1. Report for Health Promoting Schools National Strategic Hui

PURPOSE OF HUI (AUGUST 31ST AND SEPTEMBER 1ST 2010)

Different models of Health Promoting Schools delivery are used across Aotearoa / New Zealand. The first step in the journey towards national consistency involved challenging the sectors thinking and encouraging reflection on the current Health Promoting Schools models being used. This was the central purpose of the hui, as well as providing the opportunity for input into the Draft Strategic Framework. When finalised, this will provide a framework for Health Promoting Schools in New Zealand, Aotearoa.

The Draft Strategic Framework presented at the hui was developed from:

● A literature review comparing effective Health Promoting Schools and education best practice

● A baseline survey with the Health Promoting Schools sector and stakeholders

● Input from the Leadership and National Reference Groups

The hui was attended by over 100 people from across New Zealand and included Health Promoting Schools Facilitators/Advisors/Coordinators (53%), Team Leaders and Managers (16%), external stakeholders (13%) and others including the Ministry of Health representatives (20%).

As Lee Trevino once said “If you make change and it feels comfortable, you haven’t made change”. Judging by the reactions from some participants at the hui, we can affirm that preliminary steps towards change are underway...

DAY 1 Powhiri The hui opened with a stunning powhiri lead by Hapai Te Hauora Tapui. This form of welcome was to ensure unison amongst the group and prepare for the very full two day programme that lay ahead. Opening Address – Dr Barbara Disley (Project Director, Cognition Education) and Dr John Langley (CEO, Cognition Education) Following a warm welcome from Dr Barbara Disley and an inspiring opening address from Dr John Langley from Cognition Education, the context for the hui was set and the programme got underway. Public Health Strategic Overview – Warren Lindberg (Group Manager, Public Health Operations, Ministry of Health) Warren set the scene for the hui by providing an opportunity for reflection, acknowledging the challenges facing public health in New Zealand at present. With Public Health being “the science and art of preventing disease, prolonging life and promoting health through the organised efforts of society” (Acheson, 1988), Warren highlighted the necessity of true inter-sectorial collaboration given some of the strongest influences of health and wellbeing reside outside the health sector. He noted the importance of collaboration between health and education if Health Promoting Schools is to achieve improvement in health and education outcomes for our students.

Report for Health Promoting Schools National Strategic Hui 2010: August 31st and September 1st, Holiday Inn, Auckland Warren then moved on to outline New Zealand’s journey towards national consistency in Health Promoting Schools, following two major reviews commissioned by the Ministry of Health: the first in 2006 which criticised the lack of shared vision and recommended steps towards a consistent national approach, and the second in 2009 which reviewed the role of the Regional Coordinators and identified similar concerns. He then outlined the objectives and deliverables within Cognition Education’s contract as the new National Health Promoting Schools Co-ordination Service. National Baseline Survey – Dr Patricia Vermillion-Peirce (Senior Research Analyst, Cognition Education) Patricia presented the results of a two staged Baseline Survey carried out with the sector to determine the Health Promoting Schools practice currently being delivered in New Zealand. The first part included a qualitative consultation with the National Reference Group. Feedback from this exercise guided the development of questions for the quantitative survey that was carried out with the wider sector.

94 quantitative surveys from across New Zealand were completed. Responses were received from Health Promoting Schools advisors/facilitators/coordinators, team leaders and managers, other roles (such as Public Health Nurses), and external stakeholders.

In identifying the number of schools currently engaged in Health Promoting Schools, the results indicated not only room for improvement, but also vast differences in defining Health Promoting School's engagement across regions.

The survey then specifically looked at the model of Health Promoting Schools delivery nationally. This revealed not only variation in usage of the model, but also the inclusion of additional steps, and the identification of missing elements. This provided reflection on the current model which is useful in determining a way forward towards a nationally consistent approach. One enabling factor identified was the model was often adapted for each school, perhaps suggesting that one size doesn’t fit all!

The survey also identified key areas needing to be addressed for Health Promoting Schools to reach its maximum effectiveness, all of which were reflected in the Draft Strategic Framework. Unpacking the current NZ Education context for schools – Therese Ireland-Smith (HPS Project Manager, Cognition Education) Key values and beliefs drive education at both national and local levels, and this presentation outlined how they are then reflected in practice. At a national level, the Ministry of Education’s statement titled ‘Priority Outcomes 2009-2014’ identifies a range of priorities including:

2. Every child having the opportunity to participate in high-quality early childhood education.

3. Every child achieving literacy and numeracy levels that enable their success.

4. Every young person having the skills and qualifications to contribute to their and New Zealand's future.

5. Relevant and efficient tertiary education provision that meets student and labour market needs.

6. Māori enjoying education success as Māori

7. The Ministry being capable, efficient and responsive to achieve education priorities.

These priorities are reflected in the National Education Guidelines, National Administration Goals, the New Zealand Curriculum and National Standards.

Report for Health Promoting Schools National Strategic Hui 2010: August 31st and September 1st, Holiday Inn, Auckland At a local level, values and beliefs are driven not only by these documents, but also by:

Self-governance through Boards of Trustees Improvements in student achievement Evidence-based practice (what and how the curriculum is taught and assessed)

Figure One

Teaching as Inquiry was presented as an evidence-based teaching model highlighted in the New Zealand Curriculum. Cognition Education has adapted this model shown in Figure One above to enable elements of Health Promoting Schools to be carried out within the classroom and across the school community, whilst enabling students to focus on the current education priorities of literacy and numeracy.

Therese concluded by challenging participants to consider whether Health Promoting Schools could better align with schools by offering to be partners in learning, supporting schools in achieving their own beliefs and practices? The Health Context – Alison Blaiklock (Executive Director, Health Promotion Forum) Alison set the scene from a health promotion perspective, by reflecting on the current challenges facing both the discipline and Health Promoting Schools. While New Zealand has achieved some important advances in child health, the gains have left out the poorest children, and it remains better to grow old in New Zealand, than to grow up in New Zealand. Despite our advances, when compared with similar OECD countries, we rate poorly in many areas: Maori and Pacific children continue to experience disadvantage on many levels and we have a wide gap between rich and poor. Children in Aotearoa / New Zealand must be prioritised through:

Focusing on the early years

Report for Health Promoting Schools National Strategic Hui 2010: August 31st and September 1st, Holiday Inn, Auckland Ensuring nurturing relationships and supportive environments Collaborative, participatory and comprehensive approaches Respect for the dignity of each person and all peoples Education Improving determinants of health

Alison noted many approaches to health promotion are very eurocentric, which is sometimes at the expense of indigenous peoples and other minority groups. Alternative approaches (such as Te Pae Mahutonga and the Fonua Model) are emerging and are more attune to cultural diversity, ground level solutions, and respect for all people and their human rights.

There is increasing recognition that eurocentric models can be balanced with these more alternative models to strengthen notions of sustainability, interdependence and unity in diversity. Participants were left reflecting on whether this was perhaps true for our current model of Health Promoting Schools in Aotearoa / New Zealand? Homai Primary School – Laurayne Tafa (Principal) Laurayne Tafa opened her presentation by categorically stating their school was NOT a Health Promoting School – but that they have managed to achieve the improvements in health and education outcomes advocated by Health Promoting Schools, through their own processes. Laurayne had been ‘pitched’ Health Promoting Schools on several occasions, but felt the current model had not engaged with the values, beliefs and practices that her school community had developed. Feeling their school already had systems and processes in place that enabled them to achieve what they felt was important, Laurayne’s presentation was developed to challenge thinking and encourage the sector to reflect on their role and whether the current model is still relevant and appropriate for New Zealand schools.

Homai Primary School shared their own model outlining how they had achieved their success through identifying their values and beliefs, understanding those values and beliefs, and then demonstrating those values and beliefs in their practice. Participants were divided into discussion groups to look at three areas of the school practice that demonstrated these values and beliefs.

This presentation generated much discussion amongst participants, highlighting the inconsistency in delivery across New Zealand, and left some burning questions:

Was Homai Primary a Health Promoting School – and they just didn’t know it? Did it matter if they identified as a Health Promoting School or not? Or is this local ownership in action? How could Health Promoting Schools support similar schools with established systems and processes? Can Health Promoting Schools work in partnership with schools like this, building on existing systems and processes? Or must schools follow the Health Promoting Schools model exactly as its depicted? Perhaps we should be asking ourselves, what are the Health Promoting Schools' values and beliefs? What drives our practice? Synthesis of research in HPS: International and National Trends - Therese Ireland-Smith (HPS Project Manager, Cognition Education) Health promotion literature surrounding effective Health Promoting Schools was compared with a parallel body of education literature around effective schools, and while both identified the importance of:

Shared strategic direction Effective teaching and learning practices High expectations

Report for Health Promoting Schools National Strategic Hui 2010: August 31st and September 1st, Holiday Inn, Auckland Professional support Partnerships with the community and agencies Effective leadership One element that was identified as important for effective schools, that the health promotion literature did not identify, was theories of action and systems that support change in an education setting. This is interesting given schools and Health Promoting Schools' practices are about processes of continuous improvement/change.

One model developed by Fullan (2006) identified through reflective action seven core principles that underpin effective change processes in school. These include:

1. A focus on motivation

2. Capacity building, with a focus on results

3. Learning in context

4. Changing the context

5. A bias for reflection

6. Tri-level engagement

7. Persistence and flexibility in staying on course

Participants were then asked to reflect on the current Health Promoting Schools model (framework and process) and identify ‘if’, ‘where’ and ‘how’ these elements of change theory are reflected in current HPS models and practice? Health Promoting Schools vs Health Promotion in Schools (Natalie Burton, Health Promoting Schools National Coordinator, Cognition Education) Much of the hui had highlighted how values and beliefs drive practice, and questioned if the New Zealand model of Health Promoting Schools was based on a clearly articulated set of shared beliefs, values and principles. This session was developed to encourage participants to identify the core beliefs, values and principles that define Health Promoting Schools practices as opposed to other health related activities happening in schools.

Participants were provided with a range of short case studies of various activities happening in schools. Groups used a ‘Discussion Web’ to identify elements that either supported or rejected the notion that the Case Study was a good example of a Health Promoting School. This gave a picture of what elements participants felt drove and distinguished Health Promoting Schools from Health Promotion in Schools. The elements were then prioritised so that: 50% were important, 25% were very important, and 25% were vital. Some of the vital elements (values, beliefs and principles) identified included:

Whole School Approach (15) Student owned and driven (11) Led by whole community (11) Needs based (6) School owned and driven (6) Individual, built on strengths (5) Principal commitment (4) Strengths based (4) Shared vision (3) Learning outcomes (3) Agency partnerships (3) Communication (2) Community learning and ethos (2) Community owned and driven (2) Evidence based (2) Sustainability (2) Respect (2) Adaptable (2)

Report for Health Promoting Schools National Strategic Hui 2010: August 31st and September 1st, Holiday Inn, Auckland Kapa Haka Performance – Te Kura Kaupapa Maori O Rohe O Mangere A number of participants stayed on following Day 1 for a wonderful evening meal prepared by the staff at the Holiday Inn. Before the meal, a powerful kapa haka performance by tauira (students) of Te Kura Kaupapa Maori a Rohe O Mangere was given. Their passion and talent was evident and the crowd was enchanted by the performance.

DAY 2 Maorigogy – Bernie Mathews (Consultant – Education and Health for Maori) Bernie’s presentation reflected her own life’s journey through the discovery of what she terms ‘Maorigogy’: The term ‘Maori’ reflecting ethnicity, world view and inherent values (Ako). The ‘gogy’ reflecting the educational link (the art and science). Bernie sees Maorigogy as a hybrid of Pedagogy (how children learn and teach) and Andragogy (how adults learn and teach). It is based on a set of Maori values and beliefs, and it is bi-cultural and bi-lingual.

The core values and beliefs that underpin Maorigogy include:

Wairuatanga= working with a good heart, goodwill and good spirit Rangatiratanga= behaving in a chiefly manner / professionalism, leadership Whanaungatanga= building positive relationships and partnerships Kaitiakitanga= guardianship, of self, others and things Manaakitanga= caring of self, others and things Tikanga= doing the right thing, striving for always `doing the right thing‟

Through the application of these values to a Case Study (Kokiri Taikura), Bernie demonstrated how the Maorigogy values and beliefs drove practice. Improvements were evident through health, engagement and participation in class activities, as well as improvements in educational outcomes evident in AsTTle and NCEA results.

Bernie provided participants with a reflection tool that could be used to reflect on the values and beliefs underpinning Maorigogy, and challenged participants to use it as a self-reflection tool in the context of their Health Promoting Schools delivery. Health Promoting Schools Website – Natalie Burton (Health Promoting Schools National Coordinator, Cognition Education) The new Health Promoting Schools website is hosted by Te Kete Ipurangi (TKI) and can be found on www.hps.tki.org.nz. After walking through the content that could be found throughout the website, the new functions of the Online Learning Community were introduced:

Report for Health Promoting Schools National Strategic Hui 2010: August 31st and September 1st, Holiday Inn, Auckland ● A Newsletter will be produced regularly, each issue with its own focus including some ‘nuts and bolts’ theory along with examples of this theory in practice. The newsletter will also highlight professional development opportunities available throughout New Zealand as well as contact details so school queries can be forwarded to the right place. Everyone was encouraged to subscribe to the newsletter by simply typing in your email address on the appropriate box on the home page, and clicking subscribe!

● Schools, practitioners and stakeholders will be able to network with each other, seek support, discuss and debate a range of issues, resources and research through email based Mailing Lists. Everyone was encouraged to subscribe by simply typing in your email address on the appropriate box on the home page, and clicking subscribe!

● The Resource Exchange will enable the nationwide sharing of resources, tools and templates. After resources have been submitted, they will go through a Quality Assurance process to ensure they are consistent with education and health promotion best practice before being placed on the website.

Through these functions, the networking, sharing of up to date and best practice resources and professional development opportunities requested by the sector in the Baseline Survey can be realised. Whanau Ora – Grant Berghan (Independent Consultant) Grant defined Whanau Ora as being about ‘Maori families being supported to achieve their maximum health and wellbeing’. Whanau Ora is described as a health goal, a ‘brand’, a method of practice, an outcome goal and a policy.

The main objective of Whanau Ora was to construct an evidence-based framework that would lead to:

Strengthened whanau capabilities An integrated approach to whanau wellbeing Collaborative relationships between state agencies in relation to whanau services Relationships between government and community agencies that are broader than contractual Improved cost-effectiveness and value for money

The five-part framework includes:

8. A whanau aspiration aim Collective economic, social, cultural gains 8. A set of principles kaupapa tuku iho-opportunity-best outcomes- integrity-coherent services-effective resourcing- competent provision 9. Whanau outcome goals Self management, healthy lifestyles, societal inclusion, confident in te ao Maori, economic security, cohesive, resilient, nurturing 10.Whanau centred services Whanau models of practice, integrated delivery, whole of govt commitment, dedicated

Report for Health Promoting Schools National Strategic Hui 2010: August 31st and September 1st, Holiday Inn, Auckland appropriation, regional direction, building on capabilities 11.Whanau Ora governance To facilitate delivery of services to whānau 35% of the Maori population was under 15 years of age in 2006, and Grant concluded by reiterating the important role Health Promoting Schools has to play in maximising the health and educational outcomes of young Maori in Aotearoa. He felt the goals and outcomes within the Draft Strategic Framework were consistent with the aims and objectives of the Whanau Ora Framework. He finished by commenting that the challenge will be in coordinating and integrating this framework into the HPS framework, in a coherent way. Unpacking the Strategic Framework – Therese Ireland-Smith and Natalie Burton (Cognition Education) The Draft Strategic Framework was emailed out to all participants the week before the hui to ensure everyone had the opportunity to digest its content in advance of the hui. The document was divided into sections and was ‘Bus Stopped’ in a lengthy, but valuable consultation exercise.

An abundance of information provided by participants during the hui was presented to the National Reference Group the following day. They began the massive task of compiling the feedback, and preparing the second draft for further sector input before the end of the year. Poroporoaki On completion of a very full two day programme, the poroporoaki led by Hapai Te Hauora Tapui closed the hui. Many thanks were given to everyone for their passionate contributions and best wishes conveyed for a safe journey home to their friends and families.

PRESENTATIONS FROM THE HUI

Can all be located on the Health Promoting Schools website. Go to News and Events, then click on August 31st, and the hui programme and presentations are available for downloading.

HUI EVALUATIONS

In total, 75% of all hui participants completed the evaluation form.

● Hui participants responded favourably to the overall value of the Hui, rated as 4 (“mostly valuable”) on the 5 point-scale.

● Networking opportunities and tools using a Maori world view were rated as having the highest usefulness rated as 5 “very useful”, and national baseline survey results and the discussion on Health Promoting Schools vs. Health Promotion in Schools rated as being of less use at 3 “somewhat useful”.

● Templates and resources that align with the new national strategic framework, as well as workforce development opportunities were noted by approximately three quarters of participants as a professional development need.

Report for Health Promoting Schools National Strategic Hui 2010: August 31st and September 1st, Holiday Inn, Auckland ● National or Regional/District workforce development opportunities were preferred by more participants over local opportunities.

● Respondents also made suggestions for improvement to the next hui. Two themes noted most frequently were to allow more time for discussion and networking, and greater clarity surrounding the hui and related activities.

Report for Health Promoting Schools National Strategic Hui 2010: August 31st and September 1st, Holiday Inn, Auckland