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BACKGROUND: This paper presents the process taken by a nonprofit educational organization to create authentic evaluation tools for Food Education in K‐12 schools. Development was a collaborative effort between organization staff and teachers during an Evaluation Summit. The program background, development of the Summit, and plans for post‐Summit work continuation are described. The Summit included 14 teacher participants (3‐4 per grade band in preK‐1, 2‐5, 6‐8, 9‐12). METHODS: The process of tool development was captured via direct observations and analysis of artifacts (eg, participants' brainstorming chart paper, online development documents) to identify themes in successful approaches and challenges. Additional post‐Summit activities were also captured via surveys and artifacts. Outcomes of this work are outlined, including the challenges in carrying out the creation of authentic assessments that accurately reflect the classroom teaching experience, and the value of in‐person community building in the Food Education space. RESULTS: Key findings relate to the importance of in‐person collaboration amongst teachers, centering students in evaluation, and equity and accessibility in tool development. CONCLUSIONS: Although outlining challenges and outcomes was not an a priori goal of this work, it provides important information for others working in the education nonprofit space—especially as it pertains to new approaches to classroom evaluation. [ABSTRACT FROM AUTHOR]

Background: More than 20 million children in the United States lack access to primary health care. Practice Learning: Research shows that students with regular access to physical and mental health services have fewer absences, are more social, less likely to participate in risky behaviors, have improved focus and higher test scores. Implication For School Health Policy, Practice, And Equity: School‐based health centers (SBHCs) can be an important, valuable and viable health care delivery option to meet the full‐range of primary health care needs of students where they spend the majority of their wake hours, ie, in school. Children in rural and other underserved communities, as well as those underinsured, non‐insured, economically challenged, underserved, and the most vulnerable among us are especially at risk. Conclusions: This paper discusses the history, value, and importance of SBHCs from myriad perspectives, including physical and emotional wellbeing, academic and social success, and the promotion of a positive transition to adulthood. In addition, the authors' experiences that resulted in building the first SBHC in the Mid‐Hudson Valley Region of New York State are shared. These experiences form the foundation for creating an important roadmap for individuals and school leaders that are interested in bringing a SBHC to their school and district. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pediatric programs focused on treating chronic pain often do not include an educational liaison (EL) to coordinate services between the patient's medical home and school. As chronic pain in youth can have deleterious effects on school functioning, collaboration between the medical home and the school system are needed to assure these students receive appropriate accommodations. CONTRIBUTIONS TO THEORY: This manuscript describes a model of coordinated care for students with chronic pain that includes a systemic strategy for collaborative care across settings. Specifically, the role of an EL is described in the context of advocating for the patient to receive appropriate educational accommodations. CONCLUSIONS: This paper provides a guide for caregivers and professionals to assure appropriate access to support services across settings. Recommendations are included for school accommodations and services to improve academic functioning and outcomes for students with chronic pain. [ABSTRACT FROM AUTHOR]

BACKGROUND: Return to learn (RTL) after mild traumatic brain injury (mTBI) presents unique challenges for school professionals. A multidisciplinary team approach is necessary yet training school professionals is logistically difficult. This paper describes an innovative pilot RTL program and its evaluation. METHODS: Utilizing the telehealth/telementoring program Project ECHO® (Extension for Community Healthcare Outcomes), this study utilized a multidisciplinary team of subject matter experts to deliver five 1‐hour sessions across 5 cohorts of school‐based professionals (total of 133 participants). The evaluation used a mixed‐methods approach of post‐session and post‐program participant surveys and post‐program participant focus groups. RESULTS: Participants who completed a post‐program survey reported statistically significant improvements in essential aspects of RTL knowledge and self‐efficacy. This included improvements in how to manage a student with an mTBI (44.8% to 86.9%), benefits of early return to school for students following mTBI (31.8% to 86.9%), and the importance of written RTL policies/procedures (55.1% to 97.1%). CONCLUSIONS: This study demonstrates that RTL training via a telementoring approach may be a positive and effective way to train school‐based professionals and improve knowledge and self‐efficacy, especially when attending face‐to‐face trainings are difficult. This model has the potential to produce programmatic and systematic improvements for RTL education. [ABSTRACT FROM AUTHOR]

BACKGROUND: School‐based dental sealant programs are noted to increase sealant uptake among children, especially those from low‐income families and those living in rural and underserved areas. However, nationally school‐based dental sealant programs are substantially underutilized. This paper describes a partnership approach to a school‐based dental sealant program for Title 1 public schools in Hawaii. METHODS: The Hawaii Keiki: Healthy and Ready to Learn program partnered with the Hawaii Dental Service to develop and implement an interprofessional, school‐based sealant program (SBSP). This article describes the development of key factors, such as partnerships, an interprofessional team, team roles, policies, and marketing tools to optimize program success. RESULTS: The SBSP has completed over 3 academic years of implementation in Hawaii public schools. In its initial year (school year [SY] 2019‐2020), which presented challenges due to the COVID‐19 pandemic, it served 6 schools (106 students screened) on 1 island. It expanded to 14 schools on 1 island (193 students screened) in its second year (SY 2020‐2021), 28 schools on 3 islands (653 students screened) in its third year (SY 2021‐2022), and during the Fall of the fourth year, the program reached 50 schools on 3 islands (1821 students screened) and is projected to reach over 70 schools by the end of SY 2022‐2023. CONCLUSION: Taking advantage of strategic partnerships and key interprofessional team members, a school‐based dental sealant program can help to improve the oral health of children in public schools by helping to decrease barriers to care. [ABSTRACT FROM AUTHOR]

Background: School health education, including sexual health education, plays a crucial role in shaping adolescents' protective health behaviors, experiences, and outcomes. Adolescents need functional knowledge and skills to practice, adopt, and maintain healthy behaviors for preventing sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), and unintended pregnancy. Methods: The US Centers for Disease Control and Prevention's Division of Adolescent and School Health (CDC/DASH) has advanced school‐based approaches to STI/HIV and pregnancy prevention through surveillance, research and evaluation, and program partnership and collaboration for over 3 decades. Results: CDC/DASH uses systematic and innovative strategies to identify the breadth of adolescent sexual health evidence; characterize key elements of effective educational curricula; and provide practical guidance to support school‐based delivery. CDC/DASH's approach to effective health and sexual health education in schools has changed dramatically over the past 30 years and must continue to progress. Conclusion: This paper describes how and why that approach has evolved and outlines directions for the future. [ABSTRACT FROM AUTHOR]

BACKGROUND: Teacher instructional competency, the set of essential knowledge and skills needed to guide teaching practice, is critical to the successful implementation of school health education. The purpose of this paper is to introduce the Health Education Teacher Instructional Competency (HETIC) framework, a new conceptualization describing teacher characteristics, essential knowledge, and essential skills, which can influence instructional practice and improve student learning outcomes in health education. METHODS: Data from 17 publicly available guidance documents, professional standards, published reports, and empirical studies relevant to the fields of public education, school health education, and sexual health education were abstracted and analyzed using qualitative thematic content analysis. RESULTS: The framework describes 3 domains: personal characteristics, essential knowledge, and essential skills, which are believed to contribute to teachers' instructional competencies in delivering health education. The knowledge domain asserts 5 key categories, while the essential skills domain includes 3 categories (learning environments, content and delivery, and collaboration and learning) and contains 11 unique skills. Collectively, these domains are influenced by the learner, school/community, and policy‐level factors that shape health education curriculum and instruction. CONCLUSIONS: The HETIC framework presents a conceptual roadmap to guide quality health education preparation, job‐embedded training, and delivery. Improving teachers' instructional competencies strengthens learning and prosocial environments that are inclusive, responsive, and affirming of students' health and learning needs. Teacher who demonstrate instructional competency can help students to achieve desired education and health outcomes, specifically acquiring the knowledge and skills needed to adapt, practice, and maintain healthy behaviors throughout their lifetime. [ABSTRACT FROM AUTHOR]

BACKGROUND: In 2014, the Hawaii Department of Education (DOE), the only statewide school system in the United States, predominately enrolled children (keiki) from underserved communities and lacked school nurses or a school health program. Chronic absenteeism due to health concerns was identified as a barrier to academic success. METHODS: The DOE and a public university created Hawaii Keiki: Healthy and Ready to Learn (HK), a program to provide school‐based services for 170 Title 1 schools in urban and rural settings and build momentum for statewide collective action. HK has maintained support from public and private entities to address student health. RESULTS: This paper describes 5 years of program development, implementation, and continuing challenges. Most recently in 2020‐2021, HK pivoted in the face of school campus closings due to COVID‐19 with strategic plans, including telehealth, to move forward in this changed school environment. CONCLUSIONS: The HK program has increased awareness of students' needs and is addressing the imperative to build health services within public schools. The multipronged approach of building awareness of need, providing direct services, educating future care providers, and supporting sound policy development, has an impact that goes beyond any one individual area. [ABSTRACT FROM AUTHOR]

BACKGROUND: Whole school, whole community, whole child (WSCC) approaches to education address contexts beyond school that influence young people's academic and life outcomes. These recommended approaches demand mobilization of an array of actors, but such mobilization is challenging. Little research has explored strategies for convening national experts to support local communities. METHODS: This paper presents a case narrative of Every School Healthy (ESH), a grant‐funded effort to support organizations/school districts in 6 communities building WSCC initiatives by engaging national youth development organizations as expert advisors to ESH and communities. A thematic analysis of the narrative yielded 3 key learnings. RESULTS: Three themes emerged as key learnings regarding implementation of national‐local initiatives: (1) baseline assessment of local communities should be conducted to identify opportunities for maximizing strengths; (2) national organizations must be flexible with the expertise they bring to the initiative; (3) national organizations should prioritize community‐cultivated solutions and meet communities where they are. CONCLUSIONS: The 3 themes presented in this case narrative offer insights for effectively mobilizing national organizations to support healthy, equitable school environments at the local level. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Approximately 9% of school-aged children in the United States have asthma. Since 1997, the Asthma Action Plan ( AAP) has been recommended as an asthma self-management tool for individuals with asthma. In the school setting, the use of the AAP has been primarily dependent on communication between the family and the school through a paper process. METHODS To address the limited availability of AAPs, the Southeast Minnesota Beacon Project developed and implemented a secure portal designed for the electronic exchange of the AAP between providers and schools. This project was designed to assess school nurses' responses to the portal and the perceived value of AAPs, efficiency, self-efficacy, and project impact. RESULTS School nurses perceive that the AAP enables more efficient management of the care of students with asthma and increases school nurse self-efficacy in regard to asthma management. Overall, school nurses felt the AAP portal was useful and they reported satisfaction with its function as a school health office resource. CONCLUSION Electronic sharing of the AAP has the potential to increase efficiency and enhance effective communication among health care providers, families, and schools. [ABSTRACT FROM AUTHOR]

The article reports that /University of Illinois at Chicago (UIC) Department of Pediatrics has received a Health Care Innovation Award from the Centers for Medicare & Medicaid Services for its program Coordinated Healthcare for Complex Kids (CHECK). The CHECK is reportedly created for offering a comprehensive quality health care delivery system for children suffering from chronic conditions. CHECK also workswith CPS school nurse leadership to identify improved methods of communication.

BACKGROUND: School nurses are rarely integrated into primary care teams to their full potential. We aimed to characterize school nurses' perceptions related to current and optimal collaboration with primary care providers (PCPs) and identify actionable solutions to improve efficiency, quality, and coordination of pediatric care. METHODS: We conducted and qualitatively analyzed interviews with school nurses to characterize structures, processes, and perceived benefits of optimized school nurse‐PCP collaboration. RESULTS: School nurse interviewees (n = 23) identified factors important to school nurse‐PCP collaboration within 2 domains: information sharing and relationship building. Information sharing themes included health information sharing laws, data sharing systems, and technology‐based communication systems. Relationship building themes included health care sector understanding of the school nurse role, PCP knowledge of school health requirements, shared professional development opportunities, and time and personnel. Perceived benefits of optimized PCP‐school nurse collaboration were identified for children, PCPs, school nurses, and parents. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Needs assessments and action plans guided by the domains of information sharing and relationship building can inform local improvements to optimize school nurse‐PCP collaboration. CONCLUSIONS: School nurses highlighted cross‐sector solutions to enhance school nurse‐PCP collaboration including integrated information sharing systems and intentional relationship building. [ABSTRACT FROM AUTHOR]

BACKGROUND: The threat of a disaster or potential for a disaster is something that may be experienced by individuals globally. Schools are places of daily mass gatherings which make them an ideal target for mass casualty, natural disasters, and biological incidents. METHODS: An integrative review using Whittemore and Knafl's model was conducted to explore peer‐reviewed publications about K‐12 schools and natural disasters and pandemic preparedness and planning. RESULTS: Themes identified from the systematic review of 12 articles reflected determinants and level of school preparedness, disaster plan components, compliance with government requirements, emergency equipment, supplies, drills, and training, collaboration with outside agencies, and perceptions of school preparedness. Preparedness for disasters and biological events among schools varies and multiple factors contribute to the level of preparedness. Perceptions of school preparedness differ among school community members. Schools perceive more preparedness for disasters than their actual level. CONCLUSIONS: Our nation's schools are not adequately prepared for disasters. There is a need for further research in schools to identify and understand preparedness for disasters. [ABSTRACT FROM AUTHOR]

BACKGROUND: About 20‐30% of children worldwide report depressive symptoms. This study examined associations between children's depressive symptoms, life events, and family factors. METHODS: Nationally representative data (n = 95,725) were drawn from the 2017 School Health Promotion Study in Finland. The respondents were 4th and 5th grade pupils (aged 10‐12) in primary schools and their parents/guardians (n = 33,726). Data were analyzed for child‐parent dyads (n = 32,181). Associations were studied using cross tabulation and logistic regression models. RESULTS: Children's reports of poor self‐rated health, problems with family interactions, and the accumulation of life events were statistically significantly associated with depressive symptoms, also when controlling for sociodemographic factors. Financial situation and parent's depressed mood, both reported by parents, were associated with children's depressive symptoms when both were included in the regression model. However, this association disappeared when other predictors were added to the model. CONCLUSION: The results make apparent the complex associations between children's depressive symptoms and family factors. Further research is needed on the discrepancies between parent and child experiences. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Student Assistance Program (SAP) is mandated kindergarten to 12th grade in Pennsylvania schools to address barriers to student academic success. Following student referral, SAP teams use a systematic process to inform recommendations for school or community‐based services. To evaluate program outcomes, a review of student SAP referral trends over a 5‐year period was undertaken. METHODS: The Pennsylvania Network for Student Assistance Services (PNSAS), the state leadership providing oversight of SAP, partnered with Penn State College of Medicine in a retrospective analysis of student referral data from 2013 to 2018. Public school enrollment demographics were used for comparison. Frequencies and percentages were calculated. RESULTS: Referrals (total n = 352,640) increased by 24% over the 5 years; demographics 55% male, 69% non‐Hispanic white, 16% non‐Hispanic black, and 10% Hispanic. Referrals were most commonly for behavioral concerns (31%). Discontinued referrals (39%) were primarily for parent refusal/no permission. Trends included rising minority and elementary referrals over the study period. CONCLUSIONS: SAP referral demographics were consistent with state public school enrollment race/ethnicity breakdown suggesting lack of systematic bias. The proportion of behavioral referrals was consistent with rising youth behavioral health needs. PNSAS must consider strategies to support rising referral numbers and trends. [ABSTRACT FROM AUTHOR]

Background: Schools are essential public health partners for safeguarding students' health. Child Death Review (CDR) is one public health activity where collaboration with schools is integral for developing strategies to prevent child death but the degree of collaboration is unknown. This study assessed school participation in CDR and the prevalence of school problems in reviewed child death cases, comparing non‐suicide and suicide‐related deaths. Methods: Using the National Fatality Review‐Case Reporting System, we created a dataset of school‐aged children (5 to 20 years) whose death was reviewed from 2005 to 2017 and used frequencies, proportions, and chi‐squared statistics on selected measures. Results: Educational representatives infrequently participated in CDRs (24.9%). School records were rarely accessed for reviewed deaths (5.2%). Less than half (41.2%) of reviewed deaths had any school information and of these, 35.5% of children were indicated as having problems in school. Compared with non‐suicide deaths, a larger proportion of suicide deaths had school representatives attend CDRs (28.4% vs 24.1%, P <.0001), and access to educational records (4.2% vs 9.2%, P <.0001). Implications: Efforts are needed to address potential barriers to systems integration, including state policies and federal educational privacy laws. Conclusions: School participation in CDRs is lacking for both suicide and non‐suicide deaths. [ABSTRACT FROM AUTHOR]

Background: Concussion public policies have been developed to address the burden of concussions. The aim of the present study was to examine implementation compliance, barriers, and facilitators of Canada's first concussion public policy, Ontario's Policy/Program Memorandum 158: School Board Policies on Concussion (PPM158). Methods: An electronic survey was sent to 515 randomly selected elementary and high school principals across specific geographic, language, and publicly funded school types in Ontario. Data were analyzed using both qualitative and quantitative methods. Results: One hundred and thirty‐five principals responded to the survey (26%). Concussion education was provided to teachers in 81% of schools, to students in 83%, and coaches in 79%. Additionally, 89% reported having a return‐to‐learn protocol in place and 90% reported having a return‐to‐play protocol. Implementation barriers included difficulties in providing concussion education to parents (42%), obtaining notes from physicians, and maintaining the volume of documentation. Eighty‐seven percent of respondents believed that PPM158 improves student well‐being. Conclusions: Identified implementation barriers and facilitators can inform concussion policy practices to improve student well‐being. We recommend: (1) an appointed concussion policy lead at each school, (2) electronic documentation, (3) determining the optimal education format to improve parent/guardian education, (4) fostering relationships between schools and health care professionals, and (5) student concussion education in every grade in Ontario schools. [ABSTRACT FROM AUTHOR]

BACKGROUND: The closure of schools in response to COVID‐19 compromised access to essential meals for many students. The Emergency Meals‐to‐You program, a public/private partnership, was set up to address this challenge. More than 38.7 million meals were delivered between April and August 2020. This study explores lessons learned and identifies strategies for strengthening food access and security at schools and beyond. METHODS: Qualitative research methods were used. This included interviews and focus groups with participants involved in setting up and delivering the Emergency Meals‐to‐You program. Data were thematically analyzed using key phrases, ideas, and concepts, and interpreted. RESULTS: The program leveraged a multisectoral approach. Components relied on each other and included: schools, public/private partnership, eligibility, relationships, experience, centralized communication, food quality and branding, logistics, and transport. Strategies identified to strengthen food access focused on integration with emergency management structures, understanding food needs at the school level, building a fully procurable menu, and allowing distribution to be rapidly scaled. CONCLUSIONS: The lessons identified and strategies recommended provide a framework for working across the emergency management spectrum (school to national level) to strengthen food access and availability for students and their families affected by a pandemic, disaster, or crisis situation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Chronic and complex medical issues, including traumatic brain injuries (TBIs), have significant educational implications. The purpose of this study was to identify and summarize the literature on care coordination strategies among health care professionals, educators, and caregivers for children with special health care needs (CSHCN). Clarifying factors that influence care coordination for CSHCN can inform future studies on care coordination for students with TBI. Improved understanding of these factors may lead to better communication, reduction of unmet needs, more efficient service access, and improved long‐term outcomes for children. METHODS: A scoping review was conducted, guided by PRISMA‐ScR methodology. Five databases (CINAHL, PSYCINFO, EMBASE, ERIC, PubMed) were searched to identify relevant studies that focused on care coordination and educational settings. RESULTS: Twelve articles met inclusion criteria. Care coordination interventions for CSHCN used in educational settings focused on relationship‐building strategies, clear procedures and roles, and education of members of the school community. CONCLUSIONS: Findings highlight strategies to coordinate care for CSHCN and factors that may moderate effects of these interventions. Key stakeholders should now study these strategies specifically in children with TBI. [ABSTRACT FROM AUTHOR]

BACKGROUND: Dental caries is the most common chronic illness for children. Caries can reduce the quality of life, cause missed classroom hours, and decrease cognition. Strategies to improve children's oral health must be evidence‐based, developed, and implemented in consultation with communities. METHODS: A community‐academic partnership was formed between East Carolina University School of Dental Medicine and the Bertie County Public School District to develop and implement a school‐based oral health prevention program using the PRECEDE‐PROCEED Model. RESULTS: The PRECEDE component involved social, epidemiological, environmental, educational, ecological, administrative, and policy factors that informed the development of the oral health program. The PROCEED component consisted of implementation and evaluation. CONCLUSIONS: School‐based oral health programs can increase access to care for vulnerable children and improve learning. The application of the PRECEDE‐PROCEED model proved to be a valuable method for developing, implementing, and evaluating a school‐based oral health program. [ABSTRACT FROM AUTHOR]

BACKGROUND: Transgender youth report high rates of negative experiences in schools. Using a lens of minority stress, this study sought to examine in‐school experiences of transgender youth to understand youth coping and to identify key opportunities for improving school environments for transgender youth. METHODS: Participants included 41 youth across 33 in‐depth interviews (Mage = 21.7) and two focus groups (N = 8; Mage = 17.3). Thematic analysis was used to analyze data. Themes related to stress, coping, and facilitators/barriers to stress/coping were derived and coded. RESULTS: Distal stressors, such as structural discrimination and prejudice events, were found to contribute to the exclusion of transgender youth from school life, while proximal stressors, such as concealment and expectations of rejection, reinforced transgender youth's feelings of personal isolation. Participants expressed coping with both challenges by advocating for inclusion through direct action with teachers and administrators and seeking/finding connection with trusted staff and peers. CONCLUSIONS: Findings suggest that creating safe and supportive environments at school for transgender youth is an attainable goal, as all identified barriers to inclusivity and connection were modifiable. By considering the needs of transgender youth in policies and programming, schools may improve climate for and wellbeing of transgender students. [ABSTRACT FROM AUTHOR]

BACKGROUND: To achieve sustainability, we must consider scalable improvements in student movement behavior in the classroom setting, educational priorities. Flexible learning spaces that employ student‐centered pedagogy and contain a range of furniture and layout options, implemented to improve educational outcomes, may enable unintended health benefits. In this review, we summarize the evidence on the effects of flexible learning spaces on adolescent student movement behaviors and educational outcomes. METHODS: We searched 5 databases, retrieving 5 quantitative and one qualitative article meeting the review criteria. RESULTS: Students in flexible learning spaces spent less time sitting, and more time standing and moving. Students were also more engaged, on‐task, and collaborated and interacted more. Academic results for English, Mathematics and Humanities for those in flexible learning spaces were higher than peers in traditional classrooms. CONCLUSION: Evidence from the reviewed studies suggests that there may be beneficial outcomes across some movement behaviors as well as learning outcomes in classrooms that employ student‐centered pedagogy and use a built environment that facilitates autonomy and choice around where and how to learn. These learning environments present an opportunity for an interdisciplinary approach to address sedentary behavior in classrooms. [ABSTRACT FROM AUTHOR]

BACKGROUND: Individuals learn and develop across their lifespan in response to the people with whom they interact in settings, communities, cultures, and experiences. Collaborative research and policy efforts underscore the critical and reparative role of identity‐safe, culturally driven, and relationship‐rich environments—in classrooms, schools, and communities—for the healthy social, emotional, cognitive, and physical development of all learners. These themes align closely with the Whole School, Whole Community, Whole Child (WSCC) model. METHODS: Collaborative research and policy efforts, combined with the WSCC model make a strong case to elevate the unusual suspects, the settings and people outside of instructional classrooms who are key actors in creating the conditions and relationships that promote student health and well‐being. RESULTS: We describe promising cases of efforts aimed at bolstering adult capacity to foster student health and well‐being. We also discuss how these types of systemic efforts can move beyond system and program level actors to acknowledge the power of individual‐level implementation. CONCLUSIONS: It is time to recognize the systemic efforts, programmatic opportunities, and individual roles adults have in implementing an ideal WSCC model that is aligned with the collaborative research and policy efforts. [ABSTRACT FROM AUTHOR]

BACKGROUND: In this case study, multiple participants in a large urban school district used the Whole School, Whole Community, Whole Child (WSCC) model to guide development of a district wellness policy. The model's health education component is highlighted, focusing on concerns for special needs students and ones speaking English as a New Language (ENL). METHODS: Organizational structure was developed around the WSCC model and district wellness policy implementation through coordination, collaboration, and communication (3Cs) of programs, policies, and processes/practices (3Ps). RESULTS: The WSCC approach guided the creation of a district wellness policy that influenced programming for students with special needs and required Youth Risk Behavior Survey (YRBS) data collection. Using YRBS and School Health Index (SHI) data in planning sexual health education illustrated improvements over time. Formation of the School Health and Wellness Collaborative under WSCC improved family engagement in sexual health education programs and practices. Relationships were established with community partners to impact student's sexual risk behaviors. Finally, the district co‐created and implemented an evidenced‐based sexual health curriculum, modifying it for special education and ENL students. CONCLUSIONS: The WSCC approach is system changing. It takes time to develop the relationships vital to improve the 3Cs and 3Ps. Success is enhanced with a district wellness coordinator, the right people at the table, valid health data, and administrative and board support. [ABSTRACT FROM AUTHOR]

BACKGROUND: Frameworks such as the WSCC model provide evidence‐based guidance for addressing school health at the school, district, and regional level. However, frameworks do not implement themselves; they require the mobilization and collaboration of stakeholders within communities and an understanding of the unique resources and barriers within each context. Furthermore, addressing school health presents a complex systems problem. METHODS: Community‐based system dynamics (CBSD) is a participatory approach for engaging communities in understanding and changing complex systems. We used a descriptive multiple case study design to evaluate how and why CBSD was used as a tool for stakeholders to engage with the complexity of school health. RESULTS: We analyzed 3 cases to understand how these methods were used to enhance collaboration, analysis, and community action at multiple levels, including in 2 school districts, with a city‐wide stakeholder committee, and with a group of high school students. CONCLUSIONS: Community‐based system dynamics presents a promising approach for building shared language and ownership among stakeholders, tailoring to local community contexts, and mobilizing stakeholders for action based on new system insights. We close with a discussion of unique opportunities and challenges of expanding the use of CBSD in the field of school health. [ABSTRACT FROM AUTHOR]

BACKGROUND The Whole School, Whole Community, Whole Child (WSCC) model is an evidence‐based comprehensive framework to address health in schools. WSCC model use improves health and educational outcomes, but implementation remains a challenge. METHODS: Working with 6 schools in 2 districts in the Midwest, we used a mixed‐methods approach to determine the people, systems, and messages needed to activate WSCC implementation. We report on social network analysis and message testing findings and research translation to develop the Healthy Schools Toolkit. RESULTS: Social networks for both districts included more than 150 individuals. Both demonstrated network densities less than half of the desirable threshold, with evidence of clustering by role and minimal cross‐school relationships, posing challenges for WSCC implementation. Across stakeholder groups, messages that emphasize empathy, teamwork, and action were well‐received, especially when shared by trusted individuals through communication channels that align with stakeholder needs. CONCLUSIONS: The Healthy Schools Toolkit provides an example of a translational product that helps to bridge research with practice. With features that highlight 6 design principles, the toolkit provides complementary activities that schools and districts can use as they plan for integration of the WSCC model. [ABSTRACT FROM AUTHOR]

BACKGROUND: Youth violence is a significant problem affecting community health. Community–academic partnerships can advance youth nonviolence education by synergizing the strengths of collaborators while working toward a common goal. We describe a collaboration between an urban public middle school, community nonprofit, and university‐based graduate school of nursing in implementing and evaluating the Healthy Power program, a school‐based youth nonviolence program for middle‐school boys. METHODS: A participatory program evaluation approach was used to plan and implement evaluation of the Healthy Power program with a cohort of 8 students. Collaborative planning allowed for the selection of measures that reflected program objectives and were of value to community partners while also scientifically sound. A mixed‐methods approach included a focus group and a pretest–posttest with quantitative items and open‐ended questions. RESULTS: While the quantitative pre‐posttest did not show any significant change, the open‐ended questions and focus group suggested that students had advanced their understanding and application of conflict resolution skills. CONCLUSIONS: The findings support the usefulness of community–academic partnerships for peace/conflict resolution education and program evaluation. Such programs may benefit from mixed methods of evaluation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Collaborative care (CC) is a well‐established approach for the delivery of accessible behavioral health services in integrated health care settings. Substantial evidence supports its effectiveness in improving the quality and outcomes of adult services, and growing research indicates utility with child and adolescent populations. METHODS: To date, studies examining CC models for youth have focused exclusively on primary‐care settings. Nevertheless, as the most common integrated service delivery setting for youth, the education sector is an equally important context for improving access to behavioral health services for children and adolescents. RESULTS: We provide a narrative review of the literature on CC, describes the relevance of CC to schools, and details its alignment with contemporary movements in education and school‐based behavioral health. CONCLUSIONS: Potential adaptations of the CC model for use in schools are detailed to improve: (1) behavioral health service accessibility, (2) the capacity of schools to provide behavioral health services, and (3) school service effectiveness through use of evidence‐based practices. Although little research has explored the applicability of CC in the education sector, the model holds potential promise to improve the quality and efficiency of school‐based behavioral health services. [ABSTRACT FROM AUTHOR]

The article discusses school-based health centers (SBHCs) provide vulnerable children and youth in the United States with access to primary care, behavioral health care, oral health care, and vision care. Topics include senior leaders at the School-Based Health Alliance, the national voice for school-based health care in the United States; and how the rampant spread of misinformation, combined with limited health literacy.

ABSTRACT BACKGROUND The Whole Child approach and the coordinated school health (CSH) approach both address the physical and emotional needs of students. However, a unified approach acceptable to both the health and education communities is needed to assure that students are healthy and ready to learn. METHODS During spring 2013, the ASCD (formerly known as the Association for Supervision and Curriculum Development) and the US Centers for Disease Control and Prevention ( CDC) convened experts from the field of education and health to discuss lessons learned from implementation of the CSH and Whole Child approaches and to explore the development of a new model that would incorporate the knowledge gained through implementation to date. RESULTS As a result of multiple discussions and review, the Whole School, Whole Community, Whole Child ( WSCC) approach was developed. The WSCC approach builds upon the traditional CSH model and ASCD's Whole Child approach to learning and promotes greater alignment between health and educational outcomes. CONCLUSION By focusing on children and youth as students, addressing critical education and health outcomes, organizing collaborative actions and initiatives that support students, and strongly engaging community resources, the WSCC approach offers important opportunities that will improve educational attainment and healthy development for students. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Collaborative partnerships are an essential means to concomitantly improve both education outcomes and health outcomes among K-12 students. METHODS We describe examples of contemporaneous, interactive, and evolving partnerships that have been implemented, respectively, by a national governmental health organization, national nongovernmental education and health organizations, a state governmental education organization, and a local nongovernmental health organization that serves partner schools. RESULTS Each of these partnerships strategically built operational infrastructures that enabled partners to efficiently combine their resources to improve student education and health. CONCLUSIONS To implement a Whole School, Whole Community, Whole Child Framework, we need to purposefully strengthen, expand, and interconnect national, state, and local collaborative partnerships and supporting infrastructures that concomitantly can improve both education and health. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Students are the heart of the Whole School, Whole Community, Whole Child ( WSCC) model. Students are the recipients of programs and services to ensure that they are healthy, safe, engaged, supported, and challenged and also serve as partners in the implementation and dissemination of the WSCC model. METHODS A review of the number of students nationwide enjoying the 5 Whole Child tenets reveals severe deficiencies while a review of student-centered approaches, including student engagement and student voice, appears to be one way to remedy these deficiencies. RESULTS Research in both education and health reveals that giving students a voice and engaging students as partners benefits them by fostering development of skills, improvement in competence, and exertion of control over their lives while simultaneously improving outcomes for their peers and the entire school/organization. CONCLUSIONS Creating meaningful roles for students as allies, decision makers, planners, and consumers shows a commitment to prepare them for the challenges of today and the possibilities of tomorrow. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The Whole School, Whole Community, Whole Child ( WSCC) model shows the interrelationship between health and learning and the potential for improving educational outcomes by improving health outcomes. However, current descriptions do not explain how to implement the model. METHODS The existing literature, including scientific articles, programmatic guidance, and publications by national agencies and organizations, was reviewed and synthesized to describe an overview of interrelatedness of learning and health and the 10 components of the WSCC model. RESULTS The literature suggests potential benefits of applying the WSCC model at the district and school level. But, the model lacks specific guidance as to how this might be made actionable. A collaborative approach to health and learning is suggested, including a 10-step systematic process to help schools and districts develop an action plan for improving health and education outcomes. Essential preliminary actions are suggested to minimize the impact of the challenges that commonly derail systematic planning processes and program implementation, such as lack of readiness, personnel shortages, insufficient resources, and competing priorities. CONCLUSIONS All new models require testing and evidence to confirm their value. District and schools will need to test this model and put plans into action to show that significant, substantial, and sustainable health and academic outcomes can be achieved. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The Whole School, Whole Community, Whole Child ( WSCC) model provides a framework for promoting greater alignment, integration, and collaboration between health and education across the school setting and improving students' cognitive, physical, social, and emotional development. By providing a learning environment that ensures each student is emotionally and physically healthy, safe, actively engaged, supported, and challenged, the WSCC model presents a framework for school systems to evaluate, streamline, implement, and sustain policies, processes, and practices. METHODS This article examines the essential roles of the school district and of schools in aligning, developing, and implementing policy, processes, and practices to create optimal learning environments that support the whole child. RESULTS Three key factors advance efforts to align policies, processes, and practices. These include hiring a coordinator at the district and school levels, having collaborative teams address health and learning at the district and school levels, and using data to make decisions and build health outcomes into school and district accountability systems. CONCLUSIONS These key factors provide a road map for successfully implementing WSCC. More research is needed to determine the extent that coordinators, collaborative teams, and the inclusion of health indicators in accountability systems impact student health and learning. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The 2009 H1N1 vaccination campaign was the largest in US history. State health departments received vaccines from the federal government and sent them to local health departments ( LHDs) who were responsible for getting vaccines to the public. Many LHD's used school-based clinics to ensure children were the first to receive limited vaccine supplies, but the success of school-based distribution strategies varied in different locations. The goal of this project was to identify and learn from high-performing school-based vaccination clinics in order to share successes and improve performance in future school-based vaccination campaigns. METHODS We used a combination of process mapping and comparative analysis to identify and derive lessons from positive outlier cases observed during 2009 H1N1 school-based vaccination clinic implementation. We created process maps to identify the activities of LHDs conducting school-based vaccinations and used them as the basis for in-depth interviews of LHD staff. We asked interviewees to describe their activities during the 2009 H1N1 pandemic ( pH1N1) school-based vaccination campaign with a focus on successful processes. RESULTS We identified positive deviants, that is, those that performed better than expected, and categorized qualitative data from in-depth interviews with 13 successful LHDs according to the process maps. Key mechanisms for school-based vaccination success included having a relationship with local school authorities, communicating effectively with parents, and ensuring clinic logistics allowed for an easy flow of students through the vaccination process. CONCLUSIONS Utilizing rigorous methodology, we defined and learned lessons from successful LHDs when conducting school-based vaccination clinics, which can be applied to future school-based vaccination campaigns. [ABSTRACT FROM AUTHOR]

BACKGROUND: The term green health promotion is given to health promotion underpinned by the principles of ecological health and sustainability. Green health promotion is supported philosophically by global health promotion documents such as the 1986 Ottawa Charter for Health Promotion and the ecological public health movement. Green health promotion in schools means the practice, the principles of ecological health, and sustainability. METHODS: A literature review revealed a paucity of publications about green health promotion in schools. Literature about nurses and health promotion in schools is generally found in nursing publications. Literature about ecological sustainability in schools is mostly found in teaching publications. RESULTS: This article explores the nexus between nursing and health promotion, and teachers and ecological sustainability. Collaborative partnerships between health and education do not capitalize on programs such as Health Promoting Schools and the School Based Youth Health Nurse Program in Queensland, Australia. The authors consider how collaborative partnerships between health and education in schools can work toward green health promotion. CONCLUSION: Nursing's approach to health promotion and education's approach to ecological sustainability need to be aligned to enhance green health promotion in schools. Keywords: health promotion; school nursing; education; ecological sustainability. [ABSTRACT FROM AUTHOR]

BACKGROUND This study evaluated a school-based obesity intervention for elementary school children (N = 835) where health professionals assisted teachers with the integration of healthy messages into the school curriculum. METHODS Schools were randomized into a professional-facilitated intervention (PFI; N = 4) or a self-help (SH; N = 3) condition. Changes in weight-based outcomes were assessed in students enrolled in the second grade from all 7 schools (overall: N = 835 students; PFI: N = 509 students, SH: N = 326 students). Students were between ages 7 and 9 and from diverse ethnic backgrounds (Asian = 25.3%, Black = 23.3%, Hispanic = 23.1%, White = 28.3%). The sample included 321 overweight/obese (BMI ≥ 85th percentile), 477 normal-weight (BMI ≥ 5th percentile and <85th percentile), and 37 underweight (BMI < 5th percentile) students. RESULTS After 2 years, children who were overweight/obese in the PFI condition significantly reduced their standardized BMI (zBMI) compared to children in the SH condition (Wald χ2 = 28.7, p < .001). End-of-year grades decreased for overweight/obese students in both conditions; however, students in the PFI exhibited a smaller decrease in grades compared to the SH condition (Wald χ2 = 80.3, p < .001). CONCLUSION The results indicate that an obesity prevention program where health professionals assist teachers by integrating healthy messages into existing curriculum was effective in reducing zBMI compared to the SH condition. [ABSTRACT FROM AUTHOR]

BACKGROUND Although studies have shown that school-based obesity interventions can be effective, little is known about how to translate and implement programs into real-world school settings. METHODS Semistructured interviews were conducted in spring 2012 with 19 key informants who participated in a multifaceted childhood obesity intervention involving school nurses and wellness coordinators in 6 school districts and over 100 schools. RESULTS The intervention changed form according to the needs and interests of the school districts. Despite funding support, schools and nurses had little capacity to address childhood obesity without the help of the coordinator. Initiating programs at the beginning of the school year was particularly difficult for schools. Applying for grants from internal and external sources and assisting with planning and logistics for wellness activities were significant activities of the coordinator. Although some school personnel and families preferred a focus on wellness rather than obesity, those working with individual at-risk children and families found the experience especially gratifying. CONCLUSIONS In contrast to controlled studies, real-world implementation of obesity interventions in schools that are intended to create sustained change requires flexibility in intervention design, timing, and personnel. A single change agent focused on obesity-related activities was essential to success. [ABSTRACT FROM AUTHOR]

BACKGROUND There has been little evaluation of school-located vaccination programs that offer human papillomavirus (HPV) vaccine in US schools without health centers (ie, extramural programs). This article summarizes lessons learned from such programs. METHODS In July to August 2010, 5 programs were identified. Semistructured, in-depth telephone interviews were conducted with program representatives about practical aspects of planning and implementation, including configuration and effectiveness. RESULTS Most programs offered HPV vaccine as part of a broader effort to increase uptake of adolescent vaccines. Respondents stressed the importance of building partnerships with local school systems throughout all aspects of the planning and implementation phases. All programs offered HPV vaccine at no cost to students. Most did not have a mechanism to bill private insurance, and some found Medicaid reimbursements to be a challenge. Programs achieved modest rates of initiation of the 3-dose HPV vaccine series (median 10%); however, among those who initiated the series, completion rates were high (median 78%). HPV vaccine uptake was lowest for a program that offered only HPV vaccine. CONCLUSIONS Extramural programs may increase uptake of vaccines and decrease absenteeism due to noncompliance with vaccine requirements for school entry. Until extramural programs in the US receive better access to billing private insurers and Medicaid, sustainability of these programs relies on grant funding. Better integration of extramural school-located vaccine programs with existing local healthcare and other programs at schools is an area for growth. [ABSTRACT FROM AUTHOR]

BACKGROUND: In 2009, the Victorian Parliament Legislative Assembly of Australia commissioned a Parliamentary Inquiry into the opportunities for schools to become a focus for promoting healthy community living. Submissions to the Inquiry varied widely in their positions about school health promotion. The aim of this review is to analyze the submissions to identify core themes in the debates about school health promotion and how stakeholders saw schools becoming a focus for promoting healthy communities. METHODS: Submissions (N = 159) were downloaded from the Inquiry website. Open coding was used to code the data. The codes were then refined into conceptual categories to create themes. The Inquiry's terms of reference were used as an organizing framework. RESULTS: Emergent themes included barriers and enablers to school health promotion including the need for stronger leadership from the Departments of Health (DoH) and Education and Early Childhood Development (DEECD). CONCLUSION: Rather than supporting the idea that schools could have a wider role in communities, submissions pointed to the acute need for increased resource allocation to support health promotion in schools, and for coordinated approaches with stronger leadership from the health and education sectors. Without these structures, schools can only address health in an ad hoc manner with limited resources, capacity, and outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Public health professionals must monitor the effectiveness of school policies and programs to prevent youth initiation, promote quitting, and eliminate secondhand smoke. This analysis of school tobacco policies was preliminary to release of a state tobacco prevention and control plan for 2010-2015. METHODS: University health educators collaborated with the state health agency to review policies of 33 school systems in 5 Metropolitan Statistical Areas and 9 public health areas. Authors developed a systematic approach of 8 steps useful to rate implementation of school tobacco control and prevention policies and discuss implications for health education program planning. RESULTS: Thirty school policies prohibited possession and use of tobacco by students, faculty and campus visitors, and 26 of 33 specified disciplinary measures following violations. Only 4 public education agencies included 3 of the 6 elements of a model tobacco prevention and control policy as suggested by the state public health agency. None featured all 6 elements. None specified establishing school-community partnerships for tobacco prevention and control. CONCLUSIONS: Preparing smoke-free youth requires implementing and evaluating tobacco education in grades K-12 including use of model guidelines from federal agencies and professional organizations. Determining the focus of existing school tobacco policies is an initial step to encourage adoption of comprehensive policies to reduce youth use of tobacco. Youth health advocates may act together with school administrators and legislators to strengthen policies to be consistent with model guidelines for tobacco prevention and control. [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]