Principles For Health And Wellbeing - Department Of Education And Training
Principles for healthand wellbeingUnderpinning effectiveprofessional practice acrossDEECD services
Published by the Department of Educationand Early Childhood DevelopmentMelbourneApril 2014 State of Victoria (Department of Educationand Early Childhood Development) 2014The copyright in this document is owned by the State ofVictoria (Department of Education and Early ChildhoodDevelopment), or in the case of some materials, bythird parties (third party materials). No part may bereproduced by any process except in accordance withthe provisions of the Copyright Act 1968, the NationalEducation Access Licence for Schools (NEALS)(see below) or with permission.An educational institution situated inAustralia that is not conducted for profit, or abody responsible for administering such aninstitution may copy and communicate the materials,other than third party materials, for the educationalpurposes of the institution.Authorised by the Department of Educationand Early Childhood Development, 2 Treasury Place,East Melbourne, Victoria, 3002.ISBN 978-0-7594-0739-8
ContentsForeword1The Principles for Health and Wellbeing31. Introduction5Key policy drivers7DEECD health and wellbeing services and supports82. Aims and objectives9Aim9Objectives9Scope103. Principles for health and wellbeing11Principle 1 – Maximise access and inclusion11Principle 2 – Focus on outcomes15Principle 3 – Evidence-informed and reflective practice16Principle 4 – Holistic approach17Principle 5 – Person-centred and family sensitive practice18Principle 6 – Partnerships with families and communities19Principle 7 – Cultural competence20Principle 8 – Commitment to excellence214. DEECD contributing to health and wellbeing outcomes22Measuring System Performance23DEECD health and wellbeing priorities245. Understanding health and wellbeing26Multiple levels of influence on health and wellbeing28Education and health29Health literacy and the curriculum33Importance of family and community346. The continuum of intervention for health and wellbeing357. Roles and responsibilities38
ForewordHealth and wellbeing are essential for quality of life and are fundamental preconditionsfor learning and development. Active participation and engagement in learning, a positiveexperience of education or training and an informed awareness of health are crucial tolong term health and wellbeing.The DEECD strategic plan includes a focus on wellbeing and assists Victorians to buildprosperous, socially engaged, happy and healthy lives. The Principles for Health and Wellbeingarticulate the Department’s commitment to health and wellbeing and their importance toeducation and training.This commitment will enhance the ability of government, service providers, early childhoodservices, schools, families and the community to work towards enabling bright futures forVictorian children and young people.This resource will support training, joint planning, priority setting, service improvement,innovation and the development of common practices between services.Victorian regions, local governments, service providers and networks already demonstratesignificant leadership, initiative and innovation in supporting the health and wellbeing ofyoung Victorians.The Principles for Health and Wellbeing will enhance this work, and offer a common languageand approach to developing a service system that meets the needs of the whole person,and promotes and embeds health and wellbeing in our work.Foreword1
2Principles for health and wellbeing – Underpinning effective professional practice across DEECD services
The Principles for Health and WellbeingPrinciple 1 – Maximise access and inclusionQuality universal services for all, with extra effort directed to ensuring education and health and wellbeing servicesare accessible to, and inclusive of, the most vulnerable and disadvantaged.Principle 2 – Focus on outcomesHealth, learning, development and wellbeing outcomes are the focus when designing, delivering, evaluating andimproving education and health and wellbeing services.Principle 3 – Evidence-informed and reflective practiceCurrent and relevant evidence known to be effective in improving outcomes informs policy making and professionalpractice. Research and evaluation is undertaken to generate evidence and enable effective and reflective practice.Principle 4 – Holistic approachCollaboration between services and multidisciplinary professional practice is pursued to meet the needs ofchildren, young people and families and their health, wellbeing and learning goals.Principle 5 – Person-centred and family sensitive practicePeople are seen in the context of their families and environment and are supported and empowered to lead andsustain healthy lives.Principle 6 – Partnerships with families and communitiesPartnerships are forged with children, young people, families and communities, who are seen as partners in thecreation of healthy environments and good health and wellbeing.Principle 7 – Cultural competenceEffort is made to understand and effectively communicate with people across cultures and to recognise one’s ownworld view. Cultural connection is recognised as playing an integral part in healthy development and wellbeing.Principle 8 – Commitment to excellenceHigh expectations are held for every child and young person. Professionals continually assess their own workpractices to find opportunities for improvement.The Principles for Health and Wellbeing3
4Principles for health and wellbeing – Underpinning effective professional practice across DEECD services
1 IntroductionThe Department of Education and Early Childhood Development (DEECD) exists to support Victorians to build prosperous,socially engaged, happy and healthy lives. We do this by supporting lifelong learning and healthy development,strengthening families and helping people to gain the skills and knowledge they need to thrive and participate in acomplex and challenging economy and society.The Department’s 10-year goal is to make Victoria a world leader in learning and development. To achieve this weneed to support the development of the whole person. ‘Wellbeing’ is one of the four key outcomes areas that wewant to improve and measure, to track our progress. These outcomes are described ise standardsof learning anddevelopmentachieved byVictorians usingeducation,developmentand child healthservicesIncrease thenumber ofVictorians activelyparticipatingin education,developmentand child healthservicesIncrease thecontributioneducation,developmentand child healthservices make togood health andquality of life,particularly forchildren and youngpeopleIncrease theeconomic andsocial return onexpenditure onDEECD’s servicesDEECD recognises that healthy development and education is a shared responsibility, with families, learners, and ourservices all playing a role. Health and wellbeing is an important outcome in its own right, but it is also a precondition forlearning and employment, and is an indicator of successful education. This is why DEECD has a particularly important rolein contributing to the good health and wellbeing of Victorians.Recognising that investment in early childhood and on prevention, genuine early intervention and reducing disengagementproduces greater returns, we will focus on prevention and the junctures in the course of a young person’s life where we canhave the greatest impact.The Department can primarily influence health and wellbeing through its education settings and the health and wellbeingservices that are interconnected (Figure 1.1).Introduction5
Figure 1.1 DEECD health and education nexusComplex interventionfor children, youngpeople and familieswith multiple needsEarly interventionfor children andyoung people at riskPrimarypreventionDEECD Health & Wellbeing Servicesfor all childrenand young peopleDEECDEducationSettingsBirth-Early Childhood6Middle YearsAdolescencePrinciples for health and wellbeing – Underpinning effective professional practice across DEECD servicesAdulthood
Key policy driversThe development of the Principles for Health and Wellbeing has been informed by, and will enhance the Department’sresponse to Victorian and Australian Government policy and initiatives, some of which are outlined below. T he Victorian Public Health and Wellbeing Plan 2011-2015 states ‘better health has important benefits for optimaldevelopment and educational attainment’. The plan identifies early years and education settings as one of the fourpriority settings for action and engagement in ‘building a Victoria wide prevention system’. T he Victorian Parliamentary Inquiry into the Potential for Developing Opportunities for Schools to Become a Focus forPromoting Healthy Community Living (2010) recommended a broad framework for how the Victorian health-promotingschools approach could be supported through Victorian government, Catholic and independent schools. The Victorian Early Years Learning and Development Framework. This framework for all professionals working withchildren from birth to eight years of age sets clear outcomes for children’s wellbeing, together with other outcomesthat support learning and development. The framework also outlines practice principles for professionals working withchildren including collaborative, effective and reflective practice. T he National Quality Framework for Early Childhood Education and Care sets a new national benchmark for the quality ofeducation and care services. One of the key objectives of the National Quality Framework is to ensure the safety, healthand wellbeing of children attending education and care services. V ictoria as a Learning Community Action Plan (2013) sets out the Government’s vision for raising the standards oflearning and development. Implementation of the Principles for Health and Wellbeing can assist in school reform to‘shift the achievement curve’ and ‘maximise access and inclusion’. T he Shape of the Australian Curriculum: Health and Physical Education paper recognises schools as key settings fordeveloping health related knowledge and skills and promotes a strengths-based approach to improving health andwellbeing through the school curriculum. T he Victorian Auditor-General’s report on the Effectiveness of Student Wellbeing Programs and Services (2010)concluded that DEECD did not have a clear and current overarching framework defining its student wellbeing objectives,programs and services. It called for greater coordination, overarching policy and better evaluation of program andservice effectiveness. T he Victoria’s Vulnerable Children - Our Shared Responsibility Directions Paper (2012) outlines the VictorianGovernment’s first-year initiatives, longer term commitments and areas requiring further consideration as a result ofthe Protecting Victoria’s Vulnerable Children Inquiry’s recommendations.Introduction7
DEECD health and wellbeing services and supportsIn addition to education, DEECD uniquely delivers a range of health and wellbeing services to Victorian children,young people and their families. Services are available from birth through to early childhood and school settings.The target populations of these services are presented in the following table.BirthPreschool yearsUNIVERSALMaternal and Child Health ServicePrimary school yearsSecondary school yearsPrimary School NursingMaternal and Child Health LineParentlineSchool appointed wellbeing & engagement staffStudent Support ServicestargetedPrimary Welfare OfficersStudent WelfareCoordinatorsSchool Focused Youth ServiceSecondary SchoolNursingRegional Parenting ServicesEnhanced Maternal and Child Health ServicedisabilityEarly Childhood Intervention ServicesProgram for Students with DisabilitiesFlexible Support PackagesPreschool Field OfficersKindergarten InclusionSupport ServicesKOORIEKoorie Engagement Support OfficersIn Home SupportProgramHome Based LearningKoorie PreschoolAssistants8Principles for health and wellbeing – Underpinning effective professional practice across DEECD services
2 Aims and objectivesThe Principles for Health and Wellbeing are the result of an extensive engagement and consultation process.This consultation has informed the development of a common language and vision of how we can collectively promoteand support the health and wellbeing of children, young people and adult learners through DEECD services.AimThe Principles for Health and Wellbeing underpin professional practice in and across DEECD health and wellbeingservices, early childhood services and schools to promote and support young Victorians’ optimal health, wellbeingand educational outcomes.ObjectivesThe Principles for Health and Wellbeing seek to: c onvey the Department’s commitment to contributing to Victorian children and young people’s health and wellbeing,and delivering high quality services, e stablish shared principles for effective service delivery and encourage work across the ‘continuum of intervention’for health and wellbeing and preventative practice, p rovide a unifying conceptual framework for DEECD health and wellbeing services and s upport coordination and collaboration between DEECD services and those provided by other government departmentsand community organisations.Aims and objectives9
ScopeThis document and the Principles for Health and Wellbeing focus on children and young people, as early childhoodeducators, teachers, school staff and DEECD health and wellbeing services have a particular duty of care and opportunityto protect, promote and support children’s wellbeing. The Principles are also applicable to services for adult learners.The primary audience for the Principles is: early childhood services, school communities and alternative education providers, DEECD health and wellbeing services and DEECD central and regional office staff.These Principles are already applied by many services and professionals who demonstrate high quality practice.For example, early years professionals are already well advanced in promoting and supporting young children’swellbeing guided by the Victorian Early Years Learning and Development Framework – Practice Principles.The purpose here is to create a cohesive framework for health and wellbeing.10Principles for health and wellbeing – Underpinning effective professional practice across DEECD services
3 Principles for health and wellbeingThe Principles provide a shared language and basis for DEECD services to work together to improve outcomes for children,young people and adult learners. They underpin the work of these services and should be incorporated into the policies,guidelines, standards and most importantly, the daily work of service providers.Principle 1 – Maximise access and inclusionQuality universal services for all, with extra effort directed to ensuring education andhealth and wellbeing services are accessible to, and inclusive of, the most vulnerableand disadvantaged.All Victorian children and young people should be able to access education and health and wellbeing services whenneeded, regardless of their ability to pay, their race, faith, culture, sexual orientation, gender, ability or regional location.Universal access to early childhood education and care and school education is an important foundation for learning andhealth and wellbeing. Universal services also play an important role in identifying vulnerable children.For those with additional needs, delivering services in a universal venue, such as a school, may reduce the potential forstigma because these venues are not associated with a specific type of problem. Some services, such as the Maternal andChild Health Service (MCH), are available to all children and families in Victoria. The Enhanced MCH Service assertivelyresponds to the needs of children and families at risk of poor outcomes, providing more intensive intervention through anaccessible universal platform. Other services target particular groups and therefore have specific criteria for access. Forexample, the Early Childhood Intervention Services are targeted at children with a disability or developmental delay whohave a number of support needs. Student Support Services target school students facing barriers to learning and supportthem to achieve their educational and developmental potential.Accessing health and wellbeing services should be quick and easy, with no ‘wrong doors’. Those seeking assistance willbe placed in contact with the services they require, regardless of which service they first approach. Health and wellbeingservices will be well informed about the range of available services, information and resources in their area and willestablish clear referral pathways with Departmental and external services.Principles for health and wellbeing11
Shifting the curve through progressive universalism“ actions must be universal, but with a scale and intensity that is proportionate to the level of disadvantage. We call thisproportionate (progressive) universalism. Greater intensity of action is likely to be needed for those with greater social andeconomic disadvantage, but focussing solely on the most disadvantaged will not reduce the health gradient, and will onlytackle a small part of the problem.”Fair Society, Healthy Lives – The Marmot Review, February 2010In order to ‘shift the curve’ and narrow the gap in children’s health and developmental outcomes, a population approachto service provision is required.By focusing efforts on the whole community or population, rather than solely on those at highest risk, the populationcurve is shifted to the right. This ensures a greater number of people benefit from improved health and wellbeing andthere is an increase in the number of children falling into the average or above average range of health and wellbeingoutcomes (Figure 3.2).Targeting the most vulnerable groups and providing them with additional supports and services, as part of a universalapproach, decreases the number of children in the ‘vulnerable domain’ not attaining normal development.12Principles for health and wellbeing – Underpinning effective professional practice across DEECD services
Percentage of ChildrenFigure 3.1 Normal distribution of child development outcomesVulnerabilitythresholdLowAverage scoreOutcome tage of ChildrenFigure 3.2 Universal intervention improving outcomesfor more childrenTargetedstrategiesdecreasecurve forvulnerableUniversal strategies – entirepopulation movesGap narrowsLowOutcome measureHighSource: AEDI National Support Centre (Adapted from Hertzman & Power 2004, ‘Child developmentas a determinant of health across the life course’, Current Paediatrics, vol. 14(5), pp. 438-443)Principles for health and wellbeing13
Case example: Access and Service Coordination ProjectWyndham and Hobsons Bay city councils in partnership with HealthWest Primary Care Partnership, secondaryschools, alternative education providers and a wide range of youth and community services are working together toimprove identification of risk, assessment and service delivery for young people in their communities.This ‘Youth Partnerships Project’ utilised the Better Access to Services: A policy and operational framework as afoundation for the work, while a thorough consultation process with key stakeholders and its findings have informedits progress. The project involved developing a locally appropriate tool to identify initial needs and associatedprotocols for referral, as well as localised and user-friendly online youth service directories. The Initial NeedsIdentification (INI) tool and protocol have been trialled locally, supported by in-service coordination training foryouth support services and schools.Wyndham Youth Directory – Find the right serviceYouthParents & CarersService & Education ProvidersEmergencyLooking for help?Urgent helpServices that can help when a lot of detailed and urgent help is needed.Direct helpUrgent HelphelpServices that can help when you need focused help for a particular issue, or thereare a lot of problems.Direct helpSome helpSome helpJust curiousJust curiousServices that can help when a problem first appears and does not feel too serious yet.Social activities, programs and informtation that can link you in withother young people and the local community.The Initial Needs Identification tool and protocol involves community services and education providers who comein contact with young people who are disengaged or at risk of disengagement, using a common tool and protocol toscreen for health and social risk. This process seeks to give young people an opportunity to discuss their full rangeof needs as early as possible, helping them to avoid retelling their story and to receive timely support.The project has demonstrated the importance of partnerships between sectors, service coordination principles,local responses, client-centred service delivery and utilising technology. The tools will now be revised based on trialfindings and online youth service directories will be replicated in other areas of Victoria.14Principles for health and wellbeing – Underpinning effective professional practice across DEECD services
Principle 2 – Focus on outcomesHealth, learning, development and wellbeing outcomes are the focus when designing,delivering, evaluating and improving education and health and wellbeing services.Health and wellbeing services and education settings are both responsible for improving outcomes for children, youngpeople and adult learners.Data collection, monitoring and evaluation are all required to measure the impact of services on outcomes and supportcontinuous quality improvement.A focus on outcomes is used when designing, delivering, evaluating and improving DEECD services and programs. Thisapproach ensures these services respond to need and provides a basis for shared planning between services. It alsoresults in better use of resources, by focusing support where there is most need, and by providing greater consistencyand accountability across DEECD services. Services work together to achieve agreed outcomes for children, young peopleand adult learners. Their planning will be based on outcomes sought and drawn from a common understanding of prioritypopulations, local needs and the importance of strategies for prevention and health promotion shaped by local data.Promoting healthy minds for living and learningEmotional wellbeing, positive social values and supportive relationships are vital to learning, development and a positiveexperience of life.Education settings and services have a key role in promoting mental health in all children, young people and adultlearners. They do this by nurturing a positive learning environment, assisting with the development of social and emotionallearning, modelling and nurturing positive social values, building connections with families and communities and assistingthose who may be at risk of developing mental illness. Educators and services are encouraged to work together to increasetheir respective capacity to deliver and promote mental health and identify and respond to mental health concerns.Case example: The State of Bendigo’s Children reportThe City of Greater Bendigo received an award from the United Nation’s International Children’s Emergency Fund(UNICEF) as Australia’s first Child Friendly City. The award reflects a shared community commitment to creating aplace where children feel safe and secure and are able to explore and learn about the world.Building on this international recognition, the community acknowledged that more could be done to improveoutcomes for children and young people.The Bendigo Child Friendly City Leadership Group, in partnership with the City of Greater Bendigo, St Luke’s Anglicare,regional state government agencies, community groups and business leaders, developed and released The Stateof Bendigo’s Children report in March 2011. The report, which includes health and wellbeing across 20 indicators,enabled Bendigo to compare how its own children were tracking against the Victorian average for each indicator.This meant that the community was able to see its own strengths very clearly, but were also able to identify areas forimprovement.The shared responsibility for the health and development of the city’s children and young people was cemented bythe leadership group releasing the report’s findings to the public. By being transparent about its children’s strengthsand vulnerabilities, Bendigo invited the public to keep them accountable for the state of the community’s childrenand young people.Principles for health and wellbeing15
Principle 3 – Evidence-informed and reflective practiceCurrent and relevant evidence known to be effective in improving outcomes informspolicy making and professional practice. Research and evaluation is undertaken togenerate evidence and enable effective and reflective practice.Evidence-informed practice is guided by the best research and information available. Good evidence identifies thepotential benefits, harms and costs of intervention. Evidence may be of a qualitative or quantitative nature.Evidence-informed work with individuals and families requires integration of professional expertise, the best availableexternal evidence and understanding about individual and family values, culture and expectations.In the context of health promotion, evidence comes from a variety of sources including population health statistics,journals and publications, evaluation reports and locally collected data. An evidence-informed planning and evaluationframework should be adopted to guide the implementation of health and wellbeing programs. Evaluation is crucial toassess the effectiveness of a program, its cost, whether it achieved what was expected and to identify opportunities forimprovement. Evidence-informed practice and evaluation requires knowledge, research skills and techniques that need tobe learnt and applied.Case example: Catalogue of evidence-based interventionsDEECD provides an online catalogue of evidence-based interventions to assist health and wellbeing services, earlychildhood services and schools to provide and plan for early intervention programs that improve the health andwellbeing of children and young people.It is organised around key sections containing indicators of improvement in outcomes for children and young people.Each indicator has up to four recommended strategies that can be implemented and adapted to local needs.Early Childhood Indicators absenteeism kindergarten participation asthma antenatal and parental smoking M aternal and Child Healthservice participation behavioural difficulties asthma oral health food security behavioural difficulties parenting support school retention rate birth weight physical activity substance use breastfeeding reading, writing and numeracy teen pregnancy child protection sun protection young adults with a trusted adultin their lives food security injury underage convictions immunisation16Adolescent Indicators unemployed early school leaversPrinciples for health and wellbeing – Underpinning effective professional practice across DEECD services
Principle 4 – Holistic approachCollaboration between services and multidisciplinary professional practice is pursuedto meet the needs of children, young people and families and their health, wellbeingand learning goals.Across and within services, professionals need to work together to engage with a child, young person or adult learnerand provide them with an opportunity to discuss their full range of needs and strengths as early as possible. For thosewho have multiple or complex needs, services need to respond by coordinating comprehensive support that could nototherwise be provided by a single service or professional. A balance of both individual and population-wide interventionis required to impact on health and wellbeing outcomes. At the local level, partnerships are required to build the capacityof communities to develop and sustain improved environments conducive to health and wellbeing.Health is influenced by more than genetics, lifestyles and provision of services, and a joint effort is needed to respond tothe broader influences impacting on children, young people and adult learners. Collaboration should include a wide rangeof sectors, including those organisations that may not have an explicit health focus, to increase the chances of positiveoutcomes for them.Various structures and processes help support a holistic approach to service delivery. For it to succeed, sharedgovernance structures, flexible program requirements, collaborative planning, accountability and dedicated time forcollaboration is required.From a service user’s perspective:The information and support that I get comes from people who work together to understand what my family needs; theymanage and offer services that help me to be in control and do the best that I can. In my local area people are workingtogether to create a healthier community.From a service provider’s perspective:We provide coordinated support to those we work with. We work directly with the person and their family, and often withother local services to plan, and pull together the information and support they need. I enjoy working closely with, andreally involving other health services and local people, to build on community health promotion efforts.Case example: Integrated family and children’s services at Doveton CollegeThe momentum to establish Doveton College came when leaders of the Doveton and neighbouring Eumemmerringcommunities looked in depth at the needs of their community and the opportunities being missed to change lifeoutcomes. What emerged was a new service model. At Doveton College, children and families now have access toan integrated family and children’s service that
The Principles for Health and Wellbeing 3 1. Introduction 5 Key policy drivers 7 DEECD health and wellbeing services and supports 8 2. Aims and objectives 9 Aim 9 Objectives 9 . Education and health 29 Health literacy and the curriculum 33 Importance of family and community 34 6. The continuum of intervention for health and wellbeing 35
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