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1.
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.2.
Variation in Nutritional Quality of School Lunches With Implementation of National School Lunch Program Guidelines 下载免费PDF全文
Jillian M. Joyce MS RD Richard R. Rosenkranz PhD Sara K. Rosenkranz PhD 《The Journal of school health》2018,88(9):636-643
BACKGROUND
School lunches must meet National School Lunch Program (NSLP) requirements to receive reimbursement. In this study, we sought to determine whether there are significant differences in nutrient content and nutritional quality between 2 menus meeting NSLP requirements.METHODS
A cross‐sectional content analysis compared 6 weeks of a typical school lunch menu (TM) from an actual school district to a best practice school lunch menu (BPM) created by a registered dietitian based on Child and Adult Care Food Program (CACFP) best practices and Dietary Guidelines for Americans (DGA) healthy meal pattern recommendations. Daily nutrient content was determined using nutrient analysis software. Nutritional quality was computed using Healthy Eating Index (HEI) 2010.RESULTS
For nutrients required for analysis, the BPM was lower in calories, saturated fat, and sodium and higher in protein, carbohydrate, and fiber (ps < .01). For other nutrients of concern, the BPM was higher in vitamin A, vitamin D, phosphorus, and magnesium (ps < .01). The BPM had higher HEI scores for nutritional quality (p < .001).CONCLUSIONS
Results indicate the possibility for significant variation in nutritional quality of NSLP‐qualifying lunches. Using CACFP best practices and DGA recommendations may significantly impact school lunch dietary quality.3.
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.4.
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.5.
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.6.
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.7.
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.8.
David Gregg PhD Cheryl L. Somers PhD Francesca Maria Pernice PhD Stephen B. Hillman PhD Poco Kernsmith PhD 《The Journal of school health》2018,88(6):423-433
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.9.
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.10.
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.11.
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.12.
Active Commuting to School,Physical Activity,and Behavior Problems Among Third‐Grade Children 下载免费PDF全文
Mana Mann MD MPH Ellen J. Silver PhD Ruth E. K. Stein MD 《The Journal of school health》2018,88(10):734-743
BACKGROUND
We examined factors associated with active commuting to school and the relationships of active commuting and physical activity to child‐ and teacher‐reported internalizing and externalizing behavior problems in a sample of third graders.METHODS
The study sample consisted of 13,166 third graders enrolled in the Early Childhood Longitudinal Study Kindergarten Class of 1998‐1999. “Active” commuters were children who walked to school and “passive” commuters were those who took the bus or were driven. Linear analyses evaluated differences in behavior problems by school commute, physical activity, and sports team participation after adjusting for sociodemographic, regional, and neighborhood factors.RESULTS
Overall, 11% of children actively commuted. Type of commute differed by sociodemographics, region, urbanicity, school type, and neighborhood safety. Active commuters had less general physical activity participation and sports team participation. Commuting type and general physical activity were not associated with behavior problems, but sports team participation was associated with fewer child‐reported internalizing and externalizing behaviors as well as fewer teacher‐reported internalizing behaviors.CONCLUSIONS
Our findings demonstrate the ongoing need for creating and maintaining physical activity programs (such as sports teams) among school‐aged children to optimize children's overall health and well‐being.13.
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.14.
15.
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.16.
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.17.
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.18.
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.19.
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.20.
Collaboration Challenges and Opportunities: A Survey of School Foodservice Directors and Community Health Coalition Members 下载免费PDF全文