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O'Dean S, Sunderland M, Newton N, Gardner L, Teesson M, Chapman C, Thornton L, Slade T, Hides L, McBride N, Kay-Lambkin FJ, Allsop SJ, Lubans D, Parmenter B, Mills K, Spring B, Osman B, Ellem R, Smout S, McCann K, Hunter E, Catakovic A, Champion K. The Health4Life e-health intervention for modifying lifestyle risk behaviours of adolescents: secondary outcomes of a cluster randomised controlled trial. Med J Aust 2024; 220:417-424. [PMID: 38613175 DOI: 10.5694/mja2.52279] [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: 03/18/2023] [Accepted: 10/17/2023] [Indexed: 04/14/2024]
Abstract
OBJECTIVES To investigate the effectiveness of a school-based multiple health behaviour change e-health intervention for modifying risk factors for chronic disease (secondary outcomes). STUDY DESIGN Cluster randomised controlled trial. SETTING, PARTICIPANTS Students (at baseline [2019]: year 7, 11-14 years old) at 71 Australian public, independent, and Catholic schools. INTERVENTION Health4Life: an e-health school-based multiple health behaviour change intervention for reducing increases in the six major behavioural risk factors for chronic disease: physical inactivity, poor diet, excessive recreational screen time, poor sleep, and use of alcohol and tobacco. It comprises six online video modules during health education class and a smartphone app. MAIN OUTCOME MEASURES Comparison of Health4Life and usual health education with respect to their impact on changes in twelve secondary outcomes related to the six behavioural risk factors, assessed in surveys at baseline, immediately after the intervention, and 12 and 24 months after the intervention: binge drinking, discretionary food consumption risk, inadequate fruit and vegetable intake, difficulty falling asleep, and light physical activity frequency (categorical); tobacco smoking frequency, alcohol drinking frequency, alcohol-related harm, daytime sleepiness, and time spent watching television and using electronic devices (continuous). RESULTS A total of 6640 year 7 students completed the baseline survey (Health4Life: 3610; control: 3030); 6454 (97.2%) completed at least one follow-up survey, 5698 (85.8%) two or more follow-up surveys. Health4Life was not statistically more effective than usual school health education for influencing changes in any of the twelve outcomes over 24 months; for example: fruit intake inadequate: odds ratio [OR], 1.08 (95% confidence interval [CI], 0.57-2.05); vegetable intake inadequate: OR, 0.97 (95% CI, 0.64-1.47); increased light physical activity: OR, 1.00 (95% CI, 0.72-1.38); tobacco use frequency: relative difference, 0.03 (95% CI, -0.58 to 0.64) days per 30 days; alcohol use frequency: relative difference, -0.34 (95% CI, -1.16 to 0.49) days per 30 days; device use time: relative difference, -0.07 (95% CI, -0.29 to 0.16) hours per day. CONCLUSIONS Health4Life was not more effective than usual school year 7 health education for modifying adolescent risk factors for chronic disease. Future e-health multiple health behaviour change intervention research should examine the timing and length of the intervention, as well as increasing the number of engagement strategies (eg, goal setting) during the intervention. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12619000431123 (prospective).
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Affiliation(s)
- Siobhan O'Dean
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Nicola Newton
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Lauren Gardner
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Maree Teesson
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Cath Chapman
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Louise Thornton
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Leanne Hides
- Centre of Youth Substance Abuse, University of Queensland, Brisbane, QLD
- University of Queensland, Brisbane, QLD
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA
| | - Frances J Kay-Lambkin
- Priority Research Centre for Brain and Mental Health, University of Newcastle, Newcastle, NSW
| | - Steve J Allsop
- National Drug Research Institute, Curtin University of Technology, Perth, WA
| | | | | | - Katherine Mills
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Bonnie Spring
- Northwestern University, Evanston, United States of America
| | - Bridie Osman
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | | | - Scarlett Smout
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Karrah McCann
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Emily Hunter
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | | | - Katrina Champion
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
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McPhail L, Thornicroft G, Gronholm PC. Help-seeking processes related to targeted school-based mental health services: systematic review. BMC Public Health 2024; 24:1217. [PMID: 38698391 PMCID: PMC11065683 DOI: 10.1186/s12889-024-18714-4] [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: 01/16/2024] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND One in seven adolescents globally are affected by mental health conditions, yet only a minority receive professional help. School-based mental health services have been endorsed as an effective way to increase access to mental health support for people at risk, or currently presenting with mental health conditions, throughout adolescence. Despite this, low treatment utilisation prevails, therefore the aim of this review is to contribute insights into the processes related to adolescents' accessing and engaging with essential targeted mental health support within schools. METHODS This systematic review extracted qualitative, quantitative and mixed-methods data to determine what processes affect adolescents seeking help from targeted school-based mental health services (TSMS). Searches were conducted in EMBASE, Medline, PsycINFO, CINAHL, ERIC, Web of Science, in addition to manual searching and expert consultations. Data were synthesised following guidelines for thematic synthesis and narrative style synthesis. RESULTS The search resulted in 22 articles reflecting 16 studies with participant sample sizes ranging from n = 7 to n = 122. Three main themes were identified: 'access-related factors', 'concerns related to stigma', and 'the school setting'. These findings elucidate how help-seeking processes are variable and can be facilitated or hindered depending on the circumstance. We identified disparities with certain groups, such as those from low-socio economic or ethnic minority backgrounds, facing more acute challenges in seeking help. Help-seeking behaviours were notably influenced by concerns related to peers; an influence further accentuated by minority groups given the importance of social recognition. Conflicting academic schedules significantly contribute to characterising treatment barriers. CONCLUSIONS The findings of this review ought to guide the delivery and development of TSMS to facilitate access and promote help-seeking behaviours. Particularly, given the evidence gaps identified in the field, future studies should prioritise investigating TSMS in low- and middle-income settings and through quantitative methodologies. REGISTRATION The protocol for this systematic review was registered on PROSPERO (ID CRD42023406824).
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Affiliation(s)
- Lauren McPhail
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Petra C Gronholm
- Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Wu YP, Stump TK, Hay JL, Buller DB, Jensen JD, Grossman D, Shen J, Haaland BA, Jones J, Tercyak KP. Protocol for a cluster-randomized trial of a school-based skin cancer preventive intervention for adolescents. Contemp Clin Trials 2024; 140:107494. [PMID: 38458557 PMCID: PMC11065585 DOI: 10.1016/j.cct.2024.107494] [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: 09/19/2023] [Revised: 02/06/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Adolescents infrequently use sun protection and engage in intentional tanning more frequently compared to other age groups, leading to increased ultraviolet radiation (UVR) exposure that heightens skin cancer risk across the lifespan. High schools are therefore an ideal setting for offering skin cancer preventive interventions. Yet, there are limited UVR protection interventions for high school students, especially those that are personalized, tested using randomized designs, and include long-term outcome assessment to determine the durability of intervention effects. METHOD The Sun-safe Habits Intervention and Education (SHINE) cluster-randomized trial will test a novel, personalized intervention that targets high school adolescents' sun protection and tanning behaviors, and tracks their outcomes for up to one year following intervention. Enrolled high schools will be randomized to receive either the personalized SHINE intervention, which includes facial UVR photographs and sun protection action planning, or standard education using publicly available materials. Students in both conditions will receive information about skin cancer, sun protection, and skin self-examination. Outcome variables will include students' sun protection and tanning behaviors and sunburn occurrence. Potential moderators (e.g., race/ethnicity) and mediators (e.g., self-efficacy) will also be assessed and tested. CONCLUSIONS This trial examines the efficacy of a personalized intervention targeting sun protection and tanning of high school students. The project will lead to new scientific understanding of the theoretical mechanisms underlying outcomes and moderators of the intervention effects, which will inform future intervention tailoring to meet the needs of vulnerable subgroups.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah, 30 N. Mario Capecchi Dr., Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Tammy K Stump
- Department of Dermatology, University of Utah, 30 N. Mario Capecchi Dr., Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
| | - David B Buller
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 220, Golden, CO 80401, USA.
| | - Jakob D Jensen
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Communication, University of Utah, Salt Lake City, UT, USA.
| | - Douglas Grossman
- Department of Dermatology, University of Utah, 30 N. Mario Capecchi Dr., Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Jincheng Shen
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| | - Benjamin A Haaland
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| | - Jacey Jones
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
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Bjørnsen HN, Bjørnebekk G, Brandmo C. Schools as a Source of Mental Health Literacy: Adjusting and Validating a Mental Health Literacy Scale. Health Promot Pract 2024; 25:391-398. [PMID: 36942353 PMCID: PMC11064467 DOI: 10.1177/15248399231161090] [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: 03/23/2023]
Abstract
Over the last decade, there has been a growing interest in mental health literacy (MHL) in health promotion, largely motivated by increased awareness of MHL as a modifiable determinant of mental health. Accordingly, MHL has been associated with the health-promoting school approach emerging over the last 20 years. To succeed in promoting MHL, it is of vast importance to evaluate working strategies and interventions to address MHL using validated instruments. The current study describes the revision and psychometric testing of a modified version of the 10-item adolescents' positive MHL measure, the MHPK-10, the only identified instrument measuring adolescents' positive MHL. The MHPK-10 was adjusted to address the previously documented ceiling effects and was further optimized for use in schools by reworking it to measure learning rather than self-reported knowledge, becoming the new nine-item Mental Health Learning Scale (MHLS-9). The MHLS-9 was tested on a national sample of N = 2,012 Norwegian ninth graders. Data were analyzed by confirmatory factor analysis (CFA) and tests of reliability and validity. The revised CFA model for the MHLS-9 showed an improved fit over the original CFA model for the MHPK-10. The MHLS-9s' CFA model revealed excellent factor determinacy (.95) and scale reliability (ω = .91). Thus, the MHLS-9 is an improved measure for the positive component of MHL for use in school settings, enabling researchers and practitioners to evaluate and focus positive MHL interventions in schools using a short, reliable, and valid measure for adolescents' learning about the factors promoting good mental health.
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Tan E, Frambach J, Driessen E, Cleland J. Opening the black box of school-wide student wellbeing programmes: a critical narrative review informed by activity theory. Adv Health Sci Educ Theory Pract 2024; 29:663-687. [PMID: 37393378 DOI: 10.1007/s10459-023-10261-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/18/2023] [Indexed: 07/03/2023]
Abstract
PURPOSE Medical schools have a duty of care to support student wellbeing but there is little guidance on how to translate this mandate into practice. Often schools focus on implementing and reporting individual-level interventions which typically only address one aspect of wellbeing. Conversely, less attention has been paid to holistic school-wide approaches towards student wellbeing that address multiple wellbeing dimensions. Thus, this review sought to improve our understanding of how support is mediated within such school-wide wellbeing programmes. METHOD This critical narrative review was conducted in two stages. First, the authors searched several key databases for papers published up to 25th May 2021, using a systematic search strategy and TREND checklist to guide our data extraction process. We later expanded our search to include literature published from the original date to 20th May 2023. Second, the identified articles were critically analysed using activity theory as a theoretical lens to aid explanation. RESULTS We found school-wide wellbeing programmes emphasize social connectivity and building a sense of community. Tutors take a key role in the activity of supporting students' wellbeing. We mapped out the activity system components to describe the complexity of this tutor role. This analysis illustrated: tensions and contradictions in the system which may open up opportunities for change; the importance of context for influencing how system components interact; and that students' trust underpins the whole activity system. CONCLUSIONS Our review shines a light into the black-box of holistic school-wide wellbeing programmes. We identified that tutors play a key role in wellbeing systems but confidentiality is a recurring tension which may jeopardise a wellbeing system. The time has come to investigate these systems in more detail, embracing and exploring the role of context at the same time as looking for common threads.
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Affiliation(s)
- Emmanuel Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
- Department of Educational Development and Research, School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands.
| | - Janneke Frambach
- Department of Educational Development and Research, School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands
| | - Erik Driessen
- Department of Educational Development and Research, School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands
| | - Jennifer Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Jeremy J, Spandagou I, Hinitt J. A Profile of Occupational Therapists Working in School-Based Practice in Australian Primary Schools. Occup Ther Int 2024; 2024:2077870. [PMID: 38707514 PMCID: PMC11068452 DOI: 10.1155/2024/2077870] [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: 12/07/2023] [Revised: 02/24/2024] [Accepted: 03/28/2024] [Indexed: 05/07/2024] Open
Abstract
Inclusive education has increased the demand for school-based occupational therapy services and has reconceptualised the practice in mainstream schools. Therapists are now expected to work collaboratively with teachers within tiered intervention models to support access and participation of all students, including those with disabilities, within the natural classroom context. School-based occupational therapy has become a specialised area of practice, as therapists work within educational, rather than health, systems and processes. While the growth in demand and expanded scope of practice is positive for the profession, predicted workforce shortages and the necessity for specialised and enhanced practice present significant challenges. The ability of the profession to fully support the demands of an inclusive education system remains unclear. As accurate, up-to-date information on the school-based therapy workforce is the foundation for planning future personnel needs, knowledge of the current state of the workforce is critical. There is a paucity of national data regarding this growing area of practice. The aim of this study is to describe a current profile of school-based occupational therapists to better understand the workforce, practice patterns, and the funding landscape in Australia. A convenient and purposive sample of 108 Australian paediatric occupational therapists working in mainstream primary schools in New South Wales, Queensland, and Victoria was surveyed in this quantitative study, which was analysed using descriptive statistics. Results provide some insights into the workforce and practice of school-based therapy in Australia offering preliminary data for future planning in this important and growing area of paediatric practice. While specific to the local context, results invite cross-national and global comparison to reveal universal trends and localised nuances across diverse settings.
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Affiliation(s)
- Jill Jeremy
- Sydney School of Education & Social Work, Faculty of Arts & Social Science, The University of Sydney, Camperdown, Australia
| | - Ilektra Spandagou
- Sydney School of Education & Social Work, Faculty of Arts & Social Science, The University of Sydney, Camperdown, Australia
| | - Joanne Hinitt
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
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Vaughen S, Kowalczyk M, DeClemente T, Ignoffo S, Fox K, Cheatham J, Volerman A. A Model of Community Health Worker Integration into Schools: Community-based Participatory Research in Action. Prog Community Health Partnersh 2024; 18:91-101. [PMID: 38661830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND Schools are rich sites for collaborations between health and educational sectors. OBJECTIVES To identify lessons learned from formation of a community-academic partnership and application of community-based participatory research (CBPR) to develop a model that integrates community health workers into schools. METHODS Individuals from an academic medical center, a large public school district, and a community-based research institute applied CBPR principles to reimagine schools as a place for improving the health of children. LESSONS LEARNED Three lessons emerged. Leveraging each team member's expertise centered the partnership on community strengths, co-learning, and stakeholder engagement. Adherence to CBPR's principles of power sharing and equity helped navigate the challenges of collaboration between large institutions. Early focus on sustainability helped address unexpected issues, build capacity, and boost advocacy. CONCLUSIONS This partnership demonstrates how CBPR fosters conditions in which equitable partnerships between research institutions and public schools can thrive to promote childhood health.
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Aguocha CM, Merenu I. Unmet Need for School-Based Substance Use Prevention Strategies Among Secondary Schools in Orlu, Imo State. J Health Care Poor Underserved 2023; 34:1324-1336. [PMID: 38661758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND In Nigeria, the use of psychoactive substances has reached an epidemic proportion while substance use prevention remains inadequate or unavailable. METHODS Cross-sectional data from 300 Junior Secondary School students in Imo state were analyzed to evaluate the unmet need for school-based substance use prevention strategies among secondary school students in Orlu, Imo state. Information was collected using a structured questionnaire. RESULTS Substance use was common with easy access to psychoactive substances for young people. There was a perceived need for substance use prevention strategies in their school with most students lacking access to basic preventive strategies. CONCLUSION Though there was a high need for preventive strategies for substance abuse among secondary school students in Orlu, few strategies were in place to meet the needs of the students.
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Vongsachang H, Callan J, Kretz AM, Wahl M, Mukherjee MR, Neitzel A, Friedman DS, Collins ME. Teacher and school staff perspectives on their role in school-based vision programs. Can J Ophthalmol 2022; 57:381-387. [PMID: 34283966 DOI: 10.1016/j.jcjo.2021.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 05/27/2021] [Accepted: 06/15/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVE School-based vision programs (SBVPs) are one approach to increase access to vision care by providing vision screenings, eye examinations, and eyeglasses directly in schools. Few studies report on the perspectives of teachers and staff, who are important stakeholders, on SBVPs. We examined teacher and staff perspectives on their involvement in SBVPs. DESIGN Qualitative study using focus groups. PARTICIPANTS Teachers and staff at Baltimore and Chicago public schools served by SBVPs between 2016 and 2018. METHODS We conducted 21 semistructured focus groups with 117 teachers and staff in 10 Baltimore and 11 Chicago public preK-12 schools that participated in SBVPs. Sessions were recorded, transcribed, and coded using inductive thematic analysis. RESULTS Participants identified 2 main themes regarding teacher and staff involvement in SBVPs: (i) program outreach, including using multiple communication modalities to engage parents, explaining program details to families, and helping with program consent form return and (ii) promoting vision health, including identifying vision problems in the classroom, encouraging eyeglasses wear, and supporting eyeglasses maintenance. Participants also discussed limitations in capacity to partake in these activities. CONCLUSION Teachers interact with parents and students throughout the SBVP process, undertaking important roles in outreach and health promotion to ensure uptake of SBVP services. SBVPs and other school-based health programs should explore strategies to support teachers in the roles they fill to optimize program impact.
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Affiliation(s)
- Hursuong Vongsachang
- Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287
| | - Jonathan Callan
- Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287
| | - Alyssa M Kretz
- Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287
| | - Madison Wahl
- Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287
| | - M Rani Mukherjee
- Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287
| | - Amanda Neitzel
- Johns Hopkins University School of Education, 2800 N. Charles St, Baltimore, MD 21218, USA
| | - David S Friedman
- Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287
| | - Megan E Collins
- Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287; Johns Hopkins Berman Institute of Bioethics, 1809 Ashland Ave, Baltimore, MD 21205, USA.
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Haroz EE, Kalb LG, Newland JG, Goldman JL, Mast DK, Ko LK, Grass R, Shah P, Walsh T, Schuster JE. Implementation of School-Based COVID-19 Testing Programs in Underserved Populations. Pediatrics 2022; 149:e2021054268G. [PMID: 34737173 PMCID: PMC9647741 DOI: 10.1542/peds.2021-054268g] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 02/03/2023] Open
Abstract
Evidence suggests that coronavirus disease 2019 (COVID-19) testing in schools can add a layer of protection to reduce the spread of Severe Acute Respiratory Syndrome Coronavirus 2 and facilitate a safer return to in-person learning. Despite this evidence, implementation of testing in school settings has been challenging initially because of a lack of funding and limited availability of testing, but, as the pandemic has progressed and more funding and resources have been devoted to testing, other implementation challenges have arisen. We describe key implementation barriers and strategies that have been operationalized across 5 projects working to help schools with predominantly underserved populations who have faced significant COVID-19-related health disparities. We leveraged a key framework from the implementation science field to identify the challenges and used a matching tool to align implementation strategies to these challenges. Our findings suggest that the biggest obstacles to COVID-19 testing were the perceived relative advantages versus burden of COVID-19 testing, limited engagement with the target beneficiaries (eg, families, students, staff), and innovation complexity. Common strategies to overcome these challenges included identifying and preparing testing champions, altering incentive and allowance structures, assessing for readiness, and identifying barriers and facilitators. We aim to augment existing implementation guidance for schools by describing common barriers and recommended solutions from the implementation science field. Our results indicate a clear need to provide implementation support to schools to facilitate COVID-19 testing as an added layered mitigation strategy.
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Affiliation(s)
- Emily E. Haroz
- Johns Hopkins Center for American Indian Health, Baltimore, Maryland
| | - Luther G. Kalb
- Kennedy Krieger Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | | | | | - Linda K. Ko
- University of Washington, Seattle, Washington
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Ryan Grass
- Johns Hopkins Center for American Indian Health, Baltimore, Maryland
| | - Parth Shah
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Tyler Walsh
- Washington University in St Louis, St Louis, Missouri
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Boutzoukas AE, Zimmerman KO, Mann TK, Moorthy GS, Blakemore A, McGann KA, Smith MJ, Nutting B, Kerley K, Brookhart MA, Edwards L, Rak Z, Benjamin DK, Kalu IC. A School-Based SARS-CoV-2 Testing Program: Testing Uptake and Quarantine Length After In-School Exposures. Pediatrics 2022; 149:e2021054268J. [PMID: 34737175 PMCID: PMC9647777 DOI: 10.1542/peds.2021-054268j] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related quarantines, which are required after close contact with infected individuals, have substantially disrupted in-person education for kindergarten through 12th grade (K-12) students. In recent recommendations, shortened durations of quarantine are allowed if a negative SARS-CoV-2 test result is obtained at 5 to 7 days postexposure, but access to testing remains limited. We hypothesized that providing access to in-school SARS-CoV-2 testing postexposure would increase testing and reduce missed school days. METHODS This prospective cohort study was conducted in one large public K-12 school district in North Carolina and included 2 periods: preimplementation (March 15, 2021, to April 21, 2021) and postimplementation (April 22, 2021, to June 4, 2021), defined around initiation of an in-school SARS-CoV-2 testing program in which on-site access to testing is provided. Number of quarantined students and staff, testing uptake, test results, and number of missed school days were analyzed and compared between the preimplementation and postimplementation periods. RESULTS Twenty-four schools, including 12 251 in-person learners, participated in the study. During preimplementation, 446 close contacts were quarantined for school-related exposures; 708 close contacts were quarantined postimplementation. Testing uptake after school-related exposures increased from 6% to 40% (95% confidence interval: 23% to 45%) after implementation, and 89% of tests were conducted in-school. After in-school testing implementation, close contacts missed ∼1.5 fewer days of school (95% confidence interval: -2 to -1). CONCLUSIONS Providing access to in-school testing may be a worthwhile mechanism to increase testing uptake after in-school exposures and minimize missed days of in-person learning, thereby mitigating the pandemic's ongoing impact on children.
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Affiliation(s)
- Angelique E. Boutzoukas
- Departments of Pediatrics
- Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina
| | - Kanecia O. Zimmerman
- Departments of Pediatrics
- Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina
- The ABC Science Collaborative, Durham, North Carolina
| | - Tara K. Mann
- Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina
| | - Ganga S. Moorthy
- Departments of Pediatrics
- Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina
| | - Ashley Blakemore
- Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina
| | | | | | - Boen Nutting
- Iredell-Statesville Schools, Statesville, North Carolina
| | - Karen Kerley
- Iredell-Statesville Schools, Statesville, North Carolina
| | - M. Alan Brookhart
- Population Health Sciences, School of Medicine, Duke University, Durham, North Carolina
| | - Laura Edwards
- Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina
| | - Zsolt Rak
- Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina
| | - Daniel K. Benjamin
- Departments of Pediatrics
- Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina
- The ABC Science Collaborative, Durham, North Carolina
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12
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Berger TD, Gorodnichenko A, Fradkin A, Weiss B. The Impact of a Short-term Intervention on Adolescent Eating Habits and Nutritional Knowledge. Isr Med Assoc J 2021; 23:720-724. [PMID: 34811988] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Adequate dietary habits and physical activity during childhood and adolescence may promote growth and cognitive development and contribute to the prevention of chronic disease in later life. School is considered an important social environment that can promote healthy eating habits and life-style changes. OBJECTIVES To evaluate the effects of a school-based intervention on nutritional knowledge, eating habits, and physical activity of adolescents. METHODS We conducted a prospective questionnaire-based study. Anonymous questionnaires were administered at the beginning of the academic year (September 2014) in one high school. During the following year, vending machines containing milk products were installed within the school facility, and students were given two informative nutrition lectures regarding proper nutrition for age, calcium requirement and importance, and physical activity. One active sports day was initiated. At the beginning of the following academic year (September 2015), the students completed the same questionnaires. RESULTS The study was comprised of 330 teenagers, mean age 15.1 ± 1.39 years, 53% males. Response rate was 83.6% ± 0.4% to multiple choice questions, 60.7% ± 0.5% to multiple section tables, and 80.3% ± 0.9% to open questions. Post-intervention, respondents reported an increase in eating breakfast (57% vs. 47.5%, P = 0.02) and a decrease in purchasing food at school (61.6% vs. 54.3%, P = 0.03). No changes were observed in consumption of milk products, knowledge regarding calcium and vegetable consumption, or sports activities. CONCLUSIONS Short-term high school-based interventions may lead to improvements in eating habits but are not sufficient for changing nutritional knowledge and physical activity.
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Affiliation(s)
- Tal David Berger
- Department of Pediatric Gastroenterology and Nutrition, Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anna Gorodnichenko
- Department of Pediatric Gastroenterology and Nutrition, Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - Akiva Fradkin
- Department of Pediatric Gastroenterology and Nutrition, Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Batia Weiss
- Department of Pediatric Gastroenterology and Nutrition, Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Jones H, Pinto A, Evans S, Ford S, O’Driscoll M, Buckley S, Ashmore C, Daly A, MacDonald A. Provision and Supervision of Food and Protein Substitute in School for Children with PKU: Parent Experiences. Nutrients 2021; 13:3863. [PMID: 34836117 PMCID: PMC8621748 DOI: 10.3390/nu13113863] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 11/16/2022] Open
Abstract
Children spend a substantial part of their childhood in school, so provision of dietary care and inclusion of children with phenylketonuria (PKU) in this setting is essential. There are no reports describing the dietary support children with PKU receive whilst at school. The aim of this cross-sectional study was to explore the experiences of the dietary management of children with PKU in schools across the UK. Data was collected using an online survey completed by parents/caregivers of children with PKU. Of 159 questionnaire responses, 92% (n = 146) of children attended state school, 6% (n = 10) private school and 2% (n = 3) other. Fourteen per cent (n = 21/154) were at nursery/preschool, 51% (n = 79/154) primary and 35% (n = 54/154) secondary school. Sixty-one per cent (n = 97/159) said their child did not have school meals, with some catering services refusing to provide suitable food and some parents distrusting the school meals service. Sixty-one per cent of children had an individual health care plan (IHCP) (n = 95/155). Children were commonly unsupervised at lunchtime (40%, n = 63/159), with snacks (46%, n = 71/155) and protein substitute (30%, n = 47/157), with significantly less supervision in secondary than primary school (p < 0.001). An IHCP was significantly associated with improved supervision of food and protein substitute administration (p < 0.01), and better communication between parents/caregivers and the school team (p < 0.05). Children commonly accessed non-permitted foods in school. Therefore, parents/caregivers described important issues concerning the school provision of low phenylalanine food and protein substitute. Every child should have an IHCP which details their dietary needs and how these will be met safely and discreetly. It is imperative that children with PKU are supported in school.
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Affiliation(s)
- Hannah Jones
- Faculty of Health, Education & Life Sciences, Birmingham City University: City South Campus, Westbourne Road, Edgbaston, Birmingham B15 3TN, UK;
| | - Alex Pinto
- Birmingham Women’s and Children’s NHS Foundation Trust, Steelhouse Lane, Birmingham B4 6NH, UK; (A.P.); (S.E.); (C.A.); (A.D.)
| | - Sharon Evans
- Birmingham Women’s and Children’s NHS Foundation Trust, Steelhouse Lane, Birmingham B4 6NH, UK; (A.P.); (S.E.); (C.A.); (A.D.)
| | - Suzanne Ford
- National Society for Phenylketonuria, Sheffield S12 9ET, UK;
- North Bristol NHS Trust, Southmead Road, Bristol BS10 5NB, UK
| | - Mike O’Driscoll
- School of Health and Education, Middlesex University, Room WG41A (Williams Building), The Burroughs Hendon, London NW4 4BT, UK;
| | - Sharon Buckley
- Department of Psychology, Faculty of Health, Psychology and Social Care, Manchester Campus, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, UK;
| | - Catherine Ashmore
- Birmingham Women’s and Children’s NHS Foundation Trust, Steelhouse Lane, Birmingham B4 6NH, UK; (A.P.); (S.E.); (C.A.); (A.D.)
| | - Anne Daly
- Birmingham Women’s and Children’s NHS Foundation Trust, Steelhouse Lane, Birmingham B4 6NH, UK; (A.P.); (S.E.); (C.A.); (A.D.)
| | - Anita MacDonald
- Birmingham Women’s and Children’s NHS Foundation Trust, Steelhouse Lane, Birmingham B4 6NH, UK; (A.P.); (S.E.); (C.A.); (A.D.)
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Azizan NA, Papadaki A, Su TT, Jalaludin MY, Mohammadi S, Dahlui M, Nahar Azmi Mohamed M, Majid HA. Facilitators and Barriers to Implementing Healthy School Canteen Intervention among Malaysian Adolescents: A Qualitative Study. Nutrients 2021; 13:nu13093078. [PMID: 34578955 PMCID: PMC8471853 DOI: 10.3390/nu13093078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/26/2022] Open
Abstract
This study evaluated implementing a school-based intervention to promote healthier dietary habits in the school environment among Malaysian adolescents using qualitative methods. This qualitative study was conducted in four secondary schools in Perak and Selangor (two urban and two rural schools) that received the intervention (either training or training and food subsidy). A total of eight focus groups (68 students aged 15 years old) and 16 in-depth interviews were conducted with canteen operators, school convenience shop operators, school teachers and school principals in each school. Thematic analysis was used to analyse the qualitative data to identify suitable themes. We found several initiatives and changes by the schools’ stakeholders to change to a healthy school canteen programme. The stakeholders also noticed the students’ food preferences that influence healthy food intake in canteens and convenience shops. The food vendors and school administrators also found that subsidising healthy meals might encourage healthy eating. Among barriers to implementing healthy school initiatives were the student’s perception of healthy food and their eating habits, which also affect the food vendors’ profit if they want to implement a healthy canteen. The school-based intervention has the potential to promotes healthier eating among school adolescents. Continuous training and monitoring of canteen operators and convenience shops are needed, including building partnerships and educating the students on healthy eating to cultivate healthy eating habits.
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Affiliation(s)
- Nurul Ain Azizan
- Center of Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (N.A.A.); (T.T.S.); (S.M.); (M.D.)
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam 13200, Malaysia
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK;
| | - Tin Tin Su
- Center of Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (N.A.A.); (T.T.S.); (S.M.); (M.D.)
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Subang Jaya 47500, Malaysia
| | - Muhammad Yazid Jalaludin
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Shooka Mohammadi
- Center of Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (N.A.A.); (T.T.S.); (S.M.); (M.D.)
| | - Maznah Dahlui
- Center of Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (N.A.A.); (T.T.S.); (S.M.); (M.D.)
| | - Mohd Nahar Azmi Mohamed
- Department of Sports Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Hazreen Abdul Majid
- Center of Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (N.A.A.); (T.T.S.); (S.M.); (M.D.)
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
- Correspondence:
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15
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Cheng YH, Yeung CY, Sharma A, So KY, Ko HF, Wong K, Lam P, Lee A. Non-resuscitative first aid training and assessment for junior secondary school students: A pre-post study. Medicine (Baltimore) 2021; 100:e27051. [PMID: 34449493 PMCID: PMC8389963 DOI: 10.1097/md.0000000000027051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 08/09/2021] [Indexed: 01/04/2023] Open
Abstract
School-based first aid interventions can contribute to the number of adults trained in first aid in the community over time but few studies have examined the effectiveness of teaching non-resuscitative first aid on knowledge, attitudes and skills. Currently, there is no consensus on the optimal content and duration of first aid training for junior secondary students. The aim of this study was to evaluated the effectiveness of a 2.5 hour introductory non-resuscitative first aid course for junior secondary students.This prospective, single-centre, pre-post study included 140 students (11-13 years old). Students completed a questionnaire on first aid knowledge, attitude towards first aid and self-confidence to perform first aid before and after a training session. Six emergency medicine physicians taught practical first aid skills training. A game-based formative assessment was undertaken where the instructors assessed small teams of students' role-playing injured classmates and first aid responders (and vice-versa) treating abrasions, ankle sprain, choking and a scald injury.Few students had prior first aid training (14%). After adjusting for student's age, sex, prior first aid training and format delivery, the course was associated with increased mean knowledge score (pre-training 53%, post-training 88%; mean difference [MD] 35%, 95% CI: 32% to 38%), positive attitudes and more confidence in performing first aid after training (all P < .001). All teams showed a good level of competency in treating simulated injuries with first aid kits.This brief non-resuscitative first aid course was associated with noticeable and valuable changes in knowledge score and self-confidence level in performing first aid. The game-based formative assessment facilitated a positive learning environment for skill competency evaluation.
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Affiliation(s)
- Yee Han Cheng
- Accident and Emergency Department, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong Special Administrative Region, China
| | - Chi Yeung Yeung
- Accident and Emergency Department, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong Special Administrative Region, China
| | - Amar Sharma
- Yew Chung International Secondary School, 3 To Fuk Road, Kowloon Tong, Kowloon, Hong Kong Special Administrative Region, China
| | - Kit Ying So
- Accident and Emergency Department, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong Special Administrative Region, China
| | - Hiu Fai Ko
- Accident and Emergency Department, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong Special Administrative Region, China
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, China
| | - Kevin Wong
- Centre for Learning Enhancement and Research, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, China
| | - Paul Lam
- Centre for Learning Enhancement and Research, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, China
| | - Anna Lee
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, China
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16
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Abstract
The effect on students from the COVID-19 pandemic, violence related to racism, and loss of customary school routines may cause loss of both school connection and a sense of belonging. School nurses can positively influence student belonging and school connection as they encounter students throughout in-person school and virtual school environments. School nurses build connections with students whom they know and outreach to students whom they identify as vulnerable in the areas of belonging and school connectedness. With a mind-set of the Framework for 21st Century School Nursing Practice and in collaboration with a school team implementing a multitiered system of support, school nurses intentionally outreach and cultural sensitivity to grow positive school climate that benefits students.
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17
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Chrisman MS, Alnaim L. Resources Needed for Education and Meal Programs by Urban Schoolteachers and Staff During the 2019 Coronavirus Pandemic. J Sch Health 2021; 91:535-540. [PMID: 33954993 PMCID: PMC8206988 DOI: 10.1111/josh.13028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/14/2021] [Accepted: 03/29/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Adjustments in teaching resources and school meal programs are urgently needed during the COVID-19 pandemic. This study examined teaching resources that would have been helpful when schools closed, and how school meal programs should be changed in the 2020-2021 school year. METHODS In October 2020, a 27-item, cross-sectional, online survey was administered to 99 teachers and staff members in an urban, Midwestern school district. Data were analyzed using frequencies and proportions, and open-ended responses were analyzed using content analysis. RESULTS Online teaching was difficult for teachers and students, and training for online teaching, improved Internet access, and more time for grading or office hours would have been helpful when schools closed. Meal programs were offered by 86% of schools after closing, and many participants supported continuing meal programs for 2020-2021. Resources needed to continue meal programs included funding for meal reimbursement, transportation to the meal sites, and more staff. Suggested changes to meal programs included offering more variety or more food, and solving transportation issues. CONCLUSION Addressing these concerns can improve school and community health. Findings will inform efforts to enhance online teaching and improve and continue school meal programs as the world continues to be affected by COVID-19.
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Affiliation(s)
- Matthew S. Chrisman
- University of Missouri‐Kansas City, 2464 Charlotte StreetKansas CityMissouri64108
| | - Lubna Alnaim
- University of Kansas Medical Center, 3901 Rainbow BoulevardKansas CityKansas66160
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18
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Mickells GE, Figueroa J, West KW, Wood A, McElhanon BO. Adherence to Masking Requirement During the COVID-19 Pandemic by Early Elementary School Children. J Sch Health 2021; 91:555-561. [PMID: 33997986 PMCID: PMC8206918 DOI: 10.1111/josh.13033] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/25/2021] [Accepted: 04/05/2021] [Indexed: 05/09/2023]
Abstract
BACKGROUND Top public health experts and organizations strongly recommend universal masking for children older than 2 years old during the COVID-19 pandemic, but speculate it may be difficult for young children. This study sought to assess the usage of cloth face masks in grades pre-K-2 and identify associated characteristics and adverse events. It is the first data to assess mask wearing by young children in school. METHODS This online, prospective, observational, survey in multiple schools within a single school district in a major metropolitan area measured adherence to face covering mandates by students in grades pre-K-2 as measured by percentage of day with appropriate face mask wearing per report via daily teacher surveys for the first 4 weeks of school. RESULTS The primary outcome was percent of the day that the entire class was wearing their masks appropriately. Of the estimated almost 1000 students and 1048 classroom days reported, the mean percentage of the school day with appropriate mask usage was 76.9%. CONCLUSIONS For a majority of the day while conducting in-person instruction, children in grades pre-K-2 are able to adhere to mask wearing as a key mitigation strategy for limiting SARS-CoV2 infection spread and possible future use.
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Affiliation(s)
| | - Janet Figueroa
- Department of PediatricsEmory University School of Medicine2015 Upper Gate RoadAtlantaGA30322
| | - Kelly Withers West
- North Atlanta Pediatric Associates, The Pavilion at Lake HearnSuite 100, 1100 Lake Hearn DriveAtlantaGA30342
| | - Anna Wood
- Department of PediatricsEmory University School of Medicine2015 Upper Gate RoadAtlantaGA30322
| | - Barbara O. McElhanon
- Department of PediatricsEmory University School of Medicine and Children's Healthcare of Atlanta1400 Tullie Rd., Office 8327BAtlantaGA30329
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19
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Williams S, Xie L, Hill K, Mathew MS, Perry T, Wesley D, Messiah SE. Potential Utility of School-Based Telehealth in the Era of COVID-19. J Sch Health 2021; 91:550-554. [PMID: 33954998 PMCID: PMC8207081 DOI: 10.1111/josh.13031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The COVID-19 pandemic presents unique opportunities for preexisting school telemedicine programs to reach pediatric populations that might otherwise experience a lapse in health care services. METHODS A retrospective analysis of one of the largest school-based telemedicine programs in the country, based in the Dallas-Fort Worth (DFW), Texas was conducted that included 7021 pediatric patients who engaged in telehealth visits from 2014 to 2019. RESULTS Asthma or other respiratory disease was the primary diagnosis (28.4%), followed by injury or trauma (18.4%), digestive disorders (6.9%), and ear/eye/skin disease (6.9%). More participants were from the North (34.4%) and West (33.2%) ISD compared to the South (20.6%) and East (11.7%) schools. Likewise, the majority of COVID-19 cases were in the North (61.8%) and West (31.6%) DFW regions, leading to 989 (59.9%) and 551 (33.4%) deaths, respectively. CONCLUSIONS School-based telehealth programs have the potential to reach large pediatric populations most in need of health care due to COVID-19-related lapses in services, and to address COVID-19-related health issues as schools reopen. In the future, utilization could be expanded to contact tracing, testing, and screening for COVID-19.
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Affiliation(s)
- Stormee Williams
- Network Development and Innovation, Children's Health System of Texas, 1935 Medical District DrDallasTX75235
| | - Luyu Xie
- University of Texas School of Public Health, Health Science Center, Dallas Campus, 6363 Forest Park Road, BL10.204DallasTX75235
- Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, 6363 Forest Park Road, BL10.204DallasTX75235
| | - Kristina Hill
- University of Texas School of Public Health, Health Science Center, Dallas Campus, 6363 Forest Park Road, BL10.204DallasTX75235
- Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, 6363 Forest Park Road, BL10.204DallasTX75235
| | - Matthew Sunil Mathew
- University of Texas School of Public Health, Health Science Center, Dallas Campus, 6363 Forest Park Road, BL10.204DallasTX75235
- Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, Dallas, 6363 Forest Park Road, BL10.204DallasTX75235
| | - Tamara Perry
- Children's Health System of Texas, 1935 Medical District DrDallasTX75235
| | - Danielle Wesley
- Network Service Delivery, Children's Health System of Texas, 1935 Medical District DrDallasTX75235
| | - Sarah E. Messiah
- University of Texas School of Public Health, Health Science Center, Dallas Campus, 6363 Forest Park Road, BL10.204DallasTX75235
- Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, 6363 Forest Park Road, BL10.204DallasTX75235
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Davis KF, Loos JR, Boland MG. Five Years and Moving Forward: A Successful Joint Academic-Practice Public Partnership to Improve the Health of Hawaii's Schoolchildren. J Sch Health 2021; 91:584-591. [PMID: 33973241 DOI: 10.1111/josh.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND In 2014, the Hawaii Department of Education (DOE), the only statewide school system in the United States, predominately enrolled children (keiki) from underserved communities and lacked school nurses or a school health program. Chronic absenteeism due to health concerns was identified as a barrier to academic success. METHODS The DOE and a public university created Hawaii Keiki: Healthy and Ready to Learn (HK), a program to provide school-based services for 170 Title 1 schools in urban and rural settings and build momentum for statewide collective action. HK has maintained support from public and private entities to address student health. RESULTS This paper describes 5 years of program development, implementation, and continuing challenges. Most recently in 2020-2021, HK pivoted in the face of school campus closings due to COVID-19 with strategic plans, including telehealth, to move forward in this changed school environment. CONCLUSIONS The HK program has increased awareness of students' needs and is addressing the imperative to build health services within public schools. The multipronged approach of building awareness of need, providing direct services, educating future care providers, and supporting sound policy development, has an impact that goes beyond any one individual area.
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Affiliation(s)
- Katherine Finn Davis
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster Hall 410, Honolulu, HI, 96822, USA
| | - Joanne R Loos
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster Hall 440, Honolulu, HI, 96822, USA
| | - Mary G Boland
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster Hall 402, Honolulu, HI, 96822, USA
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21
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Sawyer SM, Raniti M, Aston R. Making every school a health-promoting school. Lancet Child Adolesc Health 2021; 5:539-540. [PMID: 34181886 DOI: 10.1016/s2352-4642(21)00190-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/10/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital and Murdoch Children's Research Institute, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
| | - Monika Raniti
- Centre for Adolescent Health, Royal Children's Hospital and Murdoch Children's Research Institute, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Ruth Aston
- Centre for Adolescent Health, Royal Children's Hospital and Murdoch Children's Research Institute, Parkville, VIC 3052, Australia; Centre for Program Evaluation, Melbourne Graduate School of Education, University of Melbourne, Parkville, VIC, Australia
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22
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Motevalli M, Drenowatz C, Tanous DR, Khan NA, Wirnitzer K. Management of Childhood Obesity-Time to Shift from Generalized to Personalized Intervention Strategies. Nutrients 2021; 13:1200. [PMID: 33917383 PMCID: PMC8067342 DOI: 10.3390/nu13041200] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 02/07/2023] Open
Abstract
As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics.
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Affiliation(s)
- Mohamad Motevalli
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University College of Teacher Education Upper Austria, A-4020 Linz, Austria;
| | - Derrick R. Tanous
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
| | - Naim Akhtar Khan
- Nutritional Physiology & Toxicology Division, INSERM UMR 1231, Université de Bourgogne, F-21000 Dijon, France;
| | - Katharina Wirnitzer
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
- Department of Subject Didactics and Educational Research & Development, University College of Teacher Education Tyrol, A-6020 Innsbruck, Austria
- Life and Health Science Cluster Tirol, Subcluster Health/Medicine/Psychology, A-6020 Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria
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Motevalli M, Drenowatz C, Tanous DR, Khan NA, Wirnitzer K. Management of Childhood Obesity-Time to Shift from Generalized to Personalized Intervention Strategies. Nutrients 2021; 13:1200. [PMID: 33917383 PMCID: PMC8067342 DOI: 10.3390/nu13041200&set/a 931824908+802380262] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics.
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Affiliation(s)
- Mohamad Motevalli
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
- Correspondence:
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University College of Teacher Education Upper Austria, A-4020 Linz, Austria;
| | - Derrick R. Tanous
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
| | - Naim Akhtar Khan
- Nutritional Physiology & Toxicology Division, INSERM UMR 1231, Université de Bourgogne, F-21000 Dijon, France;
| | - Katharina Wirnitzer
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
- Department of Subject Didactics and Educational Research & Development, University College of Teacher Education Tyrol, A-6020 Innsbruck, Austria
- Life and Health Science Cluster Tirol, Subcluster Health/Medicine/Psychology, A-6020 Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria
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Comfort AB, Rao L, Goodman S, Barney A, Glymph A, Schroeder R, McCulloch C, Harper CC. Improving Capacity at School-based Health Centers to Offer Adolescents Counseling and Access to Comprehensive Contraceptive Services. J Pediatr Adolesc Gynecol 2021; 34:26-32. [PMID: 32730800 PMCID: PMC7385555 DOI: 10.1016/j.jpag.2020.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 07/20/2020] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVES Many pediatric providers serving adolescents are not trained to offer comprehensive contraceptive services, including intrauterine devices (IUDs) and implants, despite high safety and satisfaction among adolescents. This study assessed an initiative to train providers at school-based health centers (SBHCs) to offer students the full range of contraceptive methods. DESIGN Surveys were administered at baseline pre-training and at follow-up 3 months post-training. Data were analyzed using generalized estimating equations for clustered data to examine clinical practice changes. SETTING Eleven contraceptive trainings at SBHCs across the United States from 2016-2019. PARTICIPANTS A total of 260 providers from 158 SBHCs serving 135,800 students. INTERVENTIONS On-site training to strengthen patient-centered counseling and to equip practitioners to integrate IUDs and implants into contraceptive services. MAIN OUTCOME MEASURES The outcomes included counseling experience on IUDs and implants, knowledge of patient eligibility, and clinician method skills. RESULTS At follow-up, providers were significantly more likely to report having enough experience to counsel on IUDs (adjusted odds ratio [aOR], 4.08; 95% confidence interval [CI], 2.62-6.36]) and implants (aOR, 3.06; 95% CI, 2.05-4.57). Provider knowledge about patient eligibility for IUDs, including for adolescents, increased (P < .001). Providers were more likely to offer same-visit IUD (aOR, 2.10; 95% CI, 1.41-3.12) and implant services (aOR, 1.66; 95% CI, 1.44-1.91). Clinicians' skills with contraceptive devices improved, including for a newly available low-cost IUD (aOR, 2.21; 95% CI, 1.45-3.36). CONCLUSIONS Offering evidence-based training is a promising approach to increase counseling and access to comprehensive contraceptive services at SBHCs.
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Affiliation(s)
- Alison B Comfort
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA.
| | - Lavanya Rao
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA
| | - Suzan Goodman
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA
| | - Angela Barney
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA
| | | | - Rosalyn Schroeder
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA
| | - Charles McCulloch
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA
| | - Cynthia C Harper
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA
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Durbeej N, McDiarmid S, Sarkadi A, Feldman I, Punamäki RL, Kankaanpää R, Andersen A, Hilden PK, Verelst A, Derluyn I, Osman F. Evaluation of a school-based intervention to promote mental health of refugee youth in Sweden (The RefugeesWellSchool Trial): study protocol for a cluster randomized controlled trial. Trials 2021; 22:98. [PMID: 33509268 PMCID: PMC7841907 DOI: 10.1186/s13063-020-04995-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 12/22/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Sweden is home to a large and growing population of refugee youths who may be at risk of mental health problems such as post-traumatic stress disorder (PTSD). Thus, there is a need for interventions that address mental health problems in these populations. Schools have been identified as an ideal setting for delivering such interventions as they offer a non-stigmatizing space and are often central to young refugees' social networks. The RefugeesWellSchool trial in Sweden will investigate an intervention comprising two programmes: Teaching Recovery Techniques (TRT) and In-service Teacher Training (INSETT), delivered in a school setting, among refugee youth. TRT is a group-based programme for children and adolescents, informed by Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). INSETT is a multi-module course for teachers providing information on trauma and the refugee experience to build teachers' cultural competence and capacity for supporting refugee youths in schools. METHODS This trial employs a cluster randomized-control design with two arms: (1) the intervention arm in which the TRT and INSETT programmes are offered (n = 350), (2) the wait-list control arm (n = 350) in which services are provided as usual until the TRT and INSETT programmes are offered approximately six months later. Data will be collected prior to the intervention, immediately following the intervention, and at three months post-intervention. Outcomes for the trial arms will be compared using linear mixed models or ANCOVA repeated measures as well as the Reliable Change Index (RCI). DISCUSSION This study will provide knowledge about the effectiveness of an intervention comprising two programmes: a group-based programme for youth reporting symptoms of PTSD and a training course for teachers, in order to build their competence and ability to support refugee youths in schools. TRIAL REGISTRATION ISRCTN, ISRCTN48178969 , Retrospectively registered 20/12/2019.
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Affiliation(s)
- Natalie Durbeej
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, 753 27 Uppsala, Sweden
| | - Serena McDiarmid
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, 753 27 Uppsala, Sweden
| | - Anna Sarkadi
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, 753 27 Uppsala, Sweden
| | - Inna Feldman
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, 753 27 Uppsala, Sweden
| | - Raija-Leena Punamäki
- Faculty of Social Sciences, Psychology, FI- 30014, University of Tampere, Tampere, Finland
| | - Reeta Kankaanpää
- Faculty of Social Sciences, Psychology, FI- 30014, University of Tampere, Tampere, Finland
| | - Arnfinn Andersen
- Norwegian Centre for Violence and Traumatic Stress Studies, NO-0409 Oslo, Norway
| | - Per Kristian Hilden
- Norwegian Centre for Violence and Traumatic Stress Studies, NO-0409 Oslo, Norway
| | - An Verelst
- Faculty of Psychology and Educational Sciences, Department of Social Work and Social Pedagogy, Centre for the Social Study of Migration and Refugees, Ghent University, Ghent, Belgium
| | - Ilse Derluyn
- Faculty of Psychology and Educational Sciences, Department of Social Work and Social Pedagogy, Centre for the Social Study of Migration and Refugees, Ghent University, Ghent, Belgium
| | - Fatumo Osman
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, 753 27 Uppsala, Sweden
- School of Education, Health and Social Studies, Dalarna University, 791 88 Falun, Sweden
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Legood R, Opondo C, Warren E, Jamal F, Bonell C, Viner R, Sadique Z. Cost-Utility Analysis of a Complex Intervention to Reduce School-Based Bullying and Aggression: An Analysis of the Inclusive RCT. Value Health 2021; 24:129-135. [PMID: 33431147 DOI: 10.1016/j.jval.2020.04.1839] [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: 10/24/2019] [Revised: 03/19/2020] [Accepted: 04/06/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Bullying and aggression among children and young people are key public mental health priorities. In this study, we evaluated the cost-effectiveness of a complex school-based intervention to address these outcomes within a large-cluster randomized trial (Inclusive). METHODS Forty state secondary schools were randomly allocated (1:1) to receive the intervention or continue with current practice as controls. Data were collected using paper questionnaires completed in classrooms including measures of their health-related quality of life using the Childhood Utility Index and police and National Health Service resource use. Further detailed data were collected on the cost of delivering the intervention. We calculated incremental cost-effectiveness ratios following the intention-to-treat principle using multilevel linear regression models that allowed for clustering of pupils at the school level. RESULTS Overall, we found that the intervention was highly cost-effective, with cost-per quality-adjusted life year thresholds of £13 284 and £1875 at 2 years and 3 years, respectively. Analysis of uncertainty in the result at 2 years revealed a 65% chance of being cost-effective, but after 3 years there was a 90% chance that it was cost-effective. CONCLUSION This study provides strong evidence collected prospectively from a randomized study that this school-based intervention is highly cost-effective. Education- and health-sector policy makers should consider investment in scaling up this intervention.
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Affiliation(s)
- Rosa Legood
- London School of Hygiene & Tropical Medicine, Keppel Street, London, England, United Kingdom.
| | - Charles Opondo
- London School of Hygiene & Tropical Medicine, Keppel Street, London, England, United Kingdom
| | - Emily Warren
- London School of Hygiene & Tropical Medicine, Keppel Street, London, England, United Kingdom
| | - Farah Jamal
- London School of Hygiene & Tropical Medicine, Keppel Street, London, England, United Kingdom
| | - Chris Bonell
- London School of Hygiene & Tropical Medicine, Keppel Street, London, England, United Kingdom
| | - Russell Viner
- UCL Great Ormond St. Institute of Child Health, 30 Guilford Street, London, England, United Kingdom
| | - Zia Sadique
- London School of Hygiene & Tropical Medicine, Keppel Street, London, England, United Kingdom
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Bardin S, Gola AA. Analyzing the Association between Student Weight Status and School Meal Participation: Evidence from the School Nutrition and Meal Cost Study. Nutrients 2020; 13:nu13010017. [PMID: 33374590 PMCID: PMC7822417 DOI: 10.3390/nu13010017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/17/2020] [Accepted: 12/20/2020] [Indexed: 11/16/2022] Open
Abstract
Childhood obesity remains a pressing public health concern. Children consume a substantial amount of their caloric intake while in school, making the passage of the Healthy Hunger-Free Kids Act (HHFKA) in 2010 and the subsequent improvements to the school meal standards a key policy change. Using data from the School Nutrition and Meal Cost Study, this paper seeks to re-examine the association between students' (N = 1963) weight status and participation in the National School Lunch Program (NSLP) and School Breakfast Program (SBP) since the implementation of these policy changes to determine whether, and how, this relationship has changed. After controlling for a wide array of student characteristics and school-level fixed effects, findings from the multivariate regression analyses indicate that usual participation in the school meal programs has no clear association with students' weight status, which contradicts findings from earlier studies conducted prior to the passage of the HHFKA. These findings are discussed in relation to changes in the demographic composition of usual NSLP participants over time.
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Affiliation(s)
- Sarah Bardin
- Mathematica, 955 Massachusetts Avenue, Suite 801, Cambridge, MA 02139, USA
- Correspondence:
| | - Alice Ann Gola
- US Department of Agriculture, Food and Nutrition Service (FNS), 1320 Braddock Place, Alexandria, VA 22314, USA;
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28
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Bojesen AB, Rayce SB. Effectiveness of a school-based road safety educational program for lower secondary school students in Denmark: A cluster-randomized controlled trial. Accid Anal Prev 2020; 147:105773. [PMID: 32947176 DOI: 10.1016/j.aap.2020.105773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 06/11/2023]
Abstract
Road accidents are one of the leading causes of death and injuries among adolescents and young adults. Road safety education programs aim to promote safe traffic behavior through information, skills training or fear appeals. During the last decade, an intervention type using victim testimonials has been developed. These types of programs aim to promote road safety by connecting a personal narrative of choices and consequences to the beliefs and behaviors of the audience. Studies on the effectiveness of this type of road safety programs among youngsters who are not yet drivers are still limited. This study used a cluster-randomized and controlled trial design to examine the effect of a Danish school-based road safety educational program using testimonials for students in lower secondary schools in Denmark on a) knowledge of risks factors in traffic and b) two types of behavior specifically relevant for the pre-driver target group: seatbelt use and safe bicycle behavior. Our analysis sample comprised 1007 students from 57 schools with a matched baseline and four-month follow-up response. Linear regression analyses suggest a small positive effect on the students' knowledge of the three most important risk factors in traffic but not on the age group most at risk. Concerning seatbelt use or overall cycling behavior no effect was found, although a small positive effect was found on helmet use. Neither was the effectiveness modified by gender, parental educational background, or risky cycling behavior at baseline. Although classroom-based interventions using testimonials may have the potential to increase knowledge of risk factors in traffic among adolescents, translating knowledge into safe traffic behavior is challenging. More studies are needed on how to further adapt the intervention to an age group who are not yet drivers. Such research may focus on mechanisms of change including the age-specific relevance of the ambassador's testimonial and on employing strong elements of action guidance.
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Affiliation(s)
- Anders Bo Bojesen
- VIVE - The Danish Center for Social Science Research, Herluf Trolles Gade 11, 1052, København K., Denmark
| | - Signe Boe Rayce
- VIVE - The Danish Center for Social Science Research, Herluf Trolles Gade 11, 1052, København K., Denmark.
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Huey MJ, Crihfield C, Jopp D. The second fifty years: A history of the American College Health Association. J Am Coll Health 2020; 68:798-814. [PMID: 33571081 DOI: 10.1080/07448481.2020.1859856] [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: 06/12/2023]
Abstract
Objective: On the occasion of the American College Health Association's (ACHA) 100th anniversary, this article seeks to explore the second fifty years of its organizational history, as well as many of the key historical moments in the field of American college health. Materials and methods: This article examines ACHA's second fifty years, decade-by-decade, in key thematic areas that have driven focus, innovation and change at both ACHA and the field of college health and well-being, including: Changes in ACHA Governance, Leadership and Organizational Structure; Clinical Care, Immunizations, Emergency Preparedness and Outbreak Response; Health Promotion: Moving from Health to Wellness to WellBeing; Mental Health: Stigma, Suicide and Access to Care; Nursing Practice and Nurse Certification; Using Education, Research, Data and Publications to Drive Change and Innovation; Advocacy for the Health of College Students and Our College Communities; Growth and Development of the American College Health Foundation; and Recognizing Quality of Care, Excellence and Outstanding Contributions to ACHA. Results: ACHA's second fifty years have provided an enormous volume of high-quality programs and services, used to further improve the health and well-being of college students. The narrative shows that the organization has indeed met its mission over the past fifty years. The article concludes with predictions of changes and advances at ACHA in the next decade. Conclusions: Since 1920, ACHA has served as the voice for college student health and well-being in the United States. ACHA's second fifty years is a remarkable story of hard work, vision and achievement by a large number of talented and committed college health professionals, students and colleagues across college campuses and in sister professional organizations.
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Affiliation(s)
- Michael J Huey
- Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA
| | | | - Devin Jopp
- American College Health Association, Silver Spring, Maryland, USA
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Panovska-Griffiths J, Kerr CC, Stuart RM, Mistry D, Klein DJ, Viner RM, Bonell C. Determining the optimal strategy for reopening schools, the impact of test and trace interventions, and the risk of occurrence of a second COVID-19 epidemic wave in the UK: a modelling study. Lancet Child Adolesc Health 2020; 4:817-827. [PMID: 32758453 PMCID: PMC7398659 DOI: 10.1016/s2352-4642(20)30250-9] [Citation(s) in RCA: 193] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/09/2020] [Accepted: 07/14/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND As lockdown measures to slow the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection begin to ease in the UK, it is important to assess the impact of any changes in policy, including school reopening and broader relaxation of physical distancing measures. We aimed to use an individual-based model to predict the impact of two possible strategies for reopening schools to all students in the UK from September, 2020, in combination with different assumptions about relaxation of physical distancing measures and the scale-up of testing. METHODS In this modelling study, we used Covasim, a stochastic individual-based model for transmission of SARS-CoV-2, calibrated to the UK epidemic. The model describes individuals' contact networks stratified into household, school, workplace, and community layers, and uses demographic and epidemiological data from the UK. We simulated six different scenarios, representing the combination of two school reopening strategies (full time and a part-time rota system with 50% of students attending school on alternate weeks) and three testing scenarios (68% contact tracing with no scale-up in testing, 68% contact tracing with sufficient testing to avoid a second COVID-19 wave, and 40% contact tracing with sufficient testing to avoid a second COVID-19 wave). We estimated the number of new infections, cases, and deaths, as well as the effective reproduction number (R) under different strategies. In a sensitivity analysis to account for uncertainties within the stochastic simulation, we also simulated infectiousness of children and young adults aged younger than 20 years at 50% relative to older ages (20 years and older). FINDINGS With increased levels of testing (between 59% and 87% of symptomatic people tested at some point during an active SARS-CoV-2 infection, depending on the scenario), and effective contact tracing and isolation, an epidemic rebound might be prevented. Assuming 68% of contacts could be traced, we estimate that 75% of individuals with symptomatic infection would need to be tested and positive cases isolated if schools return full-time in September, or 65% if a part-time rota system were used. If only 40% of contacts could be traced, these figures would increase to 87% and 75%, respectively. However, without these levels of testing and contact tracing, reopening of schools together with gradual relaxing of the lockdown measures are likely to induce a second wave that would peak in December, 2020, if schools open full-time in September, and in February, 2021, if a part-time rota system were adopted. In either case, the second wave would result in R rising above 1 and a resulting second wave of infections 2·0-2·3 times the size of the original COVID-19 wave. When infectiousness of children and young adults was varied from 100% to 50% of that of older ages, we still found that a comprehensive and effective test-trace-isolate strategy would be required to avoid a second COVID-19 wave. INTERPRETATION To prevent a second COVID-19 wave, relaxation of physical distancing, including reopening of schools, in the UK must be accompanied by large-scale, population-wide testing of symptomatic individuals and effective tracing of their contacts, followed by isolation of diagnosed individuals. FUNDING None.
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Affiliation(s)
- Jasmina Panovska-Griffiths
- Department of Applied Health Research and Institute for Global Health, University College London, London, UK; The Queen's College, University of Oxford, Oxford, UK.
| | - Cliff C Kerr
- Institute for Disease Modeling, Bellevue, WA, USA; Complex Systems Group, School of Physics, University of Sydney, Sydney, NSW, Australia
| | - Robyn M Stuart
- Department of Mathematical Sciences, University of Copenhagen, Copenhagen, Denmark; Burnet Institute, Melbourne, VIC, Australia
| | - Dina Mistry
- Institute for Disease Modeling, Bellevue, WA, USA
| | | | | | - Chris Bonell
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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31
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Macartney K, Quinn HE, Pillsbury AJ, Koirala A, Deng L, Winkler N, Katelaris AL, O'Sullivan MVN, Dalton C, Wood N. Transmission of SARS-CoV-2 in Australian educational settings: a prospective cohort study. Lancet Child Adolesc Health 2020; 4:807-816. [PMID: 32758454 PMCID: PMC7398658 DOI: 10.1016/s2352-4642(20)30251-0] [Citation(s) in RCA: 233] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND School closures have occurred globally during the COVID-19 pandemic. However, empiric data on transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children and in educational settings are scarce. In Australia, most schools have remained open during the first epidemic wave, albeit with reduced student physical attendance at the epidemic peak. We examined SARS-CoV-2 transmission among children and staff in schools and early childhood education and care (ECEC) settings in the Australian state of New South Wales (NSW). METHODS Laboratory-confirmed paediatric (aged ≤18 years) and adult COVID-19 cases who attended a school or ECEC setting while considered infectious (defined as 24 h before symptom onset based on national guidelines during the study period) in NSW from Jan 25 to April 10, 2020, were investigated for onward transmission. All identified school and ECEC settings close contacts were required to home quarantine for 14 days, and were monitored and offered SARS-CoV-2 nucleic acid testing if symptomatic. Enhanced investigations in selected educational settings included nucleic acid testing and SARS-CoV-2 antibody testing in symptomatic and asymptomatic contacts. Secondary attack rates were calculated and compared with state-wide COVID-19 rates. FINDINGS 15 schools and ten ECEC settings had children (n=12) or adults (n=15) attend while infectious, with 1448 contacts monitored. Of these, 633 (43·7%) of 1448 had nucleic acid testing, or antibody testing, or both, with 18 secondary cases identified (attack rate 1·2%). Five secondary cases (three children; two adults) were identified (attack rate 0·5%; 5/914) in three schools. No secondary transmission occurred in nine of ten ECEC settings among 497 contacts. However, one outbreak in an ECEC setting involved transmission to six adults and seven children (attack rate 35·1%; 13/37). Across all settings, five (28·0%) of 18 secondary infections were asymptomatic (three infants [all aged 1 year], one adolescent [age 15 years], and one adult). INTERPRETATION SARS-CoV-2 transmission rates were low in NSW educational settings during the first COVID-19 epidemic wave, consistent with mild infrequent disease in the 1·8 million child population. With effective case-contact testing and epidemic management strategies and associated small numbers of attendances while infected, children and teachers did not contribute significantly to COVID-19 transmission via attendance in educational settings. These findings could be used to inform modelling and public health policy regarding school closures during the COVID-19 pandemic. FUNDING NSW Government Department of Health.
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Affiliation(s)
- Kristine Macartney
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
| | - Helen E Quinn
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Alexis J Pillsbury
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Archana Koirala
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia; Nepean Hospital, Penrith, NSW, Australia
| | - Lucy Deng
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Noni Winkler
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; Australian National University, Canberra, ACT, Australia
| | - Anthea L Katelaris
- Western Sydney Public Health Unit, Western Sydney Local Health District, Parramatta, NSW, Australia
| | - Matthew V N O'Sullivan
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia; Institute for Clinical Pathology and Microbiology, NSW Health Pathology, Westmead, NSW, Australia
| | - Craig Dalton
- Hunter New England Local Health District, NSW Health, Wallsend, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Nicholas Wood
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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Maina G, Mclean M, Mcharo S, Kennedy M, Djiometio J, King A. A scoping review of school-based indigenous substance use prevention in preteens (7-13 years). Subst Abuse Treat Prev Policy 2020; 15:74. [PMID: 32998753 PMCID: PMC7528230 DOI: 10.1186/s13011-020-00314-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Early-onset substance use is a risk factor for continued use, dependency, and poor long-term health outcomes. Indigenous youth are more likely to engage in early-onset substance use than their non-Indigenous counterparts. In Canada, culturally appropriate prevention programs are needed for Indigenous youth in elementary schools. Therefore, this scoping review aims to explore the published, international literature examining school-based substance use prevention programs for Indigenous children aged 7-13. MAIN TEXT Methods: This scoping review followed a six-step approach: 1) identifying the research questions, 2) identifying relevant studies, 3) selecting the studies, 4) charting the data, 5) collating, summarizing, and reporting the results, and 6) consulting with experts. The review was reported using guidelines from Preferred Reporting Items for Systematic reviews and Meta-Analyses extensions for Scoping Reviews (PRISMA-ScR). RESULTS Eleven articles (3 Canadian; 7 American and; 1 Australian) were included in the review. The prevention programs they studied were based on existing research or were adapted from existing interventions. The programs were tailored to each communities' culture by including Indigenous stakeholders in developing or adapting prevention programs to be culturally safe and responsive. The articles evaluated the programs' Effectiveness in changing student knowledge, attitudes, and behaviors using pre- and post-intervention surveys, randomized control trials, longitudinally designed analysis, and mixed methods. Mixed quantitative findings and qualitative findings highlighted the programs' value in building community capacity and fostering cultural revitalization. CONCLUSION This review highlights best practices for developing school-based substance use prevention programs for Indigenous youth. Findings suggest that prevention programs should be culturally responsive and provide students with the knowledge and skills to prevent and manage substance use in real-life situations. Making Indigenous beliefs, values, languages, images, and worldviews central to the prevention curriculum enhanced the Effectiveness, appropriateness, and sustainability of prevention programs. Indigenous communities are best positioned to facilitate cultural tailoring without compromising the fidelity of evidence-based prevention programs.
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Affiliation(s)
- Geoffrey Maina
- College of Nursing, University of Saskatchewan, 210-1301 Central Avenue, Prince Albert, S5V 4W1 S.K, Canada.
| | - Maeve Mclean
- Master of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Solomon Mcharo
- College of Nursing, University of Saskatchewan, Saskatoon Campus, Saskatoon, Canada
| | - Megan Kennedy
- Librarian- Library, and Museums - Public Services 2, University of Alberta, Edmonton, Canada
| | - Joseph Djiometio
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, Canada
| | - Alexandra King
- Cameco Chair in Indigenous Health, University of Saskatchewan, Saskatoon, Canada
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Mahmudiono T, Nindya TS, Rachmah Q, Segalita C, Wiradnyani LAA. Nutrition Education Intervention Increases Fish Consumption among School Children in Indonesia: Results from Behavioral Based Randomized Control Trial. Int J Environ Res Public Health 2020; 17:ijerph17196970. [PMID: 32977684 PMCID: PMC7579595 DOI: 10.3390/ijerph17196970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 01/21/2023]
Abstract
This study aimed to analyze the effectiveness of behavioral-based nutrition education to increase fish consumption among school children using a raised bed pool. This was a randomized control trial study with a 3-months nutrition education intervention using a raised bed pool, as a medium to improve their internalization to increase fish consumption behavior. A paired t-test was used to calculate the difference in the increase of fish consumption, knowledge, attitude, perceived behavioral control, subjective norm, and intention. This study took place in a majority of low to medium urban households in Surabaya in Sidotopo Wetan I and Sidotopo Wetan II elementary school. Elementary school children at 4th and 5th grade and mother of elementary school children with 104 children were eligible and willing to participate. After the completion of interventions, significant improvement in delta-mean and effectiveness observed in attitude, subjective norm, perceived behavioral control, intention, knowledge, and fish consumption (p < 0.001). The 3 months of nutrition education intervention based on the theory of planned behavior significantly increase fish consumption among elementary school children. The increased consumption was believed to be related to the increase in children’s knowledge and attitude towards consuming fish.
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Affiliation(s)
- Trias Mahmudiono
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Jl. Mulyorejo Kampus C, Surabaya 60115, Indonesia; (T.S.N.); (Q.R.); (C.S.)
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON) Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jl. Salemba Raya No.6, Jakarta Pusat 10430, Indonesia;
- Correspondence: ; Tel.: +62-31-5964808
| | - Triska Susila Nindya
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Jl. Mulyorejo Kampus C, Surabaya 60115, Indonesia; (T.S.N.); (Q.R.); (C.S.)
| | - Qonita Rachmah
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Jl. Mulyorejo Kampus C, Surabaya 60115, Indonesia; (T.S.N.); (Q.R.); (C.S.)
| | - Calista Segalita
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Jl. Mulyorejo Kampus C, Surabaya 60115, Indonesia; (T.S.N.); (Q.R.); (C.S.)
| | - Luh Ade Ari Wiradnyani
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON) Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jl. Salemba Raya No.6, Jakarta Pusat 10430, Indonesia;
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Chau JPC, Lo SHS, Choi KC, Lee VWY, Lui GCY, Chan KM, Lau AYL. Effects of a multidisciplinary team-led school-based human papillomavirus vaccination health-promotion programme on improving vaccine acceptance and uptake among female adolescents: A cluster randomized controlled trial. Medicine (Baltimore) 2020; 99:e22072. [PMID: 32925744 PMCID: PMC7489727 DOI: 10.1097/md.0000000000022072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Evidence has consistently shown the high efficacy of human papillomavirus (HPV) vaccines in preventing cervical cancers. However, the HPV vaccine uptake rate in Hong Kong is very low. We will develop and evaluate an innovative, theory-based multidisciplinary team-led school-based HPV vaccination health-promotion program (MDL-SHPVP), engaging female adolescents, parents/guardians, and secondary school personnel in multicomponent educational strategies and interactive discussions. METHODS AND ANALYSIS A cluster randomized controlled trial is proposed. We will recruit 2520 female adolescents and their parents/guardians from 18 secondary day schools. The MDL-SHPVP is underpinned by the Health Belief Model and Precaution Adoption Process Model. Multicomponent interventions will be offered, including education sessions with small group dialogues with a registered nurse and trained healthcare and lay volunteers, and educational computer games. A team of volunteers will be established to raise HPV, cervical cancer, and HPV vaccine awareness. Outcomes include adolescents' uptake of the HPV vaccine, adolescents' intention to receive HPV vaccination, vaccine acceptance among parents/guardians, and parents'/guardians' and adolescents' HPV knowledge, attitudes, and beliefs. Data will be collected at baseline, 1 month, and 1 year after intervention. The generalized estimating equations analysis will be used for comparing the outcomes between the 2 groups. ETHICS AND DISSEMINATION Ethical approval was obtained from the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (Ref. no.: 2019.055). We will disseminate the study findings via peer-reviewed publications and presentations at relevant events and international and local conferences. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT04438291.
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Affiliation(s)
- Janita Pak Chun Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
| | - Suzanne Hoi Shan Lo
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
| | - Vivian Wing Yan Lee
- Centre for Learning Enhancement And Research, The Chinese University of Hong Kong
| | - Grace Chung Yan Lui
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong
| | - Kam Ming Chan
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Hospital Authority, Hong Kong
| | - Alexander Yuk Lun Lau
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong
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Merlo CL, Tiu G, Wallace-Williams D, Brener ND, Figueroa H. Hiring Requirements and Qualifications of School Food Authority Directors Changed in Some Districts After Implementation of US Department of Agriculture Professional Standards. J Acad Nutr Diet 2020; 120:1538-1547. [PMID: 32565396 PMCID: PMC10461574 DOI: 10.1016/j.jand.2020.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 02/18/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND In 2015, the US Department of Agriculture set minimum education and training requirements (ie, professional standards) to ensure that school nutrition professionals have the knowledge and experience to operate school meal programs. No study to date has examined whether hiring requirements and qualifications of school food authority (SFA) directors have changed since 2015. OBJECTIVE To assess changes in hiring requirements and qualifications of SFA directors since the US Department of Agriculture professional standards were established, overall and by district size. DESIGN Cross-sectional analysis of nationally representative district-level data from the 2012 and 2016 cycles of the School Health Policies and Practices Study. PARTICIPANTS/SETTING In 2012, 660 sampled districts completed the School Health Policies and Practices Study Nutrition Services questionnaire. In 2016, 599 sampled districts completed the questionnaire. MAIN OUTCOME MEASURES Hiring requirements for newly hired SFA directors and reported qualifications of SFA directors. STATISTICAL ANALYSES PERFORMED Differences in prevalence estimates from 2012 to 2016 for all districts and by district size were assessed with χ2 tests. RESULTS Significant increases were found for 3 hiring requirements: degree in nutrition or related field, registered dietitian credential, and food safety certification. Significant changes in 4 of the 5 reported qualifications were found including an increase in the percentage of district directors with a degree in nutrition or a related field and decreases in the percentage of directors with a School Nutrition Specialist credential from the School Nutrition Association, School Nutrition Association certifications, and certified dietary managers. Changes were found in small and medium districts, but not large districts. CONCLUSIONS District hiring requirements and SFA director qualifications have changed since the implementation of the US Department of Agriculture professional standards, including some differences by district size. Future research could identify challenges facing districts in hiring directors who have a degree in nutrition or related fields or who have specialized nutrition credentials or certificates (eg, registered dietitians).
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Webster CA, Glascoe G, Moore C, Dauenhauer B, Egan CA, Russ LB, Orendorff K, Buschmeier C. Recommendations for Administrators' Involvement in School-Based Health Promotion: A Scoping Review. Int J Environ Res Public Health 2020; 17:ijerph17176249. [PMID: 32867355 PMCID: PMC7503319 DOI: 10.3390/ijerph17176249] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 11/16/2022]
Abstract
School administrator involvement is recognized as a key factor in the extent to which school health promotion programs and initiatives are successfully implemented. The aims of this scoping review are to: (a) Identify existing documents that contain recommendations regarding the involvement of school administrators in school-based health promotion; (b) distill and summarize the recommendations; (c) examine differences in the recommendations by targeted professional level, professional group, health promotion content focus, and by whether the recommendations are evidence-based or opinion-based; and (d) evaluate the research informing the recommendations. We drew upon the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines to conduct the review. Our team conducted a comprehensive literature search with no date or geographic restrictions from January 2018 through April 2018 using four electronic databases: Academic Search Complete, Google Scholar, Physical Education Index, and PubMed. Eligibility criteria included any online documents, in English, that contained recommendations targeting school administrators’ (e.g., principals, assistant principals, superintendents) involvement (e.g., support, endorsement, advocacy) in school health programming (e.g., physical activity, nutrition, wellness). The search yielded a total of 1225 records, which we screened by title, then by abstract, and finally by full text, resulting in 61 records that met inclusion criteria. Data (e.g., recommendations, targeted contexts, targeted administrators) from these records were extracted for a content analysis. Included records contained 80 distinct recommendations, which we summarized into three themes (Collaboration, Advocacy, and Support) using a content analysis. Separate content analyses revealed no qualitative differences in the recommendations by professional level, professional group, or content focus, or by whether the recommendations were evidence-based or opinion-based. Twenty-one of the included records were peer-reviewed research articles. Using the Mixed Methods Appraisal Tool (MMAT), we appraised qualitative research articles the highest and mixed methods research articles the lowest. This review provides a basis for future research and professional practice aiming to increase school administrators’ involvement in school-based health promotion.
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Affiliation(s)
- Collin A. Webster
- Department of Physical Education, University of South Carolina, Columbia, SC 29208, USA
- Correspondence:
| | - Genee Glascoe
- Department of Educational Studies, University of South Carolina, Columbia, SC 29208, USA; (G.G.); (C.M.)
| | - Chanta Moore
- Department of Educational Studies, University of South Carolina, Columbia, SC 29208, USA; (G.G.); (C.M.)
| | - Brian Dauenhauer
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO 80639, USA; (B.D.); (C.B.)
| | - Cate A. Egan
- Department of Movement Sciences, University of Idaho, Moscow, ID 83844, USA;
| | | | - Karie Orendorff
- Department of Health and Human Development, Montana State University, Bozeman, MT 59717, USA;
| | - Cathy Buschmeier
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO 80639, USA; (B.D.); (C.B.)
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Masini A, Lanari M, Marini S, Tessari A, Toselli S, Stagni R, Bisi MC, Bragonzoni L, Gori D, Sansavini A, Ceciliani A, Dallolio L. A Multiple Targeted Research Protocol for a Quasi-Experimental Trial in Primary School Children Based on an Active Break Intervention: The Imola Active Breaks (I-MOVE) Study. Int J Environ Res Public Health 2020; 17:ijerph17176123. [PMID: 32842483 PMCID: PMC7503895 DOI: 10.3390/ijerph17176123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Children and adolescents should perform, according to the World Health Organization guidelines, at least 60 min of moderate-to-vigorous physical activity per-day in order to avoid the risk of metabolic and cardiovascular diseases. The school represents a fundamental setting to conduct interventions to promote physical activity (PA) and contrast sedentary behaviors. Active breaks (ABs), bouts of 10 min of PA conducted inside the classroom, seem to be a good strategy to promote PA and improve classroom behavior. The aim of this study protocol is to describe the design and the assessment of the Imola Active Breaks I-MOVE study. METHODS The I-MOVE study is a school-based intervention trial, with a quasi-experimental design, performed in a primary school. It involves one experimental-group performing the intervention, focused on ABs, and one control-group. Nine main outcomes are evaluated: PA and sedentary behaviors; health related fitness; motor control development; dietary patterns; anthropometric evaluation; sociodemographic determinants; cognitive function; time-on-task behavior and quality of life. CONCLUSIONS Results from the I-MOVE study will help to clarify the effects of incorporating ABs in the Italian school curriculum as a new public health strategy and an innovative school model oriented to the well-being of children and teachers for the best quality of school life.
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Affiliation(s)
- Alice Masini
- Department of Biomedical and Neuromotor Science, University of Bologna, 40126 Bologna, Italy; (A.M.); (S.T.) (L.D.)
| | - Marcello Lanari
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Sofia Marini
- Department of Life Quality Studies, University of Bologna, Campus of Rimini, 47921 Rimini, Italy; (L.B.); (A.C.)
- Correspondence: ; Tel.: +39-051-209-4812
| | - Alessia Tessari
- Department of Psychology, University of Bologna, 40126 Bologna, Italy; (A.T.); (A.S.)
| | - Stefania Toselli
- Department of Biomedical and Neuromotor Science, University of Bologna, 40126 Bologna, Italy; (A.M.); (S.T.) (L.D.)
| | - Rita Stagni
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi” University of Bologna, 40136 Bologna, Italy; (R.S.); (M.C.B.)
| | - Maria Cristina Bisi
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi” University of Bologna, 40136 Bologna, Italy; (R.S.); (M.C.B.)
| | - Laura Bragonzoni
- Department of Life Quality Studies, University of Bologna, Campus of Rimini, 47921 Rimini, Italy; (L.B.); (A.C.)
| | - Davide Gori
- Department of Biomedical and Neuromotor Science, University of Bologna, 40126 Bologna, Italy; (A.M.); (S.T.) (L.D.)
| | - Alessandra Sansavini
- Department of Psychology, University of Bologna, 40126 Bologna, Italy; (A.T.); (A.S.)
| | - Andrea Ceciliani
- Department of Life Quality Studies, University of Bologna, Campus of Rimini, 47921 Rimini, Italy; (L.B.); (A.C.)
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Science, University of Bologna, 40126 Bologna, Italy; (A.M.); (S.T.) (L.D.)
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Affiliation(s)
- Eva K Clausson
- Associate Professor in Nursing, Kristianstad University, Kristianstad, Sweden
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Koch P, McCarthy J, Raffel C, Gray HL, Guerra LA. Expanding and Enhancing Food and Nutrition Education in New York City Public Schools: An Examination of Program Characteristics and Distribution. Nutrients 2020; 12:nu12082423. [PMID: 32806716 PMCID: PMC7468993 DOI: 10.3390/nu12082423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 11/16/2022] Open
Abstract
To expand their capacity, many schools partner with food and nutrition education programs (FNPs). Public policies and funding can support FNPs, but comprehensive data on the organizations that run FNPs, their program characteristics, or distribution across schools did not exist in NYC. This study aims to help local education and health agencies assess the characteristics of food and nutrition education in schools, as well as to measure progress implementing school policies and practices. A cross-sectional study on NYC FNPs was conducted during the 2016–2017 school year. Survey data on organizations and the FNPs they operate were collected. Data on schools in which FNPs operate were gathered. To determine distribution of FNPs across schools and by school demographics, the database of FNPs in schools was combined with a publicly available database of NYC schools. In 2016–2017, 40 organizations operated 101 FNPs in 56% of NYC public schools. These FNPs varied by goals, content, activities, location, and populations served. Information on these variations can help policymakers, advocates, funders, and schools expand school-based food and nutrition education. To ensure equitable access, more coordination, investment, and collaboration are needed.
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Affiliation(s)
- Pamela Koch
- Department of Health and Behavior Studies, Teachers College, Columbia University; New York, NY 10027, USA; (P.K.); (C.R.); (L.A.G.)
| | - Julia McCarthy
- Department of Health and Behavior Studies, Teachers College, Columbia University; New York, NY 10027, USA; (P.K.); (C.R.); (L.A.G.)
- Correspondence:
| | - Claire Raffel
- Department of Health and Behavior Studies, Teachers College, Columbia University; New York, NY 10027, USA; (P.K.); (C.R.); (L.A.G.)
| | - Heewon L. Gray
- College of Public Health, University of South Florida; Tampa, FL 33620, USA;
| | - Laura A. Guerra
- Department of Health and Behavior Studies, Teachers College, Columbia University; New York, NY 10027, USA; (P.K.); (C.R.); (L.A.G.)
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Murray AL, Booth T, Eisner M, Ribeaud D, McKenzie K, Murray G. An Analysis of Response Shifts in Teacher Reports Associated with the Use of a Universal School-Based Intervention to Reduce Externalising Behaviour. Prev Sci 2020; 20:1265-1273. [PMID: 30847752 PMCID: PMC6881257 DOI: 10.1007/s11121-019-00999-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
School-based psychosocial interventions are a widely used approach to prevent or reduce externalising behaviour. However, evaluating the effects of such interventions is complicated by the fact that the interventions may not only change the target behaviour, but also the way that informants report on that behaviour. For example, teachers may become more aware of bullying behaviour after delivering lessons on the topic, resulting in increased teacher reports of the behaviour. In this study, we used multi-group confirmatory factor analysis to evaluate whether teachers exposed to the Promoting Alternative Thinking Strategies (PATHS) intervention changed the way they reported on child externalising behaviour. Using data from the z-proso study (802 participants; 51% male; 69 teachers), teacher reports of aggressive behaviour, attention deficit hyperactivity disorder and non-aggressive conduct disorder symptoms were compared pre- and post- intervention and across the intervention and control conditions. There was no evidence that teacher reporting was affected by exposure to the intervention. This helps bolster the interpretation of intervention effects as reflecting changes in child behaviour, rather than in the manner of informant reporting.
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Affiliation(s)
- Aja Louise Murray
- Institute of Criminology, University of Cambridge, Sidgwick Avenue, Cambridge, CB3 9DA, UK.
- Department of Psychology, University of Edinburgh, Edinburgh, Scotland.
| | - Tom Booth
- Department of Psychology, University of Edinburgh, Edinburgh, Scotland
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, Sidgwick Avenue, Cambridge, CB3 9DA, UK
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Zürich, Switzerland
| | - Karen McKenzie
- Department of Psychology, Northumbria University, Newcastle upon Tyne, England
| | - George Murray
- Department of Psychology, Northumbria University, Newcastle upon Tyne, England
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Wankasi HI, Sehularo LA, Rakhudu MA. A conceptual framework for effective dissemination and implementation of a policy on school health in rural Nigeria. Curationis 2020; 43:e1-e10. [PMID: 32787429 PMCID: PMC7433313 DOI: 10.4102/curationis.v43i1.2100] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 05/09/2020] [Accepted: 05/19/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There is a marked inequality between children in public schools and their counterparts in private schools in terms of school healthcare in rural Nigeria. This is because of the ineffective dissemination and implementation of a policy on school health in public schools. Effective dissemination and implementation of such policy can reduce the prevalence of risky health behaviours amongst young people and have a positive effect on academic performance. OBJECTIVES The purpose of this study was to develop a conceptual framework for the effective dissemination and implementation of a policy on school health in rural Nigeria. METHODS This study consisted of four phases as follows: an empirical phase, concept classification, framework development and critical reflection on the conceptual framework. An exploratory, descriptive and contextual research design was used to develop the framework. The work of Dickoff et al. was used to classify concepts from the empirical phase. Chinn and Kramer's nursing theory on generative method was used for the development of the conceptual framework and for critical review. RESULTS The framework consisted of six components, namely, departments of health and education (context); health or educational professionals in the ministries (agents); health or educational practitioners, pupils, parents and communities (recipients); ratification of a policy on school health, stakeholder engagement, training as well as monitoring and evaluation (process); communication, collaborative partnership, commitment and support (dynamics); and effective dissemination and implementation of a policy on school health. CONCLUSION The framework would be a firm foundation and contribution to improve the health of children in public schools, and well-being and academic performance that would be a good feat towards the future endeavour. The findings of the study are pertinent to school health nursing practice, education and research.
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Affiliation(s)
- Hellen I Wankasi
- School of Nursing Science, Faculty of Health Sciences, North-West University, Mmabatho.
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Nishimura M, Wong A, Dimaras H, Maurer D. Feasibility of a school-based vision screening program to detect undiagnosed visual problems in kindergarten children in Ontario. CMAJ 2020; 192:E822-E831. [PMID: 32690557 PMCID: PMC7828989 DOI: 10.1503/cmaj.191085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2020] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Visual problems can negatively affect visual development and learning but often go undetected. We assessed the feasibility of scaling up a school-based screening program to identify and treat kindergarten children with visual problems. METHODS We conducted a prospective cohort study offering vision screening to junior (JK) and senior kindergarten (SK) children attending 43 schools in 15 Ontario communities. Screening comprised photoscreeners and tests of visual acuity, stereoacuity and eye alignment. Children who failed any test were referred for a comprehensive eye examination, with treatment as needed (e.g., glasses). RESULTS Using a passive consent model, 89% of children were screened compared with 62% using an active consent model (p < 0.001). Referral rates to an optometrist varied across schools (mean referral rate for children in JK 53%, range 25%-83%; mean referral rate for children in SK 34%, range 12%-61%). Among 4811 children who were screened, a visual problem was detected in 516 (10.7%), including 164 (3.4%) with amblyopia and 324 (6.7%) with clinically significant refractive errors. For 347 (67.2%) of the children with a visual problem, this was their first eye examination. Rescreening in Year 2 did not lead to detection of additional problems among children who passed screening in Year 1. Regardless of location (child's school or optometrist's office), 1563 (68.9%) of children attended the follow-up optometry examination. Most of the children who were surveyed (291 of 322, 90.4%) indicated that they enjoyed vision screening. INTERPRETATION Many children in Ontario with a visual problem were not being identified by the status quo in 2015-2017. We found that in-school vision screening with follow-up eye examinations is an effective strategy for identifying at-risk children and placing them in eye care before grade 1.
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Affiliation(s)
- Mayu Nishimura
- Department of Ophthalmology and Vision Sciences (Nishimura, Wong, Dimaras), The Hospital for Sick Children; Department of Ophthalmology and Vision Sciences, Faculty of Medicine (Wong, Dimaras), University of Toronto; Institute of Health Policy Management and Evaluation (Wong, Maurer), and Division of Clinical Public Health (Dimaras), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences Program and Centre for Global Child Health (Dimaras), Sick-Kids Research Institute, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Nishimura, Maurer), Faculty of Science, McMaster University, Hamilton, Ont.
| | - Agnes Wong
- Department of Ophthalmology and Vision Sciences (Nishimura, Wong, Dimaras), The Hospital for Sick Children; Department of Ophthalmology and Vision Sciences, Faculty of Medicine (Wong, Dimaras), University of Toronto; Institute of Health Policy Management and Evaluation (Wong, Maurer), and Division of Clinical Public Health (Dimaras), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences Program and Centre for Global Child Health (Dimaras), Sick-Kids Research Institute, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Nishimura, Maurer), Faculty of Science, McMaster University, Hamilton, Ont
| | - Helen Dimaras
- Department of Ophthalmology and Vision Sciences (Nishimura, Wong, Dimaras), The Hospital for Sick Children; Department of Ophthalmology and Vision Sciences, Faculty of Medicine (Wong, Dimaras), University of Toronto; Institute of Health Policy Management and Evaluation (Wong, Maurer), and Division of Clinical Public Health (Dimaras), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences Program and Centre for Global Child Health (Dimaras), Sick-Kids Research Institute, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Nishimura, Maurer), Faculty of Science, McMaster University, Hamilton, Ont
| | - Daphne Maurer
- Department of Ophthalmology and Vision Sciences (Nishimura, Wong, Dimaras), The Hospital for Sick Children; Department of Ophthalmology and Vision Sciences, Faculty of Medicine (Wong, Dimaras), University of Toronto; Institute of Health Policy Management and Evaluation (Wong, Maurer), and Division of Clinical Public Health (Dimaras), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences Program and Centre for Global Child Health (Dimaras), Sick-Kids Research Institute, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Nishimura, Maurer), Faculty of Science, McMaster University, Hamilton, Ont
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Ledoux T, Thompson D, O'Connor T, Avery D, Kochi C, O'Connor DP, Lin SF, Binggeli-Vallarta A, Blaine RE, Sharma S, Hoelscher DM. Cross-Site Process Evaluation Results for the Early Childhood Education Center Setting: CORD Study. Child Obes 2020; 16:350-357. [PMID: 32471316 DOI: 10.1089/chi.2019.0314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: The Childhood Obesity Research Demonstration project aimed to deliver evidence-based obesity prevention interventions to at-risk families at three demonstration sites. The interventions were delivered in multiple settings, including early childhood education centers (ECECs), public schools, and primary care clinics. An evaluation center conducted cross-site process, impact, and sustainability evaluations. Results of the cross-site process evaluation for the ECECs will be described. Methods: Reach (proportion of the target population who participated), dose delivered (materials and interventions that were distributed), and fidelity (proportion of planned intervention components delivered) were assessed at two levels (researcher-to-provider and provider-to-family levels). Standardized data forms were completed by research team members at each demonstration site with assistance from the evaluation center. Results: The Childhood Obesity Research Demonstration project reached 5174 children and 390 teachers in 58 ECECs. The centers delivered an average of 3.9 hours of training to teachers. A total of 1382 different types of materials were distributed to providers, and from 1.3 to 4.3 hours of technical support were delivered to centers monthly. For fidelity at the researcher-to-provider level, 49.5% (n = 370) of eligible teachers completed all training sessions. Considerable variations across demonstration sites in reach, dose delivered, and fidelity across were observed. Conclusion: The Childhood Obesity Research Demonstration project reached large numbers of children, families, teachers, and ECECs. Maintaining intervention fidelity while reaching large numbers of at-risk individuals proved to be a challenge.
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Affiliation(s)
- Tracey Ledoux
- Department of Health and Human Performance, University of Houston, Houston, TX, USA
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Teresia O'Connor
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Dana Avery
- Department of Health and Human Performance, University of Houston, Houston, TX, USA
| | - Camila Kochi
- Department of Health and Human Performance, University of Houston, Houston, TX, USA
| | - Daniel P O'Connor
- Department of Health and Human Performance, HEALTH Research Institute, University of Houston, Houston, TX, USA
| | - Shih-Fan Lin
- Institute for Behavioral and Community Health, San Diego State University, San Diego, CA, USA
| | | | - Rachel E Blaine
- Department of Family and Consumer Sciences, California State University, Long Beach, CA, USA
| | - Shreela Sharma
- Michael & Susan Dell Center for Health Living, University of Texas Health Science Center, School of Public Health, Houston, TX, USA
| | - Deanna M Hoelscher
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin Campus, Austin, TX, USA
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Cicutto L, Gleason M, Haas-Howard C, White M, Hollenbach JP, Williams S, McGinn M, Villarreal M, Mitchell H, Cloutier MM, Vinick C, Langton C, Shocks DJ, Stempel DA, Szefler SJ. Building Bridges for Asthma Care Program: A School-Centered Program Connecting Schools, Families, and Community Health-Care Providers. J Sch Nurs 2020; 36:168-180. [PMID: 30336726 PMCID: PMC7222283 DOI: 10.1177/1059840518805824] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Asthma imposes tremendous burden on children, families, and society. Successful management requires coordinated care among children, families, health providers, and schools. Building Bridges for Asthma Care Program, a school-centered program to coordinate care for successful asthma management, was developed, implemented, and evaluated. The program consists of five steps: (1) identify students with asthma; (2) assess asthma risk/control; (3) engage the family and student at risk; (4) provide case management and care coordination, including engagement of health-care providers; and (5) prepare for next school year. Implementation occurred in 28 schools from two large urban school districts in Colorado and Connecticut. Significant improvements were noted in the proportions of students with completed School Asthma Care Plans, a quick-relief inhaler at school, Home Asthma Action/Treatment Plans and inhaler technique (p < .01 for all variables). Building Bridges for Asthma Care was successfully implemented extending asthma care to at-risk children with asthma through engagement of schools, health providers, and families.
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Affiliation(s)
- Lisa Cicutto
- Community Outreach and Research, National Jewish Health, Denver, CO, USA
- Clinical Science Program, College of Nursing, Anschutz Medical Campus, University of Colorado, Denver, CO, USA
| | - Melanie Gleason
- Building Bridges Asthma Program, Children's Hospital of Colorado, Aurora, CO, USA
- Department of Pediatrics, Section of Pediatric Pulmonary Medicine, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Christy Haas-Howard
- Nursing and Student Health Services, Denver Public Schools, Denver, CO, USA
- Asthma Grant Program, Colorado Department of Education, Denver, CO, USA
| | - Marty White
- Children's Hospital Colorado/Denver Public Schools, Denver, CO, USA
| | - Jessica P. Hollenbach
- Department of Pediatrics, School of Medicine, University of Connecticut, Hartford, CT, USA
- Asthma Center, Connecticut Children's Medical Center, Hartford, CT, USA
| | | | | | | | | | - Michelle M. Cloutier
- Asthma Center, Connecticut Children's Medical Center, Hartford, CT, USA
- Department of Pediatrics, UConn Health, Farmington, CT, USA
| | - Carol Vinick
- Asthma Center, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Christine Langton
- Asthma Center, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Donna J. Shocks
- Nursing and Student Health Services, Denver Public Schools, Denver, CO, USA
| | - David A. Stempel
- Propeller Health, San Francisco, CA, USA
- GlaxoSmithKline, Sacramento, CA, USA
| | - Stanley J. Szefler
- Pediatric Asthma Research Program, Breathing Institute, Section of Pediatric Pulmonary Medicine, Aurora, CO, USA
- Denver School of Medicine, University of Colorado, Aurora, CO, USA
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Buller DB, Reynolds KD, Buller MK, Massie K, Berteletti J, Ashley J, Meenan R. Parent reports of sun safety communication and behaviour for students in a randomised trial on a school policy implementation intervention. Aust N Z J Public Health 2020; 44:208-214. [PMID: 32459394 DOI: 10.1111/1753-6405.12987] [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: 10/01/2019] [Revised: 02/01/2020] [Accepted: 03/01/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Schools are an important setting for skin cancer prevention. An intervention for implementation of school sun safety policy, Sun Safety Schools (SSS), was evaluated. METHODS Primary schools (n=118) in California school districts that had already adopted a sun safety policy were enrolled in a study with a randomised controlled design. Half of the schools were randomised to SSS intervention (N=58). Parents completed an online post-test. RESULTS More parents in intervention schools received information about sun safety (mean=26.3%, sd=3.1%, p=0.017) and children more frequently wore sun-protective clothing when not at school (mean=2.93, sd=0.03, p=0.033) than in control schools (mean=18.0%, sd=2.5%; mean=2.83, sd=0.03, respectively). In schools where principals reported implementing sun safety practices, parents reported that children spent less time outdoors at midday (mean=14.78 hours, sd=0.25, p=0.033) and fewer were sunburned (mean=12.7%, sd=1.1%, p=0.009) than in non-implementing schools (M=16.3 hours, sd=0.67; mean=21.2%, sd=3.8%, respectively). Parents who received sun safety information (mean=3.08, sd=0.04, p=0.008) reported more child sun protection than parents not receiving information (mean=2.96, sd=0.02). CONCLUSIONS A school district sun protection policy and support for implementation increased dissemination of sun safety information to parents and student sun safety. Implications for public health: Technical assistance for sun safety policies may increase sun protection of children.
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Affiliation(s)
| | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University, California, US
| | | | - Kim Massie
- School of Community and Global Health, Claremont Graduate University, California, US
| | | | | | - Richard Meenan
- Kaiser Permanente Center for Health Research, Oregon, US
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Lee D, Wyss L, Wirick S. Creative Learning and Teaching Activities in a School-Based Program Promoting Adolescent Health. J Nurs Educ 2020; 58:485-487. [PMID: 31373671 DOI: 10.3928/01484834-20190719-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/30/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Designing educational activities that engage health profession students' interest in community-based learning is challenging. University faculty channeled concerns about regional trends in cardiovascular disease among adolescents into activities that linked students' foundational knowledge to critical application experiences. METHOD Between 2013 and 2017, university faculty partnered with a local health system and a public high school to develop a sustainable health promotion plan for the school. The university component involved activities that students implemented as part of their community clinical experiences. RESULTS Participant results and feedback were overwhelmingly positive and affirmed that linking learning to real-world concerns made preventive health care concepts interesting and easier to grasp. CONCLUSION Educational activities that involve neighboring stakeholders is a creative and meaningful way to provide engaging learning experiences for future health professionals while contributing to authentic solutions within a community-based partnership. [J Nurs Educ. 2019;58(8):485-487.].
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Wang M, Fang H. The effect of health education on knowledge and behavior toward respiratory infectious diseases among students in Gansu, China: a quasi-natural experiment. BMC Public Health 2020; 20:681. [PMID: 32404088 PMCID: PMC7222316 DOI: 10.1186/s12889-020-08813-3] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 04/29/2020] [Indexed: 03/29/2024] Open
Abstract
BACKGROUND The respiratory infectious diseases (RID) threaten the health and life quality of school students. However, previous related studies were insufficient in research design and method applied. This study aimed to evaluate the effect of health education on the knowledge and behavior of students toward RID through difference-in-difference (DID) analysis in Gansu, China. METHODS In 2015-2016, a one-year health education program in Gansu, China was conducted. The intervention group contained 1064 students before and 1001 students after the health education (2015 and 2016, respectively). The control group contained 1018 and 1001 students, respectively. The health education, including playing promotional cartoons, developing lectures, giving out handbook copies and making hand copy and blackboard newspapers, and publicity columns on RID, were conducted monthly from 2015 to 2016 in intervention group. The data were collected before and after the health education program with a questionnaire on the students' knowledge and preventive behaviors regarding RID. The ×2 and t tests were performed to compare the accuracy rate and scores for RID knowledge and behavior of the two groups. DID estimation was conducted to evaluate the effect of health education on RID knowledge and behavior while controlling the non- equilibrium variables. RESULTS After the health education program, the accuracy rate and scores of most items in the intervention group were significantly higher than those in the control group (P < 0.05) except for item k9 "What methods can prevent flu?". The DID results wherein the demographics- age, nationality, and household register were controlled showed that health education significantly improved the accuracy rate of RID knowledge by 5.2-63.9% for most items, although the accuracy rates of items k2 "What's the transmission way of the mumps?" and k9 were significantly decreased by 36.8 and 12.0%. The health education significantly improved the score of knowledge by 155.2% (P < 0.001) and the accuracy rate of all items of RID behavior by 2.9-51.5% except for item b3 "If you have phlegm, how do you usually deal with it?". In addition, the health education also significantly improved the score of behavior toward RID of the sampled students by 138.2% (P < 0.001). CONCLUSION The results of this study show that health education seemed to increase the RID knowledge and behavior of students. It is recommended that the health education should be enhanced and popularized in schools of China, and RID transmission routes and prevention methods should attract more attention.
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Affiliation(s)
- Manli Wang
- China Center for Special Economic Zone Research, Shenzhen University, Shenzhen, 518060 China
| | - Haiqing Fang
- Administration Office, Shenzhen People’s Hospital, Second Clinical Medical College of Jinan University, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, 518020 China
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48
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de Heer B, Heffern JK, Cheney JS, Secakuku A, Baldwin J. A Community-Based Evaluation of a Culturally Grounded, American Indian After-School Prevention Program: The Value of Practitioner-Researcher Collaboration. Am Indian Alsk Native Ment Health Res 2020; 27:1-20. [PMID: 32259272 DOI: 10.5820/aian.2701.2020.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Programs serving American Indian (AI) youth are an important component of maintaining cultural identity and healthy lifestyles. The current research took a community-engaged approach to evaluate an urban AI youth after-school program that has transitioned into a culturally grounded prevention program. Ways to create a successful research collaboration between AI communities and academics is discussed as well as implications for understanding the importance of culturally-grounded programs for AI youth who reside in urban areas. Overall, the cultural and health components that are integrated into the after-school program were highlighted as primary strengths because they help foster a healthy lifestyle and deeper connection to the heritage/culture for the youth who participated.
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Leung E, Wanner KJ, Senter L, Brown A, Middleton D. What will it take? Using an implementation research framework to identify facilitators and barriers in implementing a school-based referral system for sexual health services. BMC Health Serv Res 2020; 20:292. [PMID: 32264884 PMCID: PMC7140539 DOI: 10.1186/s12913-020-05147-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 03/24/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Across the United States, sexually transmitted infections and unintended pregnancy rates are alarmingly high among youth. Schools, due to their proximity and access to youth, can increase student access to sexual health services (SHS) by creating referral systems (RS) to link students to school- and community-based SHS. From 2013 to 2018, the Centers for Disease Control and Prevention's Division of Adolescent and School Health funded 17 Local Education Agencies (LEA) to partner with priority schools and stakeholders to develop and implement RS to increase student access to SHS. Cicatelli Associates Inc. (CAI) was funded to provide capacity-building to LEA. In 2016-2017, CAI conducted case studies at two LEA, both large and urban sites, but representing different geographical and political contexts, to elucidate factors that influence RS implementation. METHODS Nineteen LEA and community-based healthcare (CBH) staff were interviewed in the Southeastern (n = 9) and Western U.S. (n = 10). Key constructs (e.g., leadership engagement, resources, state and district policies) across the five domains of the Consolidated Framework for Implementation Research (CFIR) framework guided the methodology and analysis. Qualitative data was analyzed using the Framework Method and contextual factors and themes that led to RS implementation were identified. RESULTS Interviewees strongly believed that school-based RS can decrease STI, HIV and unintended pregnancy and increase students' educational attainment. We identified the following contextual key factors that facilitate successful implementation and integration of an RS: enforcing state and district policies, strong LEA and CBH collaboration, positive school culture towards adolescent health, knowledgeable and supportive staff, leveraging of existing resources and staffing structures, and influential district and school building-level leadership and champions. Notably, this case study challenged our initial assumptions that RS are easily implemented in states with comprehensive SHS policies. Rather, our conversations revealed how districts and local-level policies can have significant impact and influence to impede or promote those policies. CONCLUSIONS Through the use of the CFIR framework, the interviews identified important contextual factors and themes associated with LEAs' implementation barriers and facilitators. The study's results present key recommendations that other LEA can consider to optimize integration of RS-related evidence-based practices, systems, and policies in their districts.
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Affiliation(s)
- Emily Leung
- Cicatelli Associates, Inc. (CAI), 505 Eighth Ave. Suite 1900, New York, NY 10018 USA
| | - Kathryn J. Wanner
- Franklin and Marshall College, College Square 931 Harrisburg Ave. 1st Floor, Lancaster, PA 17603 USA
| | - Lindsay Senter
- Cicatelli Associates, Inc. (CAI), 505 Eighth Ave. Suite 1900, New York, NY 10018 USA
| | - Amanda Brown
- Cicatelli Associates, Inc. (CAI), 505 Eighth Ave. Suite 1900, New York, NY 10018 USA
| | - Dawn Middleton
- Cicatelli Associates, Inc. (CAI), 505 Eighth Ave. Suite 1900, New York, NY 10018 USA
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Johnson V, Ellis RS, Hutcherson V. Evaluating a Strategy for Implementation and Sustainability of School-Based Health Centers in 3 Disparate Communities. J Sch Health 2020; 90:286-294. [PMID: 31994216 DOI: 10.1111/josh.12875] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 02/07/2019] [Accepted: 03/24/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND School-based health centers (SBHCs) increase access to health care and improve academic achievement for underserved students. We report on the test of a strategy to take SBHCs to scale by addressing the issues of community need and support and financial sustainability. METHODS Using mixed methods, we collected data on student enrollment, utilization, health outcomes, seat time, patient revenues, surveys and key informant interviews from SBHCs located in 3 geographically and demographically different communities over a 2-year period. RESULTS The 3 health centers were comparable in their capacity to implement their operations and achieve quality outcomes but varied considerably in their abilities to achieve sustainability after 2 years of operation. All participated in a planning phase and were able to achieve community buy in and support which impacted their implementation. Only one of the SBHCs which had the highest patient utilization was able to generate enough revenue from patient billings to become sustainable after the second year. CONCLUSION Expanding SBHCs requires a period of planning to generate community buy in and support which is required for successful implementation. Sustainability requires sustained high clinic utilization and is enhanced by health centers that are able to receive high Medicaid reimbursements.
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Affiliation(s)
- Veda Johnson
- Professor, Director, , PARTNERS for Equity in Child and Adolescent Health, Department of Pediatrics, Emory University School of Medicine, 49 Jesse Hill Jr. Drive, Atlanta, GA, 30303
| | - Ruth S Ellis
- Program Director, , PARTNERS for Equity in Child and Adolescent Health, Department of Pediatrics, Emory University School of Medicine, 49 Jesse Hill Jr. Drive, Atlanta, GA, 30303
| | - Valerie Hutcherson
- Principal, , Village Research and Consulting, 3600 DeKalb Technology Parkway, Suite 140, Atlanta, GA, 30340
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