School-based health centers (SBHCs) have the capability to overcome youth barriers to care. Virtual care programs (VCP) facilitate connection between school nurse and off-site SBHC providers and can increase the reach of SBHCs. This project aimed to examine Denver Public School nurses' perspectives of a pilot VCP.
METHODS
Thirteen semi-structured qualitative interviews were conducted and coded using an inductive approach to identify key themes.
RESULTS
Four major themes emerged: (1) obtaining consent, finding space, and capacity are challenges and nurses have suggestions; (2) nurses enjoy feeling like a valued member of a health care team, and providing additional resources to students; (3) nurses perceive benefits in providing free, efficient, higher level of care; (4) adopting novel technology is a facilitator and challenge; limitations included space and privacy.
CONCLUSIONS
Key findings can be utilized to further inform practice.
{"title":"Implementing a School-Based Health Center Virtual Care Program: A Qualitative Exploration of the School Nurse Perspective","authors":"Honora Quinn Burnett MD, MPP, Alyssa Boral MSW, MPH, Samantha Schaap, Christy Haas-Howard MPH, BSN, RN, NCSN, AE-C, Sonja O'Leary MD","doi":"10.1111/josh.13415","DOIUrl":"10.1111/josh.13415","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> BACKGROUND</h3>\u0000 \u0000 <p>School-based health centers (SBHCs) have the capability to overcome youth barriers to care. Virtual care programs (VCP) facilitate connection between school nurse and off-site SBHC providers and can increase the reach of SBHCs. This project aimed to examine Denver Public School nurses' perspectives of a pilot VCP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>Thirteen semi-structured qualitative interviews were conducted and coded using an inductive approach to identify key themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>Four major themes emerged: (1) obtaining consent, finding space, and capacity are challenges and nurses have suggestions; (2) nurses enjoy feeling like a valued member of a health care team, and providing additional resources to students; (3) nurses perceive benefits in providing free, efficient, higher level of care; (4) adopting novel technology is a facilitator and challenge; limitations included space and privacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> CONCLUSIONS</h3>\u0000 \u0000 <p>Key findings can be utilized to further inform practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laurie A. Martinez PhD, MBA, MSN, RN, AHN-BC, Andra S. Opalinski PhD, APRN, CPNP-PC, NC-BC, Linda Herbert PhD
BACKGROUND
Extant literature indicates students living with food allergies (FA) experience biopsychosocial challenges (eg, social isolation, anxiety). The purpose of this study was to explore the experiences of students living with FA during a usual weekday in a school setting.
METHODS
Phenomenological study with purposive convenience sample from the US states of Florida and Colorado. Students aged 10-14 years who have been managing an IgE-mediated FA for more than 1 year within a school setting. Data collection was guided by a story path process with semi-structured interview, with Interpretive Phenomenological Analysis used to ascribe meaning to their experiences.
RESULTS
Four themes: (1) Living with Restraints: A Way of Life, (2) Managing Exposure, (3) Experiencing Stigma, and (4) Experiencing Lack of Knowledge.
CONCLUSION
Findings underscore unique biopsychosocial challenges faced by students living with FA, highlighting the need for comprehensive approaches beyond traditional biological management in developing strategies, policies, future research, and recommendations in school settings.
{"title":"The Lived Experiences of Students With Food Allergies During a Usual Weekday","authors":"Laurie A. Martinez PhD, MBA, MSN, RN, AHN-BC, Andra S. Opalinski PhD, APRN, CPNP-PC, NC-BC, Linda Herbert PhD","doi":"10.1111/josh.13420","DOIUrl":"10.1111/josh.13420","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> BACKGROUND</h3>\u0000 \u0000 <p>Extant literature indicates students living with food allergies (FA) experience biopsychosocial challenges (eg, social isolation, anxiety). The purpose of this study was to explore the experiences of students living with FA during a usual weekday in a school setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>Phenomenological study with purposive convenience sample from the US states of Florida and Colorado. Students aged 10-14 years who have been managing an IgE-mediated FA for more than 1 year within a school setting. Data collection was guided by a story path process with semi-structured interview, with Interpretive Phenomenological Analysis used to ascribe meaning to their experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>Four themes: (1) Living with Restraints: A Way of Life, (2) Managing Exposure, (3) Experiencing Stigma, and (4) Experiencing Lack of Knowledge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> CONCLUSION</h3>\u0000 \u0000 <p>Findings underscore unique biopsychosocial challenges faced by students living with FA, highlighting the need for comprehensive approaches beyond traditional biological management in developing strategies, policies, future research, and recommendations in school settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristin Kan MD, MPH, MSc, Ososese Enaholo MPH, Madeleine Kanaley BA, Gwen Holtzman BA, Khalid Ibrahim MS, Lu Morales AM, MSW, Lisa Lombard PhD, Ruchi Gupta MD, MPH
Background
Families in high-risk communities for COVID-19 transmission experienced a disproportionate burden during the pandemic. This study assessed these families' needs, changes in children's well-being, and perceptions related to the pandemic.
Methods
Four online surveys were administered January 2021 to September 2021 to parents of students, enrolled in parochial, kindergarten-eighth grade schools in Chicago neighborhoods with higher COVID-19 incidence rates by ZIP code, compared to the city average, and higher resource need.
Results
The response rate was 69.1% (n = 186 of 269) in the baseline survey; and other surveys were at 1 (n = 151), 3 (n = 145), and 5 months (n = 154). Of the sample, 83% of parents identified as Hispanic/Latinx with a mean age of 38.3 years (SD: 8.5). Approximately a quarter of parents reported difficulty paying cable and internet bills (26%) and paying utilities (25%). Parents reported children as happy (94% and 95%, p = .59) and hopeful (96% and 95%, p = .74) at 1-month (February to May 2021) and 5-month surveys (June to September 2021). Parents also reported fewer children were irritable (29% vs 19%, p = .03), felt lonely (17% vs 10%, p = .03), and felt isolated (28% vs 9%, p < .001) between those survey waves. The majority (67%) of parents felt that their child had no difficulty wearing a mask in public.
Conclusions
In this longitudinal study, Chicago parents rated children's well-being highly and reported a decrease in negative emotions over time. The areas of need identified may be particularly relevant for outreach and providing resources to Hispanic/Latino families in future emergencies or global health threats.
{"title":"Well-Being of Children and Families in COVID-19 Hotspots in Chicago","authors":"Kristin Kan MD, MPH, MSc, Ososese Enaholo MPH, Madeleine Kanaley BA, Gwen Holtzman BA, Khalid Ibrahim MS, Lu Morales AM, MSW, Lisa Lombard PhD, Ruchi Gupta MD, MPH","doi":"10.1111/josh.13416","DOIUrl":"10.1111/josh.13416","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Families in high-risk communities for COVID-19 transmission experienced a disproportionate burden during the pandemic. This study assessed these families' needs, changes in children's well-being, and perceptions related to the pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four online surveys were administered January 2021 to September 2021 to parents of students, enrolled in parochial, kindergarten-eighth grade schools in Chicago neighborhoods with higher COVID-19 incidence rates by ZIP code, compared to the city average, and higher resource need.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The response rate was 69.1% (n = 186 of 269) in the baseline survey; and other surveys were at 1 (n = 151), 3 (n = 145), and 5 months (n = 154). Of the sample, 83% of parents identified as Hispanic/Latinx with a mean age of 38.3 years (SD: 8.5). Approximately a quarter of parents reported difficulty paying cable and internet bills (26%) and paying utilities (25%). Parents reported children as happy (94% and 95%, p = .59) and hopeful (96% and 95%, p = .74) at 1-month (February to May 2021) and 5-month surveys (June to September 2021). Parents also reported fewer children were irritable (29% vs 19%, p = .03), felt lonely (17% vs 10%, p = .03), and felt isolated (28% vs 9%, p < .001) between those survey waves. The majority (67%) of parents felt that their child had no difficulty wearing a mask in public.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this longitudinal study, Chicago parents rated children's well-being highly and reported a decrease in negative emotions over time. The areas of need identified may be particularly relevant for outreach and providing resources to Hispanic/Latino families in future emergencies or global health threats.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.13416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abigail R. Murdock MPH, Michelle L. Rogers PhD, Tracy L. Jackson PhD, MPH, Karine Monteiro MPH, Laura C. Chambers PhD, MPH
Background
The COVID-19 pandemic negatively affected adolescent mental health due to school closures, isolation, family loss/hardships, and reduced health care access.
Methods
We compared adolescent mental health in Rhode Island before versus during the pandemic, separately among middle and high schoolers. This serial cross-sectional study used Youth Risk Behavior Survey data from 2019 and 2021 (N = 7403). Multivariable logistic regression models estimated the association between year and mental health status, adjusting for sociodemographics.
Results
Middle schoolers in 2021 had higher odds of ever seriously considering suicide (22.6% vs 16.7%) and ever attempting suicide (9.3% vs 6.1%) compared to 2019. Among high schoolers, those in 2021 had higher odds of experiencing persistent sadness/hopelessness in the past year (37.4% vs 32.0%). However, high schoolers in 2019 and 2021 had similar odds of considering suicide in the past year, while those in 2021 had lower odds of having attempted suicide in the past year (8.5% vs 14.6%).
Conclusion
The COVID-19 pandemic may have worsened multiple aspects of adolescent mental health in Rhode Island, particularly among middle schoolers.
Implications for school health policy, practice, and equity
Promoting school connectedness, creating supportive environments, and diversifying the mental health workforce may help overcome adverse pandemic effects.
{"title":"Mental Health Status of Rhode Island Middle School and High School Students Before Versus During the COVID-19 Pandemic","authors":"Abigail R. Murdock MPH, Michelle L. Rogers PhD, Tracy L. Jackson PhD, MPH, Karine Monteiro MPH, Laura C. Chambers PhD, MPH","doi":"10.1111/josh.13424","DOIUrl":"10.1111/josh.13424","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The COVID-19 pandemic negatively affected adolescent mental health due to school closures, isolation, family loss/hardships, and reduced health care access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We compared adolescent mental health in Rhode Island before versus during the pandemic, separately among middle and high schoolers. This serial cross-sectional study used Youth Risk Behavior Survey data from 2019 and 2021 (N = 7403). Multivariable logistic regression models estimated the association between year and mental health status, adjusting for sociodemographics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Middle schoolers in 2021 had higher odds of ever seriously considering suicide (22.6% vs 16.7%) and ever attempting suicide (9.3% vs 6.1%) compared to 2019. Among high schoolers, those in 2021 had higher odds of experiencing persistent sadness/hopelessness in the past year (37.4% vs 32.0%). However, high schoolers in 2019 and 2021 had similar odds of considering suicide in the past year, while those in 2021 had lower odds of having attempted suicide in the past year (8.5% vs 14.6%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The COVID-19 pandemic may have worsened multiple aspects of adolescent mental health in Rhode Island, particularly among middle schoolers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for school health policy, practice, and equity</h3>\u0000 \u0000 <p>Promoting school connectedness, creating supportive environments, and diversifying the mental health workforce may help overcome adverse pandemic effects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samantha Bates PhD, LISW, Danielle R. Harrell PhD, LCSW
BACKGROUND
In the United States (U.S.), 77% of school district leaders reported that their students had fallen behind in their social-emotional development due to COVID-19 school closures. Although research has measured indicators of social-emotional well-being from the perspective of other informants, little is known about student perceptions of perceived changes in their socioemotional competencies and, to a lesser degree, their nonacademic needs.
AIMS
The current study examined middle school students' nonacademic needs, perceptions of socioemotional competencies, and predictors of “socioemotional loss.”
MATERIALS & METHODS
The authors utilized secondary data from 395 middle school students gathered in August 2020 and November 2020 in one large middle school in the southern region of the U.S. Multivariate and linear regression analyses explored students' nonacademic needs, assessed changes in perceptions of their socioemotional competencies over time, and identified predictors of “socioemotional loss” during the “return to learn” period.
RESULTS
Our findings indicated that 3% to 14% of students reported nonacademic needs, with the greatest needs related to food, housing, and healthcare. Further, 48% of students reported perceived losses in their socioemotional competencies, and students formerly receiving school-based support services were those most affected (71% vs. 46%, p = .01). Among the subgroup reporting losses, living in a single-parent household significantly predicted socioemotional loss (β = −.16, p = .02).
DISCUSSION
School-based practitioners, including educators, policymakers, social workers, and mental health providers, can utilize these findings to deliver interventions to students that experienced hardships during the pandemic.
CONCLUSION
Responding to these risks will be critical as schools adapt and intervene in response to the COVID-19 pandemic.
{"title":"COVID-19 School Closures: Disruptions in School-Based Support Services and Socioemotional Loss Among Middle School Students","authors":"Samantha Bates PhD, LISW, Danielle R. Harrell PhD, LCSW","doi":"10.1111/josh.13421","DOIUrl":"10.1111/josh.13421","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> BACKGROUND</h3>\u0000 \u0000 <p>In the United States (U.S.), 77% of school district leaders reported that their students had fallen behind in their social-emotional development due to COVID-19 school closures. Although research has measured indicators of social-emotional well-being from the perspective of other informants, little is known about student perceptions of perceived changes in their socioemotional competencies and, to a lesser degree, their nonacademic needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> AIMS</h3>\u0000 \u0000 <p>The current study examined middle school students' nonacademic needs, perceptions of socioemotional competencies, and predictors of “socioemotional loss.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> MATERIALS & METHODS</h3>\u0000 \u0000 <p>The authors utilized secondary data from 395 middle school students gathered in August 2020 and November 2020 in one large middle school in the southern region of the U.S. Multivariate and linear regression analyses explored students' nonacademic needs, assessed changes in perceptions of their socioemotional competencies over time, and identified predictors of “socioemotional loss” during the “return to learn” period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>Our findings indicated that 3% to 14% of students reported nonacademic needs, with the greatest needs related to food, housing, and healthcare. Further, 48% of students reported perceived losses in their socioemotional competencies, and students formerly receiving school-based support services were those most affected (71% vs. 46%, p = .01). Among the subgroup reporting losses, living in a single-parent household significantly predicted socioemotional loss (β = −.16, p = .02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>School-based practitioners, including educators, policymakers, social workers, and mental health providers, can utilize these findings to deliver interventions to students that experienced hardships during the pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> CONCLUSION</h3>\u0000 \u0000 <p>Responding to these risks will be critical as schools adapt and intervene in response to the COVID-19 pandemic.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.13421","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138687763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William S. Frye PhD, BCB, ABPP, Kimberly Swan MS, ED, Lauren M. Gardner PhD, ABPP
BACKGROUND
Pediatric programs focused on treating chronic pain often do not include an educational liaison (EL) to coordinate services between the patient's medical home and school. As chronic pain in youth can have deleterious effects on school functioning, collaboration between the medical home and the school system are needed to assure these students receive appropriate accommodations.
CONTRIBUTIONS TO THEORY
This manuscript describes a model of coordinated care for students with chronic pain that includes a systemic strategy for collaborative care across settings. Specifically, the role of an EL is described in the context of advocating for the patient to receive appropriate educational accommodations.
CONCLUSIONS
This paper provides a guide for caregivers and professionals to assure appropriate access to support services across settings. Recommendations are included for school accommodations and services to improve academic functioning and outcomes for students with chronic pain.
{"title":"Utilization of an Educational Liaison for Coordinated Care Between the Medical Home and School-Based Professionals for Students with Chronic Pain","authors":"William S. Frye PhD, BCB, ABPP, Kimberly Swan MS, ED, Lauren M. Gardner PhD, ABPP","doi":"10.1111/josh.13423","DOIUrl":"10.1111/josh.13423","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> BACKGROUND</h3>\u0000 \u0000 <p>Pediatric programs focused on treating chronic pain often do not include an educational liaison (EL) to coordinate services between the patient's medical home and school. As chronic pain in youth can have deleterious effects on school functioning, collaboration between the medical home and the school system are needed to assure these students receive appropriate accommodations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> CONTRIBUTIONS TO THEORY</h3>\u0000 \u0000 <p>This manuscript describes a model of coordinated care for students with chronic pain that includes a systemic strategy for collaborative care across settings. Specifically, the role of an EL is described in the context of advocating for the patient to receive appropriate educational accommodations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> CONCLUSIONS</h3>\u0000 \u0000 <p>This paper provides a guide for caregivers and professionals to assure appropriate access to support services across settings. Recommendations are included for school accommodations and services to improve academic functioning and outcomes for students with chronic pain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138687707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christian Thurstone MD, Ryan Loh PhD, Sonja O'Leary MD, Sophia Bruce BA, Kristie Ladegard MD
Background
There are known health disparities in adolescent substance treatment access and engagement. The purpose of this project is to compare outcomes from school- and clinic-based substance treatment and to evaluate if providing school-based substance treatment reduces disparities in treatment access and engagement.
Method
This quality improvement retrospective chart review compares baseline and outcome data for adolescents accessing school-based (n = 531) and clinic-based (n = 523) substance treatment in a natural quasi-experimental study with nonequivalent control group design. Baseline demographic and clinical measures include age, sex, ethnicity, race, and clinical diagnoses. Outcome measures include the number of sessions completed, proportion reaching a week of self-reported abstinence, and proportion providing a negative urine drug screen.
Results
Compared to the clinic-based sample, the school-based sample includes more female (47.65% vs 26.77%) and Hispanic/Latinx (59.89% vs 46.46%) adolescents. The school-based group has a similar proportion reaching a negative urine drug screen (31.84% vs 28.83%, p = .5259) or a week of abstinence (43.15% vs 41.03%, p = .6718) as the clinic-based sample. There are significant differences in total session completion over a period of 16 weeks between school-based and clinic-based adolescents. In multivariable analyses, there was a significant interaction effect of race/ethnicity by location on the number of sessions completed.
Conclusion
Providing school-based substance treatment increases access to care and treatment engagement for female, African American, and Hispanic/Latinx adolescents without diminishing outcomes.
{"title":"School-Based Services May Eliminate Substance Treatment Disparities: Results From a Nonrandomized Program Evaluation","authors":"Christian Thurstone MD, Ryan Loh PhD, Sonja O'Leary MD, Sophia Bruce BA, Kristie Ladegard MD","doi":"10.1111/josh.13413","DOIUrl":"10.1111/josh.13413","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There are known health disparities in adolescent substance treatment access and engagement. The purpose of this project is to compare outcomes from school- and clinic-based substance treatment and to evaluate if providing school-based substance treatment reduces disparities in treatment access and engagement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This quality improvement retrospective chart review compares baseline and outcome data for adolescents accessing school-based (n = 531) and clinic-based (n = 523) substance treatment in a natural quasi-experimental study with nonequivalent control group design. Baseline demographic and clinical measures include age, sex, ethnicity, race, and clinical diagnoses. Outcome measures include the number of sessions completed, proportion reaching a week of self-reported abstinence, and proportion providing a negative urine drug screen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to the clinic-based sample, the school-based sample includes more female (47.65% vs 26.77%) and Hispanic/Latinx (59.89% vs 46.46%) adolescents. The school-based group has a similar proportion reaching a negative urine drug screen (31.84% vs 28.83%, p = .5259) or a week of abstinence (43.15% vs 41.03%, p = .6718) as the clinic-based sample. There are significant differences in total session completion over a period of 16 weeks between school-based and clinic-based adolescents. In multivariable analyses, there was a significant interaction effect of race/ethnicity by location on the number of sessions completed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Providing school-based substance treatment increases access to care and treatment engagement for female, African American, and Hispanic/Latinx adolescents without diminishing outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138628715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lynnea M. LoPresto PhD, MS, RDN, Diana L. Cassady DrPH, Melanie S. Dove MPH, ScD
BACKGROUND
Districts with federal nutrition programs must have an updated local school wellness policy (LSWP) to promote nutrition, physical activity, and student wellness. This study evaluates factors associated with LSWP quality among low-income districts.
METHODS
In 2018, we collected LSWPs from websites of 200 randomly selected, county-stratified, low-income-serving California public districts. Multivariable linear regression assessed associations between district characteristics, model LSWP use (national, state, none), and adoption date on policy quality.
RESULTS
On the WellSAT 3.0 scale of 0-100, mean (95% CI) comprehensiveness was 65.0 (63.2-66.7) and strength was 37.3 (35.3-39.2). Nearly verbatim adoption of model LSWPs was high (68.5% state model, 13.0% a national model). Half were adopted before mandated updates. District size (≥1000 students) and national model LSWP adoption were associated with higher comprehensive scores. National model LSWP adoption was associated with higher strength scores in updated policies compared with those not updated.
IMPLICATIONS
LSWPs have improved school food and activity environments, but district engagement in LSWP is low. Integration into education frameworks that reduce learning barriers could provide synergy for re-engagement.
CONCLUSIONS
High adoption of model policies and low update compliance indicate little district engagement in LSWP. Mixed methods studies of districts with high-quality LSWP are needed.
{"title":"Evaluation of School Wellness Policies in Low-Income California Districts After the 2016 USDA Final Rule","authors":"Lynnea M. LoPresto PhD, MS, RDN, Diana L. Cassady DrPH, Melanie S. Dove MPH, ScD","doi":"10.1111/josh.13422","DOIUrl":"10.1111/josh.13422","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> BACKGROUND</h3>\u0000 \u0000 <p>Districts with federal nutrition programs must have an updated local school wellness policy (LSWP) to promote nutrition, physical activity, and student wellness. This study evaluates factors associated with LSWP quality among low-income districts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>In 2018, we collected LSWPs from websites of 200 randomly selected, county-stratified, low-income-serving California public districts. Multivariable linear regression assessed associations between district characteristics, model LSWP use (national, state, none), and adoption date on policy quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>On the WellSAT 3.0 scale of 0-100, mean (95% CI) comprehensiveness was 65.0 (63.2-66.7) and strength was 37.3 (35.3-39.2). Nearly verbatim adoption of model LSWPs was high (68.5% state model, 13.0% a national model). Half were adopted before mandated updates. District size (≥1000 students) and national model LSWP adoption were associated with higher comprehensive scores. National model LSWP adoption was associated with higher strength scores in updated policies compared with those not updated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> IMPLICATIONS</h3>\u0000 \u0000 <p>LSWPs have improved school food and activity environments, but district engagement in LSWP is low. Integration into education frameworks that reduce learning barriers could provide synergy for re-engagement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> CONCLUSIONS</h3>\u0000 \u0000 <p>High adoption of model policies and low update compliance indicate little district engagement in LSWP. Mixed methods studies of districts with high-quality LSWP are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.13422","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138628883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin W. Chaffee DDS, MPH, PhD, Jing Cheng MD, MS, PhD, Elizabeth T. Couch RDH, MS, Bonnie Halpern-Felsher PhD
BACKGROUND
Adolescents' school engagement, mental health, and substance use have been major concerns during the COVID-19 pandemic, particularly given disruptions to school instruction. We examined how the instructional setting was associated with academic and health-related outcomes within an adolescent cohort followed during the pandemic.
METHODS
During 3 semi-annual follow-up surveys, adolescents (N = 1066 students; 2242 observations) from 8 California high schools responded to items measuring academic self-efficacy, school connectedness, internalizing and externalizing problems, and use of substances. Separate generalized estimating equation models predicted outcomes based on the instructional setting.
RESULTS
Relative to in-person instruction, students in remote instruction reported lower academic self-efficacy (Beta: −0.11; 95% confidence interval [CI]: −0.22, −0.01) and school connectedness (Beta: −0.37; 95% CI: −0.48, −0.25), greater odds of past 30-day internalizing problems (AOR: 1.46; 95% CI: 1.09, 1.95), externalizing problems (AOR: 1.36; 95% CI: 1.02, 1.82), and cigarette, cigar, smokeless tobacco, or hookah use (AOR: 2.50; 95% CI: 1.06, 5.91), but lower odds of past 30-day e-cigarette use (AOR: 0.50; 95% CI: 0.30, 0.86).
CONCLUSIONS
Multiple adverse outcomes related to school engagement, mental health, and substance use were associated with remote instruction. To reduce such impacts under future emergencies, schools should rely sparingly on remote instruction and provide appropriate supportive resources.
{"title":"Engagement, Mental Health, and Substance Use Under In-Person or Remote School Instruction During the COVID-19 Pandemic","authors":"Benjamin W. Chaffee DDS, MPH, PhD, Jing Cheng MD, MS, PhD, Elizabeth T. Couch RDH, MS, Bonnie Halpern-Felsher PhD","doi":"10.1111/josh.13418","DOIUrl":"10.1111/josh.13418","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> BACKGROUND</h3>\u0000 \u0000 <p>Adolescents' school engagement, mental health, and substance use have been major concerns during the COVID-19 pandemic, particularly given disruptions to school instruction. We examined how the instructional setting was associated with academic and health-related outcomes within an adolescent cohort followed during the pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>During 3 semi-annual follow-up surveys, adolescents (N = 1066 students; 2242 observations) from 8 California high schools responded to items measuring academic self-efficacy, school connectedness, internalizing and externalizing problems, and use of substances. Separate generalized estimating equation models predicted outcomes based on the instructional setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>Relative to in-person instruction, students in remote instruction reported lower academic self-efficacy (Beta: −0.11; 95% confidence interval [CI]: −0.22, −0.01) and school connectedness (Beta: −0.37; 95% CI: −0.48, −0.25), greater odds of past 30-day internalizing problems (AOR: 1.46; 95% CI: 1.09, 1.95), externalizing problems (AOR: 1.36; 95% CI: 1.02, 1.82), and cigarette, cigar, smokeless tobacco, or hookah use (AOR: 2.50; 95% CI: 1.06, 5.91), but lower odds of past 30-day e-cigarette use (AOR: 0.50; 95% CI: 0.30, 0.86).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> CONCLUSIONS</h3>\u0000 \u0000 <p>Multiple adverse outcomes related to school engagement, mental health, and substance use were associated with remote instruction. To reduce such impacts under future emergencies, schools should rely sparingly on remote instruction and provide appropriate supportive resources.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138628717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle Dougherty MPH, Eion R. Plenn BS, Stephanie L. Corey MPH, Lindsay Onufer EdD, Robert W. S. Coulter PhD, Coulter Lab Qualitative Team
BACKGROUND
High school staff can play a key role in supporting students with LGBTQ+ identities through informal strategies; however, more research is needed to understand how staff are employing these strategies.
METHODS
We conducted semi-structured interviews, collecting information on informal strategies used to support students identifying as LGBTQ+ from a diverse sample of 23 school staff from high schools across the United States.
RESULTS
Staff employed informal support strategies across social ecological levels: within the school community, staff interacted with parents/guardians of students and advocated for more inclusive policies. Within the classroom, staff created inclusive physical environments, implemented inclusive curricula, and employed bullying prevention strategies. Interpersonally, staff listened to and affirmed students and collaborated to employ support strategies. Intrapersonal qualities, including having a personal connection to the LGBTQ+ community and demonstrating open-mindedness, facilitated staff efforts to support students.
CONCLUSIONS
Supporting staff in the implementation of the strategies we identified could foster more inclusive school environments, advancing equity for students identifying as LGBTQ+.
{"title":"Going the Extra Mile: How High School Staff Use Informal Strategies to Support, Protect, and Care for LGBTQ+ Students*","authors":"Michelle Dougherty MPH, Eion R. Plenn BS, Stephanie L. Corey MPH, Lindsay Onufer EdD, Robert W. S. Coulter PhD, Coulter Lab Qualitative Team","doi":"10.1111/josh.13417","DOIUrl":"10.1111/josh.13417","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> BACKGROUND</h3>\u0000 \u0000 <p>High school staff can play a key role in supporting students with LGBTQ+ identities through informal strategies; however, more research is needed to understand how staff are employing these strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>We conducted semi-structured interviews, collecting information on informal strategies used to support students identifying as LGBTQ+ from a diverse sample of 23 school staff from high schools across the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>Staff employed informal support strategies across social ecological levels: within the school community, staff interacted with parents/guardians of students and advocated for more inclusive policies. Within the classroom, staff created inclusive physical environments, implemented inclusive curricula, and employed bullying prevention strategies. Interpersonally, staff listened to and affirmed students and collaborated to employ support strategies. Intrapersonal qualities, including having a personal connection to the LGBTQ+ community and demonstrating open-mindedness, facilitated staff efforts to support students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> CONCLUSIONS</h3>\u0000 \u0000 <p>Supporting staff in the implementation of the strategies we identified could foster more inclusive school environments, advancing equity for students identifying as LGBTQ+.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138627809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号