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1.
The Influence of Organizational Culture on School‐Based Obesity Prevention Interventions: A Systematic Review of the Literature 下载免费PDF全文
Kayla N. Fair DrPH MPH Kayce D. Solari Williams PhD MPH MS Judith Warren PhD E. Lisako Jones McKyer PhD MPH Marcia G. Ory PhD MPH 《The Journal of school health》2018,88(6):462-473
BACKGROUND
Although the influence of organizational culture has been examined on a variety of student outcomes, few studies consider the influence that culture may have on school‐based obesity prevention interventions. We present a systematic review of the literature to examine how elements of organizational culture may affect the adoption, implementation, and sustainability of school‐based obesity prevention interventions.METHODS
Fourteen studies examining the impact of organizational‐level characteristics on school‐based obesity prevention interventions were identified through the online databases EBSCO (CINAHL, ERIC, Agricola), Web of Science, Medline (PubMed), and Scopus.RESULTS
Five themes were identified as elements of organizational culture that influence the adoption, implementation, and sustainability of school‐based obesity prevention interventions: organizational response to limited resources, value placed on staff training and professional development, internal support, organizational values, and school climate.CONCLUSIONS
Organizational culture can greatly influence the success of school‐based obesity interventions. The collection of data related to organizational‐level factors may be used to identify strategies for creating and sustaining a supportive environment for obesity prevention interventions in the school setting.2.
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.3.
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.4.
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.5.
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.6.
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.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.
Perceived Weight Discrimination and School Connectedness Among Youth: Does Teacher Support Play a Protective Role? 下载免费PDF全文
《The Journal of school health》2018,88(10):754-761
BACKGROUND
Weight discrimination has been associated with poor academic performance and decreased school attendance. Little is known about weight discrimination and students' feelings of belonging to their school. This study examined the association between weight discrimination and school connectedness among adolescents. Teacher support was examined as a protective factor.METHODS
Middle school students (N = 639; 57% white; Mean age = 12.16 years) completed a health behaviors survey. Weight discrimination from peers and/or good friends was dichotomized into never versus experienced weight discrimination. The mean of 5 school connectedness items assessed level of school connectedness. Teacher support was measured by taking the mean of 4 teacher support items. Hierarchical linear regression was used to examine the association between weight discrimination and school connectedness. Teacher support was tested as a moderator.RESULTS
Weight discrimination was associated with lower levels of school connectedness (p < .05). Teacher support was associated with higher levels of school connectedness (p < .001) but did not moderate the association between weight discrimination and school connectedness.CONCLUSION
The association between weight discrimination and low levels of school connectedness is important as students spend most of their time at school and should benefit from the positive effects of feeling connected to school.9.
Analyzing Multilevel Factors Underlying Adolescent Smoking Behaviors: The Roles of Friendship Network,Family Relations,and School Environment 下载免费PDF全文
BACKGROUND
This study investigates the extent to which friendship network, family relations, and school context are related to adolescent cigarette smoking. Friendship network is measured in terms of delinquent peers; family relations in terms of parental supervision; and school environment in terms of objective (eg, antismoking policy) and subjective (eg, school attachment) characteristics.METHODS
Findings are based on the secondary analysis of the health behavior in school‐aged children, 2009–2010. Two‐level hierarchical generalized linear models are estimated using hierarchical linear modeling 7.RESULTS
At the student level, ties to delinquent friends is significantly related to higher odds of smoking, while greater parental supervision is associated with lower odds. At the school level, antismoking policy and curriculum independently lower smoking behavior. Better within‐class peer relations, greater school attachment, and higher academic performance are also negatively related to smoking. Last, the positive association between delinquent friends and smoking is weaker in schools with a formally enacted antismoking policy. However, this association is stronger in schools with better peer relations.CONCLUSIONS
Adolescent smoking behavior is embedded in a broader ecological setting. This research reveals that a proper understanding of it requires comprehensive analysis that incorporates factors measured at individual (student) and contextual (school) levels.10.
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.11.
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.12.
Rachel M. Flynn PhD Amanda E. Staiano PhD Robbie Beyl PhD Rebekah A. Richert PhD Ellen Wartella PhD Sandra L. Calvert PhD 《The Journal of school health》2018,88(10):768-775
BACKGROUND
Youth in the United States have low levels of cardiorespiratory fitness, a risk factor for childhood obesity. Lower levels of physical fitness for black and Hispanic youth contribute to health disparities. In this feasibility study, we examined active video games (AVGs) as a tool to improve fitness and attitudes toward physical activity during early adolescence.METHOD
A 6‐week AVG program took place in a youth development program in a high‐poverty neighborhood in New York City. Youth aged 10 to 15 years (50% overweight or obese) participated in 2 fitness tests and completed surveys that captured barriers to physical activity pre‐ and postintervention. Each week, participants played Wii Fit games for 30 minutes.RESULTS
Participants improved the number of sit‐ups and step‐ups they completed from pre‐ to postintervention (p < .05). Participants also increased their self‐efficacy, intention to exercise and perceived social support to exercise (p < .05). Youth reported a high level of enjoyment and perceived Wii Fit as ways to increase physical fitness and increase their physical activity.CONCLUSION
AVGs may be a viable alternative exercise program to increase physical activity for black and Hispanic youth living in poverty‐impacted neighborhoods.13.
14.
Crime Prevention Through Environmental Design (CPTED) Characteristics Associated With Violence and Safety in Middle Schools 下载免费PDF全文
Kevin J. Vagi PhD Mark R. Stevens MSPH MA Thomas R. Simon PhD Kathleen C. Basile PhD Sherry P. Carter MURP Stanley L. Carter ICACP 《The Journal of school health》2018,88(4):296-305
BACKGROUND
This study used a new Crime Prevention Through Environmental Design (CPTED) assessment tool to test the associations between physical attributes of schools and violence‐related behaviors and perceptions of students.METHODS
Data were collected from 4717 students from 50 middle schools. Student perceptions of risk and safety, and violence were assessed. Evaluators used the CPTED School Assessment (CSA) to quantify how well the physical elements of each school correspond to ideal CPTED principles. Generalized linear mixed models were used to adjust for school‐ and student‐level characteristics.RESULTS
Higher CSA scores were generally associated with higher perceptions of safety and lower levels of violence perpetration and perceived risk in unadjusted models. Higher CSA scores were also associated with lower odds of missing school because of safety concerns in most adjusted models, with significant adjusted odds ratios (AORs) ranging from 0.32 to 0.63. CSA scores for parking and bus loading areas also remained associated with higher perceived safety (AORs = 1.28 and 1.32, respectively) and lower perceived risk (AORs = 0.73 and 0.66, respectively) in adjusted models.CONCLUSIONS
The CSA is useful for assessing school environments that are associated with violence‐related behaviors and perceptions. The CSA might help guide school environmental modifications to reduce violence.15.
The School Contextual Effect of Sexual Debut on Sexual Risk‐Taking: A Joint Parameter Approach 下载免费PDF全文
Tianji Cai PhD Yisu Zhou PhD Michael D. Niño PhD Nichola Driver MPA PhD 《The Journal of school health》2018,88(3):200-207
BACKGROUND
Previous research has identified individual and school‐level characteristics that are associated with sexual risk‐taking, but the impact of school‐level mechanisms on sexual risk‐taking is not well understood. We examine the aggregated effects that early sex at the school level have on risky sexual behaviors.METHODS
We use 3 waves of data from the National Longitudinal Study of Adolescent Health. An individual's first sexual intercourse before age 15 was recorded along with various risky sexual behaviors at debut. Two variables at respondent's later stage of life were also included: having sex in exchange for drugs or money, and contraction of sexually transmitted disease (STD). Longitudinal analysis was conducted using a joint parameter model that tested unobserved school effects on individual behaviors simultaneously.RESULTS
An increase in early sexual initiation at the school level was associated with higher probability of sexual debut, along with increased involvement in sexual risk‐taking controlling for student family background.CONCLUSIONS
School behavioral mechanisms are directly related to sexual health behaviors among youth. Our findings have implications for school‐based interventions, education programs, and the role of parents.16.
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.17.
The Application of Optimal Defaults to Improve Elementary School Lunch Selections: Proof of Concept 下载免费PDF全文
Katharine L. Loeb PhD Cynthia Radnitz PhD Kathleen L. Keller PhD Marlene B. Schwartz PhD Nancy Zucker PhD Sue Marcus PhD Richard N. Pierson MD Michael Shannon MEd Danielle DeLaurentis BA 《The Journal of school health》2018,88(4):265-271
BACKGROUND
In this study, we applied behavioral economics to optimize elementary school lunch choices via parent‐driven decisions. Specifically, this experiment tested an optimal defaults paradigm, examining whether strategically manipulating the health value of a default menu could be co‐opted to improve school‐based lunch selections.METHODS
The design was a randomized comparison of optimal versus suboptimal (standard) default lunch menus for all first‐graders in a school district for a period of 1 week. We hypothesized that making the default lunch option healthier, while providing parents the opportunity to access and choose from the standard school menu for their child, would yield more frequent selection of healthier items than when the default option was suboptimal.RESULTS
Overall, 127 (93%) first‐grade children's families participated. Among those families randomized to receive the nutritionally optimized default menu, all but one remained with these options; of those parents randomized to the standard menu (suboptimal default), all parents remained with these options (Χ2 = 123.06, df = 1, p < .001).CONCLUSIONS
The mere positioning of choices, without restricting options, significantly affected which menu items the children received during the test period. Results are proof of concept for a strategy to increase health‐promoting school lunch content, procedures, and policies.18.
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.19.
Ashley Chamberlin MS RDN Selena Nguyen‐Rodriguez PhD MPH Virginia B. Gray PhD RDN Wendy Reiboldt PhD Caitlin Peterson BS Donna Spruijt‐Metz PhD 《The Journal of school health》2018,88(7):493-499
BACKGROUND
Existing literature indicates a relationship between stress and emotional eating in adults, yet limited research has examined the impact of school‐related stress on emotional eating in adolescents. This study investigated the influence of academic factors on emotional eating among minority adolescents.METHODS
A survey was implemented among a sample of minority adolescents (N = 666) to investigate the relationship between emotional eating and 3 academic factors: academic self‐esteem, grade point average (GPA), and academic worries. Forced‐entry multiple linear regressions were used to test for relationships.RESULTS
Findings indicate that GPA, academic self‐esteem, and academic worries were related to emotional eating scores in adolescents. There were no significant differences in academic factors between emotional eaters and nonemotional eaters.CONCLUSIONS
Additional research is needed to further elucidate the complex interaction between emotional eating behavior and academics.20.
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