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Keeton VF, Soleimanpour S, Geierstanger S, Schapiro NA. Case Management for Social Needs of Youth and Families in School-Based Health Centers. J Sch Health 2024; 94:462-468. [PMID: 38234257 PMCID: PMC10987258 DOI: 10.1111/josh.13432] [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: 03/24/2023] [Revised: 11/15/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND School-based health centers (SBHCs) are ideal settings to address social needs of youth and families. Case managers can play a vital role in social care interventions. METHODS We piloted a program to incorporate a Case Manager into the care team of 1 SBHC serving 2 local schools with over 900 students and their surrounding communities. This project's purpose was to evaluate program feasibility, utilization, and acceptability. Our mixed-methods evaluation included analyses of data from electronic health records, client satisfaction surveys, and staff interviews. RESULTS During the 6-month pilot, the Case Manager served 133 clients (about one third of all SBHC clients served) through 593 contacts. Most contacts included referrals to support services (90%) and 37% addressed newcomer immigrant adjustment. All 37 respondents to the satisfaction survey during the 3-month administration period (44% response rate) reported that the Case Manager made them feel comfortable asking for help; 95% reported getting the help they needed. The 7 SBHC staff interviewed shared many program benefits, including increased time for clinical services. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Inequities in children's health and educational achievement are influenced by structural factors. Results from our pilot program demonstrate that SBHCs may be well-positioned to deliver social care interventions and that case managers enhance the ability to deliver quality care. CONCLUSIONS School-based programs to address unmet social needs are critical to supporting learning and wellness for all youth. Robust studies are needed to further test the impacts of case management in SBHCs.
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Affiliation(s)
- Victoria F Keeton
- Department of Obstetrics, Gynecology, and Reproductive Sciences, CA Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA
| | - Samira Soleimanpour
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
| | - Sara Geierstanger
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
| | - Naomi A Schapiro
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA
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Connolly K, Koslouski JB, Chafouleas SM, Schwartz MB, Edmondson B, Briesch AM. Evaluating the Usability of the Wellness School Assessment Tool Whole School, Whole Community, Whole Child (WellSAT WSCC): A School Wellness Policy Assessment Tool. J Sch Health 2024; 94:406-414. [PMID: 37933437 DOI: 10.1111/josh.13410] [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: 03/21/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Adoption of the Whole School, Whole Community, Whole Child (WSCC) model has been slowed by a lack of available tools to support implementation. The Wellness School Assessment Tool (WellSAT) WSCC is an online assessment tool that allows schools to evaluate the alignment of their policies with the WSCC model. This study assesses the usability of the WellSAT WSCC. METHODS Using a convergent mixed methods design, we collected qualitative and quantitative data from 5 school-based participants with roles in development and evaluation of policy. Participants explored the platform while engaging in a think-aloud procedure and scored a sample policy using the platform. They also completed the System Usability Scale and responded to open-ended questions about the usability of the platform. RESULTS Participants rated the WellSAT WSCC as an above-average user experience, but data suggested several areas for improvement, including improved instructions, enhanced visual design of the platform, and guidance for subsequent policy changes. CONCLUSION The WellSAT WSCC provides an above-average user experience but can be improved to increase user experience. These improvements increase the potential for greater use to facilitate integration of the WSCC model into school policy.
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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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Bright MA, Huq MS, Miller MD, Patel S, Li Z, Finkelhor D. Randomized Control Trial of a School-Based Curriculum that Teaches About Multiple Forms of Abuse. Child Maltreat 2024; 29:364-374. [PMID: 36639370 DOI: 10.1177/10775595231152623] [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] [Indexed: 06/17/2023]
Abstract
Most school-based prevention curricula for young children fail to address multiple types of abuse and limit instruction to a single day, despite evidence that polyvictimization is common and children learn better when allowed to practice material repeatedly. This study utilized a cluster randomized control trial design to evaluate a multi-abuse prevention program, the Monique Burr Foundation for Children (MBF) Child Safety Matters®, based on varying lesson structure. Participants included nine Florida schools consisting of 843 children in grades K-2. Schools were randomized within cluster to implement in two lessons, four lessons, or after study data collection (i.e., control group). Lessons averaged 34 minutes (SD = 8.8 minutes) in length for 2-lesson group and 23.6 minutes (SD = 6.9 minutes) for the 4-lesson condition. Knowledge was assessed before implementation and on average 11 weeks after implementation. There were no statistical differences between clusters. Controlling for pre-test scores, schools in the four-lesson group scored highest on a measure of knowledge of potentially risky and unsafe situations (M = 69.68, SE = .80) on post-test, followed by schools in the two-lesson group (M = 67.31, SE = .77), followed by schools in the control group (M = 62.92, SE = .76). Results support use of more frequent, shorter lessons for prevention programs and the promise of addressing multiple forms of child victimization.
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Affiliation(s)
| | - Mona Sayedul Huq
- Department of Pediatrics, University of Florida, Gainesville, FL, USA
| | - M David Miller
- School of Human Development and Organizational Studies in Education, University of Florida, Gainesville, FL, USA
| | - Shivam Patel
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Ziying Li
- School of Human Development and Organizational Studies in Education, University of Florida, Gainesville, FL, USA
| | - David Finkelhor
- Crimes Against Children Research Center, Family Research Laboratory, and Department of Sociology, University of New Hampshire, Durham, NH, USA
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Teesson M, Birrell L, Slade T, Mewton LR, Olsen N, Hides L, McBride N, Chatterton ML, Allsop S, Furneaux-Bate A, Bryant Z, Ellem R, Baker MJ, Healy A, Debenham J, Boyle J, Mather M, Mihalopoulos C, Chapman C, Newton NC. Effectiveness of a universal, school-based, online programme for the prevention of anxiety, depression, and substance misuse among adolescents in Australia: 72-month outcomes from a cluster-randomised controlled trial. Lancet Digit Health 2024; 6:e334-e344. [PMID: 38670742 DOI: 10.1016/s2589-7500(24)00046-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND The CSC study found that the universal delivery of a school-based, online programme for the prevention of mental health and substance use disorders among adolescents resulted in improvements in mental health and substance use outcomes at 30-month follow-up. We aimed to compare the long-term effects of four interventions-Climate Schools Combined (CSC) mental health and substance use, Climate Schools Substance Use (CSSU) alone, Climate Schools Mental Health (CSMH) alone, and standard health education-on mental health and substance use outcomes among adolescents at 72-month follow-up into early adulthood. METHODS This long-term study followed up adolescents from a multicentre, cluster-randomised trial conducted across three states in Australia (New South Wales, Queensland, and Western Australia) enrolled between Sept 1, 2013, and Feb 28, 2014, for up to 72 months after baseline assessment. Adolescents (aged 18-20 years) from the original CSC study who accepted contact at 30-month follow-up and provided informed consent at 60-month follow-up were eligible. The interventions were delivered in school classrooms through an online delivery format and used a mixture of peer cartoon storyboards and classroom activities that were focused on alcohol, cannabis, anxiety, and depression. Participants took part in two web-based assessments at 60-month and 72-month follow-up. Primary outcomes were alcohol use, cannabis use, anxiety, and depression, measured by self-reported surveys and analysed by intention to treat (ie, in all students who were eligible at baseline). This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613000723785), including the extended follow-up study. FINDINGS Of 6386 students enrolled from 71 schools, 1556 (24·4%) were randomly assigned to education as usual, 1739 (27·2%) to CSSU, 1594 (25·0%) to CSMH, and 1497 (23·4%) to CSC. 311 (22·2%) of 1401 participants in the control group, 394 (26·4%) of 1495 in the CSSU group, 477 (37·%) of 1289 in the CSMH group, and 400 (32·5%) of 1232 in the CSC group completed follow-up at 72 months. Adolescents in the CSC group reported slower year-by-year increases in weekly alcohol use (odds ratio 0·78 [95% CI 0·66-0·92]; p=0·0028) and heavy episodic drinking (0·69 [0·58-0·81]; p<0·0001) than did the control group. However, significant baseline differences between groups for drinking outcomes, and no difference in the predicted probability of weekly or heavy episodic drinking between groups were observed at 72 months. Sensitivity analyses increased uncertainty around estimates. No significant long-term differences were observed in relation to alcohol use disorder, cannabis use, cannabis use disorder, anxiety, or depression. No adverse events were reported during the trial. INTERPRETATION We found some evidence that a universal online programme for the prevention of anxiety, depression, and substance use delivered in early adolescence is effective in reducing the use and harmful use of alcohol into early adulthood. However, confidence in these findings is reduced due to baseline differences, and we did not see a difference in the predicted probability of drinking between groups at 72-month follow-up. These findings suggest that a universal prevention programme in adolescence is not sufficient to have lasting effects on mental health and substance use disorders in the long term. In addition to baseline differences, substantial attrition warrants caution in interpretation and the latter factor highlights the need for future long-term follow-up studies to invest in strategies to increase engagement. FUNDING Australian National Health and Medical Research Council.
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Affiliation(s)
- Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Louise R Mewton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Nick Olsen
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Leanne Hides
- Lives Lived Well Group, National Centre for Youth Substance Use Research, School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Mary Lou Chatterton
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Ainsley Furneaux-Bate
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Zachary Bryant
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Rhiannon Ellem
- Lives Lived Well Group, National Centre for Youth Substance Use Research, School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Megan J Baker
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Annalise Healy
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Julia Boyle
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Marius Mather
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Catherine Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
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Larsson R, Ljung E, Josefsson S, Ljung T. 'We get to learn as we move': effects and feasibility of lesson-integrated physical activity in a Swedish primary school. BMC Public Health 2024; 24:1087. [PMID: 38641777 PMCID: PMC11027527 DOI: 10.1186/s12889-024-18509-7] [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] [Received: 04/04/2023] [Accepted: 04/03/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Physical activity (PA) promotes health in adults as well as children. At the same time, a large proportion of children do not meet the recommendations for PA, and more school-based efforts to increase PA are needed. This study investigates the effectiveness and feasibility of lesson-integrated PA in a Swedish primary school. METHODS We evaluate a new method called 'Physical Activity and Lesson in Combination' (abbreviated FALK in Swedish) using a mixed methods approach; a quasi-experimental study followed by qualitative interviews. Two schools participated in the study, one constituting the intervention group (I-school, n = 83) and the other the control group (C-school, n = 81). In addition to regular physical education, the I-school had three 30-minute FALK lessons each week. A total of 164 students aged 7-9 years wore pedometers for a whole week, four times over two semesters, and the number of steps per day (SPD) and the proportion of students with < 10,000 SPD were compared. Statistical differences between the schools were tested with ANOVA, Chi2, t-tests, and ANCOVA. Interviews with students (n = 17), parents (n = 9) and teachers (n = 9) were conducted and analysed using qualitative content analysis. RESULTS The results show that FALK led to the I-school getting more SPD and fewer students with < 10,000 SPD. Also, FALK was experienced as a positive, clear, and flexible method, simultaneously encouraging PA and learning. Challenges experienced concerned the teachers' work situation, time, finding suitable learning activities, outdoor school environment changes, and extreme weather conditions. CONCLUSIONS This study indicates that FALK has the desired effects on PA and is a feasible method of integrating PA into theoretical teaching. We conclude that FALK is worth testing at more schools, given that implementation and sustainment of FALK considers both general enablers and barriers, as well as context-specific factors at the individual school.
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Affiliation(s)
- Robert Larsson
- Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, 721 23, Västerås, Box 883, Sweden.
| | - Eva Ljung
- Borlänge municipality, Borlänge, Sweden
| | | | - Thomas Ljung
- Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, 721 23, Västerås, Box 883, Sweden
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Dawson MLW, Neal A, West K. Go Team Go! Interprofessional Practice for Pediatric Feeding in the Schools. Lang Speech Hear Serv Sch 2024; 55:394-408. [PMID: 38227486 DOI: 10.1044/2023_lshss-23-00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Abstract
PURPOSE The purpose of this clinical focus article is to discuss processes and procedures for building school-based programs to address the feeding and swallowing needs of students in the public-school setting. Interprofessional practice (IPP) team member roles and responsibilities, screening, eligibility, considerations for developing Individualized Education Programs that address the needs of students with pediatric feeding disorder (PFD) and dysphagia, as well as billing documentation requirements, are discussed. Additionally, coordination across the continuum of service delivery for students with PFD and dysphagia is investigated. Guidance on documentation, processes, and procedures that comply with the Individuals with Disabilities Education Act mandates will be provided. CONCLUSIONS This clinical focus article will demonstrate that students with PFD and dysphagia continue to present to public schools and require skilled services and supports in order to meet their individualized needs. School-based speech-language pathologists have a legal requirement to provide these supports when deemed educationally relevant. Schools must employ processes and procedures that result in the timely and effective evaluation and identification of students with PFD and dysphagia. An IPP approach to the management of PFD and dysphagia is critical to ensure optimal outcomes for students found eligible for services.
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Affiliation(s)
- Michelle L W Dawson
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
| | - Angie Neal
- South Carolina State Department of Education, Office of Special Education Services, Columbia
| | - Kristen West
- Department of Communication Sciences and Disorders, Pennsylvania Western University, Clarion
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West KM. Treating Pediatric Feeding Disorders and Dysphagia: Evidence-Based Interventions for School-Based Clinicians. Lang Speech Hear Serv Sch 2024; 55:444-457. [PMID: 38198285 DOI: 10.1044/2023_lshss-23-00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
PURPOSE Children with pediatric feeding disorder (PFD) and dysphagia are increasingly prevalent in school-based caseloads. This tutorial discusses the current best practices for treating children with PFD and dysphagia as well as considerations for service delivery in educational settings. METHOD The rationale for treating PFD and dysphagia in an educational setting is discussed. A review of various interventions for PFD and dysphagia and a discussion of the available evidence are provided. The principles of experience-dependent neuroplasticity and theory-driven practice are discussed in light of the need for additional empirical research. Practical considerations to enhance evidence-based practice for PFD and dysphagia in educational settings are explored. RESULTS The reader will be able to identify evidence-based interventions for students with PFD and dysphagia and plan for the implementation of these approaches in the school setting. CONCLUSIONS Students with PFD and dysphagia require skilled interventions to support their participation in educationally relevant activities and to promote continued development of feeding and swallowing skills while at school. A discussion of the current evidence for various interventions is provided to promote the utilization of evidence-based interventions in school-based settings.
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Affiliation(s)
- Kristen M West
- Department of Communication Sciences and Disorders, Pennsylvania Western University Edinboro, PA
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Leksy K, Gawron G, Rosário R. Associations between Polish school principals' health literacy and implementation of the Health Promoting School approach during the COVID-19 pandemic. PLoS One 2024; 19:e0301055. [PMID: 38564529 PMCID: PMC10986982 DOI: 10.1371/journal.pone.0301055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
The coronavirus pandemic has contributed to increasing the responsibility of school principals for the health of all school community members. Moreover, evidence confirms the significant role of school principals' health literacy (HL) for health promotion in schools. Therefore, the presented study aims to evaluate the associations between Polish school principals HL and the implementation of the Health Promoting School (HPS) approach in Polish schools. The present study was conducted as part of an international survey on the global COVID-HL network (www.covid-hl.eu) between June 2021 and December 2021. Three subscales of the HPS were considered and an exploratory analysis were used in this study. Associations between the median split of each subscale of HPS (outcome) and health literacy (predictor) were performed using logistic regression. Research results showed that the highest level of HPS implementation was directed at pupils. Principals perceived themselves as having the highest HL on the 'accessibility' subscale and these respondents had significantly higher odds of implementing learning opportunities for students. The study suggests that principals with adequate HL may be more likely to effectively implement HPS strategies in schools. This research could provide insights into the complex interplay between HL and the HPS approach and inform the development of more effective strategies for promoting health and HL in schools.
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Affiliation(s)
- Karina Leksy
- Institute of Pedagogy, Department of Social Science, University of Silesia, Katowice, Poland
| | - Grzegorz Gawron
- Institute of Sociology, Department of Social Science, University of Silesia, Katowice, Poland
| | - Rafaela Rosário
- School of Nursing, University of Minho, Braga, Portugal
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
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LoPresto LM, Cassady DL, Dove MS. Evaluation of School Wellness Policies in Low-Income California Districts After the 2016 USDA Final Rule. J Sch Health 2024; 94:327-335. [PMID: 38087398 PMCID: PMC10939874 DOI: 10.1111/josh.13422] [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: 02/01/2023] [Revised: 10/20/2023] [Accepted: 11/14/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND Districts with federal nutrition programs must have an updated local school wellness policy (LSWP) to promote nutrition, physical activity, and student wellness. This study evaluates factors associated with LSWP quality among low-income districts. METHODS In 2018, we collected LSWPs from websites of 200 randomly selected, county-stratified, low-income-serving California public districts. Multivariable linear regression assessed associations between district characteristics, model LSWP use (national, state, none), and adoption date on policy quality. RESULTS On the WellSAT 3.0 scale of 0-100, mean (95% CI) comprehensiveness was 65.0 (63.2-66.7) and strength was 37.3 (35.3-39.2). Nearly verbatim adoption of model LSWPs was high (68.5% state model, 13.0% a national model). Half were adopted before mandated updates. District size (≥1000 students) and national model LSWP adoption were associated with higher comprehensive scores. National model LSWP adoption was associated with higher strength scores in updated policies compared with those not updated. IMPLICATIONS LSWPs have improved school food and activity environments, but district engagement in LSWP is low. Integration into education frameworks that reduce learning barriers could provide synergy for re-engagement. CONCLUSIONS High adoption of model policies and low update compliance indicate little district engagement in LSWP. Mixed methods studies of districts with high-quality LSWP are needed.
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Affiliation(s)
- Lynnea M LoPresto
- Department of Public Health Sciences, School of Medicine, University of California, Davis, CA
| | - Diana L Cassady
- Department of Public Health Sciences, School of Medicine, University of California, Davis, CA
| | - Melanie S Dove
- Department of Public Health Sciences, School of Medicine, University of California, Davis, CA
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LaMonica-Weier A, Perlia Bavis M. Kids First: A Multicomponent Onboarding for Practitioner Students in a School-Based Health Center. J Sch Nurs 2024; 40:231-236. [PMID: 35253498 DOI: 10.1177/10598405221085682] [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: 11/16/2022] Open
Abstract
School-Based Health Centers (SBHCs) often serve vulnerable populations who have been exposed to adverse childhood experiences (ACEs) which have been tied to an increase in adult health risk factors. At an urban SBHC serving adolescent students, 75% of patients reported three or more ACEs. This SBHC also had multiple practitioner students. A multicomponent onboarding was created to implement the Patient Interaction Standard of Care, addressing the SBHC model, adolescent care, and ACEs. Practitioner students that completed the onboarding demonstrated 97% adherence to the Patient Interaction Standard of Care "Always" or "Most of the Time." By onboarding frequent practitioner students, care provided to this vulnerable patient population was more consistently aligned to evidenced-based care appropriate for the SBHC model, adolescent care, and ACEs. This demonstrates the importance of mandatory onboarding completion compliance and further implementation across other SBCHs.
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Gaal SR, Fuller MB. School Safety and Mental Health Awareness: Recommendations from K-12 Texas Public School Teachers. J Sch Health 2024; 94:308-316. [PMID: 38288657 DOI: 10.1111/josh.13425] [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: 01/29/2023] [Revised: 12/07/2023] [Accepted: 12/17/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND Mass school shootings have created fear in the American public. The results of this fear have been the hardening of schools, lockdowns, and active shooter drills, yet the mass shootings have not ended. The goal of this study was to analyze the mental health awareness of K-12 public schools teachers in Texas with a goal to identify the connections between mental health awareness and school safety. METHODS Data were used from an archival database of K-12 teacher responses in the 2020 Texas Educators' Needs Assessment Regarding School Safety and Victims Services to assess the current state of student mental health concerns and the connection of these concerns to school safety. This needs assessment included one mixed methods survey that was collected from Texas K-12 educators and Texas educators working in higher education in 2020. The original study included 25,161 usable responses (6.1%). For the purpose of this study, only K-12 teacher responses were used in the analysis. The K-12 teacher participants (n = 19,888) included the following institutional levels: (a) special setting, 2,919 (14.7%); (b) elementary school, 6,813 (34.3%); (c) middle/intermediate school, 4,189 (21.1%); (d) high school, 5,864 (29.5%); and (e) district level, 103 (0.5%). A total of 8,053 participant's qualitative responses and 10 of the original quantitative survey questions from the archival data were used to identify all findings in the study. RESULTS Collected qualitative and quantitative participant responses' outlined a need to improve student mental health by strengthening the focus on supporting all stakeholders (e.g., teachers, parents, counselors, and students) in mental health awareness and education. Participant comments focused on the lack of training, counselor support, and community support regarding the mental health needs of their students. CONCLUSION Recommendations to improve student mental health that were developed from this study identified key goals in school counselor role and responsibility to student mental health, increased involvement of community agencies, and improvement to in-school mental health counseling. Final recommendations of this study were focused on the need to improve student mental health if stakeholders want to develop a positive school environment. The failure to build an environment that is focused on student mental health will continue to affect the goal to improve overall school safety.
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Affiliation(s)
- Susanne R Gaal
- Department of Education Leadership, College of Education, Sam Houston State University, Huntsville, TX; Adjunct Professor, Lonestar College, Houston, TX
| | - Matthew B Fuller
- Department of Education Leadership, College of Education, Sam Houston State University, Huntsville, TX
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13
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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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14
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Fisher S, Benner K, Huang H, Day E. Substance Use Screening, Brief Intervention, and Referral to Treatment in Urban Settings: Barriers and Facilitators to Implementation With Minoritized Youth. J Sch Health 2024; 94:299-307. [PMID: 38239183 PMCID: PMC10939917 DOI: 10.1111/josh.13430] [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: 01/27/2023] [Revised: 12/06/2023] [Accepted: 12/17/2023] [Indexed: 02/18/2024]
Abstract
BACKGROUND Substance use in minoritized youth is associated with negative long-term health and life outcomes. The present study explores perspectives of school stakeholders at urban minority-serving schools regarding integration of an evidence-based intervention, screening, brief intervention, and referral to treatment (SBIRT) into existing school prevention models. METHODS Twenty-two participants were interviewed using the Consolidated Framework for Implementation Research to identify barriers and facilitators to SBIRT implementation. Qualitative data were transcribed, coded, and analyzed. RESULTS Four major themes related to barriers to SBIRT implementation included: lack of training, unclear role expectations, student confidentiality, and punitive school climates. The 3 major facilitators included: the feasibility of the intervention, its fit within multi-tiered systems of support, and the districts increasing collaboration with community mental health providers. These major themes along with other minor themes are discussed. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY SBIRT implementation within low-income, minority-serving schools may reduce substance use disparities among minoritized youth, improving health and life outcomes. Recommendations addressed training, school climate, and student engagement, highlighting a collaborative and supportive approach involving all stakeholders. CONCLUSIONS While SBIRT implementation has barriers and facilitators, overall, school staff were optimistic about implementation. In light of these findings, additional research should embed SBIRT in these settings.
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Affiliation(s)
- Sycarah Fisher
- Department of Educational Psychology, University of Georgia, Athens, GA USA
| | - Kalea Benner
- College of Social Work, University of Kentucky, Lexington, KY, USA
| | | | - Elizabeth Day
- Department of Educational Psychology, University of Georgia, Athens, GA USA
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15
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Brener N, Underwood JM, Mpofu J. New Online Tool From the Centers for Disease Control and Prevention Tracks School Health Policies and Practices. J Adolesc Health 2024; 74:634-636. [PMID: 38323961 PMCID: PMC11022274 DOI: 10.1016/j.jadohealth.2023.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 02/08/2024]
Affiliation(s)
- Nancy Brener
- Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
| | - J Michael Underwood
- Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Jonetta Mpofu
- Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
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16
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Debenham J, Birrell L, Champion KE, Newton N. An on-line school-based substance use harm reduction programme: The Illicit Project randomized controlled trial results. Addiction 2024; 119:741-752. [PMID: 38105000 DOI: 10.1111/add.16403] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 11/01/2023] [Indexed: 12/19/2023]
Abstract
AIMS The aim of this study was to measure the effectiveness of an on-line, neuroscience-based harm reduction intervention (The Illicit Project) on substance use, harms and knowledge over a 12-month period. DESIGN We used a two-arm cluster-randomized controlled trial. SETTING The study was conducted at eight secondary schools across New South Wales, Australia. PARTICIPANTS A total of 950 (mean age = 15.9; standard deviation = 0.68) in grades 10-12 at participating schools in 2020 took part. INTERVENTION AND COMPARATOR The Illicit Project intervention group (schools = five, n = 681) received an on-line, universal substance use and harm reduction programme over three classes. The active control group (schools = three, n = 269) received school-based health education as usual. MEASUREMENTS Self-report questionnaires assessed primary [alcohol, nicotine, cannabis, 3,4-methylenedioxymethamphetamine (MDMA), cocaine and prescription drug misuse] and secondary outcomes (alcohol-related harms and drug literacy) at baseline and the 6- and 12-month follow-up assessment. FINDINGS Approximately 63% (n = 595) of the sample completed the 12-month follow-up assessment, including 58% of the intervention group (n = 396/679) and 66% of the active control group (n = 179/271). Participants in the intervention group had slower annual increases in binge drinking [odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.12-0.89], nicotine use (OR = 0.80, 95% CI = 0.52-1.23), MDMA use (OR = 0.14, 95% CI = 0.02-1.00), cocaine use (OR = 0.06, 95% CI = 0.01-0.64) and prescription drug misuse (OR = 0.07, 95% CI = 0.01-0.54) compared with the active control group. There was limited evidence of an intervention effect on cannabis use and alcohol-related harm (P > 0.5). The secondary outcomes showed that the intervention group maintained higher levels of drug literacy knowledge (β = 3.71, 95% CI = 1.86-5.56) and harm reduction help-seeking skills (β = 1.55, 95% CI = 0.62-2.48) compared with the active control group. CONCLUSION The Illicit Project (an on-line, neuroscience-based substance use harm reduction intervention) was effective in slowing the uptake of risky substance use and improving drug literacy skills among late secondary school students in Australia, compared with school-based health education as usual.
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Affiliation(s)
- Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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17
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Bell R. Confronting School Shootings in America: The Pediatrician's Role. Pediatrics 2024; 153:e2023065281. [PMID: 38433663 DOI: 10.1542/peds.2023-065281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 03/05/2024] Open
Affiliation(s)
- Rebecca Bell
- University of Vermont Children's Hospital, Burlington, Vermont
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18
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Martínez-Hernández N, Lloret-Irles D. Are School-Based Interventions Effective in Preventing Internet Misuse? A Systematic Review. J Prev (2022) 2024; 45:193-212. [PMID: 38060136 PMCID: PMC10981624 DOI: 10.1007/s10935-023-00757-9] [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] [Accepted: 11/10/2023] [Indexed: 12/08/2023]
Abstract
Problems related to the use of the internet have triggered the appearance of internet addiction. With this problem comes the need for prevention. The objective of this study is to update the knowledge about the effectiveness of internet addiction prevention programs in schools. The specific aims are: (1) to identify the objectives of school's prevention programs, (2) to analyse the components and instruments used, (3) to evaluate the quality of the relevant studies and (4) to compare the results of the publications. A search with the terms "Internet", "Internet Use Disorder", "addiction", "prevention", "school", "effectiveness", and "prevention program" was carried out in 10 bibliographic databases in August 2021. For the selection of articles, the 25 quality criteria of the CONSORT 2010 list were used. Only articles that evaluated school prevention programs and had a quality score greater than 10 were selected. The results are shown in three tables. Eleven publications that met the inclusion criteria were identified. The measurement scales used are very heterogeneous. Ten of the 11 programs were effective in preventing adolescent internet misuse, abuse, or addiction. Increasing students' self-control reduces the problem of internet abuse. The validity of the results is discussed considering the methodological quality of the studies.
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Affiliation(s)
- Nieves Martínez-Hernández
- Department of Health Psychology, University Miguel Hernández, Avinguda de la Universitat d'Elx, s/n, 03202, Elche, Alicante, Spain.
| | - Daniel Lloret-Irles
- Department of Health Psychology, University Miguel Hernández, Faculty of Medicine, 03550, Sant Joan d'Alacant, Alicante, Spain
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19
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Russo R, King E, Elliott N. The formative evaluation and pre-testing of a SunSmart policy implementation support toolkit targeting sun safe hat-wearing in NSW primary schools. Health Promot J Austr 2024; 35:303-310. [PMID: 37208977 DOI: 10.1002/hpja.746] [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] [Received: 12/22/2022] [Revised: 04/05/2023] [Accepted: 05/09/2023] [Indexed: 05/21/2023] Open
Abstract
ISSUE ADDRESSED Strategies that support the implementation of the SunSmart program in primary schools are essential to optimising policy uptake. Evidence outlining the type of support required, however, is lacking. This project explored the usefulness of an implementation support approach to sun safe hat-wearing in schools. METHODS Formative research was undertaken with 16 primary schools in Greater Western Sydney to explore current sun protection behaviours and practices, perceived barriers and motivators of sun safe hat-wearing, and resource needs. Based on these insights, a resource toolkit was developed and tested in 14 demonstration sites. Follow-up interviews evaluated the usefulness of the toolkit and implementation support approach. RESULTS Sun safe hat-wearing practices varied among schools. Commonly reported motivators included school policies, role modelling, incentives and knowledge. Commonly reported barriers included negative social norms, forgetfulness, cost and lack of understanding. Formative insights informed the development of the 'Motivation, Access, Triggers' Model and a 23-resource toolkit. Following toolkit rollout, champions reported that the ability to select resources according to local needs was useful, and most found that the toolkit supported their school with sun safe hat-wearing. CONCLUSIONS A toolkit with local champions and leadership buy-in has the potential to improve policy implementation. The opportunity to prioritise resource selection enables schools to address their specific needs in line with their sun protection policy. SO WHAT?: The provision of policy implementation support can help schools overcome the challenges of transforming a written SunSmart policy into practice.
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Affiliation(s)
- Rachel Russo
- Cancer Council NSW, Woolloomooloo, New South Wales, Australia
| | - Elizabeth King
- Cancer Council NSW, Woolloomooloo, New South Wales, Australia
| | - Naomi Elliott
- Cancer Council NSW, Woolloomooloo, New South Wales, Australia
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20
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McCabe E, Grunin L, Jameson B. Advancing School Health: Building a Partnership Between School Nurses and the Centers for Disease Control and Prevention. J Sch Nurs 2024; 40:123-124. [PMID: 38291717 DOI: 10.1177/10598405241227884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Affiliation(s)
- Ellen McCabe
- Hunter College, Hunter-Bellevue School of Nursing, The City University of New York, USA
| | - Laura Grunin
- Rory Meyers College of Nursing, New York University, USA
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21
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Close J. Medicaid Reimbursement for School-Based Mental Health Services. Pediatrics 2024; 153:e2023064074. [PMID: 38426284 DOI: 10.1542/peds.2023-064074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 03/02/2024] Open
Affiliation(s)
- Jeylan Close
- National Clinician Scholars Program, Department of Psychiatry and Behavioral Sciences, Child & Family Mental Health & Community Psychiatry Division, Duke Margolis Center for Health Policy, Duke University, Durham, North Carolina
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22
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Ramirez M, Shah PD, Chu HY, Garza L, Linde S, Garrison MM, Zhou C, Bishop S, Ibarra G, Ko LK. Reopening schools safely and educating youth (ROSSEY) study: Protocol for a community-based, cluster randomized controlled trial. Contemp Clin Trials 2024; 139:107480. [PMID: 38382823 PMCID: PMC10960672 DOI: 10.1016/j.cct.2024.107480] [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] [Received: 11/07/2023] [Revised: 01/22/2024] [Accepted: 02/17/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION ROSSEY is a community-academic partnership aiming to develop and test a COVID-19 risk communication intervention for elementary school students and families in Yakima County, Washington. We describe the ROSSEY study protocol that will be implemented in the Yakima School District. METHODS Aim 1 is to identify the community's social, ethical, and behavioral needs and resources for students to return to school and maintain onsite learning. We will conduct semi-structured interviews with students and school employees and focus groups with parents. Aim 2 is to evaluate the effectiveness of risk communication on students' school attendance. We will conduct a cluster randomized control trial. We will enroll 14 Yakima School District elementary schools with 900 student participants and randomize the schools into the COVID-19 risk communication intervention or control group. Aim 3 will assess implementation of the risk communication intervention and schools' COVID-19 mitigation strategies. We will use the RE-AIM framework to guide this work, which will entail conducting semi-structured interviews with students and school employees and focus groups with parents. DISCUSSION Implementation of science-based risk communication can educate the community on the benefits and safety of COVID-19 testing and vaccination. Risk communication may also inform families about the role of COVID-19 testing and vaccines as part of mitigation strategies to allow for safe in-person learning. Schools have extraordinary influence to promote children's health through policy and practice change. Study findings will provide evidence to facilitate policy decisions and best practices at schools that facilitate adoption of COVID-19 risk communication. TRIAL REGISTRATION ClinicalTrials.govNCT04859699. Registered on April 26, 2021.
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Affiliation(s)
- Magaly Ramirez
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States of America.
| | - Parth D Shah
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States of America; Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, United States of America
| | - Helen Y Chu
- Department of Medicine, Allergy & Infectious Diseases, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Lorenzo Garza
- Sunnyside School District, Sunnyside, WA, United States of America
| | - Sandra Linde
- Astria Health, Sunnyside, WA, United States of America
| | - Michelle M Garrison
- Department of Public Health, Purdue University College of Health and Human Sciences, West Lafayette, IN, United States of America
| | - Chuan Zhou
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, United States of America; Department of Pediatrics, Division of General Pediatrics, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Sonia Bishop
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States of America
| | - Genoveva Ibarra
- Center for Community Health Promotion, Fred Hutchinson Cancer Center, Sunnyside, WA, United States of America
| | - Linda K Ko
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States of America; Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, United States of America; Institute of Translational Health Sciences, Seattle, WA, United States of America
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23
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Barnes C, Jones J, Wolfenden L, Robertson K, Seidler AL, Norman J, Budgen P, Mattingly M, Piliskic C, Moorhouse L, Mozina J, Plaskett J, McDermott S, Darney S, Vuong C, Douglass N, McDonnell K, Sutherland R. A collaborative network trial to evaluate the effectiveness of implementation strategies to maximize adoption of a school-based healthy lunchbox program: a study protocol. Front Public Health 2024; 12:1367017. [PMID: 38601495 PMCID: PMC11004312 DOI: 10.3389/fpubh.2024.1367017] [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] [Received: 01/08/2024] [Accepted: 03/12/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction An important impediment to the large-scale adoption of evidence-based school nutrition interventions is the lack of evidence on effective strategies to implement them. This paper describes the protocol for a "Collaborative Network Trial" to support the simultaneous testing of different strategies undertaken by New South Wales Local Health Districts to facilitate the adoption of an effective school-based healthy lunchbox program ('SWAP IT'). The primary objective of this study is to assess the effectiveness of different implementation strategies to increase school adoption of the SWAP across New South Wales Local Health Districts. Methods Within a Master Protocol framework, a collaborative network trial will be undertaken. Independent randomized controlled trials to test implementation strategies to increase school adoption of SWAP IT within primary schools in 10 different New South Wales Local Health Districts will occur. Schools will be randomly allocated to either the intervention or control condition. Schools allocated to the intervention group will receive a combination of implementation strategies. Across the 10 participating Local Health Districts, six broad strategies were developed and combinations of these strategies will be executed over a 6 month period. In six districts an active comparison group (containing one or more implementation strategies) was selected. The primary outcome of the trial will be adoption of SWAP IT, assessed via electronic registration records captured automatically following online school registration to the program. The primary outcome will be assessed using logistic regression analyses for each trial. Individual participant data component network meta-analysis, under a Bayesian framework, will be used to explore strategy-covariate interactions; to model additive main effects (separate effects for each component of an implementation strategy); two way interactions (synergistic/antagonistic effects of components), and full interactions. Discussion The study will provide rigorous evidence of the effects of a variety of implementation strategies, employed in different contexts, on the adoption of a school-based healthy lunchbox program at scale. Importantly, it will also provide evidence as to whether health service-centered, collaborative research models can rapidly generate new knowledge and yield health service improvements. Clinical trial registration This trial is registered prospectively with the Australian New Zealand Clinical Trials Registry (ACTRN12623000558628).
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Affiliation(s)
- Courtney Barnes
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Jannah Jones
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Katie Robertson
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Anna Lene Seidler
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Jennifer Norman
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Pip Budgen
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia
| | - Megan Mattingly
- Health Promotion, Murrumbidgee Local Health District, Albury, NSW, Australia
| | - Carla Piliskic
- Health Promotion Unit, Population Health, Nepean Blue Mountains Local Health District, Penrith, NSW, Australia
| | - Lisa Moorhouse
- Health Equity, Promotion and Prevention Service, South Eastern Sydney Local Health District, Darlinghurst, NSW, Australia
| | - Jennifer Mozina
- Population Health, Southern NSW Local Health District, Queanbeyan, NSW, Australia
| | - Jennifer Plaskett
- Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW, Australia
| | - Sarah McDermott
- Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW, Australia
| | - Sara Darney
- Western NSW Health Promotion, Western NSW Local Health District, Dubbo, NSW, Australia
| | - Cecilia Vuong
- Health Promotion Service, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Nina Douglass
- Health Promotion Service, Central Coast Local Health District, Gosford, NSW, Australia
| | - Kara McDonnell
- Population Health Promotion, Northern Sydney Local Health District, Brookvale, NSW, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
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24
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Jeppesen LS, Damsgaard L, Stolpe MN, Melcher JNS, Wienecke J, Nielsen G, Smedegaard S, Henriksen AH, Hansen RA, Hillman CH, Tammelin TH, Resaland GK, Daly-Smith A, Bugge A. Study protocol for the ACTIVE SCHOOL study investigating two different strategies of physical activity to improve academic performance in Schoolchildren. BMC Pediatr 2024; 24:174. [PMID: 38461348 PMCID: PMC10924402 DOI: 10.1186/s12887-024-04647-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 02/14/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND Previous research has suggested that school-based physical activity (PA) interventions may have a positive impact on academic performance. However, existing literature on school-based interventions encompasses various forms of PA, spanning from vigorous intensity PA outside the academic classes to light intensity PA and movement integrated into academic learning tasks, and results on academic performance are inconclusive. ACTIVE SCHOOL will implement two different PA interventions for one school year and assess the effects on the pupils' academic performance, with math performance as the primary outcome. METHODS/DESIGN The ACTIVE SCHOOL project consists of two phases: 1) Development phase and 2) Randomized Controlled Trial (RCT). In phase one, two interventions were developed in collaboration with school staff. The two interventions were tested in an 8-weeks feasibility study. In phase two, a RCT-study with three arms will be conducted in 9-10-year-old children for one school year. The RCT-study will be carried out in two intervention rounds during the school years 2023/2024 and 2024/2025. Schools will be randomized to one of two interventions or control;1) Run, Jump & Fun intervention (4 × 30 min/week of moderate-to-vigorous physical activity; 2) Move & Learn intervention (4 × 30 min/week focusing on embodied learning in math and Danish lessons); or 3) a control condition, consisting of normal teaching practices. Outcome measures include academic performance, PA level, cognitive functions, cardiorespiratory fitness, anthropometry, well-being and school motivation (collected before, during and after the intervention period). A process evaluation will be conducted to assess implementation. DISCUSSION The ACTIVE SCHOOL study will expand knowledge regarding the impact of PA on academic performance. The study will have the potential to significantly contribute to future research, as well as the scientific and educational debate on the best way to implement PA to support education and learning. TRIAL REGISTRATION The study was registered on the 25th of October 2022 in ClinicalTrials.gov, NCT05602948.
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Affiliation(s)
- Lise Sohl Jeppesen
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, University College Copenhagen, Physiotherapy, Copenhagen, Denmark.
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
| | - Linn Damsgaard
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, University College Copenhagen, Physiotherapy, Copenhagen, Denmark
| | - Malene Norup Stolpe
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, University College Copenhagen, Physiotherapy, Copenhagen, Denmark
| | | | - Jacob Wienecke
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Glen Nielsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Søren Smedegaard
- Faculty of Teacher Education, UCL University College, Odense, Denmark
| | - Anne Husted Henriksen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Rasmus Ahmt Hansen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Charles H Hillman
- Center for Cognitive & Brain Health, Department of Psychology, Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - Tuija H Tammelin
- Likes, School of Health and Social Studies, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Geir K Resaland
- Centre for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - Andrew Daly-Smith
- Wolfson Centre for Applied Health Research, Faculty of Health Studies, University of Bradford, Richmond Road, Bradford, BD7 IDP, UK
| | - Anna Bugge
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, University College Copenhagen, Physiotherapy, Copenhagen, Denmark
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Sekhar DL, Schaefer EW, Hoke AM, Rosen P, Chuzie RA, Milakovic DM. Lessons Learned from an Academic Partnership to Review Pennsylvania Network for Student Assistance Services' Annual Survey. J Sch Health 2024; 94:228-234. [PMID: 37553008 DOI: 10.1111/josh.13389] [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: 01/09/2023] [Revised: 06/04/2023] [Accepted: 07/17/2023] [Indexed: 08/10/2023]
Abstract
INTRODUCTION Pennsylvania's Student Assistance Program (SAP) began in the mid-1980s to address student barriers to academic success. SAP teams, groups of trained school and community professionals, review referrals, and connect students to services. State leadership conducts an annual SAP team survey, but capacity to evaluate data and affect change is limited. In 2020, leadership partnered with [institution name] to collaboratively review the survey data. METHODS Frequencies and percentages were calculated. Open responses were coded. Logistic regression models evaluated the association between SAP team size, team meeting frequency, and team maintenance. RESULTS The 2019 to 2020 survey had 1003 respondents. Median number of SAP team members was 8 (range 1-21). The majority (54%) indicated their SAP team met once per week/cycle for 30 to 90+ minutes. Larger teams met more often. Annual team maintenance occurred for 38% of teams, and was more common for larger teams. SAP team members identified mental health (68%), trauma (44%), and parent engagement (36%) as top training needs. CONCLUSIONS An academic partnership successfully provided the capacity to review SAP survey responses, and informed evidenced-based discussion of best practice guidelines and realignment of staff professional development opportunities.
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Affiliation(s)
- Deepa L Sekhar
- Department of Pediatrics, Penn State College of Medicine, 90 Hope Drive, A14, Hershey, PA
| | - Eric W Schaefer
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Alicia M Hoke
- Department of Pediatrics, Penn State College of Medicine, 90 Hope Drive, A14, Hershey, PA
| | - Perri Rosen
- Pennsylvania Network of Student Assistance Services, Commonwealth of Pennsylvania, PA
| | - Roberta A Chuzie
- Pennsylvania Network of Student Assistance Services, Commonwealth of Pennsylvania, PA
| | - Dana M Milakovic
- Pennsylvania Network of Student Assistance Services, Commonwealth of Pennsylvania, PA
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Licata J, Evatt M, Pasek T, Bilenski B. Empowering middle school students to save lives through increasing awareness of food allergies and anaphylaxis through virtual media: A quality improvement project. J Pediatr Nurs 2024; 75:221-223. [PMID: 38195373 DOI: 10.1016/j.pedn.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Affiliation(s)
- Jodi Licata
- Duquesne University School of Nursing, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA 15282, United States of America.
| | - Manjulata Evatt
- Duquesne University, Pittsburgh, PA, United States of America
| | - Tracy Pasek
- University of Pittsburgh Medical Center Children's Hospital of Pittsburgh University of Pennsylvania School of Nursing, Philadelphia, PA, United States of America
| | - Bridgett Bilenski
- North Allegheny School District, Pittsburgh, PA, United States of America
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Hoke AM, Keller CM, Grimm CL, Lehman EB, Sekhar DL. Impact of Wellness Policy Review, Wellness Council Activity, and Student Health Objectives on Overall School Wellness Climate. J Sch Health 2024; 94:235-242. [PMID: 36928540 PMCID: PMC10504407 DOI: 10.1111/josh.13324] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/11/2023] [Revised: 02/17/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The whole school, whole community, whole child (WSCC) model suggests wellness councils, ongoing review of wellness policy, and a plan for evaluating set objectives are some of the key features needed to support school wellness infrastructure. This study explored the relationship between implementation of these infrastructure features and overall school wellness environment assessment scores among a sampling of Pennsylvania schools. METHODS The Healthy Champions program provides Pennsylvania schools an opportunity to self-assess their wellness environments across several school wellness topics. Staff enrolled their school in the program by completing a self-report electronic assessment. Enrollment data from the 2020/2021 program year were analyzed using the Kruskal-Wallis test and linear fixed model to identify the impact of varied implementation levels across 3 wellness infrastructure activities. Interactions between these variables and overall assessment score were also analyzed. RESULTS Of the 645 Pennsylvania schools enrolled and analyzed, we observed higher mean wellness environment assessment scores (∆ 0.74 95% CI 0.40-1.07; p < 0.001) among schools that reported some frequency of all 3 wellness infrastructure activities, compared to schools that reported no frequency for the activities. IMPLICATIONS Schools with existing policies and practices related to the 3 wellness infrastructure activities should consider the degree of implementation to best support overall wellness in their school setting. Additional research to explore implementation barriers and supports is needed. CONCLUSIONS Analyses indicated that overall wellness environment assessment scores are impacted by implementation thresholds for wellness council meeting frequency, revision of wellness policy, and review of student health promotion objectives.
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Devries K, Tanton C, Knight L, Nakuti J, Nanyunja B, Laruni Y, Amollo M, Apota J, Opobo T, Pearlman J, Allen E, Bonell C, Naker D. Good School Toolkit-Secondary Schools to prevent violence against students: protocol for a pilot cluster randomised controlled trial. BMJ Open 2024; 14:e077788. [PMID: 38346875 PMCID: PMC10862314 DOI: 10.1136/bmjopen-2023-077788] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/22/2024] [Indexed: 02/15/2024] Open
Abstract
INTRODUCTION No whole-school interventions which seek to reduce physical, sexual and emotional violence from peers, intimate partners and teachers have been trialled with adolescents. Here, we report a protocol for a pilot trial of the Good School Toolkit-Secondary Schools intervention, to be tested in Ugandan secondary schools. Our main objectives are to (1) refine the intervention, (2) to understand feasibility of delivery of the intervention and (3) to explore design parameters for a subsequent phase III trial. METHODS AND ANALYSIS We will conduct a pilot cluster randomised controlled trial, with two arms and parallel assignment. Eight schools will be randomly selected from a stratified list of all eligible schools in Kampala and Wakiso Districts. We will conduct a baseline survey and endline survey 18 months after the baseline, with 960 adolescents and 200 teachers. Qualitative data and mixed methods process data collection will be conducted throughout the intervention. Proportion of staff and students reporting acceptability, understanding and implementing with fidelity will be tabulated at endline for intervention schools. Proportions of schools consenting to participation, randomisation and proportions of schools and individual participants completing the baseline and endline surveys will be described in a Consolidated Standards of Reporting Trials diagram. ETHICS AND DISSEMINATION The ethical requirements of our project are complex. Full approvals have been received from the Mildmay Ethics Committee (0407-2019), the Uganda National Council for Science and Technology (SS 6020) and the London School of Hygiene & Tropical Medicine (16212). Results of this study will be published in peer-reviewed academic journals, and shared with public bodies, policy makers, study participants and the general public in Uganda. TRIAL REGISTRATION NUMBER PACTR202009826515511.
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Affiliation(s)
- Karen Devries
- London School of Hygiene & Tropical Medicine, London, UK
| | - Clare Tanton
- London School of Hygiene & Tropical Medicine, London, UK
| | - Louise Knight
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | - Mathew Amollo
- Africhild Centre, Makerere University, Kampala, Uganda
| | - John Apota
- Africhild Centre, Makerere University, Kampala, Uganda
| | - Timothy Opobo
- Africhild Centre, Makerere University, Kampala, Uganda
| | - Jodie Pearlman
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Chris Bonell
- Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
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Craig DW, Walker TJ, Sharma SV, Cuccaro P, Heredia NI, Pavlovic A, DeFina LF, Kohl HW, Fernandez ME. Examining associations between school-level determinants and the implementation of physical activity opportunities. Transl Behav Med 2024; 14:89-97. [PMID: 37713255 PMCID: PMC10849171 DOI: 10.1093/tbm/ibad055] [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: 09/16/2023] Open
Abstract
School-based physical activity (PA) opportunities can help students engage in greater amounts of daily PA, meet PA guidelines, and lead to improved health and educational outcomes. However, we do not completely understand the organizational challenges to implementing these opportunities successfully. This exploratory study examined associations between school-level determinants and the implementation of school-based PA opportunities. We analyzed cross-sectional survey data from schools (n = 46) participating in the Healthy Zone School Program (HZSP) (Dallas, Texas, USA) during 2019-2020. Respondents completed an electronic survey that included measures of school-level determinants (e.g. culture, leadership, priority) and the implementation of school-based PA opportunities. We used linear regression models to examine associations between determinants and implementation outcomes (number of PA opportunities delivered, perceived overall success of each PA program/activity used). After adjusting for campus type (i.e. elementary, middle, high, K-12), student race/ethnicity, and percentage of economically disadvantaged students, no constructs were associated with the number of PA opportunities implemented. Linear regression models suggest access to knowledge and information (β = 0.39, P = .012, 95% CI = 0.24-1.44) and implementation climate (β = 0.34, P = .045, 95% CI = 0.02-1.59) were positively associated with the success of school-based PA opportunities. Our findings provide suggestive evidence that access to knowledge and information and a supportive school climate may improve the overall success of PA opportunities provided to students. Future research should examine additional school-level determinants to understand their importance to implementation and inform the development of strategies to improve schools' capacity for implementing PA opportunities successfully.
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Affiliation(s)
- Derek W Craig
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX 77030,USA
| | - Timothy J Walker
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX 77030,USA
| | - Shreela V Sharma
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Paula Cuccaro
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX 77030,USA
| | - Natalia I Heredia
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX 77030,USA
| | - Andjelka Pavlovic
- Division of Youth Education, The Cooper Institute, 12330 Preston Road, Dallas, TX 75230, USA
| | - Laura F DeFina
- Division of Youth Education, The Cooper Institute, 12330 Preston Road, Dallas, TX 75230, USA
| | - Harold W Kohl
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Boulevard, Austin, TX 78712, USA
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, 1616 Guadalupe Street, Austin, TX 78701USA
| | - Maria E Fernandez
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX 77030,USA
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Messman E, Heinze J, Hsieh HF, Hockley N, Pomerantz N, Grodzinski A, Scott B, Goldstein N, Zimmerman M. Anonymous Reporting Systems for School-Based Violence Prevention: A Systematic Review. Health Educ Behav 2024; 51:62-70. [PMID: 35081818 DOI: 10.1177/10901981211073734] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
IMPACT STATEMENT Anonymous reporting systems (ARS) have been used as a violence prevention strategy in schools by providing a means for individuals within a school community to safely and securely report information about potential violence or concerns about mental health, for example, through an anonymous hotline or reporting app. Despite widespread implementation of ARS in schools, as well as mandates for reporting systems in schools in 21 states, there is limited evidence on the effectiveness of ARS for school violence prevention, and information about best practices for ARS implementation is lacking. This systematic review aims to summarize the current research on the effectiveness of ARS as a school safety and violence prevention strategy, which is an important step in building an evidence-base to guide schools and policymakers about best practices.
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Perry TT, Marko A, Russell AF, Cooke AT, Bingemann TA, Ross KR, Young MC. How Schools Can Help Address Social Determinants of Health in Asthma Management. J Allergy Clin Immunol Pract 2024; 12:316-326. [PMID: 37839577 DOI: 10.1016/j.jaip.2023.10.015] [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: 07/21/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
Schools are in a unique position to address social determinants of health (SDOHs) in pediatric asthma management because of their potential to provide resources and facilitate collaboration with health care providers and services for children at risk within their community. SDOHs include economic factors, educational attainment and health literacy, neighborhood factors and the built environment, social and community aspects including discrimination and racism, and health care access and quality. These factors have a significant impact on asthma health in children, and certain populations such as minoritzed populations and those living in high-poverty environments have been shown to be at greater risk for adverse effects of SDOHs on asthma outcomes. School-based asthma programs address several SDOHs including health literacy, the built environment, and health care quality and access and have been shown to improve asthma outcomes. Key components include connection between the school and the health care team, self-management education, and directly observed therapy. School nurses play a key role in directing and managing effective programs because they can evaluate and support a student's health while considering the effect of SDOHs at interpersonal, institutional, community, and policy levels.
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Affiliation(s)
- Tamara T Perry
- Division of Allergy and Immunology, College of Medicine, Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, Little Rock, Ark
| | - Angela Marko
- Division of Pediatric Pulmonology and Sleep Medicine, UH Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio.
| | - Anne F Russell
- School of Nursing and Health Sciences, Spring Arbor University, Spring Arbor, Mich; Food Allergy and Anaphylaxis Michigan Association, Ann Arbor, Mich
| | - Abigail T Cooke
- Allergy and Asthma Specialists, Durango, Colo; Colorado State University-Pueblo: Graduate School of Nursing, Pueblo, Colo
| | - Theresa A Bingemann
- Departments of Allergy, Immunology and Rheumatology and Pediatric Allergy and Immunology, University of Rochester School of Medicine, Rochester, NY
| | - Kristie R Ross
- Division of Pediatric Pulmonology and Sleep Medicine, UH Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio
| | - Michael C Young
- Division of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
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Sanz-Mas M, Ubalde-López M, Borràs S, Brugueras S, Continente X, Daher C, Marí-Dell'Olmo M, López MJ. Adapting Schools to Climate Change with Green, Blue, and Grey Measures in Barcelona: Study Protocol of a Mixed-Method Evaluation. J Urban Health 2024; 101:141-154. [PMID: 38236429 PMCID: PMC10897086 DOI: 10.1007/s11524-023-00814-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 01/19/2024]
Abstract
Under the framework of the Urban Innovative Actions program of the European Commission, in 2020, 11 primary schools in Barcelona were transformed into climate shelters by implementing green, blue, and grey measures. Schoolyards were also opened to the local community to be used during non-school periods. Here we present the study protocol of a mixed-method approach to evaluate the effectiveness of the interventions in terms of improving environmental quality and health for users. We evaluated school level through the following: (1) quantitative pre-post quasi-experimental study, and (2) qualitative evaluation. The quantitative study included measures of (a) environmental variables (collected via low-cost and non-low-cost sensors), (b) students' health and well-being (collected via health questionnaires, attention levels test, and systematic observations), and (c) teachers' health and well-being (collected via thermal comfort measurements and health questionnaires). The qualitative methods evaluated the perceptions about the effects of the interventions among students (using Photovoice) and teachers (through focus groups). The impact of the interventions was assessed at community level during summer non-school periods through a spontaneous ethnographic approach. Data collection started in August 2019 and ended in July 2022. The evaluation provides the opportunity to identify those solutions that worked and those that need to be improved for future experiences, as well as improve the evaluation methodology and replication for these kinds of interventions.
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Affiliation(s)
- Marta Sanz-Mas
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain
- Departament de Ciències Experimentals i de La Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Mònica Ubalde-López
- Departament de Ciències Experimentals i de La Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- ISGlobal, Barcelona Institute for Global Health, Doctor Aiguader 88, 08003, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
| | - Sílvia Borràs
- ISGlobal, Barcelona Institute for Global Health, Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Sílvia Brugueras
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
| | - Xavier Continente
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain.
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain.
| | - Carolyn Daher
- Departament de Ciències Experimentals i de La Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- ISGlobal, Barcelona Institute for Global Health, Doctor Aiguader 88, 08003, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
| | - Marc Marí-Dell'Olmo
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain
| | - María José López
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain
- Departament de Ciències Experimentals i de La Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain
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Henry KL, Stanley LR, Swaim RC. Can High and Consistent School-Related Protective Factors Prevent Cannabis Use Among American Indian Middle School Students? J Sch Health 2024; 94:138-147. [PMID: 37547948 PMCID: PMC10840609 DOI: 10.1111/josh.13380] [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: 11/23/2022] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND High cannabis use rates among American Indian (AI) adolescents necessitate the identification of factors that protect against early cannabis initiation. METHODS Data collected from 279 AI middle school students attending reservation-based schools in 2018 and 2019 were analyzed. Three waves of data, with approximately 6 months between each, were used. A repeated measures latent class analysis examined a school-related protective factor index over three waves. The predictive power of lifetime cannabis use on school protection class membership was estimated, along with differences in past month cannabis use at follow-up 2 across school protection classes while holding baseline use constant. RESULTS Four school protection classes were identified: high, moderate, low, and declining protection. Abstinence at baseline was associated with an increased odds of membership in the high protection class compared to the moderate and low protection classes. Students with consistent and high school protection throughout middle school were significantly less likely to report past month cannabis use at follow-up 2 compared to other classes. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Maintaining a high level of school protection throughout middle school substantially lowers the odds of cannabis use among AI adolescents. CONCLUSIONS Interventions to promote school-related protective factors in this population are essential and should be designed and tested.
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Affiliation(s)
- Kimberly L Henry
- Department of Psychology and Colorado School of Public Health, Colorado State University, Fort Collins, CO
| | - Linda R Stanley
- Tri-Ethnic Center for Prevention Research, Colorado State University, Fort Collins, CO
| | - Randall C Swaim
- Tri-Ethnic Center for Prevention Research, Colorado State University, Fort Collins, CO
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Lever N, Orenstein S, Jaspers L, Bohnenkamp J, Chung J, Hager E. Using the Whole School, Whole Community, Whole Child Model to Support Mental Health in Schools. J Sch Health 2024; 94:200-203. [PMID: 36866745 DOI: 10.1111/josh.13322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/12/2023] [Indexed: 01/06/2024]
Abstract
The COVID-19 pandemic increased already high rates of student mental health concerns and further underscored inequities and disparities in access to services and care. As schools continue to address the effects of the pandemic, they must prioritize student mental health and well-being. In this commentary, using feedback from the Maryland School Health Council, we present the connection between mental health in school and the Whole School, Whole Community, Whole Child (WSCC) model, a school health model commonly employed by schools and school districts. In doing so, we aim to highlight how school districts can use this model to address child mental health needs across a multi-tiered system of support.
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Affiliation(s)
- Nancy Lever
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Shawn Orenstein
- National Center for School Mental Health, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Lea Jaspers
- Anne Arundel County Public Schools, Annapolis, MD
| | - Jill Bohnenkamp
- National Center for School Mental Health, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Joyce Chung
- Departments of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Erin Hager
- Departments of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Mozid NE, Espinosa RN, Grayson C, Falode O, Yang Y, Glaudin C, Guastaferro K. Piloting an Alternative Implementation Modality for a School-Based Child Sexual Abuse Prevention Curriculum. Int J Environ Res Public Health 2024; 21:149. [PMID: 38397640 PMCID: PMC10888176 DOI: 10.3390/ijerph21020149] [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: 01/10/2024] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND In the U.S., the most pervasive child sexual abuse (CSA) prevention strategy involves school-based prevention programs; however, the reach of these programs is limited due to implementation constraints, such as budgets or turnover. This is notable as standard delivery of often requires two facilitators in the classroom. Leveraging a natural experiment in the implementation of Safe Touches, the current study sought to explore the feasibility of implementation with a single facilitator using pre-recorded videos compared to the standard in-person delivery. METHODS A six-item CSA-related knowledge questionnaire was delivered to (N = 1480) second-graders post-workshop. An independent-samples t-test was used to compare the mean of CSA-related knowledge item responses for each delivery modality. Student-level data were paired with teacher evaluations and an interview with the facilitator. RESULTS Across workshops delivered in 25 schools, there was no significant difference in knowledge based on CSA-related questions by workshop modality. Teachers indicated the facilitators responded effectively to the children's questions and comments in both delivery modalities. Input from the facilitator was positive. CONCLUSIONS Triangulation of student knowledge, teacher input, and facilitator experience indicates the viability and feasibility of this implementation strategy for Safe Touches, and potentially other school-based CSA prevention programs. To ensure equitable access to the CSA prevention program, the empirical examination of, and investment in, alternative implementation options for school-based CSA preventive programs is encouraged.
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Affiliation(s)
| | | | | | | | | | | | - Kate Guastaferro
- School of Global Public Health, New York University, New York, NY 10003, USA (O.F.); (Y.Y.)
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Wilcox H, Bishop S, Francis B, Lombard K, Beresford SAA, Ornelas IJ. Process evaluation of the Yéego! Program to increase healthy eating and gardening among American Indian elementary school children. BMC Public Health 2024; 24:232. [PMID: 38243203 PMCID: PMC10797868 DOI: 10.1186/s12889-024-17689-6] [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] [Received: 07/17/2023] [Accepted: 01/06/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND American Indian children are at increased risk for obesity and diabetes. School-based health promotion interventions are one approach to promoting healthy behaviors to reduce this risk, yet few studies have described their implementation and fidelity. We conducted a qualitative process evaluation of the Yéego! Healthy Eating and Gardening Program, a school-based intervention to promote healthy eating among Navajo elementary school children. The intervention included a yearlong integrated curriculum, as well as the construction and maintenance of a school-based garden. METHODS Our process evaluation included fidelity checklists completed by program staff and qualitative interviews with program staff and classroom teachers after the intervention was implemented. We used content analysis to identify themes. RESULTS We identified several themes related to evidence of delivery adherence, program satisfaction, and lessons learned about delivery. Intervention staff followed similar procedures to prepare for and deliver lessons, but timing, teaching styles, and school-level factors also impacted overall implementation fidelity. Teachers and students had positive perceptions of the program, especially lessons that were highly visual, experiential, and connected to Navajo culture and the surrounding community. Teachers and program staff identified ways to enhance the usability of the curriculum by narrowing the scope, relating content to student experiences, and aligning content with school curriculum standards. CONCLUSIONS The program was implemented with moderately high fidelity across contexts. We identified areas where modifications could improve engagement, acceptability, efficacy, and sustainability of the program. Our results have implications for the evaluation and dissemination of school-based health interventions to promote healthy eating among children, especially in American Indian communities.
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Affiliation(s)
- Heather Wilcox
- University of Washington, Box 351621, Seattle, WA, 98195, USA
| | - Sonia Bishop
- Fred Hutchinson Cancer Research Center, Seattle, USA
| | | | | | | | - India J Ornelas
- University of Washington, Box 351621, Seattle, WA, 98195, USA.
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Leksy K, Gawron G, Rosário R, Sormunen M, Velasco V, Sandmeier A, Simovska V, Wojtasik T, Dadaczynski K. The importance of school leaders in school health promotion. A European call for systematic integration of health in professional development. Front Public Health 2024; 11:1297970. [PMID: 38249376 PMCID: PMC10797775 DOI: 10.3389/fpubh.2023.1297970] [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] [Received: 09/20/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024] Open
Abstract
School leaders such as principals are key not only for educational and school quality but also for initiating and sustainably anchoring any innovation in schools. Although there is widespread agreement about the importance of holistic approaches to school health promotion, the role of principals has received increased, but not yet systematic, attention. In this context, it is unclear which leadership competencies are needed and to what extent they are taught. Hence, this paper aims to reflect whether and to what extend health promotion plays a role in preservice and inservice training of principals in Europe. Based on the results we call for a more systematic analysis of existing teaching opportunities and teaching needs for health-promoting leadership, the development of a European competence framework for health-promoting leadership, the development and implementation of a European system that monitors and evaluates the effectiveness of those preservice and inservice training programs, and the development of case-studies to stimulate a mutual learning process.
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Affiliation(s)
- Karina Leksy
- Department of Social Science, Institute of Pedagogy, University of Silesia, Katowice, Poland
| | - Grzegorz Gawron
- Department of Social Science, Institute of Sociology, University of Silesia, Katowice, Poland
| | - Rafaela Rosário
- School of Nursing, University of Minho, Braga, Portugal
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Braga, Portugal
- Research Centre in Nursing, School of Nursing, University of Minho, Braga, Portugal
| | - Marjorita Sormunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Veronica Velasco
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | - Venka Simovska
- Danish School of Education, Aarhus University, Copenhagen, Denmark
| | - Tomasz Wojtasik
- Regional In-Service Teachers Training Centre Metis in Katowice, Katowice, Poland
| | - Kevin Dadaczynski
- Department of Health Sciences, Fulda University of Applied Science, Fulda, Germany
- Center for Applied Health Science, Leuphana University Lueneburg, Lueneburg, Germany
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Randby JS, Ogden T, Lien N. Implementation and effectiveness of a school-based intervention to increase adherence to national school meal guidelines: a non-randomised controlled trial. Public Health Nutr 2024; 27:e25. [PMID: 38164650 PMCID: PMC10830359 DOI: 10.1017/s1368980023002938] [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] [Received: 06/19/2023] [Revised: 11/26/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Implementation of school meal guidelines is often inadequate, and evidence for effective implementation strategies for school-based nutrition interventions is limited. The aim of the present study was to examine the implementation and effectiveness of a multi-strategy implementation intervention to increase adherence to the Norwegian national school meal guideline. DESIGN The study was a school-based hybrid implementation effectiveness trial with a pre-post non-equivalent control group design, testing three implementation strategies: internal facilitation, training and an educational meeting. SETTING Primary schools and after-school services in two counties in south-east Norway. PARTICIPANTS School principals, after-school leaders and class teachers from thirty-three schools in the intervention county and principals and after-school leaders from thirty-four schools in a comparison county. RESULTS There was a significant difference of 4 percentage points in change scores between the intervention and the comparison groups at follow-up, after adjusting for baseline adherence (B = 0·04, seB = 0·01, t = 3·10, P = 0·003). The intervention effect was not associated with the school's socio-economic profile. School-level fidelity was the implementation dimension that was most strongly correlated (r s = 0·48) with the change scores in the intervention group, indicating that principals' support is important for gaining the largest intervention effects. CONCLUSIONS A school-based intervention with low intensity, based on trained teachers as internal facilitators, can increase adherence to the national school meal guideline among Norwegian primary schools, irrespective of local socio-economic conditions. Implementation fidelity, at an organisational level, may be a useful predictor for intervention outcomes in schools.
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Affiliation(s)
- Jorunn Sofie Randby
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Pb. 1046 Blindern, 0317Oslo, Norway
- Department of Child and Adolescent Health, Norwegian Directorate of Health, Pb. 220 Skøyen, 0213Oslo, Norway
| | - Terje Ogden
- Norwegian Center for Child Behavioral Development, P.b. 7053 Majorstuen, 0306Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Pb. 1046 Blindern, 0317Oslo, Norway
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Pickard K, Maddox B, Boles R, Reaven J. A cluster randomized controlled trial comparing the effectiveness of two school-based interventions for autistic youth with anxiety. BMC Psychiatry 2024; 24:6. [PMID: 38166851 PMCID: PMC10763300 DOI: 10.1186/s12888-023-05441-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Recent systematic reviews have indicated that cognitive behavioral therapy (CBT) is effective in reducing anxiety symptoms for autistic and non-autistic children. However, the vast majority of CBT research for autistic youth has been implemented within university settings and primarily by mental health providers. Schools hold great promise to equitably manage the mental health symptoms of autistic youth. Although preliminary research evaluating CBT within schools has been promising, CBT has not yet been compared to another readily available school mental health program. The goal of this protocol paper is to describe a multi-site study comparing two school-based interventions, Facing Your Fears-School Based (FYF-SB) and Zones of Regulation (ZOR) via a cluster randomized controlled type 1 hybrid effectiveness-implementation trial to determine which of the two interventions will best support autistic youth with anxiety in schools. METHODS Up to 100 elementary and middle schools will be randomized into FYF-SB or ZOR. Once schools are randomized, a minimum of two interdisciplinary school providers at each school will be trained to deliver either FYF-SB or ZOR over the course of 12 weeks to groups of 2-5 autistic students ages 8-14 years. Over the course of two years, a total of 200 autistic students will receive either ZOR or FYF-SB. The primary outcome of this trial is child anxiety, as rated by masked evaluators and via caregiver- and student-report, which will be measured at baseline, post-treatment, and 6-month follow-up. Semi-structured interviews will also be conducted with a purposive sample of students, caregivers, and school providers to understand the acceptability, appropriateness, and feasibility of either ZOR or FYF-SB. Stakeholder engagement is a central component of this project via two stakeholder advisory boards that will directly inform and oversee the project. DISCUSSION Results of this study will provide evidence about the relative impact of two school-based mental health interventions on outcomes reported as meaningful by caregivers and school providers. The additional focus on evaluating factors that support the implementation of FYF-SB and ZOR will allow future studies to test targeted implementation strategies that support mental health programming uptake and implementation within public schools. TRIAL REGISTRATION This trial is registered with clinicaltrials.gov (NCT05863520).
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Affiliation(s)
- Katherine Pickard
- Emory School of Medicine Department of Pediatrics, Division of Autism and Related Disabilities, 1920 Briarcliff Road, Atlanta, GA, 30329, USA.
| | - Brenna Maddox
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Richard Boles
- University of Colorado Anschutz Medical Campus, JFK Partners, Aurora, CO, USA
| | - Judy Reaven
- University of Colorado Anschutz Medical Campus, JFK Partners, Aurora, CO, USA
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Barmania S. Kevin Dadaczynski: championing school health promotion. Lancet Child Adolesc Health 2024; 8:12. [PMID: 38097313 DOI: 10.1016/s2352-4642(23)00323-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
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Mitchell JM, Kranz AM, Steiner ED. Barriers and Strategies Used to Continue School-Based Health Services During the COVID-19 Pandemic. Matern Child Health J 2024; 28:155-164. [PMID: 37971625 DOI: 10.1007/s10995-023-03824-z] [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] [Accepted: 10/24/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE To examine perceived barriers and strategies adopted to continue the delivery of school-based health services when schools reopened in Fall of 2021 during the COVID-19 pandemic and to assess whether these barriers and strategies varied by locality. METHODS We developed and subsequently conducted an online survey of school nurses who worked at the 1178 public elementary schools in Virginia in May 2021 to describe the impact of the COVID-19 pandemic on the delivery of school-based health services. We compared perceived barriers, strategies adopted and the effectiveness of strategies to continue the delivery of school-based health services by geographic locality (city vs. rural; suburban vs. rural and city vs. suburban). RESULTS More than half of schools located in cities expected nine of ten potential barriers to affect the delivery of school-based health services during Fall 2021. More than 50% of responding schools located in urban, suburban and rural area indicated that external barriers outside of their control, including insufficient funding and families not able to bring students to school, were likely to be barriers to delivering care. Strategies identified as "very effective" did not vary by locality. Across all localities, more schools reported virtual strategies were less effective than in-person strategies. CONCLUSIONS FOR PRACTICE Lessons from the early stages of the COVID-19 pandemic provide critical information for natural disaster and public health emergency preparedness. School locality should be considered in the development of plans to continue the delivery of school-based health services after natural disasters or during public health emergencies.
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Affiliation(s)
- Jean M Mitchell
- Georgetown University McCourt School of Public Policy, Old North 314, 37th & "O Sts. NW, Washington, DC, USA.
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Chan VF, Yard E, Mashayo E, Mulewa D, Drake L, Price-Sanchez C, Omar F. Does an integrated school eye health delivery model perform better than a vertical model in a real-world setting? A non-randomised interventional comparative implementation study in Zanzibar. Br J Ophthalmol 2023; 108:152-158. [PMID: 36376063 PMCID: PMC10804016 DOI: 10.1136/bjo-2022-321752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 05/04/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few studies on school eye health programmes have shown they were cost-effective. We compared the performance (Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM)) between an integrated model (IM) and a vertical model (VM) of school eye health delivery in Zanzibar. METHODS The set of RE-AIM performance indicators of the IM (n=9) and VM (n=10) cohorts was compared. The VM implemented only the eye health interventions, while the IM had the eye health interventions conducted within the school feeding programme. Semistructured interviews were conducted with 36 stakeholders to understand the challenges and outcomes experienced when implementing both models. RESULTS The IM achieved higher screening coverage, voluntary follow-up rate, screening validity and spectacle compliance than VM. This was due to effective coordination between implementers, motivated teachers to prevent vision problems and related negative impacts in children, and activities implemented timeously post-training. Both models recorded low wearing compliance. All schools in the IM cohort completed screening activities, but two schools in the VM cohort did not. Both models ceased activities after the funding stopped. Local stakeholders emphasised that evidence from this study can be used to advocate for more resources for children's eye health. CONCLUSIONS The IM cohort achieved better reach, effectiveness, adoption rate and implementation performance than the VM cohort. The poor maintenance performance indicators in both arms postfunding call for improvement to the implementation strategy to ensure the sustainability of school eye health. In the optics of scaling up, an integrated approach is recommended.
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Affiliation(s)
- Ving Fai Chan
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Brien Holden Vision Institute Foundation (Africa) Trust, Durban, South Africa
| | - Elodie Yard
- Partnership for Child Development, Imperial College London, London, UK
| | - Eden Mashayo
- Brien Holden Vision Institute Foundation (Africa) Trust, Durban, South Africa
| | - Damaris Mulewa
- Partnership for Child Development, Imperial College London, London, UK
| | - Lesley Drake
- Partnership for Child Development, Imperial College London, London, UK
| | | | - Fatma Omar
- Ministry of Health, Zanzibar, United Republic of Tanzania
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Chan VF, Yard E, Mashayo E, Mulewa D, Drake L, Omar F. Contextual factors affecting integration of eye health into school health programme in Zanzibar: a qualitative health system research. BMC Health Serv Res 2023; 23:1414. [PMID: 38098051 PMCID: PMC10722834 DOI: 10.1186/s12913-023-10469-9] [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] [Received: 03/28/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Short-term school eye health programmes supported by external funders have sustainability issues. This study aimed to understand the contextual factors affecting integrating eye health into the school health programme. METHODS We elicited responses from 83 respondents, purposefully selected from the Ministry of Health (n = 7), Ministry of Education and Vocational Training (n = 7), hospitals/eye centres (n = 5), master trainers (4) and schools (n = 60) who participated in in-depth interviews. Their responses were analysed and grouped into contextual factors according to the WHO Consolidated Framework for Implementation Research: stakeholders/political, institutional, physical, cultural, delivery system and others. Themes were then generated, and quotations were presented to illustrate the findings. RESULTS The six contextual factors affecting the integration of eye health into the school eye health programme were i) Stakeholders/political (Good ministry coordination, defined departmental roles and resource mobilisation from multiple stakeholders; Good stakeholder synergies and address current gaps); ii) Institutional (Institutional coordination and adequate clinic space; Securing human and financial resources; Strategic advocacy for institutional resources); iii) Physical (Long travel distance to service points); vi) Cultural (low eye health awareness among parents, teachers and children); iv) Delivery system (Practical approach to increase screening coverage using teachers as screeners; Balance teachers' workload, increase screening sensitivity and follow up and; v) Others (Comprehensive training material and effective training delivery; Improved curriculum, teacher selection and supervision and incentives). CONCLUSION Integrated school eye health delivery is generally well-received by stakeholders in Zanzibar, with the caveat that investment is required to address the six contextual factors identified in the study.
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Affiliation(s)
- Ving Fai Chan
- Centre of Public Health, School of Medicine, Dentistry and Biomedical Medicine, Royal Victoria Hospital, Institute of Clinical Sciences, Queen's University of Belfast, Block B, Belfast, BT12 6BA, UK.
- Brien Holden Vision Institute Foundation Africa Trust, Durban, South Africa.
- University of KwaZulu Natal, Durban, South Africa.
| | - Elodie Yard
- Partnership for Child Development, Imperial College London, London, UK
- Oriole Global Health, Nairobi, Kenya
| | - Eden Mashayo
- Brien Holden Vision Institute Foundation Africa Trust, Durban, South Africa
| | - Damaris Mulewa
- Partnership for Child Development, Imperial College London, London, UK
| | - Lesley Drake
- Partnership for Child Development, Imperial College London, London, UK
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Vennegoor G, van Assema P, Molleman GRM, van Empelen P, Dieleman J, Jansen MWJ. Fidelity, adaptation and integration of whole-school health promotion within Dutch schools: a cross-sectional survey study. Health Promot Int 2023; 38:daad173. [PMID: 38124497 PMCID: PMC10733658 DOI: 10.1093/heapro/daad173] [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: 12/23/2023] Open
Abstract
Implementing comprehensive health promotion programs in the school setting can be challenging, as schools can be considered complex adaptive systems. As a first step towards understanding what works in improving implementation for which schools and under which conditions, this study aimed to examine the degree of implementation of health promoting school (HPS) programs, in terms of five dimensions of fidelity (adherence, dose, participant responsiveness, quality of delivery and program differentiation), and the dimensions of adaptation and integration. The HPS Implementation Questionnaire was distributed among ± 2400 primary, secondary, secondary vocational and special needs schools in the Netherlands. Employees of 535 schools (22.3%) filled out the questionnaire. Data were analysed by descriptive statistics and ANOVA tests. The average degree of implementation was 2.55 (SD = 0.58, range = 0.68-3.90; scaled 0-4). The lowest scores were achieved for participant responsiveness and adherence, and the highest for integration and adaptation. Schools that identified as HPS reported significantly higher overall degree of implementation, adherence, dose, participant responsiveness, program differentiation and adaptation than schools that didn't. Primary schools achieved a significantly higher degree of implementation, dose, participant responsiveness, quality of delivery and integration than other school types. In conclusion, many schools work on student health and well-being to some extent, but the vast majority have much room for improvement. Higher implementation scores for schools that identified as HPS underline the value of HPS programs. A broader perspective on health and more insight into conditions for effectiveness and implementation in secondary and secondary vocational schools are needed.
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Affiliation(s)
- Gerjanne Vennegoor
- Academic Collaborative Center for Public Health Limburg, P.O. Box 33, 6400 AA Heerlen, The Netherlands
- Department of Health Promotion, Research Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Patricia van Assema
- Academic Collaborative Center for Public Health Limburg, P.O. Box 33, 6400 AA Heerlen, The Netherlands
- Department of Health Promotion, Research Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Gerard R M Molleman
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
- Department of Healthy Living, Public Health Service Gelderland-Zuid, P.O. Box 1120, 6501 BC Nijmegen, The Netherlands
| | - Pepijn van Empelen
- Expertise Center Child Health, Netherlands Organization for Applied Scientific Research (TNO), P.O. Box 3005, 2301 DA Leiden, The Netherlands
| | - Joyce Dieleman
- Public Health Service Noord- en Oost Gelderland, Academic Collaborative Center AGORA, P.O. Box 3, 7200 AA Zutphen, The Netherlands
| | - Maria W J Jansen
- Academic Collaborative Center for Public Health Limburg, P.O. Box 33, 6400 AA Heerlen, The Netherlands
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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Dabravolskaj J, Veugelers PJ, Mandour BA, Flynn J, Maximova K. Delivering health promotion during school closures in public health emergencies: building consensus among Canadian experts. Health Promot Int 2023; 38:daad172. [PMID: 38091618 PMCID: PMC10716908 DOI: 10.1093/heapro/daad172] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
School-based health promotion is drastically disrupted by school closures during public health emergencies or natural disasters. Climate change will likely accelerate the frequency of these events and hence school closures. We identified innovative health promotion practices delivered during COVID-19 school closures and sought consensus among education experts on their future utility. Fifteen health promotion practices delivered in 87 schools across Alberta, Canada during COVID-19 school closures in Spring 2020, were grouped into: 'awareness of healthy lifestyle behaviours and mental wellness', 'virtual events', 'tangible supports' and 'school-student-family connectedness'. Two expert panels (23 school-level practitioners and 20 decision-makers at the school board and provincial levels) rated practices on feasibility, acceptability, reach, effectiveness, cost-effectiveness and other criteria in three rounds of online Delphi surveys. Consensus was reached if 70% or more participants (strongly) agreed with a statement, (strongly) disagreed or neither. Participants agreed all practices require planning, preparation and training before implementation and additional staff time and most require external support or partnerships. Participants rated 'awareness of healthy lifestyle behaviours and mental wellness' and 'virtual events' as easy and quick to implement, effective and cost-effective, sustainable, easy to integrate into curriculum, well received by students and teachers, benefit school culture and require no additional funding/resources. 'Tangible supports' (equipment, food) and 'school-student-family connectedness' were rated as most likely to reach vulnerable students and families. Health promotion practices presented herein can inform emergency preparedness plans and are critical to ensuring health remains a priority during public health emergencies and natural disasters.
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Affiliation(s)
- Julia Dabravolskaj
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria St, Toronto, ON M5B 1T8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada
| | - Paul J Veugelers
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, AB T6G 1K4, Canada
| | - Boshra A Mandour
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, AB T6G 1K4, Canada
| | - Jenn Flynn
- APPLE Schools, 206-A, 12227 – 107 Ave NW, Edmonton, AB T5M 1Y9, Canada
| | - Katerina Maximova
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria St, Toronto, ON M5B 1T8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada
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Narayan A, DeLine-Caballero SS, Prober CG. Building Bridges With School Boards-An Understudied Seat of Health Equity. JAMA Pediatr 2023; 177:1255-1256. [PMID: 37870854 DOI: 10.1001/jamapediatrics.2023.4226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
This Viewpoint describes the role of school boards in both education delivery and health outcomes and the importance of clinician involvement in effecting health-promoting policies for all students.
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Affiliation(s)
- Aditya Narayan
- Stanford University School of Medicine, Palo Alto, California
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Lim C, Chung PJ, Biely C, Jackson NJ, Puffer M, Zepeda A, Anton P, Leifheit KM, Dudovitz R. School Attendance Following Receipt of Care From a School-Based Health Center. J Adolesc Health 2023; 73:1125-1131. [PMID: 37702648 DOI: 10.1016/j.jadohealth.2023.07.012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/28/2023] [Accepted: 07/05/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE School-based health centers (SBHCs) may mitigate barriers to health care access and improve students' academic outcomes, but few studies test this hypothesis. We examined whether school attendance improved after students received care at an SBHC. METHODS We conducted a secondary analysis of data from 17 SBHCs affiliated with a single large urban school district and demographic and attendance data from SBHC users (N = 14,030) and nonusers (N = 230,046) from August 2015-February 2020. We examined the percent of full school days present each month for three years before and after students' first SBHC visit and a proxy visit date for SBHC nonusers. Propensity weighted linear regression models tested whether visiting an SBHC was associated with a change in the attendance trajectory compared to a matched sample of SBHC nonusers. RESULTS Among SBHC users, attendance trajectories declined more steeply prior to their first SBHC visit than after the first visit (preslope -0.71%, postslope -0.05%), whereas SBHC nonusers had a similar attendance trajectory over the entire period (preslope -0.18%, postslope -0.17%), with difference-in-difference 0.65. Changes in trajectories were more pronounced for students with a mental health encounter. Prior to the first SBHC mental health visit, SBHC users displayed a marked decline in monthly attendance (preslope -1.02%). After the first mental health visit, attendance increased (postslope 1.44%), with difference-in-difference 2.33. DISCUSSION SBHC utilization was associated with improved school attendance over time, particularly for students with a mental health diagnosis. Investing in SBHCs may reduce school absenteeism and support student health.
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Affiliation(s)
- Caryssa Lim
- Department of Health Systems Science, Kaiser Permanente School of Medicine, Pasadena, California.
| | - Paul J Chung
- Department of Health Systems Science, Kaiser Permanente School of Medicine, Pasadena, California; Departments of Pediatrics and Health Policy & Management, University of California Los Angeles, Los Angeles, California
| | - Christopher Biely
- Departments of Pediatrics and Health Policy & Management, University of California Los Angeles, Los Angeles, California
| | - Nicholas J Jackson
- Department of Medicine, University of California Los Angeles, Los Angeles, California
| | - Maryjane Puffer
- The L.A. Trust for Children's Health, Los Angeles, California
| | - Alex Zepeda
- The L.A. Trust for Children's Health, Los Angeles, California
| | | | - Kathryn M Leifheit
- Departments of Pediatrics and Health Policy & Management, University of California Los Angeles, Los Angeles, California
| | - Rebecca Dudovitz
- Departments of Pediatrics and Health Policy & Management, University of California Los Angeles, Los Angeles, California.
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Ahmed KR, Horwood S, Khan A. Effects of a School-Based Physical Activity Intervention on Adolescents' Mental Health: A Cluster Randomized Controlled Trial. J Phys Act Health 2023; 20:1102-1108. [PMID: 37611913 DOI: 10.1123/jpah.2023-0062] [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] [Received: 02/18/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the effectiveness of a school-based multicomponent physical activity intervention on mental health of adolescents. METHODS A clustered, randomized, controlled trial was employed in 8 high schools in Dhaka, Bangladesh, which were randomly assigned to either an intervention or control group; 40 students in grades 8 and 9 from each school took part in the trial (n = 160/group). Students in the intervention schools participated in a 12-week physical activity intervention with multiple components (eg, supervised circuits, lunchtime sports, health education, infographics), while control schools received no intervention. Participants completed baseline and postintervention surveys measuring depressive symptoms (Center for Epidemiologic Studies Depression Scale) and life satisfaction (Cantril Ladder), along with other sociodemographic and behavioral characteristics. Linear mixed-effects modeling was used to evaluate the intervention effects. RESULTS Depressive symptoms in the intervention group decreased at postintervention, but remained stable in the control group. There was an increase in life satisfaction in the intervention group and a decrease in the control group. Multivariable modeling showed that students in the intervention group had a significantly lower level of depressive symptoms (β = -4.60; 95% confidence interval, -5.76 to -3.46) and higher level of life satisfaction (β = 1.43; 95% confidence interval, 0.77 to 2.10) compared with their counterparts in the control group. Sensitivity analyses supported the positive effects of the intervention. CONCLUSIONS Our school-based, multicomponent physical activity intervention is effective in improving mental health indicators in adolescents. Future trials should be ramped up to include schools in rural and regional settings, using robust measures of mental well-being.
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Affiliation(s)
- Kazi Rumana Ahmed
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD,Australia
- Department of Health Promotion and Health Education, Bangladesh University of Health Sciences, Dhaka,Bangladesh
| | - Sharon Horwood
- School of Psychology, Deakin University, Geelong, VIC,Australia
| | - Asaduzzaman Khan
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD,Australia
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Yarnoff B, Wagner LD, Honeycutt AA, Vogt TM. Analysis of School-Day Disruption of Administering School-Located Vaccination to Children in Three Local Areas, 2012-2013 School Year. J Sch Nurs 2023; 39:456-462. [PMID: 34405720 DOI: 10.1177/10598405211038598] [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: 11/15/2022] Open
Abstract
The purpose of this study was to determine the amount of time elementary and middle-school students spend away from the classroom and clinic time required to administer vaccines in school-located vaccination (SLV) clinics. We conducted a time study and estimated average time away from class and time to administer vaccine by health department (HD), student grade level, vaccine type, and vaccination process for SLV clinics during the 2012-2013 school year. Average time away from classroom was 10 min (sample: 688 students, 15 schools, three participating HD districts). Overall, time to administer intranasally administered influenza vaccine was nearly half the time to administer injected vaccine (52.5 vs. 101.7 s) (sample: 330 students, two HDs). SLV administration requires minimal time outside of class for elementary and middle-school students. SLV clinics may be an efficient way to administer catch-up vaccines to children who missed routine vaccinations during the coronavirus disease-2019 pandemic.
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Affiliation(s)
- Ben Yarnoff
- Health Economics Program, RTI International, Durham, NC, USA
| | - Laura Danielle Wagner
- Health Economics Program, RTI International, Durham, NC, USA
- Global Public Health Impact Center, RTI International, Durham, NC, USA
| | | | - Tara M Vogt
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Mahon C, Hamburger D, Yager Z, Almaraz M, Mooney J, Tran T, O'Dowd O, Bauert L, Smith KG, Gomez-Trejo V, Webb JB. Pilot feasibility and acceptability trial of BE REAL's BodyKind: A universal school-based body image intervention for adolescents. Body Image 2023; 47:101636. [PMID: 37812940 DOI: 10.1016/j.bodyim.2023.101636] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/14/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023]
Abstract
Body dissatisfaction is prevalent among adolescents and a primary risk factor for eating disorders, yet there are few body image interventions for older adolescents that support development of positive body image. Therefore, we assessed the feasibility, acceptability and preliminary effectiveness of BodyKind, a four-lesson, mixed gender, teacher-led, school-based curriculum for older adolescents, that combines principles of self-compassion, compassion for others, cognitive dissonance, and social activism to address contemporary adolescent body image concerns (i.e., appearance bias, comparisons on social media) and strengthen positive body image development. The sample contained 147 adolescents, predominantly racial/ethnic minorities (>95%), 54.8% male, 41.5% female and 4.1% gender-minority students aged 15-18 years (M=16.24, SD=.96) from a low-income, inner-city high school in the Midwestern US. Two teachers received training and delivered the curriculum to students. This single arm, mixed methods trial assessed student and teacher acceptability, teacher fidelity and student intervention outcomes. Despite reasonable teacher fidelity, recruitment/attendance rates, post-intervention data loss (35% attrition) limited evaluations of program effectiveness and study feasibility. Important learnings regarding study feasibility will inform optimisation for future school-based trials. Findings demonstrate high acceptability of BodyKind among teachers and adolescents in a lower socioeconomic school setting, and further randomized controlled effectiveness trials are required.
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Affiliation(s)
- Ciara Mahon
- School of Psychology, University College Dublin (UCD), Ireland.
| | | | | | - Mayra Almaraz
- Anti-Bias, Antiracist (ABAR) Facilitator, Education Consultant at Critical Learning Collaborative, USA
| | - Jan Mooney
- Department of Psychological Science, Health Psychology Ph.D. Program, University of North Carolina at Charlotte (UNC Charlotte), USA
| | - Tran Tran
- Department of Psychological Science, Health Psychology Ph.D. Program, University of North Carolina at Charlotte (UNC Charlotte), USA
| | - Orlagh O'Dowd
- School of Psychology, University College Dublin (UCD), Ireland
| | - Lia Bauert
- Department of Psychological Science, Health Psychology Ph.D. Program, University of North Carolina at Charlotte (UNC Charlotte), USA
| | - K G Smith
- Department of Public Health Sciences, Master of Health Administration Program, University of North Carolina at Charlotte (UNC Charlotte), USA
| | | | - Jennifer B Webb
- Department of Psychological Science, Health Psychology Ph.D. Program, University of North Carolina at Charlotte (UNC Charlotte), USA
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