Journal of School Health最新文献

Background: Mental health care is critical to improving mental health but factors associated with student utilization are poorly understood.

Methods: Data were from high school students (N = 2933; mean age = 15.7 ± .6) enrolled in a California cohort. We examined associations of sociodemographic factors, substance use, and mental health symptoms at baseline (Fall 2021) with mental health care at follow-up (Spring 2022).

Results: At follow-up, 7.7% of students reported out-of-school therapy, and 16.0% reported in-school counseling. Generally, therapy was more common for female and gender minority (vs male), some sexual minority youth (vs heterosexual), black, non-Hispanic white, and multi-ethnic (vs Asian), and English language speakers. Higher socioeconomic status was associated with greater use of out-of-school therapy, but not in-school counseling. Students with clinical levels of mental health symptoms, or alcohol or e-cigarette use had greater odds of mental health care (ORs = 1.42-2.61;ps <.05), though utilization was less than 20% for out-of-school therapy and less than 30% for in-school counseling among these students.

Conclusions: Mental health care is underutilized, and disproportionately used by certain student sub-groups. Findings indicate a need to increase mental health care utilization in- and out-of-school.

Background: Many students would benefit from trauma-informed physical activity (PA); however, there is a lack of systematic guidance on incorporating trauma-informed practices across school-based PA opportunities. The purpose of this study was to generate a feasible framework for trauma-informed school-based PA.

Methods: Framework development was guided by a modified Delphi approach, including an exploration phase and an evaluation phase. First, a multidisciplinary working group reviewed extant literature, mapping trauma-informed practices onto the domains and components of the Comprehensive School Physical Activity Program (CSPAP). Subsequently, experts (n = 14) provided quantitative feedback on the utility and feasibility of these practices.

Results: Thirty-three practices met pre-determined thresholds for utility and feasibility. Across CSPAP domains, this included attending to: (a) safety; (b) positive communication and relationships; (c) empowerment, choice, and voice; (d) emotion management and skill building; (e) instructor competencies and support; and (f) cultural, historical, and gender issues.

Implications for school health policy, practice, and equity: Incorporating trauma-informed practices into existing frameworks and approaches to school-based PA may promote uptake of practices that help meet the social and emotional needs of trauma-exposed youth.

Conclusions: The present output provides a foundation for generating tools and supports for incorporating trauma-informed practices into school-based PA promotion efforts.

Background: Since the 1990s, national standards have been developed in K-12 subject areas. National standards in health education were first released in 1995 with a second set released in 2007. A third edition, the  National Health Education Standards: Model Guidance for Curriculum and Instruction was developed in 2022 under the auspices of the National Consensus for School Health Education. The purpose of this article is to present an overview of the third edition including descriptions of the development process; the 8 standards and aligned performance expectations; considerations related to the translation, dissemination, and implementation of the standards; and projections for potential impact regarding teaching and student outcomes.

Methods: To develop new standards, the National Consensus formed 3 groups: the Management, Development, and Expert Review Groups. These groups employed an iterative process that included the development of 3 drafts of the standards before finalization. This process included a review of each draft by the 3 groups. The second draft included additional qualitative feedback from over 500 school health education leaders, practitioners, and stakeholders.

Results: The third edition includes 8 standards with aligned performance expectations. A description and rationale are provided for each standard along with standard-specific teaching guidance.

Conclusions: The third edition of the National Standards for School Health Education provides guidance to state departments of education and local schools in the development and implementation of health instruction that promotes meaningful learning to guide students in the promotion of their own health and the health of others.

Background: We aimed to characterize relationships between delayed high school start time policy, which is known to lengthen school night sleep duration, and patterns in activity outcomes: physical activity, non-school electronic screen time (non-schoolwork), and sports and extracurricular activity among adolescents.

Methods: We used data from the START study, a multi-site evaluation of a natural experiment, assessing the effects of a school start time policy change in high schools in the Minneapolis, Minnesota metropolitan area. The study follows students in 2 schools that shifted to a later start time (8:20 or 8:50 am) after baseline year and 3 schools that maintained a consistent, early start time (7:30 am) over the 3-year study period. Activity was measured by participant self-report on an in-school survey. The analysis used a difference-in-differences estimator, in which the changes in each outcome observed in the comparison schools estimate the changes in each outcome that would have been observed in the late-start adopting schools had they not delayed their start times after baseline.

Results: Over 2 years of follow-up, no changes emerged to suggest that later school start times either interfered with, or promoted, any activity-related outcome that was measured.

Implications: Communities interested in promoting sleep by delaying start times may do so knowing that there are unlikely to be adverse effects on adolescent physical activity, electronic screen time, or organized sports and activity participation.

Conclusions: A shift to later school start times does not appear to enhance or detract from the healthfulness of students' activity level.

Background: A systematic adaptation of an evidence-based state health curriculum (Michigan Model for Health™, MMH) was created to enhance physical activity and family engagement materials but retain the core functional elements of the curriculum.

Methods: The Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) was used to document the adaptation, which used materials from an evidence-informed physical activity program (Interrupting Prolonged sitting with ACTivity, InPACT). Acceptability, appropriateness, feasibility, and perceived value of the adaptation were assessed by key stakeholders, regional school health coordinators (HCs).

Results: A planned, fidelity-consistent adaptation was created in which InPACT resources were integrated into the MMH curriculum, with recommended integrations packaged in a supplemental guide. Training was modified as appropriate. The guide had high acceptability, appropriateness, and feasibility among HCs (n = 17), and 71% of HCs (n = 24) indicated that it had really strong value.

Conclusions: Next steps involve implementing the adapted curriculum and evaluating its effects on family engagement, youth physical activity levels, and overall curriculum effectiveness.

Background: Schools are both learning environments for students and workplaces for faculty. Recognizing the role of organizational factors in staff health in school environments, the study aimed to explore which factors, including transformational leadership, teachers' perceived management support and HPS accreditation awards, were most associated with promoting a healthy lifestyle for teachers.

Methods: A cross-sectional study was undertaken of 137 elementary schools in 2014, involving 433 directors and 2090 teachers. Data were collected using an anonymous structured questionnaire. Hierarchical linear modeling was used to analyze both teacher- and school-level factors associated with health-promoting lifestyles.

Results: There was a significant positive correlation between teachers' overall health-promoting lifestyle profile (HPLP-II) scores and both perceived management support (coefficient = .98, p < .001) and transformational leadership (coefficient = .38, p = .039). All 6 HPLP-II subscales also showed significant positive correlations with perceived management support (coefficients .12-.24, p < .001).

Conclusion: Supporting a healthy working atmosphere and strong principal transformational leadership are keys to enhancing teachers' health-promoting lifestyles. Future research could explore how transformational leadership and management support influence teachers' health behaviors and identify effective strategies and interventions.

Background: Adverse childhood experiences (ACEs) are associated with behavioral health challenges and high school dropout, and behavioral health is associated with high school dropout. Less is known about the role of behavioral health challenges in the relationship between ACEs and high school dropout.

Methods: Using data from the Panel Study of Income Dynamics (2013) and its 2014 Childhood Retrospective Circumstances Study supplement, the current study conducts mediational path analysis to examine the direct and indirect effects of cumulative ACEs on high school dropout via adolescent depression, anxiety, and substance use.

Results: Experiencing more ACEs was associated with depression, anxiety, and substance use. Only depression and substance use were associated with high school dropout. There was a significant direct effect between increased ACEs and high school dropout and significant indirect effects via depression and substance use, but not anxiety.

Conclusions: Adolescent behavioral health interventions to address the long-term effects of ACEs may also support academic achievement. School-based interventions, particularly those aligned with trauma-sensitive school frameworks and engaging various school personnel, including school nurses, should be considered. Community- and policy-level interventions aimed at primary prevention of ACEs are also needed.

Background: This study offers a comprehensive review of academic performance measurement instruments in physical activity and education settings, aiming to provide a comprehensive list of tools used for measuring academic performance in relation to variables associated with physical activity.

Methods: Academic performance outcomes, including cognitive skills, attitudes, academic achievement, and academic behavior categorized by CDC, were investigated using specific keywords in search engines between 2000 and June 2022, with 233 articles (describing 220 studies) included.

Results: Participant demographics, mainly elementary students, displayed variability. The review found that 37.3% of studies measured cognitive skills and attitudes (primarily attention), 57.3% assessed academic achievement (GPA, subject scores, or standardized tests), and 15.9% evaluated academic behaviors (mostly on-task/off-task behaviors). Various instruments were employed, notably those measuring attention, intelligence, memory, and attitude. Positive associations were found in 63.4%, 78.6%, and 85.7% of studies for cognitive skills, academic achievement, and academic behavior, respectively.

Conclusion: This literature review highlights the prevalence of studies on academic achievement, diverse cognitive skills instruments, and a focus on attention. Despite predominantly positive relationships, some studies reported non-significant or negative associations, particularly for cognitive skills. Future research should emphasize these areas using reliable instruments.

Background: We sought to determine the impact of school gardens and nutrition education on student fruit and vegetable consumption from limited-income communities in Alabama.

Methods: Third grade students at 99 Alabama schools with and without gardens on-site were randomized to receive either nutrition education or to a wait-list control group. Multi-level models were used to assess the effects of treatment and control with and without school gardens.

Results: Students attending schools with gardens demonstrated highest consumption of fruits and vegetables prior to treatment. Nutrition education alone translated into significant dietary improvements. Both gardens and education translated into greatest dietary improvements.

Implications for school health policy, practice, and equity: Devising financially accessible, practical, and culturally relevant ways to improve student health through garden and nutrition education may help improve student diet. Forming comprehensive Extension, SNAP-Ed, and school collaboration to support gardens, nutrition education, and healthy school policies and systems can be a way to support and sustain healthy student learning environments.

Conclusions: Combined gardening and nutrition education is associated with increases in fruit and vegetable consumption among majority rural, Southern students from limited-resource communities.