Journal of School Health最新文献

Background: To health professionals working in American school-based health centers, the benefits of school-based health programs are obvious. The philosophical warrant for this work has been reasserted for over 70 years. And yet, the divisiveness of health and health care in the U.S. has led to questions and even concerns about the appropriateness of co-locating healthcare services in schools.

Contributions to practice: We address three common misconceptions to provide an accurate depiction of the work school-based health centers do. The misconceptions we address are: 1. that education and health care should be separate; 2. that parents and guardians alone are responsible for their children's health; and 3. that school-based health centers cut out parents and guardians from involvement in their children's health.

Implications for school health policy, practice, and equity: Misconceptions about school-based health centers undermine the important work being done in these centers, including the pursuit of improved child health outcomes. Clarifying these misconceptions is of the utmost importance.

Conclusions: It is important to understand and actively address common misconceptions about school-based health centers. Doing so can help leverage the opportunities these centers and programs present.

Background: School-based physical activity (PA) programs are an equitable, evidence-based approach to combat health and PA disparities. This study examined factors associated with implementation of BE Physically Active 2Day (BEPA 2.0), a K-5 school-based PA program, and examined how support from Cooperative Extension via Supplemental Nutrition Assistance Program Education (SNAP-Ed) partners influenced implementation.

Methods: Teachers in schools receiving BEPA 2.0 trainings were surveyed about program use 3-6 months post-training. Descriptive and chi-square analyses were conducted to evaluate the relationships between implementation factors (e.g., training, support, barriers) and program delivery. Logistic regression was used to summarize the odds of program delivery related to implementation factors.

Findings: Responses were returned by 355 teachers. The odds of program delivery among trained respondents were 2.64 (1.22, 5.47) times the odds among untrained respondents. Most implementors (72.4%) provided activities 1-2 times/week. More frequent implementation (≥ 3 times/week) [OR = 2.43 (1.27, 4.73)] and fewer barriers were reported among those who received support from SNAP-Ed partners (p = 0.01).

Implications for school health policy, practice, and equity: SNAP-Ed program partnerships should be considered when implementing school-based strategies to increase PA opportunities for vulnerable youth.

Conclusions: High PA program implementation among trained teachers was enhanced with partner support.

Background: School-based substance use prevention is important, yet many educators are not trained in the curriculums. The purpose of this study was to assess changes in educators' knowledge about substances and confidence in delivering drug education before and after participating in educator trainings, as well as overall perceptions of the trainings, for three curriculums: tobacco, cannabis, and all drugs prevention.

Methods: We conducted one-arm pre-post analyses evaluating educators' changes in knowledge about products and confidence to deliver curriculums. A total of 1064, 648, and 171 educators participated in the trainings and completed surveys (June 2021-November 2023) about drug knowledge (closed-ended, three items for tobacco, five for cannabis), confidence to deliver curriculums (Likert, four items for all trainings), and perceptions of the trainings (open-ended, four items for all trainings). Paired-sample t-tests and McNemar tests of paired proportions were conducted for the matched sample. Two coders double-coded open-ended responses to identify key themes.

Results: The training for tobacco was associated with pre-post improvements on all knowledge questions (p's ≤ 0.001). Trainings for all three curriculums were associated with pre-post improvements for all confidence questions (p's < 0.007). Participants qualitatively reported wanting longer trainings with more in-depth content and navigation of materials.

Implications for school health policy, practice, and equity: Our findings suggest that trainings are a promising method that may improve the knowledge and confidence of educators who deliver drug education curriculums.

Conclusions: Educator trainings will likely benefit from detailed content on various substances, interactive activities, and show educators how to tailor curriculums based on their students' specific needs.

Background: This practice paper exemplifies a systematic approach used to learn about existing mental well-being programs for youth 11-14 years to inform curriculum development for after-school settings.

Methods: We reviewed 3389 mental well-being programs from publicly accessed databases and conducted a content analysis using inductive and deductive coding to explore the domains each program addressed.

Results: Through our content analysis of the final eight programs, we found strong alignment with the Collaborative for Academic, Social and Emotional Learning (CASEL) core social-emotional competencies: self-awareness, self-management, social awareness, relationship skills, and decision-making.

Implications for practice: Although using established processes (e.g., PICO, CFIR) to review public databases is an effective research strategy, engaging in research-intensive endeavors is time consuming and may not be practical for after-school administration. The benefits of community-academic partnerships, such as EMPOWER, are highlighted as an approach, and opportunity, to promote evidence-based research practices to inform programming in community organizations.

Conclusion: Enhancing youth social emotional competencies is an important means to supporting youth mental well-being. Incorporating a systematic approach to select youth mental well-being programs provides a structure, for our EMPOWER project, that can steer the choice of curricula to meet the needs of after-school program contexts.

Background: School shooting events and lockdowns have increased in the United States, raising concerns about their impact on youth mental health.

Method: This study assessed the association between school lockdowns and changes in youth mental health in 10,049 children who participated in the Adolescent Brain and Cognitive Development study. The exposure was school lockdowns related to violence and shooting incidents, and the outcomes were Child Behavior Checklist scores on five mental health disorders.

Results: Approximately 20.3% of children reported ever experiencing a school lockdown with 39.3% of these lockdowns occurring in the past year. Past-year lockdown exposure (versus no lockdown exposure) was associated with increased symptoms of anxiety disorders (β = 0.20, 95% CI: 0.01, 0.38), somatic disorders (β = 0.23, 95% CI: 0.09, 0.38), and stress problems (β = 0.30, 95% CI: 0.05, 0.56). Among children who reported a past-year lockdown, those indicating clinical ranges of ADHD (OR = 2.23, 95% CI: 1.17, 4.25) or stress problems (OR = 2.75, 95% CI: 1.05, 7.25) had higher odds than their counterparts of reporting that the lockdown had a lot/some impact (versus little/no impact).

Implications for school health policy, practice, and equity: Emergency preparedness in schools should prioritize mental health support post-lockdowns.

Conclusions: Research and funding are needed to understand the nature, frequency, and consequences of school lockdowns.

Background: Few studies have investigated how heat impacts play from the perspective of children. The purpose of this study was to explore children's experiences of recess play during high temperatures.

Methods: We used the draw-and-tell method to retrospectively explore the experiences of recess during hot weather among students (N = 38) between the ages of 5-12 attending four elementary schools in one school district in Arizona (United States). Students were asked to imagine themselves at recess on a hot day, select their preferred playground picture (shaded or unshaded), draw a picture of themselves in the playground, and explain their drawings. Drawings and narrations were analyzed using content analysis and constant comparative methods.

Results: Most students (89%) selected the playground picture with shade. Four themes describing students' experiences were found: (a) discomfort, (b) self-awareness of heat affecting health and safety, (c) influence of heat on play and physical activity, and (d) adaptive strategies for managing heat during recess.

Conclusions: Students are aware that playing outside in the heat has the potential to negatively impact their health and adapt their play to occur in the shade.

Implications for school health policy, practice, and equity: Outdoor school play spaces should increase access to shade.

Background: Universal, classroom-based mental health literacy (MHL) curricula are associated with improved mental health knowledge, attitudes, and help-seeking behaviors. Young adolescents are an ideal target given their need for and receptivity toward MHL education.

Methods: We conducted a scoping review to identify universal, school-based MHL programs primarily for students aged 10-14 years, with adequate descriptions of curriculum implementation and content, and measured outcomes.

Findings: Thirty-one articles describing 24 programs met the inclusion criteria. The content and educational strategies varied, with no two programs having the same curriculum. The studies show promising results for improvement in mental health knowledge, attitudes, help-seeking, and student mental health.

Implications for school health policy, practice, and equity: Collaborative work between educational and mental health professionals, along with rigorous study of outcomes, aiming to reach a consensus on a core MHL curriculum and best implementation practices, will advance efforts to improve MHL.

Conclusions: This scoping review confirmed that existing universal, school-based MHL programs for middle school-aged students improve mental health knowledge. The programs are diverse, and their outcomes are often challenging to compare. Ongoing study in this field to optimize design and implementation for improved effectiveness is needed.

Background: Schools play a key role in children's health. Following COVID-19, programs that promote students' well-being are needed more than ever. This study examines the continuation of a wellness initiative in Anchorage, Alaska, in the 2021-2022 school year.

Methods: Interviews were conducted with n = 25 principals and cafeteria managers. Content analyses of the qualitative data were conducted using an immersion/crystallization approach. Codes were grouped to create themes contained under larger domains.

Results: All schools continued aspects of the wellness initiative following COVID-19. Principals and cafeteria managers indicated: recess, movement opportunities, and longer lunch periods are important for mental health, socialization, and relationship building; COVID-19 exacerbated previous challenges with staffing shortages; additional pressure for the academic time made scheduling the wellness initiative challenging; longer lunch periods give younger students time to eat but cause poor behavior in older students which were alleviated through supportive strategies; and 30-minute recess and movement breaks offer more time to move, reset, and focus on schoolwork.

Implications for school health policy, practice, and equity: The study underscores the importance of school administrators integrating wellness initiatives into their policies, with buy-in from school and district leadership.

Conclusions: This study highlights the need for and importance of school wellness initiatives following COVID-19 extended school closures.

Background: Traumatic brain injury (TBI) is a common injury in children. Though research on youth TBI has largely focused on high school students, this study describes selected school outcomes after TBI in the past 12 months among children aged 5-17 years.

Methods: Data from parent-proxy respondents from the pilot administration of the National Concussion Surveillance System (a random-digit-dial telephone survey with over 10,000 adult respondents) were examined. Descriptive statistics of demographic and injury characteristics of children who sustained a TBI were calculated. The association between TBI signs/symptoms and selected school outcomes were determined by multinomial logistic regressions.

Results: Among the 3557 children sampled via parent-proxy-reporting, 9.9% sustained a TBI in the past year. Changes in sleep or being more tired than usual, trouble concentrating, sensitivity to light or noise, and difficulty learning or remembering new things were associated with a greater risk of worse school outcomes following a TBI.

Implications for school health policy, practice, and equity: To promote a positive return to learn (RTL) experience among children following TBI, school districts may prioritize accommodations (e.g., breaks in learning, extra time for assignments) and implement existing ascending levels of academic support where warranted.

Conclusion: These findings may inform stakeholders seeking to enhance RTL and provide needed support or services for school-aged children who sustain a TBI.

Background: School violence is a significant public health concern. Most perpetrators exhibit psychosocial and behavioral warning signals which are often inadequately addressed. While policy and funding typically reinforce politically popular target hardening and threat assessment strategies, these are not most supported by research or requested by education faculty and administration.

Theoretical contributions: The most common threats to school safety are ubiquitous events causing students to feel disconnected, alienated, isolated, and unsafe in school. Theoretical and empirical research indicates that focusing on rare but extreme school violence is less productive than preventative approaches including universal socio-emotional programs, mental health supports, and climate and culture building to produce effective strategies for safe school environments.

Implications for school health policy, practice, and equity: Comprehensive school safety plans should include three essential preventative components: (1) targeted, student-centered approaches addressing social, emotional, and behavioral wellbeing; (2) equity-focused institutional culture and climate approaches aligned with appropriate disciplinary strategies; and (3) well-defined target hardening, threat assessment and reporting measures.

Conclusions: Increasing evidence suggests that keeping schools safe requires coordinated approaches to school safety including student-centered psycho-social behavioral initiatives, systematic attention to equitable culture and climate, and meaningful, racially sensitive target hardening coordinated among and between service professionals.