Adolescent health promotion and risk reduction: cementing the social contract between pediatricians and the schools.

In this article the implications of a biopsychosocial model of adolescent health promotion for the delivery of relevant services in the schools are examined. Adolescent health status is reviewed and is found, despite existing efforts for health promotion and risk reduction, to be in need of substantial improvement. For this to happen, having an early and sustained positive impact on the health trajectory of children is essential; further school-based and school-linked curricular efforts for health promotion are a necessary feature of a successful strategy for adolescent health promotion. In fact, this approach brings to life the social contract between pediatricians and the public to apply the biopsychosocial model at both clinical and societal levels. Curricula serve as the glue that binds diverse health-related concerns and findings emerging from health research into a coordinated, thorough, and detailed strategy and set of actions for school-based and school-linked health promotion efforts. School-linked health programs are consistent with a biopsychosocial perspective, from which the school is best viewed as a health-promoting environment, centered in concepts and practices outlined in and conveyed through the curriculum and associated instructional practices and delivery systems. Many benefits can result from pediatricians and other medical professionals taking a renewed, prominent role in comprehensive school-based and school-linked health promotion efforts, beginning in the early grades, when the trajectory of adolescent health is strongly set into motion.