National Survey of School Employees: COVID-19, School Reopening, and Student Wellness

BACKGROUND

During spring 2020, COVID-19 forced widespread United States school building closures in an unprecedented disruption for K-12 students and staff. Partnering with the American School Health Association (ASHA), we sought to identify areas of concern among school staff planning for school reopening with the goal of addressing gaps in resources and education.

METHODS

This 16-item web-based survey was distributed via email to 7467 ASHA members from May to June 2020. Topics focused on 3 Whole School, Whole Community, Whole Child components: physical environment, health services, and mental health. Chi-square tests were used to identify differences in responses by school characteristics and school role on each survey item.

RESULTS

A total of 375 respondents representing 45 states completed the survey. The majority were female (91.7%), white (83.4%) and non-Hispanic (92.2%), and school nurses (58.7%). Priority concerns were feasibility of social distancing (93.6%), resurgence of COVID-19 (92.8%), and the availability of health supplies (88.8%).

CONCLUSION

Understanding staff concerns in the context of the Whole School, Whole Community, Whole Child model better positions the school community to address ongoing gaps and changing needs as schools continue to address COVID-19 complications.

Factors Associated with Caregiver Preferences for Children's Return to School during the COVID-19 Pandemic

BACKGROUND

Amid the COVID-19 pandemic, there is a need to understand caregiver preferences for their children's instructional format for the start of the 2020 to 2021 academic year. The purpose of the current study was to assess caregiver preferences for on-campus versus virtual learning at home during the fall and factors associated with these preferences.

METHODS

Participants were caregivers of 4436 children and adolescents who were enrolled in pre-kindergarten through high school at a large, public school district in Texas. Caregivers were asked to complete an anonymous, online survey about their initial preferences for their student's back to the school learning environment.

RESULTS

Caregivers of high- and middle-school students were more likely to endorse a preference for an on-campus/virtual hybrid instructional format and less likely to endorse a preference for a traditional, face-to-face instructional format compared to caregivers of elementary school students. Regardless of the school level, concerns about child health and safety were the factor most strongly associated with caregiver preferences for on-campus versus virtual learning at home during the fall.

CONCLUSIONS

These data highlight the importance of school re-opening plans offering virtual options and addressing caregiver concerns about children's health and safety amid the COVID-19 pandemic.

Community-Engaged Approach to the Development and Implementation of a Student-Centered Return to Learn Care Plan After Concussion

BACKGROUND

Current return to learn (RTL) after concussion guidelines lack specificity for individualized student care, limiting potential for adoption and implementation. We used a community-engaged research framework to develop and evaluate the implementation of a student-centered care plan that assists school personnel in facilitating RTL.

METHODS

We used best-practice RTL guidelines and input from administrators and medical experts to iteratively develop a flexible student-centered care plan. Thirteen schools participated. Coding completion of care plans indicated feasibility and fidelity; interviews with RTL coordinators indicated acceptability.

RESULTS

The care plan includes educational materials, symptom checklists, and guidelines for classroom adjustments linked to student symptoms. Care plans were initiated for 24 (70.6%) of 34 students with concussions, indicating feasibility. Fidelity was high, with the following subsections completed: Action Checklist (90%), Symptom Evaluation (91%), Temporary Adjustment Recommendations (95%). Qualitative analysis of interviews suggested care plans were acceptable and facilitate consistent communication, prioritization of individual needs of students, and increased ability to delegate tasks to other school staff.

CONCLUSIONS

Implementation of a student-centered, individually tailored care plan for RTL is feasible and acceptable in public high schools. Future research should examine how to expediently initiate student-centered concussion care plans after diagnosis to optimize recovery.

Establishing Consensus for Essential Elements in Returning to Learn Following a Concussion

BACKGROUND

Returning to learn following a concussion is the process of managing a student's recovery during the school day by implementation of academic supports with varying intensity. Due to a lack of consensus or even guidance on Return to Learn, this paper set out to establish cross discipline consensus on some essential elements of Return to Learn using a Delphi method.

METHODS

Sixteen national organizations participated in a Delphi process to reach consensus on overarching themes of Return to Learn focused on: returning a student to school, composition of the school-based concussion management team, progress-monitoring, educational safeguards, neuropsychological testing, and legislation. Two rounds of questionnaires were disseminated via email using a Delphi process. Consensus was established during round 2.

RESULTS

Twelve national organizations were able to reach consensus and endorse 13 essential elements of Return to Learn following a concussion.

CONCLUSIONS

There continues to be limited research on concussion Return to Learn leading to confusion in the field. In this paper, we demonstrate consensus on a number of essential elements, from a wide variety of professional disciplines who participate in the care of students following a concussion, as a starting place for some guidance on Return to Learn.