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}
The COVID-19 pandemic affected school students in several ways, including mental health issues, physical activity, or education. The objective of this paper is to shed light on an underexplored aspect of the pandemic by estimating its impact on the provision and utilization of routine school-based medical services by school doctors in Austria.
Methods
We utilize survey-based data on school medical services collected by the Austrian Ministry of Education, Science and Research in the 2018/2019 and 2019/2020 school years. We compare both years using fixed-effects regression.
Results
In the 2019/20 school year, compared to 2018/19, we observe a decline in engagement of school health professionals in health-promoting school projects (−4.3%-points) and in first-aid training sessions (−8.6%-points). Most networking activities with other school-based advisory teams decreased; only membership of a school-based crisis team increased (+6.9%-points). The share of compulsory check-ups (−24.8%-points) and student-initiated medical consultations (−17.7%-points) decreased significantly.
Implications for School Health Policy, Practice, and Equity
Findings outline the need for strategies to provide school-based medical services in crises, especially in countries where school health professionals are key points of contact for medical concerns.
Conclusions
Our results indicate a significant reduction in routine school medical services during the pandemic.
{"title":"Impact of the COVID-19 Pandemic on School-Based Medical Services in Austria","authors":"Walter Hyll","doi":"10.1111/josh.70069","DOIUrl":"10.1111/josh.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The COVID-19 pandemic affected school students in several ways, including mental health issues, physical activity, or education. The objective of this paper is to shed light on an underexplored aspect of the pandemic by estimating its impact on the provision and utilization of routine school-based medical services by school doctors in Austria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilize survey-based data on school medical services collected by the Austrian Ministry of Education, Science and Research in the 2018/2019 and 2019/2020 school years. We compare both years using fixed-effects regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the 2019/20 school year, compared to 2018/19, we observe a decline in engagement of school health professionals in health-promoting school projects (−4.3%-points) and in first-aid training sessions (−8.6%-points). Most networking activities with other school-based advisory teams decreased; only membership of a school-based crisis team increased (+6.9%-points). The share of compulsory check-ups (−24.8%-points) and student-initiated medical consultations (−17.7%-points) decreased significantly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Findings outline the need for strategies to provide school-based medical services in crises, especially in countries where school health professionals are key points of contact for medical concerns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results indicate a significant reduction in routine school medical services during the pandemic.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 12","pages":"1026-1035"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976814","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}
Wenhao Zhang, Brianna Routh, Molly Stenberg, Haley Scott
Background
U.S. Department of Agriculture Child Nutrition Programs provide essential nutrition supporting student health and academic outcomes. Rural school nutrition professionals (SNPs) face challenges such as staff shortages, limited resources, and inadequate training. This study evaluates a flexible training program tailored to address these issues.
Methods
Guided by the Theory of Planned Behavior and Lippitt-Knoster model, an observational cohort study design with pre- and post-training evaluations measured SNPs' knowledge, confidence, and behavioral intention. Participants completed 40-h director or 8-h staff training delivered through live virtual, asynchronous virtual, and in-person formats. Data were analyzed using descriptive statistics, Mann–Whitney U tests, and three-way cross-tabulations.
Results
Participants demonstrated significant improvements in confidence levels and knowledge of both school nutrition basics and culinary skills. High behavioral intentions toward desirable practices were observed among participants. Flexible delivery formats enhanced participation and satisfaction, with virtual options especially beneficial for rural settings.
Implications for School Health Policy, Practice, and Equity
Flexible, theory-based training models addressing rural SNPs' specific needs improve school meal quality, staff retention, and equitable access to nutrition education.
Conclusions
Tailored training programs incorporating diverse methods and incentives strengthen rural SNP capacity, enhancing health outcomes for students.
{"title":"The Impact of Nutrition Training Programs on Knowledge, Confidence, and Behavioral Intention Among School Nutrition Professionals","authors":"Wenhao Zhang, Brianna Routh, Molly Stenberg, Haley Scott","doi":"10.1111/josh.70058","DOIUrl":"10.1111/josh.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>U.S. Department of Agriculture Child Nutrition Programs provide essential nutrition supporting student health and academic outcomes. Rural school nutrition professionals (SNPs) face challenges such as staff shortages, limited resources, and inadequate training. This study evaluates a flexible training program tailored to address these issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Guided by the Theory of Planned Behavior and Lippitt-Knoster model, an observational cohort study design with pre- and post-training evaluations measured SNPs' knowledge, confidence, and behavioral intention. Participants completed 40-h director or 8-h staff training delivered through live virtual, asynchronous virtual, and in-person formats. Data were analyzed using descriptive statistics, Mann–Whitney U tests, and three-way cross-tabulations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants demonstrated significant improvements in confidence levels and knowledge of both school nutrition basics and culinary skills. High behavioral intentions toward desirable practices were observed among participants. Flexible delivery formats enhanced participation and satisfaction, with virtual options especially beneficial for rural settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Flexible, theory-based training models addressing rural SNPs' specific needs improve school meal quality, staff retention, and equitable access to nutrition education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Tailored training programs incorporating diverse methods and incentives strengthen rural SNP capacity, enhancing health outcomes for students.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 11","pages":"924-932"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976766","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}
Cynthya Maya-Hernández, Araceli Salazar-Coronel, Antonio Amadeo Carmona-Chávez, Alicia Muñoz-Espinosa, Carmen Morales-Ruán, Alejandra Jiménez-Aguilar
Background
The Mexican government has implemented two nationwide initiatives to improve the food environment in schools: the 2010 General Guidelines for Dispensing and Distributing Foods and Beverages in Public School Stores (Guidelines), and the 2015 National School Drinking Fountain Program (PNBE). Nevertheless, a 2018 assessment of 10 middle schools in Mexico City revealed high consumption of sugar-sweetened beverages and limited use of drinking fountains.
Methods
A qualitative study was carried out in 2018–2019 to explore the perceptions of 13 stakeholders (school principals, food store personnel, one drinking fountain coordinator, and government representatives) regarding the barriers and opportunities associated with the Guidelines and PNBE initiatives. Content analysis was performed using ATLAS.ti v8.0.
Results
Both initiatives yielded positive outcomes such as higher water consumption in specific neighborhoods, greater use of refillable bottles, and improved oversight efforts by school authorities. However, their full implementation has been hindered by systemic and behavioral barriers, including student preference for ultra-processed foods, minimal parental involvement, inadequate fountain maintenance, and weak policy enforcement. Study participants recommended updating the food and beverage regulations, launching additional educational campaigns, and fostering intersectoral collaboration.
Implications for School Health Policy, Practice, and Equity
Advancing healthier and more equitable school food environments demands urgent action to remove contextual and structural barriers, foster stakeholder engagement, and introduce more robust enforcement mechanisms.
Conclusions
Strengthening policy enforcement, fostering participatory decision-making, and addressing systemic barriers are essential.
{"title":"Compliance, Barriers, and Improvement Areas of Two Food Programs in Mexican Middle Schools: Stakeholders' Perceptions","authors":"Cynthya Maya-Hernández, Araceli Salazar-Coronel, Antonio Amadeo Carmona-Chávez, Alicia Muñoz-Espinosa, Carmen Morales-Ruán, Alejandra Jiménez-Aguilar","doi":"10.1111/josh.70070","DOIUrl":"10.1111/josh.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Mexican government has implemented two nationwide initiatives to improve the food environment in schools: the 2010 <i>General Guidelines for Dispensing and Distributing Foods and Beverages in Public School Stores</i> (Guidelines), and the 2015 <i>National School Drinking Fountain Program</i> (<i>PNBE</i>). Nevertheless, a 2018 assessment of 10 middle schools in Mexico City revealed high consumption of sugar-sweetened beverages and limited use of drinking fountains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative study was carried out in 2018–2019 to explore the perceptions of 13 stakeholders (school principals, food store personnel, one drinking fountain coordinator, and government representatives) regarding the barriers and opportunities associated with the Guidelines and PNBE initiatives. Content analysis was performed using ATLAS.ti v8.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both initiatives yielded positive outcomes such as higher water consumption in specific neighborhoods, greater use of refillable bottles, and improved oversight efforts by school authorities. However, their full implementation has been hindered by systemic and behavioral barriers, including student preference for ultra-processed foods, minimal parental involvement, inadequate fountain maintenance, and weak policy enforcement. Study participants recommended updating the food and beverage regulations, launching additional educational campaigns, and fostering intersectoral collaboration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Advancing healthier and more equitable school food environments demands urgent action to remove contextual and structural barriers, foster stakeholder engagement, and introduce more robust enforcement mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Strengthening policy enforcement, fostering participatory decision-making, and addressing systemic barriers are essential.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 12","pages":"1036-1046"},"PeriodicalIF":1.8,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976844","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}
Amber Shields, Yunhee Chang, David Holben, Richard Balkin, Aleshia Hall-Campbell
Background
Research on the value of technologically-advanced equipment for school meal practices is limited. This study aimed to investigate whether the use of this equipment is associated with two best practices in school meals—the frequency of scratch cooking and the incorporation of locally-sourced ingredients.
Methods
Data were collected through a cross-sectional survey from a sample of U.S. K-12 public school nutrition directors and managers stratified by USDA FNS region, state, and urbanicity. Ordered logit models were used to estimate the associations between the use of technologically advanced equipment and the frequency of scratch cooking and incorporation of local products.
Results
The responses from 241 directors and managers revealed that both best practices were performed less than half the time. Total use of technologically-advanced equipment was found to be consistently positively associated with the use of local/regional products in meals (OR = 1.09, 95% CI: 1.03–1.16). There was little evidence of a significant association between equipment use and scratch cooking frequency.
Implications for School Health Policy, Practice, and Equity
The correlation between equipment use and local food integration highlights the need for targeted interventions addressing nutritional disparity.
Conclusions
The correlation between equipment use and local food integration highlights the need for targeted interventions addressing nutritional disparity.
{"title":"Use of Innovative Kitchen Equipment Promotes Use of Locally-Sourced Foods in School Meals","authors":"Amber Shields, Yunhee Chang, David Holben, Richard Balkin, Aleshia Hall-Campbell","doi":"10.1111/josh.70051","DOIUrl":"10.1111/josh.70051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Research on the value of technologically-advanced equipment for school meal practices is limited. This study aimed to investigate whether the use of this equipment is associated with two best practices in school meals—the frequency of scratch cooking and the incorporation of locally-sourced ingredients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected through a cross-sectional survey from a sample of U.S. K-12 public school nutrition directors and managers stratified by USDA FNS region, state, and urbanicity. Ordered logit models were used to estimate the associations between the use of technologically advanced equipment and the frequency of scratch cooking and incorporation of local products.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The responses from 241 directors and managers revealed that both best practices were performed less than half the time. Total use of technologically-advanced equipment was found to be consistently positively associated with the use of local/regional products in meals (OR = 1.09, 95% CI: 1.03–1.16). There was little evidence of a significant association between equipment use and scratch cooking frequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>The correlation between equipment use and local food integration highlights the need for targeted interventions addressing nutritional disparity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The correlation between equipment use and local food integration highlights the need for targeted interventions addressing nutritional disparity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 11","pages":"913-923"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976817","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 purpose of this study was to investigate the role of adverse childhood experiences (i.e., ACEs) and intersecting identities (i.e., gender and ethnicity) on school engagement among adolescents in the United States.
Methods
We analyzed the 2021 National Survey of Children's Health Data.
Results
We first identified four ACE classes, with each class representing different proportions of intersecting identities: No ACEs, Multiple Low Risk, Mental Health Issues, and Multiple High Risk. We then found significant differences in school engagement across the ACE class memberships and eight different intersecting identities, both separately and together. When we investigated ACE class memberships and intersecting identities separately, the results underscored the pervasive negative impact of the Multiple High Risk class on school engagement across all intersecting identities. Regarding intersecting identities, Asian female adolescents exhibited the highest school engagement levels, while White male adolescents had the lowest. When considering both ACE class memberships and intersecting identities, Asian male, Black female, Black male, Hispanic male, and White male adolescents in the Multiple High Risk class demonstrated lower school engagement levels, which contrasted with the results when examining only either intersecting identities or ACEs.
Implications for School Health Policy, Practice, and Equity
These findings highlight the importance of addressing both factors in school health policies and practices to better support various adolescent populations.
Conclusions
Our study provides a foundation for future studies and informs the development of more equitable, trauma-informed school policies and practices to foster student engagement.
{"title":"Role of Adverse Childhood Experiences and Intersecting Identities on Adolescents' School Engagement in the United States*","authors":"Juhee K. Cavins, Hye Yeon Lee, Isak Kim","doi":"10.1111/josh.70072","DOIUrl":"10.1111/josh.70072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The purpose of this study was to investigate the role of adverse childhood experiences (i.e., ACEs) and intersecting identities (i.e., gender and ethnicity) on school engagement among adolescents in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed the 2021 National Survey of Children's Health Data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We first identified four ACE classes, with each class representing different proportions of intersecting identities: <i>No ACEs, Multiple Low Risk, Mental Health Issues, and Multiple High Risk</i>. We then found significant differences in school engagement across the ACE class memberships and eight different intersecting identities, both separately and together. When we investigated ACE class memberships and intersecting identities separately, the results underscored the pervasive negative impact of the <i>Multiple High Risk</i> class on school engagement across all intersecting identities. Regarding intersecting identities, Asian female adolescents exhibited the highest school engagement levels, while White male adolescents had the lowest. When considering both ACE class memberships and intersecting identities, Asian male, Black female, Black male, Hispanic male, and White male adolescents in the <i>Multiple High Risk</i> class demonstrated lower school engagement levels, which contrasted with the results when examining only either intersecting identities or ACEs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>These findings highlight the importance of addressing both factors in school health policies and practices to better support various adolescent populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study provides a foundation for future studies and informs the development of more equitable, trauma-informed school policies and practices to foster student engagement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 12","pages":"1060-1071"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976841","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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