto, Luigi Fantini(Public Health Unit Milano2 (PHUMi2) CommunityMedicine); Chiara Sequi (Provincial Office ofEducation of Milan); Tiziana Germani(School Director 1 CD San Giuliano Milanese), ItalyBackgroundPinocchio is a puppet who empowered himself to become a child. In doing this he ishelped by a blue fairy, who tells him he can become a real boy, if he proves himselfbrave, truthful, and unselfish. Thus begin the puppet’s adventures to become a realboy, which involve many encounters. Likewise pupils need to be empowered andthe school represents the place where significant encounters take place and whereempowerment can be developed.Public Health Unit Milano2 (PHUMi2), located in the Lombardia Region, actually serves46 municipalities in the hinterland of Milan, with 556.000 inhabitants and 351 schoolswith more than 60.000 pupils. In 2001 we investigated around 70% of the schools abouttheir activities in health education. At that time, schools used a medical model of healtheducation offering lectures on health-related topics, such as nutrition, hygiene and oralhealth, smoking habits, sexual education, prevention of accidents. The average numberof health topics addressed in pre-school was 1.5, in primary school 1.8 and in secondaryschool 2.8. No strategies had been developed to promote healthy living through thewhole school approach.StrategyWe focused on the process of change. In 2002 we invited the Regional Office ofEducation in Lombardia and teachers from the schools of the area to participate inthe development of a theoretical model of a “Smoke-free School” (SFS) using a healthpromoting approach. Subsequently, based on a whole school approach, we decidedto certificate those schools that planned, implemented and evaluated actions in fiveareas;1.2.3.4.5.CurriculumTraining for teachersPartnershipSmoke-free school environmentSmoking cessation.In five years 130 schools have been certified as “SFS” and 79% of them obtained resultsin at least three of the above areas.After achieving this schools now asked for a more comprehensive working model andwe accepted the challenge of a new approach and started to work toward a “HealthPromoting School” (HPS).22