Shichen Zheng, Susan L. Stewart, Elisa K. Tong, Theresa H. Keegan, Melanie S. Dove
Background
Since 2016, California has prohibited e-cigarette use alongside smoking in K-12 schools. School tobacco policies may reduce student e-cigarette use.
Methods
We analyzed 2022 to 2023 California Healthy Kids Survey (CHKS) and School Staff Survey data (n = 219,114). Multivariable logistic regression was used to examine associations between student and staff awareness of school tobacco policies and current e-cigarette use, adjusting for demographics.
Results
Among students, 5.2% reported current e-cigarette use; 69.6% knew of a school policy. Most staff knew the policy (91.2%), but fewer endorsed consistent enforcement (88.2%) or prevention education (61.7%). Compared to students reporting no policy, those aware of one (OR = 0.54, p < 0.0001) or unsure (OR = 0.40, p < 0.0001) had lower use. Higher staff knowledge was associated with increased use (OR = 1.2, p = 0.0199), while enforcement agreement was associated with lower use (OR = 0.81, p = 0.0019).
Conclusions
Student knowledge and staff perceptions of policy enforcement were associated with lower e-cigarette use. Findings suggest that consistent enforcement and school-wide communication, not just policy presence, are essential for impact.
Implications
Improving policy visibility and staff training on enforcement may strengthen school policies and reduce tobacco use.
{"title":"Student and Staff Knowledge of School Tobacco Policies and Student E-Cigarette Use, California 2022–2023","authors":"Shichen Zheng, Susan L. Stewart, Elisa K. Tong, Theresa H. Keegan, Melanie S. Dove","doi":"10.1111/josh.70077","DOIUrl":"10.1111/josh.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Since 2016, California has prohibited e-cigarette use alongside smoking in K-12 schools. School tobacco policies may reduce student e-cigarette use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 2022 to 2023 California Healthy Kids Survey (CHKS) and School Staff Survey data (<i>n</i> = 219,114). Multivariable logistic regression was used to examine associations between student and staff awareness of school tobacco policies and current e-cigarette use, adjusting for demographics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among students, 5.2% reported current e-cigarette use; 69.6% knew of a school policy. Most staff knew the policy (91.2%), but fewer endorsed consistent enforcement (88.2%) or prevention education (61.7%). Compared to students reporting no policy, those aware of one (OR = 0.54, <i>p</i> < 0.0001) or unsure (OR = 0.40, <i>p</i> < 0.0001) had lower use. Higher staff knowledge was associated with increased use (OR = 1.2, <i>p</i> = 0.0199), while enforcement agreement was associated with lower use (OR = 0.81, <i>p</i> = 0.0019).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Student knowledge and staff perceptions of policy enforcement were associated with lower e-cigarette use. Findings suggest that consistent enforcement and school-wide communication, not just policy presence, are essential for impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>Improving policy visibility and staff training on enforcement may strengthen school policies and reduce tobacco use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006767","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}
Limited research has examined whether fear in schools contributes to relationships between community violence exposure and negative outcomes for children. This study aimed to explore the relationship between community violence exposure in early childhood and school suspension, examining whether fear in schools and teacher-reported externalizing behavior mediated this relationship.
Methods
Data from the LONGSCAN consortium and path models were used to examine the relationship between violence exposure at age six, fear in schools at age six, teacher-reported externalizing behaviors at age eight, and suspension ages 11–12.
Results
Findings indicated both fear in schools and teacher-reported externalizing behavior mediated the relationship between violence exposure and school suspension.
Implications for School Health Policy, Practice, and Equity
Findings suggest policies prohibiting suspension in childhood and the provision of additional services in schools may help prevent children who are exposed to community violence from experiencing school suspension and its associated consequences. Trauma-informed schools, increased provision of mental health services, and increasing school bonds may all help to reduce school fear and ultimately improve student outcomes, particularly for minoritized students.
Conclusions
Future research using larger, more generalizable data is needed to better understand detected relationships.
{"title":"Community Violence Exposure and Fear in Schools: Paths to Suspension Following Community Violence Exposure in Early Childhood","authors":"Abigail S. Novak, Rebekah Reysen","doi":"10.1111/josh.70083","DOIUrl":"10.1111/josh.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Limited research has examined whether fear in schools contributes to relationships between community violence exposure and negative outcomes for children. This study aimed to explore the relationship between community violence exposure in early childhood and school suspension, examining whether fear in schools and teacher-reported externalizing behavior mediated this relationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the LONGSCAN consortium and path models were used to examine the relationship between violence exposure at age six, fear in schools at age six, teacher-reported externalizing behaviors at age eight, and suspension ages 11–12.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings indicated both fear in schools and teacher-reported externalizing behavior mediated the relationship between violence exposure and school suspension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Findings suggest policies prohibiting suspension in childhood and the provision of additional services in schools may help prevent children who are exposed to community violence from experiencing school suspension and its associated consequences. Trauma-informed schools, increased provision of mental health services, and increasing school bonds may all help to reduce school fear and ultimately improve student outcomes, particularly for minoritized students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Future research using larger, more generalizable data is needed to better understand detected relationships.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006744","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}
The opioid crisis continues to claim lives across the United States, which has led to increased attention toward harm reduction strategies as methods for addressing this public health issue. Specifically, naloxone, an opioid overdose reversal drug, became available over-the-counter in 2023, greatly improving its accessibility. However, despite this progress, general awareness about how to use naloxone remains limited, especially among youth who are being increasingly impacted by the opioid epidemic.
Implications for School Health Policy, Practice, and Equity
Integrating opioid overdose response and naloxone education into high school health curricula is a promising strategy to equip students with the knowledge to recognize the signs of an overdose and respond effectively. Pilot programs and trainings have already demonstrated the effectiveness of such educational initiatives. However, widespread implementation of such education remains a challenge without broader community support and systemic action. For this reason, policy-level interventions, such as those being done in Texas, Virginia, Colorado, and Massachusetts, could play a crucial role in bridging this gap and implementing life-saving education into classrooms.
{"title":"Opioid Overdose Response and Naloxone Education in Schools","authors":"Suhanee Mitragotri, Scott G. Weiner","doi":"10.1111/josh.70089","DOIUrl":"10.1111/josh.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The opioid crisis continues to claim lives across the United States, which has led to increased attention toward harm reduction strategies as methods for addressing this public health issue. Specifically, naloxone, an opioid overdose reversal drug, became available over-the-counter in 2023, greatly improving its accessibility. However, despite this progress, general awareness about how to use naloxone remains limited, especially among youth who are being increasingly impacted by the opioid epidemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Integrating opioid overdose response and naloxone education into high school health curricula is a promising strategy to equip students with the knowledge to recognize the signs of an overdose and respond effectively. Pilot programs and trainings have already demonstrated the effectiveness of such educational initiatives. However, widespread implementation of such education remains a challenge without broader community support and systemic action. For this reason, policy-level interventions, such as those being done in Texas, Virginia, Colorado, and Massachusetts, could play a crucial role in bridging this gap and implementing life-saving education into classrooms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006803","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}
Anneke Vang Hjort, Adrian Bauman, Sofie Rolff Carlsen, Johanne Triantafyllou Lorenzen, Charlotte Demant Klinker
Background
Understanding current practice is crucial for implementing Health Promoting Schools (HPS) and Whole School Approaches to Physical Activity (WSA-PA). This study validated two survey tools to assess HPS and WSA-PA implementation, respectively.
Methods
Content validity was established via literature review and expert and target group consultations. Teachers at Danish schools for vulnerable youth (ages 16–25) completed surveys in fall 2023. Structural validity was assessed using confirmatory factor analysis, construct validity via the Multitrait-Multimethod (MTMM) approach, and reliability with Cronbach's Alpha, Omega H, and Intraclass Correlation Coefficient.
Results
A total of 921 staff at 78 schools participated (72% response rate). The HPS scale had 24 items, while the WSA-PA had 21 across various subfactors, such as school ethos, health services, and resources. Statistical analyses demonstrated good structural validity (e.g., RMSEA = 0.023 for HPS, RMSEA = 0.043 for WSA-PA) and acceptable reliability. MTMM confirmed both convergent and discriminant validity.
Implications for School Health Policy, Practice, and Equity
These tools can help schools monitor and improve HPS and WSA-PA implementation, supporting equity and informing national policies.
Conclusion
The validated tools can guide schools in enhancing HPS and WSA-PA practices. Further research should refine these instruments.
{"title":"A Novel Survey for Assessing Health-Promoting School Practices and Capacity: Validation and Adaptability to Physical Activity","authors":"Anneke Vang Hjort, Adrian Bauman, Sofie Rolff Carlsen, Johanne Triantafyllou Lorenzen, Charlotte Demant Klinker","doi":"10.1111/josh.70071","DOIUrl":"10.1111/josh.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Understanding current practice is crucial for implementing Health Promoting Schools (HPS) and Whole School Approaches to Physical Activity (WSA-PA). This study validated two survey tools to assess HPS and WSA-PA implementation, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Content validity was established via literature review and expert and target group consultations. Teachers at Danish schools for vulnerable youth (ages 16–25) completed surveys in fall 2023. Structural validity was assessed using confirmatory factor analysis, construct validity via the Multitrait-Multimethod (MTMM) approach, and reliability with Cronbach's Alpha, Omega H, and Intraclass Correlation Coefficient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 921 staff at 78 schools participated (72% response rate). The HPS scale had 24 items, while the WSA-PA had 21 across various subfactors, such as school ethos, health services, and resources. Statistical analyses demonstrated good structural validity (e.g., RMSEA = 0.023 for HPS, RMSEA = 0.043 for WSA-PA) and acceptable reliability. MTMM confirmed both convergent and discriminant validity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>These tools can help schools monitor and improve HPS and WSA-PA implementation, supporting equity and informing national policies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The validated tools can guide schools in enhancing HPS and WSA-PA practices. Further research should refine these instruments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 12","pages":"1047-1059"},"PeriodicalIF":1.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994278","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}
Water safety education is essential to prevent drowning. In Australia, while water safety education is included in the school curriculum, the focus is often on skill attainment rather than knowledge.
Methods
This study assessed water safety knowledge in Grade 5 and 6 students (aged 9–11 years). Surveys were conducted with students and parents. Additionally, swim teachers conducted standardized knowledge assessments.
Results
Matched surveys were completed by 99 students and their parents. Students' mean knowledge score was 8.7 (SD = 2.4) out of 15. Private swimming lessons and speaking English at home were linked to higher knowledge scores. Only 55.6% of students achieved the knowledge standards in swim teacher assessments. Parents overestimated their child's knowledge in 42.1% of cases, underestimated it in 31.6%, and accurately assessed it in 26.3% of cases.
Implications for School Health Policy, Practice, and Equity
Water safety knowledge gaps are notable for students who lack swimming lessons or speak a language other than English at home, suggesting a need for tailored approaches. Educators face challenges integrating water safety education into classroom learning, highlighting the need for resources and support.
Conclusions
Ongoing support and resources for teachers are essential to ensure all children develop essential water safety knowledge and skills.
{"title":"Measuring Australian Primary School Children's Water Safety Knowledge: Alignment With the Victorian Water Safety Certificate","authors":"Lauren Petrass, Hannah Calverley, Bernadette Matthews","doi":"10.1111/josh.70081","DOIUrl":"10.1111/josh.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Water safety education is essential to prevent drowning. In Australia, while water safety education is included in the school curriculum, the focus is often on skill attainment rather than knowledge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study assessed water safety knowledge in Grade 5 and 6 students (aged 9–11 years). Surveys were conducted with students and parents. Additionally, swim teachers conducted standardized knowledge assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Matched surveys were completed by 99 students and their parents. Students' mean knowledge score was 8.7 (SD = 2.4) out of 15. Private swimming lessons and speaking English at home were linked to higher knowledge scores. Only 55.6% of students achieved the knowledge standards in swim teacher assessments. Parents overestimated their child's knowledge in 42.1% of cases, underestimated it in 31.6%, and accurately assessed it in 26.3% of cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Water safety knowledge gaps are notable for students who lack swimming lessons or speak a language other than English at home, suggesting a need for tailored approaches. Educators face challenges integrating water safety education into classroom learning, highlighting the need for resources and support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ongoing support and resources for teachers are essential to ensure all children develop essential water safety knowledge and skills.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976780","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}
Jeanette M. Ricci, Ben D. Kern, Chad M. Killian, Alan Trinh, Wesley J. Wilson, Hans van der Mars
Background
State policies play a key role in the provision of physical education (PE) opportunities at the district and school level.
Methods
An analysis was conducted on how states in the United States with various PE policies differ in terms of PE access as a measure of policy implementation. PE access for students was reported by 3306 K—5th grade PE teachers across all 51 states.
Results
State-level adherence to six key PE policies varied from 23% to 100%. Teachers in states with a policy requiring a minimum number of weekly PE minutes reported significantly greater average PE access compared to states with no policy (M = 99.67, SD = 26.30 min/week, M = 81.15, SD = 19.25 min/week, respectively; t(49) = 2.88, p < 0.01). There was no difference in PE access for students with disabilities between states with or without an Adapted Physical Education (APE) endorsement (t(49) = 0.54, p = 0.30).
Implications for School Health Policy, Practice, and Equity
Based on study findings, mandating PE instructional time at the state level may be a strategy to promote PE access among schools in the United States.
Conclusions
The presence of certain state-level PE policies positively impacts PE access for elementary students.
{"title":"Impact of State-Level Physical Education Policies on PE Access in the United States: A Comparative Analysis of Policy Implementation and Weekly PE Minutes","authors":"Jeanette M. Ricci, Ben D. Kern, Chad M. Killian, Alan Trinh, Wesley J. Wilson, Hans van der Mars","doi":"10.1111/josh.70079","DOIUrl":"10.1111/josh.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>State policies play a key role in the provision of physical education (PE) opportunities at the district and school level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An analysis was conducted on how states in the United States with various PE policies differ in terms of PE access as a measure of policy implementation. PE access for students was reported by 3306 K—5th grade PE teachers across all 51 states.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>State-level adherence to six key PE policies varied from 23% to 100%. Teachers in states with a policy requiring a minimum number of weekly PE minutes reported significantly greater average PE access compared to states with no policy (<i>M =</i> 99.67, SD = 26.30 min/week, <i>M =</i> 81.15, SD = 19.25 min/week, respectively; <i>t</i>(49) = 2.88, <i>p</i> < 0.01). There was no difference in PE access for students with disabilities between states with or without an Adapted Physical Education (APE) endorsement (<i>t</i>(49) = 0.54, <i>p</i> = 0.30).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Based on study findings, mandating PE instructional time at the state level may be a strategy to promote PE access among schools in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The presence of certain state-level PE policies positively impacts PE access for elementary students.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994315","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}
Peers' physical exercise behaviors may influence adolescents' participation in physical exercise; however, few studies have systematically explored peer effects in physical exercise among adolescents.
Methods
Data from the China Education Panel Survey were used to examine peer effects in adolescent physical exercise within classroom units. A total of 14,998 seventh- and ninth-grade students from 405 classes across 106 schools nationwide participated in this study.
Results
Significant and positive peer effects in physical exercise within classroom units were observed, with classmates' average extracurricular exercise time positively influencing individual extracurricular exercise time. This result remained robust after sequentially controlling for individual and family characteristics, contextual effects, and correlated effects, as well as after applying the instrumental variable method and conducting robustness checks. Further moderation analysis revealed that age negatively moderated the relationship between classmates' and individual extracurricular physical exercise time, whereas other demographic and family characteristic variables showed no significant moderating effects.
Conclusion
The design of adolescent physical education policies and the implementation of exercise promotion programs should adequately take peer effects into consideration and expand the social multiplier effect of exercise, thereby effectively enhancing youth engagement in physical exercise.
{"title":"Do Your Peers Matter? Peer Effects in Adolescent Physical Exercise","authors":"Shanshan Xu, Liang Hu","doi":"10.1111/josh.70073","DOIUrl":"10.1111/josh.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Peers' physical exercise behaviors may influence adolescents' participation in physical exercise; however, few studies have systematically explored peer effects in physical exercise among adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the China Education Panel Survey were used to examine peer effects in adolescent physical exercise within classroom units. A total of 14,998 seventh- and ninth-grade students from 405 classes across 106 schools nationwide participated in this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant and positive peer effects in physical exercise within classroom units were observed, with classmates' average extracurricular exercise time positively influencing individual extracurricular exercise time. This result remained robust after sequentially controlling for individual and family characteristics, contextual effects, and correlated effects, as well as after applying the instrumental variable method and conducting robustness checks. Further moderation analysis revealed that age negatively moderated the relationship between classmates' and individual extracurricular physical exercise time, whereas other demographic and family characteristic variables showed no significant moderating effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The design of adolescent physical education policies and the implementation of exercise promotion programs should adequately take peer effects into consideration and expand the social multiplier effect of exercise, thereby effectively enhancing youth engagement in physical exercise.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 12","pages":"1072-1081"},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976763","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}
This study examines how school-based health centers (SBHCs) are implemented and sustained through schools and a healthcare system in a four-county rural region in New York State.
Methods
Twelve semi-structured interviews were conducted with school superintendents and employees of the healthcare system, including SBHC medical providers (physician assistant, mental health therapist, nurse), SBHC manager, care coordinator, Chief of Pediatrics, and executive leader between January and April 2024. Interviews were thematically coded using collective impact and collective action frameworks.
Results
SBHCs are implemented and sustained through a strong collaborative culture, shared financial, physical, and human resources, and a common agenda for student well-being. Trust and open communication were essential in clarifying roles and overcoming institutional challenges. Key barriers included funding for startup costs, challenges in data sharing and confidentiality, and different institutional priorities. Regular communication, local governmental support, and community trust helped mitigate these challenges.
Implications for School Health Policy, Practice, and Equity
Policies should support schools and healthcare systems as equal partners, ensure sustainable funding, and provide clearer guidance on data sharing to advance health equity in rural areas.
Conclusions
Collaborative partnerships, trust, and open communication between schools and healthcare systems are essential to support SBHCs in rural communities.
{"title":"School and Healthcare Collaboration in Implementing and Sustaining School-Based Health Centers in Rural Communities","authors":"Xue Zhang, Mildred E. Warner, Chen Wu","doi":"10.1111/josh.70085","DOIUrl":"10.1111/josh.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study examines how school-based health centers (SBHCs) are implemented and sustained through schools and a healthcare system in a four-county rural region in New York State.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twelve semi-structured interviews were conducted with school superintendents and employees of the healthcare system, including SBHC medical providers (physician assistant, mental health therapist, nurse), SBHC manager, care coordinator, Chief of Pediatrics, and executive leader between January and April 2024. Interviews were thematically coded using collective impact and collective action frameworks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SBHCs are implemented and sustained through a strong collaborative culture, shared financial, physical, and human resources, and a common agenda for student well-being. Trust and open communication were essential in clarifying roles and overcoming institutional challenges. Key barriers included funding for startup costs, challenges in data sharing and confidentiality, and different institutional priorities. Regular communication, local governmental support, and community trust helped mitigate these challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Policies should support schools and healthcare systems as equal partners, ensure sustainable funding, and provide clearer guidance on data sharing to advance health equity in rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Collaborative partnerships, trust, and open communication between schools and healthcare systems are essential to support SBHCs in rural communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976829","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}
Childhood myopia is a global health concern, with high prevalence in East Asia. Risky eye behaviors fuel myopia, but how combined parental and teacher supervision affects these behaviors remains poorly understood.
Methods
This cross-sectional study surveyed 5193 participants in 8 schools. Indicator variables of parent-teacher supervision were divided into three levels. Student eye behaviors were defined as myopia-risk behaviors. K-means clustering and binary logistic regression analyzed the relationship between supervised level and eye behaviors.
Results
Among the 5193 participants, the number of high, medium, and low supervision groups was 3204 (61.7%), 1165 (22.4%), and 824 (15.9%), respectively. Compared with the high-level group, the medium-level and low-level groups had higher risks of lying down to read books or using electronic devices in the dark, and lower risks of sitting upright while studying.
Implications for School Health Policy, Practice, and Equity
Findings highlight the need for school health policies promoting collaborative parent-teacher supervision, tailored practices to reduce risky eye behaviors, and equitable interventions to address supervision disparities.
Conclusions
Supervision by parents and teachers may reduce students' risk of unhealthy eye behaviors. This provides beneficial strategies for preventing myopia among students.
{"title":"Analysis of Supervised and Eye Behaviors Among Students","authors":"Qiuyue Li, Sihan Jiang, Mingyu Gong, Liling Zhu, Tianqi Lan, Yiming Chen","doi":"10.1111/josh.70086","DOIUrl":"10.1111/josh.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Childhood myopia is a global health concern, with high prevalence in East Asia. Risky eye behaviors fuel myopia, but how combined parental and teacher supervision affects these behaviors remains poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study surveyed 5193 participants in 8 schools. Indicator variables of parent-teacher supervision were divided into three levels. Student eye behaviors were defined as myopia-risk behaviors. K-means clustering and binary logistic regression analyzed the relationship between supervised level and eye behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 5193 participants, the number of high, medium, and low supervision groups was 3204 (61.7%), 1165 (22.4%), and 824 (15.9%), respectively. Compared with the high-level group, the medium-level and low-level groups had higher risks of lying down to read books or using electronic devices in the dark, and lower risks of sitting upright while studying.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Findings highlight the need for school health policies promoting collaborative parent-teacher supervision, tailored practices to reduce risky eye behaviors, and equitable interventions to address supervision disparities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Supervision by parents and teachers may reduce students' risk of unhealthy eye behaviors. This provides beneficial strategies for preventing myopia among students.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976752","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}
Ritika Kale, Erin N. Harrop, Jaylyn R. Kelly, Sarah A. Sullivan, Kendrin R. Sonneville
Background
Weight-related bullying is linked to negative mental health outcomes. However, anti-bullying policies targeting weight-based bullying remain limited. This study aimed to gather youth perspectives on weight-related bullying and potential school interventions.
Methods
Data were collected in November 2022 from the MyVoice National Poll of Youth, a diverse cohort of U.S. youth (ages 14–24). Respondents (n = 621) answered five open-ended questions about weight-related bullying, which were analyzed using inductive content analysis.
Results
A majority of respondents (71.6%) reported witnessing weight-related bullying. While most respondents attributed bullying to characteristics of the individual doing the bullying (e.g., insecurity), characteristics of the target of the bullying were more commonly named for weight-related bullying compared to bullying in general (46.5% vs. 29.2%; p = 0.0013). Respondents suggested both educational/programming approaches and policy solutions. Most respondents (68.5%) supported the inclusion of weight-related bullying in school anti-bullying policies.
Implications for School Health Policy, Practice, and Equity
Research on anti-bullying laws shows potential benefits for youth (e.g., reduced bullying, improved mental health). As policies addressing weight-related bullying expand, research is needed to assess their effectiveness and minimize unintended consequences.
Conclusions
Youth support the inclusion of weight-related bullying in school policies, which could help create more supportive environments and improve mental health outcomes.
{"title":"Addressing Weight-Related Bullying in Schools: Youth Perspectives on School Policies and Interventions","authors":"Ritika Kale, Erin N. Harrop, Jaylyn R. Kelly, Sarah A. Sullivan, Kendrin R. Sonneville","doi":"10.1111/josh.70054","DOIUrl":"10.1111/josh.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Weight-related bullying is linked to negative mental health outcomes. However, anti-bullying policies targeting weight-based bullying remain limited. This study aimed to gather youth perspectives on weight-related bullying and potential school interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected in November 2022 from the MyVoice National Poll of Youth, a diverse cohort of U.S. youth (ages 14–24). Respondents (<i>n</i> = 621) answered five open-ended questions about weight-related bullying, which were analyzed using inductive content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A majority of respondents (71.6%) reported witnessing weight-related bullying. While most respondents attributed bullying to characteristics of the individual doing the bullying (e.g., insecurity), characteristics of the target of the bullying were more commonly named for weight-related bullying compared to bullying in general (46.5% vs. 29.2%; <i>p</i> = 0.0013). Respondents suggested both educational/programming approaches and policy solutions. Most respondents (68.5%) supported the inclusion of weight-related bullying in school anti-bullying policies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Research on anti-bullying laws shows potential benefits for youth (e.g., reduced bullying, improved mental health). As policies addressing weight-related bullying expand, research is needed to assess their effectiveness and minimize unintended consequences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Youth support the inclusion of weight-related bullying in school policies, which could help create more supportive environments and improve mental health outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 12","pages":"1007-1016"},"PeriodicalIF":1.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976747","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}
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