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Orenstein S, Yarnell J, Connors E, Bohnenkamp J, Hoover S, Lever N. The State School Mental Health Profile: Findings from 25 States. J Sch Health 2024; 94:443-452. [PMID: 38321623 DOI: 10.1111/josh.13442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND State-level leadership and conditions are instrumental to local and regional comprehensive school mental health system (CSMHS) quality, sustainability, and growth. However, systematic documentation of state-level school mental health (SMH) policy, infrastructure, funding, and practice is limited. METHODS Using a multi-phase, multi-method process, we developed the State School Mental Health Profile (State Profile) to offer a comprehensive landscape of state SMH efforts. State leaders in 25 states completed the State Profile once over a 3-year data collection period. Mixed methods results are reported in 8 domains. RESULTS State education agencies were reportedly most involved in SMH technical assistance, advocacy, leadership, funding, and service provision, with mental health agencies reported as second most involved. Nearly half of state respondents reported having a state-level SMH director or coordinator. Policies with the greatest perceived impact require implementation of and funding for SMH services and supports. Despite leveraging multiple sources of funding, most states emphasized lack of funding as a primary barrier to establishing CSMHSs. All states reported staffing shortages. CONCLUSION The State Profile can assist multi-agency state leadership teams to self-assess policy, infrastructure, and resources to support CSMHSs statewide. Findings point to areas of opportunity to advance equity across resource allocation, service provision, and policy development.
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Affiliation(s)
- Shawn Orenstein
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201
| | - Jordy Yarnell
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201
| | - Elizabeth Connors
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201
- Department of Psychiatry, Yale University, 389 Whitney Avenue, Office 106, New Haven, CT, 06511
| | - Jill Bohnenkamp
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201
| | - Sharon Hoover
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201
| | - Nancy Lever
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201
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Ruff RR, Barry Godín TJ, Whittemore R, Murray Small T, Santiago-Galvin N, Sharma P. Unmet Dental Needs in Children Following Suspension of School-Based Oral Health Services Due to COVID-19. J Sch Health 2024; 94:427-432. [PMID: 38234044 DOI: 10.1111/josh.13433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 11/17/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Dental caries (tooth decay) is the world's most prevalent noncommunicable disease and can lead to pain, infection, and edentulism. Many children with caries lack access to traditional dental services. School-based caries prevention can increase access to care and reduce health inequities. Disruptions in school-based care due to pandemic control policies may result in children losing access to their primary dental care option. METHODS The CariedAway project was a school-based caries prevention program in operation from 2019 to 2023 in urban schools with a high proportion of low-income, minority students. Program operations were suspended for 2 years due to the COVID-19 pandemic. We estimated the prevalence of untreated decay, swelling, fistula, and pulpal involvement in participants at baseline and again after restrictions were lifted. RESULTS A total of 2998 children between the ages of 5 and 13 years were enrolled and received preventive care prior to pandemic shutdowns, and 1398 (47%) completed a follow-up observation after 2 years. At baseline, approximately 30% had untreated caries on any dentition, 11% of children presented with evidence of dental sealants, and no participants had swelling, fistula, or pulpal involvement. After 24 months, 12% of participants had swelling fistula, or pulpal involvement that was not treated during the pandemic period. CONCLUSION There are considerable unmet dental needs in high-risk children that may be further exacerbated by a lack of access to care during disease outbreaks.
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Affiliation(s)
- Ryan R Ruff
- New York University College of Dentistry, New York, NY, USA
- New York University School of Global Public Health, New York, NY
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Abstract
Schools' health screenings can identify students' missed health concerns. Data from the 2016 School Health Policies and Practices Study were used to determine the proportion of U.S. school districts with physical and mental health screening policies and the proportion that arrange off-campus mental health services. We also examined differences between districts with and without mental health screening policies regarding having physical health screening policies, patterns of these policies, and off-campus mental health service arrangements. Eleven percent of districts had no policies on any of the four physical health screenings assessed, and 87% lacked policies on mental health screenings, the latter especially concerning considering the impact of COVID-19. Districts with policies on mental health screenings were significantly more likely to have body mass index (p < .01) and oral health (p < .001) screening policies, and to arrange for off-campus case management (p < .001), family counseling (p < .05), group counseling (p < .01), self-help (p < .05) and intake evaluation (p < .05).
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Affiliation(s)
- Ellen M McCabe
- Hunter Bellevue School of Nursing, Hunter College, New York, NY, USA
| | - Beth E Jameson
- Seton Hall University College of Nursing, Nutley, NJ, USA
| | - Shiela M Strauss
- Hunter Bellevue School of Nursing, Hunter College, New York, NY, USA
- New York University, Rory Meyers College of Nursing, New York, NY, USA
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Creel LM, Feygin YB, Shipley M, Davis DW, Cole Hall T, Downs C, Hoskins S, Pasquenza N, Duncan SD. A case study on variations in network structure and cross-sector alignment in two local systems serving pregnant and parenting women in recovery. Health Serv Res 2024; 59 Suppl 1:e14251. [PMID: 37848179 PMCID: PMC10796293 DOI: 10.1111/1475-6773.14251] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE To describe network structure and alignment across organizations in healthcare, public health, and social services sectors that serve pregnant and parenting women with substance use disorder (SUD) in an urban and a rural community. DATA SOURCES AND STUDY SETTINGS Two community networks, one urban and one rural with each including a residential substance use treatment program, in Kentucky during 2021. STUDY DESIGN Social network analysis measured system collaboration and cross-sector alignment between healthcare, public health, and social services organizations, applying the Framework for Aligning Sectors. To understand the alignment and structure of each network, we measured network density overall and between sectors, network centralization, and each organization's degree centrality and effective size. DATA COLLECTION/EXTRACTION METHODS Computer-assisted telephone interviews were conducted to document alignment around shared purpose, data, financing, and governance. PRINCIPAL FINDINGS On average, overall and cross-sector network densities in both communities were similar. However, alignment was highest for data sharing and financing in the urban community and for shared purpose and governance in the rural community. Cross-sector partnerships involving healthcare organizations were more prevalent in the rural county (44% vs. 38% for healthcare/public health, 44% vs. 29% for healthcare/social services), but more prevalent for those involving public health/social services organizations in the urban county (42% vs. 24%). A single healthcare organization had the highest degree centrality (Mdn [IQR] = 26 [26-9.5]) and effective size (Mdn [IQR] = 15.9 [20.6-8.7]) within the rural county. Social services organizations held more central positions in the urban county (degree centrality Mdn [IQR] = 13 [14.8-9.5]; effective size Mdn [IQR] = 10.4 [11.4-7.9]). CONCLUSIONS Cross-sector alignment may strengthen local capacity for comprehensive SUD care for pregnant and parenting women. Healthcare organizations are key players in cross-sector partnerships in the rural community, where one healthcare facility holds the central brokerage role. In contrast, public health agencies are key to cross-sector collaboration with social services in the urban community.
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Affiliation(s)
- Liza M. Creel
- Division of Health Care Policy and Research, Department of Medicine, School of MedicineUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Yana B. Feygin
- Norton Children's Research Institute affiliated with the University of Louisville School of MedicineUniversity of Louisville School of MedicineLouisvilleKentuckyUSA
| | - Madeline Shipley
- Scientific and Health Policy InitiativesISPOR – The Professional Society for Health Economics and Outcomes ResearchLawrencevilleNew JerseyUSA
| | - Deborah W. Davis
- Norton Children's Research Institute affiliated with the University of Louisville School of MedicineUniversity of Louisville School of MedicineLouisvilleKentuckyUSA
| | | | - Chaly Downs
- Addition Recovery ServicesVolunteers of America, Mid‐StatesLouisvilleKentuckyUSA
| | - Stephanie Hoskins
- Addition Recovery ServicesVolunteers of America, Mid‐StatesLouisvilleKentuckyUSA
| | - Natalie Pasquenza
- External RelationsVolunteers of America, Mid‐StatesLouisvilleKentuckyUSA
| | - Scott D. Duncan
- Division of Neonatal Medicine, Department of Pediatrics, School of MedicineUniversity of LouisvilleLouisvilleKentuckyUSA
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Fuji KT, White ND, Packard KA, Kalkowski JC, Walters RW. Effect of a Financial Education and Coaching Program for Low-Income, Single Mother Households on Child Health Outcomes. Healthcare (Basel) 2024; 12:127. [PMID: 38255016 PMCID: PMC10815544 DOI: 10.3390/healthcare12020127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 12/23/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
The financial difficulties of parents have a negative impact on the health of their children. This problem is more pronounced in single mother families. There is limited research on low-income, single mothers and how interventions to help them address financial difficulties may also benefit their children. The purpose of this study was to evaluate the effect of a year-long financial education and coaching program on school absenteeism and health care utilization of children in employed, low-income, single mother households. This was a post hoc analysis of the Finances First study, a randomized controlled trial conducted in 2017-2020 examining the impact of a financial coaching and education program on economic stability and health outcomes in 345 low-income, single mothers. Either generalized estimating equations (GEEs) or generalized linear mixed models (GLMMs) were used to account for relationships between participants. For the continuous outcomes of child absenteeism, physician visits, emergency room visits, and hospitalization days, a linear mixed-effects model was used. The Finances First study demonstrated improvements in various financial strain measures. Compared to the control group, children of intervention group participants experienced 1 fewer day of school absence (p = 0.049) and 1 fewer physician visit (p = 0.032) per year, but no impact was seen on emergency room visits (p = 0.55) or hospitalizations (p = 0.92). Addressing social determinants of health in parents is necessary for improving child health outcomes.
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Affiliation(s)
- Kevin T. Fuji
- Department of Pharmacy Sciences, School of Pharmacy and Health Professions, Creighton University, Omaha, NE 68178, USA
| | - Nicole D. White
- Department of Pharmacy Practice, School of Pharmacy and Health Professions, Creighton University, Omaha, NE 68178, USA
| | - Kathleen A. Packard
- Department of Pharmacy Practice, School of Pharmacy and Health Professions, Creighton University, Omaha, NE 68178, USA
| | - Julie C. Kalkowski
- Financial Hope Collaborative, Heider College of Business, Creighton University, Omaha, NE 68178, USA
| | - Ryan W. Walters
- Department of Clinical Research and Public Health, School of Medicine, Creighton University, Omaha, NE 68178, USA
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Hwang G. The impact of access to prenatal health insurance for noncitizen women on child health. Health Serv Res 2023; 58:1066-1076. [PMID: 37438931 PMCID: PMC10480078 DOI: 10.1111/1475-6773.14198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVE To estimate the effects of prenatal public health insurance targeting noncitizens on the health of U.S.-born children of noncitizen mothers beyond birth outcomes. DATA SOURCES AND STUDY SETTING This paper uses the restricted version of the 1998-2014 National Health Interview Survey with state-level geographic identifiers. STUDY DESIGN The empirical strategy compares outcomes in states that adopted the Children's Health Insurance Plan (CHIP) Unborn Child Option with states that never adopted or adopted it at different times, controlling for differences in the pre-treatment period. I use a flexible event-study analysis to quantify the effects of the Unborn Child Option on noncitizen women's health insurance coverage, health care utilization, and their children's health. DATA COLLECTION/EXTRACTION METHODS All data are derived from pre-existing sources. PRINCIPAL FINDINGS The study finds that the impact of the Unborn Child Option is a 4.7%-point increase in public health insurance coverage (p < 0.01) and 0.48 more doctor's office visits (p < 0.1) annually among noncitizens of childbearing ages. Subsequently, the reform leads to a 7%-point rise in the rate of parents reporting their 4-6-year-old children are in "excellent" or "very good" health (p < 0.01). While no improvements are evident at birth and at younger ages, observed health improvements begin to appear by preschool age. CONCLUSIONS The study contributes to the literature by providing evidence that certain benefits of in-utero public health insurance targeting noncitizens may appear several years after birth, specifically around preschool age.
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Affiliation(s)
- Grace Hwang
- Health Analysis DivisionCongressional Budget OfficeWashingtonDCUSA
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Polsky JY, Garriguet D. The local restaurant environment in relation to eating out and sugary drink intake among Canadian children and youth. Health Rep 2023; 34:3-15. [PMID: 37647458 DOI: 10.25318/82-003-x202300800001-eng] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Background Accessibility of food retail in communities may play a role in shaping the food choices of local residents. However, previous studies have shown mixed results. This study examined associations between the local restaurant environment and the frequency of eating food from restaurants and intake of sugary drinks among Canadian children and youth. Data and methods The study cohort consisted of 23,776 participants (aged 1 to 17 years) in the 2019 Canadian Health Survey on Children and Youth who resided in large urban population centres across the Canadian provinces. Measures of geographic access to various restaurant types within walking distance of participants' residential areas came from the 2018 Canadian Food Environment Dataset. Poisson regression models with robust standard errors assessed associations between measures of absolute densities (number per km²) of full-service, fast-food and other restaurants, and the relative density of fast-food restaurants (as a percentage of total restaurants) with the frequency of eating food from fast-food or full-service restaurants and sugary drink intake in the previous seven days. Results After adjustment for a range of sociodemographic covariates, there were no consistent associations between absolute and relative measures of restaurant access and the frequency of eating food from restaurants or intake of sugary drinks. Interpretation Results reveal no consistent relationships between local restaurant exposures and the frequency of eating food from restaurants or sugary drink intake among Canadian children and youth. Efforts to create environments that foster healthy food choices among young people will remain important but will likely need to target multiple activity spaces beyond the local neighbourhood.
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Azzolina D, Bressan S, Lorenzoni G, Baldan GA, Bartolotta P, Scognamiglio F, Francavilla A, Lanera C, Da Dalt L, Gregori D. Pediatric Injury Surveillance From Uncoded Emergency Department Admission Records in Italy: Machine Learning-Based Text-Mining Approach. JMIR Public Health Surveill 2023; 9:e44467. [PMID: 37436799 PMCID: PMC10372563 DOI: 10.2196/44467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/07/2023] [Accepted: 03/23/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Unintentional injury is the leading cause of death in young children. Emergency department (ED) diagnoses are a useful source of information for injury epidemiological surveillance purposes. However, ED data collection systems often use free-text fields to report patient diagnoses. Machine learning techniques (MLTs) are powerful tools for automatic text classification. The MLT system is useful to improve injury surveillance by speeding up the manual free-text coding tasks of ED diagnoses. OBJECTIVE This research aims to develop a tool for automatic free-text classification of ED diagnoses to automatically identify injury cases. The automatic classification system also serves for epidemiological purposes to identify the burden of pediatric injuries in Padua, a large province in the Veneto region in the Northeast Italy. METHODS The study includes 283,468 pediatric admissions between 2007 and 2018 to the Padova University Hospital ED, a large referral center in Northern Italy. Each record reports a diagnosis by free text. The records are standard tools for reporting patient diagnoses. An expert pediatrician manually classified a randomly extracted sample of approximately 40,000 diagnoses. This study sample served as the gold standard to train an MLT classifier. After preprocessing, a document-term matrix was created. The machine learning classifiers, including decision tree, random forest, gradient boosting method (GBM), and support vector machine (SVM), were tuned by 4-fold cross-validation. The injury diagnoses were classified into 3 hierarchical classification tasks, as follows: injury versus noninjury (task A), intentional versus unintentional injury (task B), and type of unintentional injury (task C), according to the World Health Organization classification of injuries. RESULTS The SVM classifier achieved the highest performance accuracy (94.14%) in classifying injury versus noninjury cases (task A). The GBM method produced the best results (92% accuracy) for the unintentional and intentional injury classification task (task B). The highest accuracy for the unintentional injury subclassification (task C) was achieved by the SVM classifier. The SVM, random forest, and GBM algorithms performed similarly against the gold standard across different tasks. CONCLUSIONS This study shows that MLTs are promising techniques for improving epidemiological surveillance, allowing for the automatic classification of pediatric ED free-text diagnoses. The MLTs revealed a suitable classification performance, especially for general injuries and intentional injury classification. This automatic classification could facilitate the epidemiological surveillance of pediatric injuries by also reducing the health professionals' efforts in manually classifying diagnoses for research purposes.
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Affiliation(s)
- Danila Azzolina
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | - Silvia Bressan
- Department of Women's and Children's Health, University of Padova, Padua, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy
| | - Giulia Andrea Baldan
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy
| | - Patrizia Bartolotta
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy
| | - Federico Scognamiglio
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy
| | - Andrea Francavilla
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy
| | - Corrado Lanera
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy
| | - Liviana Da Dalt
- Department of Women's and Children's Health, University of Padova, Padua, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy
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Lárez NA, Sharkey JD, Frattaroli S, Avila E, Medina A. Implementing youth participatory action research at a continuation high school. Health Serv Res 2023. [PMID: 37282759 DOI: 10.1111/1475-6773.14190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE To describe the process of implementing a Youth Participatory Action Research (YPAR) project at a continuation high school (CHS) and share the results of a youth-designed research project that explores barriers to high school completion. DATA SOURCES AND STUDY SETTING YPAR was implemented across three cohorts at a CHS in the central coast of California from 2019 to 2022. Student survey respondents were enrolled CHS students between March and April 2021. STUDY DESIGN A modified YPAR curriculum integrating research methodology and social justice topics was used to guide student-led research that resulted in a cross-sectional survey. DATA COLLECTION Field notes maintained by the first author documented the process of implementing YPAR including the curriculum, conversations, and research decisions and procedures. A student-designed survey disseminated to all enrolled students resulted in 76 (66%) participant responses. The survey included 18 close-ended questions and three narrative responses. PRINCIPAL FINDINGS This study details how YPAR methodologies can be translated to a high school credit recovery program. For example, student cohorts were needed to maintain continuity over time. A student-designed survey revealed that 72% of student respondents reported taking care of family members and illuminated high rates of depression symptoms. CONCLUSIONS This study offers a detailed description of how we implemented YPAR at a credit recovery program and provides student-driven perspectives on educational reform and evaluation. This project addresses the implementation and challenges of using YPAR to engage youth in transformational resistance to rapidly study and improve CHS' policy and practice.
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Affiliation(s)
- Natalie A Lárez
- Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, California, USA
| | - Jill D Sharkey
- Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, California, USA
| | - Shannon Frattaroli
- Health Policy Research Scholars Program National Program Center, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Elena Avila
- Youth Student Researchers from the Continuation High School, Santa Barbara, California, USA
| | - Andres Medina
- Youth Student Researchers from the Continuation High School, Santa Barbara, California, USA
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Hasson RE, Eisman AB, Wassmann A, Beemer LR, Templin T, Malinoff L, Zernicke R, Rabaut L. Aligning Organizational Priorities and System Policies to Support Implementation Scale-Up of a Tailored Classroom-Based Physical Activity Intervention in Low-Resource Schools. J Sch Health 2023; 93:464-474. [PMID: 36918350 DOI: 10.1111/josh.13321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 02/07/2023] [Accepted: 02/12/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND A mismatch between organizational priorities and system-level policies can negatively impact implementation and sustainment of classroom-based physical activity (PA) interventions. The purpose of this study was twofold: (1) present methods to systematically identify organization- and system-level implementation barriers, and (2) align organizational priorities and system policies by designing multi-level implementation strategies. This alignment will support implementation scale-up of a tailored PA intervention in one low-resource intermediate school district (ISD; 16 districts, 32 schools) in central Michigan. METHODS Multi-level assessments of organizational readiness were conducted using the Hexagon Discussion and Analysis Tool to assess intervention-context fit, the Wellness School Assessment Tool 3.0 to evaluate district PA policy strength and comprehensiveness, and semi-structured interviews were conducted to assess administrative support and priorities related to PA programming. RESULTS Our assessments revealed three implementation barriers: limited structural capacity to sustain teacher training, limited resources across districts and school buildings to support teachers, and misalignment of ISD and district PA policies and priorities. CONCLUSIONS Greater attention to organizational capacity and existing infrastructure should be considered a priori to support effective implementation and sustainment of PA interventions in low-resource schools.
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Affiliation(s)
- Rebecca E Hasson
- University of Michigan School of Kinesiology, Ann Arbor, MI 48109; University of Michigan Exercise & Sports Science Initiative, Ann Arbor, MI 48109
| | - Andria B Eisman
- Wayne State University College of Education, Detroit, MI 48202; Wayne State Center for Health and Community Impact, Detroit, MI 48202
| | - Amy Wassmann
- Saginaw Intermediate School District, Saginaw, MI 48603
| | - Lexie R Beemer
- University of Michigan School of Kinesiology, Ann Arbor, MI 48109
| | - Thomas Templin
- University of Michigan School of Kinesiology, Ann Arbor, MI 48109
| | | | - Ronald Zernicke
- University of Michigan School of Kinesiology, Ann Arbor, MI 48109; University of Michigan Exercise & Sports Science Initiative, Ann Arbor, MI 48109
| | - Lisa Rabaut
- University of Michigan Exercise & Sports Science Initiative, Ann Arbor, MI 48109
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11
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Smith LB, O'Brien C, Kenney GM, Tabb LP, Verdeflor A, Wei K, Lynch V, Waidmann T. Racialized economic segregation and potentially preventable hospitalizations among Medicaid/CHIP-enrolled children. Health Serv Res 2023; 58:599-611. [PMID: 36527452 PMCID: PMC10154153 DOI: 10.1111/1475-6773.14120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To examine geographic variation in preventable hospitalizations among Medicaid/CHIP-enrolled children and to test the association between preventable hospitalizations and a novel measure of racialized economic segregation, which captures residential segregation within ZIP codes based on race and income simultaneously. DATA SOURCES We supplement claims and enrollment data from the Transformed Medicaid Statistical Information System (T-MSIS) representing over 12 million Medicaid/CHIP enrollees in 24 states with data from the Public Health Disparities Geocoding Project measuring racialized economic segregation. STUDY DESIGN We measure preventable hospitalizations by ZIP code among children. We use logistic regression to estimate the association between ZIP code-level measures of racialized economic segregation and preventable hospitalizations, controlling for sex, age, rurality, eligibility group, managed care plan type, and state. DATA EXTRACTION METHODS We include children ages 0-17 continuously enrolled in Medicaid/CHIP throughout 2018. We use validated algorithms to identify preventable hospitalizations, which account for characteristics of the pediatric population and exclude children with certain underlying conditions. PRINCIPAL FINDINGS Preventable hospitalizations vary substantially across ZIP codes, and a quarter of ZIP codes have rates exceeding 150 hospitalizations per 100,000 Medicaid-enrolled children per year. Preventable hospitalization rates vary significantly by level of racialized economic segregation: children living in the ZIP codes that have the highest concentration of low-income, non-Hispanic Black residents have adjusted rates of 181 per 100,000 children, compared to 110 per 100,000 for children in ZIP codes that have the highest concentration of high-income, non-Hispanic white residents (p < 0.01). This pattern is driven by asthma-related preventable hospitalizations. CONCLUSIONS Medicaid-enrolled children's risk of preventable hospitalizations depends on where they live, and children in economically and racially segregated neighborhoods-specifically those with higher concentrations of low-income, non-Hispanic Black residents-are at particularly high risk. It will be important to identify and implement Medicaid/CHIP and other policies that increase access to high-quality preventive care and that address structural drivers of children's health inequities.
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Affiliation(s)
| | | | | | - Loni Philip Tabb
- Drexel UniversityDornsife School of Public HealthPhiladelphiaPennsylvaniaUSA
| | | | - Keqin Wei
- Health Policy CenterUrban InstituteWashingtonDCUSA
- Urban InstituteOffice of Technology and Data ScienceWashingtonDCUSA
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Mallinson DC, Elwert F, Ehrenthal DB. Spillover Effects of Prenatal Care Coordination on Older Siblings Beyond the Mother-Infant Dyad. Med Care 2023; 61:206-215. [PMID: 36893405 PMCID: PMC10009763 DOI: 10.1097/mlr.0000000000001822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
BACKGROUND Pregnancy care coordination increases preventive care receipt for mothers and infants. Whether such services affect other family members' health care is unknown. OBJECTIVE To estimate the spillover effect of maternal exposure to Wisconsin Medicaid's Prenatal Care Coordination (PNCC) program during pregnancy with a younger sibling on the preventive care receipt for an older child. RESEARCH DESIGN Gain-score regressions-a sibling fixed effects strategy-estimated spillover effects while controlling for unobserved family-level confounders. SUBJECTS Data came from a longitudinal cohort of linked Wisconsin birth records and Medicaid claims. We sampled 21,332 sibling pairs (one older; one younger) who were born during 2008-2015, who were <4 years apart in age, and whose births were Medicaid-covered. In all, 4773 (22.4%) mothers received PNCC during pregnancy with the younger sibling. MEASURES The exposure was maternal PNCC receipt during pregnancy with the younger sibling (none; any). The outcome was the older sibling's number of preventive care visits or preventive care services in the younger sibling's first year of life. RESULTS Overall, maternal exposure to PNCC during pregnancy with the younger sibling did not affect older siblings' preventive care. However, among siblings who were 3 to <4 years apart in age, there was a positive spillover on the older sibling's receipt of care by 0.26 visits (95% CI: 0.11, 0.40 visits) and by 0.34 services (95% CI: 0.12, 0.55 services). CONCLUSION PNCC may only have spillover effects on siblings' preventive care in selected subpopulations but not in the broader population of Wisconsin families.
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Affiliation(s)
- David C. Mallinson
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, United States
| | - Felix Elwert
- Department of Sociology, College of Letters and Sciences, University of Wisconsin-Madison, United States
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, United States
- Center for Demography and Ecology, University of Wisconsin-Madison, United States
| | - Deborah B. Ehrenthal
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania, United States
- Social Science Research Institute, Pennsylvania State University, University Park, Pennsylvania, United States
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Voss S, Coenen M, Hummel J, Jung-Sievers C, Zu Rhein V, Rehfuess E. Einflussfaktoren beim Aufbau von Präventionsketten in Neubaugebieten am Beispiel des Münchner Stadtteils Freiham – eine qualitative Studie. Präv Gesundheitsf 2022. [PMCID: PMC9744050 DOI: 10.1007/s11553-022-01001-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Einleitung Präventionsketten sind integrierte kommunale Strategien zur Förderung von Gesundheit und sozialer Teilhabe von Kindern, Jugendlichen und Familien sowie zur Vermeidung der Folgen von Kinderarmut. Sie sind als intersektorale Netzwerke in mehreren Kommunen in Deutschland etabliert. Der Aufbau von Präventionsketten in Neubaugebieten wurde bislang noch nicht systematisch erforscht. Im Rahmen der Prozessevaluation zur Präventionskette Freiham, die in dem sich derzeit im Bau befindlichen gleichnamigen Münchner Stadtteil implementiert wird, wurde eine qualitative Interview- und Fokusgruppenstudie durchgeführt. Das Ziel war, relevante Einflussfaktoren für den Aufbau von Präventionsketten in einem neu entstehenden Stadtteil zu identifizieren. Methoden Für die Studie wurden wiederholt Interviews mit dem Netzwerkwerkmanagement der Präventionskette Freiham durchgeführt sowie eine Fokusgruppe mit Vertreter*innen der beteiligten städtischen Referate. Zudem fanden Interviews mit 12 lokalen Fachkräften aus den Sektoren Bildung, Soziales und Gesundheit statt. Die Auswertung erfolgte mit der Methode der qualitativen Inhaltsanalyse in Anlehnung an Mayring. Ergebnisse Wichtige Einflussfaktoren für eine gelingende Implementierung stellten aus Sicht der Teilnehmer*innen die Ausstattung mit finanziellen und personellen Ressourcen sowie die Unterstützung durch die kommunale Politik und Verwaltungsspitzen dar. Für eine erfolgreiche Arbeit im Netzwerk waren die zentrale Netzwerkkoordination, eine transparente Kommunikation, die Integration der unterschiedlichen Interessen der Akteur*innen und die Vermittlung eines Mehrwerts des Engagements entscheidend. Eine spezifische Herausforderung für das Setting eines Neubaugebiets war der Aufbau von bedarfs- und zielgruppenorientierten Netzwerkstrukturen angesichts einer zunächst geringen Anzahl an Bewohner*innen und noch nicht etablierter Unterstützungsstrukturen. Schlussfolgerung Ausreichende Finanzierung und Rückhalt in Politik und Verwaltung sind zentrale Einflussfaktoren für die Implementierung einer Präventionskette in Kommunen. Insbesondere in Neubaugebieten ohne gewachsene Infrastruktur erfordert der Aufbauprozess eine langfristig angelegte Unterstützung.
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Affiliation(s)
- Stephan Voss
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie – IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377 München, Deutschland ,Pettenkofer School of Public Health, München, Deutschland
| | - Michaela Coenen
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie – IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377 München, Deutschland ,Pettenkofer School of Public Health, München, Deutschland
| | - Julia Hummel
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie – IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377 München, Deutschland ,Pettenkofer School of Public Health, München, Deutschland
| | - Caroline Jung-Sievers
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie – IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377 München, Deutschland ,Pettenkofer School of Public Health, München, Deutschland
| | - Valerie Zu Rhein
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie – IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377 München, Deutschland ,Pettenkofer School of Public Health, München, Deutschland
| | - Eva Rehfuess
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie – IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377 München, Deutschland ,Pettenkofer School of Public Health, München, Deutschland
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14
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Plummer RS, Alter Z, Lee RM, Gordon AR, Cory H, Brion-Meisels G, Reiner J, Topping K, Kenney EL. "It's Not the Stereotypical 80s Movie Bullying": A Qualitative Study on the High School Environment, Body Image, and Weight Stigma. J Sch Health 2022; 92:1165-1176. [PMID: 35702896 PMCID: PMC10137145 DOI: 10.1111/josh.13203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/09/2022] [Accepted: 04/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Schools are crucial for preventing negative health outcomes in youth and are an ideal setting to address weight stigma and poor body image. The current study sought to examine and describe the nature of weight stigma and body image in adolescents, ascertain aspects of the school environment that affect body image, and identify recommendations for schools. METHODS We conducted 24 semi-structured interviews with students at 2 high schools in 2020. Qualitative data were analyzed using inductive coding and an immersion/crystallization approach. RESULTS Students did not report weight discrimination or harmful body image messaging from teachers or administrators. Physical education (PE) class and dress codes were 2 instances where covert weight stigma appeared. The most common forms of peer weight stigma reported were weight-based teasing and self-directed appearance critiques. Students recommended that schools eliminate dress codes, diversify PE activities, address body image issues in school, and be cognizant of teasing within friend groups. CONCLUSIONS Weight stigma presents itself in unique ways in high school settings. Schools can play a role in reducing experiences of weight stigma and negative body image. Weight-related teasing within friend groups was common and may not be captured in traditional assessments of bullying. More nuanced survey instruments may be needed.
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Affiliation(s)
- Rachel S. Plummer
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115
| | - Zanny Alter
- Harvard Graduate School of Education, 13 Appian Way, Cambridge, MA, 02138
| | - Rebekka M. Lee
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115
| | - Allegra R. Gordon
- Department of Community Health Sciences, Boston University School of Public Health, 715AlbanySt, Boston, MA, 02118; Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115
| | - Hannah Cory
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115
| | | | - Jennifer Reiner
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115
| | - Kimm Topping
- Harvard Graduate School of Education, 13 AppianWay, Cambridge, MA, 02138
| | - Erica L. Kenney
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115
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15
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Platt JM, Pamplin JR, Gimbrone C, Rutherford C, Kandula S, Olfson M, Gould MS, Martínez-Alés G, Shaman J, Keyes K. Racial Disparities in Spatial and Temporal Youth Suicide Clusters. J Am Acad Child Adolesc Psychiatry 2022; 61:1131-1140.e5. [PMID: 35031449 PMCID: PMC9271532 DOI: 10.1016/j.jaac.2021.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 12/20/2021] [Accepted: 01/04/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Deaths by suicide correlate both spatially and temporally, leading to suicide clusters. This study aimed to estimate racial patterns in suicide clusters since 2000. METHOD Data from the US National Vital Statistics System included all International Classification of Diseases, Tenth Revision (ICD-10)-coded suicide cases from 2000-2019 among American Indian/Alaska Native (AI/AN), Asian/Pacific Islander (A/PI), Black, or White youth and young adults, aged 5-34 years. We estimated age, period, and cohort (APC) trends and identified spatiotemporal clusters using the SaTScan space-time statistic, which identified lower- and higher-than-expected suicide rates (cold and hot clusters) in a prespecified area (150 km) and time interval (15 months). We also calculated the average proportion of deaths by suicide contained in clusters, to quantify the relative importance of spatiotemporal patterning as a driver of overall suicide rates. RESULTS From 2010-2019, suicide rates increased from between 37% among AI/AN (95% CI = 1.22, 1.55) to 81% among A/PI (95% CI = 1.65, 2.01) groups. Suicide clusters accounted for 0.8%-10.3% of all suicide deaths, across racial groups. Since 2000, the likelihood of detecting cluster increased over time, with considerable differences in the number of clusters in each racial group (4 among AI/AN to 72 among White youth). Among Black youth and young adults, 27 total clusters were identified. Hot clusters were concentrated in southeastern and mid-Atlantic counties. CONCLUSION Suicide rates and clusters in youth and young adults have increased in the past 2 decades, requiring attention from policy makers, clinicians, and caretakers. Racially distinct patterns highlight opportunities to tailor individual- and population-level prevention efforts to prevent suicide deaths in emerging high-risk groups.
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Affiliation(s)
| | - John R Pamplin
- Center for Urban Science and Progress, New York University, New York; Grossman School of Medicine, New York University, New York
| | | | | | | | - Mark Olfson
- Mailman School of Public Health, Columbia University, New York; Columbia University Irving Medical Center and New York State Psychiatric Institute, New York
| | - Madelyn S Gould
- Mailman School of Public Health, Columbia University, New York; Columbia University Irving Medical Center and New York State Psychiatric Institute, New York
| | | | - Jeffrey Shaman
- Mailman School of Public Health, Columbia University, New York
| | - Katherine Keyes
- Mailman School of Public Health, Columbia University, New York
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16
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Packer J, Russell SJ, McLaren K, Siovolgyi G, Stansfield C, Viner RM, Croker H. The impact on dietary outcomes of licensed and brand equity characters in marketing unhealthy foods to children: A systematic review and meta-analysis. Obes Rev 2022; 23:e13443. [PMID: 35261144 PMCID: PMC9285539 DOI: 10.1111/obr.13443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 01/02/2023]
Abstract
Licensed and brand equity characters are used to target children in the marketing of products high in fat, salt, and sugar (HFSS), but the impact of characters on dietary outcomes is unclear. The primary aim of this review was to quantify the impact of both licensed and brand equity characters on children's dietary outcomes given that existing regulations often differentiates between these character types. We systematically searched eight interdisciplinary databases and included studies from 2009 onwards until August 2021, including all countries and languages. Participants were children under 16 years, exposure was marketing for HFSS product with a character, and the outcomes were dietary consumption, preference, or purchasing behaviors of HFSS products. Data allowed for meta-analysis of taste preferences. A total of 16 articles (including 20 studies) met the inclusion criteria, of which five were included in the meta-analysis. Under experimental conditions, the use of characters on HFSS packaging compared with HFSS packaging with no character was found to result in significantly higher taste preference for HFSS products (standardized mean difference on a 5-point scale 0.273; p < 0.001). Narrative findings supported this, with studies reporting impact of both character types on product preferences including food liking and snack choice. There was limited evidence on the impact on purchase behaviors and consumption. These findings are supportive of policies that limit the exposure of HFSS food marketing using characters to children.
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Affiliation(s)
- Jessica Packer
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Simon J Russell
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Katie McLaren
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Gabriela Siovolgyi
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Claire Stansfield
- EPPI-Centre, UCL Social Research institute, University College London, London, UK
| | - Russell M Viner
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Helen Croker
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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17
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Stromberg MH, Rubtsova A, Sales J, McGee R. Impact of Developmental Disability on Frequent School Absenteeism in US Children Aged 6 to 17 Years: National Survey of Children's Health, 2016 to 2017. J Sch Health 2022; 92:681-691. [PMID: 35365877 DOI: 10.1111/josh.13168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/26/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Mary Harbert Stromberg
- Rollins School of Public Health, Emory University, 817 S Cooper Street Memphis, TN, 38104, USA
| | - Anna Rubtsova
- Rollins School of Public Health, Emory University, 1518 Clifton Road, NE Atlanta, GA, 30322, USA
| | - Jessica Sales
- Rollins School of Public Health, Emory University, 1518 Clifton Road, NE Atlanta, GA, 30322, USA
| | - Robin McGee
- Rollins School of Public Health, Emory University, 1518 Clifton Road, NE Atlanta, GA, 30322, USA
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18
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Soleimanpour S, Geierstanger S, Lucas R, Ng S, Ferrey I. Risk and Resilience Factors Associated With Frequency of School-Based Health Center Use. J Sch Health 2022; 92:702-710. [PMID: 35246989 DOI: 10.1111/josh.13176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/05/2021] [Accepted: 12/19/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND School-based health centers (SBHCs) provide health care to vulnerable youth. The purpose of the study was to identify characteristics of youth who use SBHCs with the highest frequency to understand their health needs and receipt of health services. METHODS This study examined cross-sectional survey data from adolescents in 3 urban school districts (n = 2641) to identify the characteristics of youth who use SBHCs with high frequency (10+ visits). Analyses included calculations of simple frequencies and percentages, chi-square tests of significance and multivariate regression. RESULTS High-frequency SBHC users were more likely to have seriously considered attempting suicide (adjusted odds ratio [AOR]: 3.2), be sexually active (AOR: 6.8), and have been victimized at school (AOR: 2.2) compared to their peers who did not use the SBHC. High-frequency SBHC users were also significantly more likely than their peers to report "always" getting mental health (AOR: 7.0) and sexual health (AOR: 6.6) care when needed, and having talked with a health care provider about their moods/feelings (AOR: 3.1) and how school is going (AOR: 3.2) in the past year. CONCLUSIONS These findings hold important relevance to demonstrating the value of SBHCs in increasing vulnerable youth's access to health care, particularly in urban settings.
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Affiliation(s)
- Samira Soleimanpour
- Philip R. Lee Institute for Health Policy Studies, University of California, 490 Illinois Street, Floor 7, San Francisco, CA, 94158, USA
| | - Sara Geierstanger
- Philip R. Lee Institute for Health Policy Studies, University of California, 490 Illinois Street, Floor 7, San Francisco, CA, 94158, USA
| | - Ruby Lucas
- Philip R. Lee Institute for Health Policy Studies, University of California, 490 Illinois Street, Floor 7, San Francisco, CA, 94158, USA
| | - Sandy Ng
- Philip R. Lee Institute for Health Policy Studies, University of California, 490 Illinois Street, Floor 7, San Francisco, CA, 94158, USA
| | - Ignacio Ferrey
- Center for Healthy Schools and Communities, Alameda County Health Care Services Agency, 1000 San Leandro Boulevard, Suite 300, San Leandro, CA, 94577, USA
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19
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Miura SST, Bernat D, Reid KM, Macdonald M, Porter L, Choi K. Current Tobacco Use Trends and Harm Perceptions Among High School Students by Asthma Status and Sex, 2012-2018. J Sch Health 2022; 92:521-529. [PMID: 35266149 PMCID: PMC9869457 DOI: 10.1111/josh.13180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 10/30/2021] [Accepted: 11/04/2021] [Indexed: 06/03/2023]
Abstract
BACKGROUND Tobacco use is known to worsen asthma management. No studies have investigated how trends in youth tobacco use and related harm perceptions vary by asthma status and sex. This study examined these trends among Florida high school students during 2012-2018. METHODS Data from the 2012, 2014, 2016, and 2018 Florida Youth Tobacco Survey were analyzed. Public high school students (grades 9-12) with known asthma status were included along with their current tobacco product use, tobacco product harm perceptions, and demographics. Weighted multivariable logistic regression was used to assess trends in tobacco product use and harm perceptions and test differences by asthma status and sex. RESULTS From 2012 to 2018, high school students with asthma had the slowest decline in cigarette and cigar use prevalence (asthma status-time interaction p = .01) compared to those with no asthma. Cigarette and cigar smoking were perceived as less harmful over time, except among females with asthma who smoked cigarettes (p < .05). CONCLUSIONS Those with asthma showed a slower decline and were more likely to smoke cigarettes. Results indicate that further public health efforts are needed to address tobacco use among high school students with asthma.
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Affiliation(s)
- Sarah Selica T Miura
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, NW, 5th Floor, Washington, DC, 20052, USA
| | - Debra Bernat
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, NW, 5th Floor, Washington, DC, 20052., USA
| | - Keshia M Reid
- Public Health Research Unit, Division of Community Health Promotion, Florida Department of Health, 4052 Bald Cypress Way, Bin A24, Tallahassee, FL, 32399-1712, USA
| | - Megan Macdonald
- Division of Children's Medical Services, Florida Department of Health, 4052 Bald Cypress, Bin A06, Tallahassee, FL, 32399-1712, USA
| | - Lauren Porter
- Public Health Research, Division of Community Health Promotion, Florida Department of Health, 4052 Bald Cypress Way, Bin A24, Tallahassee, FL, 32399-1712, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 9000 Rockville Pike, Building 3 Room 5W05, Bethesda, MD, 20892, USA
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20
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Vang TM, Nishina A. Fostering School Belonging and Students' Well-Being Through a Positive School Interethnic Climate in Diverse High Schools. J Sch Health 2022; 92:387-395. [PMID: 35067912 DOI: 10.1111/josh.13141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/02/2021] [Accepted: 10/07/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND School belonging has been linked to students' health and well-being. As US schools become more ethnically diverse, it is important to understand how schools can contribute to a sense of belonging for students from all ethnic groups. METHODS The present study examines the association between school interethnic climate, school belonging, and 3 well-being indicators (psychological, physical, and academic) among 657 10th graders across 2 states. RESULTS Positive school interethnic climate was associated with stronger feelings of school belonging, and was indirectly associated with better psychological adjustment, fewer physical symptoms, and better grades via school belonging. There were no differences between White and non-White students in the findings. CONCLUSIONS Focusing on fostering a positive interethnic atmosphere may be a useful target for schools to support students' health and well-being as well as academic performance.
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Affiliation(s)
- Tseng M Vang
- Graduate Student, , University of California, Davis, 1 Shields Avenue, Davis, CA 95616
| | - Adrienne Nishina
- Associate Professor, , University of California, Davis, 1 Shields Avenue, Davis, CA 95616
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21
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Barrense-Dias Y, Chok L, Stadelmann S, Berchtold A, Suris JC. Sending One's Own Intimate Image: Sexting Among Middle-School Teens. J Sch Health 2022; 92:353-360. [PMID: 35174499 PMCID: PMC9306908 DOI: 10.1111/josh.13137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/03/2021] [Accepted: 08/22/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND There is a gap in the literature regarding data on sexting among youth under the age of 16 whereas the problems related to this practice could affect them more because of their ongoing development. This study aims to determine the prevalence rate and characteristics of sending one's own sexually related image among middle-school teens. METHODS Data were obtained from a web-based in-school survey conducted between October 2019 and February 2020. The sample comprised 3006 (mean age 13.7; 50.2% males) 10th-grade pupils in the canton of Vaud (Switzerland). Participants were asked "Have you ever sent a sexually related/sexy image of yourself?". Analysis of variance/chi-square tests and multinomial regression analyses were used to compare the groups. RESULTS Overall, 93.0% reported never, 3.7% once and 3.3% several times. No gender differences were found. Sending was associated with older age, low academic performance, cyberbullying victimization and reception of unsolicited sexually related images. CONCLUSIONS Education and health professionals should be aware that it is necessary to discuss the theme, perhaps with a more global approach including pressure, consent, exchange of nonsexual images, and so on from an early age. The context and reasons for sending remain to be explored, particularly to determine if the pressure is greater at this age.
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Affiliation(s)
- Yara Barrense-Dias
- Research Manager, , Department of Epidemiology and Health Systems, Research Group on Adolescent Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Lorraine Chok
- Research Assistant, , Department of Epidemiology and Health Systems, Research Group on Adolescent Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Sophie Stadelmann
- Research Collaborator, , Department of Epidemiology and Health Systems, Research Group on Adolescent Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - André Berchtold
- Associate Professor, , Swiss Center of Competence in Research LIVES, University of Lausanne, Lausanne, Switzerland
| | - Joan-Carles Suris
- Associate Professor, , Department of Epidemiology and Health Systems, Research Group on Adolescent Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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22
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Henkhaus LE, Gonzales G, Buntin MB. An Algorithm Using Administrative Data to Measure Adverse Childhood Experiences (ADM-ACE). Health Serv Res 2022; 57:963-972. [PMID: 35275403 PMCID: PMC9264467 DOI: 10.1111/1475-6773.13972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 02/25/2022] [Accepted: 03/03/2022] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To develop an algorithm using administrative data to measure adverse childhood experiences (ADM-ACE) within routinely collected health insurance claims and enrollment data. DATA SOURCES We used claims and enrollment data from Tennessee's Medicaid program (TennCare) in 2018. STUDY DESIGN We studied five types of ACEs: maltreatment and peer violence, foster care and family disruption, maternal mental illness, maternal substance use disorder, and abuse of the mother. We used diagnosis and procedure codes, prescription drug fills, and enrollment files to develop the ADM-ACE, which we applied to measure the prevalence of ACEs and to examine prevalence by demographic characteristics among our sample of children in TennCare. We compared ADM-ACE prevalence to child welfare records and survey results from Tennessee. DATA COLLECTION/EXTRACTION METHODS Our study sample included children aged 0-17 years who were linked to their mothers if also enrolled in TennCare in 2018 (N=763,836 children). PRINCIPAL FINDINGS Approximately 19.2% of children in TennCare had indicators for ADM-ACEs. The prevalence of ACEs was higher among children who were younger (p<0.001), non-Hispanic White or Black (compared to Hispanic) (p<0.001), and children residing in rural vs. urban counties (p<0.001). The prevalence of maltreatment identified through the ADM-ACE (1.6%) falls between the percent of children in Tennessee who were reported to child welfare authorities and the percent for whom reports of maltreatment were substantiated. Comparison with survey reports from Tennessee parents suggests an advantage in measuring maternal mental illness with the ADM-ACE using health insurance claims data. CONCLUSIONS The ADM-ACE can be applied to health encounter data to study and monitor the prevalence of certain ACEs, their association with health conditions, and the effects of policies on reducing exposure to ACEs or improving health outcomes for children with ACEs.
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Affiliation(s)
- Laura E Henkhaus
- Data Science Institute, Vanderbilt University, 2301 Vanderbilt Place, PMB #407791, Nashville, TN
| | - Gilbert Gonzales
- Department of Medicine, Health, and Society, Vanderbilt University, 2301 Vanderbilt Place, PMB #351665, Nashville, TN
| | - Melinda B Buntin
- Department of Health Policy, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 1200, Nashville, TN
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Zheng K, Roehlkepartain EC, Santelli JS, Smaldone A, Bruzzese JM. Associations between Developmental Assets and Adolescent Health Status: Findings from the 2016 National Survey of Children's Health. J Sch Health 2022; 92:300-308. [PMID: 35001405 PMCID: PMC10103581 DOI: 10.1111/josh.13131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/25/2021] [Accepted: 07/10/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Developmental assets foster positive health outcomes among adolescents, but have not been studied in adolescents with chronic illness or depression, two conditions that impact behaviors in school. We examined parent-reported assets in a national sample of adolescents and compared the number and types of assets by health statuses. METHODS Data were from the 2016 National Survey of Children's Health (N = 15,734 adolescents), which captured 15 of 40 assets in the Developmental Assets Framework. We categorized adolescents as healthy; chronic physical illness alone; depression alone; and chronic physical illness with co-morbid depression. Data were analyzed using analysis of variance and logistic regression. RESULTS Healthy adolescents and those with chronic physical illness alone were comparable in number and types of assets. Adolescents with chronic physical illness and co-morbid depression had fewer assets compared to healthy adolescents and those with chronic physical illness alone. Similar associations were found in comparing healthy adolescents to those with depression without chronic physical illness. CONCLUSIONS The presence of depression, among adolescents with and without chronic physical illness, was associated with fewer internal and external assets. The absence of assets may serve as a unique indicator of underlying depressive symptoms among adolescents in the school setting.
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Affiliation(s)
- Katherine Zheng
- Northwestern University, Feinberg School of Medicine, 633 N. Saint Clair St, 20th floor, Chicago, IL, 60611
| | | | - John S Santelli
- Columbia Mailman School of Public Health, New York, NY, 10032
| | - Arlene Smaldone
- Columbia University School of Nursing, 560 West 168th Street, New York, NY, 10032
| | - Jean-Marie Bruzzese
- Columbia University School of Nursing, 560 West 168th Street, New York, NY, 10032
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24
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Chan CT, Olivieri-Mui BL, Mayer KH. Associations between State-Level High School HIV Education Policies and Adolescent HIV Risk Behaviors. J Sch Health 2022; 92:316-324. [PMID: 34951018 PMCID: PMC10069761 DOI: 10.1111/josh.13130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND School-based human immunodeficiency virus (HIV) education can reach most adolescents, but inconsistencies exist in state-level content policies. The purpose of this study was to evaluate the associations between state-level high school HIV education policies and adolescent HIV risk behaviors. METHODS This was a cross-sectional analysis of the 2019 Youth Risk Behavior Survey linked to the Guttmacher Institute Sex and HIV Education report. Logistic regression models examined the associations of state-level HIV education mandates and content policies with 3 HIV risk behaviors: (1) 4 or more lifetime sexual partners; (2) substance use before last sex; (3) condomless last sex. RESULTS Across 33 states, 128,986 high school students were included. Multivariable adjusted models demonstrated no associations between mandated HIV education and risk behaviors. Covering abstinence along with other safe sex options was associated with lower odds, whereas stressing abstinence was associated with higher odds of at least 4 lifetime sexual partners and condomless last sex. Discriminatory sexual orientation content was associated with increased condomless last sex; associations for all HIV risk behaviors were stronger among sexual minority youth. CONCLUSIONS Increased HIV risk behaviors associated with state policies stressing abstinence or requiring discriminatory sexual orientation content support the need for comprehensive and inclusive HIV education.
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Affiliation(s)
- Carrie T Chan
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115
- Stanford Children's Health, 750 Welch Road Suite 212, Palo Alto, CA, 94304
- Department of Family Health Care Nursing, University of California San Francisco, 2 Koret Way, San Francisco, CA, 94131
| | - Brianne L Olivieri-Mui
- The Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, 1200 Centre Street, Roslindale, MA, 02131
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, 7 Haviland Street, Boston, MA, 02215
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215
- Department of Global Health and Population, Harvard School of Public Health, 9 Bow Street, Cambridge, MA, 02138
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25
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Altman E, Linchey J, Santamaria G, Thompson HR, Madsen KA. Weight Measurements in School: Setting and Student Comfort. J Nutr Educ Behav 2022; 54:249-254. [PMID: 35277221 PMCID: PMC9135350 DOI: 10.1016/j.jneb.2021.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/16/2021] [Accepted: 11/19/2021] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To examine how body mass index assessments are conducted in schools and whether student comfort with assessments varies by students' perceived weight status, weight satisfaction, or privacy during measurements. METHODS In-person cross-sectional surveys with diverse fourth- to eighth-grade students (n = 11,510) in 54 California schools in 2014-2015 about their experience being weighed in the prior school year. RESULTS Half of the students (49%) reported being weighed by a physical education teacher and 28% by a school nurse. Students were more comfortable being weighed by nurses than physical education teachers (P = 0.01). Only 30% of students reported privacy during measurements. Students who were unhappy with their weight (P <0.001) and those who perceived themselves as overweight (P <0.001) were less comfortable being weighed than their peers. CONCLUSIONS AND IMPLICATIONS Student weight dissatisfaction, higher perceived weight status, and being female were associated with discomfort with school-based weight measurements. Prioritizing school nurses to conduct weight measurements could mitigate student discomfort, and particular attention should be paid to students who are unhappy with their weight to avoid weight stigmatization.
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Affiliation(s)
- Emily Altman
- School of Public Health, University of California Berkeley, Berkeley, CA.
| | - Jennifer Linchey
- School of Public Health, University of California Berkeley, Berkeley, CA
| | - Gabriel Santamaria
- School of Public Health, University of California Berkeley, Berkeley, CA
| | - Hannah R Thompson
- School of Public Health, University of California Berkeley, Berkeley, CA
| | - Kristine A Madsen
- School of Public Health, University of California Berkeley, Berkeley, CA
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26
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Szeszulski J, Helal Salsa G, Cuccaro P, Markham CM, Martin M, Savas LS, Valerio-Shewmaker M, Walker TJ, Springer AE. Using Community-Academic Partnerships and a Creative Expression Contest to Engage Youth in the Development of Communication Materials for Promoting Behaviors That Prevent COVID-19. Health Promot Pract 2022; 23:609-618. [PMID: 35043711 DOI: 10.1177/15248399211070547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Youth can transmit COVID-19 to adults, but few communication materials exist for engaging youth in COVID-19 prevention behaviors. We describe the process of leveraging a community-academic partnership in a rapid response initiative to engage youth in a contest (i.e., Youth-Led Creative Expression Contest to Prevent COVID-19 across Texas) to develop creative public health messaging centered on the prevention of COVID-19 transmission and infection for their peers. Core activities included developing a request for applications that solicited submission of creative expression materials promoting the use of COVID-19 prevention behaviors (mask-wearing, social distancing, handwashing, not touching the face) from Texas youth in elementary, middle, and/or high school; sending the request for applications to 48 organizations in Austin, Brownsville, Dallas, El Paso, Houston, and San Antonio in summer 2020; and recruiting a youth advisory board to score submissions and award prizes. We report on youth engagement in the COVID communication contest across Texas and use statistics (chi-square and t-tests) to characterize and compare youth participants and their creative expression artwork. The contest resulted in 3,003 website views and 34 submissions eligible for scoring. Each submission averaged >2 prevention behaviors. On average, winning submissions included a higher number of prevention behaviors than nonwinning submissions. The prevention behavior "not touching the face" was included more often in winning submissions than nonwinning submissions. Elementary school children were less likely to include a mask in their submission compared with older youth. Existing community-academic networks can engage youth in the development of geographically and age-tailored communication materials.
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Affiliation(s)
- Jacob Szeszulski
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, USA.,The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, TX, USA
| | - Ghadir Helal Salsa
- The University of Texas Health Science Center at Houston, School of Public Health in Brownsville, Brownsville, TX, USA
| | - Paula Cuccaro
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Christine M Markham
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Mary Martin
- The University of Texas Health Science Center at Houston, School of Public Health in San Antonio, San Antonio, TX, USA
| | - Lara S Savas
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Melissa Valerio-Shewmaker
- The University of Texas Health Science Center at Houston, School of Public Health in Brownsville, Brownsville, TX, USA
| | - Timothy J Walker
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Andrew E Springer
- The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, TX, USA
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27
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Wong A, Szeto S, Lung DWM, Yip PSF. Diffusing Innovation and Motivating Change: Adopting a Student-Led and Whole-School Approach to Mental Health Promotion. J Sch Health 2021; 91:1037-1045. [PMID: 34636048 DOI: 10.1111/josh.13094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Research suggests that a whole-school approach to mental health promotion can be more effective than a compartmentalized approach. In particular, student-led initiatives have demonstrated a positive impact on students' mental health, though not without systemic and individual barriers. Factors that lead to successful implementation and sustaining of student-led initiatives are currently not well understood. METHODS A case study is presented to demonstrate how a student-led intervention came about, inspired changes in the school organization and members, and transformed the school's approach to mental health promotion. Analysis of in-depth interviews with student leaders and adult advisors was informed by theories of innovation diffusion and human motivation. RESULTS Key factors and mechanisms of change were identified for the initiation, transformation, and institutionalization stages of the student-led initiative. Changes in students' identity and adult advisors' mindset were found to be integral to the successful conversion to a whole-school approach in mental health promotion. CONCLUSIONS This study confirms the value of mobilizing the student body as an active resource in promoting mental health in school and the importance of input from school management, advisors, and intervention expert. Recommendations on how to implement a student-led initiative and sustain the positive changes are given.
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Affiliation(s)
- Anna Wong
- Post-doctoral Fellow, , The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Pokfulam, Hong Kong, China
| | - Samantha Szeto
- Research Assistant, , The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Pokfulam, Hong Kong, China
| | - Daniel W M Lung
- Programme Development Officer, , The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Pokfulam, Hong Kong, China
| | - Paul S F Yip
- Director and Professor, , The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Pokfulam, Hong Kong, China
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28
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Ferenchak KS, Trieu SL, Franco R, Jackson NJ, Dudovitz R. Beyond Co-Location: Development of a School Health Integration Measure. J Sch Health 2021; 91:970-980. [PMID: 34636051 DOI: 10.1111/josh.13088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 01/30/2021] [Accepted: 02/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND School-based health centers (SBHCs) can integrate health and educational services to achieve common goals of student wellness and success. As no method exists to quantify the degree of integration for clinics and partner schools, this study aimed to design such a measure. METHODS Measure items were drafted from the literature. Eleven school health experts from Los Angeles, CA, used a modified Delphi method to reach consensus around items for inclusion in a School Health Integration Measure (SHIM), evaluating each on its appropriateness, substantivity, and feasibility. Twenty-eight staff at 17 SBHC campuses pilot tested the SHIM to examine its psychometric properties. RESULTS From 36 items, the expert panel utilized 4 rounds to reach consensus on 12 items across 5 domains: health authority, integrated programming, marketing and recruitment, shared outcomes, and staff collaboration. In the SHIM pilot, scores ranged from 2.25 to 5 (possible 1-5, mean 3.53). The measure had high internal consistency (alpha = 0.9385) and was associated with participants' general assessment of integration at their sites (p = .001). CONCLUSIONS The SHIM provides a new tool to quantify health and educational service integration at SBHC sites, drive practice improvement, and test whether integration leads to better student outcomes.
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Affiliation(s)
- Kenny S Ferenchak
- Resident Physician, , Department of Pediatrics, University of Washington, Seattle Children's, 4800 Sand Point Way, NE, OC.7.830, PO Box 5371, Seattle, WA 98105; former Medical Student, UCLA David Geffen School of Medicine, UCLA David Geffen School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095
| | - Sang Leng Trieu
- Program Director, , The Los Angeles Trust for Children's Health, 333 S. Beaudry Avenue, 29th Floor, Los Angeles, CA 90017
| | - Rosina Franco
- Senior Physician, , Student Medical Services, Student Health and Human Services, Los Angeles Unified School District, 121 N. Beaudry Avenue, Roybal Annex, Los Angeles, CA 90012
| | - Nicholas J Jackson
- Assistant Professor, , UCLA Division of General Internal Medicine and Health Services Research, 1100 Glendon Avenue, Suite 1820, Los Angeles, CA 90024
| | - Rebecca Dudovitz
- Associate Professor, , Department of Pediatrics and Children's Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, and UCLA Mattel Children's Hospital, 10833 Le Conte Ave. 12-358 CHS, Los Angeles, CA 90095
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29
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Barratt J, Patte KA, Battista K, Leatherdale ST. The Impact of Changes in Physical Education Class Enrollment on Moderate-to-Vigorous Physical Activity Among a Large Sample of Canadian Youth. J Sch Health 2021; 91:1030-1036. [PMID: 34611924 DOI: 10.1111/josh.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/06/2021] [Accepted: 03/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Few youth engage in sufficient daily moderate-to-vigorous physical activity (MVPA), and the likelihood of meeting guidelines declines through secondary school. Physical education (PE) can afford youth with opportunities for MVPA. Therefore, the purpose of this study was to investigate the impact of changes in PE enrollment on MVPA and MVPA guideline adherence in Ontario and Alberta secondary students. METHODS Linked survey data was used from 1514 students who participated in year 3 (2014/2015 baseline) and year 6 (2017/2018 follow-up) of the COMPASS Study. Regression models tested whether changes in PE enrollment predicted changes in self-reported MVPA (minutes) and MVPA guideline adherence from grade 9 (baseline) to grade 12 (follow-up), controlling for sports participation and sociodemographic variables. RESULTS Students who remained enrolled in PE in grade 12 reported a daily average of 30 minutes more MVPA. Among students meeting MVPA guidelines and enrolled in PE in grade 9, students not taking PE in the current term in grade 12 were less likely to continue to meet guidelines than students currently enrolled in PE (adjusted odds ratio 0.53; 95% confidence interval: 0.36, 0.78; p < .0013). CONCLUSIONS Findings from this study could inform the future implementation of a mandatory PE credit for upper year secondary students.
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Affiliation(s)
- Jaime Barratt
- PhD candidate, , School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Karen A Patte
- Assistant Professor, , Department of Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Kate Battista
- COMPASS Data Analyst, , School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Scott T Leatherdale
- Professor, , School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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30
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Mann G, Kaiser K, Trapp N, Cafer A, Grant K, Gupta K, Bolden C. Barriers, Enablers, and Possible Solutions for Student Wellness: A Qualitative Analysis of Student, Administrators, and Staff Perspectives. J Sch Health 2021; 91:1002-1013. [PMID: 34611898 DOI: 10.1111/josh.13092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 02/08/2021] [Accepted: 03/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Child well-being, which includes physical, mental, and social health, has a critical effect on academic performance. Schools face many challenges in meeting needs for child well-being. Schools in low-resource areas, including the Mississippi Delta, face greater challenges when meeting student needs. METHODS Eleven focus groups with middle school students and 12 interviews with teachers, staff, and administration in one Mississippi Delta middle school were completed in 2019. The Social Ecological Model and Theory of Organizational Readiness for Change were used as a framework for the study. RESULTS Focus group data with middle school students and interviews with teachers, staff, and administrators show that academic stressors play a major role in student well-being; yet, teachers, staff, and administrators face immense pressure to achieve high test scores. However, students seem to be encouraged by a positive school environment, which could help minimize some stressors. CONCLUSIONS It seems that small improvements to the school environment could have a significant effect on student well-being, especially when school infrastructure and limited resources do not support comprehensive changes.
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Affiliation(s)
- Georgianna Mann
- Assistant Professor, , Department of Nutrition and Hospitality Management, University of Mississippi, 220 Lenoir Hall, P.O. Box 1848 University, MS, 38677., USA
| | - Kimberly Kaiser
- Assistant Professor, , Department of Legal Studies, University of Mississippi, M302 Mayes University, MS, 38677., USA
| | - Noah Trapp
- Medical student, , University of Wisconsin School of Medicine and Public Health, Health Sciences Learning Center, University of Wisconsin-Madison, 750 Highland Ave. Madison, WI, 53705., USA
| | - Anne Cafer
- Assistant Professor, , Department of Sociology and Anthropology, University of Mississippi, 543 Lamar Hall University, MS, 38677, USA
| | - Khyla Grant
- Undergraduate student, , Division of Family and Consumer Sciences, Highway 8 West, Delta State University, Cleveland, MS, 38733., USA
| | - Kritika Gupta
- Graduate Student, , Department of Nutrition and Hospitality Management, University of Mississippi, 116 Lenoir Hall, P.O. Box 1848 University, MS, 38677., USA
| | - Candace Bolden
- Undergraduate student, , Department of Nutrition and Hospitality Management, University of Mississippi, 108 Lenoir Hall, P.O. Box 1848 University, MS, 38677., USA
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31
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Sava LM, Earnshaw VA, Menino DD, Perrotti J, Reisner SL. LGBTQ Student Health: A Mixed-Methods Study of Unmet Needs in Massachusetts Schools. J Sch Health 2021; 91:894-905. [PMID: 34553384 DOI: 10.1111/josh.13082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, and queer and questioning (LGBTQ) youth experience poor physical and mental health outcomes relative to their non-LGBTQ peers. School health professionals (SHPs), such as school nurses, play a key role in addressing LGBTQ student health needs. However, few studies examine school health needs of LGBTQ students from both the youth and SHP perspective. METHODS From August 2017 to July 2018, 28 LGBTQ youth and 19 SHPs (N = 47) in Massachusetts participated in online focus groups and a brief survey on school health needs and experiences. Qualitative themes were coded using Rapid Qualitative Inquiry principles and NVIVO. RESULTS Both LGBTQ students and SHPs identified an urgent need for inclusive sexual education and mental health services. LGBTQ students raised access to safer bathrooms, information, and guidance on gender transitioning, and access to safe spaces as school-based needs. Missing from SHPs' perspectives, students also discussed sexual violence/harassment of transgender students and racism impacting youth of color. CONCLUSIONS LGBTQ students, especially transgender students and LGBTQ youth of color, have unmet health needs that need to be addressed. Recognizing these needs is the first step towards inclusive health services and support for all students in schools. Next, interventions to increase the capacity of SHPs to address LGBTQ student health are necessary.
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Affiliation(s)
- Lauren M Sava
- The Fenway Institute at Fenway Health, Boston, MA, 02215
| | | | - David D Menino
- Boston Children's Hospital, 21 Autumn Street, Boston, MA, 02215
| | - Jeff Perrotti
- The Massachusetts Commission on LGBTQ Youth, 250 Washington Street 4th Floor, Boston, MA, 02108
| | - Sari L Reisner
- Director of Transgender Research, Brigham and Women's Hospital, Assistant Professor of Medicine, Harvard Medical School, Assistant Professor of Epidemiology, Harvard T.H. Chan School of Public Health, Director of Transgender Health Research and Affiliated Research Scientist, The Fenway Institute at Fenway Health, 221 Longwood Ave, Boston, MA, 02215
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Gorse MM, Bacolores JP, Cheung J, De Pedro KT. Teen, Queer, and Asian: Lesbian, Gay, Bisexual, Transgender, Queer, Plus Asian American Students' Experiences in Schools. J Sch Health 2021; 91:906-914. [PMID: 34486117 DOI: 10.1111/josh.13077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The experiences of youth with intersecting LGBTQ+ and Asian American (AA) identities have been largely unexplored. This study explored these experiences of LGBTQ+ AA California youth with mental health, school climate, and school victimization. METHODS Drawing from the 2016-2017 California Healthy Kids Survey (N = 326,124), this study utilized secondary data analyses to examine mental health, school climate, and school victimization among students of specific AA ethnicities (eg, Cambodian, Hmong, Vietnamese) and LGBTQ+ identities. The participants in this study included 7th, 9th, and 11th graders from California public schools, with subsamples of lesbian or gay students (N = 13,291), bisexual students (N = 30,127), and transgender students (N = 7916). RESULTS The results indicated that Asian Indian, Cambodian, Hmong, Japanese, Korean, Laotian, and Other Asian LGBTQ+ students experienced more negative school climate and victimization compared to their Chinese, Filipino, Vietnamese, and white LGBTQ+ peers. For instance, 41.1% of Cambodian transgender students reported they were beaten up compared to 27.1% of white transgender students. Mental health differences between LGBTQ+ AA and LGBTQ+ white students were also found. CONCLUSIONS This study's findings can inform school administrators and teachers how to best support LGBTQ+ AA populations.
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Affiliation(s)
| | | | - Jordan Cheung
- Brown University, 9 Rocky Mountain, Trabuco Canyon, CA, 92679
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Russell SJ, Hope S, Croker H, Crozier S, Packer J, Inskip H, Viner RM. Modeling the impact of calorie-reduction interventions on population prevalence and inequalities in childhood obesity in the Southampton Women's Survey. Obes Sci Pract 2021; 7:545-554. [PMID: 34631133 PMCID: PMC8488449 DOI: 10.1002/osp4.520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/26/2021] [Accepted: 05/02/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND In the United Kingdom, rates of childhood obesity are high and inequalities in obesity have widened in recent years. Children with obesity face heightened risks of living with obesity as adults and suffering from associated morbidities. Addressing population prevalence and inequalities in childhood obesity is a key priority for public health policymakers in the United Kingdom and elsewhere. Where randomized controlled trials are not possible, potential policy actions can be simulated using causal modeling techniques. OBJECTIVES Using data from the Southampton Women's Survey (SWS), a cohort with high quality dietary and lifestyle data, the potential impact of policy-relevant calorie-reduction interventions on population prevalence and inequalities of childhood obesity was investigated. METHODS Predicted probabilities of obesity (using UK90 cut-offs) at age 6-7 years were estimated from logistic marginal structural models adjusting for observed calorie consumption at age 3 years (using food diaries) and confounding. A series of policy-relevant intervention scenarios were modeled to simulate reductions in energy intake (differing in effectiveness, the targeting mechanisms, and level of uptake). RESULTS At age 6-7 years, 8.3% of children were living with obesity, after accounting for observed energy intake and confounding. A universal intervention to lower median energy intake to the estimated average requirement (a 13% decrease), with an uptake of 75%, reduced obesity prevalence by 1% but relative and absolute inequalities remained broadly unchanged. CONCLUSIONS Simulated interventions substantially reduced population prevalence of obesity, which may be useful in informing policymakers.
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Affiliation(s)
- Simon J. Russell
- Obesity Policy Research UnitPopulation, Policy and PracticeGreat Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Steven Hope
- Obesity Policy Research UnitPopulation, Policy and PracticeGreat Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Helen Croker
- Obesity Policy Research UnitPopulation, Policy and PracticeGreat Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Sarah Crozier
- MRC Lifecourse Epidemiology UnitMedicineUniversity of SouthamptonSouthamptonUK
- NIHR Applied Research Collaboration WessexSouthampton Science ParkInnovation CentreSouthamptonUK
| | - Jessica Packer
- Obesity Policy Research UnitPopulation, Policy and PracticeGreat Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Hazel Inskip
- MRC Lifecourse Epidemiology UnitMedicineUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Russell M. Viner
- Obesity Policy Research UnitPopulation, Policy and PracticeGreat Ormond Street Institute of Child HealthUniversity College LondonLondonUK
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Korpics J, Altman L, Feinglass J, Stillerman A. Prevalence and Impact of Adverse Childhood Experiences on Chicago Public School Students in the Youth Risk Behavior Survey. J Sch Health 2021; 91:802-812. [PMID: 34426968 DOI: 10.1111/josh.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 03/03/2021] [Accepted: 04/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) can impair health and other outcomes. To obtain district-level data about the prevalence and impact of ACEs in Chicago Public Schools (CPS), we advocated for CPS to add a short ACE screener to the 2017 Youth Risk Behavior Survey (YRBS) and analyzed the results. METHODS Responses to the screener were scored zero, one, or two ACEs. Student scores for violence and victimization, substance use, sexual health risk, mental health, housing insecurity, physical health, grades, and multiple risk/high vulnerability (those students in the top 20% of affirmative responses) were correlated with ACE scores for categories and individual items. RESULTS Among 1883 student respondents (response rate 73%), there were 17.8% affirmative responses for experiencing physical abuse and 19.8% for witnessing domestic violence; 20% reported at least one ACE and 8% both. A significant dose-response was found for behaviors, experiences, and sleep by ACE scores. CONCLUSIONS ACEs were common among CPS high school students and associated with many negative behavior and health-related outcomes. Increased awareness of ACEs and their impact among all school personnel can inform and strengthen the development of safer, more supportive, and trauma-informed schools that help all students and families thrive.
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Affiliation(s)
- Jacqueline Korpics
- Cook County Health and Northwestern Feinberg School of Medicine, 1950 W Polk St, Chicago, IL, 60612
| | - Lara Altman
- Illinois ACE Response Collaborative, PhD Candidate, School of Education and Social Policy, Northwestern University, Walter Annenberg Hall, 2120 Campus Drive, Evanston, IL, 60208
| | - Joseph Feinglass
- Division of General Internal Medicine, Northwestern University, 750 N Lakeshore Dr. 10th Floor, Chicago, IL, 60611
| | - Audrey Stillerman
- School Health Centers, Clinical Assistant Professor of Family Medicine, Office of Community Engagement and Neighborhood Health Partnerships, University of Illinois at Chicago, 818 S. Wolcott, Rm 809, Chicago, IL, 60612
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Strochlic R, Woodward-Lopez G, Hewawitharana S, Streng K, Richardson J, Whetstone L, Gorshow D. A Harvest of the Month Curriculum Increases Fruit and Vegetable Intake among 4th-6th Grade Students. J Sch Health 2021; 91:750-760. [PMID: 34291460 DOI: 10.1111/josh.13066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 11/30/2020] [Accepted: 02/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Most children do not eat enough fruits and vegetables (FV). Schools are a critical setting for supporting children to consume FV. To fill a gap in available materials, a classroom curriculum was developed and evaluated to determine impacts on student FV-related knowledge, attitudes, and behaviors. METHODS A pre-/post-intervention survey was administered to 4th-6th grade students in 3 intervention and one comparison schools. Post-intervention student focus groups, parent/guardian surveys, and teacher surveys provided complementary information. RESULTS Intervention students had a significantly greater increase in total FV intake, fruit intake, and 100% juice consumption, and preference for several types of FV relative to comparison group students. Students, teachers, and parents reported overall high levels of satisfaction with the curriculum. CONCLUSIONS The Harvest of the Month curriculum is effective at increasing fruit intake among a low-income, diverse student population in grades 4-6, is acceptable to students, teachers, and parents, and is feasible to implement. Findings suggest this impact is the result of changes in preferences, skills, and motivation but not self-efficacy or perceived social norms. Some tailoring of the curriculum may be needed to increase its appropriateness for 6th-grade students, increase the impact on vegetable intake, and limit intake of juice.
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Affiliation(s)
- Ron Strochlic
- Academic Coordinator, , Division of Agriculture & Natural Resources, Nutrition Policy Institute, University of California, 1111 Franklin Street, 5th Floor, Oakland, California, 94607., USA
| | - Gail Woodward-Lopez
- Associate Director of Research, , Division of Agriculture & Natural Resources, Nutrition Policy Institute, University of California, 1111 Franklin Street, 5th Floor, Oakland, California, 94607., USA
| | - Sridharshi Hewawitharana
- Research Data Analyst, , Division of Agriculture & Natural Resources, Nutrition Policy Institute, University of California, 1111 Franklin Street, 5th Floor, Oakland, California, 94607., USA
| | - Katharina Streng
- Health Program Specialist, , California Department of Public Health, Nutrition Education and Obesity Prevention Branch, 1616 Capitol Avenue, Sacramento, California, 95814., USA
| | - Jackie Richardson
- Health Program Manager, , California Department of Public Health, Nutrition Education and Obesity Prevention Branch, 1616 Capitol Avenue, Sacramento, California, 95814., USA
| | - Lauren Whetstone
- Research Science Supervisor, , California Department of Public Health, Nutrition Education and Obesity Prevention Branch, 1616 Capitol Avenue, Sacramento, California, 95814., USA
| | - Derek Gorshow
- Program Director, College of Education, , Alameda County Office of Education, 313 West Winton Avenue, Hayward, California, 94544., USA
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Hussaini KS, Offutt-Powell T, James G, Koumans EH. Assessing the Effect of School-Based Health Centers on Achievement of National Performance Measures. J Sch Health 2021; 91:714-721. [PMID: 34254315 PMCID: PMC10949088 DOI: 10.1111/josh.13060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/04/2020] [Accepted: 12/28/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND We assess the impact of School-Based Health Centers (SBHCs) on National Performance Measures (NPMs) related to health care access and utilization among Medicaid-insured youth in Delaware. METHODS Our retrospective analysis of Delaware's SBHC program data linked with Medicaid claims during 2014-2016 for 13 to 18-year-olds assessed achievement of NPMs and use of mental health services using propensity scores. We estimated crude and adjusted prevalence ratios (APR) for SBHC-enrolled compared with non-enrolled youth. RESULTS Students enrolled in SBHCs had more health care visits (M = 8.7; 95% CI: 7.9-9.5) compared with non-SBHC-enrolled youth (M = 4.5; 95% CI: 4.3-4.7). Compared with non-SBHC, those enrolled in SBHCs were more likely to receive: well-child visits (APR = 1.2; 95% CI: 1.1-1.3); annual risk assessment (APR = 11.0; 95% CI: 6.9-17.5); BMI screening (APR = 5.6; 95% CI: 3.3-9.4); nutrition counseling (APR = 4.1; 95% CI: 2.8-6.0); physical activity counseling (APR = 6.3; 95% CI: 4.2-9.4); STIs and chlamydia screening (APR = 1.9; 95% CI: 1.3-2.8); mental health visits (APR = 2.6; 95% CI: 2.2-3.1). CONCLUSIONS We found that among Medicaid-insured youth, those enrolled in SBHCs vs not enrolled in SBHCs had greater health care utilization as evident from NPMs and mental health services.
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Affiliation(s)
- Khaleel S Hussaini
- Field Support Branch, , Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA., USA
| | - Tabatha Offutt-Powell
- Section Chief, , Epidemiology Health Data and Informatics Section, Delaware Department of Health and Social Services, Division of Public Health, New Castle, DE., USA
| | - Gloria James
- Bureau Chief, , Adolescent and Reproductive Health, Family Health Systems, Delaware Department of Health and Social Services, Division of Public Health, New Castle, DE., USA
| | - Emilia H Koumans
- Medical Officer, , Centers for Disease Control and Prevention, Division of Reproductive Health, Women's Health and Fertility Branch, Atlanta, GA., USA
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Brickhouse TH, Dahman BA, Peters BWR, Liu H, Kumar AM. The impact of dental Medicaid reform on dental care provider activity and market penetration of dental support organizations. J Am Dent Assoc 2021; 152:822-31. [PMID: 34454708 DOI: 10.1016/j.adaj.2021.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/14/2021] [Accepted: 05/04/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Medicaid state dental programs have experienced changes related to provider practice settings with the increased growth of dental support organizations (DSOs). The authors conducted this study to assess the impact of state Medicaid reform on the dental practice environment by examining provider activity and practice setting. METHODS This was a retrospective cohort study of more than 13 million dental claims in the Virginia Medicaid program. It included children and dental care providers in the Virginia dental Medicaid program at some time during a 9-year period (fiscal years 2003-2011). The independent variable was the provider practice setting: private practice, DSO, and safety-net practice. The outcomes included annual measures of claims, patients, and payments per provider. The outcomes were examined over 3 phases of the study period: prereform (2003-2005), implementation phase (2006-2008), and postreform maturation (2009-2011). RESULTS Provider activity increased after dental program reform, with private-practice providers delivering most of the dental care in the Medicaid program. There was a significant penetration of DSO providers in number of providers, claims per provider, and patients per provider (P < .001). Regression results found that providers in DSO settings had an increased number of patients and claims compared with private-practice providers. CONCLUSIONS Medicaid reform has resulted in a significant increase in provider participation and growth of DSO-affiliated providers. PRACTICAL IMPLICATIONS Areas of the state with more dense population had a higher penetrance of dentists practicing in DSO settings providing dental services to children enrolled in Medicaid.
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Terkawi AS, Bakri B, Alsadek AS, Al-Hasan AH, Alrahhal MS, Alsaleh FM, Alsatouf FA, Arab MAI, Jnaid H, Hadid AA, Terkawi RS, Zahran MM, Alghannam NA, Altirkawi KA. Child and adolescent health in northwestern Syria: findings from Healthy-Syria 2017 study. Avicenna J Med 2021; 9:61-74. [PMID: 31143699 PMCID: PMC6530271 DOI: 10.4103/ajm.ajm_184_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives: Since the uprising in 2011, there has been limited health-care data from inside Syria in the academic literature. This study aims to provide an updated account of pediatric health needs in the northwestern part of Syria; this should help inform the management and delivery of health-care services in this population. Methods: This is a prospective study, using a data registry, of all pediatric patients seen in a single center in northwestern Syria, between February and December 2017. We used international classification of diseases (ICD-10) codes to define cases, and tested several covariates, including age, sex, season of the year, and conditions of living for possible correlations with major illness categories. Results: We included 11,819 patients, of whom 5,288 (45%) were male and 6,531 (55%) were female. Collectively, these patients had 23,427 encounters. Respiratory diseases were the most encountered illnesses among all age groups (6320 [27%]), except late teen females, among whom gynecological/obstetric complaints dominated. Infectious diseases caused the greatest disease burden across all age groups, with upper respiratory tract infections (URTIs), infectious diarrhea, and otitis media representing almost half (47%) of all cases in this category. Nutritional deficiencies were diagnosed in 978 patients (8%), mostly in infants and toddlers (92%). We identified 1192 (17%) cases of acute diarrhea among all age groups, making it the second most common condition after URTIs. As compared to town residents, patients living in camps for internally displaced people accounted for more cases of infectious diarrhea (58%), chronic anemia (60%), and malnutrition (66%), especially severe acute malnutrition (76% of malnutrition cases). Vaccine-preventable illnesses represented a sizable category; we reported 69 cases of hepatitis A, 2 of poliomyelitis, 9 of pertussis, 37 of varicella, 11 of mumps, 8 of rubella, and 1 case of measles. Conclusion: We have identified urgent health-care issues in this population, including extreme malnutrition, high rates of infectious diseases, and high rates of teenage pregnancy. Also, we observed a relapse of some vaccine-preventable illnesses, such as mumps and rubella, which are likely associated with the decline in vaccination rates.
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Affiliation(s)
- Abdullah Sulieman Terkawi
- Syrian Expatriate Medical Association (SEMA), SEMA-US, Charlottesville, Virginia, USA.,Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA.,Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia.,Outcomes Research Consortium, Cleveland, Ohio, USA
| | - Basil Bakri
- Syrian Expatriate Medical Association (SEMA), SEMA-US, Cincinnati, Ohio, USA
| | | | | | | | | | | | | | - Hussam Jnaid
- Department of Family Medicine and Polyclinics, Syrian Expatriate Medical Association (SEMA), SEMA-Turkey, Gaziantep, Turkey.,Department of Internal Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Adnan A Hadid
- Department of Family Medicine and Polyclinics, Syrian Expatriate Medical Association (SEMA), SEMA-Turkey, Gaziantep, Turkey.,Department of Pediatrics, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rayan S Terkawi
- Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Khalid A Altirkawi
- Department of Pediatrics, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
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Reid AL, Porter KJ, You W, Kirkpatrick BM, Yuhas M, Vaught SS, Zoellner JM. Low Health Literacy Is Associated With Energy-Balance-Related Behaviors, Quality of Life, and BMI Among Rural Appalachian Middle School Students: A Cross-Sectional Study. J Sch Health 2021; 91:608-616. [PMID: 34096052 PMCID: PMC9660538 DOI: 10.1111/josh.13051] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 06/07/2023]
Abstract
BACKGROUND Many studies document associations between low health literacy (HL) and poor health behaviors and outcomes. Yet, HL is understudied among adolescents, particularly from underserved, rural communities. We targeted rural adolescents in this cross-sectional study and explored relationships between HL and (1) energy-balance-related health behaviors and (2) body mass index (BMI) and quality of life (QOL). METHODS Surveys were administered to 7th graders across 8 middle schools in rural Appalachia. HL was assessed using the Newest Vital Sign. Energy-balance-related behaviors and QOL were assessed using validated instruments. Height and weight were objectively measured. Analyses were conducted using the Hodges-Lehmann nonparametric median difference test. RESULTS Of the 854 adolescent students (mean age = 12; 55% female), 47% had limited HL. Relative to students with higher HL, students with lower HL reported significantly lower frequency of health-promoting behaviors (water, fruit and vegetable intake, physical activity, sleep), higher frequency of risky health behaviors (sugar-sweetened beverages, junk food, screen time), and had higher BMI percentiles and lower QOL (all p < .05). CONCLUSIONS Low HL is associated with energy-balance-related behaviors, BMI, and QOL among rural, Appalachian adolescents. Findings underscore the relevance of HL among rural middle school students and highlight implications for school health.
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Affiliation(s)
- Annie L Reid
- Researcher, , School of Medicine, Department of Public Health Sciences, University of Virginia, 16 E. Main Street, Christiansburg, VA, 24073., USA
| | - Kathleen J Porter
- Assistant Professor, , School of Medicine, Department of Public Health Sciences, University of Virginia, 16 E. Main Street, Christiansburg, VA, 24073., USA
| | - Wen You
- Associate Professor, , School of Medicine, Department of Public Health Sciences, University of Virginia, P.O. Box 800717, Charlottesville, VA, 22908., USA
| | - Brittany M Kirkpatrick
- Postdoctoral Research Associate, , School of Medicine, Department of Public Health Sciences, University of Virginia, 16 E. Main Street, Christiansburg, VA, 24073., USA
| | - Maryam Yuhas
- Assistant Professor, , Department of Nutrition and Food Studies, Syracuse University, 558 White Hall, Syracuse, NY, 13244., USA
| | - Shannon S Vaught
- Director of Middle Schools and Division Director of Testing, , Wythe County Public Schools, 1570 West Reservoir Street, Wytheville, VA, 24382., USA
| | - Jamie M Zoellner
- Professor, , School of Medicine, Department of Public Health Sciences, University of Virginia, 16 E. Main Street, Christiansburg, VA, 24073., USA
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Kelly RK, Nash R. Food Literacy Interventions in Elementary Schools: A Systematic Scoping Review. J Sch Health 2021; 91:660-669. [PMID: 34137459 DOI: 10.1111/josh.13053] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Childhood is a critical period for developing food-related skills and knowledge, known as food literacy (FL). Schools may be an important setting for interventions aiming to improve FL in children. This systematic scoping review aimed to characterize food literacy interventions in elementary schools. METHODS Databases (PubMed, Web of Science, and EBSCO) were searched for FL interventions in elementary schools (students aged 4-12 years). Studies were assessed according to design, duration, theoretical underpinning, and ascertainment of FL outcome(s). Interventions were assessed according to FL competencies (functional, interactive, and critical). RESULTS After exclusions, 116 studies were eligible for review, including 105 original interventions. Interventions ranged from 45 minutes to 4 years. Social cognitive theory was the most referenced theory and common interventions included; classroom lessons, games, school gardens, food preparation, and cooking classes. Most studies measured FL outcomes quantitatively (96%, N = 111). All studies addressed functional FL (N = 116), while 77% (N = 89) addressed interactive FL and 28% (N = 32) addressed critical FL. CONCLUSIONS This first international review of FL programs in elementary schools found great heterogeneity in school-based FL intervention design and measurement of FL. Few interventions addressed critical FL, which should be a focus for future interventions.
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Affiliation(s)
- Rebecca K Kelly
- Academic associate, Medical officer, DPhil candidate, , Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Rosie Nash
- Lecturer in Public Health, Pharmacist, , Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Lyle DM, Boreland FT, Soomro N, Glisson-Gladman M. Is Time Spent Outside the Family Home a Risk Factor for Lead Exposure in Pre-School Children Living in Broken Hill? Int J Environ Res Public Health 2021; 18:7721. [PMID: 34360015 DOI: 10.3390/ijerph18157721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/09/2021] [Accepted: 07/17/2021] [Indexed: 11/17/2022]
Abstract
Broken Hill is amongst a group of communities internationally that are at greater risk from lead due to active or historical lead industries. Current evidence suggests there is no safe level of lead for young children. This paper describes places outside the family home where young Broken Hill children spend time and considers the potential for this to contribute to lead risk. We interviewed 65 families of children 3 years old or younger and detailed the top five places children spent time at outside the family home. Exposure to private residences outside the family home was recorded for most (88%) young children. Nearly two thirds stayed there five or more hours per week. Most children went there on a weekly basis over many months (median, 12 months), increasing the likelihood of exposure to lead hazards. Further investigation of the lead hazard and risk behaviour of children at these residences would assist in developing guidelines for remediation of the lead hazard for all private residences in Broken Hill. This approach to elucidating the potential sources and pathways of lead and other heavy metal exposures for young children may have merit in other settings where comprehensive zonal remediation is not feasible or may not be warranted.
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Campbell K, Weingart R, Ashta J, Cronin T, Gazmararian J. COVID-19 Knowledge and Behavior Change among High School Students in Semi-Rural Georgia. J Sch Health 2021; 91:526-534. [PMID: 33997969 PMCID: PMC8207023 DOI: 10.1111/josh.13029] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/15/2021] [Accepted: 03/29/2021] [Indexed: 05/19/2023]
Abstract
BACKGROUND Many schools transitioned online to reduce viral spread and promote social distancing amid the COVID-19 pandemic. Remote learning may impact health behaviors and coping strategies among adolescents, including reduced physical activity and increased screen time. Social media and peers provide information about the pandemic to adolescents and may influence prevention behaviors. This study aims to assess adolescent knowledge and information about COVID-19, determine students' behavior change, and identify sources students turn to for information on the pandemic. METHODS Students from 2 high schools in semi-rural Georgia participated in a cross-sectional online survey in March 2020 (N = 761). RESULTS Common sources for COVID-19 news were peers (80%) and social media (58%). Few adolescents (3%) indicated that teenagers were at higher risk of severe illness due to COVID-19. Responses reveal adolescents understand social distancing and many are participating in prevention behaviors, including handwashing (87%) and staying at home as much as possible (87%). Most respondents reported increases in screen time outside of class (82%). CONCLUSIONS Findings suggest adolescents are obtaining COVID-19 knowledge from various sources, including social media, with varying degrees of implementation of prevention practices. Increases in screen time and reduced physical activity may impact long-term health among adolescents.
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Affiliation(s)
- Katherine Campbell
- Department of Epidemiology, Rollins School of Public HealthEmory University, 1518 Clifton RoadAtlantaGA30322
| | - Rachel Weingart
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public HealthEmory University1518 Clifton RoadAtlantaGA30322
| | - Jasleen Ashta
- Department of Global Health, Rollins School of Public HealthEmory University1518 Clifton RoadAtlantaGA30322
| | - Thomas Cronin
- Department of Epidemiology, Rollins School of Public HealthEmory University1518 Clifton RoadAtlantaGA30322
| | - Julie Gazmararian
- Department of Epidemiology, Rollins School of Public HealthEmory University1518 Clifton RoadAtlantaGA30322
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Szeszulski J, Walker TJ, McCurdy SA, Hoelscher DM. Use of School Wellness Policy Templates in One Texas Public Health Region: A Mixed-Methods Analysis. J Sch Health 2021; 91:562-573. [PMID: 33954996 PMCID: PMC8192465 DOI: 10.1111/josh.13032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Federal law requires most school districts to develop school wellness policies (SWPs), which state agencies assist in by providing templates. Templates provide standard language, which districts may edit for numerous reasons. We aimed to identify the frequency/consistency of template usage and identify the types of edits districts make when using SWP templates. METHODS We identified SWPs (N = 117) and templates (N = 2) from districts in 1 Texas public health region. We developed template specific coding guides, which allowed us to examine the frequency SWPs used template text within multiple areas (eg, nutrition goals, reporting). We also collected/categorized SWP edits from the template text and conducted a thematic analysis of locally developed SWPs and SWP templates. RESULTS Of 117 SWPs, 81.2% used a 2020 template, 13.7% used a 2005 template, and 5.1% created their own SWP. Across template-based SWPs, 44 content edits (0.4 per policy) occurred in 9 categories. Thematic analysis revealed: (1) locally developed SWPs created an informed mission statement linked to their goals; (2) Locally developed SWPs provided details that the current template includes in wellness plans. CONCLUSIONS Most districts used exact template language when writing their SWP. Adding spaces where districts can specify details could improve SWP content.
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Affiliation(s)
- Jacob Szeszulski
- The University of Texas Health Science Center at Houston,
Center for Health Promotion and Prevention Research and the Michael & Susan Dell
Center for Healthy Living, 7000 Fannin St #2528, Houston, TX, 77030
| | - Timothy J. Walker
- The University of Texas Health Science Center at Houston,
Center for Health Promotion and Prevention Research, 7000 Fannin St #2630, Houston,
TX, 77030
| | - Sheryl A. McCurdy
- The University of Texas Health Science Center at Houston,
Center for Health Promotion and Prevention Research, 7000 Fannin St #2572, Houston,
Texas, 77030
| | - Deanna M. Hoelscher
- The University of Texas Health Science Center at Houston
(UTHealth) School of Public Health, Austin Campus, Michael & Susan Dell Center
for Healthy Living, 1616 Guadalupe St., Suite 6.300, Austin, TX, 78701
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Davis KF, Loos JR, Boland MG. Five Years and Moving Forward: A Successful Joint Academic-Practice Public Partnership to Improve the Health of Hawaii's Schoolchildren. J Sch Health 2021; 91:584-591. [PMID: 33973241 DOI: 10.1111/josh.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND In 2014, the Hawaii Department of Education (DOE), the only statewide school system in the United States, predominately enrolled children (keiki) from underserved communities and lacked school nurses or a school health program. Chronic absenteeism due to health concerns was identified as a barrier to academic success. METHODS The DOE and a public university created Hawaii Keiki: Healthy and Ready to Learn (HK), a program to provide school-based services for 170 Title 1 schools in urban and rural settings and build momentum for statewide collective action. HK has maintained support from public and private entities to address student health. RESULTS This paper describes 5 years of program development, implementation, and continuing challenges. Most recently in 2020-2021, HK pivoted in the face of school campus closings due to COVID-19 with strategic plans, including telehealth, to move forward in this changed school environment. CONCLUSIONS The HK program has increased awareness of students' needs and is addressing the imperative to build health services within public schools. The multipronged approach of building awareness of need, providing direct services, educating future care providers, and supporting sound policy development, has an impact that goes beyond any one individual area.
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Affiliation(s)
- Katherine Finn Davis
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster Hall 410, Honolulu, HI, 96822, USA
| | - Joanne R Loos
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster Hall 440, Honolulu, HI, 96822, USA
| | - Mary G Boland
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster Hall 402, Honolulu, HI, 96822, USA
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Spencer J, Gilmore B, Lodenstein E, Portela A. A mapping and synthesis of tools for stakeholder and community engagement in quality improvement initiatives for reproductive, maternal, newborn, child and adolescent health. Health Expect 2021; 24:744-756. [PMID: 33794046 PMCID: PMC8235899 DOI: 10.1111/hex.13237] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/24/2021] [Accepted: 02/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Stakeholder and community engagement promotes collaboration and gives service users an opportunity to actively participate in the care they receive. Recognizing this potential, The Network for Improving Quality of Care for maternal, newborn and child health aimed to identify tools and operational guidance to integrate stakeholder and community engagement into quality improvement (QI) implementation. METHODS A mapping, consisting of a literature review and an open call through email and listservers, for implementation tools was conducted. Materials were included if they provided guidance on stakeholder and community engagement aligned to the Network's QI framework comprising seven phases. Screening of tools was done by two reviewers. RESULTS The literature search and the call for tools returned 197 documents with 70 tools included after screening. Most included tools (70%) were published after 2010. International organizations were the most frequently cited authors of tools. Only 15 tools covered all seven phases of the QI framework; few tools covered the more 'technical' phase of the QI framework: adapting standards and refining strategies. CONCLUSION The quantity of tools and their varied characteristics including types of stakeholder and community engagement processes across the QI framework confirms that engagement cannot be captured in a 'one-size-fits-all' formula. Many tools were designed with a generic focus to allow for adaption and use in different settings and sectors. Country programmes looking to strengthen engagement approaches can take advantage of available tools through an online portal on the WHO website and adapt them to meet their specific needs and context. PUBLIC INVOLVEMENT Programme implementers provided tools and resources during data collection.
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Affiliation(s)
- Jessie Spencer
- Division of Public HealthMichigan State UniversityCollege of Human MedicineFlintMIUSA
| | - Brynne Gilmore
- UCD Centre for Interdisciplinary ResearchEducation and Innovation in Health SystemsSchool of Nursing, Midwifery and Health SystemsUniversity College DublinDublinIreland
| | | | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent Health and AgeingWorld Health OrganizationGenevaSwitzerland
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Best NC, Nichols AO, Waller AE, Zomorodi M, Pierre-Louis B, Oppewal S, Travers D. Impact of School Nurse Ratios and Health Services on Selected Student Health and Education Outcomes: North Carolina, 2011-2016. J Sch Health 2021; 91:473-481. [PMID: 33843082 DOI: 10.1111/josh.13025] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/05/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Determination of adequate school nurse staffing is a complex process. School nurse-to-student ratios and the health services school nurses provide to students should be considered. The purpose of this study was to examine the impact of North Carolina school nurse-to-student ratios and school nurse health services on the health and education outcomes (eg, absences, grades, self-management) of students receiving services for asthma and diabetes. METHODS This study of all 115 school districts in North Carolina used the Annual School Health Services Report Survey from 2011 to 2016. Descriptive statistics for health services, programs and outcomes, and generalized linear modeling were used to estimate the association of ratios and health services with asthma and diabetes outcomes. RESULTS By the 2015-2016 school year, the average ratio decreased to 1:1086 in North Carolina public schools. Annually, 100,187 students received services for asthma, 3832 students received services for type 1 diabetes, and 913 students received services for type 2 diabetes. Lower ratios and nurse health services were associated with improved student outcomes, including decreased absences (p = .05), improved grades (p = .05), and student self-management of their health condition (p = .05). CONCLUSIONS Lower school nurse-to-student ratios and services were associated with improvements in students' health and education outcomes.
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Affiliation(s)
- Nakia C Best
- Assistant Professor, , Sue & Bill Gross School of Nursing, University of California, Irvine, 106B Berk Hall Mail Code 3959, Irvine, CA, 92697., USA
| | - Ann O Nichols
- State School Health Nurse Consultant, , Division of Public Health, NC Department of Health and Human Services, 1928 Mail Service Center, Raleigh, NC, 27699., USA
| | - Anna E Waller
- Executive Director & Research Professor, , Carolina Center for Health Informatics, Department of Emergency Medicine, The University of North Carolina at Chapel Hill, 100 Market Street, Chapel Hill, NC, 27516., USA
| | - Meg Zomorodi
- Assistant Provost for Interprofessional Education and Practice & Professor, , Office of Interprofessional Education and Practice & School of Nursing, The University of North Carolina at Chapel Hill, Carrington Hall CB 7460, Chapel Hill, NC, 27599., USA
| | | | - Sonda Oppewal
- Professor, , School of Nursing, The University of North Carolina at Chapel Hill, Carrington Hall CB 7460, Chapel Hill, NC, 27599., USA
| | - Debbie Travers
- Associate Consulting Professor, , School of Nursing, Duke University, 307 Trent Drive, Durham, NC, 27710, USA
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Chaabane S, Doraiswamy S, Chaabna K, Mamtani R, Cheema S. The Impact of COVID-19 School Closure on Child and Adolescent Health: A Rapid Systematic Review. Children (Basel) 2021; 8:415. [PMID: 34069468 DOI: 10.3390/children8050415] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 12/25/2022]
Abstract
School closures during pandemics raise important concerns for children and adolescents. Our aim is synthesizing available data on the impact of school closure during the coronavirus disease 2019 (COVID-19) pandemic on child and adolescent health globally. We conducted a rapid systematic review by searching PubMed, Embase, and Google Scholar for any study published between January and September 2020. We included a total of ten primary studies. COVID-19-related school closure was associated with a significant decline in the number of hospital admissions and pediatric emergency department visits. However, a number of children and adolescents lost access to school-based healthcare services, special services for children with disabilities, and nutrition programs. A greater risk of widening educational disparities due to lack of support and resources for remote learning were also reported among poorer families and children with disabilities. School closure also contributed to increased anxiety and loneliness in young people and child stress, sadness, frustration, indiscipline, and hyperactivity. The longer the duration of school closure and reduction of daily physical activity, the higher was the predicted increase of Body Mass Index and childhood obesity prevalence. There is a need to identify children and adolescents at higher risk of learning and mental health impairments and support them during school closures.
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Masis N, McCaffrey J, Johnson SL, Chapman-Novakofski K. Evaluation of Preferences Among Students Participating in the US Department of Agriculture Fresh Fruit and Vegetable Program. J Sch Health 2021; 91:401-409. [PMID: 33768549 DOI: 10.1111/josh.13015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/09/2020] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Improving children's fruit and vegetable (FV) preferences may be important as preferences can predict FV consumption. The purpose of this study was to evaluate FV preferences over time, with repeated experience, as part of the Fresh Fruit and Vegetable Program (FFVP). METHODS Fruits (F; N = 28) and vegetables (V; N = 29) were distributed twice a week, over 35 weeks, at a participating FFVP school (N = 236 students, 12 teachers, K-2nd grade). Preference ratings using 3-point Likert scale were analyzed over 35 weeks. RESULTS For 57 FVs rated for preference, ratings revealed that F had higher frequency of children choosing "I like it" than for V (78% F; 38.2% V; p < .05) and liking distribution was different between F and V (p < .001). Significant relations were found between liking and: (1) grade (r = -0.02, p = .02), and (2) time (r = -0.09, p < .001). Models indicated that V served (β = -0.40), timepoint (β = -0.07), and grade level (β = -0.02) accounted for significant variance for preference ratings (R2 = 0.17, p < .001), indicating that preference ratings declined over time. CONCLUSIONS Fruits were preferred over vegetables. Overall preference ratings were negatively impacted by time, grade level, and vegetables served. Being exposed one time to a variety of FVs did not improve ratings for vegetables.
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Affiliation(s)
- Natalie Masis
- Medical Science Liaison, , Scientific and Medical Affairs, Abbott, 2900 Easton Square Place, Columbus, OH, 43219, USA
| | - Jennifer McCaffrey
- Assistant Dean, , Family and Consumer Sciences, University of Illinois Extension, 520 Bevier Hall MC-184, 905 South Goodwin Avenue, Urbana, IL, 61801, USA
| | - Susan L Johnson
- Professor of Pediatrics; Director, , The Children's Eating Laboratory, University of Colorado School of Medicine, Anschutz Medical Campus, 12631 East 17th Avenue, Box F561, Aurora, CO, 80045, USA
| | - Karen Chapman-Novakofski
- Professor, , Nutrition, University of Illinois at Urbana-Champaign, 343 Bevier Hall, 905 South Goodwin Avenue, Urbana, IL, 61801, USA
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Pattison KL, Hoke AM, Schaefer EW, Alter J, Sekhar DL. National Survey of School Employees: COVID-19, School Reopening, and Student Wellness. J Sch Health 2021; 91:376-383. [PMID: 33655549 PMCID: PMC8014727 DOI: 10.1111/josh.13010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND During spring 2020, COVID-19 forced widespread United States school building closures in an unprecedented disruption for K-12 students and staff. Partnering with the American School Health Association (ASHA), we sought to identify areas of concern among school staff planning for school reopening with the goal of addressing gaps in resources and education. METHODS This 16-item web-based survey was distributed via email to 7467 ASHA members from May to June 2020. Topics focused on 3 Whole School, Whole Community, Whole Child components: physical environment, health services, and mental health. Chi-square tests were used to identify differences in responses by school characteristics and school role on each survey item. RESULTS A total of 375 respondents representing 45 states completed the survey. The majority were female (91.7%), white (83.4%) and non-Hispanic (92.2%), and school nurses (58.7%). Priority concerns were feasibility of social distancing (93.6%), resurgence of COVID-19 (92.8%), and the availability of health supplies (88.8%). CONCLUSION Understanding staff concerns in the context of the Whole School, Whole Community, Whole Child model better positions the school community to address ongoing gaps and changing needs as schools continue to address COVID-19 complications.
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Affiliation(s)
- Krista L Pattison
- Project Manager, , Penn State PRO Wellness, 90 Hope Drive, Hershey, PA, 17033., USA
| | - Alicia M Hoke
- Project Manager, , Penn State PRO Wellness, 90 Hope Drive, Hershey, PA, 17033., USA
| | - Eric W Schaefer
- Biostatistician, , Penn State College of Medicine, 90 Hope Drive, Hershey, PA, 17033., USA
| | - Jeanie Alter
- Executive Director, , The American School Health Association, 501 N Morton Street, Suite 110, Bloomington, IN, 47404., USA
| | - Deepa L Sekhar
- Associate Professor of Pediatrics, , Penn State College of Medicine, 500 University Drive, HS83, Hershey, PA, 17033., USA
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Panisch LS, Baiden P, Findley E, Jahan N, LaBrenz CA. Adverse childhood experiences and risk factors associated with asthma among children in the United States: the intersection of sex and race/ethnicity. J Asthma 2021; 59:1122-1130. [PMID: 33783306 DOI: 10.1080/02770903.2021.1910296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The objectives of this cross-sectional study were to examine: 1) the association between adverse childhood experiences (ACEs) and asthma among children, and 2) the interaction between sex and race/ethnicity on asthma. METHODS Data for this study were obtained from the 2017-2018 National Survey of Children's Health. Binary logistic regression was conducted on an analytic sample of 49,000 children ages 0-17 years with asthma as the outcome variable and ACEs as the main explanatory variable. RESULTS Based on parent reports, we found that 11.5% of children had asthma and about 42% had at least one ACE, with 9.7% having ≥3 ACEs. Controlling for other factors, children with ≥3 ACEs had 1.45 times higher odds of having asthma when compared to children with no ACEs. Non-Hispanic Black males and females were more likely to have asthma when compared to non-Hispanic White males. CONCLUSIONS The findings of this study demonstrate an association between ACEs and asthma with children exposed to ≥3 ACEs more likely to have asthma underscoring the importance of cumulative effect of ACEs on asthma. Our study also revealed an interaction between sex and race/ethnicity on asthma among children. Additional studies are needed to understand the mechanisms through which ACEs is associated with asthma among children.
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Affiliation(s)
- Lisa S Panisch
- Department of Psychiatry, Center for the Study and Prevention of Suicide, University of Rochester Medical Center, Rochester, NY, USA
| | - Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Erin Findley
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Nusrat Jahan
- Department of Psychology, The University of Texas at Arlington, Arlington, TX, USA
| | - Catherine A LaBrenz
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
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