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BACKGROUND: Since the inception of the Youth Risk Behavior Surveillance System in 1991, all surveys have been conducted in schools, using paper and pencil instruments (PAPI). For the 2019 YRBSS, sites were offered the opportunity to conduct their surveys using electronic data collection. This study aimed to determine whether differences in select metrics existed between students who completed the survey electronically versus using PAPI. METHODS: Thirty risk behaviors were examined in this study. Data completeness, response rates and bivariate comparisons of risk behavior prevalence between administration modes were examined. RESULTS: Twenty‐nine of 30 questions examined had more complete responses among students using electronic surveys. Small differences were found for student and school response rates between modes. Twenty‐five of 30 adolescent risk behaviors showed no mode effect. CONCLUSIONS: Seven of 44 states and DC participated electronically. Because survey data were more complete; school and student response rates were consistent; and minor differences existed in risk behaviors between modes, the acceptability of collecting data electronically was demonstrated. [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: Schools are important arenas for the promotion of critical health literacy (CHL) among adolescents. Key domains of CHL are information appraisal, understanding social determinants of health, and abilities to act on determinants of health. In this paper, we examine the psychometric properties of the Critical Health Literacy for Adolescents Questionnaire (CHLA‐Q). METHODS: A cross‐sectional survey study was performed at 5 schools in Norway. Respondents included 522 pupils aged 13‐15 years old. Confirmatory factor analysis (CFA) was conducted to examine the structural validity. Internal reliability was assessed using ordinal Cronbach's alpha. RESULTS: The estimated model had acceptable closeness of fit. Five of 6 scales displayed adequate internal reliability. CONCLUSION: The results indicate acceptable fit of the CHLA‐Q framework and that 5 of the 6 scales are applicable to inform future research and interventions. More research is needed on measurement of the second domain of CHL. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mode share is an important metric for active school travel programs. Common methods for measuring mode share include Hands Up surveys and family surveys, but these require teacher and parental involvement. We used these methods as part of an evaluation of a school‐based bicycle training program, and added a novel observational count approach. This paper compares mode share results across the 3 methods. METHODS: We collected data over 2015–2017 at 16 elementary schools. Our outcome of interest was mode share (walk, drive, and bicycle). RESULTS: We found variations in travel mode estimates between methods and across schools. Overall most school journeys were made by walking (55.7% by observational counts, 46.3% by Hands Up surveys, and 51.5% by family surveys) or car (42.5%, 51.4%, and 46.2%, respectively), and a small proportion by bicycle (1.8%, 2.3%, and 2.2%, respectively). At individual schools, Hands Up and family survey results were similar; there was less agreement between these and observational counts. CONCLUSION: School travel practitioners face pragmatic choices in data collection. Observational counts are a nonintrusive method suited for school‐wide travel patterns. Hands up and family surveys may be more appropriate for assessing differences between classrooms, ages, or family characteristics. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Behavioral support may be effective in increasing physical activity (PA) in school settings. However, there are no data collection systems to concurrently record PA and behavioral support. This paper describes the development and validation of the System for Observing Behavioral Ecology for Youth in Schools (SOBEYS)-an instrument used with existing observation systems to record PA within a behavioral ecological context. METHODS In 2013, experts created a set of behavioral categories to record prompting and reinforcement of PA during a recreational school activity program. The school provided supervision and equipment for lunchtime PA, making it possible to assess both PA and behavioral support. The system was implemented in spring semester 2014 at 1 suburban junior high school (N = 1452; 48% girls, 74% Caucasian) in the western Unites States. RESULTS Following multiple field trials, the SOBEYS instrument recorded behavioral categories of visual and verbal prompting, verbal, and nonreinforcement by adults and peers, and token reinforcement. Construct validity and acceptable interobserver agreement (>90%; kappa between 0.22 and 0.94) resulted. CONCLUSION Trained SOBEYS users can accurately and reliably record the presence of behavioral support aimed at prompting and reinforcing PA in conjunction with established systematic observation instruments to record PA context and quantity. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND This study describes the perceived impact of H1N1 influenza and the adoption of the recommended measures to address the pandemic in schools. METHODS A cross-sectional self-reported survey was conducted in 433 schools in Barcelona addressed to the school principal or the H1N1 influenza designated person. A descriptive analysis was performed, stratifying by educational level and type of school. A logistic regression analysis also was conducted. RESULTS Around 70% of the respondents reported that there had been H1N1 influenza cases among students, being this percentage significantly higher among those schools offering primary education (74.4%) (p < .05). The main measures (single-use paper towels, availability of sanitizer solutions and 15 minutes ventilation per day of enclosed spaces) were implemented in most of the centers. However, the correct adoption of the main measures took place in around 30% of the schools, being the percentage lower in those offering only secondary education (Odds ratio [OR]: 0.518; 95% confidence interval [CI]:0.272-0.986) and those located in medium (OR: 0.438, 95% CI: 0.234-0.811) or low socioeconomic status (SES) districts (OR: 0.321, 95% CI: 0.159-0.649). CONCLUSIONS Despite the climate of social alarm, the perceived impact of H1N1 influenza in most schools was moderate. In future potential threats, the educational level and the SES of the school should be considered, especially when measures requiring purchasing any product are recommended but not provided. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The aim of this study was to assess the beliefs and attitudes of preservice health and physical education ( HPE) specialist and nonspecialist schoolteachers toward obese children. METHODS A total of 177 nonspecialist and 62 HPE specialist trainee teachers completed a series of pen-and-paper validated measures of attitudes and beliefs toward obese children. RESULTS Both groups of preservice teachers reported strong implicit and moderate explicit anti-fat bias. Enrollment in the HPE specialist degree was found to be a significant predictor of both implicit bad/good anti-fat bias (β = 3.97, p = .002) and implicit bias on the stupid/smart scale (β = 2.983, p = .016) of the IAT. Beliefs that obese children were less healthy, more self-conscious, and less satisfied with themselves were strongly endorsed by the majority of participants. HPE specialists were found to have significantly lower expectations for obese children in regard to 'reasoning' (mean difference = 0.21, p = .0107) and 'cooperation' skills (mean difference = 0.25, p = .0354) compared to nonspecialist trainees. CONCLUSIONS This study is the first to document the strong anti-fat bias of both preservice nonspecialist and HPE specialist teachers. It is also the first to find that preservice HPE specialist teachers have stronger anti-fat biases and differential expectations regarding particular abilities of obese children, compared to nonspecialists. [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: Sexting is sending, receiving, or forwarding sexually explicit messages, images, or videos through electronic means. Research has examined sexting in high school and college students. This study seeks to add to the existing literature by exploring the nature of pressured or problematic sexting in middle school‐aged subjects. METHODS: We asked participants in public colleges in Massachusetts, Colorado, and Virginia, to recall their sexting‐related experiences in middle and high school. We utilized an online survey tool for data collection. We performed bivariate quantitative statistical analyses to examine attitudinal and behavioral differences, as well as motivations and consequences of adolescent sexting. RESULTS: The study revealed unique patterns of early‐onset sexting compared to sexting in later adolescence. Early‐onset adolescents typically start sexting before they become sexually active and are at a higher risk for poor outcomes associated with sexting, they are more likely to seek therapy. Early sexting is significantly more pressured than sexting in later adolescence. CONCLUSIONS: The study is an important contribution to the existing research on pressured sexting. Exploring pressured sexting at very early ages finds that early sexting activity is more likely pressured, creates more stress than later in life, and hence, it needs attention from school mental health professionals and education programs. The authors suggest that comprehensive sex education, including sexting should begin earlier than middle school to prevent risky online sexual behavior and provide for learning coping mechanisms for adolescents. [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: School‐based health centers (SBHCs) provide health care to vulnerable youth. The purpose of the study was to identify characteristics of youth who use SBHCs with the highest frequency to understand their health needs and receipt of health services. METHODS: This study examined cross‐sectional survey data from adolescents in 3 urban school districts (n = 2641) to identify the characteristics of youth who use SBHCs with high frequency (10+ visits). Analyses included calculations of simple frequencies and percentages, chi‐square tests of significance and multivariate regression. RESULTS: High‐frequency SBHC users were more likely to have seriously considered attempting suicide (adjusted odds ratio [AOR]: 3.2), be sexually active (AOR: 6.8), and have been victimized at school (AOR: 2.2) compared to their peers who did not use the SBHC. High‐frequency SBHC users were also significantly more likely than their peers to report "always" getting mental health (AOR: 7.0) and sexual health (AOR: 6.6) care when needed, and having talked with a health care provider about their moods/feelings (AOR: 3.1) and how school is going (AOR: 3.2) in the past year. CONCLUSIONS: These findings hold important relevance to demonstrating the value of SBHCs in increasing vulnerable youth's access to health care, particularly in urban settings. [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: To inform prevention strategies, this study provides incidence, factors, and actions taken when a suspected concussion occurred in K‐12 schools in Utah. METHODS: Data were collected using Utah's Student Injury Reporting System (SIRS) from the academic years 2011‐2012 to 2018‐2019. SIRS is a unique online system that tracks injuries that occur in the school setting among K‐12 students in Utah. Descriptive statistics were computed to characterize students with a suspected concussion. Chi‐square (χ2) analysis looking at characteristics by school level was also conducted. RESULTS: Over 63,000 K‐12 students in Utah sustained an injury at school during the study period. Suspected concussions comprised 10% of all injuries. The prevalence of concussions was highest among males (60.6%) and elementary school students (42.6%) and most often occurred outdoors (57.6%) or on a playground/playfield (33.9%), and in sports‐ and recreation‐related activities (75.1%) (specifically contact sports, 24.0%). Most students with a suspected concussion were absent 1 day or less from school (71.4%) but about 68% were seen by a medical professional. Further, there were differences by school level. Females and students playing contact sports had a higher percentage of suspected concussions as school level increased, whereas males and concussions sustained during school hours had a lower percentage of suspected concussions as school level increased. CONCLUSIONS: SIRS enables schools in Utah to identify groups at risk for concussion, as well as activities most commonly associated with these injuries, within the school environment. Using this information, schools may implement targeted prevention strategies to protect students. [ABSTRACT FROM AUTHOR]

BACKGROUND Improving children's fruit and vegetable (FV) preferences may be important as preferences can predict FV consumption. The purpose of this study was to evaluate FV preferences over time, with repeated experience, as part of the Fresh Fruit and Vegetable Program (FFVP). METHODS: Fruits (F; N = 28) and vegetables (V; N = 29) were distributed twice a week, over 35 weeks, at a participating FFVP school (N = 236 students, 12 teachers, K‐2nd grade). Preference ratings using 3‐point Likert scale were analyzed over 35 weeks. RESULTS: For 57 FVs rated for preference, ratings revealed that F had higher frequency of children choosing "I like it" than for V (78% F; 38.2% V; p <.05) and liking distribution was different between F and V (p <.001). Significant relations were found between liking and: (1) grade (r = −0.02, p =.02), and (2) time (r = −0.09, p <.001). Models indicated that V served (β = −0.40), timepoint (β = −0.07), and grade level (β = −0.02) accounted for significant variance for preference ratings (R2 = 0.17, p <.001), indicating that preference ratings declined over time. CONCLUSIONS: Fruits were preferred over vegetables. Overall preference ratings were negatively impacted by time, grade level, and vegetables served. Being exposed one time to a variety of FVs did not improve ratings for vegetables. [ABSTRACT FROM AUTHOR]

BACKGROUND Choose Health: Food, Fun, and Fitness (CHFFF) is aimed at 3rd to 6th graders, and uses experiential learning, food preparation, active games, goal setting, and a family newsletter to target behaviors shown to decrease childhood obesity and chronic disease risk. This study aimed to evaluate CHFFF as intended in low‐income settings. METHODS: A quasi‐experimental design with delayed intervention was used. CHFFF participants in 27 after‐school and 28 in‐school groups in 5 New York counties in 2014 to 2015 completed a self‐report survey at initial enrollment, after a no‐intervention control period, and after receiving CHFFF. Statistical analyses were based on 561 3rd to 6th graders who completed all 3 surveys and participated in at least 4 of the 6 lessons. RESULTS: Compared to their control period, after receiving CHFFF, youth significantly improved in the following multi‐item dietary scores: overall dietary intake (p <.001), vegetable intake (p <.001), fruit intake (p <.01), soda/fast food intake (p <.05) and intent to consume soda/fast food (p <.001). Youth also reported reading Nutrition Facts labels and sharing about healthy eating with their family more often (both p <.001), and greater likelihood of having tried a new food (p <.001). CONCLUSIONS: Results provide evidence for the effectiveness of this curriculum in improving self‐reported child diet and related behaviors. [ABSTRACT FROM AUTHOR]

BACKGROUND: In this study, we determined the prevalence of and factors associated with parent unawareness of youth tobacco use. METHODS: We used data from waves 1, 2, and 3 (2013‐2016) of the Population Assessment of Tobacco and Health study, a nationally representative study of 13,650 US youth ages 12 to 17 and their parents. We conducted weighted multivariate analyses comparing parent unawareness of youth‐reported ever use and associations between parents' unawareness of youth use and covariates. RESULTS: Youth ever tobacco use ranged from 21.8% in 2013‐2014, to 24.1% in 2014‐2015, to 23.4% in 2015‐2016. Parent unawareness ranged from 57.6% in 2013‐2014, to 61.9% in 2014‐2015, and 64.5% in 2015‐2016. Factors associated with higher parent unawareness of youth tobacco use in 2015‐2016 were youth being female, black, or Hispanic (adjusted odds ratio [AOR] = 1.24‐2.61; all ps <.05). Youth with lower academic performance, relatives who used tobacco, tobacco available in the home, or past 30‐day use, were less likely to have parents unaware of their use (AORs 0.33‐0.56; all ps <.05). CONCLUSIONS: Among youth who reported ever using tobacco, most had parents who were unaware of their use. School‐based efforts targeting specific sociodemographic factors could increase parent awareness of youth tobacco use. [ABSTRACT FROM AUTHOR]

BACKGROUND: For pandemic preparedness, researchers used online systematic searches to track unplanned school closures (USCs). We determine if Twitter provides complementary data. METHODS: Twitter handles of Michigan public schools and school districts were identified. All tweets associated with these handles were downloaded. USC‐related tweets were identified using 5 keywords. Descriptive statistics and multivariable logistic regression were performed in R. RESULTS: Among 3469 Michigan public schools, 2003 maintained their own active Twitter accounts or belonged to school districts with active Twitter accounts. Of these 2003 schools, in 2015‐2016 school year, at least 1 USC announcement was identified for 349 schools via the current method only, 678 schools via Twitter only, and 562 schools via both methods. No USC announcements were identified for 414 schools. Rural schools were less likely than city schools to have active Twitter coverage (adjusted relative risk [adjRR] = 0.3956, 95% confidence interval [CI] 0.3312‐0.4671), and to announce USCs on Twitter (adjRR = 0.5692, 95% CI 0.4645‐0.6823), but more likely to have USCs identified by the current method (adjRR = 1.4545, 95% CI 1.3545‐1.5490). CONCLUSIONS: Each method identified USCs that were missed by the other. Our results suggested that identifying USCs on Twitter is complementary to the current method. [ABSTRACT FROM AUTHOR]

BACKGROUND: Compared to other racial groups, Hispanic/Latino(a) adolescents experience higher rates of alcohol (ab)use and alcohol‐related problems. Evidence suggests there are gender differences in alcohol use patterns indicating the likelihood of gender differences in how various determinants influence alcohol use among the genders. Assessing the mechanisms that contribute to Hispanic adolescents' alcohol use requires an understanding of the multidimensional social and environmental processes that operate together to impact their alcohol use. In this study, we examined socio‐ecological determinants of Hispanic adolescent alcohol use by gender. METHODS: Data from 10th grade Hispanic/Latino(a) students (N = 781) from four high schools in Los Angeles were used to examine associations between socio‐ecological characteristics and adolescent alcohol use by gender. RESULTS: Overall, 37.5% of participants reported past 30‐day alcohol use. Among boys, alcohol use was associated with intrapersonal (not qualifying for reduced lunch), interpersonal (mother's education and peer drinking), and institutional (alcohol‐prone school club membership) determinants. Among girls, alcohol use was associated with intrapersonal (academic achievement) and interpersonal (parent and peer alcohol use behavior) determinants. CONCLUSIONS: Prevention and intervention efforts need to take into consideration the gender differences in social‐ecological risk and protective factors when designing educational or intervention programs and services targeted at Hispanic adolescents. This is crucial to addressing multi‐component factors that influence their substance use behavior. [ABSTRACT FROM AUTHOR]

BACKGROUND: Suicidal ideation, an important risk factor for suicide, is strongly associated with substance use. Factors such as family cohesion, connection with friends, and social support can be protective against suicidal behaviors. The purpose of this study was to explore the association between suicidal ideation, substance use, and resiliency factors among middle school students. METHODS: The 2013 New Mexico Youth Risk and Resiliency Survey provided the data for this analysis. Suicidal ideation was defined as affirmative responses to questions about thoughts of killing oneself and/or making a suicide plan. We used logistic regression to explore the association between suicidal ideation, substance use, and resiliency factors. RESULTS: Overall, 23% of students reported suicidal ideation. Among girls, having a caring friend was associated with lower odds of suicidal ideation only among those not using other drugs. Among boys, having a caring friend decreased the odds of suicidal ideation regardless of substance use. CONCLUSIONS: Suicidal ideation is prevalent among middle school children. Substance abuse is associated with suicidal ideation; however, individual and community support can be protective. Interventions aimed at reducing suicidal behaviors among middle school students should account for the impact of substance use and help strengthen social support. [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: Poor mental health outcomes persist among adolescent youth. Secondary schools play a critical role in fostering positive mental health by implementing policies and practices grounded in evidence. The factors associated with implementation, however, are unclear. This study examines which school‐ and state‐level factors are associated with improved implementation of mental health policies and practices at secondary schools across the United States. METHODS: US Centers for Disease Control and Prevention data stemming from 3 datasets (School Health Policies and Practices, School Health Profiles, and Youth Risk Behavior Surveillance System) surveys were integrated and analyzed. RESULTS: Health educator certification, school use of data during school improvement planning, presence of a health/safety coordinator, presence of a health council and state‐provided health educator professional development in mental health and suicide prevention were each significantly positively associated with schools' implementation of mental health policies and practices. CONCLUSIONS: To promote improved implementation of mental health policies and practices in schools and provide better support for youth mental health outcomes, the use of certified health educators and health‐related supports should be considered. State health and education agencies should undertake evaluations of its mental health practices to ensure the assistance they offer to schools is evidence based. [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]

ABSTRACT: BACKGROUND: Nutritious and attractive school meals can improve health equality and public health. Current official guidelines and recommendations on food and nutrient composition of school meals in 3 Nordic countries; Sweden, Finland, and Iceland, are described and compared with actual practice, ie, availability of foods and nutrients in served reference meals in 3 selected areas in each country. METHODS: A country comparison was made between official guidelines, and actual practice was studied in participating schools. Reference portions of school meals (N = 170) provided in 24 compulsory schools were photographed and weighed. Food and nutrient availability were compared with official guidelines in each country. RESULTS: Emphasis of recommendations on whole‐grain bread in Sweden, whole grains in Finland, and fish in Iceland were reflected in food availability. The energy content of the meals provided was lower than guidelines and there was a large variation in energy content between days. CONCLUSIONS: The guidelines regarding food availability were quite well followed, but the large variation in energy and nutrient content of provided school meals between days indicates a need for standardization. [ABSTRACT FROM AUTHOR]

ABSTRACT: BACKGROUND: Existing literature indicates a relationship between stress and emotional eating in adults, yet limited research has examined the impact of school‐related stress on emotional eating in adolescents. This study investigated the influence of academic factors on emotional eating among minority adolescents. METHODS: A survey was implemented among a sample of minority adolescents (N = 666) to investigate the relationship between emotional eating and 3 academic factors: academic self‐esteem, grade point average (GPA), and academic worries. Forced‐entry multiple linear regressions were used to test for relationships. RESULTS: Findings indicate that GPA, academic self‐esteem, and academic worries were related to emotional eating scores in adolescents. There were no significant differences in academic factors between emotional eaters and nonemotional eaters. CONCLUSIONS: Additional research is needed to further elucidate the complex interaction between emotional eating behavior and academics. [ABSTRACT FROM AUTHOR]

ABSTRACT: BACKGROUND: The purpose of this study was to determine whether there was an association between dietary patterns and children's academic performance. METHODS: This cross‐sectional study involved 315 children aged 9‐11 years from 26 schools in Australia. Academic performance was measured in 4 domains (reading, writing, numeracy, and language—subdomains: spelling, grammarm and punctuation) using the National Assessment Program in Literacy and Numeracy (NAPLAN). A self‐reported child questionnaire collected dietary intake data. “Core” (healthy) and “noncore” (unhealthy) dietary patterns were derived using principal components analysis. RESULTS: The noncore pattern was associated with lower NAPLAN scores across all academic domains (mean: −12.6, 95% CI: −18.7 to −6.4, r2 = .073, p < .001) except writing, while the core foods pattern was not associated with NAPLAN scores across all domains. When the noncore model was adjusted for sociodemographic covariates (child body mass index, ethnicity, sex, parental education, household income, marital status, mother's employment hours, and number of siblings), the association was attenuated but remained statistically significant (NAPLAN summary score: −8.5, 95% CI −15.0 to −1.9, r2 = .123, p = .011). CONCLUSIONS: Academic performance was deleteriously associated with a nutrient‐poor, energy‐dense diet, yet not associated with a nutritious diet. [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: Health education (HE) courses in schools are vital paths for improving teenagers' health literacy. HE and physical education (PE) teachers lead HE courses, and their teaching intentions and competency influence the effectiveness of the courses and the ability to promote students' health literacy. This study attempted to understand HE and PE teachers' health literacy teaching intentions and professional competency and to investigate their relationships. METHODS: This study adopted a cross‐sectional design. A questionnaire survey was administered to 906 middle school HE and PE teachers in Taiwan by mail, and 545 provided valid data with consent. RESULTS: Participants had a favorable health literacy (47.78/50), positive health literacy teaching beliefs and attitudes, and acceptable efficacy. They intended to implement health literacy instruction within the subsequent year. Teaching beliefs, attitudes, and efficacy were all positively correlated with intentions (all p < .001). Demographic variables, health literacy, and teaching beliefs, attitudes, and efficacy explained 33.5% of the variance of teaching intentions. CONCLUSION: Teaching beliefs, attitudes, and efficacy were crucial predictors of health literacy teaching intentions. To improve students' health literacy, educational authorities and schools should pay attention to HE and PE teachers' intentions and vital factors, thereby enhancing teachers' willingness to perform health literacy instruction. [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 Hennepin County partnered with schools to implement lunchroom strategies to encourage fruit and vegetable consumption. An in-depth evaluation measured changes in consumption following implementation of encouragement strategies including slicing apples and attractive labels. METHODS A pre-post prospective evaluation measured changes in average fruit and vegetable consumption at 2 elementary schools. The plate waste method was used to weigh individual waste. To measure consumption, 373 students were matched pre/post. Additional measures included change in fruit and vegetable selection, change in whole servings consumed and apple consumption. RESULTS Average fruit consumption increased by 3.0 g (p = .09), average vegetable consumption increased by 1.1 g (p = .27), neither significantly. The number of students selecting fruit significantly increased (p = .02), while the number taking vegetables increased, but not significantly (p = .28). The number of students consuming an entire serving of fruit (p = .15) or vegetables (p = .45) both increased but not significantly. Apple consumption more than doubled at one school. CONCLUSIONS Implementing lunchroom changes can increase the number of students selecting fruit, and changes including slicing can increase consumption of apples. Additional strategies are needed to increase vegetable selection and fruit and vegetable consumption. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND We assessed the associations of 5 school and 7 neighborhood variables with fifth-grade students achieving Healthy Fitness Zone (HFZ) or Needs Improvement-Health Risk (NI-HR) on aerobic capacity (AC) and body composition (BC) physical fitness components of the state-mandated FITNESSGRAM® physical fitness test. METHODS Data for outcome (physical fitness) and predictor (school and neighborhood) variables were extracted from various databases (eg, Data Quest, Walk Score®) for 160 schools located in San Diego, California. Predictor variables that were at least moderately correlated (|r| ≥ .30) with ≥1 outcome variables in univariate analyses were retained for ordinary least squares regression analyses. RESULTS The mean percentages of students achieving HFZ AC (65.7%) and BC (63.5%) were similar (t = 1.13, p = .26), while those for NI-HR zones were significantly different (AC = 6.0% vs BC = 18.6%; t = 12.60, p < .001). Correlations were greater in magnitude for school than neighborhood demographics and stronger for BC than AC. The school variables free/reduced-price lunch (negative) and math achievement (positive) predicted fitness scores. Among neighborhood variables, percent Hispanic predicted failure of meeting the HFZ BC criterion. CONCLUSIONS Creating school and neighborhood environments conducive to promoting physical activity and improving fitness is warranted. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Studies have assessed health in schoolchildren. Less is known about the environmental and occupational health of teachers. METHODS A cross-sectional survey of teachers was conducted in 24 randomly selected public elementary schools. Questionnaire included sociodemographic information, healthcare, school conditions, and health outcomes. Chi-square and logistic regression were used to analyze bivariate relationships. Multivariable logistic regression model was created for each health outcome, adjusted for sex and smoking to calculate estimates of association ( OR) for variables that were significant in bivariate analysis. RESULTS Response rate was 71.2 % (N = 797). Classroom conditions significantly associated with respiratory symptoms included having no windows or windows that do not open were associated with asthma or colds ( OR 2.0); carpeting was associated with having asthma, itchy eyes, and eye irritation ( OR 1.9); mold or water damage was associated with respiratory infections, eye irritation ( OR 2.1), nasal congestion ( OR 2.4), and sore throat ( OR 2.7); visible dust was associated with frequent colds ( OR 2.2), nasal congestion ( OR 1.7), and sore throat (1.9). CONCLUSIONS Asthma, respiratory infections, colds, eye irritation, nasal congestion, and sore throat were associated with the classroom environment. Results indicate that the school environment could affect teachers' respiratory health. Further assessments are necessary to establish causation. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Owing to the associations between diet and health, it is important that effective health promotion strategies establish healthful eating behaviors from an early age. We reviewed the intensity of school-based interventions aimed to modify dietary behavior in preadolescent and adolescents and related intervention characteristics to effectiveness. METHODS Our systematic literature search of 8 databases sought to identify interventions measuring dietary intake in school settings to students aged 9 to 18. We evaluated these studies for effectiveness, intensity, intervention category, and follow-up measures. RESULTS Of the 105 interventions 81 were found to be effective immediately postintervention, irrespective of intensity. Studies that were 6 weeks to 5 months in duration, targeted students' environment or group (alone or in combination), and reached students only in schools were more effective. Only one-fifth of interventions conducted a follow-up measure, and a majority showed a loss of effectiveness from postintervention to follow-up. CONCLUSIONS We identified characteristics of effective interventions. These findings may inform the development of future interventions targeting dietary behavior in preadolescents and adolescents in the school-based setting. [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 This study investigates school lifestyle among adolescents in terms of physical activity ( PA) structure: (1) adolescents participating in a physical education lesson ( PEL) versus (2) aggregate recess time exceeding 60 minutes. METHODS The research was conducted in 24 secondary schools in the Czech Republic (boys N = 208, girls N = 433). For the whole day (1-3 days) participants wore the ActiTrainer accelerometer, which monitored PA, and heart rate. A total of 1122 school days were recorded. RESULTS Both boys and girls participating in a PEL reported significantly better results compared with nonparticipating individuals regarding all indicators of volume and intensity of school PA ( SPA). In most SPA indicators, longer aggregate recess time (>60 minutes) had a statistically significant effect, particularly on the volume of SPA. The recommended 500 steps/hours for SPA was achieved by 83% of boys participating in PEL and 69% of girls. In contrast just 32% of nonparticipating boys and 31% of girls reached this level. With longer recess time the recommendation was met by 43% of boys (42% of girls) compared with 26% of boys (23% of girls) with shorter recess time. CONCLUSIONS An increase in SPA and an improved lifestyle in adolescents on school days are significantly supported more by PELs than by longer recess time. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND NEEDs for Bones ( NFB), based on the Health Belief Model, is a 4-lesson osteoporosis-prevention curriculum for 11- to 14-year-olds. This study examined the relationship between enjoyment of food tastings and interest in NFB. METHODS NFB was administered by teachers as part of standard practice and evaluated after the fourth lesson using a 21-item survey. Significant clustering of students within classrooms required use of random-intercept multilevel ordinal regression models in SAS proc GLIMMIX, with students nested within classrooms. Analyses considered tasting experience, eating attitudes, sex, grade, and cohort. RESULTS Students (N = 1619; 50% girls) participated from 85 fourth to eighth grade classrooms (47% sixth grade and 31% seventh grade) in 16 Pennsylvania SNAP-Ed eligible schools over 2 academic years. For all foods tasted, students who did not enjoy the food tasting were less interested in the lesson than students who did enjoy the food tasting (all p < .001); refried beans (odds ratio [ OR] = 0.30), soy milk ( OR = 0.55), cranapple juice ( OR = 0.51), sunflower kernels ( OR = 0.48), and Swiss cheese ( OR = 0.49). The relationship persisted net of covariates. CONCLUSIONS Enjoyment of food tasting activities can predict interest in nutrition education on osteoporosis prevention, supporting resource allocation and inclusion of food tasting activities in school-age nutrition education. [ABSTRACT FROM AUTHOR]

BACKGROUND Approximately one third of California school-age children are overweight or obese. Legislative approaches to assessing obesity have focused on school-based data collection. During 2010-2011, the Chula Vista Elementary School District conducted districtwide surveillance and state-mandated physical fitness testing ( PFT) among fifth grade students. We compared height, weight, and body mass index ( BMI) to examine measurement differences between the projects. METHODS We assessed demographic characteristics and BMI category frequencies. We used paired t-tests to test continuous variables. κ statistics were used to assess categorical agreement. RESULTS Of 3549 children assessed, 69% were Hispanic. Fifty-one percent were boys. Mean heights, weights, and BMIs were significantly different for each project (p < .0001). Surveillance height (106.7-165.1 cm) and weight (21.6-90.8 kg) ranges were lesser than PFT ranges (109.2-180.3 cm and 22.7-98.4 kg). The overall BMI category agreement was good (weighted κ = 0.77). Categorical percentage agreement was highest among normal weight children (94.9%) and lowest among underweight children (56.6%). CONCLUSIONS Methodological differences might have resulted in the observed height, weight, and BMI differences. As school-based interventions become common, districts should carefully consider measurement reliability, training, and data-handling protocols to have confidence in their findings. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Across the United States, school health education programs provide a wide variety of knowledge and skills to their students. There are currently no guidelines for school health methods courses. METHODS Using a 2-wave mailing followed by a third wave e-mail reminder, a final population of 226 university school health methods instructors at school health preparation programs were surveyed. RESULTS A total of 138 completed surveys (61%) were returned. The topics taught in school health education methods courses emphasized the most included aligning objectives, instruction, and assessment (79%); development of lesson plans (73%); teaching methods that engage learners (72%); and application of the National Health Education Standards and performance indicators (69%). The content taught and how the instructors assessed their students differed statistically by 1 or more of the following: whether they had a health education degree, had experience teaching in the public schools, and if their program was accredited. CONCLUSIONS This study provides information regarding what school health methods instructors across the United States are teaching in their classes. Using this information as a baseline can serve as a guide for preservice faculty teaching a school health methods course. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND A San Francisco Bay Area school health initiative was established in fall 2010 to improve wellness programs in 4 local school districts using the Coordinated School Health ( CSH) model. This study examines the role of district-wide wellness coordinators and the ways in which they contribute to intentional coordination of health and wellness programs and activities in their school districts. METHODS This study included 8 schools across 4 school districts. Researchers conducted semistructured interviews and focus groups with district and school staff, students, parents, wellness committee members, and wellness coordinators in 2012 to examine a range of perspectives about the coordination of school health and wellness. RESULTS District wellness coordinators' efforts were linked to an increase in (1) awareness of health and wellness, (2) integration of wellness activities within and across schools and districts, and (3) leveraged resources. CONCLUSIONS Wellness coordinators are critical to successful CSH efforts. Through intentional and strategic collaboration with key stakeholders, wellness coordinators advance CSH goals of integrating health and wellness programs within and across school districts, reaching more students equitably and leveraging resources. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Evidence show that school connectedness is important to youth wellness. However, considerable inconsistency in the concepts and measures of school connectedness exists across studies. In addition, many measures do not capture the multifaceted dimensions of the school connectedness construct. This study examined the psychometric properties of a school connectedness scale that aimed to measure comprehensively the key constructs of school connectedness. METHODS The scale was developed with teachers and tested with an ethnically diverse sample of 717 high school students enrolled in a school connectedness course using confirmatory factor analysis. RESULTS Confirmatory factor analyses demonstrated the association of the 15 items with the 5 factors identified in the literature-school involvement, academic motivation, school attachment, teacher support, and peer relations (χ2 = 439.99, df = 83, p < .0001, Comparative Fit Index = 0.991, Tucker-Lewis index = 0.988, root mean square error of approximation = 0.077). Cronbach coefficient alphas for the factors ranged from 0.73 to 0.93. CONCLUSIONS Although further tests need to be conducted to assess its validity and reliability, this newly developed scale may provide researchers a tool to measure comprehensively school connectedness for program evaluation. [ABSTRACT FROM AUTHOR]