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BACKGROUND: Psychosocial support provision in schools is a promising strategy for overcoming barriers to accessing mental health care. This study aimed to assess teachers' knowledge, attitudes, practices, skills, and perceived barriers in providing psychosocial support to students in Jordan. METHODS: The sample included teachers working in public schools, private schools, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) schools, and Zaatari camp schools, as well as non‐formal education centers. The study utilized a multi‐stage stratified cluster sampling technique to select a nationally representative sample. RESULTS: A total of 549 teachers were included, and only 25.2% have ever received mental health training. Most teachers reported a high level of good and acceptable knowledge of psychosocial support and had a positive attitude toward the provision of psychosocial support, however, about a quarter (25.5%) agreed on feeling nervous in discussing students' psychosocial problems with their parents or school administrators. The least enacted practice was the systematic engagement with parents, school administration, and other community resources in students' well‐being (sometimes, 31.6%; rarely, 20.4%). Gaps in skills were mainly in communicating with external resources and parents. The main barriers included parents' misunderstanding of teachers' role in providing psychosocial support to students (56.8%), lack of integration of psychosocial support in the curriculum (55.6%), and challenges in identifying students with psychosocial problems due to large class sizes (54.3%). CONCLUSION: The results show that gaps extend beyond the individual level of teachers to the community level. School‐based psychosocial support interventions must consider the multiple factors that influence their implementation at multiple levels, including the individual, relational, community, and societal levels. [ABSTRACT FROM AUTHOR]

Background: Return to school supports are recommended to facilitate adolescents' re‐entry to school following a concussion. However, little is known as to what school stakeholders prefer for a return‐to‐school process. This study sought to describe the preferences of high school students, parents, and educators for a Return‐to‐School Framework for adolescents following a concussion. Methods: We conducted qualitative semi‐structured, 1‐on‐1 or group interviews with high school students (n = 6), parents (n = 5), and educators (n = 15) from Calgary, Canada. Interviews aimed to describe participants' preferences for a Return‐to‐School Framework for students following a concussion. Interviews were analyzed using conventional content analysis. Results: We organized the data into 4 main themes: (1) purpose of the Return‐to‐School Framework; (2) format and operation of the Return‐to‐School Framework; (3) communication about a student's concussion; and (4) necessity of concussion education for students and educators. Implications for School Health Policy, Practice, and Equity: A Return‐to‐School Framework following concussion should be developed in consultation with families, educators, and students and supports should be tailored to each student. Conclusions: Participants preferred a standardized and consistent Return‐to‐School Framework including ongoing communication between stakeholders as well as feasible and individualized school supports. [ABSTRACT FROM AUTHOR]

BACKGROUND: The COVID‐19 pandemic has had drastic effects on K‐12 teachers. Researchers partnered with a teacher advisory board to identify factors associated with K‐12 teachers' consideration of leaving teaching during Fall 2020. METHODS: A web‐based survey focused on teachers' working experiences was emailed to school union membership listservs in Indiana, Kentucky, and Ohio. A logistic regression model was developed to identify working conditions associated with teachers considering leaving the profession. RESULTS: Among 5873 K‐12 teachers, 27% (n = 1319) were considering leaving the profession either because of COVID‐19 (10%), for other reasons (6%) or were undecided (11%). Teachers who were midcareer, having taught 6‐10 years, who perceived less supervisor support, whose job duties had changed significantly, who were dissatisfied with the COVID‐19 related decision‐making, who reported poor or fair mental health, and who were mostly or extremely afraid that a household member would get COVID‐19 had higher odds of considering leaving teaching or being undecided about future career plans. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE AND EQUITY: Understanding factors influencing teachers' career decisions will help school leaders improve teacher retention amid challenging circumstances. CONCLUSION: In this study in 3 midwestern US states, limited supervisor support, significant job duty change, dissatisfaction with COVID‐19‐related decision‐making, poor or fair mental health, and fear that a household member would get COVID‐19 were associated with teachers' consideration of leaving the profession or being undecided about future career plans. [ABSTRACT FROM AUTHOR]

BACKGROUND: Insufficient sleep is a growing public health concern. Thirty percent of Canadian children and youth are not meeting national sleep recommendations. Inadequate sleep can negatively influence students' academics and physical and psychosocial health. Schools have been identified as ideal health promotion settings to influence children's health including their sleep behaviors. The objective of this study was to explore teachers' perspectives on sleep behaviors and their role in school‐based sleep promotion. METHODS: Nineteen elementary teachers were purposively sampled from the greater Edmonton area, Alberta, Canada. Interpretive description was used as the guiding method, and data were generated through one‐on‐one semi‐structured interviews. Inductive descriptive thematic analysis was used to identify interview themes. RESULTS: Three themes related to teachers' perspectives on sleep behaviors and school‐based sleep promotion were identified: the importance of students' sleep, prioritizing sleep as part of teaching and learning, and a culture of healthy sleep habits. CONCLUSIONS: This study found that teachers considered sleep to be essential for elementary students' academic success and wellbeing, and a whole school approach was necessary to support a healthy sleep culture in schools. [ABSTRACT FROM AUTHOR]

Background: Mass school shootings have created fear in the American public. The results of this fear have been the hardening of schools, lockdowns, and active shooter drills, yet the mass shootings have not ended. The goal of this study was to analyze the mental health awareness of K‐12 public schools teachers in Texas with a goal to identify the connections between mental health awareness and school safety. Methods: Data were used from an archival database of K‐12 teacher responses in the 2020 Texas Educators' Needs Assessment Regarding School Safety and Victims Services to assess the current state of student mental health concerns and the connection of these concerns to school safety. This needs assessment included one mixed methods survey that was collected from Texas K‐12 educators and Texas educators working in higher education in 2020. The original study included 25,161 usable responses (6.1%). For the purpose of this study, only K‐12 teacher responses were used in the analysis. The K‐12 teacher participants (n = 19,888) included the following institutional levels: (a) special setting, 2,919 (14.7%); (b) elementary school, 6,813 (34.3%); (c) middle/intermediate school, 4,189 (21.1%); (d) high school, 5,864 (29.5%); and (e) district level, 103 (0.5%). A total of 8,053 participant's qualitative responses and 10 of the original quantitative survey questions from the archival data were used to identify all findings in the study. Results: Collected qualitative and quantitative participant responses' outlined a need to improve student mental health by strengthening the focus on supporting all stakeholders (e.g., teachers, parents, counselors, and students) in mental health awareness and education. Participant comments focused on the lack of training, counselor support, and community support regarding the mental health needs of their students. Conclusion: Recommendations to improve student mental health that were developed from this study identified key goals in school counselor role and responsibility to student mental health, increased involvement of community agencies, and improvement to in‐school mental health counseling. Final recommendations of this study were focused on the need to improve student mental health if stakeholders want to develop a positive school environment. The failure to build an environment that is focused on student mental health will continue to affect the goal to improve overall school safety. [ABSTRACT FROM AUTHOR]

Background: Grief and loss are common experiences for children and adolescents, particularly during the COVID‐19 pandemic. Educators feel unprepared to support grieving students due to lack of training. We studied educator experiences receiving grief‐sensitive training as part of the grief‐sensitive schools initiative (GSSI), which provides grief‐sensitive training, online video‐based and print resources, and a financial grant to schools and school districts for use in supporting grieving students. Methods: Fourteen New York and Florida educators who received GSSI training participated in small focus groups or semi‐structured interviews on their experiences receiving GSSI training and supporting grieving students during the pandemic. Transcripts were analyzed using grounded‐theory analysis. Results: Emergent themes included increased confidence engaging grieving students, the desire for recurring trainings, the value of receiving training from an expert on pediatric grief and loss and the opportunity to ask questions, the need for grief‐sensitive training to reflect the cultural diversity of school communities, the unique losses experienced by students during the pandemic, and compassion fatigue and burnout in educators. Implications for School Health Policy, Practice, and Equity: Policymakers should recognize the effects of grief on students' learning and development and collaborate with educators to develop resources. Conclusions: Educators found GSSI training useful in supporting grieving students, particularly during the pandemic. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Despite widespread availability of COVID‐19 vaccines, millions of Americans have not received the recommended vaccine doses. In the District of Columbia (DC), COVID‐19 vaccination rates are lowest among residents who are Non‐Hispanic (NH) Black and among school‐aged children. We assessed COVID‐19 vaccine hesitancy among staff and parents of students in DC K‐12 public and public charter schools. METHODS: We conducted a telephone‐based survey from February 6 to April 16, 2022 to staff, students, and parents of students who participated in school‐based COVID‐19 screening testing. COVID‐19‐related survey items included: vaccination status, reasons for not getting vaccinated, perceived vaccine access, and trusted COVID‐19 information sources. Utilizing time‐to‐event analyses, we evaluated differences across demographic groups. RESULTS: The interview response rate was 25.8% (308/1193). Most unvaccinated participants were NH Black and ages 5 to 11 years. Median time from vaccine eligibility to uptake was 236 days for NH Black participants vs. 10 days for NH White participants. Vaccine safety was the top concern among unvaccinated participants. Government and healthcare providers were the most trusted COVID‐19 information sources. CONCLUSIONS: Differences in timing of vaccine uptake among respondents and greater vaccine hesitancy among NH Black participants compared to other racial/ethnic groups highlight a need for continued tailored outreach and communication using trusted sources to convey the importance, benefits, and safety of COVID‐19 vaccination. [ABSTRACT FROM AUTHOR]

BACKGROUND: An estimated 1 in 5 adolescents have sustained a concussion in North America. Teachers and school administrators are responsible for implementing academic accommodations and other supports for optimal return to learn following a concussion. The primary objective of this study was to describe the prevalence and feasibility of providing academic accommodations to students following concussion from the perspectives of middle and high school teachers and school administrators. METHODS: A cross‐sectional survey was administered to teachers and school administrators (grades 7‐12) across Canada online via REDCap. Participants were recruited via word‐of‐mouth and social media sampling. Survey responses were analyzed descriptively using proportions. RESULTS: The survey was completed by 180 educators (138 teachers and 41 school administrators), of whom 86% had previously provided academic accommodations to students following concussion, and 96% agreed that students should have access to accommodations following concussion. Some accommodations (eg, breaks, extra time) were provided more often and were more feasible to provide than others (eg, no new learning, reduced bright light). Educators reported limited preparation time and limited school personnel support to assist students following concussion. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: The most feasible accommodations should be prioritized, ensuring students are supported within the school environment. CONCLUSIONS: Teachers and school administrators confirmed the importance of providing accommodations to students following concussion. [ABSTRACT FROM AUTHOR]

BACKGROUND: teen Mental Health First Aid (tMHFA) is an Australian school‐based universal program for grade 10 to 12 students. tMHFA teaches teens how to recognize and respond to a peer in crisis or experiencing mental health concerns. METHODS: Schools implementing tMHFA in 2019 and 2020 were propensity score matched, yielding a sample of instructors (n = 130) and students (n = 1915) in 44 high schools in 24 American states. Effectiveness and acceptability were assessed with student surveys at baseline and after implementation. RESULTS: There were significant findings for primary outcomes, including improved helpful first aid intentions (Cohen ds = 0.57 to 0.58), confidence supporting a peer (ds = 0.19 to 0.31); the number of adults rated as helpful (ds = 0.37 to 0.44); and reductions in stigmatizing beliefs (ds = 0.21 to 0.40) and "harmful first aid intentions" (ds = 0.11 to 0.42). Instructors and students rated the program favorably with students sharing improvements on their recognition and responses to mental health problems and crises. CONCLUSION: tMHFA is an effective, feasible, and scalable training program for increasing mental health literacy and decreasing mental health stigma in adolescents in the short term, consistent with trials of tMHFA in Australian adolescents. [ABSTRACT FROM AUTHOR]

Background: The association between early childhood psychosocial problems and poorer educational outcomes is well‐documented, but the extent to which this association persists is less understood. The current study assessed the correlations between first‐grade psychosocial functioning and educational outcomes through eighth grade in a large longitudinal sample of Chilean students. Methods: The Pediatric Symptom Checklist‐Chilean (PSC‐CL) and Teacher Observation of Classroom Adaptation Re‐Revised (TOCA‐RR) assessed psychosocial functioning for 9736 students who were screened four times from first through eighth grade through the Skills for Life program. Adjusted linear mixed effects models assessed the association between first grade PSC‐CL and TOCA‐RR risk and third, sixth, and eighth grade GPA and school attendance. Results: First‐grade PSC‐CL and TOCA‐RR risk both significantly predicted lower third, sixth, and eighth grade GPAs; all p <.001. The relationships between first‐grade psychosocial functioning and later school attendance rates were less consistent but still significant at certain time points. Conclusions: First‐grade psychosocial risk was persistently associated with lower academic performance in a longitudinal sample of Chilean students followed through elementary and middle school. Implications for School Health Policy, Practice, and Equity: Early school‐based psychosocial screening and follow‐up interventions have the potential to improve students' long‐term educational outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND: The benefits of delaying school start times for secondary students are well‐established. However, no previous study has considered how changing school start times impacts sleep and daytime functioning for K‐12 teachers. METHODS: Teachers in a large suburban school district completed 3 annual surveys (pre‐change n = 1687, post‐change n = 1857, follow‐up n = 1812) assessing sleep and daytime functioning. RESULTS: With delayed start times, high school teachers had later rise times (high school [HS]: 28 minutes, middle school [MS]: 14 minutes), increased sleep duration (HS: 22 minutes, MS: 13 minutes), and improved daytime functioning. Improvements for middle school teachers were noted but were not statistically significant. With earlier start times, elementary teachers reported earlier bedtimes (9 minutes) and wake times (9 minutes), with no changes in sleep duration or daytime functioning. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Today's school health policies often focus on wellness. Findings from this study reveal that the policy of healthy school start times can have a significant, positive impact on adults who teach in later‐starting secondary schools. Later school start times for secondary teachers provide greater parity with their elementary colleagues in terms of sleep opportunity. CONCLUSIONS: This study extends previous findings on how the policy of later secondary school start times improves the health and well‐being of adolescents, highlighting that healthy start times contribute to increased sleep opportunity for MS and HS teachers and improved daytime functioning for HS teachers, with changed start times having no significant negative effect on elementary school teachers. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal injuries are common in adolescents, and recently schools have been suggested as an opportune location for injury prevention strategies. This study aimed to identify the current practices and perceptions of post‐primary PE teachers in Ireland on injury prevention exercise programs (IPEP), which are key to informing potential implementation strategies. Methods: Post‐primary PE teachers (n = 287) completed an online anonymous survey. Outcome measures included current IPEP practices in PE class, teachers' attitudes toward IPEPs, willingness to implement, and perceived ability to implement an IPEP in PE class. Descriptive statistics were calculated, and Mann‐Whitney U tests were used to compare differences between groups. Results: Results indicated that only 1 in 5 PE teachers currently used an IPEP in class. Of these, no teacher used an existing IPEP exactly as intended, while most teachers were willing to implement an IPEP (80.5%). Those who previously received formal IPEP education or were aware of an existing IPEP had significantly higher perceived ability to implement an IPEP in class (p <.001). Conclusions: This study demonstrates that despite a willingness among PE teachers to implement IPEPs in class, few currently do. Thus, post‐primary PE class may be an under‐utilized setting for adolescent injury prevention and warrants further investigation. [ABSTRACT FROM AUTHOR]

BACKGROUND: The COVID‐19 pandemic has caused interruptions to the K‐12 US school landscape since spring 2020. METHODS: In summer 2020, we completed a pilot study utilizing interviews (n = 13) with school staff (ie, nurses, educators) from across the United States. We aimed to understand the status of school operation and re‐entry plans after the primary period of school closure, along with resources needed for students and staff during the COVID‐19 pandemic. RESULTS: All interviewees described their school's re‐entry plan as complete or in‐development. Ten plans included strategies to meet students' mental health needs. Only 3 clearly planned for staff mental health resources. Interviews suggest gaps in planning and execution of mental health resources for school staff, a group already vulnerable to stress, anxiety, and burnout. IMPLICATIONS FOR SCHOOL HEALTH: Several school staff mental health resources were developed as a result of the pandemic, though ongoing impacts necessitate integration of these supports into school operation plans. This is particularly important as schools continue to navigate periods of altered operation in response to elevated community COVID‐19 infection rates. CONCLUSIONS: As schools implement strategies to support students, similar consideration should be given to the adults in the school environment who teach and support school‐aged children. [ABSTRACT FROM AUTHOR]

METHODS: Using the Theory of Planned Behavior (Ajzen 1991) as a theoretical framework, this study examined what administrators and teachers at a public elementary school located in a district in Northeast Georgia communicated as to their salient behavioral beliefs (attitude), normative beliefs (subjective norms), and control beliefs (perceived behavioral control) relative to the implementation of the district's written recess policy. RESULTS: The results of this study demonstrated that teachers new to the field and those certified in early childhood education were more supportive of implementing the practice. The results further demonstrated that more experienced teachers and those certified in elementary education were less supportive. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: The findings in this study revealed that obtaining participant buy‐in was critical for the implementation and that targeted professional development would be a suitable vehicle for improving school health for students. CONCLUSIONS: The most cited reasons for support for the policy were an understanding that an unstructured break was beneficial for students and that participants considered it a non‐negotiable. The most cited reasons for a lack of support included more time needed for academics and a need for expanded behavioral consequences. [ABSTRACT FROM AUTHOR]

Background: Accumulating evidence has underscored the importance of fostering children's emotion regulation (ER) within primary school settings and the role of teachers in such efforts. This study sought to assess the needs of teachers in supporting students' ER, through a better understanding of teachers' perceptions and use of healthy versus unhealthy ER strategies in the classroom. Methods: Primary school teachers (n = 212; 91% female) completed an online, researcher‐developed needs assessment survey assessing their perceptions regarding the importance of ER instruction and challenges surrounding children's ER, as well as the perceived effectiveness and reported use of healthy and unhealthy ER strategies in the classroom. Results: Cochran's Q and chi‐square analyses revealed misperceptions regarding the effectiveness of healthy and unhealthy strategies, as well as discrepancies between teachers' perceptions regarding the effectiveness of specific healthy strategies (eg, meditation) and their reported use of them. Conclusions: While teachers recognize the growing importance of fostering ER in the classroom, the present findings suggest that there is a need for more professional development regarding the effectiveness and implementation of ER strategies in the primary school context. Efforts should be made to provide teachers with concrete recommendations for the implementation of ER strategies in the classroom. [ABSTRACT FROM AUTHOR]

BACKGROUND: Researchers have found a relationship between having food allergies and anxiety in children. Anxiety may relate to others' lack of food allergy knowledge. This study investigated the relationship between having a food allergy and self‐reported anxiety among children. Furthermore, knowledge of food allergies among children without food allergies and teachers was explored. METHODS: Children with food allergies and their parents each completed a perceived food allergy severity questionnaire. Children without food allergies completed a food allergy knowledge measure. All children completed a self‐reported anxiety measure. Teachers completed a questionnaire investigating knowledge, attitudes, and beliefs about food allergies. Correlational analyses and analyses of variance were conducted. RESULTS: Overall anxiety was significantly higher in children with food allergies than in children without food allergies. When controlling for the effects of sex and age, children with food allergies had significantly higher social phobia and school phobia. Teachers correctly answered 69.7% of knowledge‐based questions about food allergies; children without food allergies correctly answered 62.7%. CONCLUSIONS: Findings highlight the need for an integrated approach in which families, school personnel, psychologists and other mental health professionals, and medical professionals work together to increase awareness about the multifaceted needs of children with food allergies. [ABSTRACT FROM AUTHOR]

Background: School‐based programs are widely implemented to address childhood obesity. Despite the promise of these programs, evidence on their effectiveness is mixed. Adopting a dissemination and implementation (D&I) science focus utilizing mixed methods can provide a broader understanding and more robust details about these programs. The goal of this evaluation is to understand how implementation factors and teacher experience influence implementation success and outcomes of the Integrated Nutrition Education Program (INEP), an elementary school‐based nutrition program, using a mixed‐methods design. Methods: Reach, effectiveness, adoption, implementation, maintenance (RE‐AIM) framework guided the development of the evaluation and multiple methods were deployed. Hierarchical linear regression was used to assess the association between D&I construct variables within levels of influence and teacher perception of INEP impact from a quantitative end‐of‐year teacher survey. Follow‐up qualitative interviews with teachers were analyzed using constant comparison analysis. Results: Workload and burden emerged as significant factors related to implementation in the quantitative analysis. The follow‐up qualitative data collection identified other factors teachers found important to the adoption, implementation, and maintenance of INEP. Conclusion: Results of this evaluation can be used to inform program improvement efforts for INEP and provide information on ways to promote reach, effectiveness, adoption, implementation, and maintenance of similar school‐based health promotion programs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Asthma is one of the leading causes of school absenteeism. Schools can play an important role in coordinating asthma care. The purpose of this study was to assess the implementation of asthma‐related school health policies and practices across states and how they have changed over time. METHODS: Data were analyzed from 36 states that conducted School Health Profiles surveys during 2008 to 2018. Trends in 6 topics were analyzed by logistic regression and JointPoint trend test. RESULTS: Trends in efforts to identify and track students with asthma and improve students' and parents' knowledge about asthma were stable or increased. Interest among lead health education teachers in receiving professional development on asthma trended downward in 35 of 36 states. CONCLUSIONS: Stable to upward trends suggest that a majority of schools have maintained or improved their efforts to identify and track students with asthma and increase the knowledge of students and parents about asthma. However, further improvement is needed in referral of students with asthma to health care professionals and encouraging asthma‐related professional development of lead health education teachers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Menstrual hygiene management is an important public health issue for adolescents. The objective of this study was to explore teacher perceptions and experiences addressing adolescent menstruation experiences at school and examine their perception of the impact of menstruation on student learning. METHODS: Teachers in a Midwest school district participated in an online survey about their perceptions of adolescent school‐based menstruation experiences, including: experience and comfort‐level with providing menstruation assistance, presence of menstrual products in classroom/office for students, perceptions about adolescent school‐based menstruation experiences, and perceptions on the impact of menstruation on student learning. RESULTS: Two hundred and nine teachers participated in this study. Teachers perceived students' school‐based menstruation experiences to be mostly negative, stressful, embarrassing, and focused on concealment. Teachers described school‐based menstruation events as a distraction to learning and responded by offering emotional support and menstrual products, typically purchased by teachers. CONCLUSION: Teachers' negative perception of about menstruation and distractions in the classroom are amplified by social norms associated with overall menstruation‐related stigma. Findings emphasize the importance of educating teachers on how to more positively address student menstruation experiences to foster a more supportive environment conducive to learning for these students. [ABSTRACT FROM AUTHOR]

BACKGROUND Child well‐being, which includes physical, mental, and social health, has a critical effect on academic performance. Schools face many challenges in meeting needs for child well‐being. Schools in low‐resource areas, including the Mississippi Delta, face greater challenges when meeting student needs. METHODS: Eleven focus groups with middle school students and 12 interviews with teachers, staff, and administration in one Mississippi Delta middle school were completed in 2019. The Social Ecological Model and Theory of Organizational Readiness for Change were used as a framework for the study. RESULTS: Focus group data with middle school students and interviews with teachers, staff, and administrators show that academic stressors play a major role in student well‐being; yet, teachers, staff, and administrators face immense pressure to achieve high test scores. However, students seem to be encouraged by a positive school environment, which could help minimize some stressors. CONCLUSIONS: It seems that small improvements to the school environment could have a significant effect on student well‐being, especially when school infrastructure and limited resources do not support comprehensive changes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite proven health and learning benefits, health education implementation in elementary schools is not optimal. This study investigated learning environment, leadership, and training factors that may influence elementary‐level health education implementation in the current standardized testing‐saturated environment. METHODS: Survey data were collected from principals of 8 Michigan elementary schools and, via focus groups, 30 teachers in their schools. Teacher groups were separated into 2 categories based on principals' understanding of state health education policies. Grounded theory analysis was used. RESULTS: Despite all 30 teachers' positive attitudes toward health education, numerous consistent implementation barriers were identified; competition for instructional time with tested subjects was most critical. Teachers with principals who indicated a greater understanding of state policies reported more: consistent instruction; availability of resources, and encouragement to teach select topics, especially mental health. CONCLUSION: That these findings were produced in a state with strong CSHE polices, proven curricula, and expansive support systems are disheartening and accentuate the profound impact of standardized testing on elementary‐level health education implementation. More promising, principals' understanding of applicable state‐level policies appeared to generate stronger health education implementation. Future research should focus on the possible impact of time devoted to health instruction on standardized test scores. [ABSTRACT FROM AUTHOR]

BACKGROUND: Educators' negative weight biases toward students with high body weight have been well‐documented. The present investigation examined whether inclusion of body weight in school anti‐bullying policies is associated with lower levels of weight bias among educators. METHODS: Data on explicit weight bias was collected from a sample of secondary school teachers and principals in the United States (N = 246) and examined in relation to the presence of weight‐related language in each participant's school district anti‐bullying policy. RESULTS: The results indicate that, although educators on average make negative judgments about individuals with high weight, these biases were lower for educators whose school district anti‐bullying policy included enumeration of body weight. Notably, this association did not hold when policies enumerated "appearance." CONCLUSIONS: The study findings suggest that the explicit mention of "weight" in school anti‐bullying policies may represent a feasible mechanism to reduce explicit weight bias among U.S. secondary school educators. [ABSTRACT FROM AUTHOR]

BACKGROUND Teacher resistance is sometimes cited as a barrier to implementing Breakfast in the Classroom (BIC), an approach to school breakfast in which students eat at their desks after the school day has begun. Given their role in serving breakfast with BIC, teacher perceptions may be critical in implementing an effective BIC program. METHODS: K‐5 teachers (N = 249) in an urban, low‐income school district completed an online survey that assessed their expectations of BIC (retrospectively), perceptions of its benefits and challenges, and current program satisfaction. Descriptive statistics, Pearson's correlation tests, and multiple regression analyses were performed. RESULTS: Most teachers (64%) whose students were currently receiving BIC were satisfied with the program overall, and 81% of teachers agreed that (1) BIC should continue and (2) is worth the effort. The most commonly identified problem was lack of breakfast variety and healthfulness. Retrospective positive expectations were positively correlated with current program satisfaction (r =.61, p <.001), although overall post‐implementation perceptions are much more positive. Additionally, the perception that BIC improves students' health is related to higher satisfaction with BIC. CONCLUSIONS: Focusing on the health implications of BIC may be important to implementing new BIC programs. [ABSTRACT FROM AUTHOR]

BACKGROUND School equity refers to the extent to which students are treated fairly, ensuring that each student receives what they need to be successful. School staff can play a vital role in creating an equitable school climate for adolescents, but little is known about how staff perceive equity in their school and how this in turn may relate to students' perceptions. This study sought to explore congruence between teacher and student perceptions of school equity and how congruence or incongruence related to students' sense of connectedness to school. METHODS: Data for the study came from the Maryland Safe and Supportive Schools Climate Survey, which was administered online to 5523 school staff and 59,218 students across 104 middle and high schools. RESULTS: Multilevel models indicated that, compared to high staff and high student ratings, there was lower connectedness among the schools with low staff, low student ratings of equity as well as the schools with high staff, low student and low staff, high student ratings of equity. CONCLUSIONS: The findings suggest that staff perceptions of school equity are often higher than students and incongruence in perceptions may have a negative impact on students' connection to school. [ABSTRACT FROM AUTHOR]

BACKGROUND School is an important setting to promote healthy eating habits for children. We compared the effects of 4 conditions on the nutritional quality of snacks brought to school. We also investigated teachers' opinions regarding the process, barriers, and facilitators in regulation implementation. METHODS: We compared the nutritional quality of morning snacks based on 1958 photographs from schools divided into 4 conditions: regulation based on a list of permitted foods and beverages; regulation banning sweets, chips, and sugary drinks; information without regulation; or no intervention. Based on 5 focus groups (N = 18 participants), we investigated factors influencing regulation implementation. RESULTS: In schools with a list of permitted foods and beverages, 76% of the children had a healthy snack, compared to 52% to 54% in the 3 other conditions (p <.01). They also brought less sweet foods compared to those in the other conditions (41% vs. 68% to 71%, p <.01). In focus groups, most teachers supported regulation but also expressed ambivalence about their legitimacy. CONCLUSIONS: In this study, a regulation based on a list of permitted foods and beverages showed the best results. All actors should be involved in a progressive implementation process to increase acceptance of such regulation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Top public health experts and organizations strongly recommend universal masking for children older than 2 years old during the COVID‐19 pandemic, but speculate it may be difficult for young children. This study sought to assess the usage of cloth face masks in grades pre‐K‐2 and identify associated characteristics and adverse events. It is the first data to assess mask wearing by young children in school. METHODS: This online, prospective, observational, survey in multiple schools within a single school district in a major metropolitan area measured adherence to face covering mandates by students in grades pre‐K‐2 as measured by percentage of day with appropriate face mask wearing per report via daily teacher surveys for the first 4 weeks of school. RESULTS: The primary outcome was percent of the day that the entire class was wearing their masks appropriately. Of the estimated almost 1000 students and 1048 classroom days reported, the mean percentage of the school day with appropriate mask usage was 76.9%. CONCLUSIONS: For a majority of the day while conducting in‐person instruction, children in grades pre‐K‐2 are able to adhere to mask wearing as a key mitigation strategy for limiting SARS‐CoV2 infection spread and possible future use. [ABSTRACT FROM AUTHOR]

BACKGROUND: Due to the COVID‐19 pandemic, students and teachers have transitioned to online learning. The transition required changes in teaching practices to accommodate for an online learning environment. However, there are no studies characterizing physical educators' and school health experts' perspectives on physical education via distance learning or identifying best practices and their implications for student health. METHODS: Using purposive and snowball sampling, we conducted semi‐structured interviews with 19 physical education teachers and school health experts across 21 California school districts on best practices for physical education via distance learning. Interviews were recorded, transcribed, and analyzed using a grounded theory approach. RESULTS: Four major themes emerged: (1) participants felt high quality physical education via distance learning was both critical and possible; (2) strategies for creating a successful distance learning environment included personalization, creativity, and inclusiveness; (3) resources necessary for success included professional development, administrative support, and equipment; and (4) lessons for the long‐term. CONCLUSIONS: Participants identified effective strategies, challenges, and recommendations for the future. Participants felt optimistic about their ability to provide quality physical education via distance learning, given the necessary supports, and perceived that they played a critical role in supporting student health during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

BACKGROUND: Schools are a promising site for influencing the dietary intake of children and adolescents. The US Department of Agriculture recently released flexibilities to requirements for whole‐grains, sodium, and low‐fat milk in schools who demonstrated difficulty meeting nutrition standards for school meal programs. The support of School Nutrition Directors (SNDs) is vital to the success of school food environment changes; however, few studies have explored SNDs perceptions to changes in nutrition standards. METHODS: Experiences and perspectives toward nutrition standards of 10 SNDs, and their satisfaction with flexibilities for whole‐grains, sodium, and low‐fat milk were explored using a semi‐structured interview. Responses were analyzed using an inductive approach with thematic analysis. RESULTS: Three broad categories emerged challenges with the Healthy, Hunger‐Free Kids Act, food preferences and acceptability, and support and representation. A greater need for internal and external support, assistance in equipment and staff, procurement of foods compliant with regulations and acceptable to students, and more input on federal decisions and policies were perceived as important. CONCLUSIONS: Results provide critical insight into the implementation of nutrition standards. Future research and changes to school nutrition programs should consider these challenges as they strive to meet the needs of this important population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Evidence suggests that schools play an important role in student health; however, little is known about variability in teachers' use of food‐related classroom practices. In this study, we examined associations between teacher demographic and individual factors and their food‐related practices and modeling in the classroom. METHODS: We had 239 teachers in the United States complete an online survey about their demographics (years of teaching experience, socioeconomic status of the school), personal health status, height and weight, and nutrition knowledge. Teachers also reported on the unhealthy food‐related practices they use in their classroom (eg, candy as a reward) and modeling (ie, engaging in unhealthy and healthy eating practices in front of students). RESULTS: Hierarchical linear regressions were computed for each outcome separately. After controlling for socioeconomic status, fewer years of teaching experience and lower perception of personal health were associated with the use of unhealthy practices in the classroom. Teachers who were dieting were more likely to endorse healthy modeling. CONCLUSIONS: Teacher demographic and individual factors are associated with food‐related classroom behavior. These findings have implications for interventions to promote the health of teachers and their students. [ABSTRACT FROM AUTHOR]

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

BACKGROUND: Refugee background young people are at increased risk of mental health problems. In countries of refugee resettlement, schools are important sites where mental health difficulties can be identified and service access facilitated; however, little is known about how best to support these practices within schools. METHODS: This article explores school and mental health service providers' perspectives on mental health challenges and referral pathways for refugee youth in South Australia. It draws on semi‐structured in‐depth interviews with 17 secondary school staff and 10 mental health service providers, which were analyzed thematically. RESULTS: Key challenges for school staff in identifying mental health issues were understanding behaviors, overcoming stigma, cultural and linguistic barriers, engaging with parents, staff preparation and training, and embeddedness within Western understandings of mental health. There was also limited awareness of appropriate mental health services and referral pathways. Service providers recognized schools' key role in identifying mental health issues for refugee students. CONCLUSIONS: Enhanced training and support is required for teachers to identify and refer students who might be experiencing mental health issues. "On‐site" school services, bi‐cultural workers, and increased knowledge of existing within‐school supports and referral pathways to external services would enhance outcomes for refugee students. [ABSTRACT FROM AUTHOR]

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

BACKGROUND Establishing and maintaining a positive, inclusive social climate in school is essential, especially given the many potential social pressures that make school a toxic environment for vulnerable students. We explored middle school physical education (PE) teachers' perceptions of the factors that influence the implementation of social‐oriented approaches to include overweight and obese students. METHODS: We used a qualitative multicase study design guided by the Social Ecological Constraints model to study 9 PE teachers' perspectives and actions. We analyzed the transcripts of semistructured interviews, field notes, and artifacts related to teaching, PE programs, and school policies. Trust was established in conventional ways. RESULTS: Social‐ecological factors influenced teachers including program and school culture, policies, and norms of collaboration. Teachers acted beyond their instructional setting level strategies and used school‐program level strategies to socially include overweight and obese in PE. CONCLUSIONS: Some environments challenge employment of more than simple accommodations and a caring attitude; in others, teachers can collaborate with other school personnel to teach social goals through negotiating constraints, creating ingenious modifications and interactive tasks, and incorporating personal and social skills as a primary curricular goal. [ABSTRACT FROM AUTHOR]

BACKGROUND Classroom‐based physical activity (CBPA) breaks are a common strategy to increase elementary school children's physical activity (PA) levels. There is limited research examining how teacher‐level factors impact teacher implementation of CBPA breaks. In this study, we assessed the relationship of teacher‐level factors with teacher use of a CBPA resource. METHODS: We randomized 6 elementary schools in rural Oregon into control (N = 3) or intervention (N = 3) conditions. Each teacher at intervention schools received the CBPA resource. Teachers at control schools received 1 CBPA‐Toolkit per grade level to share, and received no training. We surveyed teachers on their use of the toolkit, implementation support and self‐efficacy, and value for PA. Logistic regression was used to examine the odds of toolkit use by teacher‐level factors. RESULTS: Among survey respondents (N = 83), 57% were self‐identified toolkit users and 48% attended a training. Training participation and teacher implementation self‐efficacy were associated with greater odds of using the toolkit (odds ratio, OR = 7.76 [95% confidence interval, CI = 1.39‐43.19] and OR = 5.54 [95% CI = 1.24‐23.87], respectively). CONCLUSION: CBPA tools supported with training aimed at developing teachers' implementation self‐efficacy increased the likelihood of teachers employing CBPA tools. [ABSTRACT FROM AUTHOR]

BACKGROUND: Educational and healthcare systems operate in silos. Few studies explore educators' perspectives of collaboration with pediatricians or cross‐system solutions for school‐identified concerns. We sought to investigate educators' viewpoints of collaboration with pediatricians. METHODS: We conducted semistructured, qualitative interviews with full‐time teachers, vice‐principals, and principals, who worked with low‐income first‐ or second‐grade students. Interviews explored which students were concerning to educators, educators' experiences with collaboration, and barriers and facilitators of collaboration. Interview transcripts were analyzed with modified grounded theory. RESULTS: We interviewed 12 teachers and 3 principals/vice‐principals. Students' socioemotional problems were a foremost concern. Effective collaboration with pediatricians was not typical. Participants described not knowing they could communicate with pediatricians or that collaboration was often limited or unidirectional. Respecting boundaries of parental privacy and maintaining parental trust emerged as potential barriers. Some participants described negative experiences with pediatricians and reflected on societal perceptions of doctors and teachers, which could affect the development of relationships. Participants recognized potential benefits to collaboration, including gaining a holistic understanding of a child's health and home life. CONCLUSIONS: Educators perceived collaboration with pediatricians as inadequate. More developed and tested programs that foster collaboration between schools and pediatricians are needed to support low‐income youth. [ABSTRACT FROM AUTHOR]

BACKGROUND: Health educators in public high schools can provide educational interventions to reduce teen unintended pregnancy and sexually transmitted infections (STIs). Characteristics of teachers and schools influence their decision to provide condom education. Studies to determine characteristics must be conducted so HIV/sex education can be improved. If schools do not participate in these studies, barriers must be identified so researchers can collect sufficient data to produce information for curriculum reform. METHODS: A study was conducted to identify teacher characteristics that influence their decision and intention to provide appropriate condom education. Follow‐up e‐mails were sent to administrators who opted out of the study to request more information about their decision to not participate. All responses were submitted via e‐mail correspondence. RESULTS: Six superintendents and 6 principals provided a reason for their decision to opt out. Superintendents cited being busy with district initiatives, time constraints, and lack of interest in participating in the study as reasons they did not wish to participate. Principals cited competing requests for participation in research, participation in other surveys, and time constraints. CONCLUSIONS: Securing administrative approval for human sexuality research is challenging. Administrators contend with many priorities, do not wish to overburden teachers, consider participation in voluntary research as a low priority, and may be more likely to respond to telephone requests. Administrators may not want to disclose that human sexuality or HIV education courses may not be taught by certified or qualified health educators. [ABSTRACT FROM AUTHOR]

BACKGROUND Concussions are a public health concern and concussion management in school requires a team approach. We examined schoolteachers' and administrators' perceptions of concussions, management, and implementation of return‐to‐learn (RTL) guidelines. METHODS: We audio‐recorded and transcribed semistructured interviews with teachers (N = 16) and administrators (N = 6) from a public school system. We analyzed data using an analytic induction and constant comparison approach. RESULTS: Two themes emerged: different understanding, and school context. Participants with no sport coaching experience were less familiar with concussions than those who coached a sport. Participants with personal experience with concussions were more sympathetic toward concussed students' needs. Teachers expressed feeling ill‐equipped to implement RTL guidelines without specific instructions in the complex school environment. However, school administrators had minimal understanding of teacher‐described challenges. CONCLUSIONS: Teachers and administrators recognize that concussions are a health concern, but differ in their perceptions of concussions, management, and implementation of RTL guidelines. Personal experiences mediate individual perceptions about concussions. The daily realities of a school environment complicate teachers' capacity to implement RTL guidelines. Conversely, school administrators did not express awareness of any challenges with concussion management. To best facilitate students' recovery schools should include all stakeholders when devising concussion management policies. [ABSTRACT FROM AUTHOR]

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

ABSTRACT BACKGROUND Schools may be an effective avenue for interventions that prevent childhood obesity. I am Moving I am Learning/Choosy Kids© (IMIL/CK) is a curriculum recommended by Head Start (HS) for education in nutrition, physical activity, and healthy lifestyle habits. METHODS We formed an academic-community partnership (ACP), the Springfield Collaborative for Active Child Health, to promote prevention of childhood obesity, in part, to implement the IMIL/CK curriculum in local HS sites. The ACP included a medical school, HS program, public school district, and state health department. RESULTS Community-based participatory research principles helped identify and organize important implementation activities: community engagement, curriculum support, professional teacher training, and evaluation. IMIL/CK was piloted in 1 school then implemented in all local HS sites. All sites were engaged in IMIL/CK professional teacher training, classroom curriculum delivery, and child physical activity assessments. Local HS policy changed to include IMIL/CK in lesson plans and additional avenues of collaboration were initiated. Furthermore, improvements in physical activity and/or maintenance or improvement of healthy weight prevalence was seen in 4 of the 5 years evaluated. CONCLUSIONS An ACP is an effective vehicle to implement and evaluate childhood obesity prevention programming in HS sites. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Many students do not receive return to learn (RTL) services upon return to academics following a concussion. METHODS Using a mixed-methods approach, we conducted a survey of RTL practices and experiences in Washington State schools between January 2015 and June 2015. We then held a statewide summit of RTL stakeholders and used a modified Delphi process to develop a consensus-based RTL implementation model and process. RESULTS Survey participants included 83 educators, 57 school nurses, 14 administrators, and 30 parents, representing 144 schools in rural and urban areas. Unmet need domains and recommendations identified were (1) a current lack of school policies; (2) barriers to providing or receiving accommodations; (3) wide variability in communication patterns; and (4) recommendations shared by all stakeholder groups (including desire for readily available best practices, development of a formal school RTL policy for easy adoption and more training). Using stakeholder input from RTL summit participants and survey responses, we developed an RTL implementation model and checklist for RTL guideline adoption. CONCLUSIONS Washington State children have unmet needs upon returning to public schools after concussion. The student-centered RTL model and checklist for implementing RTL guidelines can help schools provide timely RTL services following concussion. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND In recent decades, the alignment of health and education has been at the forefront of school reform. Whereas the establishment of national in-school physical activity ( ISPA) recommendations and state-level mandates demonstrates success, there has been less achievement in areas that address health disparities. The purpose of this investigation was to explore barriers and facilitators to implementing state-mandated ISPA policies in the Mississippi Delta. METHODS Focus groups or interviews were conducted with district administrators, school principals, teachers, and students. A total of 2 semistructured moderator guides were developed to focus on (1) student ISPA practices and preferences and (2) facilitators and barriers to implementing ISPA policies and practices. RESULTS A total of 6 themes were developed. In that, 2 themes addressed participant-described barriers ( primary challenges and interferences and excuses). Three themes highlighted participant-described facilitators ( compromises, things that work, and being active at school). Finally, 1 theme encompassed the participant-described need to address educating the whole child. CONCLUSIONS There is a critical need for meaningful and relevant solutions to circumvent challenges to implementing ISPA policies and practices in the Mississippi Delta. The Whole School, Whole Community, Whole Child model offers a broad means of visualizing rural, low-income, racially concentrated schools to circumvent challenges and foster ISPA policies and practices. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Food literacy can encourage adolescents to develop healthy dietary patterns. This study examined home economics teachers' ( HET) perspectives of the importance, curriculum, self-efficacy, and food environments regarding food literacy in secondary schools in Australia. METHODS A 20-item cross-sectional survey was completed by 205 HETs. The survey focused on the importance of aspects of food literacy, HETs' self-efficacy, and attitudes toward food literacy and schools' food environments. Data were analyzed descriptively, and associations between participants' demographic characteristics and perceptions were investigated by chi-square analyses. RESULTS HETs rated aspects of food literacy including preparing and cooking food, knowing about healthy foods and food safety and hygiene practices as very important. They indicated animal welfare, where food comes from, and plan and manage time for food shopping to be the least important aspects of food literacy. HETs reported that students' involvement in food literacy activities resulted in healthier diets and improved food practices, but the schools' food environments are not comprehensively supportive of food literacy. CONCLUSIONS HETs report that food literacy is very important for adolescents to learn. The focus is more on microaspects in comparison to macroaspects of food literacy. Schools' food environments are ideally positioned to shape dietary intake of adolescents but their potential is not being realized. [ABSTRACT FROM AUTHOR]

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

BACKGROUND: After-school programs (ASPs) play a crucial role in supplementing the present school day. However, implementing ASPs in the urban environment and among adolescents (grades 6-12) poses unique challenges. The purpose of this study was to conduct a systematic literature review to identify evidence-based barriers and facilitators to after-school programming in urban school environments. METHODS: Twenty-five publications meeting the authors' inclusion criteria over the past 10 years were reviewed and synthesized. RESULTS: Results demonstrated that the demand for ASPs is increasing. Several barriers, including staffing, funding, resources, transportation, and space, were identi?ed. Speci?c challenges regarding the implementation of ASPs for adolescents in urban areas were also determined. A number of best practices were identified along with benefits for academic engagement and social-emotional coping skill development. CONCLUSIONS: Efforts to address these specific barriers and facilitators to ASP implementation may contribute to improving broader health and academic outcomes among adolescent youth. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Weight-related bullying is prevalent among youth and associated with adverse health consequences, including increased risk for body dissatisfaction and disordered eating behaviors, which are risk factors for eating disorders. Although concerns about these problems have stimulated calls for broader intervention efforts in schools, actions thus far have been limited. This study examined educators' perspectives about potential policy actions to address these issues in schools. METHODS Educators (N = 240) completed an online questionnaire assessing their support for 11 potential school-based policy actions to address weight-related bullying and eating disorders. Participants also rated policies according to their feasibility and potential for positive impact. RESULTS Forty-eight percent of participants observed weight-related bullying in their school and 99% expressed the importance of intervening in such incidents. A large majority (75%-94%) supported 8 of the 11 policies, especially actions requiring school-based health curriculum to include content on eating disorder prevention (94%), and addressing weight-bullying through antibullying policies (92%), staff training (89%), and school curriculum (89%). Strongly supported policies were viewed by participants as being the most impactful and feasible to implement. CONCLUSIONS Educators recognize weight-related bullying and eating disorders as problems in their schools that warrant improved prevention and intervention efforts at the policy level. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND In September 2013, a Massachusetts high school launched a nutrition program in line with 2013 United States Department of Agriculture requirements. We sought to understand attitudes of stakeholders toward the new program. METHODS We employed community-based participatory research methods in a qualitative evaluation of the food program at the school, where 98% of students are students of color and 86% qualify for free/reduced lunch. We conducted 4 student (N = 32), 2 parent (N = 10), 1 faculty/staff focus group (N = 14), and interviews with school leadership (N = 3). RESULTS A total of 10 themes emerged from focus groups and interviews, in 3 categories-impressions of the food (insufficient portion size, dislike of the taste, appreciation of the freshness, increased unhealthy food consumption outside school), impact on learning (learning what's healthy, the program's innovativeness, control versus choice), and concerns about stakeholder engagement (lack of student/family engagement, culturally incompatible foods). A representative comment was: 'You need something to hold them from 9 to 5, because if they are hungry, McDonald's is right there.' CONCLUSION Stakeholders appreciated the educational value of the program but stakeholder dissatisfaction may jeopardize its success. Action steps could include incorporating culturally appropriate recipes in the school's menus and working with local restaurants to promote healthier offerings. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The effects of increases in physical activity ( PA) on early literacy skills in preschool children are not known. METHODS Fifty-four African-American preschool children from a low socioeconomic urban Head Start participated over 8 months. A 2-group, quasi-experimental design was used with one preschool site participating in the PA intervention and a second site participating as the control site. The PA program was designed to promote 300 minutes/week of moderate to vigorous PA academic lessons. Academic achievement related to early literacy and phonological awareness in the areas of rhyming and alliteration were assessed at baseline, 4 and 8 months. RESULTS Over 8 months, rhyming significantly (p < .01) improved in the PA group (173±12%) compared with the controls (28 ± 8%) resulting in between group differences at 8 months (p < .01). Alliteration significantly (p < .01) improved in the PA group (52 ± 16%) compared with controls (13 ± 5%), resulting in between group differences at 8 months (p < .01). As minutes of exposure to moderate to vigorous PA increased, the change in picture naming ( R2 = .35, p < .05), alliteration ( R2 = .38, p < .05), and rhyming ( R2 = .42, p < .05), increased. CONCLUSION A teacher-directed PA program is effective at increasing PA and improving early literacy. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Factors contributing to the relief of depression among adolescents have not been sufficiently revealed. The aim of this study was to assess the effect of teacher support on depression in adolescent students. METHODS We conducted a self-rating questionnaire survey among 2862 junior high school students and 93 homeroom teachers in Japan. We employed binary logistic regression models, with teacher support averaged for each class as an explanatory variable and depression as an objective variable. To examine the interaction terms of class average score for teacher support by economic status, by student sex, and by grade satisfaction were estimated. RESULTS Higher class average scores for teacher support were independently associated with lower levels of depression among adolescents (odds ratio [ OR], 0.739; 95% confidence interval [ CI], 0.575-0.948). Furthermore, the interaction of class average scores for teacher support with grade satisfaction was significant (p = .025). The interaction of class average score for teacher support with economic status and with student sex was not significant. CONCLUSIONS Our findings suggest that higher class average scores for teacher support were significantly associated with lower depression. These results can help homeroom teachers enhance interventions and promote the health of their homeroom students. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND School climate is well recognized as an important influence on student behavior and adjustment to school, but there is a need for theory-guided measures that make use of teacher perspectives. Authoritative school climate theory hypothesizes that a positive school climate is characterized by high levels of disciplinary structure and student support. METHODS A teacher version of the Authoritative School Climate Survey ( ASCS) was administered to a statewide sample of 9099 7th- and 8th-grade teachers from 366 schools. The study used exploratory and multilevel confirmatory factor analyses ( MCFA) that accounted for the nested data structure and allowed for the modeling of the factor structures at 2 levels. RESULTS Multilevel confirmatory factor analyses conducted on both an exploratory (N = 4422) and a confirmatory sample (N = 4677) showed good support for the factor structures investigated. Factor correlations at 2 levels indicated that schools with greater levels of disciplinary structure and student support had higher student engagement, less teasing and bullying, and lower student aggression toward teachers. CONCLUSIONS The teacher version of the ASCS can be used to assess 2 key domains of school climate and associated measures of student engagement and aggression toward peers and teachers. [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]