School Disrepair and Substance Use Among Regular and Alternative High School Students

BACKGROUND: The physical environment influences adolescent health behavior and personal development. This article examines the relationship between level of school disrepair and substance use among students attending regular high school (RHS) and alternative high school (AHS). METHODS: Data were collected from students (N = 7058) participating in 2 randomized controlled trials of a school-based substance abuse prevention program implemented across the United States. Students provided substance use and demographic information on a self-reported survey. Data for the physical disrepair of schools were collected from individual rater observations of each school environment. We hypothesized that school disrepair would be positively associated with substance use controlling for individual characteristics and a socioeconomic status proxy. Multilevel mixed modeling was used to test the hypothesized association and accounted for students nested within schools. RESULTS: Findings indicated that students attending AHS with greater school disrepair were more likely to report the use of marijuana and other illicit drugs (ie, cocaine, heroin). Students attending RHS with greater school disrepair were less likely to report smoking cigarettes. CONCLUSIONS: Differences in findings between RHS and AHS students are discussed, and implications for substance use prevention programming are offered. Students attending AHS with greater school disrepair may require more substance abuse prevention programming, particularly to prevent illicit substance use.     

Correlates of Condom Use Among Male High School Students in Nairobi, Kenya

BACKGROUND: Correct and consistent condom use is an effective strategy to reduce the risk of sexually transmitted infections (STIs). This study examines sociodemographic, behavioral, and psychosocial characteristics of 3 groups of adolescent males: consistent, sporadic, and non-condom users.
METHODS: The sample consisted of 931 sexually experienced male high school students in Nairobi, Kenya. Cross tabulations and general linear models were used to test the relation between each explanatory variable and condom user group.
RESULTS: Fifty-three percent of respondents reported having used condoms. Compared with nonusers and sporadic users, consistent users engaged in sexual intercourse for the first time at an older age and reported higher condom use self-efficacy, more positive peer attitudes toward safe sex, and stronger attitudes toward condom use. Compared with sporadic and consistent users, nonusers reported fewer sexual partners, less substance use, and more frequent intercourse with non-romantic partners. Sporadic users, compared with the other 2 groups, had more sexual partners and stronger attitudes that support that males and females have separate roles. The 3 groups did not differ in HIV/AIDS knowledge. On average, respondents responded correctly to two thirds of the questions. All groups perceived their risk of contracting an STI as low, and this perception did not differ by condom use. Differences in participants' age by group were minimal.
CONCLUSIONS: The study supports the need for interventions that target specific condom use groups.     

Implementing and Evaluating a School-Based Program to Improve Childhood Vision*

BACKGROUND: Approximately 20% of the American schoolchildren have a vision problem. Children from low-income urban areas have been shown to have more than twice the normal rate of vision problems. This study evaluated the effectiveness of A Vision for Success, a school-based program designed to provide eyeglasses to children in a timely manner in selected New York City public elementary schools and to encourage their regular use at school. METHODS: An intervention-control group design with 265 first- and second-grade students across 8 New York City public schools was implemented. Participating students had failed a prior mandated vision screening. Students in A Vision for Success received (1) a school-based professional optometric screening, (2) provision of 2 pairs of eyeglasses (1 kept by the teacher for classroom use), and (3) teachers' encouragement of eyeglass use as prescribed in school. Mean rates of classroom eyeglass use were assessed between groups by direct observation prior to and after the optometric screening. RESULTS: Mean rates of eyeglass use for students in intervention and control groups at baseline were 22% and 19%, respectively (p > .10). At follow-up, eyeglass use rose to 47% in the intervention group, whereas the control group's rate remained consistent at 19% (p < .001). Significant differences persisted for boys and girls. CONCLUSIONS: Children disproportionately affected by visual dysfunction can receive glasses in a timely manner and wear them regularly in the classroom. Even more intensive efforts will be needed for some children to help ensure that they wear glasses in school.     

A Multilevel Examination of School and Student Characteristics Associated With Physical Education Class Enrollment Among High School Students

BACKGROUND: Schools can be an efficient venue for promoting physical activity (PA) among adolescents. Physical education (PE) requires investigation because it is a variable associated with adolescent PA levels and its existence in schools represents a significant opportunity for strategies to combat declining PA levels among this population. This article examines the between-school variability in student rates of PE enrollment among a large sample of high schools in Ontario, Canada, and identifies the school- and student-level characteristics associated with PE enrollment. METHODS: This cross-sectional study utilized self-reported school- and student-level data from administrators and students at 73 high schools. Students' enrollment in PE, demographic, behavioral, and psychosocial variables was linked to school environment data comprising of school demographics and administrator assessed quality of policies, facilities, and programs related to PA. Analysis involved multilevel modeling. RESULTS: The mean rate of PE enrollment among the 73 high schools was 62.4%, with rates by school ranging from 28.9% to 81.1%. When student demographics, behavioral, and psychosocial factors were controlled for, there was still a school effect for student PE enrollment. The school effect was explained by the provision of daily PE and school median household income. CONCLUSIONS: This is the first study to examine the extent to which PE enrollment varies between schools and to identify school factors associated with school variability in rates of PE enrollment. Although most variation in PE enrollment lies between students within schools, there is sufficient between-school variation to be of interest to practitioners and policy makers.     

Cost-Effectiveness of a School-Based Emotional Health Screening Program

Background:  School-based screening for health conditions can help extend the reach of health services to underserved populations. Screening for mental health conditions is growing in acceptability, but evidence of cost-effectiveness is lacking. This study assessed costs and effectiveness associated with the Developmental Pathways Screening Program, in which students undergo universal classroom emotional health screening and those who have positive screens are provided with on-site clinical evaluation and referral.
Methods:  Costs are enumerated for screening and clinical evaluation in terms of labor and overhead and summarized as cost per enrolled student, per positive screen, and per referral. Cost-effectiveness is summarized as cost per student successfully linked to services. School demographics are used to generate a predictive formula for estimating the proportion of students likely to screen positive in a particular school, which can be used to estimate program cost.
Results:  Screening costs ranged from $8.88 to $13.64 per enrolled student, depending on the prevalence of positive screens in a school. Of students referred for services, 72% were linked to supportive services within 6 weeks. Cost-effectiveness was estimated to be $416.90 per successful linkage when 5% screened positive and $106.09 when 20% screened positive. A formula to estimate the proportion of students screening positive proved accurate to within 5%.
Conclusion:  Information concerning costs and effectiveness of school-based emotional health screening programs can guide school districts in making decisions concerning resource allocation.     

2011年湛江市城区部分中小学生急救知识认知情况调查

[目的]了解中小学生的急救知识水平,以便给相关部门日后的工作提供有力的参考依据。[方法]2011年6月,在湛江市城区抽取部分中小学生进行调查。[结果]调查818名中小学生,认为急救知识非常重要的占82.03%,参加过急救培训相关活动的占18.82%,非常需要系统急救知识培训的占46.09%;知道对脊椎外伤如何正确摆放体位的占11.49%,知道什么是心肺复苏术的占8.07%。[结论]中小学生的急救知识知晓率普遍不高,急救能力欠缺。     

Teen Perceptions of Facilitator Characteristics in a School-Based Smoking Cessation Program

Background: Facilitators are often responsible for the implementation of public health programs, yet little is known about how they influence outcomes. Not‐On‐Tobacco (N‐O‐T) is a youth smoking‐cessation program implemented by trained facilitators. The purpose of this study was to investigate teens’ perceptions of facilitator characteristics and the relationship between those perceptions and program outcomes. Methods: Data were collected from N‐O‐T participants aged 14 to 19 who completed a survey about perceptions of facilitator characteristics that were linked to program outcomes 3 months post‐baseline (n = 769). Eight facilitator characteristics were ordered, based on importance to participants. Chi‐square tests measured differences in perceptions of facilitator characteristics according to race and sex, and an aggregate facilitator favorability score was created and analyzed in relation to program outcomes (smoking reduction or cessation vs increase/no change). Logistic regression was used to analyze facilitator characteristics’ relationship to outcomes, controlling for race and sex. Results: Participants rated facilitator characteristics of trustworthy, cares about students, and confidential as most important. Girls consistently ranked facilitator characteristics as more important than did boys. There were few significant differences based on race, except that white students rated nonjudgmental to be more important than did nonwhite students. There were no significant findings from the logistic regression, but there was a significant relationship between the aggregate facilitator favorability score and favorable changes in smoking outcomes (reduction or cessation). Conclusions: This study provides insights into the facilitator characteristics that are important to teen participants. It demonstrates that teens’ overall perceptions of facilitators contribute to their perception of how the program contributes to their success and program outcomes.     

Evaluation of the Aboriginal and Torres Strait Islander Mental Health First Aid Program

Objective : This study reports findings from an uncontrolled evaluation of a course designed to educate participants in how to recognise and respond to mental health problems until professional help is received. Methods : Utilising a mixed methods design, participants in 21 different courses, delivered across two Australian states, were invited to complete pre‐, post‐, and follow‐up surveys and provide qualitative feedback on their training experiences. Results : Participants reported feeling more confident in their capacity to respond appropriately to a person presenting with a mental health need and believed they would be more likely to provide assistance. Satisfaction was attributed to the skills and sensitivities of instructors who had lived experience of mental health concerns in Aboriginal and Torres Strait Islander communities. Conclusion : This course holds promise in improving mental health literacy in relation to Aboriginal and Torres Strait Islander mental health. Implications for public health : Few courses are available that address issues relating to the social and emotional wellbeing of Aboriginal and Torres Strait Islander People. This study illustrates how community engagement with primary health and specialist mental health services might be strengthened.     

A Comparison of Weight-Related Behaviors Among High School Students Who Are Homeless and Non-Homeless

BACKGROUND: Previous research has shown that youth who are homeless engage in high-risk behaviors. However, there has been little information published on nutritional and physical activity behaviors in this population, and studies comparing homeless youth in school with their non-homeless peers are scarce. This study compares weight-related risk behaviors of public high school students in Massachusetts based on homeless status.
METHODS: We obtained data from 3264 9th through 12th grade students who participated in the 2005 Massachusetts Youth Risk Behavior Survey. Multivariable logistic regression, controlling for gender, grade, race/ethnicity, and sexual orientation, was performed to assess the relationship between homeless status as defined by the McKinney-Vento Homeless Assistance Act and weight-related indicators. Analyses were weighted and adjusted for the multistage complex sampling design.
RESULTS: Of this sample, 4.2% reported being homeless (n = 152). Higher prevalence of homelessness was found among males, racial/ethnic minorities, sexual minorities, and students who were not in a traditional grade level. The distribution of body mass index was similar among students who were homeless and non-homeless (underweight 4.0 and 3.0%, and overweight 27.1 and 27.1%, respectively). Homeless students were more likely than non-homeless students to report disordered weight-control behaviors including fasting (aOR 2.5, 95% CI 1.4–4.5) and diet pill use (aOR 3.3, 95% CI 1.6–6.9).
CONCLUSIONS: More than 4% of public high school students in Massachusetts meet the federal definition of homelessness. These students are at high risk for disordered weight-control behaviors. Policy decisions at the school, state, and federal levels should make a concerted effort to target these students with social services and nutritional interventions.