Implementing evidence-based substance use prevention curricula in North Carolina public school districts

The Safe and Drug-Free Schools and Communities Act (SDFSCA) provides funding for prevention education to nearly every school district in the nation. Recent federal policy requires SDFSCA recipients to implement evidence-based prevention programs. This paper reports the extent to which North Carolina public school districts implement evidence-based substance use prevention curricula. Results showed that while the majority of school districts use evidence-based prevention curricula, they are rarely the most commonly used curricula. Evidence-based curricula are much more likely to be used at the middle school level than at the elementary or high school levels. Urbanicity, coordinator time, and coordinator experience correlated with extensive use of evidence-based curricula in the bivariate analysis, but only time spent on prevention by the Safe and Drug-Free Schools (SDFS) coordinator significantly predicted extensive use in the multivariate analysis. Increasing district SDFSCA coordinator time is a necessary step for diffusing evidence-based curricula.     

Local option policies and alcohol availability in North Carolina counties

Concerned about social problems related to alcohol, communities are considering legal alternatives for restricting its availability. Whether restrictive local policies are realistic means for curtailing the physical availability of alcohol is unknown. Using North Carolina's 100 counties as the unit of analysis, the extent to which 1994 local option policies predicted 1995 rates of alcohol permits, controlling for other factors related to the demand for alcohol, was examined. Counties with restrictive policies were found to have lower rates of alcohol permits than counties with permissive policies, after accounting for alcohol demand. Local option policies may be a reasonable strategy for limiting the physical availability of alcohol. In turn, limiting alcohol availability may be effective in reducing alcohol-related community problems such as traffic crashes and violent assaults.     

Results of evaluability assessments of local wellness policies in 6 US school districts

BACKGROUND: A US federal mandate that school districts devise and implement local wellness policies (LWPs) has potential widespread impact on the nutritional content of foods and beverages available in schools and on the amount of physical activity that students engage in; however, evidence concerning the mandate's effectiveness is limited. This study describes the content of LWPs of 6 US school districts and steps taken toward their implementation and evaluation. METHODS: During visits to 6 school districts, we interviewed 88 school and community representatives about the content of their district's LWPs and how the LWPs were being implemented and evaluated. RESULTS: The 6 LWPs were consistent with the federal mandate, although they varied in content and degree of specificity, and none had been fully implemented. All 6 districts were pursuing strategies to ensure that foods and beverages available at school met nutrition standards but did not offer nutrition education to all K‐12 students. All 6 districts offered students only limited opportunities for physical activity, and all 6 collected data to monitor process and outcomes of their LWPs. CONCLUSIONS: Partial implementation of LWPs in the districts we visited resulted in significant improvement in the nutritional quality of foods available at district schools, but only slight improvement in students' opportunities for school‐based physical activity. We provide recommendations for school districts on implementation and evaluation. Future research is needed to determine the impact of these LWPs on students' health.     

Establishing a baseline measure of school wellness-related policies implemented in a nationally representative sample of school districts

The Child Nutrition and WIC Reauthorization Act of 2004 required school districts to establish a local school wellness policy by the first day of the 2006-2007 school year. To provide a baseline measure of the extent to which wellness-related policies were implemented in school districts nationwide in 2006, this study analyzed data from the 2006 School Health Policies and Programs Study (SHPPS). SHPPS used a cross-sectional design to measure policies and practices among a nationally representative sample of 538 public school districts. The authors applied a standardized wellness policy coding system to the data by matching each element to relevant questions from SHPPS and calculated the percentage of school districts meeting each element in the coding system. Statistical analyses included calculation of 95% confidence intervals for percentages and mean number of elements met in each area. In 2006, none of the districts met all elements included in the coding system for local wellness policies. In addition, the percentage of districts meeting each element varied widely. On average, districts met the greatest number of elements in the area of nutrition education and the least number of elements in the area of physical activity. By applying a coding system for district policies to an existing dataset, this study used a novel approach to determine areas of strength and weakness in the implementation of local school wellness-related policies in 2006.     

An examination of after school care programs in North Carolina Public Schools

Educators have become increasingly concerned about the large number of children who must provide for their own care before and/or after school hours. The mounting evidence that at least some of these “latchkey” children are harmed by such circumstances has led many public school systems to develop After School Care Programs (ASCP). Because North Carolina has the nation's highest percentage of mothers working outside of the home, efforts undertaken by this state are of particular significance. Each of the 141 public school systems in North Carolina was surveyed. Based on responses received from 138 of these systems, 48 ASCP were identified. Information is provided on location, population, operational policies, content, personnel, evaluation, and plans for future changes. A review of the literature and a discussion of pertinent issues are also provided.     

An examination of after school care programs in North Carolina Public Schools

Educators have become increasingly concerned about the large number of children who must provide for their own care before and/or after school hours. The mounting evidence that at least some of these “latchkey” children are harmed by such circumstances has led many public school systems to develop After School Care Programs (ASCP). Because North Carolina has the nation's highest percentage of mothers working outside of the home, efforts undertaken by this state are of particular significance. Each of the 141 public school systems in North Carolina was surveyed. Based on responses received from 138 of these systems, 48 ASCP were identified. Information is provided on location, population, operational policies, content, personnel, evaluation, and plans for future changes. A review of the literature and a discussion of pertinent issues are also provided.     

A prospective study of injury incidence among North Carolina high school athletes

Sports-related injuries are an issue of concern in high school sports athletes. A prospective cohort study of injury risk factors was conducted from 1996 to 1999 among varsity high school athletes in 12 sports in 100 North Carolina high schools. Data were collected by trained school personnel. Unadjusted and adjusted incidence rates and rate ratios were estimated using Poisson regression models. The overall rate of injury was 2.08 per 1,000 athlete-exposures (95% confidence interval (CI): 1.79, 2.41). At 3.54 per 1,000 athlete-exposures (95% CI: 2.87, 4.37), football had the highest rate of injury of all sports. The adjusted rate ratio for athletes with a history of injury, compared with those without a prior injury, was 1.94 (95% CI: 1.69, 2.22). The injury rate rose with each year of playing experience (rate ratio=1.06, 95% CI: 1.01, 1.12). In a subanalysis restricted to gender-comparable sports, boys had a higher rate of injury than did girls (rate ratio=1.33, 95% CI: 0.99, 1.79). All other factors did not appear to be independent predictors of the injury rate. The influence of prior injury suggests that proper rehabilitation and primary prevention of the initial injury are important strategies for injury control.     

Heat-related fatalities in North Carolina

We used medical examiner's records to identify heat-related fatalities (N=161) that occurred during the period January 1, 1977, to December 31, 2001, in North Carolina. Estimates of the population at risk were derived from US census data. Annual fatality rates increased with increases in average summer temperature and with the number of days per year at 90 degrees F or higher. Of the occupational heat-related fatalities (n=40), 45% occurred among farm laborers, many of whom died unnoticed and without medical attention.     

Occupational Health in North Carolina

Trend-surface computer maps were prepared to estimate the areal concentration isopleths of cadmium, copper, magnesium, manganese, lead, and zinc, suspended particulates, and the associated benzene-soluble concentrations which occurred on April 13, 1970. The samples were collected from a 17-station ambient air surveillance network in Houston and then analyzed. A comparison of maps indicates important areal differences in the distribution of all pollutants. Suggestions are made as to how these maps could be utilized for further studies based on areal data.     

Canadian-trained nurses in North Carolina

Little is known about nurses who leave Canada to work in the US. The main purpose of this study is to gain some insight into the emigration component of nursing supply and demand by comparing characteristics of nurses who left Canada to nurses who stayed. Specifically, Canadian-trained RNs who work in the state of North Carolina are compared to RNs who work in Canada. Results show that there are 40% more Canadian-trained RNs in North Carolina than there are in Prince Edward Island. A higher percentage of Canadian-trained RNs in North Carolina are male, under 40 years of age, have baccalaureate training and graduated less than 10 years ago. Canadian-trained nurses in both countries have very low rates of unemployment. The loss of Canadian-trained RNs to the US is a significant problem, and there is an urgent need to obtain a better understanding of why nurses leave the country.     

Household responses to school closure resulting from outbreak of influenza B, North Carolina

School closure is a proposed strategy for reducing influenza transmission during a pandemic. Few studies have assessed how families respond to closures, or whether other interactions during closure could reduce this strategy's effect. Questionnaires were administered to 220 households (438 adults and 355 children) with school-age children in a North Carolina county during an influenza B virus outbreak that resulted in school closure. Closure was considered appropriate by 201 (91%) households. No adults missed work to solely provide childcare, and only 22 (10%) households required special childcare arrangements; 2 households incurred additional costs. Eighty-nine percent of children visited at least 1 public location during the closure despite county recommendations to avoid large gatherings. Although behavior and attitudes might differ during a pandemic, these results suggest short-term closure did not cause substantial hardship for parents. Pandemic planning guidance should address the potential for transmission in public areas during school closure.     

Drug use and suicide ideation and behavior among North Carolina public school students.

We used data from 3064 respondents to the 1990 North Carolina Youth Risk Behavior Survey to examine the relationship between adolescent drug use and suicide ideation and behavior. Principal components analysis followed by varimax rotation was performed separately on the drug use and suicide items. Correlation coefficients computed between the two sets of factor scores and comparison of mean drug use factor scores revealed that drug use, particularly of crack/cocaine, was related to increased suicide ideation and behavior.     

Characteristics of drowning deaths in North Carolina

A retrospective study of 1,052 unintentional drowning deaths in North Carolina during the period from 1980 through 1984 was carried out, with emphasis on the victims' activity and alcohol consumption, and the settings of the accidents. The data suggest that many drownings are preventable, and reinforce the etiologic importance of ethanol consumption in such deaths. The overall drowning rate for North Carolina residents during the period covered by the study was 3.2 per 100,000 persons. Nonwhite males had the highest rate, 8.8 per 100,000 population. The next highest rate was for white males, 4.7 per 100,000. Swimming and wading, involved in 41 percent of the drowning deaths, was the most frequently associated activity. Fishing was involved in 15 percent of the deaths, and motor vehicle accidents with 8 percent. Most occurred in freshwater settings, notably lakes and ponds, 39 percent, and rivers and creeks, 29 percent. Of the 752 victims 15 years and older tested for blood ethanol, 53 percent had positive tests and 38 percent had blood alcohol concentrations of 100 milligrams per deciliter or greater. Significant percentages of victims 15 years and older with blood alcohol concentrations greater than 100 milligrams per deciliter were found in all settings and activity groups.