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School Wellness Committees Are Associated With Lower Body Mass Index Z‐Scores and Improved Dietary Intakes in US Children: The Healthy Communities Study 下载免费PDF全文
Lauren E. Au PhD RD Patricia B. Crawford DrPH RD Gail Woodward‐Lopez MPH RD Klara Gurzo MA Janice Kao MPH Karen L. Webb PhD MPH Lorrene D. Ritchie PhD RD 《The Journal of school health》2018,88(9):627-635
BACKGROUND
Our objective was to examine the association between school wellness committees and implementation of nutrition wellness policies and children's weight status and obesity‐related dietary outcomes.METHODS
A cross‐sectional study was conducted of 4790 children aged 4‐15 years recruited from 130 communities in the Healthy Communities Study. Multilevel statistical models assessed associations between school wellness policies and anthropometric (body mass index z‐score [BMIz]) and nutrition measures, adjusting for child and community‐level covariates.RESULTS
Children had lower BMI z‐scores (?0.11, 95% confidence interval [CI]: ?0.19, ?0.03) and ate breakfast more frequently (0.14 days/week, 95% CI: 0.02‐0.25) if attending a school with a wellness committee that met once or more in the past year compared to attending a school with a wellness committee that did not meet/did not exist. Children had lower added sugar (p < .0001), lower energy‐dense foods (p = .0004), lower sugar intake from sugar‐sweetened beverages (p = .0002), and lower dairy consumption (p = .001) if attending a school with similar or stronger implementation of the nutrition components of the school wellness policies compared to other schools in the district.CONCLUSIONS
A more active wellness committee was associated with lower BMI z‐scores in US schoolchildren. Active school engagement in wellness policy implementation appears to play a positive role in efforts to reduce childhood obesity.2.
Meg Bruening PhD MPH RD Marc A. Adams PhD MPH Punam Ohri‐Vachaspati PhD RD Jane Hurley PhD 《The Journal of school health》2018,88(6):416-422
BACKGROUND
Salad bars are placed in schools to promote fruit and vegetable consumption among students. This study assessed differences in school nutrition practices and perceptions in schools with and without salad bars.METHODS
Cross‐sectional surveys were completed by school nutrition managers (N = 648) in Arizona schools participating in the National School Lunch Program during 2013–2014. Mixed general estimating equation binomial regressions assessed factors related to having a salad bar after mutually adjusting for clustering within districts, school level, free/reduced rate, and respondents' time in current position.RESULTS
On average, 61% of schools reported having a salad bar. After adjustment, school nutrition managers were significantly more likely to report having a salad bar if they served lunch by grade level (vs mixed grades), had a full‐service kitchen, and their personal perception of salad bars was positive; schools were less likely to have a salad bar if menu and food service decisions were made at the school level.CONCLUSIONS
Several school‐level nutrition practices and perceptions were associated with having a salad bar in schools. Enhancement of these factors may facilitate having salad bars in schools.3.
School Factors Associated With the Implementation of Integrated Pest Management‐Related Policies and Practices 下载免费PDF全文
BACKGROUND
Schools are particularly vulnerable to pests, but integrated pest management (IPM) can address pest problems. This study describes IPM policies and practices and the extent to which they are associated with school characteristics.METHODS
We analyzed data from the 2014 School Health Policies and Practices Study, a nationally representative survey of schools in the United States (N = 568, response rate = 69%). Pairwise comparisons assessed differences in pest prevention strategies by school characteristics.RESULTS
Nationwide, 55.3% of schools conducted campus‐wide inspections for pests at least monthly; 35.6% of schools notified staff, students, and families prior to each application of pesticides; and 56.1% of schools required custodial or maintenance staff to receive training on pest management practices that limit the use of pesticides. During the 12 months before the study, 46.5% of schools almost always or always used spot treatments and baiting rather than widespread applications of pesticides, and 36.8% of schools almost always or always marked indoor and outdoor areas that had been treated with pesticides. No clear pattern emerged for school characteristics associated with IPM policies and practices.CONCLUSIONS
The variation in implementation of IPM‐related policies and practices suggest opportunities for targeted education among school staff about IPM principles.4.
Composition of School Meals in Sweden,Finland, and Iceland: Official Guidelines and Comparison With Practice and Availability 下载免费PDF全文
Ragnheidur Juniusdottir MEd Agneta Hörnell PhD Ingibjorg Gunnarsdottir PhD Hanna Lagstrom PhD Maria Waling PhD Cecilia Olsson PhD Sanna Talvia PhD MSc MEd Anna S. Olafsdottir PhD 《The Journal of school health》2018,88(10):744-753
BACKGROUND
Nutritious and attractive school meals can improve health equality and public health. Current official guidelines and recommendations on food and nutrient composition of school meals in 3 Nordic countries; Sweden, Finland, and Iceland, are described and compared with actual practice, ie, availability of foods and nutrients in served reference meals in 3 selected areas in each country.METHODS
A country comparison was made between official guidelines, and actual practice was studied in participating schools. Reference portions of school meals (N = 170) provided in 24 compulsory schools were photographed and weighed. Food and nutrient availability were compared with official guidelines in each country.RESULTS
Emphasis of recommendations on whole‐grain bread in Sweden, whole grains in Finland, and fish in Iceland were reflected in food availability. The energy content of the meals provided was lower than guidelines and there was a large variation in energy content between days.CONCLUSIONS
The guidelines regarding food availability were quite well followed, but the large variation in energy and nutrient content of provided school meals between days indicates a need for standardization.5.
Katherine Y. Grannon MPH RDN Nicole Larson PhD MPH RD Jennifer Pelletier PhD Michael J. O'Connell BS Marilyn S. Nanney PhD RD 《The Journal of school health》2018,88(9):685-692
BACKGROUND
In this study, we describe state agency strategies to support weight‐related policy implementation in schools, and examine the association among state support, obesity prevalence, and strength of state policies governing school nutrition and physical education.METHODS
The 2012 School Health Policies and Practices Study describes prevalence of implementation support state agencies provided to schools/districts. Implementation support items were analyzed by weight‐related policy area (eg, advertising, wellness policy) and by type of support (eg, technical assistance). Results were summed to create a total weight‐related policy support score. Linear regression was used to examine associations between policy support and state youth obesity prevalence (2011‐2012 National Survey for Children's Health), overall and stratified by state policy strength (2012 Classification of Laws Associated with School Students).RESULTS
States provided support most commonly for school meals and wellness policies (89% and 81%, respectively) and least often for after‐school PE (26%). Most states (80%) provided technical assistance. The total weight‐related policy support score had a significant positive association with state‐level youth overweight/obesity prevalence (p = .03).CONCLUSION
State agencies appear to be responding to their youth obesity prevalence with technical support. Schools and state agencies should work in collaboration to provide a healthy school environment for all students.6.
Collaboration Challenges and Opportunities: A Survey of School Foodservice Directors and Community Health Coalition Members 下载免费PDF全文
BACKGROUND
The Healthy, Huger‐Free Kids Act (HHFKA) presents challenges for foodservice directors (FSDs) in sourcing and preparing foods that meet nutrition standards. Concurrently, community health coalition members (CHCs) are engaging schools through community and school nutrition initiatives. We hypothesized significant differences in perceptions between FSDs and CHCs related to implementation of HHFKA such that FSDs would perceive greater foodservice challenges, while CHCs would be more supportive of community nutrition initiatives.METHODS
A perceptions survey was administered by email to 528 FSDs and 334 CHCs during summer 2016. Experience, education level, urban/rural differences, school demographics, and involvement between FSDs and CHCs were compared.RESULTS
Overall, 132 FSDs and 80 CHCs responded (29.5% FSDs, 24.7% CHCs). Overall perception of HHFKA foodservice challenge ranged between neutral (eg, neither challenging nor unchallenging) to somewhat challenging, and did not differ between groups. CHCs were significantly more supportive of community nutrition initiatives, while FSDs responded neutrally.CONCLUSIONS
FSDs awareness of CHCs desire for collaboration may increase FSDs support for broader school nutrition initiatives such as school gardens, farm to school, and student/community engagement. There is great potential for integrating student and community health programs through partnerships.7.
Susan L. Hogue PharmD MPH Rafael Muniz MD Christopher Herrem PhD Suyapa Silvia PhD Martha V. White MD 《The Journal of school health》2018,88(5):396-404
BACKGROUND
Anaphylaxis is a serious and growing concern in the school setting as the prevalence of food allergies and food‐induced severe allergic reactions continues to increase.METHODS
A cross‐sectional, web‐based survey was conducted regarding anaphylactic events that occurred during the 2014‐2015 school year. Eligible schools were enrolled in the EPIPEN4SCHOOLS® program (Mylan Specialty L.P., Canonsburg, PA), which provides free epinephrine auto‐injectors to qualifying US schools. Participating schools completed a 29‐item survey on anaphylactic event occurrence and treatment, epinephrine stock, school policies regarding anaphylaxis, school staff training, and school nursing coverage.RESULTS
Responses were provided by 12,275 schools. Epinephrine was administered on school property for 63.7% of reported anaphylactic events (1272/1998). In 38.5% (235/610) of events for which epinephrine was not used, antihistamines were cited as the reason. Only 59.4% of schools cited epinephrine as their standard first‐line therapy for anaphylaxis. School nurses were most likely to be trained in anaphylaxis recognition and permitted to administer epinephrine; however, just 53.6% of schools had a full‐time nurse on staff.CONCLUSIONS
Process‐related barriers to the appropriate use of epinephrine go beyond access to medication. Widespread staff training and review of school policies are needed to ensure that anaphylaxis is appropriately managed in schools.8.
Formative Research to Create a Farm‐to‐School Program for High School Students in a Lower Income,Diverse, Urban Community 下载免费PDF全文
Anna E. Greer PhD CHES Stacey Davis BS Cristina Sandolo BA Nicole Gaudet MS Brianna Castrogivanni MS 《The Journal of school health》2018,88(6):453-461
BACKGROUND
Using Social Cognitive Theory as a framework, we examined opportunities for promoting local produce consumption among high school students in a lower‐income, ethnically diverse, urban community.METHODS
Six focus groups (N = 53) were conducted with students. Using Atlas.ti qualitative software, data were coded and reviewed to identify code categories which could be taken to represent themes.RESULTS
Students (56.8% girls, 86.5% nonwhite) described local produce as being grown “nearby” or “in Connecticut.” Overwhelmingly, students perceived local produce to be of higher quality (eg, “tastes better,” “fresher”) than nonlocal produce. Students reported that the foods served at school are “unnatural” and “made in a factory.” Salient perceived outcomes associated with consuming local produce included “benefits the environment,” “builds community and trust,” and “keeps taxes down.” Students recommended hanging large colorful posters highlighting the positive outcomes associated with consuming local produce in school locations with captive audiences such as lunch lines and classrooms. Labels identifying the food origins of cafeteria foods provided as well as taste tests of local produce might support students' self‐efficacy for consuming local fruits and vegetables.CONCLUSIONS
These findings provide theory‐based strategies for how to promote local produce consumption among a diverse group of urban high schools students.9.
BACKGROUND
Although there are over 26,000 private schools in the United States, little is known about the relationship of their characteristics to mandated and recommended time allocations for physical education (PE).METHODS
Private secondary schools (N = 450; grades 6‐12) in California completed a 15‐item questionnaire related to school characteristics and PE policies and practices. Using correlational analysis and predictive modeling, we assessed the associations and influences of various factors relative to the schools meeting state (California) and national professional time targets for PE.RESULTS
Whereas most schools fell short of meeting PE weekly time recommendations, 5 of 10 tested variables were significantly associated with schools meeting PE minutes/week targets: school enrollment, school level, having a fitness testing policy, PE class size, and not permitting exemptions for PE. Large schools and those serving high school students provided more PE and were more likely to meet PE time allocation standards. Having policies for PE minutes/week and no exemptions for PE were significantly associated with a school having all its PE classes taught by a specialist.CONCLUSIONS
Private secondary schools should consider the adoption of professional guidelines related to PE time allocations, class size, conducting physical fitness testing, employing PE specialists, and not permitting exemptions for PE.10.
Assessing School Wellness Policies and Identifying Priorities for Action: Results of a Bi‐State Evaluation 下载免费PDF全文
Susan P. Harvey PhD Deborah Markenson MS Cheryl A. Gibson PhD 《The Journal of school health》2018,88(5):359-369
BACKGROUND
Obesity is a complex health problem affecting more than one‐third of school‐aged youth. The increasing obesity rates in Kansas and Missouri has been particularly concerning, with efforts being made to improve student health through the implementation of school wellness policies (SWPs). The primary purpose of this study was to conduct a rigorous assessment of SWPs in the bi‐state region.METHODS
SWPs were collected from 46 school districts. The Wellness School Assessment Tool (WellSAT) was used to assess comprehensiveness and strength. Additionally, focus group discussions and an online survey were conducted with school personnel to identify barriers and supports needed.RESULTS
Assessment of the SWPs indicated that most school districts failed to provide strong and specific language. Due to these deficiencies, districts reported lack of enforcement of policies. Several barriers to implementing the policies were reported by school personnel; supports needed for effective implementation were identified.CONCLUSIONS
To promote a healthful school environment, significant improvements are warranted in the strength and comprehensiveness of the SWPs. The focus group discussions provided insight as to where we need to bridge the gap between the current state of policies and the desired beneficial practices to support a healthy school environment.11.
National Analysis of State Health Policies on Students' Right to Self‐Carry and Self‐Administer Asthma Inhalers at School 下载免费PDF全文
Madeleine M. Toups MPP Valerie G. Press MD MPH Anna Volerman MD 《The Journal of school health》2018,88(10):776-784
BACKGROUND
Asthma has no known cure, and though manageable, it disrupts the everyday lives of over 6 million US children. Because children spend more than half of their waking hours in school, students must be able to carry and administer their inhaler at school to manage their asthma.METHODS
This policy paper is a comprehensive review of all 50 states and the District of Columbia's laws and policies for the self‐carry and administration of quick‐relief asthma inhalers among children in prekindergarten through 12th grade.RESULTS
All states permit students to carry and administer their inhalers at school, although each state differs in their development and implementation of policies for asthma self‐management at school. This review examines how states regulate self‐carry policies by looking at policy development, regulated school systems, relevant stakeholders, required medical records, and school liability.CONCLUSIONS
Each state's laws have nuances that create gray areas, increasing the potential of misinterpreted or incorrectly implemented policies for asthma self‐management at school. As a result, children may not have immediate access to their inhaler for symptom management or in an emergency. State policymakers should reform current laws to remove barriers for students to carry and use inhalers at school.12.
Enhancing Educator Engagement in School Mental Health Care Through Digital Simulation Professional Development 下载免费PDF全文
Michael W. Long SD MPH Glenn Albright PhD Jeremiah McMillan BA Kristen M. Shockley PhD Olga Acosta Price PhD 《The Journal of school health》2018,88(9):651-659
BACKGROUND
Despite the critical role of educators as gatekeepers for school mental health services, they receive limited training to support student mental health. We report findings from a trial of an online mental health role‐play simulation for elementary school teachers on changes in attitudes and self‐reported helping behaviors for students experiencing psychological distress.METHODS
We randomly assigned 18,896 elementary school teachers to wait‐list control or intervention conditions in which they received the 45‐ to 90‐minute online role‐play simulation. We administered a version of the validated Gatekeeper Behavior Scale at baseline and postintervention, which measures attitudinal dimensions shown to predict teacher helping behavior change. Self‐reported helping behaviors were collected at baseline and 3‐month follow‐up. Outcomes were compared between the intervention follow‐up and control group baseline measures.RESULTS
The intervention group posttraining scores were significantly higher (p < .001) than the control group for all the preparedness, likelihood, and self‐efficacy Gatekeeper Behavior subscales. All 5 helping behaviors were significantly higher among the intervention group at follow‐up compared to the control group at baseline.CONCLUSIONS
We found that a brief online role‐play simulation was an effective strategy for improving teacher attitudes and behaviors needed to perform a positive mental health gatekeeper role in schools.13.
Use of a Model Wellness Policy May Not Increase the Strength and Comprehensiveness of Written School Wellness Policies 下载免费PDF全文
Erin Eggert MS EP‐C Hilary Overby MS EP‐C Lacey McCormack PhD MPH RD LN EP‐C Jessica Meendering PhD EP‐C 《The Journal of school health》2018,88(7):516-523
BACKGROUND
Many state agencies have developed model wellness policies (MWPs) to serve as examples for schools when writing their own school wellness policy (SWP). The purpose of this study was to evaluate if a MWP aids schools in writing stronger, more comprehensive SWPs.METHODS
For this cross‐sectional study, 91 school districts submitted their current SWP and completed a survey that classified districts into either districts that utilized the state MWP (N = 56; 61.5%) or those that did not (NMWP, N =35; 38.5%). The Wellness School Assessment Tool (WellSAT) was used to assess the strength, comprehensiveness, total overall score, and subsection scores of each policy. Dependent variables were compared between groups using t tests. Statistical significance was set at p ≤ .05. Data are presented as mean ±SD.RESULTS
No significant differences were found between groups in total overall (MWP 76.8 ± 37.9; NMWP 62.1 ± 34.3), strength (MWP 25.3 ± 17.6; NMWP 19.1 ± 12.8), or comprehensiveness scores (MWP 51.5 ± 21.2; NMWP 43.0 ± 22.1). The only subsection score difference identified between groups was the Nutrition Standards comprehension score (p = .02).CONCLUSIONS
These data suggest MWPs may not improve the quality of written SWPs. Further research is needed to better understand the needs of school districts in SWP development.14.
Amanda Terry PhD 《The Journal of school health》2018,88(4):289-295
BACKGROUND
The purpose of this study was to determine the impact of the coverage of state legislation and the expansiveness ratings of state model policies on the state‐level prevalence of bullying in schools.METHODS
The state‐level prevalence of bullying in schools was based on cross‐sectional data from the 2013 High School Youth Risk Behavior Survey. Multiple regression was conducted to determine whether the coverage of state legislation and the expansiveness rating of a state model policy affected the state‐level prevalence of bullying in schools.RESULTS
The purpose and definition category of components in state legislation and the expansiveness rating of a state model policy were statistically significant predictors of the state‐level prevalence of bullying in schools. The other 3 categories of components in state legislation—District Policy Development and Review, District Policy Components, and Additional Components—were not statistically significant predictors in the model.CONCLUSIONS
Extensive coverage in the purpose and definition category of components in state legislation and a high expansiveness rating of a state model policy may be important in efforts to reduce bullying in schools. Improving these areas may reduce the state‐level prevalence of bullying in schools.15.
Effects of a School‐Based Pedometer Intervention in Adolescents: 1‐Year Follow‐Up of a Cluster‐Randomized Controlled Trial 下载免费PDF全文
Barbara Isensee PhD Vivien Suchert PhD Julia Hansen PhD Burkhard Weisser MD Reiner Hanewinkel PhD 《The Journal of school health》2018,88(10):717-724
BACKGROUND
Physical activity (PA) is one of the most important health behaviors that may be modified by each individual. To foster PA in adolescents, a school‐based intervention was evaluated.METHODS
A cluster‐randomized controlled trial with preassessment in 2014 and follow‐up assessment in 2015 included 29 schools with 1020 students (47.6% girls, mean age = 13.69 years). Intervention students received pedometers and monitored their steps for 12 weeks. Classes with the most steps were awarded. Primary outcomes included moderate‐to‐vigorous PA, out‐of‐school sports activities, active transport assessed through questionnaires, as well as cardiorespiratory fitness measured using the 20‐m shuttle‐run test and anthropometric data (weight, height, body fat, and waist circumference) assessed by study staff.RESULTS
Significant interaction terms between group and time were found for all 3 indicators of PA; intervention students showed a higher increase of PA than control students. The same pattern was shown for cardiorespiratory fitness, but the effect missed significance. A more favorable development for the intervention students was shown for body fat and waist‐to‐height ratio, while there was no effect on body mass index percentile.CONCLUSIONS
An easy way to administer school‐based PA program may enhance students' leisure‐time PA even 1 year after the intervention has ended.16.
Examining Time to Treatment and the Role of School‐Based Health Centers in a School‐Based Sexually Transmitted Infection Program 下载免费PDF全文
Mallika Sabharwal BS Lisa Masinter MD MPH MS FACOG Kingsley N. Weaver MPH 《The Journal of school health》2018,88(8):590-595
BACKGROUND
Barriers to health care service utilization contribute to the spread of sexually transmitted infections (STIs) among teens. School‐based STI screening programs reach adolescents outside of the clinic‐based health care model and schools with school‐based health centers (SBHCs) may expedite treatment because of their proximity to the population. This study examined whether students who tested positive for STIs in a school‐based screening program had differing times to treatment based on treatment location.METHODS
All positive cases of chlamydia and gonorrhea from the 2012‐2013 school year in a Chicago Department of Public Health (CDPH) and Chicago Public Schools school‐based STI screening program were reviewed. Median time to treatment was compared for those treated at an SBHC versus those treated elsewhere (CDPH STI clinic, community health center, private physician).RESULTS
Overall, 540 students had positive results. The median age was 17 years, 427 had chlamydia (79.1%), 59 had gonorrhea (10.9%), and 54 had dual infections (10.0%); 144 were tested in a school with a SBHC on site (26.7%). Of the 483 students who received treatment (89.4%), those treated at a SBHC had a faster time to treatment compared to CDPH STI clinics (median 17 days versus 28 days, respectively, p < .001).CONCLUSIONS
For students testing positive in the Chicago school‐based STI program, time to treatment is accelerated in locations with SBHCs.17.
Addressing Gaps in Cardiopulmonary Resuscitation Education: Training Middle School Students in Hands‐Only Cardiopulmonary Resuscitation 下载免费PDF全文
Kate H. Magid BA Debra Heard PhD Comilla Sasson MD PHD FAHA FACEP 《The Journal of school health》2018,88(7):524-530
BACKGROUND
Training middle school students to perform hands‐only cardiopulmonary resuscitation (HOCPR) is a potential method to increase overall rates of bystander cardiopulmonary resuscitation (CPR). We aimed to examine the feasibility of teaching this population CPR using teacher‐implemented education sessions guided by American Heart Association (AHA) training kits and resources.METHODS
We conducted a national HOCPR training campaign in middle schools during the 2014‐2015 school year. Participating schools utilized AHA CPR training kits to train seventh and eighth grade students. We assessed pretest/posttest knowledge and comfort in performing HOCPR.RESULTS
We recruited 1131 schools and trained approximately 334,610 students in HOCPR. The average pretest score on knowledge questions was 50% and the average posttest score was 84%. Most students (76%) felt comfortable performing HOCPR after the education session. Overall, 98% of teachers said they would continue to implement CPR training in the future.CONCLUSIONS
Large‐scale, teacher‐implemented CPR education sessions in the middle school setting are a successful approach to increase middle school student's knowledge and comfort in performing HOCPR and to increase overall bystander CPR rates.18.
Effect of Cardiorespiratory Fitness on Academic Achievement is Stronger in High‐SES Elementary Schools Compared to Low 下载免费PDF全文
Michael D. Garber MPH Kaitlyn K. Stanhope MPH Monica P. Shah MPH Patricia Cheung MPH Julie A. Gazmararian PhD MPH 《The Journal of school health》2018,88(10):707-716
BACKGROUND
Academic achievement is influenced by factors at the student, school, and community levels. We estimated the effect of cardiorespiratory fitness performance on academic performance at the school level in Georgia elementary schools and examined effect modification by sociodemographic factors.METHODS
This study is a repeat cross‐sectional analysis of Georgia elementary schools between 2011 and 2014 (approximately 1138 schools per year). Multivariable beta regression estimated the effect of the proportion of 4th and 5th graders meeting cardiorespiratory fitness standards on the proportion of 5th graders passing standardized tests for Reading, English and Language Arts, Mathematics, Science, and Social Studies and considered potential interaction by school‐level socioeconomic status (SES), racial composition, and urbanity.RESULTS
There was a 0.15 higher estimated odds (OR: 1.15 (1.09, 1.22)) of passing the mathematics standardized test for every 10‐percentage‐point increase in school‐level cardiorespiratory fitness among high‐SES schools and 0.04 higher odds (OR: 1.04 (1.02, 1.05)) for low‐SES schools. This pattern was similar for other academic subjects. No effect modification by racial composition or urbanity was observed for any academic subject.CONCLUSIONS
Promoting physical fitness may be effective in improving academic performance among high‐SES schools, but additional strategies may be needed among lower‐SES schools.19.
Impacts of a School‐Wide,Peer‐Led Approach to Sexuality Education: A Matched Comparison Group Design 下载免费PDF全文
Dana Rotz PhD Brian Goesling PhD Jennifer Manlove PhD Kate Welti MPP Christopher Trenholm PhD 《The Journal of school health》2018,88(8):549-559
BACKGROUND
Teen Prevention Education Program (PEP) is a school‐wide, peer‐led comprehensive sexuality education program currently implemented in more than 50 schools across 2 states. Many teen pregnancy prevention researchers and practitioners view peer‐led programs as a promising approach for reducing teen pregnancy and associated sexual risk behaviors. However, prior research on the effectiveness of these programs indicates mixed results.METHODS
We randomly assigned schools to implement Teen PEP immediately (intervention group) or on a delayed schedule (comparison group) and used propensity score matching to improve the comparability of the study groups. We surveyed students at baseline and about 6 months after the program ended.RESULTS
Teen PEP did not significantly impact rates of sexual activity or unprotected sex; however, the program led to improvements in exposure to information about sexual health topics and knowledge of preventing pregnancy and transmission of sexually transmitted infections.CONCLUSIONS
Teen PEP succeeded in accomplishing some of its most proximal goals, increasing students' access to information and knowledge. However, we found little evidence that the program affects sexual risk‐taking within 6 months of its conclusion. Future research will examine the program's longer‐term impacts on sexual risk behaviors.20.
Deborah A. Temkin PhD Daniel Princiotta MA Renee Ryberg MA Daniel S. Lewin PhD DABSM CBSM 《The Journal of school health》2018,88(5):370-378