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

BACKGROUND: Over the last 3 decades, US obesity rates have increased dramatically as more children and more adults become obese. This study explores an innovative program, Active Generations, an intergenerational nutrition education and activity program implemented in out-of-school environments (after school and summer camps). It utilizes older adult volunteers to implement a version of the evidence-based childhood obesity prevention program, Coordinated Approach to Child Health, in 8 US cities. METHODS: Approximately 760 children in third- to fifth-grade participated in Active Generations, a 10-lesson, intergenerational, childhood obesity prevention program. Children completed an age-appropriate survey instrument, the Active Generations survey (AGS). The AGS is a valid and reliable, self-administered, self-report, paper-and-pencil survey designed to assess knowledge, attitudes, and behaviors. It was administered by trained volunteers on the first day and last day of the program. Constructs assessed included physical activity, nutrition, and media use. RESULTS: Students significantly increased their reported fruit and vegetable consumption post-program. For example, the percentage of students reporting eating 3 or more servings of vegetables per day was 16% greater post-program. Students were more likely to report reading food labels and greater confidence that they could participate in physical activity. They also significantly decreased their daily screen time. CONCLUSIONS: Active Generations is a promising childhood obesity prevention program. [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: Developmental assets foster positive health outcomes among adolescents, but have not been studied in adolescents with chronic illness or depression, two conditions that impact behaviors in school. We examined parent‐reported assets in a national sample of adolescents and compared the number and types of assets by health statuses. METHODS: Data were from the 2016 National Survey of Children's Health (N = 15,734 adolescents), which captured 15 of 40 assets in the Developmental Assets Framework. We categorized adolescents as healthy; chronic physical illness alone; depression alone; and chronic physical illness with co‐morbid depression. Data were analyzed using analysis of variance and logistic regression. RESULTS: Healthy adolescents and those with chronic physical illness alone were comparable in number and types of assets. Adolescents with chronic physical illness and co‐morbid depression had fewer assets compared to healthy adolescents and those with chronic physical illness alone. Similar associations were found in comparing healthy adolescents to those with depression without chronic physical illness. CONCLUSIONS: The presence of depression, among adolescents with and without chronic physical illness, was associated with fewer internal and external assets. The absence of assets may serve as a unique indicator of underlying depressive symptoms among adolescents in the school setting. [ABSTRACT FROM AUTHOR]

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

BACKGROUND: In this study, we 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: Federal law requires water access in schools where meals are served. Schools report high rates of water accessibility in cafeterias, but observations indicate lower adherence. Although observation is costly, it permits a more detailed assessment of a water source to determine whether it provides effective access that encourages water consumption and thus, healthy hydration for students. METHODS: To offer a less costly alternative to observations, researchers developed and validated a photo‐evidence tool to examine characteristics of effective school drinking water access. Two observers recorded characteristics of 200 water sources in 30 schools, including type, wear, cleanliness, and water flow, and examined obstructions and beverage promotion near sources, as well as, drinking vessel availability. Observers photographed sources which were coded by a separate research team. Agreement between observation audits and photograph coding was assessed through percent agreement, and kappa statistics and correlation coefficients. RESULTS: Kappas indicated substantial (K > 0.60) or near perfect agreement (K > 0.80) for all characteristics of effective drinking water access with exception of wear. There was moderate agreement (r = 0.66) for water source cleanliness. CONCLUSIONS: Development and validation of a photo‐evidence tool to examine characteristics of effective drinking water access in schools. [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]

BACKGROUND: Only half of US schoolchildren receive influenza vaccine. School‐located influenza vaccination (SLIV) might raise vaccination rates but conducting flu vaccine clinics at schools is challenging to implement. We compared 2 school‐based programs designed to raise influenza vaccination rates: parent reminder/educational messages sent to parents from schools which is a low‐intensity intervention vs the combination of reminder/educational messages plus SLIV clinics which is a high‐intensity intervention. METHODS: We assigned 36 schools (6 school districts, 2 per group) to 3 groups: (1) control, ie, no SLIV and no parent reminder/education, (2) parent reminder/education emailed by schools, and (3) parent reminder/education plus SLIV clinics. Some schools had SLIV clinics in prior years. Health department nurses conducted SLIV clinics. RESULTS: Among 24,832 children at 36 schools, vaccination rates were control (51.3%), parent reminder/education‐only (41.2%), and reminder/education + SLIV (58.7%). On multivariate analyses which controlled for vaccination in prior seasons, children in reminder/education + SLIV schools had higher vaccination rates (OR 1.27, 95% CI 1.10‐1.47), but children in reminder/education‐only schools had lower rates (OR 0.87, 95% CI 0.75‐1.00) than children in control schools. CONCLUSIONS: Parent reminder/education combined with SLIV clinics raise vaccination rates, but parent reminder/education alone does not. [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: Studies have examined relationships between teacher characteristics and student achievement in courses such as math and science. This study is among the first to examine effects of teacher characteristics on student knowledge in a health course. METHODS: Student (N = 6143) pretest and posttest data were linked to teacher (N = 67) data. Changes in student knowledge scores from pre‐ to postcourse were explored using mixed‐effects linear models. Teacher characteristics included professional development (PD) attendance, having a dedicated classroom, certification type, educational background, years' experience, and athletic coaching status. RESULTS: Teacher characteristics associated with greater student knowledge gains included: being certified to teach health versus not certified (p < .001), having a dedicated classroom versus no classroom (p = .017), and for middle school teachers, having attended ≥3 PD sessions versus ≤2 (p = .023). Less knowledge gain was associated with teachers that coached versus noncoaches (p = .040) and having a health degree versus no health degree (p = .049). Post hoc analyses revealed the negative effect of health degree was only significant among coaches (p = .026). CONCLUSIONS: Findings suggest opportunities for maximizing student knowledge gains through tailored selection of health teachers and provision of appropriate teaching support. [ABSTRACT FROM AUTHOR]

BACKGROUND: Based on Mayer and Salovey's model of emotional intelligence, this study examined whether perceived stress mediates the interplay of emotional intelligence and life satisfaction for girls and boys during early and middle adolescence. METHODS: Using multigroup structural equation modeling with questionnaire data from a sample of Spanish adolescent students (N = 800; MAgeT1 = 14.02, MAgeT2 = 15.00, SD = 1.21) in 2 waves (T1 = March 2015; T2 = December 2015). RESULTS: Results of multigroup structural equation modeling indicated no group differences between boys and girls in early adolescence (7th and 8th grade) and middle adolescence (9th and 10th grade), as stress function as mediator between emotional intelligence and life satisfaction for all groups. However, latent mean comparison indicated that girls not only perceive and understand emotions better than boys, but they also perceive higher amounts of stress at an older age. CONCLUSION: Results indicate the potential risk of perceived stress that might drop the protective effect of emotional intelligence on life satisfaction. These findings have implications for future research and educational practice considering combined prevention programs for adolescent's health and well‐being. [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: While dietary sources of calcium are important for bone health, the intake of milk and milk products decreases as children get older. A free milk in schools program may mitigate this decrease in milk consumption. We evaluated the Fonterra Milk for schools program (a free milk initiative) by determining changes in children's milk consumption and anthropometric measures over a 2‐year period. METHODS: The evaluation was conducted in children aged 7‐9 years in a representative sample of primary schools participating in the free milk program, in Auckland, New Zealand. The primary outcome was the proportion of children meeting the New Zealand guidelines for dairy and milk product consumption over 7 days (≥2 servings per day). Changes in anthropometric measures were also assessed as secondary outcomes. RESULTS: Nine schools (N = 511 children) participated in the evaluation. The proportion of children meeting the New Zealand guidelines for milk and milk product consumption over 7 days increased significantly from baseline to 2 years' follow‐up (72% vs 94%; p < .001). Body mass index z scores did not change significantly between baseline and 2 years' follow‐up. CONCLUSIONS: The Fonterra Milk for Schools initiative appears to be an effective way of increasing milk/milk product consumption behaviors in school‐aged children. [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 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 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 The aims of this study were to examine the relationships among physical activity (PA)-related beliefs and to determine to what extent Iranian adolescents in different stages of PA adoption differ in perceived benefits and barriers during a 3-year transition from junior high school to high school. METHODS Data were collected from female adolescents in 2010 (N = 558), of whom 412 provided follow-up data in 2013. One-way analysis of variance and logistic regression were conducted for statistical analysis. RESULTS Participants in the action and maintenance stages reported the greatest agreement with benefits. Pre-contemplators were about 4 times more likely to cite 'not enough time' than preparers ( OR = 3.95). Pre-contemplators were over 4 times more likely to cite not liking exercise than those in action and maintenance stages at baseline ( OR = 4.32 and 4.85), a finding which was maintained at follow-up ( OR = 3.66 and 8.65). CONCLUSIONS These findings could help with the creation of interventions tailored to encourage pre-contemplators to progress toward adoption of PA. Providing transportation supports, enhancing time management, and mitigating boredom may be helpful strategies either to prevent relapse in adoption stages or to move females in early stages of change toward action and maintenance. [ABSTRACT FROM AUTHOR]

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 The landmark School Health Education Study ( SHES) project influenced by the conceptual approach to teaching and learning provides perspective on modern school health instruction. Conceptual education, the cornerstone of the SHES curriculum framework (CF), Health Education: A Conceptual Approach to Curriculum Design, fosters a student's understanding of information that develops with experience. METHODS Data were collected through content analysis of the SHES CF and the National Health Education Standards: Achieving Excellence ( NHES), 2nd edition. Similarity of essential framework elements was established. Inter-rater reliability was established. RESULTS Alignment of the SHES components with the NHES reveals parallel conceptual structures around which to develop curriculum. CONCLUSIONS The conceptual approach to curriculum planning has enduring value. It provides a foundation for teaching and learning that is adaptable, flexible, and can maintain permanence in conjunction with emerging scientific evidence and cultural and political influences on health behavior. [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 According to commercial marketing theory, a market orientation leads to improved performance. Drawing on the social marketing principles of segmentation and audience research, the current study seeks to identify segments to examine responses to a school-based alcohol social marketing program. METHODS A sample of 371 year 10 students (aged: 14-16 years; 51.4% boys) participated in a prospective (pre-post) multisite alcohol social marketing program. Game On: Know Alcohol ( GO: KA) program included 6, student-centered, and interactive lessons to teach adolescents about alcohol and strategies to abstain or moderate drinking. A repeated measures design was used. Baseline demographics, drinking attitudes, drinking intentions, and alcohol knowledge were cluster analyzed to identify segments. Change on key program outcome measures and satisfaction with program components were assessed by segment. RESULTS Three segments were identified; (1) Skeptics, (2) Risky Males, (3) Good Females. Segments 2 and 3 showed greatest change in drinking attitudes and intentions. Good Females reported highest satisfaction with all program components and Skeptics lowest program satisfaction with all program components. CONCLUSION Three segments, each differing on psychographic and demographic variables, exhibited different change patterns following participation in GO: KA. Post hoc analysis identified that satisfaction with program components differed by segment offering opportunities for further research. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Recess is a part of the elementary school day with strong implications for school climate. Positive school climate has been linked to a host of favorable student outcomes, from attendance to achievement. We examine 6 low-income elementary schools' experiences implementing a recess-based program designed to provide safe, healthy, and inclusive play to study how improving recess functioning can affect school climate. METHODS Data from teacher, principal, and recess coach interviews; student focus groups; recess observations; and a teacher survey are triangulated to understand the ways that recess changed during implementation. Comparing schools that achieved higher- and lower-functioning recesses, we link recess functioning with school climate. RESULTS Recess improved in all schools, but 4 of the 6 achieved a higher-functioning recess. In these schools, teachers and principals agreed that by the end of the year, recess offered opportunities for student engagement, conflict resolution, pro-social skill development, and emotional and physical safety. Respondents in these four schools linked these changes to improved overall school climate. CONCLUSIONS Recess is an important part of the school day for contributing to school climate. Creating a positive recess climate helps students to be engaged in meaningful play and return to class ready to learn. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Little is known regarding youth perceptions of tap water and school water fountains and how these relate to water and sugar-sweetened beverage ( SSB) intake. METHODS We used national 2010 YouthStyles data to assess perceptions of tap water and school water fountains and associations with water and SSB intake. RESULTS Nearly 1 in 5 participants disagreed their tap water was safe and nearly 2 in 5 disagreed school water fountains were clean and safe. Perceived tap water risk was more prevalent among non-Hispanic ( NH) Blacks (26.4%) and Hispanics (28.3%) compared with NH Whites (14.7%, p < .001) and more prevalent among lower-income youth. Negative water fountain perceptions were more common among high school-aged youth. Perceived tap water risk was not associated with SSB intake (odds ratio [ OR] = 1.0, 95% confidence interval [ CI]: 0.6, 1.5) or water intake ( OR = 1.4, 95% CI: 0.9, 2.1). Negative water fountain perceptions were associated with SSB intake only among Hispanics (race/ethnicity interaction p < .001; OR = 2.9, 95% CI: 1.3, 6.6) but were not associated with water intake. CONCLUSION Negative perceptions of tap water and water fountains among youth are common and should be considered in efforts to provide water in schools. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND In 2007, legislation was proposed in 24 states and the District of Columbia for school-based human papillomavirus ( HPV) vaccine mandates, and mandates were enacted in Texas, Virginia, and the District of Columbia. Media coverage of these events was extensive, and media messages both reflected and contributed to controversy surrounding these legislative activities. Messages communicated through the media are an important influence on adolescent and parent understanding of school-based vaccine mandates. METHODS We conducted structured text analysis of newspaper coverage, including quantitative analysis of 169 articles published in mandate jurisdictions from 2005 to 2009, and qualitative analysis of 63 articles from 2007. Our structured analysis identified topics, key stakeholders and sources, tone, and the presence of conflict. Qualitative thematic analysis identified key messages and issues. RESULTS Media coverage was often incomplete, providing little context about cervical cancer or screening. Skepticism and autonomy concerns were common. Messages reflected conflict and distrust of government activities, which could negatively impact this and other youth-focused public health initiatives. CONCLUSIONS If school health professionals are aware of the potential issues raised in media coverage of school-based health mandates, they will be more able to convey appropriate health education messages and promote informed decision-making by parents and students. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Violence-exposed youth rarely receive mental health services, even though exposure increases risk for academic and psychosocial problems. This study examines the association between violence exposure and mental health service contact. The 4 forms of violence exposure were peer, family, sexual, and witnessing. METHODS Data are from 1534 Boston public high school students who participated in a 2008 self-report survey of violence exposure and its correlates. Multivariate logistic regressions estimated associations between each form of violence with service contact, then examined whether associations persisted when controlling for suicidality and self-injurious behaviors. RESULTS In unadjusted models, violence-exposed students more often reported service contact than their peers. However, in multivariate models, only exposure to family (odds ratio [ OR] = 1.69, 95% confidence interval [ CI] = 1.23-2.31) and sexual violence ( OR = 2.34, 95% CI = 1.29-4.20) were associated with service contact. Associations attenuated when controlling for suicidality and self-injurious behaviors, indicating they were largely explained by self-harm. Sexual violence alone remained associated with mental health service contact in fully adjusted models, but only for girls ( OR=3.32, 95% CI=1.30-8.45), suggesting sex-specific pathways. CONCLUSIONS Associations between adolescent violence exposure and mental health service contact vary by forms of exposure. Outreach to a broader set of exposed youth may reduce the impact of violence and its consequences for vulnerable students. [ABSTRACT FROM AUTHOR]

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

BACKGROUND Whereas dating violence among high school students has been linked with sexual risk-taking and substance use, this association has been understudied among early adolescents. We estimated the prevalence of physical and nonphysical dating violence in a sample of middle school students and examined associations between dating violence, sexual, and substance use behaviors. METHODS Logistic regression models for clustered data from 7th grade students attending 10 Texas urban middle schools were used to examine cross-sectional associations between dating violence victimization and risk behaviors. RESULTS The sample (N = 950) was 48.5% African American, 36.0% Hispanic, 55.7% female, mean age 13.1 years ( SD 0.64). About 1 in 5 reported physical dating violence victimization, 48.1% reported nonphysical victimization, and 52.6% reported any victimization. Adjusted logistic regression analyses indicated that physical, nonphysical, and any victimization was associated with ever having sex, ever using alcohol, and ever using drugs. CONCLUSIONS Over 50% of sampled middle school students had experienced dating violence, which may be associated with early sexual initiation and substance use. Middle school interventions that prevent dating violence are needed. [ABSTRACT FROM AUTHOR]

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

BACKGROUND: In 2002, the US Centers for Disease Control and Prevention recommended that schools adopt policies that reduce exposure of children to ultraviolet radiation to prevent skin cancer. We report here the development of a school sun-safety policy measure and baseline descriptive statistics from the assessment of written policies collected in 2005-2007 from public school districts that enrolled in a randomized trial evaluating a policy promotion program. METHODS: Written policies were collected from 103 of 112 school districts in Colorado and Southern California prior to randomization. We developed methods for selecting policy headings/sections topics likely to contain sun-safety policies for students and for assessing the presence, strength, and intent of policies. Trained coders assessed the content of each policy document. RESULTS: Overall, 31% of districts had a policy addressing sun safety, most commonly, protective clothing, hats, sunscreen, and education at baseline. More California districts (51.9%) had these policies than Colorado districts (7.8%, p < .001). Policy scores were highest in districts with fewer Caucasian students (b = −0.02, p = .022) in Colorado (b = −0.02, p = .007) but not California (b = 0.01, p = .299). CONCLUSION: The protocol for assessing sun-safety policy in board-approved written policy documents had several advantages over surveys of school officials. Sun-protection policies were uncommon and limited in scope in 2005-2007. California has been more active at legislating school policy than Colorado. School district policies remain a largely untapped method for promoting the sun protection of children. [ABSTRACT FROM AUTHOR]