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CHAPTER II

REVIEW OF LITERATURE

This chapter presents the review of conceptual and research

literature which have been on the present study, its synthesis, conceptual

frameworks, and definition of key terms.

Conceptual Literature

The following literature concepts are all about health management,

academic performance, and health education.

Health Management. According to Farrell et. al (2015) discusses

the role of care management (CM) in improving healthcare delivery in the

U.S. by focusing on the triple aim of enhancing care experience, improving

population health, and reducing costs. It outlines three key strategies for

effective CM implementation: identifying populations with modifiable risks,

aligning CM services to meet those populations' needs, and preparing

appropriate personnel for service delivery. The brief emphasizes the need

for ongoing research to optimize CM practices and support from

policymakers to facilitate effective population health management.

Excellent health management is quite vital for the developing world

and, according to Kalavani et. al (2023), should not be politically motivated

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but merit oriented. Indeed, appointments of unqualified administrators can

critically undercut public trust and produce both forgone access and a

range of inefficiencies with health care systems. On merit-based selection

processes, transparent standards, and routine auditing to improve the

quality of care and competent and accountable health care administrators.

The book by Bresnen (2017) states the ongoing development of

healthcare administrators who are, in the final analysis, the major

architects of the upgrading of the whole healthcare sector, not only the

NHS in the UK. The authors look at how health administrators acquire,

exchange and use knowledge through groups of practice and how these

have a bearing on organizational performance and service delivery. By

charting out three healthcare organizations, the publication attains insight

into the significant pressure put on the managers because of institutional

reforms, financial demands and escalated expectations for competent

leaders. The report provides a fairer, clearer picture of the balance of

service efficiency and the need for the process of improvement in

organizations.

Academic Performance. According to Cox et. al (2020), high

academic expectations are crucial for students' learning outcomes and

motivation. Teachers set high standards, leading to improved engagement,

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attendance, and higher likelihood of completing education. Schools foster

a culture of pride and collaboration, fostering academic resilience and

sustained success. The Tell Them from Me (TTFM) survey provides

valuable data on student engagement and wellbeing. Consistently

promoting high expectations fosters a positive and inclusive environment,

enhancing the overall educational experience. Building trust between

teachers and students enhances engagement, communication, and

emotional well-being, contributing to students' academic performance.

According to Liem (2019), cognitive skills and non-cognitive factors,

such as psychological aspects and learning environment, significantly

impact students' academic success. Strategies such as improving working

memory, self-efficacy, and coping strategies can improve performance.

Early memory improvement, higher self-efficacy, adaptive coping

strategies, mindfulness practices, and addressing individual learning needs

can boost performance. Addressing individual learning needs and

implementing mindfulness practices can also significantly improve

students' academic performance.

Teaching methods that address individual learning needs also help

students succeed. Teacher effectiveness is a crucial school-related factor,

with teachers having a significant impact on students' achievement.

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According to Opper et al. (2019), teachers have a two to three times

greater impact on students' reading and mathematics performance than

any other school-related factor. However, value-added modeling-type

statistical methods are imprecise, especially in the early stages of a

teacher's career or school district. The best method of measuring teacher

effectiveness is through job performance, including classroom practices

and student learning progress. Performance-based assessments are

essential for identifying effective teachers and providing targeted support.

Policies that focus on the quality of teachers involved and continuous

professional development are essential for the success of students.

Health Education. Health education is a crucial tool for promoting

health and well-being among students. As per Iovino, E. A., et al. (2021),

High academic expectations are crucial for students' learning outcomes

and motivation. Teachers set high standards, leading to improved

engagement, attendance, and higher likelihood of completing education.

Schools foster a culture of pride and collaboration, fostering academic

resilience and sustained success. The Tell Them from Me (TTFM) survey

provides valuable data on student engagement and wellbeing. Consistently

promoting high expectations fosters a positive and inclusive environment,

enhancing the overall educational experience. Building trust between

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teachers and students enhances engagement, communication, and

emotional well-being, contributing to students' academic performance.

Moreover, Gagnon (2024) adds that health education is essential for

a healthier community. It teaches people about health and encourages

healthy habits. Community health workers help plan and run health

education programs. They work with everyone in the community, from

citizens to government officials, to improve health and wellness. This kind

of education can help with chronic diseases, injuries, mental health,

maternal and infant health, nutrition, exercise, obesity, tobacco, and

substance abuse. It can also address healthcare disparities; help make

better government policies and improve the local economy.

Vadurro (2018) adds that health education is a vital tool for fostering

a healthy community, involving community health workers and

stakeholders to improve health, wellness, and ensure equal healthcare

access. Public health educators provide educational resources and

programs to communities, addressing health disparities such as racial,

ethnic, socioeconomic, gender, and rural disparities. They work with

communities to examine trends in behaviors and health outcomes,

collaborating to support wellness efforts. Health education impacts areas

like chronic disease awareness, maternal and infant health, tobacco use,
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injury prevention, mental health, and obesity prevention. Collaboration with

public health departments, schools, and nonprofits is essential for

designing educational programs.

Review of Literature

The researcher reviewed several published materials which were

found relevant to the correlation of health management and academic

performance of students.

According to Shaw et.al (2015), unhealthy children are at a higher

risk of academic struggles compared to healthier children. Improving

health factors like nutrition, weight, and physical activity can positively

impact students' academic performance. However, rising obesity rates and

decreasing fitness levels highlight the need for further attention. The

relationship between better health and better academic outcomes is

complex and influenced by factors like culture, stigma, gender, and

socioeconomic status. School psychologists play a crucial role in

developing effective solutions to address these health issues, aiming to

improve student health and academic resilience.

On the other hand, Vonk et.al (2024) stated Childhood obesity and

mental health are significant global concerns, and schools are

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implementing programs to improve students' physical and mental health.

However, studies show that schools with Healthy School (HS) certification

have lower BMI students, but no effect on their mental health. The main

factor affecting students' health is their parents' economic status, and

these programs may not significantly improve their physical health.

Therefore, schools should focus on addressing these issues to improve

students' overall well-being.

The result of the study of Beane (2020), this examined the

correlation between academic achievement and health in a national

sample of college students using quantitative data analysis. The research

focused on three health-promoting behaviors (physical activity, strength

training, and fruit and vegetable consumption), three negative health

behaviors (cigarette, e-cigarette, and opioid use), and obesity with GPA.

Results showed a significant positive relationship between health

behaviors and grade average. Students who met health recommendations

for fruit and vegetable consumption, moderate activity, and vigorous

physical activity had higher grade averages. Conversely, those who used

cigarettes, opioids, or were obese had lower grade averages.

The result of the study of Anachuna (2024), analyzed the health and

welfare practices of principals in public and private secondary schools in

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Anambra state. The study, conducted with 657 principals in Anambra

state, found that private secondary school principals in the state adopt and

engage more in students' health management practices than public

counterparts. The findings suggest that physical and health education

teachers in public secondary schools should be encouraged to increase

their commitment to instilling a positive health awareness attitude in their

students to reduce disease incidence. The study underscores the

importance of improving students' health and welfare in education.

Leroy et al (2016) found that children and adolescents with chronic

health conditions (CHCs) face lower academic achievement, increased

disability, fewer job opportunities, and limited community interactions as

they enter adulthood. School health services provide safe and effective

management of CHCs, often for students with limited access to healthcare.

A systematic review found that direct access to school nursing and health

services, as well as disease-specific education, improved health and

academic outcomes among students with CHCs.

Wang et al (2023) highlighted the importance of digital health

management based on the Internet of Things (IoT) to eliminate human

errors and aid doctors in making more accurate diagnoses. This article

reviews the latest advancements in digital health management using multi-

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modal signal monitoring, focusing on lower-limb data collection, statistical

analysis, and rehabilitation via digital health management.

The result of the study of Kalimaposo et. al (2023) studies the

discuss the gains, pains, and gain-challenges in safety and health

management in schools. According to the authors, concerns and demands

for maintaining healthy working and learning environment that adequately

address the needs of learners and staff respectively will enhance

performance, attendance rates and overall mental and physical well-being

of learners and staff. Nonetheless, they describe some disadvantages

which include no funding, poor research involvement, no accessories,

safety without privacy, mental health disorders and no practice.

The result of the study of Choliq et. al (2023), it examines the

management of special health services in Nurul Qarnain Islamic Boarding

School in Indonesia. The research uses qualitative methods, including

interviews, document reviews, and observation, to understand the

application of special health service management in Islamic boarding

schools. The study identifies challenges in human resources, facilities,

health information media, implementation, supervision, evaluation, and

health post management. The study recommends improved human

resources, infrastructure, and communication between Islamic boarding

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schools and Community Health Centers for integrated health care,

focusing on promotive, preventive, curative, and rehabilitative care.

Minkkinen et. al (2017) studies investigate the relationship between

school health and academic achievement among Finnish adolescents,

emphasizing the impact of both individual and classmates' health on

educational outcomes. It highlights that externalizing problems in the

classroom negatively affect learning and academic performance,

suggesting that a positive social and emotional climate is essential for

student success. The findings advocate for a collaborative approach to

health and education, indicating that school health initiatives can

significantly influence students' potential for academic achievement and

access to further education.

Hussain et. al (2015) study aimed to evaluate the health education

needs of elementary school students in Pakistan, utilizing a mixed-

methods approach that included both quantitative and qualitative data

collection. A total of 400 students participated, with an 82% response rate,

revealing that while 68% were aware of health education concepts, they

lacked detailed knowledge. The findings highlighted a significant interest

among students in various health topics, including disease awareness and

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hygiene, indicating the necessity for a comprehensive health education

program to enhance their understanding and well-being.

Synthesis

The study shows similarities between health and academic

performance, that highlights the importance of healthy behaviors for

student success. Beane (2020) found that students who engage in regular

physical activity, strength training, and eat nutritious foods like fruits and

vegetables tend to have higher GPAs. On the other hand, unhealthy habits

such as smoking, using opioids, and being obese are linked to lower

grades. This suggests that maintaining good health can boost academic

performance. Shaw et al. (2015) also said that compared to their healthier

counterparts, children in poorer health have more school difficulties, such

as failing or dropping out of school. A healthy weight, regular exercise, and

a good diet are necessary for academic achievement. However, many

students are finding it challenging to succeed academically due to the

increased incidence of childhood obesity and decreased physical fitness.

Academic success and health can have a complicated relationship

because of the ways that culture, gender, and socioeconomic status affect

results. These findings were similar to study of Minkkinen et al. (2017),

who demonstrated that ill health might have a detrimental effect on

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academic performance on an individual and peer level. Student

achievement depends on a happy and encouraging school climate,

confirming the notion that schools must address health and education.

Overall, this study is similar to each since they tackle about the

effects of health management to the academic performance of students. It

shows the that having good health management will significantly improve

the student’s performance and will avoid some issues to their education.

Definition of Terms

The following terms were used in this study:

Academic Goals. According to Spacey (2024), this are targets that

an individual sets for their education. In this study, it is what students want

to achieve in school.

Academic Performance. According to Kumar et.al (2021),

academic performance is the knowledge gained by the student which is

assessed by marks by a teacher and/or educational goals set by students

and teachers to be achieved over a specific period. In this study, it is how

students perform for different activities.

Challenges. Horikoshi (2023) suggests that challenges are a

natural part of life for most people and are highlighted in times of rapid
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change and global issues. In this study, it is the struggles that students

face in school.

Health Education. According to Hassan (2024), health education

is /the profession of educating people to make an informed decision. In this

study, it is teaching students to have a better understanding of their health.

Health Management. According to Petković (2019), health

management is considered as an important area of public health skills and

as such, it covers three key areas of health management: people

management, planning and resource management. In this study, it is about

how students manage their health.

Study Habits. According to Drew (2023), Study habits refer to

consistent practices and approaches to study that enhance academic

performance. Good study habits include finding a quiet location to study

and taking breaks. In this study, it is the students’ way of studying to

improve their academic performance.

Conceptual Framework

This part shows the conceptual paradigm using input-Process-

Output model by Tyler to describe the outline of the study and to know the
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correlation between health management and students’ performance of

Grade 11 students.

INPUT PROCESS OUTPUT

1.) The relationship

between the health
management and
Students Profile Administration academic
performance students
Questionnaire of 2.) Design of Low-Cost
Pill Organizer with
Questionnaire Reminders for
enhancing the health
management and
improve students’
academic
performance.

Figure 1

Research Paradigm of the Study

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In the IPO model, a process is viewed as a series of boxes

(processing elements) connected by inputs and outputs.

The IPO model provided the general structure and guide for the

direction of the study substituting the variables of this study on the IPO

model. The research paradigm of the study is shown in Figure 1.

The paradigm identifies the input process and output of the study.

The first box shows the input that discusses the student's profiles that will

be needed when doing the survey for the study. The survey will be done

through giving questionnaires to every respondent.

The second box includes the process which is the administration of

questionnaires. The questionnaires will be administered after the analysis

on the student's profile. The pupils will need to provide accurate responses

to the questions on the questionnaires to remove any doubts. Analyses of

questionnaires and each student's responses will be performed as part of

the documentation.
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The third box shows the output. In this part, it shows the design of

Low-Cost Pill Organizer with Reminders for enhancing the health

management and improve students’ academic performance.