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School-based risk behavior surveys traditionally have been administered via paper-and-pencil. This study assessed the feasibility of conducting in-class online surveys in US high schools. A paper-and-pencil questionnaire assessing computer availability and perceptions of online surveys was mailed to a nationally representative sample of public and private high school principals in fall 2008. Completed surveys were returned by principals from 580 of 704 selected schools. Prevalence and 95% confidence intervals were computed. Most high schools have at least 1 computer lab, most computers in computer labs are connected to the Internet, and just under half of schools with a stationary computer lab had a sufficient number of computers to accommodate an in-class online survey administration. The 2 most common problems associated with online surveys were logistics of providing enough computers for an entire class and rotating classes into computer labs. Nearly two thirds of principals preferred online to paper-and-pencil surveys when administered to 4 randomly selected classes that met at different times during the school day, but less than half reported this preference when administered to 4 randomly selected classes that met at the same time during the school day. Many schools do not have sufficient computer capacity to participate in a voluntary in-class online survey. An online survey could impose significant perceived and actual burden on schools and therefore could result in unacceptably low school participation rates. Online administration for in-class surveys of students in US high schools are not recommended. [ABSTRACT FROM AUTHOR]

Handwashing in the school setting is important for infectious disease control, yet maintaining adequate handwashing supplies is often made difficult by lack of funds, limited staff time, and student vandalism. This study measured the availability of handwashing supplies for students in New Mexico public schools and determined the impact of scheduled school nurse inspections on the availability of handwashing supplies. Participating school districts in New Mexico were matched by size and randomized into intervention and control groups. Baseline inspections were conducted in November 2008 followed by 2 subsequent bimonthly inspections. For each student bathroom, the presence or absence of soap and either paper towels or hand dryers was indicated on an inspection checklist. The intervention group reported findings to the New Mexico Department of Health (NMDOH) and to school administrative and custodial staff requesting that any identified problems be addressed. The control group reported inspection findings to the NMDOH only. Descriptive analyses were conducted to determine the proportion of bathrooms with soap and either paper towels or hand dryers. Comparisons were made between the intervention schools and the control schools at baseline and during the intervention period. The intervention group had significantly higher probability of bathrooms being supplied with soap ( p < .05) and paper towels/hand dryers ( p < .02) during the intervention period. Regularly scheduled school nurse inspections of hand hygiene supplies, with reporting to appropriate school officials, can improve the availability of handwashing supplies for students. [ABSTRACT FROM AUTHOR]

Multiple approaches exist, both in theory and in practice, to reduce young people's risk of violent victimization when they are in school. Among these approaches, a growing number of school districts are choosing to install metal detectors. We sought to review the literature available on the impacts of metal detectors on school violence and perceptions about school violence. We conducted an extensive literature search, including databases for the medical, public health, sociology, and political science literature. Of 128 papers that met our search criteria, 7 studies met inclusion criteria for the literature review. Each of the papers reviewed utilized data that originated from self-report surveys. Four of the studies consisted of secondary analyses of national databases, with the other 3 utilizing local surveys. The studies varied as to the outcome, ranging from student/staff perceptions of safety at school to student self-reports of weapon carrying and/or victimization, and showed mixed results. Several studies suggested potential detrimental effects of metal detectors on student perceptions of safety. One study showed a significant beneficial effect, linking metal detector use to a decrease in the likelihood that students reported carrying a weapon while in school (7.8% vs 13.8%), without a change in weapon carrying in other settings or a decline in participation in physical fights. There is insufficient data in the literature to determine whether the presence of metal detectors in schools reduces the risk of violent behavior among students, and some research suggests that the presence of metal detectors may detrimentally impact student perceptions of safety. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mississippi (MS) Delta adults and youth report obesity rates far exceeding those of the state and nation. State law requires in-school physical activity and nutrition practices to address childhood obesity but does not require evaluation of outcomes, specifically the impact on weight-related outcomes. This paper offers 3 things: (1) describes the weight status of elementary school-age children in the MS Delta; (2) explains the importance of including waist-to-height ratio (WHtR) values when reporting body mass index (BMI); and (3) provides impetus for policy that requires weight-related health risk, as measured by WHtR, to be assessed regularly as a means to evaluate school health policy. METHODS: We took anthropometric measures in a cross-sectional investigation of 1136 children from 11 public elementary schools in the MS Delta. Measures included BMI, waist circumference (WC) and WHtR. RESULTS: The prevalence of overweight and obesity (BMI ≥85th percentile) was 47.1% (18.3% overweight and 28.8% obese). In this sample, 59.9% and 42.0% were 'at risk' for weight-related chronic disease based on WC (≥75th percentile) and WHtR (>0.5), respectively. The differences in these proportions were statistically significant. The predominantly black districts reported higher on all of the weight-related measures. CONCLUSIONS: Investigators recommend the assessment of health policy include measures of health risk in addition to BMI, namely WHtR as it accounts for growth in both WC and height over age. Furthermore, WHtR is a more accurate indicator of fat distribution and health risk than WC alone. [ABSTRACT FROM AUTHOR]

Weight perception has been studied with a limited focus on 'feeling overweight.' This study, using a more inclusive definition of overestimation and underestimation, examines adolescents' weight perception focusing on how accurate it is in relation to body mass index (BMI)-based weight status and how it varies across socio-demographic factors. Data are from the 2007 Minnesota Student Survey, a paper-and-pencil survey completed in the classroom by students in public schools. The final analyses were based on the data from 87,418 high school students who were asked about their height and weight. Weight perception and the BMI-based weight status (based on self-reported weight and height) were strongly and positively correlated, but substantial discordance was observed with more than a quarter of the students (27.6%) having discordant weight perception. Males, minorities, and those from low-income households were more likely than their respective counterparts to have a discordant weight perception. Overall, underestimation was more prevalent than overestimation. Girls were more likely to overestimate, while boys were more likely to underestimate. Black and Hispanic females and those from low-income households were more likely to underestimate than overestimate their weight, while Asian/Pacific Islander males were more likely to overestimate than underestimate. If underestimation is more prevalent among Black or Hispanic females and those from low-income households, the already higher prevalence of obesity among these groups is unlikely to decrease. Overestimation, on the other hand, can be a risk factor for unhealthy weight-control behaviors. Monitoring adolescents' perceived weight in addition to their BMI is critical to understanding the challenge we face with childhood obesity. [ABSTRACT FROM AUTHOR]

ABSTRACT: The Safe and Drug-Free Schools and Communities Act (SDFSCA) provides funding for prevention education to nearly every school district in the nation. Recent federal policy requires SDFSCA recipients to implement evidence-based prevention programs. This paper reports the extent to which North Carolina public school districts implement evidence-based substance use prevention curricula. Results showed that while the majority of school districts use evidence-based prevention curricula, they are rarely the most commonly used curricula. Evidence-based curricula are much more likely to be used at the middle school level than at the elementary or high school levels. Urbanicity, coordinator time, and coordinator experience correlated with extensive use of evidence-based curricula in the bivariate analysis, but only time spent on prevention by the Safe and Drug-Free Schools (SDFS) coordinator significantly predicted extensive use in the multivariate analysis. Increasing district SDFSCA coordinator time is a necessary step for diffusing evidence-based curricula. (J Sch Health. 2004;74(9):353-358). [ABSTRACT FROM AUTHOR]

BACKGROUND: Associations between school participation in an academic medical center‐supported school‐based wellness initiative and programmatic components implemented with change in average student body mass index (BMI) over time were examined. METHODS: This was an observational study of 103 K‐12 South Carolina schools over school years 2014‐2018, classified as participating (n = 87 schools, 27,855 students) or non‐participating (n = 16 schools; 3608 students). Associations between students' BMI z‐score (BMIz) and school participation were evaluated by linear multilevel mixed‐effects modeling using data from FitnessGram and the School Wellness Checklist© (SWC), respectively. RESULTS: One‐third of the students had a BMI percentile ≥85. Average student BMIz decreased in participating schools (p =.026) and increased in non‐participating schools (p =.004) over time. For schools that participated two or more years, there was an inverse relationship between SWC score and student BMIz (p =.002) that did not differ by school type, rural/urban location, Title 1 status, or student sex. Physical activity and stress management interventions for students, as well as employee wellness and establishing a wellness committee at the school level were significantly associated with decreased average student BMIz (all p <.05). CONCLUSION: Implementation of similar comprehensive school‐based wellness programs focused on improving physical activity, stress management, and employee engagement may help prevent and reduce pediatric obesity in diverse communities. [ABSTRACT FROM AUTHOR]

BACKGROUND: As a result of national lockdown due to the COVID‐19 outbreak, teachers were forced to suspend their classes and replace them with online teaching and home schooling. Additional stressors such as competing family responsibility have increased their worries and mental health problems. The aim of this study was to determine the impact of COVID‐19‐related worries on teachers' emotional symptoms, considering the mediating role of several protective factors. METHODS: A total of 614 Chilean teachers (94.60% women) participated in this study using a cross‐sectional design and incidental sampling method. Self‐report data was collected assessing emotional symptoms, COVID‐19‐related worries, life satisfaction, affect balance, and resilience. Descriptive analyses, Pearson's correlations, hierarchical regressions, and mediation models were conducted. RESULTS: The results indicated that emotional symptoms were associated with prepandemic physical and mental health problems, higher levels of worries and negative affect, as well as lower levels of life satisfaction and resilience. Results from the mediation models showed that the negative impact of COVID‐19‐related worries on emotional symptoms was alleviated by affect balance and resilience. CONCLUSIONS: These findings highlight the importance of addressing the risk and protective factors for teachers' mental health during exceptional situations such as the ongoing pandemic. [ABSTRACT FROM AUTHOR]

Background: There is a gap in the literature regarding data on sexting among youth under the age of 16 whereas the problems related to this practice could affect them more because of their ongoing development. This study aims to determine the prevalence rate and characteristics of sending one's own sexually related image among middle‐school teens. Methods: Data were obtained from a web‐based in‐school survey conducted between October 2019 and February 2020. The sample comprised 3006 (mean age 13.7; 50.2% males) 10th‐grade pupils in the canton of Vaud (Switzerland). Participants were asked "Have you ever sent a sexually related/sexy image of yourself?". Analysis of variance/chi‐square tests and multinomial regression analyses were used to compare the groups. Results: Overall, 93.0% reported never, 3.7% once and 3.3% several times. No gender differences were found. Sending was associated with older age, low academic performance, cyberbullying victimization and reception of unsolicited sexually related images. Conclusions: Education and health professionals should be aware that it is necessary to discuss the theme, perhaps with a more global approach including pressure, consent, exchange of nonsexual images, and so on from an early age. The context and reasons for sending remain to be explored, particularly to determine if the pressure is greater at this age. [ABSTRACT FROM AUTHOR]

BACKGROUND: Developmental assets foster positive health outcomes among adolescents, but have not been studied in adolescents with chronic illness or depression, two conditions that impact behaviors in school. We examined parent‐reported assets in a national sample of adolescents and compared the number and types of assets by health statuses. METHODS: Data were from the 2016 National Survey of Children's Health (N = 15,734 adolescents), which captured 15 of 40 assets in the Developmental Assets Framework. We categorized adolescents as healthy; chronic physical illness alone; depression alone; and chronic physical illness with co‐morbid depression. Data were analyzed using analysis of variance and logistic regression. RESULTS: Healthy adolescents and those with chronic physical illness alone were comparable in number and types of assets. Adolescents with chronic physical illness and co‐morbid depression had fewer assets compared to healthy adolescents and those with chronic physical illness alone. Similar associations were found in comparing healthy adolescents to those with depression without chronic physical illness. CONCLUSIONS: The presence of depression, among adolescents with and without chronic physical illness, was associated with fewer internal and external assets. The absence of assets may serve as a unique indicator of underlying depressive symptoms among adolescents in the school setting. [ABSTRACT FROM AUTHOR]

BACKGROUND: We present results of the development and feasibility testing of CATCH Healthy Smiles, a school‐based oral health program, among children in grades K‐2 in Houston, Texas. METHODS: Study design was cross‐sectional (N = 2 schools; N = 125 parent‐child dyads; 31 kindergarteners, 42 first graders, and 52 second graders). CATCH Healthy Smiles program was implemented by trained school teachers in the 2016‐2017 school year. Trained dentists conducted dental assessments to measure dental caries increment score (d3mfs). Parent‐reported 24‐hour dietary recalls and surveys assessed child and parent behavioral, environmental, and psychosocial factors. Logistic regression analysis assessed factors associated with caries experience adjusting for covariates. RESULTS: Of the 113 children with complete dental assessments, 54% children in grade K, 62% in first grade, and 73% in second grade had caries experience. Children with caries experience had a higher body weight (AdjOR = 1.13, 95% confidence interval [CI]: 1.02‐1.29), were less likely to be girls (AdjOR = 0.22, 95% CI: 0.05‐0.82), had greater odds of difficulty drinking hot or cold beverages because of dental problems (AdjOR = 13.13, 95% CI: 1.09‐275.14), greater frequency of consuming sugar‐sweetened beverages (AdjOR = 11.53, 95% CI: 2.10‐87.19), greater odds of receiving government assistance (AdjOR = 14.62, 95% CI: 2.74‐119.81), and lower odds of seeing a dental provider (AdjOR = 0.11, 95% CI: 0.02‐0.45). Process evaluation showed that 100% of the CATCH Healthy Smiles lessons and activities were taught in the two schools with a high degree of program fidelity and acceptability across the schools, children, and parents. CONCLUSIONS: These data will be used to conduct a subsequent fully powered cluster randomized controlled trial. [ABSTRACT FROM AUTHOR]

BACKGROUND: Limited research has addressed the effects of health literacy interventions in elementary schools. However, school‐aged children's health literacy is critical because children make decisions about their health every day. The purpose of the pilot project was to explore the feasibility of integrated health literacy lesson plans for second graders. METHODS: A pretest‐posttest evaluation was conducted with second grade students following implementation of health literacy lessons that were integrated into core curriculum (language arts, science, and social studies). RESULTS: Health educators, a hospital/health care system, and a school district developed a partnership. A research team of teachers, administrators, health literacy experts and health care organizations designed and implemented health literacy lesson plans. A developmentally appropriate measure of health literacy was adapted from the Newest Vital Sign. Data showed that students' health literacy scores significantly increased after implementation of 4 lesson plans. CONCLUSIONS: This was an exploratory, pilot project that provided a useful starting point for discussing how to integrate health literacy into elementary school curriculum. An interdisciplinary team developed integrated health literacy materials that acknowledged the needs of teachers, the resources available, and the developmental stages of children. This intervention serves as a model for future health literacy initiatives in schools. [ABSTRACT FROM AUTHOR]

BACKGROUND: In this study, we explore how a health education course may play a role in pre‐service teachers' perceptions in teaching and integrating health education activities to nurture K‐8 students' health literacy. METHODS: We used mixed methods to examine the effect of a health education course in a teacher education program. Of 55 pre‐service teachers, 41voluntarily participated in the study. Quantitative data were obtained through an online questionnaire administered to participants at the beginning and end of the course. We conducted 6 focus groups at the end of the course. RESULTS: The inferential analysis from a series of analysis of variance with repeated measures revealed significant differences in health knowledge (F = 113.39, p <.01, η2 = 0.74), preparedness (F = 104.74, p <.01, η2 = 0.73), attitudes (F = 15.02, p <.01, η2 = 0.28), and beliefs (F = 8.87, p <.01, η2 = 0.19) between time points. Qualitative data led to the conclusion that where one health education course is insufficient, such a course is the first step into future curriculum development and implementation. CONCLUSION: One health education course might be beneficial for general education teachers to increase their knowledge and preparation to teaching school health. On‐going training is needed for program success. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Prior research identified 4 distinct dating trajectories from 6th to 12th grade: Low, Increasing, High Middle School, and Frequent. The purpose of this study was to examine whether 10th graders in the Low dating group differed on emotional, interpersonal, and adaptive skills from youth in the other trajectories. METHODS: The sample consisted of 594 10th graders. We compared the 4 dating groups using teacher ratings (social skills, leadership, depression) and student self‐reports (positive relationships with friends, at home, and at school; depression, suicidal ideation). To compare scores by dating trajectory, we used chi‐square test and analysis of variance. RESULTS: Students in the Low dating group had significantly higher teacher ratings of social skills and leadership, and lower ratings of depression compared to the other groups. Self‐reports of positive relationships did not differ by dating groups. Self‐reported depression was significantly lower in the Low dating group, but suicidal ideations did not differ. CONCLUSION: Adolescents who were not in a romantic relationship had good social skills and low depression, and fared better or equal to peers who dated. These results refute the notion that non‐daters are maladjusted. Health promotion interventions in schools should include non‐dating as one option of healthy development. [ABSTRACT FROM AUTHOR]

BACKGROUND: Workplace safety and health is a major public health concern, but largely absent from the school health curriculum. Little is known about teachers' perceptions of teaching workplace safety and health topics. METHODS: We administered a 41‐item questionnaire reflecting the theory of planned behavior, modified to measure knowledge, to 242 middle and high school teachers in career and technical education and academic subjects. We conducted confirmatory factor analysis to assess the measures' psychometric properties and factorial ANOVAs to compare differences among participants' knowledge, attitude toward, self‐efficacy, and intention (to teach) workplace safety and health by sex, prior work injury, and main subject taught. RESULTS: Confirmatory factor analyses indicated the measures reflected the theory. Factorial ANOVAs suggested female teachers had statistically significantly lower mean self‐efficacy scores than did male teachers to teach workplace safety and health. Male occupational career and technical education teachers demonstrated higher mean knowledge scores than male teachers in other subjects. Participants not injured at work had higher knowledge scores than those who had been injured. CONCLUSION: Self‐efficacy (influenced by sex) and knowledge (influenced by subject taught and previous workplace injury) revealed factors that may affect teachers' provision of workplace safety and health education, a critical yet overlooked component of school health. [ABSTRACT FROM AUTHOR]

BACKGROUND: Emergent evidence suggests a positive school climate may be a promising population‐level intervention to promote academic achievement and student well‐being. However, researchers have called for expanding the school climate evidence‐base to better describe how the construct is associated with student outcomes. The purpose of this study was to determine the associations between 10 school climate domains and academic achievement among middle and high school students. METHODS: ANOVAs were used to analyze survey data from 6–12 grade students in a Mid‐Atlantic US state (n = 2405, response rate: middle school = 82.4%, 50.5% female; high school = 62.5%, 56.1% female). RESULTS: Significant main effects were found for all school climate domains and varied between middle and high school students apart from academic support. Effect sizes ranged from small to medium, with academic support demonstrating the strongest effects among both middle and high school students. CONCLUSIONS: Findings suggest school climate is associated with academic achievement for both middle and high school students. Correctly identifying the role of key aspects of school climate by grade‐level may provide improved and developmentally appropriate recommendations for the delivery of instruction and school‐based interventions that promote positive school well‐being and student performance. [ABSTRACT FROM AUTHOR]

BACKGROUND: Bullying has been associated with many mental health problems. The effect of bullying has been found to be affected by the way students are involved in bullying. The purpose of the study was to explore the association between mental well‐being, hopelessness, and being involved in bullying (as a bully, victim, or bully‐victim), and to detect more harmful bullying types to students' mental well‐being. METHODS: The study was conducted among Estonian students from grades 5 to 9 (N = 2048). The survey was nationwide, cross‐sectional, anonymous, and web‐based by nature. Mental well‐being was assessed by using WHO‐5 well‐being index and hopelessness by 1‐item Beck Hopelessness Scale. RESULTS: The odds for being severely distressed (ie, students expressing both poor mental well‐being and hopelessness) were greater for both sexes bullying others and being victims of bullying. For bully‐victims the odds were greater for girls only. The victims of extensive cyber bullying expressed the lowest level of mental well‐being for both sexes. CONCLUSIONS: Boys might be the most vulnerable if being pure victims, while girls if being bully‐victims. More attention should be paid to cyber bullying, as victims of extensive cyber bullying had the lowest level of mental well‐being. [ABSTRACT FROM AUTHOR]

ABSTRACT: 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. [ABSTRACT FROM AUTHOR]

ABSTRACT: BACKGROUND: The purpose of this study was to characterize the temporal, social, and physical contexts for physical activities commonly reported in a diverse cohort of 753 boys and girls from fifth to seventh grade. METHODS: Data were obtained from a multilevel longitudinal study, the Transitions and Activity Changes in Kids. The Physical Activity Choices instrument assessed previous 5‐day participation in specific physical activities and their temporal, social, and physical contexts. Mixed model repeated measure analyses of variance and multinomial analyses examined sex differences and change over time. RESULTS: Fifth grade boys and girls reported participation in similar activities at similar frequencies, which declined significantly by seventh grade. One temporal pattern, playing with younger children, changed over time from “both inside/outside” to “outside” school. Boys and females reported more activities performed in class/team groups over time. Most activities took place primarily at home for all participants in both grades. CONCLUSIONS: Boys and girls reported declines in the variety and frequency of activities from fifth to seventh grade. There were sex‐specific patterns in physical activities and groups; however, all participants reported home as the primary location and a shift to class/team groups over time. Schools are well‐positioned to provide additional physical activity opportunities. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The aims of this study were to (1) examine the reactions of teachers and student teachers to children experiencing pain, (2) identify the most common challenges and potential resources that are associated to dealing with them, and (3) examine whether their responses differed as a function of their experience or sex. METHODS Forty teachers and 318 student teachers completed a survey which included descriptive information, a questionnaire that assesses different responses of participants to children who experience pain, and provides a list of problems and resources that participants might encounter and implement, respectively, when dealing with these children. RESULTS The study participants most often endorsed use of coping and health-promoting responses. Experienced teachers endorsed solicitous responses significantly more often than student teachers. Women reported responding more with solicitous responses than men. Absenteeism and the negative effect of pain on the ability of students to engage in school activities were the most common pain-related challenges mentioned by the study participants overall. CONCLUSIONS The findings emphasize (1) the need for developing guidelines to help teachers to help students experiencing chronic pain, and (2) the importance of including information about pediatric chronic pain in teachers training. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Schools are an important setting for improving behaviors associated with obesity, including physical activity. However, within schools there is often a tension between spending time on activities promoting academic achievement and those promoting physical activity. METHODS A community-based intervention provided administrators and teachers with a training on evidence-based public health and then collaborated with them to identify and implement environmental (walking track) and local school policy interventions (brain breaks). The evaluation included conducting in-depth interviews and SOPLAY observations to assess the facilitators and barriers and impact of the dissemination of environmental and policy changes. RESULTS Individual, organizational, intervention, and contextual factors influenced dissemination. Teachers reported that brain breaks increased student focus and engagement with classroom material and decreased student behavioral problems. Students decreased sedentary behavior and increased vigorous behavior. Of the 4 schools, 2 increased walking. CONCLUSIONS Active dissemination of environmental and policy interventions by engaging school administrators and teachers in planning and implementation shows potential for increasing physical activity in rural school settings. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Researchers have emphasized the importance of integrating mental health education with academic curriculum. The focus of the current studies was Mental Health Matters ( MHM), a mental health curriculum that is integrated with English language arts. It is taught by trained community member volunteers and aims to increase knowledge and decrease stigma toward individuals with mental health disorders. METHODS In Study 1, 142 sixth graders participated in MHM and completed pre- and postprogram measures of mental health knowledge, stigma, and program acceptability. Teachers also completed ratings of acceptability. Study 2 (N = 120 seventh graders) compared participants who had participated in MHM the previous year with those who had not using the same measures. RESULTS Sixth grade students and teachers rated the program as highly acceptable. Participants significantly increased their knowledge and decreased their levels of stigma. Seventh graders who had participated in MHM had significantly more mental health knowledge than peers who had not, but there were no differences in stigma. CONCLUSIONS The model appears to be acceptable to students and teachers. Future research is needed to assess the long-term effectiveness of integrating mental health education with other academic curriculum such as language arts or science. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Studies of body mass index (BMI) change have focused on understanding growth trajectories from childhood to adolescence and adolescence to adulthood, but few have explored BMI trajectories solely in elementary (grades K-5) school children. This report complements these studies by exploring changes in obesity status using analytic methods developed to investigate categorical changes in life-course events. METHODS Sequences of a 4-state BMI variable (underweight, normal, overweight, and obese) were calculated using height and weight data collected annually (2008-2013) from 414 kindergarten and first-grade students participating in the Community and Schools Together (CAST) project. These sequences were explored using the TraMineR software package to investigate the distribution of sequences and states, calculate transition rates among states, and examine clustering of sequences. RESULTS Aggregated cluster solutions were identified consisting of either 4 clusters (normal, stepped, mixed, and obese) or 3 clusters (aggregation of obese cluster cases into stepped cluster) with membership in the former predicted by ethnicity and socioeconomic status (SES) and the latter by SES alone. Transition rate patterns among states varied markedly by cluster and state. CONCLUSION The finding of early emergence of stable obesity states, especially in Hispanic children confirms the need for early childhood interventions to influence BMI. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Despite previous research indicating an adolescents' alcohol, tobacco, and other drug ( ATOD) use is dependent upon their sex and the sex composition of their social network, few social network studies consider sex differences and network sex composition as a determinant of adolescents' ATOD use behavior. METHODS This systematic literature review examining how social network analytic studies examine adolescent ATOD use behavior is guided by the following research questions: (1) How do studies conceptualize sex and network sex composition? (2) What types of network affiliations are employed to characterize adolescent networks? (3) What is the methodological quality of included studies? After searching several electronic databases ( PsycINFO, EBSCO, and Communication Abstract) and applying our inclusion/exclusion criteria, 48 studies were included in the review. RESULTS Overall, few studies considered sex composition of networks in which adolescents are embedded as a determinant that influences adolescent ATOD use. Although included studies all exhibited high methodological quality, the majority only used friendship networks to characterize adolescent social networks and subsequently failed to capture the influence of other network types, such as romantic networks. CONCLUSIONS School-based prevention programs could be strengthened by (1) selecting and targeting peer leaders based on sex, and (2) leveraging other types of social networks beyond simply friendships. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The ability to understand and manage emotional experience is critical to children's health. This study confirmed the validity of the How I Feel ( HIF) Questionnaire, a measure of children's emotional arousal and regulation, exploring its associations with measures of emotional and social functioning. METHODS The sample was comprised of 1379 Italian students (aged 8 to 12 years) who attended schools interested in the study aims. Participants completed the 30-item HIF scale, and measures of emotional self-efficacy and social desirability (SD). Factor structures were assessed using confirmatory factor analysis. Invariance by age and gender, internal consistency, temporal stability, and concurrent validity were also tested. RESULTS A 3-factor model was identified: frequency and intensity of (1) positive emotion - PE (8 items, α = .82), (2) negative emotion - NE (12 items, α = .86), and (3) positive and negative emotion control - EC (10 items, α = .77). This factor structure was invariant across age and gender groups. The HIF displayed moderate longitudinal stability over a 15-month period and a low social desirability effect. Positive emotion was positively associated with social acceptance and visibility, and negatively with social withdrawal. CONCLUSIONS The HIF is a reliable and valid measure for research and school intervention promoting students' emotional and mental health. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The aims of this study were to examine the relationships among physical activity (PA)-related beliefs and to determine to what extent Iranian adolescents in different stages of PA adoption differ in perceived benefits and barriers during a 3-year transition from junior high school to high school. METHODS Data were collected from female adolescents in 2010 (N = 558), of whom 412 provided follow-up data in 2013. One-way analysis of variance and logistic regression were conducted for statistical analysis. RESULTS Participants in the action and maintenance stages reported the greatest agreement with benefits. Pre-contemplators were about 4 times more likely to cite 'not enough time' than preparers ( OR = 3.95). Pre-contemplators were over 4 times more likely to cite not liking exercise than those in action and maintenance stages at baseline ( OR = 4.32 and 4.85), a finding which was maintained at follow-up ( OR = 3.66 and 8.65). CONCLUSIONS These findings could help with the creation of interventions tailored to encourage pre-contemplators to progress toward adoption of PA. Providing transportation supports, enhancing time management, and mitigating boredom may be helpful strategies either to prevent relapse in adoption stages or to move females in early stages of change toward action and maintenance. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND According to commercial marketing theory, a market orientation leads to improved performance. Drawing on the social marketing principles of segmentation and audience research, the current study seeks to identify segments to examine responses to a school-based alcohol social marketing program. METHODS A sample of 371 year 10 students (aged: 14-16 years; 51.4% boys) participated in a prospective (pre-post) multisite alcohol social marketing program. Game On: Know Alcohol ( GO: KA) program included 6, student-centered, and interactive lessons to teach adolescents about alcohol and strategies to abstain or moderate drinking. A repeated measures design was used. Baseline demographics, drinking attitudes, drinking intentions, and alcohol knowledge were cluster analyzed to identify segments. Change on key program outcome measures and satisfaction with program components were assessed by segment. RESULTS Three segments were identified; (1) Skeptics, (2) Risky Males, (3) Good Females. Segments 2 and 3 showed greatest change in drinking attitudes and intentions. Good Females reported highest satisfaction with all program components and Skeptics lowest program satisfaction with all program components. CONCLUSION Three segments, each differing on psychographic and demographic variables, exhibited different change patterns following participation in GO: KA. Post hoc analysis identified that satisfaction with program components differed by segment offering opportunities for further research. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Some adolescents are victims of negative appearance-related feedback, and this may have lasting adverse effects on their self-evaluation. The aim of this study was to examine the frequency and impact of appearance teasing across sex and weight status. METHODS The participants were 570 Czech adolescents (47.9% girls) evaluated at age 13 during the European Longitudinal Study of Pregnancy and Childhood. Instruments used were body mass index and an adapted version of the Physical Experiences Survey that measures appearance teasing sources (parents, peers, among others), body part teased, and the impact of teasing. Chi-square test and multivariate analyses of variance were conducted to compare groups by sex and weight status. Logistic regression was then used for adjusted analyses. RESULTS Girls were more likely to report appearance teasing than boys. Overweight adolescents, both girls and boys, were more likely to be teased than non-overweight adolescents. Overweight adolescents compared with non-overweight adolescents reported higher levels of impact of body-related teasing. CONCLUSIONS Czech adolescents continue to adopt the societal standards of Western countries, stigmatizing overweight peers. This may affect more obese adolescents. Future research has to evaluate different sources of appearance-related teasing. Interventions in schools are suitable for the reduction of appearance-related prejudices. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Children spend most of their awake time at school, and it is important to identify individual and school-level correlates of their physical activity (PA) levels. This study aimed to identify the between-school variability in Portuguese children PA and to investigate student and school PA correlates using multilevel modeling. METHODS The sample included 1075 Portuguese children of both sexes, aged 6-10 years, from 24 schools. Height and weight were measured and body mass index (BMI) was estimated. Physical activity was estimated using the Godin and Shephard questionnaire (total PA score was used); cardiorespiratory fitness was estimated with the 1-mile run/walk test. A structured inventory was used to access information about the school environment. A multilevel analysis (level-1: student-level; level-2: school-level) was used. RESULTS Student-level variables (age, sex, 1-mile run/walk test) explained 7% of the 64% variance fraction of the individual-level PA; however, school context explained approximately 36% of the total PA variance. Variables included in the model (school size, school setting, playground area, frequency and duration of physical education class, and qualification of physical education teacher) are responsible for 80% of the context variance. CONCLUSIONS School environment is an important correlate of PA among children, enhancing children's opportunities for being active and healthy. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The effectiveness of health education methods courses for pre-service elementary teachers has not been assessed for improving the pre-service elementary teacher's self-efficacy for using the professional teacher standards in health education ( PTSHE). METHODS A quasi-experimental design was used to assess pre-service elementary teachers' self-efficacy toward using the PTSHE. Four institutions whose elementary education programs provide a health education methods course were recruited to participate in the study. Students were recruited to participate and they completed the Pre-service Health Education National Standards Self-efficacy ( PHENSS) Scale at the beginning and end of the semester. Data were analyzed using SPSS (version 15) software. RESULTS A significant increase in the PHENSS Scale scores indicated that a 3-credit health education methods course could improve the pre-service elementary teacher's self-efficacy to use the national standards in their teaching of health education. Further analysis indicated statistically significant improvement of the participants' PHENSS scores in 2 of the 7 standards. CONCLUSION Teacher self-efficacy can be a useful measure of the pre-service elementary teachers' ability to use the national standards for health education. The design of the methods course may affect the PHENSS scores. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Sugar-sweetened beverages ( SSBs) may play a role in increased rates of obesity. This study examined patterns and frequencies of beverage consumption among youth in 3 distinct regions in Canada, and examined associations between beverage consumption and age, sex, body mass index ( BMI), physical activity and dieting behavior, as well as beverage displacement. METHODS The study included data from 10,188 youth (ages 13-18) from Hamilton and Thunder Bay, Ontario, and Prince Edward Island ( PEI) in 2009 to 2010. The study used in-school self-reported surveys with 12 questions regarding beverage consumption during the previous day, along with self-reported height, weight, physical activity levels, and demographic information. Logistic regression analyses were conducted to examine variables associated with SSB intake. RESULTS Overall, 80% of youth consumed at least 1 SSB in the previous day, with 44% consuming 3 or more SSBs. Youth in Thunder Bay consumed significantly more SSBs than Hamilton and PEI, and youth in Hamilton consumed more SSBs than PEI. Boys consumed significantly more SSBs than girls. Older and more physically active youth consumed significantly fewer SSBs. No significant association between BMI and SSB consumption was observed in any model. A modest positive correlation was identified between SSB consumption and milk (r = .06, p < .001) and 100% fruit juice (r = .10, p < .001). CONCLUSIONS A large proportion of youth consumed SSBs, many at high levels. Research evaluating SSB policy and interventions should be considered a priority. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Research suggests participation in sports is an important contributor to overall adolescent physical activity ( PA). Sports play has become increasingly important in physical education ( PE) classes as a means for promoting healthful and enjoyable PA. Research is needed that investigates physiological and perceptual responses to sport play. METHODS We studied 101 (55 males; 46 females, age 11-14) students who participated in flag football ( FF), basketball ( BB), and flag rugby ( FR). Activity counts were collected using accelerometers. Perceived competence and enjoyment were measured using the intrinsic motivation inventory. RESULTS Each sport activity produced acceptable levels of activity and positive perceptual responses, but differences among sports were noted. Accelerometry data indicated that FR and BB were more intense than FF (p < .001). Perceptual data indicated participation in FR elicited higher perceptions of competence and greater enjoyment when compared to FF and BB (p < .001). CONCLUSIONS Participation in sport activity within middle school PE classes provides excellent opportunities for energy expenditure and positive perceptual responses. Most importantly, FR provides an activity stimulus that has potential benefits both physiologically and psychologically. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study examined the impact of school-based mental health programs on children's school outcomes and the utilization of acute mental health services. METHODS: The study sample included 468 Medicaid-enrolled children aged 6 to 17years who were enrolled 1 of 2 school-based mental health programs (SBMHs) in a metropolitan area sometime during school year 2006-2007. A multilevel analysis examined the relative effects of SBMHs on children's absence, suspension, grade promotion, use of acute mental health services, as well as the association of child and school-level factors on the outcomes of interest. RESULTS: Little change in average number of days absent per month and no significant change in the use of acute mental health services were found. The mean number of days suspended per month out-of-school decreased from 0.100 to 0.003 days (p < .001). The percentage of children promoted to the next grade increased almost 13% after program enrollment (p < .01). Program type did not predict outcome changes except grade promotion. CONCLUSIONS: Despite the positive effect of school-based mental health programs on some school outcomes, the lack of difference between programs suggests the need to identify active mechanisms associated with outcome to make the delivery of care more efficient. [ABSTRACT FROM AUTHOR]

BACKGROUND National estimates of middle school bullying approximate 40%, making it the leading form of school violence. Meta-analysis of conventional anti-bullying efforts have shown mixed results, averaging small reductions in bullying behavior. Social-Emotional Learning and Positive Youth Development provide a theory-driven alternative for approaching bullying and victimization by strengthening social competencies that reduce related youth risk behaviors. METHODS A sample of 7th grade students ( N = 323) participated in Take the Lead (TTL); a 16-session curriculum designed to build social competencies of all participants. Data were coded and collected using a pretest/posttest time-lag control group cohort study design. Participants self-reported bully and victim behaviors using the Peer Relations Questionnaire. Extracted data were assessed for changes in bullying and victim behaviors, from pretest to posttest, between groups and sexes. RESULTS Participants in TTL reported significant reductions in bullying (p < .001), and victimization (p < .001), from pretest to posttest, and compared to controls (p < .001). Findings remained consistent between sexes (p < .001). Control groups experienced increases in bully and victim behaviors during the same time period, which were significantly reduced following participation in TTL (p < .001). CONCLUSION Identifying intervention alternatives to address bullying behaviors must remain a research priority. This study supports the application of theory-driven SEL and PYD constructs within a curriculum designed to improve social competencies of all students. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Unhealthy lifestyles during childhood constitute a public health problem in Japan. However, current health education in Japan is ineffective in counteracting them. Previous studies contend that healthy lifestyles in children vary by academic grade and sex. This study examined changes throughout childhood suggests some intervention points for lifestyle education. METHODS The participants were 2833 elementary and junior high school students living in Japanese rural areas. Data on 26 variables assigned to 5 subfactors were collected. We estimated the composite score of each subfactor on the basis of item response theory. A 2-way ANOVA and a graph review were performed to explore the differences and changes by sex and grade. RESULTS Most of the main effects for sex and grade were statistically significant. Lifestyle behaviors acquired early in elementary school were lost as students progressed to higher grades. CONCLUSIONS The research indicated the following emphases: (1) Physical activity and leisure habits should be focused on girls and hygiene habits on boys; (2) Continuous education for a healthy lifestyle is essential to maintain good health among children; (3) Education for healthy lifestyle can be classified into 2 important stages such as for dietary and sleeping habits, education from the upper grades of elementary school is important, whereas for other routine activities, reeducation in junior high school is effective. [ABSTRACT FROM AUTHOR]

BACKGROUND: Physical Education and School Sport (PESS) is an integral part of the school curriculum in Ireland. Historically the 'Healthy Body, Healthy Mind' philosophy has promoted the inclusion of PESS alongside more cognitive school subjects. Research suggests that PESS can promote cognitive function and provide educational benefits. However, there is little research on how the choice of school sport influences academic achievement. This study investigated how participation in school sport influences the Leaving Certificate points score in an Irish secondary school. In particular, the study will investigate how the particular sport chosen by students participating in school sport during their Leaving Certificate years influences their Leaving Certificate results. METHODS: We recorded the Leaving Certificate scores and sports participation from 402 boys graduating from a secondary school in the Ireland during 2008-2011. Sports participation was assigned 1 of 4 categories: rugby, rowing, soccer, and no sport. RESULTS: Participation in sports during the Leaving Certificate years conferred a 25.4-point benefit to the final Leaving Certificate score. However, participation in rowing, the only individual sport available in the study, resulted in significantly higher Leaving Certificate scores than rugby, soccer and no sport (p < .05), conferring an additional 73.4-point benefit over the next highest group, rugby. CONCLUSION: Promoting participation in school sport and providing access to a range of team and individual sports throughout the secondary school years may be a beneficial way to improve students' Leaving Certificate results. [ABSTRACT FROM AUTHOR]

BACKGROUND: Food service directors have a concern that federal reimbursement is not meeting the demands of increasing costs of healthier meals. The purpose of this article is to report the food option changes and the annual revenues and expenses of the school food service environment. METHODS: The HEALTHY study was a 3-year (2006 to 2009) randomized, cluster-designed trial conducted in 42 middle schools at 7 field centers. The schools selected had at least 50% of students who were eligible for free or reduced-price lunch or who belonged to a minority group. A randomly assigned half of the HEALTHY schools received a school health intervention program consisting of 4 integrated components: nutrition, physical activity, behavioral knowledge and skills, and social marketing. The nutrition component consisted of changing the meal plans to meet 5 nutrition goals. Revenue and expense data were collected from income statements, federal meal records, à la carte sale sheets, school store sale sheets, donated money/food records, and vending machines. RESULTS: Although more intervention schools reached the nutritional goals than control schools, revenues and expenses were not significantly different between groups. CONCLUSION: The HEALTHY study showed no adverse effect of school food policies on food service finances. [ABSTRACT FROM AUTHOR]

BACKGROUND: Media use is associated with an increased risk of chronic disease and reduced quality of life among children. This study examined the relationship between media use during discretionary hours after school and psychological and physical assets among preadolescent girls. METHODS: A cross-sectional analysis was conducted using data from a larger quasi-experimental evaluation of a positive youth development program through sport for third- to fifth-grade girls. Indicators of media use were the number of hours per school day spent watching television and videos and using computers. Psychological assets included global self-esteem, body size satisfaction, and commitment to physical activity; physical assets included physical activity. Nested random effects analysis of variance (ANOVA) models were used to examine the relationship between media use and psychological and physical assets controlling for relevant confounding factors. RESULTS: The analytic sample included 1027 participants; most were ≥10 years old, non-White; 27% self-reported ≥4 hours of media use on school days. In adjusted results, media use was inversely associated with self-esteem (p = .008) and commitment to physical activity (p < .001). Time spent using media was not associated with body size satisfaction or physical activity in this age group. CONCLUSIONS: Media use was negatively associated with self-esteem and commitment to physical activity. It may be useful for school professionals to encourage after-school programs that offer opportunities for girls to reduce sedentary pursuits and improve important psychological and physical assets. [ABSTRACT FROM AUTHOR]

BACKGROUND: While school-based mental health professionals obviously must provide mental health services to students directly, the literature is increasingly identifying an empowerment role for these professionals, whereby they support teachers as primary service providers. The purpose of this study was to identify subtypes of school social workers within the context of collaborative practice, and to identify individual and contextual factors associated with these classifications as well as overall levels of collaboration. METHODS: Latent class analysis, conducted using data collected as part of the National School Social Work Survey 2008 (N = 1639), was employed to examine underlying subtypes of school social work practitioners in relation to collaborative practices and to examine predictors of collaborative practice. RESULTS: Four broad categories of school social workers were identified, including (1) noncollaborators, (2) system-level specialists, (3) consultants, and (4) well-balanced collaborators. These classes were associated with the number of schools served, grade level, education, and clinical licensure status; level of administrative responsibility was not associated with class membership. CONCLUSION: While school social workers varied in collaborative practices, opportunities exist to enhance their role in educating and supporting teachers to serve as primary providers to students with social, mental health, and behavioral needs. The implications for school-based mental health providers, teachers, administrators, policymakers, and researchers are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Foods provided in schools represent a substantial portion of US children’s dietary intake; however, the school food environment has proven difficult to describe due to the lack of comprehensive, standardized, and validated measures. METHODS: As part of the Arkansas Act 1220 evaluation project, we developed the School Cafeteria Nutrition Assessment (SCNA) measures to assess food availability in public school cafeterias (n = 113). The SCNA provides a measure to evaluate monthly school lunch menus and to observe foods offered in school cafeterias during the lunch period. These measures provide information on the availability of fruit, vegetables, grains (whole or white), chips (reduced fat or regular), side dishes, main dishes, beverages, `a la carte selections, and desserts, as well as information on healthier preparation of these items. Using independent raters, the inter-rater reliability of the measure was determined among a subsample of these schools (n = 32). RESULTS: All food categories assessed, with the exception of the side dish and chip categories, had inter-rater reliability rates of 0.79 or greater, regardless of school type. The SCNA scores encompassed the majority of the possible scores, indicating the ability for the measures to differentiate between school cafeterias in the availability of healthier options. CONCLUSION: These measures allow comprehensive, rapid measurement of school cafeteria food availability with high inter-rater reliability for public health and school health professionals, communities, and school personnel. These measures have the potential to contribute to school health efforts to evaluate cafeteria offerings and/or the impact of policy changes regarding school foods. [ABSTRACT FROM AUTHOR]

BACKGROUND: A US federal mandate that school districts devise and implement local wellness policies (LWPs) has potential widespread impact on the nutritional content of foods and beverages available in schools and on the amount of physical activity that students engage in; however, evidence concerning the mandate’s effectiveness is limited. This study describes the content of LWPs of 6 US school districts and steps taken toward their implementation and evaluation. METHODS: During visits to 6 school districts, we interviewed 88 school and community representatives about the content of their district’s LWPs and how the LWPs were being implemented and evaluated. RESULTS: The 6 LWPs were consistent with the federal mandate, although they varied in content and degree of specificity, and none had been fully implemented. All 6 districts were pursuing strategies to ensure that foods and beverages available at school met nutrition standards but did not offer nutrition education to all K-12 students. All 6 districts offered students only limited opportunities for physical activity, and all 6 collected data to monitor process and outcomes of their LWPs. CONCLUSIONS: Partial implementation of LWPs in the districts we visited resulted in significant improvement in the nutritional quality of foods available at district schools, but only slight improvement in students’ opportunities for school-based physical activity. We provide recommendations for school districts on implementation and evaluation. Future research is needed to determine the impact of these LWPs on students’ health. [ABSTRACT FROM AUTHOR]

BACKGROUND: To assess the need for cultural tailoring of an effective sexual health middle school curriculum, ‘‘It’s Your Game: Keep It Real’’ (IYG), prior to implementation in Puerto Rican (PR) middle schools. METHODS: Seventy-three seventh-grade bilingual students participated in IYG curriculum activities (both group-based and computer-based) in two 2-hour testing sessions in spring 2008. Rating scales of acceptability, understandability, credibility, ease of use, and motivational appeal and qualitative feedback via open-ended responses and group process provided insight into needed surface and deep structure cultural tailoring. RESULTS: Students rated IYG highly on cultural tailoring and motivational parameters and were highly engaged by the lesson content. School personnel rated IYG as a feasible strategy for use in PR middle schools. While surface cultural elements (eg, characters, attire, body language) were identified as important foci for adaptation, content related to deeper cultural elements such as core behaviors, risky situations, attitudes, and specific skills were considered as relevant to PR youth as to their US counterparts. CONCLUSION: Effective human immunodeficiency virus, sexually transmitted disease, and pregnancy skills training prevention programs such as IYG that are developed for minority US youth may offer a feasible option for international implementation when extensive cultural adaptation is not a viable option. [ABSTRACT FROM AUTHOR]

Using data from the 2006 Health Behavior in School-aged Children (HBSC) survey, the prevalence of 6 forms of bullying (physical, verbal, relational, sexual, cyber, and racist), and the role of smoking and drinking in bullying was examined among Italian adolescents for this study. The sample was composed of 2667 Italian middle and secondary school students (49.9% girls) randomly selected. The revised Olweus Bully/Victim Questionnaire was used to measure physical, verbal, relational, sexual, cyber, and racist forms of bullying. For each form, 3 categories were created and compared with students 'not involved in bullying': bully, victim, and bully-victim. Logistic regressions were applied to test the connections among the 3 forms of involvement in different types of bullying and smoking and drinking. Prevalence of having been bullied or having bullied others at school at least once in the last 2 months was 11.6% for physical, 52% for verbal, 47.9% for relational, 18.5% for sexual, 19.4% for cyber, and 9.4% for racist bullying. Compared to girls, boys were more likely to be involved in physical bullying; moreover, boys were more involved as bullies in verbal, sexual, cyber, and racist bullying. In contrast, girls were more likely to be victims of verbal, relational, sexual, and cyber bullying than were boys. Logistic regressions showed the connection between the different forms of involvement in bullying and smoking and drinking. Our results indicate that all forms of bullying behavior are associated with legal substance use. Implication for prevention program was discussed. [ABSTRACT FROM AUTHOR]

School-based vaccination programs may provide an effective strategy to immunize adolescents against influenza. This study examined whether adolescent attitudes toward influenza vaccination mediated the relationship between receipt of a school-based influenza vaccination intervention and vaccine uptake. Participants were recruited from 2 counties participating in a school-based influenza vaccination intervention trial in rural Georgia (N = 337). Data were collected from surveys distributed to adolescents at pre- and post-intervention time points and from documents indicating vaccine uptake. Guided by the Health Belief Model and the Integrated Behavioral Model, surveys assessed demographic, behavioral, and psychosocial variables. A mediation analysis was used to test whether changes in psychosocial variables from baseline to follow-up mediated the relationship between study condition and influenza vaccine uptake. Controlling for background variables, step 1 of the mediation analysis revealed a significant relationship between study condition and vaccine uptake (odds ratio = 1.77, p = .038). Step 2 of the mediation analysis revealed a significant relationship between study condition and changes in psychosocial variables from baseline to follow-up. Steps 3 and 4 of the mediation analysis revealed that there was full mediation of the relationship between study condition and receipt of an influenza vaccination by intention to receive an influenza vaccination. Findings suggest that the success of our school-based influenza vaccination intervention in increasing vaccine uptake was mediated by adolescents' intention to receive an influenza vaccination. Future influenza vaccination efforts geared toward rural adolescents may benefit from addressing adolescent attitudes toward influenza vaccination, particularly increasing intention to receive a vaccine. [ABSTRACT FROM AUTHOR]

Teachers play an essential role in the school community, and H1N1 vaccination of teachers is critical to protect not only themselves but also adolescents they come in contact within the classroom through herd immunity. School-aged children have a greater risk of developing H1N1 disease than seasonal influenza. The goal of this study was to assess the relationship between attitudes toward H1N1 vaccination and vaccine acceptance among middle and high school teachers in rural Georgia. Participants were recruited from 2 counties participating in a school-based influenza vaccination intervention in rural Georgia. Data were collected from surveys distributed to middle and high school teachers in participating counties in September 2009 prior to implementing the interventions to increase vaccination against seasonal influenza. Multivariate logistic regression was used to assess the association between teachers' attitudes toward H1N1 vaccination and H1N1 vaccine acceptance, controlling for demographic variables. Among participants, 52.9% indicated that they would get the H1N1 vaccine. In multivariate analyses, H1N1 vaccine acceptance was associated with male gender (odds ratio[OR] = 3.67, p = .016), fear of contracting H1N1 (OR = 3.18, p = .025), and receipt of a seasonal influenza vaccine in the past year (OR = 3.07, p = .031). H1N1 vaccine acceptance was not significantly associated with age, race, perceived severity of H1N1, belief that the H1N1 vaccine would cause illness, or talking about H1N1 with friends. Teachers may play a pivotal role in school-based H1N1 vaccinations. Understanding and addressing teachers' attitudes toward H1N1 vaccination may assist in future immunization efforts. [ABSTRACT FROM AUTHOR]

In elementary grades, comprehensive health education curricula mostly have demonstrated effectiveness in addressing singular health issues. The Michigan Model for Health (MMH) was implemented and evaluated to determine its impact on multiple health issues, including social and emotional skills, prosocial behavior, and drug use and aggression. Schools (N = 52) were randomly assigned to intervention and control conditions. Participants received 24 lessons in grade 4 (over 12 weeks) and 28 more lessons in grade 5 (over 14 weeks), including material focusing on social and emotional health, interpersonal communication, social pressure resistance skills, drug use prevention, and conflict resolution skills. The 40-minute lessons were taught by the classroom or health teacher who received curriculum training and provided feedback on implementation fidelity. Self-report survey data were collected from the fourth-grade students (n = 2512) prior to the intervention, immediately after the intervention, and 6 weeks after the intervention, with the same data collection schedule repeated in fifth grade. Students who received the curriculum had better interpersonal communication skills, social and emotional skills, and drug refusal skills than the control group students. Intervention students also reported lower intentions to use alcohol and tobacco, less alcohol and tobacco use initiated during the study and in the past 30 days, and reduced levels of aggression. The effectiveness of the MMH in promoting mental health and preventing drug use and aggression supports the call for integrated strategies that begin in elementary grades, target multiple risk behaviors, and result in practical and financial benefits to schools. [ABSTRACT FROM AUTHOR]

Adolescent school victimization due to lesbian, gay, bisexual, or transgender (LGBT) status is commonplace, and is associated with compromised health and adjustment. Few studies have examined the long-term implications of LGBT school victimization for young adult adjustment. We examine the association between reports of LGBT school victimization and young adult psychosocial health and risk behavior. The young adult survey from the Family Acceptance Project included 245 LGBT young adults between the ages of 21 and 25 years, with an equal proportion of Latino and non-Latino White respondents. A 10-item retrospective scale assessed school victimization due to actual or perceived LGBT identity between the ages of 13 and 19 years. Multiple regression was used to test the association between LGBT school victimization and young adult depression, suicidal ideation, life satisfaction, self-esteem, and social integration, while controlling for background characteristics. Logistic regression was used to examine young adult suicide attempts, clinical levels of depression, heavy drinking and substance use problems, sexually transmitted disease (STD) diagnoses, and self-reported HIV risk. Lesbian, gay, bisexual, and transgender-related school victimization is strongly linked to young adult mental health and risk for STDs and HIV; there is no strong association with substance use or abuse. Elevated levels of depression and suicidal ideation among males can be explained by their high rates of LGBT school victimization. Reducing LGBT-related school victimization will likely result in significant long-term health gains and will reduce health disparities for LGBT people. Reducing the dramatic disparities for LGBT youth should be educational and public health priorities. [ABSTRACT FROM AUTHOR]

Computerized point-of-sale (POS) machine software that allows parents to place restrictions on their child's school meal accounts is available. Parents could restrict specific foods (eg, chips), identify specific days the child can purchase extra foods, or set monetary limits. This descriptive study examines the use of parental restrictions on student cafeteria POS accounts in a convenience sample of 2 school districts. POS alerts, with student gender, grade, ethnicity, and students' free or reduced-price meal eligibility, were obtained from 2 school food service departments for the 2007-2008 school year. The alerts were coded into 5 categories: financial, medical, restrictions, snacks OK, and extras OK. The distribution of alerts by district, students, and demographics was then tabulated. District A (4839 students) had more students with alerts (n = 789, 16%) than District B (8510 students; n = 217, 2.6%), and 94 District A students had a second alert. District A parents had to provide written permission for their child to purchase snacks (n = 654, 13.5%) and extra meal items (n = 113, 2.3%). Most alerts were for full-pay students in both districts (74% and 66%) and varied by demographics of the students. Few parents actually used this system to limit student purchases of foods outside the school meal. Future studies should investigate the influence of these restrictions on student food choices. [ABSTRACT FROM AUTHOR]

Concerns have been expressed that No Child Left Behind (NCLB) may be reducing the amount of classroom time devoted to subjects other than those for which students are tested. The purpose of this article is to explore whether NCLB legislation has affected the provision of evidence-based drug prevention curricula (EBC) in the nation's middle schools, a subject area that is not assessed by standardized tests. Data were collected in spring 2005 and spring 2008 from a nationally representative sample of middle schools. Respondents completed a survey regarding their provision of EBC (2005 response rate: 78.1%). We also collected data on schools' adequate yearly progress (AYP) status as of 2005 as a measure of their compliance with NCLB targets. We restricted our sample to schools that responded to our survey in both waves (n = 1324, or 76.9% of those schools responding in 2005) and conducted logistic regression analyses to determine whether those schools not making AYP in 2005 were less likely to be using an EBC in 2008. Our results revealed no relationship between AYP status in 2005 and EBC use in 2008. Analyses of demographic characteristics showed that schools making AYP were more likely to be small and rural, and to serve majority White student populations whose families were characterized by lower levels of poverty. Our failure to find any relationship between AYP status and the provision of EBC suggests that concerns about the potential adverse effects of NCLB on drug use prevention have yet to be validated. Implications of our results are discussed. [ABSTRACT FROM AUTHOR]

During the 2004-2005 school year, the Mississippi Department of Education, Office of Child Nutrition, initiated a pilot program to distribute free fruit and vegetable snacks to students during the school day. This article describes the first-year implementation of the Mississippi Fruit and Vegetable Pilot Program. The process evaluation addressed where, when, and how produce was distributed; what was distributed; challenges and successes; and recommended modifications. Five of the 25 program schools were selected to participate in the evaluation; selection was based on grade levels served and demographic characteristics. Data were collected from program staff (N = 11) and administrators (N = 6) via interviews and logs; student (N = 42) and parent (N = 19) focus groups; student questionnaires (N = 660); and school staff questionnaires (N = 207). Distributing fresh fruit and vegetable snacks at school was well received by staff and students. Most schools distributed the fresh fruit and vegetable snacks at morning break in classrooms or a central courtyard. Twenty-two types of fresh fruit, 4 types of dried fruit, and 7 types of vegetables were served to students during the program year. Commonly distributed fruit included apples, oranges, pears, bananas, and tangerines. Carrots were the staple vegetable, followed by celery. Key challenges included getting students to try new foods and receiving the produce in a timely manner without spoiling. Main successes included seeing students try new fruit and vegetable snacks, having the program run smoothly, and teacher support. The program fit well within the school structure and could be an effective component of a multifaceted approach to enhancing child nutrition. [ABSTRACT FROM AUTHOR]