Opinions of Rural Texas Parents Concerning Elementary School Health Education

ABSTRACT: Parents of elementary school children in rural east-central Texas were surveyed about their attitudes toward and knowledge of Comprehensive School Health Education. Data indicated widespread support for health education compared to other subject areas. Parents felt alcohol and other drugs, nutrition, and first aid were the most important topics to be covered in elementary school, while sexuality, cancer, and stress were the least important. Parents were most comfortable discussing alcohol and other drugs, family life, and growth and development with their children and least comfortable discussing exercise, cancer, and sexuality. Implications for school health programs are discussed.     

Social Profile of Middle School-Aged Adolescents Who Use Electronic Cigarettes: Implications for Primary Prevention

Electronic cigarette (EC) use continues to increase among adolescents. From a primary prevention point of view, an important gap in our knowledge includes determining whether young smokers that use EC maintain a distinct social profile from kids who use combustible cigarettes (CC). Survey data from middle school students in West Virginia, USA were collected between September and November of 2015 (N = 6547, response rate 84.7%) as part of a state wide school-based mental health intervention program. Data was analyzed using multinomial logistic regression for categorical data. The results show that compared to never smokers, EC-only users possessed a weaker social support and parental monitoring profile and performed worse in school. Additionally, EC-only users were more likely to feel alienated from school, to associate with delinquent peers, to spend time outside late at night, and to engage in unsupervised gatherings with their friends. In 11 of 13 statistical models no difference was observed between EC-only users compared with CC-only users. However, dual users (that had used both EC and CC in their lifetime) demonstrated a significantly greater risk profile compared with EC-only users. We conclude that middle school-aged kids that use EC share a similar risk profile as kids of the same age that use CC. Similar to traditional cigarette smoking, EC use in young adolescents is likely to be a social marker of a pathway to further delinquency and should therefore be subject to primary prevention approaches.     

Alcohol and Drug Use Among Gang Members: Experiences of Adolescents Who Attend School

BACKGROUND: Problems related to gangs have been noted in large cities and in many schools across the United States. This study examined the patterns of alcohol, drug use, and related exposures among male and female high school students who were gang members. METHODS: Analyses were based on the Youth Violence Survey, conducted in 2004, and administered to over 80% of eligible public school students in grades 7, 9, 11, and 12 (N = 4131) in a high-risk, urban school district. The self-administered survey, completed during a class period, included measures of alcohol and drug use and related exposures. Tests of associations were determined using chi-square tests and logistic regression analyses. RESULTS: In this study, 8.8% of students reported gang membership. Students who initiated alcohol use prior to age 13 (OR = 4.90; 95% CI: 3.65–6.58), who drank alcohol 3 or more times per week (OR = 9.57; 95% CI: 6.09-15.03) and who used drugs 3 or more times per week (OR = 6.51; 95% CI: 4.59-9.25) were more likely to report gang membership than students who did not report alcohol or drug use. Boys were more likely than girls to report alcohol-related fighting and drug selling. DISCUSSION: Gang members were significantly more likely than non-gang members to have initiated alcohol early, to have reported a high prevalence of alcohol use, to have engaged in alcohol-related physical fighting, peer drinking, drug use, drug selling, peer drug selling, and having seen drug deals in their neighborhood. Schools may serve as a critically important source for intervention and prevention efforts for gang members, especially those in 7th grade, who still attend school.     

Noise Exposures of Rural Adolescents

Purpose: This project was conducted to characterize the noise exposure of adolescents living in rural and agricultural environments. Methods: From May to October, 25 adolescents ages 13 through 17, living either on a farm or a rural nonfarm, were enrolled in the study. Subjects received training on the correct operation and use of personal noise dosimeters and the proper way to record their daily tasks on activity cards. Subjects completed 4 days of self‐monitoring noise dosimetry, 2 days in the first round (May‐July) and 2 days in the second round (August‐October). In addition to dosimetry, subjects completed activity logs of their daily tasks. Results: The mean daily noise exposures of adolescents living on farms and in nonfarm rural homes were between 55.4 dBA (A‐weighted decibels) and 103.5 dBA, with 44% of the daily measurements greater than the National Institute of Occupational Safety and Health Recommended Exposure Level of 85 dBA. Task‐based analysis of noise exposures found that activities involving mechanized equipment resulted in the highest exposures, while activities in the home resulted in the lowest exposure. No particular demographic group had a statistically higher noise exposure; therefore, specific factors apart from activities and noise sources could not be identified as risk factors for exposure to hazardous noise levels. Conclusions: The results of this project indicate that rural adolescents complete a variety of activities and are exposed to noise sources with a broad range of decibel levels. While the exposures may change from day to day, there are occasions when exposure to noise exceeds the recommended levels.     

某县农村中学留守青少年心理健康状况现况调查

目的 了解某县农村中学青少年心理健康状况,探索该地区不同类型青少年的心理差异,为青少年的心理健康发展制定有效干预措施提供依据. 方法 采用分层整群随机抽样法抽取某县农村中学的初中生700人,以班为单位,利用中学生心理健康诊断测验(MHT)中学习焦虑、对人焦虑、孤独倾向、自责倾向四个因子对留守青少年、非留守青少年的一般情况和心理健康状况进行测评. 结果 某县农村中学11～17岁青少年的留守率为67.89％;留守青少年的心理健康状况差于非留守青少年,其MHT总分、学习焦虑、对人焦虑、自责倾向均明显高于非留守青少年,差异有统计学意义(P＜0.05);留守青少年女生的心理健康状况中学习焦虑、孤独倾向差于男生,差异有统计学意义(P＜0.05);不同年级留守青少年心理健康状况在MHT总分、学习焦虑、对人焦虑、孤独倾向、自责倾向项目中差异有统计学意义(P＜0.05). 结论 某县农村中学留守青少年的心理健康状况差于非留守青少年,留守青少年的女生比留守青少年男生的心理健康状况相对较差,初一年级的留守青少年心理健康状况最好.     

A Qualitative Study of Junior High School Principals' and School Food Service Directors' Experiences with the Texas School Nutrition Policy

ObjectiveThe objective of this study was to learn about the experiences of principals and school food service directors with the Texas Public School Nutrition Policy.DesignSemistructured qualitative interviews were conducted to gain first hand reactions to the new nutrition policy.SettingData were gathered from Texas middle schools.ParticipantsPrincipals and food service directors from 24 schools randomly selected from 10 Texas Education regions were interviewed.Phenomenon of InterestParticipants were interviewed about their reactions to the implementation of the Texas School Nutrition Policy.AnalysisTwo researchers, using thematic analysis, independently analyzed each interview. Differences in coding were reconciled and themes were generated.ResultsThe themes that surfaced included resistance to the policy, policy development process, communication, government role, parental role, food rewards, fund raising, and leadership.Conclusions and implicationsResistance to the policy was not extreme. In the future a wider array of school personnel who are affected by school food regulations should be included in the development of new policies. It is critical to communicate with all concerned parties about the policy.     

Prevalence and Correlates of Walking and Biking to School Among Adolescents

Increasing the rates that our adolescents walk and bicycle to school, also called active transport to school (ATS), could increase the physical activity (PA) levels of that age group. This type of activity has been identified as a missed opportunity for PA. It is currently estimated that 15% of American youth walk or bicycle to school. These rates of ATS are lower than those of European and Asian youth. Efforts to enhance levels of non-motorized transport to school could aid in reducing obesity rates among American youth, decrease traffic congestion and attenuate emission of greenhouse gasses. The objective was to identify demographic, environmental and psychosocial predictors of ATS. A 30-questionnaire was completed by 2,692 students. Logistic regression was used to identify psychosocial, demographic and environmental predictors of ATS. Only 4.6% of students used ATS. Predictors of ATS were street connectedness (density of street intersections) and gender, (boys had higher ATS rates). Public health officials should be alert for opportunities to select sites for new schools that are in neighborhoods with well connected street systems. Interventions promoting ATS will need to target male and female students and there appears to be an opportunity to increase rates that students bicycle to school.     

A Survey of Physicians Who Studied Public Health During Medical School

Introduction:The need for more physicians trained in prevention, research methods, and management has been argued by many leaders in medical education. Columbia University attempts to address this need by providing medical students with a variety of options for studying public health.Methods:A survey of Columbia’s medical graduates who had taken elective courses in public health explored the reasons they began their studies, why some did not continue, their assessment of the value of public health courses, and their careers after graduation.Results:Responses were received from 60 graduates. Health policy, international health, and clinical prevention were the primary interests leading them to study public health. Courses in epidemiology, biostatistics, and policy and management were cited as most useful. The pressure of clinical training was the major reason why some did not complete the master of public health (MPH) degree in a timely fashion. Among students who had enrolled in the MPH program and finished medical school before 1990, 84% eventually received the MPH, although some took as many as 12 additional years to complete the degree. Medical students who studied public health did not differ greatly from their classmates in their specialty choices, but those who completed the MPH chose academic, governmental, and corporate practice settings more frequently than other young physicians, and devoted more time to non-clinical activities.Conclusion:Public health educators can serve a variety of career needs for future physicians. In addition to personal interests, the presence of role models is an important reason students begin studying public health.     

Weight Control Strategies of Overweight Adolescents Who Successfully Lost Weight

The purpose of this pilot study was to evaluate the differences in weight control behaviors, dietary intake, and physical activity between overweight adolescents who lost weight and overweight adolescents who did not lose weight. This cross-sectional study compared 62 overweight adolescents who lost weight in the past with 68 overweight adolescents who did not lose weight. Youth responded to questions regarding weight control behaviors during the past year, physical activity, sedentary activity, and dietary intake. Results showed that adolescents who lost weight were more likely to report using healthful weight control behaviors such as drinking less soda and increasing their exercise level, self-weighing, consuming diets higher in protein, and spending less time watching television compared to overweight adolescents who did not lose weight. Unhealthful weight control behaviors and specific weight loss plans were not associated with weight loss in these teenagers. Adolescents would benefit from hearing this information to prevent the development of these behaviors. Providers should advise adolescents to engage in healthful weight control behaviors, such as increasing physical activity and decreasing the amount of time spent watching television, to assist with weight management.     

A Participatory Study of School Dropout and Behavioral Health of Latino Adolescents

The dropout of Latino adolescents from public schools has been linked to behavioral health issues such as delinquency and family conflict. Greater understanding is needed about the interplay of cultural, social, and developmental factors in this process. This article reports the findings of 14 group interviews conducted using a participatory approach with Latinos in a large school district in the southeastern USA. Findings support the need for comprehensive school-based interventions along the continuum from early intervention to intensive treatment for Latino adolescents who are at risk of dropping out. Participatory research is recommended for identifying strategies that integrate culturally and developmentally appropriate adaptations into existing behavioral health and dropout prevention services.     

Predictors of Alcohol Use Among Rural Adolescents

There is increasing evidence that alcohol use is becoming more common during childhood and early adolescence. However, little is known about alcohol use among rural youths. This article reports a study of alcohol use among 367 fifth-grade students in two rural South Carolina school districts. More than one third (n = 131) of the fifth graders reported having used alcohol. Of these, 34 percent (n = 44) reported drinking during the previous month; 8 percent had been intoxicated during the previous two months; and 54 percent reported drinking in the home with or without parental approval. Logistic regression analysis was used to determine the predictors of alcohol use by fifth graders. The results indicated that gender (OR = 2.82), mother's alcohol use (OR = 1.86), father's alcohol use (OR = 2.13), and smoking (OR = 8.30) were significantly associated with alcohol use. The findings suggest that prevention programs address cigarette smoking and drinking behaviors of parents to reduce alcohol use and the acquisition of other health compromising behavior by youths. Early intervention approaches must go beyond the schools and target families as well as community populations.     

A Strategy to Increase the Number of Urban Family Practice Resident Physicians Who Enter Rural Practice

Physician geographic maldistribution is a problem in the United States health care system. Innovative strategies are needed to entice resident family physicians training in the larger, more numerous suburban and urban training programs to practice in rural areas upon completing their training. This paper describes a strategy used at St. Elizabeth Medical Center Family Practice Residency Program, Dayton, OH, to encourage rural practice. In the St. Elizabeth plan, the interested family practice resident moonlights in a rural practice provided by the local county hospital. The county medical staff covers the resident physician's practice during the frequent absences. The residency program faculty provide on-site supervision, telephone back-up coverage, and practice consultation. The county hospital provides billing services; the resident physician retains 100 percent of collections. The resident physician gains exposure to the knowledge, skills, and attitudes needed in rural practice. Upon completion of residency training, the physician remains in practice and is not required to pay back any expenses incurred by the hospital. Two resident physicians participate currently; three others have expressed interest in practicing in the community. A similar plan might work in parts of the United States where, like Ohio, training programs and rural communities are not far apart.     

Using Herbs and Spices to Increase Vegetable Intake Among Rural Adolescents

ObjectiveTo test whether adding herbs and spices to school lunch vegetables increases selection and intake compared with lightly salted control versions among rural adolescents.DesignThis study compared intake of vegetables with herbs and spices with lightly salted controls (phase I) and tested whether 5 repeated exposures would increase students’ intake of herb and spice seasoned vegetables (phase II).Participants and SettingA total of 600–700 students at a rural middle/high school (age 11–18 years).InterventionIn phase I, herbs and spices were added to 8 vegetables and outcomes were compared with 8 control recipes. In phase II, the impact of repeated exposure to herb and spice blends served on different vegetables was assessed.Main OutcomesVegetable selection rates, weighed intake, and willingness to eat again.AnalysisTwo-way ANOVAs tested effects of condition (herbs and spices vs control; before vs after exposure) and age (middle vs high school) on selection and intake.ResultsIn phase I, students ate more control than seasoned broccoli (P = .01), cauliflower (P = .006), and green beans (P = .01), and high schoolers generally consumed more seasoned vegetables than did middle schoolers (P < .03). In phase II, repeated exposure to herbs and spices increased reported willingness to eat again for seasoned broccoli (P = .003).Conclusions and ImplicationsIn a short-term intervention, herbs and spices did not produce robust increases in school lunch vegetable intake among rural adolescents, but limited repeat exposure may increase students’ willingness to consume these flavors. Additional work is needed to identify individual and school-level characteristics that affect students’ willingness to select and consume vegetables with herbs and spices.