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Adoption and Implementation of California State Transgender and Nonbinary Protections in Los Angeles Area High Schools 加州跨性别和非二元性别保护在洛杉矶地区高中的采用和实施。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-12-10 DOI: 10.1111/josh.70100
Rory P. O'Brien, Kevin Yu, Julie A. Cederbaum, Laura Ferguson, Jeremy T. Goldbach, Harmony Rhoades, John R. Blosnich

Background

California is a leader in adopting numerous transgender and nonbinary adolescent (TNBA)-protective education policies. However, the adoption and implementation of these policies remain largely unexamined. This study explored local school adoption and implementation of California state TNBA-protective policies.

Methods

Nine Los Angeles area high schools enrolled in another study (R01MD016082) participated in this explorative qualitative case study. Case study methods included document collection, campus observations, member checks, and seven student focus group discussions (FGDs; n = 39) between August 2022 and April 2024. Data were analyzed by multiple coders following the Framework Method to compare the implementation of school, district, and state policies.

Results

Implementation of name changes, gender-neutral restrooms, private accommodations, and sexual health education varied between schools and districts. While many schools did not meet state mandates to protect TNBA student access to education, others feasibly implemented these policies, and some adopted innovative approaches to protect TNBA. District oversight, publication of policies and facility access, staff training, funding, and infrastructure were key factors in successful implementation.

Implications for School Health Policy, Practice, and Equity

Study findings highlight the feasibility of the implementation of TNBA protections in schools, with recommendations to adopt gender transition planning, publish policies for student access, and ensure the availability of gender-neutral restrooms and private accommodations.

Conclusions

Implementation of these policies is feasible with sufficient support and oversight. TNBA-protective policies can be strengthened with accountability mechanisms and promotion of implementation strategies, such as technical assistance. Future research should examine the implementation of these policies statewide.

背景:加州在采取众多保护跨性别和非二元青少年(TNBA)的教育政策方面处于领先地位。然而,这些政策的采纳和执行在很大程度上仍未经审查。本研究探讨加州州tnba保护政策在当地学校的采用与执行情况。方法:参与另一项研究(R01MD016082)的九所洛杉矶地区高中参与了本探索性质的案例研究。案例研究方法包括在2022年8月至2024年4月期间收集文件、校园观察、成员检查和7个学生焦点小组讨论(fgd; n = 39)。数据由多个编码员按照框架方法进行分析,以比较学校、地区和州政策的实施情况。结果:不同学校和地区在更名、中性卫生间、私人住宿和性健康教育方面的实施情况各不相同。虽然许多学校没有达到国家规定的保护TNBA学生获得教育的要求,但其他学校可行地实施了这些政策,有些学校采用了创新的方法来保护TNBA。地区监督、政策和设施获取的公布、工作人员培训、资金和基础设施是成功实施的关键因素。对学校卫生政策、做法和公平的影响:研究结果强调了在学校实施TNBA保护措施的可行性,并建议通过性别过渡规划,公布学生使用政策,并确保提供性别中立的厕所和私人住宿。结论:只要有足够的支持和监督,这些政策的实施是可行的。可以通过问责机制和促进执行战略,例如技术援助,来加强保护tnba的政策。未来的研究应该检查这些政策在全州的实施情况。
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引用次数: 0
Evaluating a Nutrition Education Program's Impact on Knowledge and Eating Behavior Among Low-Income Youth: A Social Cognitive Theory Perspective 评估营养教育计划对低收入青年的知识和饮食行为的影响:一个社会认知理论的视角。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-12-04 DOI: 10.1111/josh.70099
Kahyun Nam, Pamela Hodges Kulinna, Margarita Pivovarova, Jongseon Kim, Omar Albaloul

Background

Childhood obesity disproportionately affects low-income Hispanic children. After-school programs (ASPs) provide opportunities to address nutritional disparities through targeted educational interventions.

Methods

This study evaluated a 5-week general nutrition education program in 80 third- to sixth-grade students at a Title I elementary school. Nutrition knowledge, self-efficacy, and dietary behaviors were assessed using the Healthy Plate Photo Method (HPPM) and healthy habits survey (HHS). Data were analyzed using ANCOVA and mediation analysis.

Results

Significant improvements occurred in nutriti`on knowledge (HPPM: R2 = 0.51, p < 0.001; HHS: R2 = 0.52, p < 0.001). Attendance positively predicted knowledge gains (β = 0.38–0.39). However, no significant changes were observed in self-efficacy (p = 0.53) or dietary behaviors (p = 0.82). Self-efficacy did not mediate the knowledge–behavior relationship.

Implications for School Health Policy, Practice, and Equity.

Brief ASP nutrition interventions can effectively enhance foundational knowledge among underserved populations. However, achieving behavioral change may require longer interventions incorporating self-efficacy building strategies and environmental supports. Schools should integrate family and community components to address socioeconomic barriers affecting dietary practices.

Conclusions

While ASPs successfully improve nutrition knowledge, translating knowledge into sustained dietary behavior changes may require comprehensive, multi-level interventions addressing individual, family, and community factors.

背景:儿童肥胖不成比例地影响低收入西班牙裔儿童。课后计划(asp)通过有针对性的教育干预提供了解决营养差异的机会。方法:本研究评估了一所小学80名三至六年级学生为期5周的普通营养教育计划。采用健康餐盘照片法(HPPM)和健康习惯调查(HHS)对营养知识、自我效能感和饮食行为进行评估。采用方差分析和中介分析对数据进行分析。结果:营养知识有显著改善(HPPM: R2 = 0.51, p 2 = 0.52, p)。对学校卫生政策、实践和公平性的影响:简短的ASP营养干预可以有效提高服务不足人群的基础知识。然而,实现行为改变可能需要更长时间的干预,包括自我效能建立策略和环境支持。学校应结合家庭和社区因素,解决影响饮食习惯的社会经济障碍。结论:虽然asp成功地提高了营养知识,但将知识转化为持续的饮食行为改变可能需要针对个人、家庭和社区因素的全面、多层次的干预措施。
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引用次数: 0
Advancing Rural School Safety: A Community-Engaged Model for Behavioral Threat Assessment 促进农村学校安全:社区参与的行为威胁评估模型。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-12-04 DOI: 10.1111/josh.70094
Daniela M. Susnara, M. Blake Berryhill, Jennifer Humber, Holly Morgan, Elizabeth K. Wilson, Karyn Bowen

Background

Behavioral threat assessment and management (BTAM) has been shown to improve school safety and promote a positive school climate. While some states' departments of education mandate BTAM, others leave the decision of its adoption to local districts, creating variability in its implementation and usage across the country.

Contributions to Practice

This paper shares insights on implementing and training high school educators and local law enforcement in BTAM in rural school districts within a state that does not mandate its use. The paper highlights effective community engagement strategies and their role in overcoming barriers, particularly in communities that may be resistant to change.

Implications for School Health Policy, Practice, and Equity

The findings suggest that proactive BTAM implementation can improve student safety and foster an environment conducive to learning. Furthermore, it underscores the importance of community buy-in for successful program adoption.

Conclusions

While BTAM is not universally mandated, this paper demonstrates that through strategic community engagement and targeted training, rural districts can successfully implement BTAM to enhance school safety and student well-being.

背景:行为威胁评估与管理(BTAM)已被证明可以改善学校安全,促进积极的学校氛围。虽然一些州的教育部门授权使用BTAM,但其他州的教育部门将其采用的决定权留给了当地地区,这就造成了其在全国范围内的实施和使用的差异。对实践的贡献:本文分享了在没有强制使用BTAM的州内农村学区实施和培训高中教育工作者和当地执法的见解。该报告强调了有效的社区参与战略及其在克服障碍方面的作用,特别是在可能抗拒变革的社区中。对学校健康政策、实践和公平的影响:研究结果表明,主动实施BTAM可以提高学生的安全性,营造有利于学习的环境。此外,它还强调了社区支持对项目成功采用的重要性。结论:虽然BTAM没有被普遍强制执行,但本文表明,通过战略性社区参与和有针对性的培训,农村地区可以成功实施BTAM,以增强学校安全和学生福祉。
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引用次数: 0
Universal School Meal Policies and Perceived Stigma: Quantitative Evidence From Eight US States 普遍学校供餐政策和感知耻辱:来自美国八个州的定量证据。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-12-04 DOI: 10.1111/josh.70098
Dania Orta-Aleman, Monica D. Zuercher, Leah E. Chapman, Marlene B. Schwartz, Caitlin D. French, Anisha I. Patel, Lorrene Ritchie, Juliana Cohen, Wendi Gosliner

Background

Universal school meals (USMs) policies, which provide free meals to all students regardless of income, have the potential to improve child nutrition and reduce stigma. Quantitative evidence on the association between USM and stigma is limited.

Methods

Leveraging a natural policy variation in state-level USM implementation, we surveyed 1066 middle and high school students from eight US states (four with USM, four without) during the 2022–2023 school year. Stigma was measured as self-reported embarrassment about eating school lunch. We used generalized estimating equations to examine the associations between USM, embarrassment, and lunch participation.

Results

Overall about one in nine students (11.5%) across all surveyed states reported embarrassment, which was associated with 11% less frequent (aRR = 0.89, 95% CI: 0.83–0.97). School lunch participation overall, especially among those from low-income families. While USM was associated with lower odds of embarrassment among students from low-income families, higher-income students in USM states were more likely to feel embarrassed.

Implications

Addressing stigma requires pairing USM with strategies to enhance meal quality, cultural relevance, and inclusive messaging.

Conclusions

USM can alleviate stigma for lower-income students yet may increase embarrassment among higher-income peers, highlighting the need for comprehensive approaches benefiting all socioeconomic groups.

背景:普遍学校供餐政策为所有学生提供免费膳食,无论其收入如何,都有可能改善儿童营养并减少耻辱感。关于USM和柱头之间的关联的定量证据是有限的。方法:利用各州实施USM的自然政策变化,我们在2022-2023学年调查了来自美国8个州(4个有USM, 4个没有)的1066名初高中学生。耻辱感是指在吃学校午餐时自我报告的尴尬。我们使用广义估计方程来检验USM、尴尬和午餐参与之间的关系。结果:总体而言,在所有被调查的州中,大约九分之一的学生(11.5%)报告了尴尬,这与11%的频率降低有关(aRR = 0.89, 95% CI: 0.83-0.97)。学校午餐的总体参与率,尤其是来自低收入家庭的学生。低收入家庭的学生感到尴尬的几率较低,而高收入家庭的学生则更容易感到尴尬。含义:解决耻辱需要将USM与提高膳食质量,文化相关性和包容性信息传递的策略配对。结论:USM可以减轻低收入学生的耻辱感,但可能会增加高收入同龄人的尴尬,强调需要综合方法使所有社会经济群体受益。
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引用次数: 0
Learning Modalities During COVID-19 and Adolescent Mental Health in North Carolina 北卡罗来纳州COVID-19和青少年心理健康期间的学习方式
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-12-02 DOI: 10.1111/josh.70093
Justin Cole Gilbert, Martie P. Thompson, Sophia Ryan, Manan Roy

Background

The mental health of youth represents a critical public health issue and has worsened over the course of the pandemic, partially attributed to social isolation and school closures.

Methods

This analysis leveraged data on school learning modality (COVID-19 School Data Hub), emergency department (ED) visits (North Carolina SHEPS data), and school-district characteristics (National Center for Education Statistics) to investigate how school learning modality predicts mental health-related ED visitation in the state of North Carolina. Generalized linear mixed models were employed to quantify how the odds of mental health ED visitation varied with school learning modality. Models adjust for school-level covariates (e.g., broadband, student:teacher ratio) and patient-level characteristics (age, sex). Patient and school data are nested within counties, which were included as a random effect to address potential clustering within the data.

Results

In-person (odds ratios [OR]: 0.92, 95% CI: 0.85–0.99) and hybrid (odds ratios: 0.95, 95% CI: 0.93–0.98) modalities were associated with lower ORs for ED visits due to mental health compared to a virtual learning modality.

Implications for School Health Policy, Practice, and Equity

School districts should consider increasing the provision of mental health services for students during circumstances in which a virtual learning modality is utilized and consider adopting hybrid learning rather than virtual learning when feasible.

Conclusions

School administrators should seek to balance students' mental health and learning needs in times of crisis.

背景:青年的心理健康是一个重要的公共卫生问题,在大流行期间恶化了,部分原因是社会孤立和学校关闭。方法:本分析利用学校学习方式(COVID-19学校数据中心)、急诊科(ED)就诊(北卡罗来纳州SHEPS数据)和学区特征(国家教育统计中心)的数据,调查学校学习方式如何预测北卡罗来纳州与心理健康相关的ED就诊。采用广义线性混合模型来量化心理健康ED访问的几率随学校学习方式的变化。模型根据学校水平的协变量(例如,宽带、师生比例)和患者水平的特征(年龄、性别)进行调整。患者和学校数据嵌套在县内,这些县作为随机效应包括在内,以解决数据中潜在的聚类问题。结果:与虚拟学习模式相比,面对面(优势比[OR]: 0.92, 95% CI: 0.85-0.99)和混合(优势比:0.95,95% CI: 0.93-0.98)模式与心理健康导致的急诊科就诊的OR较低相关。对学校卫生政策、实践和公平的影响:学区应考虑在使用虚拟学习方式的情况下增加对学生的心理健康服务,并考虑在可行的情况下采用混合学习而不是虚拟学习。结论:在危机时刻,学校管理者应寻求平衡学生的心理健康和学习需求。
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引用次数: 0
Evaluating School-Based Substance Use Services: Insights From a Systematic Review 评估以学校为基础的物质使用服务:来自系统回顾的见解。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-12-02 DOI: 10.1111/josh.70095
Hannah L. Maxey, Brittany J. Daulton, Mykayla Moore, Kelsey Binion

Background

Substance use among youth can have lifelong consequences and therefore requires early and targeted services for those at risk. Schools possess a unique opportunity to provide substance use services to youth for both prevention and intervention. However, limited research exists on the school-based substance use services and their effectiveness.

Methods

Using PRISMA guidelines, online databases were searched for studies done between 2004 and 2024 on school-based substance use services, their outcomes, and the characteristics of those administering them.

Findings

Results showed school-based substance use services being offered in multiple settings. Screening and intervention were the most common services provided. Although specific outcomes varied by study, including academic performance, perceptions, and actions, most were positive.

Implications for School Health Policy, Practice, and Equity

Schools should create strategic plans for feasible and sustainable substance use services. Use of the screening, brief intervention, and referral to treatment (SBIRT) framework can be used to organize these efforts. Establishing robust referral networks is of particular importance for schools.

Conclusions

This review highlights opportunities for schools to focus on screening and brief intervention for in-school services while also building a strong referral network for times when treatment is necessary.

背景:青少年药物使用可能产生终生后果,因此需要为有风险的人提供早期和有针对性的服务。学校有独特的机会为青少年提供预防和干预药物使用服务。然而,关于以学校为基础的药物使用服务及其有效性的研究有限。方法:使用PRISMA指南,检索在线数据库,检索2004年至2024年间关于基于学校的物质使用服务、其结果和管理人员特征的研究。研究结果:结果显示,在多种环境中提供了以学校为基础的药物使用服务。筛查和干预是最常见的服务。虽然具体的结果因研究而异,包括学习成绩、认知和行动,但大多数都是积极的。对学校卫生政策、实践和公平的影响:学校应为可行和可持续的物质使用服务制定战略计划。使用筛选、短暂干预和转诊治疗(SBIRT)框架可以用来组织这些工作。建立健全的转诊网络对学校来说尤为重要。结论:这篇综述强调了学校有机会将重点放在筛查和校内服务的简短干预上,同时在需要治疗的时候建立一个强大的转诊网络。
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引用次数: 0
System-Level, Decision-Making, and Program Operations During the Implementation of the Medicaid Direct Certificate (DC-M) Pilot on Maryland Community School Meals 马里兰州社区学校膳食医疗补助直接认证(DC-M)试点实施过程中的系统级、决策和项目操作。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-12-02 DOI: 10.1111/josh.70096
Samantha G. Alarcon Basurto, Rishitha Reddy Chintala, Dorbor Tarley, Julia Gross, Erin R. Hager, Susan M. Gross

Background

The Maryland Department of Education participated in the USDA's Direct Certification with Medicaid (DC-M) pilot during the 2022–2023 school year. This program lets Medicaid-enrolled students automatically qualify for Free or Reduced-Price Meals (FARM) and incorporates Medicaid data into eligibility calculations for the Community Eligibility Provision (CEP), which allows high-poverty schools to offer free meals to all students. This study assesses how DC-M impacts CEP participation from a systems perspective, using a causal loop diagramming approach across 12 Maryland public school districts.

Methods

Semi-structured, in-depth interviews were conducted among stakeholders from school district offices of food and nutrition services. Inductive qualitative coding was applied to interview transcripts, identifying causal relationships among codes using Kumu software.

Results

Interview findings (n = 12 interviews) identified 36 interconnected factors organized into five reinforcing feedback loops and one balancing loop, revealing three themes: school district landscape influence on student enrollment, federal and state policies' effects on school meal funding, and school-level meal operations impacted by school meal policies.

Implications for School Health Policy, Practice, and Equity

Schools can increase meal participation through DC-M.

Conclusions

This study uses a systems approach to pinpoint barriers and facilitators that can inform strategies for improving FARM eligibility and supporting CEP programs.

背景:马里兰州教育部在2022-2023学年参与了美国农业部的医疗补助直接认证(DC-M)试点。该计划允许参加医疗补助计划的学生自动获得免费或减价膳食(FARM)的资格,并将医疗补助数据纳入社区资格条款(CEP)的资格计算中,该条款允许高度贫困的学校向所有学生提供免费膳食。本研究利用马里兰州12个公立学区的因果循环图方法,从系统角度评估了DC-M如何影响CEP参与。方法:对来自学区食品和营养服务办公室的利益相关者进行半结构化的深度访谈。对访谈笔录进行归纳定性编码,利用Kumu软件识别编码间的因果关系。结果:访谈结果(n = 12)确定了36个相互关联的因素,这些因素被组织成5个强化反馈回路和1个平衡回路,揭示了三个主题:学区景观对学生入学的影响,联邦和州政策对学校膳食资金的影响,以及学校膳食政策对学校膳食运营的影响。对学校健康政策、实践和公平的影响:学校可以通过DC-M增加膳食参与。结论:本研究使用系统方法来确定障碍和促进因素,从而为提高FARM资格和支持CEP计划的策略提供信息。
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引用次数: 0
Tracking Secondary School Students: A Qualitative Investigation of an Online Student Monitoring System With Parent Portal 中学生跟踪:基于家长门户的在线学生监控系统的定性研究。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-12-02 DOI: 10.1111/josh.70097
Eline M. Meuleman, Ina M. Koning, Danique M. Heemskerk, Vincent Busch, Maartje M. van Stralen

Background

The transition to secondary school brings academic and social challenges, with student monitoring systems offering real-time insights to enhance communication between students, parents, and teachers. While these systems improve tracking and support, their effects on student autonomy, wellbeing, and parent–child dynamics are understudied.

Methods

This exploratory research examines the perspectives of five students, seven parents, and twelve teachers using Dutch secondary school systems with parent portals, by conducting semi-structured interviews.

Results

Results of the interviews show benefits such as improved teacher communication and better parental support for students but also challenges such as increased teacher workload and concerns over student privacy, autonomy, and well-being.

Implications for School Health Policy, Practice, and Equity

Schools should balance the benefits of student monitoring systems with their impact on autonomy and well-being. While progress tracking is valuable, unrestricted parental access may lead to over-monitoring. Limiting access to designated times (e.g., four times a year) can preserve student independence while keeping parents informed.

Conclusion

The study highlights the need for balanced system design to protect students' wellbeing and autonomy while enhancing educational collaboration.

背景:向中学的过渡带来了学业和社会挑战,学生监控系统提供实时洞察,以加强学生,家长和老师之间的沟通。虽然这些系统改善了跟踪和支持,但它们对学生自主性、幸福感和亲子动态的影响尚未得到充分研究。方法:本探索性研究通过进行半结构化访谈,考察了使用荷兰中学系统和家长门户的五名学生、七名家长和十二名教师的观点。结果:访谈结果显示了诸如改善教师沟通和更好的家长对学生的支持等好处,但也显示了诸如教师工作量增加和对学生隐私、自主权和福祉的担忧等挑战。对学校健康政策、实践和公平的影响:学校应该平衡学生监控系统的好处及其对自主性和福祉的影响。虽然进度跟踪很有价值,但不受限制的家长访问可能会导致过度监控。限制在指定时间(例如一年四次)可以保护学生的独立性,同时让家长了解情况。结论:本研究强调了平衡的制度设计的必要性,以保护学生的福祉和自主权,同时加强教育合作。
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引用次数: 0
“Look at Yourself”: Teachers' Reflective Practices Toward Enjoyment in Primary School Physical Education “看你自己”:小学体育教师享受教学的反思性实践
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-10-07 DOI: 10.1111/josh.70092
Anoek Adank, Nina Bartelink, Steven Vos, Dave Van Kann

Background

Enjoyment is key in primary school physical education (PE), yet ensuring enjoyable PE experiences for all children is challenging. Reflection may help teachers improve lesson quality and foster PE enjoyment.

Methods

This cross-sectional study explored Dutch primary school teachers' perspectives on enjoyable PE and reflective practices. An online questionnaire was completed by 173 teachers (70.5% PE specialists, 29.5% generalists) who teach at least one PE lesson per week. Teacher type differences were analyzed using Chi-square tests, Mann–Whitney U tests, and logistic regressions.

Results

Perspectives on reflective practices were similar among teacher types. Generalists reported more teacher- and policy-related barriers to providing enjoyable PE, while specialists cited child-related challenges. Most teachers reflected internally, with limited use of written reflection or feedback from children and colleagues. Specialists used professional networks and peer feedback more. Time constraints and low prioritization were key barriers to reflection.

Implications for School Health Policy

Schools should allocate time and promote reflection tools. Generalists could benefit from coaching and targeted professional development. For specialists, teacher education might foster reflective practices using video and child feedback to improve child outcomes like PE enjoyment.

Conclusions

Tailored strategies are needed to strengthen reflection and improve PE quality to foster children's PE enjoyment.

背景:享受是小学体育教育的关键,但确保所有孩子都能享受体育教育是一项挑战。反思可以帮助教师提高教学质量,培养体育乐趣。方法:本横断面研究探讨荷兰小学教师对愉快体育与反思性实践的看法。173名教师(70.5%为体育专家,29.5%为通才)完成了一份在线问卷,他们每周至少教一节体育课。采用卡方检验、Mann-Whitney U检验和logistic回归分析教师类型差异。结果:不同类型教师对反思性实践的看法相似。通才们报告说,在提供愉快的体育活动方面,教师和政策方面存在更多障碍,而专家们则提到了与儿童有关的挑战。大多数教师在内部进行反思,很少使用书面反思或来自孩子和同事的反馈。专家们更多地使用专业网络和同行反馈。时间限制和低优先级是进行反思的主要障碍。对学校卫生政策的影响:学校应分配时间并推广反思工具。多面手可以从指导和有针对性的职业发展中受益。对于专家来说,教师教育可以通过视频和儿童反馈来促进反思实践,以提高儿童的成绩,比如体育乐趣。结论:加强反思,提高体育质量,培养儿童体育享受,需要有针对性的策略。
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引用次数: 0
Is There a Fun and Inexpensive Way to Train in School CPR? 有没有一种既有趣又便宜的方法来训练学校的心肺复苏术?
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-10-06 DOI: 10.1111/josh.70091
Ayşegül Güneş
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引用次数: 0
期刊
Journal of School Health
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