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1.

BACKGROUND

Risks associated with teen sexting draw increasing concern from teachers and communities as developments in communication software and devices make sharing private content faster and simpler each year. We examined rates, recipients, and predictors of teen sexting to better plan education and preventative policies and strategies. A comprehensive literature review was conducted to determine the most likely predictors of teen sexting using prior survey studies and theoretical conceptions.

METHODS

We surveyed 314 high school students in an urban area of a large Midwestern city.

RESULTS

Males were found to more frequently report sexting. Impulsivity, frequency of electronic communication, peer pressure, peer sexting, and social learning significantly predicted sexting beyond age, race, and sex. Self‐esteem did not moderate the effect of peer pressure to sext. Structural predictive models attained good fit to the data, and neither were moderated by sex.

CONCLUSIONS

Sexting was highly associated with reported peer pressure, perceived norms, and impulsive decision making. Adolescents in relationships may be at particular risk of sexting. These findings will help parents, teens, and educators take appropriate measures to inform about and encourage the safe use of technology.
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2.

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.
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3.

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.
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4.

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.
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5.

BACKGROUND

Currently, no intervention concerning transition of health care responsibilities from parents to teens exists for adolescents in the general population. The purpose of this intervention was to evaluate teacher satisfaction and student knowledge gain of a health unit developed for adolescents on becoming their own health care advocates.

METHODS

Throughout the 2014–2015 school year, 13 health and career technical education teachers in 11 Delaware high schools taught the unit to 948 students in 2 90‐minute classes in 35 classrooms. Assessments included teacher reflections and student pre‐ and posttests to measure knowledge transfer and gain and gather feedback.

RESULTS

Teacher and student feedback indicated the materials were appropriate and useful in teaching students to navigate the health care system. Student knowledge increased from pretest (64%) to posttest (82%), (p < .001). The educational background of the teacher did not influence this outcome. Students reported they will know what to do better at their next doctor's appointment because of this unit and indicated support for peers to learn this information.

CONCLUSIONS

The unit resulted in content knowledge increase for students. It was consistently effective throughout all schools regardless of social and demographic characteristics, teacher type, or experience teaching the unit.
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6.

BACKGROUND

We examined the effects of the Galaxy Rescuers game, a collaborative board game on schoolchildren's bullying intervention.

METHODS

We conducted a group‐randomized controlled trial. We recruited 328 fifth graders at an elementary school in northern Taiwan. The study took place in fall 2015 over a 7‐week period. We used the generalized estimation equation (GEE) to evaluate the intervention effects on students' scores on the outcome measures.

RESULTS

At posttest, the change in bullying knowledge was statistically significant for the game‐only group and the game‐with‐debriefing group. Students in the game‐with‐debriefing group also showed an increase in empathy and a decrease in bullying attitude. At the follow‐up test, knowledge increase remained significant for both the game‐only group and the game‐with‐debriefing group. Game satisfaction survey indicated that 66.8% of the players said that the game was enjoyable.

CONCLUSIONS

The Galaxy Rescuers game is effective in changing players' bullying knowledge, attitude, and empathy. This game is an entertaining tool for promoting awareness of bullying and encouraging defending atmosphere among children.
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7.

BACKGROUND

Sexual minority young people have demonstrated higher rates of emotional distress and suicidality in comparison to heterosexual peers. Research to date has not examined trends in these disparities, specifically, whether there have been disparity reductions or increases and how outcomes have differed over time by sex and sexual orientation group.

METHODS

Minnesota Student Survey data, collected from 9th and 12th graders in 3 cohorts (1998, 2004, 2010) were used to examine emotional distress and suicidality rates. Logistic regression analyses were completed to examine outcome changes over time within and across sexual orientation/sex groups.

RESULTS

With few exceptions, sexual minority youth are at increased risk of endorsing emotional distress and suicidality indicators in each surveyed year between 1998 and 2010. Young people with both‐sex partners reported more emotional distress across all health indicators compared to their opposite‐sex partnered peers. With a few exceptions, gaps in disparities between heterosexual and sexual minority have not changed from 2004 to 2010.

CONCLUSIONS

Disparities in emotional health persist among youth. Research is needed to advance understanding of mental health disparities, with consideration of sexual orientation differences and contextualized to sociocultural status and changes over time. Personalized prevention strategies are needed to promote adolescent mental health.
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8.

BACKGROUND

School‐level socioeconomic status (SES) influences on adolescents' lifestyle behaviors is understudied. We examined how school‐level SES and sex influence adolescents' health‐related lifestyle behaviors and intentions.

METHODS

Grade 8 students aged 13‐14 years completed an online questionnaire regarding their sociodemographic characteristics, dietary behaviors, physical activity participation and recreational screen‐time, and intentions regarding these behaviors. School‐level SES, based on an Index of Community Socio‐Educational Advantage (ICSEA), was categorized as low or high. Generalized estimating equations estimated individual‐level summary statistics, adjusted for clustering.

RESULTS

Students (N = 2538; response rate = 79%) from 23 high schools (low ICSEA = 16) participated. Compared with low ICSEA students, high ICSEA students were more likely to report eating breakfast daily (OR 1.9 [95% CI 1.5, 2.4]), not drinking sugar‐sweetened beverages (SSBs) daily (2.9 [1.9, 4.3]), and were more likely to have intentions to eat breakfast (1.8 [1.3, 2.3]) and ≥ 5 vegetable serves (1.2 [1.0, 1.5]) daily. Boys were more likely than girls to meet recommendations for breakfast eating, vegetable intake, moderate‐to‐vigorous physical activity and screen‐time, but boys were less likely to meet recommendations regarding SSB intake.

CONCLUSIONS

Students from low ICSEA schools would benefit from additional support to improve dietary‐related behaviors and intentions. More research is required to identify what targeted approaches will address sex differences in adolescents' lifestyle behaviors.
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9.

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.
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10.

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.
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11.

BACKGROUND

Research demonstrates a link between decreased cognitive function in overweight school‐aged children and improved cognitive function among students with high fitness levels and children engaging in regular physical activity (PA). The purpose of this study was to examine whether regular PA and proper nutrition together had a significant effect on academic achievement.

METHODS

Using the seventh wave of the Early Childhood Longitudinal Study, Kindergarten Class 1998–99 (ECLS‐K) dataset, linear regression analysis with a Jackknife resampling correction was conducted to analyze the relationship among nutrition, PA, and academic achievement, while controlling for socioeconomic status, age, and sex. A nonactive, unhealthy nutrition group and a physically active, healthy nutrition group were compared on standardized tests of academic achievement.

RESULTS

Findings indicated that PA levels and proper nutrition significantly predicted achievement scores. Thus, the active, healthy nutrition group scored higher on reading, math, and science standardized achievement tests scores.

CONCLUSIONS

There is a strong connection between healthy nutrition and adequate PA, and the average performance within the population. Thus, results from this study suggest a supporting relationship between students' health and academic achievement. Findings also provide implications for school and district policy changes.
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12.

BACKGROUND

Sedentary behavior is linked to many adverse health outcomes; however, its relationship with academic achievement is less understood. We examined sedentary behavior's impact on academic achievement over 3 years in 4408 adolescents from the COMPASS study.

METHODS

Sedentary behavior (screen‐based: watching/streaming television shows/movies, video/computer games, surfing the internet; communication‐based: texting/messaging/emailing, talking on the phone; and doing homework) and academic achievement (overall math and English marks) were self‐reported.

RESULTS

Holding time fixed, moving from the lowest quartile (Q1) to Q2, Q3, or Q4 of watching/streaming television shows/movies (Q2: OR = 0.90; 95%CI: 0.84‐0.97, Q3: OR = 0.85; 95%CI: 0.74‐0.98, Q4: OR = 0.74; 95%CI: 0.64‐0.85) or to Q2 of surfing the internet (Q2: OR = 0.87; 95%CI: 0.78‐0.97) decreased the likelihood of surpassing English standards. Moving from Q1 to Q2 of communication‐based sedentary behavior (OR = 0.90; 95%CI: 0.82‐0.99) decreased the likelihood of surpassing math standards. Moving from Q1 to Q4 (OR = 1.31; 95%CI: 1.15‐1.50) of watching/streaming television shows/movies increased the likelihood of surpassing math standards. Moving from Q1 to Q4 of doing homework (OR = 1.16; 95%CI: 1.02‐1.31) increased the likelihood of surpassing English standards.

CONCLUSIONS

Predicting academic achievement from total sedentary behavior is challenging. Targeting specific types of sedentary behavior should be considered for improving math and English achievement.
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13.

BACKGROUND

Positive associations between suicidal behaviors and asthma have been established in previous adolescent studies. Few studies consider social risk factors, such as bullying. This study involved an analysis of suicidal behaviors and asthma, but also includes an assessment of whether these relationships were modified by the co‐occurrence of bullying.

METHODS

Data included 13,154 participants from the 2013 Youth Risk Behavior Survey (YRBS), collected by the US Centers for Disease Control and Prevention. Logistic regression models were constructed and summarized using odds ratios (ORs) and 95% confidence intervals (95% CIs).

RESULTS

When comparing adolescents with asthma who were bullied at school to those who were not bullied at school, the odds of contemplating suicide were increased by nearly 2‐fold (OR = 1.8, 95% CI = 1.5‐2.3), and the odds of creating a suicide plan were 2.3 times higher (OR = 2.3, 95% CI = 1.7‐3.1). The odds of a suicide attempt and incurring an injury from a suicide attempt were also substantially increased. Similarly, increased odds of suicidal behaviors were observed for adolescents with asthma who were bullied electronically.

CONCLUSION

Having asthma and being bullied are both associated with increased odds of suicidal behaviors.
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14.

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.
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15.

BACKGROUND

Although previous research indicates an association between school connectedness and adolescents' sleep quality, its causal direction has not been determined. This study used a 2‐wave cross‐lagged panel analysis to explore the likely causal direction between these 2 constructs.

METHODS

Participants were 888 Chinese adolescents (43.80% boys; Mage = 15.55) who provided self‐report data on school connectedness and sleep quality as well as demographic variables at the beginning and the end of a school year.

RESULTS

After controlling for sex and age, we found that sleep problems at the beginning of the school year were a significant and negative predictor of school connectedness at the end of the school year (b2 = ?.26, SE = .13, β2 = ?.10, p < .05), but school connectedness at the beginning of the school year did not predict sleep problems at the end of the school year (b1 = .05, SE = .03, β1 = .09, p > .05). Separate analyses by sex showed that the above pattern of results was mainly driven by the boys.

CONCLUSIONS

Our findings demonstrated that sleep problems could be a risk factor for adolescent boys' school connectedness.
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16.

BACKGROUND

Motor competence (MC) affects numerous aspects of children's daily life. The aims of this study were to: evaluate MC, provide population‐based percentile values for MC; and determine the prevalence of developmental coordination disorder (DCD) in Spanish schoolchildren.

METHODS

This cross‐sectional study included 1562 children aged 4 to 6 years from Castilla‐La Mancha, Spain. MC was assessed using the Movement Assessment Battery for Children‐Second Edition. Values were analyzed according to age, sex, socioeconomic status (SES), environment (rural/urban), and type of school.

RESULTS

Boys scored higher than girls in aiming and catching, whereas girls aged 6 scored higher than boys in balance. Children living in rural areas and those attending to public schools obtained better scores in aiming and catching than those from urban areas and private schools. The prevalence of DCD was 9.9%, and 7.5% of children were at risk of having movement problems.

CONCLUSION

Motor test scores can represent a valuable reference to evaluate and compare the MC in schoolchildren. Schools should identify motor problems at early ages and design initiatives which prevent or mitigate them.
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17.

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.
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18.

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.
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19.

BACKGROUND

Significant proportions of young people experience body dissatisfaction, which has implications for psychological and physical well‐being. Lesson content and perceived competence may be important variables for the experience of body dissatisfaction, yet these have been underexplored in physical education. The aim of this cross‐sectional study is to identify the relationships between body dissatisfaction and perceptions of competence, and to explore whether body dissatisfaction depends on lesson content.

METHODS

A paper‐and‐pencil questionnaire was completed by 446 (210 boys, 236 girls) 13‐ to 14‐year‐old pupils from 37 physical education classes. The questionnaire assessed body dissatisfaction and perceived competence in physical education. Lesson content was also recorded. Twenty‐nine of the classes were engaged in team activities, eg, ball games. Eight classes were engaged in individual activities, eg, fitness.

RESULTS

Multilevel analysis identified a significant negative association between body dissatisfaction and perceptions of competence in physical education. Lesson content did not significantly predict variations in body dissatisfaction scores.

CONCLUSIONS

Teachers should focus on enhancing pupils' perceptions of competence in physical education to support the development of body satisfaction.
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20.
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