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1.
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.2.
Young Ho Yun MD Yaeji Kim MA Jin A. Sim MS Soo Hyuk Choi BA Cheolil Lim PhD Joon‐ho Kang PhD 《The Journal of school health》2018,88(8):569-575
BACKGROUND
The objective of this study was to develop the School Health Score Card (SHSC) and validate its psychometric properties.METHODS
The development of the SHSC questionnaire included 3 phases: item generation, construction of domains and items, and field testing with validation. To assess the instrument's reliability and validity, we recruited 15 middle schools and 15 high schools in the Republic of Korea.RESULTS
We developed the SHSC questionnaire of 158 items categorized into 5 domains: (1) Governance and Infrastructure, (2) Need Assessment, (3) Planning, (4) Health Prevention and Promotion Program, and (5) Monitoring and Feedback. All SHSC domains and subdomains demonstrated acceptable reliability with good internal consistency. Each domain and subdomain except for “Planning” was associated significantly with students' health status. Most subdomains, including school health philosophy, school policy, communication, the evaluation system, and monitoring, were significantly and negatively associated with student absence.CONCLUSIONS
The SHSC shows significant association with the overall student health and can be useful in assessing comprehensive school health programs.3.
4.
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.5.
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.6.
7.
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.8.
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.9.
Sarah H. Green MPH Giridhar Mallya MD MSHP Colleen Brensinger MS Ann Tierney MS Karen Glanz PhD MPH 《The Journal of school health》2018,88(4):281-288
BACKGROUND
Schools can reduce student access to competitive foods and influence healthy food choices by improving the school nutrition environment. This study describes changes in competitive nutrition environments in 100 K‐8 schools participating in the Philadelphia Campaign for Healthier Schools.METHODS
Interviews with school staff were used to elicit information about policies, practices, and guidelines to restrict/limit competitive foods in schools, before and 1 year into the campaign. To increase the validity of responses, respondents provided documentation for reported policies and guidelines. Baseline interviews were conducted between April and June 2011 and follow‐up interviews were conducted between April and June 2012.RESULTS
At follow‐up, significantly more schools reported having policies and/or guidelines in place to regulate food as a reward in the classroom, food served at parties and celebrations, outside foods allowed in school, and the availability of sodas and sugar‐sweetened beverages. There were no measurable effects on food available in school stores, fundraisers, or afterschool programs. Availability of concrete documentation of policies was limited, but when provided, it corroborated the interview responses.CONCLUSIONS
In the context of a comprehensive school wellness policy, school wellness councils were associated with increases in school‐level policies and practices that improved the competitive nutrition environment.10.
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.11.
The Utility of Measuring Intentions to Use Best Practices: A Longitudinal Study Among Teachers Supporting Students With Autism 下载免费PDF全文
Jessica Fishman PhD Rinad Beidas PhD Erica Reisinger MSEd David S. Mandell ScD 《The Journal of school health》2018,88(5):388-395
BACKGROUND
School‐based interventions can result in profound social, behavioral, and academic improvement for students with autism, but teachers rarely implement them. It is important to understand why this occurs and use this information to increase the use of evidence‐based practices. Toward this goal, 2 proof‐of‐construct studies demonstrate the theoretical and methodological advantages of measuring behavioral intentions to use specific practices.METHODS
Two observational studies enrolled public school teachers who work with students with autism. The studies measure the strength of teachers' intentions to use each of 4 different evidence‐based practices, assess variability in intentions, and test whether intentions predict future teacher behavior.RESULTS
In adjusted analyses, intentions to use a specific evidence‐based practice were strongly associated with subsequent use (adjusted odds ratio = 5.2). The proportion of teachers who reported strong intentions varied from a low of 33% to a high of 66%, depending on the practice.CONCLUSIONS
The findings illustrate that the strength of intentions, which varies depending on the specific practice, can predict implementation. More generally, the studies demonstrate how measures of intention can aid efforts to identify implementation barriers. The approach taken can be applied to study implementation of any practices designed to improve student health.12.
Health Literacy Teaching Beliefs,Attitudes, Efficacy,and Intentions of Middle School Health and Physical Education Teachers 下载免费PDF全文
Hsiang‐Ru Lai PhD Der‐Min Wu MSPH Pi‐Hsia Lee EdD Yu‐Siang Jhang MEd 《The Journal of school health》2018,88(5):350-358
BACKGROUND
Health education (HE) courses in schools are vital paths for improving teenagers' health literacy. HE and physical education (PE) teachers lead HE courses, and their teaching intentions and competency influence the effectiveness of the courses and the ability to promote students' health literacy. This study attempted to understand HE and PE teachers' health literacy teaching intentions and professional competency and to investigate their relationships.METHODS
This study adopted a cross‐sectional design. A questionnaire survey was administered to 906 middle school HE and PE teachers in Taiwan by mail, and 545 provided valid data with consent.RESULTS
Participants had a favorable health literacy (47.78/50), positive health literacy teaching beliefs and attitudes, and acceptable efficacy. They intended to implement health literacy instruction within the subsequent year. Teaching beliefs, attitudes, and efficacy were all positively correlated with intentions (all p < .001). Demographic variables, health literacy, and teaching beliefs, attitudes, and efficacy explained 33.5% of the variance of teaching intentions.CONCLUSION
Teaching beliefs, attitudes, and efficacy were crucial predictors of health literacy teaching intentions. To improve students' health literacy, educational authorities and schools should pay attention to HE and PE teachers' intentions and vital factors, thereby enhancing teachers' willingness to perform health literacy instruction.13.
Roderick T. Bartee PhD Kate A. Heelan PhD Bree L. Dority PhD 《The Journal of school health》2018,88(9):644-650
BACKGROUND
Research is emerging suggesting that fitness not only improves health, but enhances academic achievement in children. Many studies have found the strongest correlation with academic achievement to be aerobic fitness. The purpose of this study is to examine the influence of aerobic fitness and academic ranking on the association between improvements in students' aerobic fitness and their academic achievement.METHODS
Data were collected from 1152 second‐ through fifth‐grade students enrolled in 10 Midwestern schools. School‐fixed effects models were used to estimate the impact of improved aerobic fitness from the fall to the spring semester on students' spring percentile rankings in math and reading.RESULTS
Students whose progressive aerobic cardiovascular endurance run improved from the fall to spring semester moved up the national spring math percentile rankings by 2.71 percentiles (p < .001) for all students, 4.77 (p < .001) for less‐fit students, and 3.53 (p < .05) for lower performing math students. No statistically significant relationship was found between improved aerobic fitness and reading achievement.CONCLUSIONS
Improving fitness could potentially have the greatest academic benefit for those elementary students who need it the most—the less fit and the lower academic performers.14.
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.15.
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.16.
Relationship Between Cardiorespiratory Fitness,Weight Status,and Academic Performance: Longitudinal Evidence From 1 School District 下载免费PDF全文
Denise Burke Aske PhD MPH Virginia Rall Chomitz PhD MS Xiaodong Liu EdD Lisa Arsenault PhD Sarita Bhalotra MD PhD Dolores Acevedo‐Garcia PhD MPA‐URP 《The Journal of school health》2018,88(8):560-568
OBJECTIVES
We examined the longitudinal relationship between cardiovascular fitness (CRF) and academic performance (AP) among students in a diverse public school district. Furthermore, we determined whether the relationship between CRF and AP varied by student sociodemographic characteristics.METHODS
This study used data from 2005‐2006 to 2008‐2009. AP was assessed by Massachusetts Comprehensive Assessment System (MCAS) math (N = 1224) and English Language Arts (ELA) (N = 1248) z‐scores. CRF was assessed by an age‐ and sex‐adjusted 20‐yard shuttle run (pass/fail). Multilevel growth models were used to estimate the relationship between MCAS z‐scores and changes in grade, CRF, and weight status, controlling for student sociodemographic characteristics.RESULTS
Students who passed the fitness test performed better on MCAS tests (ELA: .159, p < .001; Math: 0.346, p < .001) at each study wave relative to those who did not pass. The relationship between AP and fitness was attenuated for low socioeconomic status(ELA: ?.111, p < .05) and minority (Math: black ?0.249, p < .01; Latino ?0.216, p < .01) students.CONCLUSIONS
These results add to the literature highlighting the role of CRF as an important predictor of performance on standardized tests. More research is needed to understand the disparities experienced by low‐income and minority students.17.
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
BACKGROUND
Although adolescents generally get less than the recommended 9 hours of sleep per night, research and effort to delay school start times have generally focused on high schools. This study assesses the relation between school start times and sleep in middle school students while accounting for potentially confounding demographic variables.METHODS
Seventh and eighth grade students attending 8 late starting schools (~8:00 am , n = 630) and 3 early starting schools (~7:23 am , n = 343) from a diverse suburban school district completed online surveys about their sleep behaviors. Doubly robust inverse probability of treatment weighted regression estimates of the effects of later school start time on student bedtimes, sleep duration, and daytime sleepiness were generated.RESULTS
Attending a school starting 37 minutes later was associated with an average of 17 additional minutes of sleep per weeknight, despite an average bedtime 15 minutes later. Students attending late starting schools were less sleepy than their counterparts in early starting schools, and more likely to be wide awake.CONCLUSIONS
Later school start times were significantly associated with improved sleep outcomes for early adolescents, providing support for the movement to delay school start times for middle schools.18.
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.19.
Gender Expression,Violence, and Bullying Victimization: Findings From Probability Samples of High School Students in 4 US School Districts 下载免费PDF全文
Allegra R. Gordon ScD MPH Kerith J. Conron ScD Jerel P. Calzo PhD MPH Matthew T. White PhD Sari L. Reisner ScD S. Bryn Austin ScD 《The Journal of school health》2018,88(4):306-314
BACKGROUND
Young people may experience school‐based violence and bullying victimization related to their gender expression, independent of sexual orientation identity. However, the associations between gender expression and bullying and violence have not been examined in racially and ethnically diverse population‐based samples of high school students.METHODS
This study includes 5469 students (13–18 years) from the 2013 Youth Risk Behavior Surveys conducted in 4 urban school districts. Respondents were 51% Hispanic/Latino, 21% black/African American, 14% white. Generalized additive models were used to examine the functional form of relationships between self‐reported gender expression (range: 1 = Most gender conforming, 7 = Most gender nonconforming) and 5 indicators of violence and bullying victimization. We estimated predicted probabilities across gender expression by sex, adjusting for sexual orientation identity and potential confounders.RESULTS
Statistically significant quadratic associations indicated that girls and boys at the most gender conforming and nonconforming ends of the scale had elevated probabilities of fighting and fighting‐related injury, compared to those in the middle of the scale (p < .05). There was a significant linear relationship between gender expression and bullying victimization; every unit increase in gender nonconformity was associated with 15% greater odds of experiencing bullying (p < .0001).CONCLUSIONS
School‐based victimization is associated with conformity and nonconformity to gender norms. School violence prevention programs should include gender diversity education.20.
Trend Disparities in Emotional Distress and Suicidality Among Sexual Minority and Heterosexual Minnesota Adolescents From 1998 to 2010 下载免费PDF全文
Carolyn M. Porta PhD MPH RN SANE‐A FAAN Ryan J. Watson PhD Marion Doull PhD Marla E. Eisenberg ScD MPH Nathan Grumdahl BSN RN PHN Elizabeth Saewyc PhD RN FSAHM FCAHS FAAN 《The Journal of school health》2018,88(8):605-614