In 1994, an Institute of Medicine committee was convened to study comprehensive school health programs (CSHPs) in grades K-12 and to make recommendations for national, state, and local actions. The background of the study, issues considered by the committee, and an overview of CSHPs are discussed in the first two chapters of this report. The remainder of the report discusses the four topics of school health that the committee examined in depth: education, services, infrastructure, and research and evaluation. Based on research on physical and health education, the committee recommends that: (1) all students receive sequential, age-appropriate health education every year during the elementary and middle or junior high grades; (2) a one-semester high-quality health education course at the secondary level become a requirement for high school graduation; and (3) all elementary teachers receive preparation in health education content and methodology during their preservice training. Based on research on services, the committee recommends that: (1) school health services be formally planned, and their quality be continuously monitored; (2) research be conducted on school-based services; (3) confidentiality of health records be given high priority; and (4) established sources of funding for school health services continue from both public health and education funds, and new approaches be developed. Based on research on CSHP infrastructure, the committee recommends that: (1) the mission of the federal Interagency Committee on School Health be revitalized, with the help of an official advisory committee and participation of individual National Coordinating Committee on School Health member organizations at the state and local levels; (2) a formal organization with broad representation be established in every school district; (3) individual schools establish a school health committee and appoint a coordinator to oversee the school health program; and (4) to implement high-quality CSHPs, the training and utilization of competent, properly prepared personnel be expanded. Recommendations for research and evaluation of CSHPs include the following: (1) pursuing an active research agenda on CSHPs to fill critical knowledge gaps, with increased emphasis on basic research and outcome evaluation and on dissemination of these findings; (2) launching a major research effort to establish model comprehensive programs and to develop approaches to their study; and (3) studying further each of the individual components of a CSHP. Nine appendices include guidelines for CSHPs and federal funding streams for CSHPs. (LPP)