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Feeding difficulties occur at a high rate in children with normal development and at a disproportionally high rate in children with developmental disabilities. Prolonged problematic eating, categorized as Pediatric Feeding Disorder (PFD), can result in poor physical growth and jeopardize overall health. Extant research on applied behavior analysis (ABA) based parent-implemented interventions (PIIs) has been widely accepted and found to be effective in supporting children with feeding difficulties. A vast majority of studies have separately explored the efficacy of ABA-based interventions and PIIs for children with feeding difficulties. In addition, previous meta-analyses and systematic reviews have focused on studies utilizing single-case research design. Present study comprehensively assessed the overall effectiveness of ABA-based PIIs for children with PFD with studies utilizing group experimental design. Meta-analytic procedures were used to estimate the effects of ABA-based PIIs on child and parent outcomes for children with PFD. A total of 11 studies were included in the analysis. Characteristics of the parent training programs was summarized. A random-effect model was employed and the results showed a moderate but statistically significant effect size (g = -0.73, 95% CI [-1.34, -0.13]) for ABA-based PIIs on child feeding outcomes, indicating a positive impact on mitigating child feeding challenges. However, the effect size estimate for one of the parental outcomes (i.e., parent stress) was small and statistically nonsignificant (g = -0.38, 95% CI [-0.83, 0.07]). Moderator analysis was also performed to examine the moderating effects of the following variables on child feeding outcomes and parental outcomes: training delivery format, direct child participation, utilization of escape extinction, and utilization of consequence- and antecedent-based treatment package. Results showed that all four variables had a moderating effect on child feeding outcomes but only two variables showed a moderating effect on parental stress. This study not only marked as the first attempt to systematically evaluate the empirical evidence from group experimental designed studies, but also explored potential moderators that may play vital roles in the effectiveness of ABA-based PIIs with children with PFD. Discussion of the implications along with future directions conclude this dissertation. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

In this dissertation I use modern microeconomic methods to examine the impact of K-12 education policy interventions on student outcomes. In the first chapter I explore how increased funding for school policing and sentiment surrounding school policing can have downstream effects on student discipline, and how these effects vary by student and school characteristics. I leverage variation in school police presence induced by participation in a federal grant program in a difference-in-differences framework to show that, on average, suspension rates for Hispanic students increase significantly following grant receipt. Using natural language processing tools, I investigate how grant application content can influence these heterogeneous effects, and find that applications from school districts with a greater share of minority students are more likely to include negative language, and that this trickles down to worse outcomes for all students in those districts. The second chapter examines the impact of a grade retention policy on student outcomes in Tennessee, where legislation passed in 2011 requiring third-grade students to demonstrate reading proficiency before being promoted to fourth grade. We use a difference-in-differences approach to show that the policy had small but lasting positive effects on reading achievement and disciplinary outcomes of students targeted by the law, and do not find that this policy deters students from attending school. We concur that due to low overall retention rates and the nature of Tennessee's policy, which allowed students to participate in an alternative intervention in lieu of being retained, these positive results are likely driven by an increase in research-based interventions provided to students. The third chapter examines the impact of the Healthy Hunger-Free Kids Act of 2010, which aimed to improve the nutritional quality of school lunches nationwide, on student outcomes. Using a generalized difference-in-differences approach, I find that discipline rates in schools with greater exposure to shifts in school meal content decreased, and that these meal changes did not deter students from attending school. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Children in medical facilities encounter systemic barriers to education despite legal mandates. This study aimed to enhance educational opportunities by addressing inconsistencies through research-based strategies. The study adopted a dual strategy, positing that proactive organizational readiness measures alongside the implementation of an in-house program would cultivate a supportive educational environment. It utilized two PDSA cycles, each concentrating on organizational readiness and program quality, respectively. Using a mixed methods design, improvements in both were revealed. Key themes emerged, including a focus on student health, organizational adaptability, and improved communication. The first cycle addressed readiness, implementing strategies aligned with research a leadership readiness assessment. The attendance data indicated significant improvements following the intervention. The second cycle focused on program quality, utilizing a Quality Indicator Rubric. Results showcased increased quality, with notable progress in assessing student responsiveness and increased scores on the rubric. Overall, the study emphasizes data-driven approaches to enhance educational opportunities for medical facility students, empowering families and school districts to make informed decisions. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Within our rapidly changing and growing global society, adolescent development into adulthood remains a pervasive issue that youth serving institutions and youth engagement practitioners across the world must address. While literature shows that there are numerous factors that contribute to the physical, mental, and social-emotional development of our next generation, little research exists related to the impact community-based, youth sports leaders within organizations/programs have on the health and well-being of historically marginalized communities. This research investigated how Black, community-based, youth sports leaders leverage themselves as critical brokers for marginalized communities. The purpose of this interview study, guided by a critical brokerage perspective, was to learn how Black, community-based, youth sports leaders within organizations create brokering orientations and utilize their social and/or cultural capital to serve and uplift marginalized communities. This study focused on Black youth sports leaders who engage in critical brokering orientations to positively impact historically marginalized communities. These leaders engaged in this work to support adolescent development into adulthood and to eliminate inequities that exist within marginalized communities. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

The inconsistent implementation of the Whole School, Whole Community, Whole Child framework within one school district has been a problem. The purpose of this study was to explore the perceptions and experiences of 17 participants (nine teachers, three school counselors, two librarians, two administrators, and one instructional coach) in a school district that has adopted the Whole School, Whole Community, Whole Child framework (WSCC). The research questions included: (a) What are school staff perceptions around the implementation of a Whole School, Whole Community, Whole Child framework? (b) What does it mean to implement a WSCC framework? (c) What are staff perceptions of the impact of the WSCC framework on students' social, emotional, cognitive, and health development? (d) What changes have been made in the district since the implementation of the WSCC framework? (e) What suggestions do staff have for the future of WSCC in the school district? (f) What advantages or disadvantages are there in implementing a WSCC framework? Data were collected through interviews and documentation. The findings revealed nine significant themes labelled social emotional learning increases engagement and opportunities for academic success; WSCC creates positive environment and relationships for students and teachers; implementation of SEL curriculum and structure changes; the need for improved professional development; limited scope of professional development and training; need for increased accountability for district's implementation methods; inconsistent implementation levels; the disadvantage of potential financial, time, and opportunity costs; and the disadvantage of lack of accountability or training to support. Recommendations for future research were provided. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Insufficient referral and participation in Part C Early Intervention (EI) services are common among children aged birth to 3 years, including those automatically eligible due to diagnosed medical conditions. States have established lists of diagnosed medical conditions to streamline eligibility determination for these children. However, there is limited understanding regarding the knowledge and utilization of the state-approved lists as well as the associated policies and referral practices, among pediatricians and Part C EI personnel. To address this gap and gather recommendations for improvement, a concurrent embedded mixed-method study was conducted in Michigan and Washington. The study involved survey questionnaire completed by 193 Part C EI personnel and 69 pediatricians, and semi-structured interviews with 45 Part C EI personnel and 22 pediatricians from both states. The findings revealed that pediatricians have significantly (p < 0.05) less knowledge of the state-approved lists, associated policies and referral practices compared to Part C EI personnel. There is considerable variability in how referral practices are implemented by pediatricians and Part C EI personnel, indicating a lack of common understanding. Based on these findings, recommendations are proposed. Some of the short-term recommendations include improving the state-approved lists, development of a state-wide universal web-based referral form for pediatricians and establishing a centralized fax number for efficient information transmission. In the long term, implementing an integrated electronic health record (EHR) system and providing comprehensive training on referral and eligibility determination processes for both Part C EI personnel and pediatricians are emphasized to enhance collaboration and improve EI services. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Childhood obesity has become a global epidemic, with long-term implications for the physical and psychological well-being of individuals. Elementary schools serve as a crucial environment for addressing this issue by providing physical education (PE) programs. However, barriers to implementing quality PE curricula can impede efforts to fight against childhood obesity. This qualitative research dissertation aims to identify and understand these barriers, while examining their connection to Abraham Maslow's Hierarchy of Needs as a framework for understanding the complexity of this issue. The study uses a qualitative approach through open-ended questionnaires, interviews, and surveys to reveal barriers in implementing quality PE curriculum (QPE). Participants include PE teachers. The findings reveal complex barriers that impact the delivery of a QPE program, which are linked to different levels of Maslow's Hierarchy of Needs. Physiological barriers, such as inadequate food and access to nutritional education, lack of space, and resources, impede students' access to physical activities that satisfy basic needs. Safety concerns, including extreme behaviors, affect students' sense of security and well-being. Furthermore, social and psychological barriers emerge as crucial factors that prevent the development of students' self-esteem and social belonging within the context of PE impacting students' self-actualization and fulfillment abilities. This research explores the connection between these barriers and childhood obesity. It demonstrates how the barriers identified within the framework can contribute to poor physical health and the increased risk of obesity among elementary students. The study highlights the importance of addressing these barriers to promote a more active, healthy lifestyle and reduce childhood obesity rates. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Early childhood is an optimal time for establishing healthy eating habits which may prevent disease later in life. In Georgia, the child obesity rate?hovers at 13% with the majority being children from low-income Black or Hispanic families. Currently, the "Dietary Guidelines for Americans" recommend children aged 2-5 consume 1-1.5 cups of vegetables daily, yet only a small percentage consume recommended amounts. As nutrition gatekeepers, parents play important roles in facilitating their children's vegetable intake, but they may experience barriers that extend beyond the scope of diet. This indicates that multi-layered approaches which target multiple health determinants will be required to achieve healthy equity. Interventions to strengthen other key influencers of health and go beyond singularly addressing dietary factors are needed. Studies show there is an inverse relationship between education level and poor health, indicating that one potential intervention area is early education, which encompasses physical, cognitive, and linguistic developmental areas as well as scientific and mathematical reasoning. One under-explored area of potential intervention to simultaneously address both nutritional and educational disparities is a cross-curricular approach that integrates SAM (Science, Arts, Mathematics) into food learning experiences. Food can function as a vehicle to integrate academic and developmental learning. SAM use among school-aged children has successfully improved cognitive development and academic achievement in classroom content areas. However, utilization of SAM by parents to promote vegetable intake in younger children within a home setting remains untested. In this study, researchers developed a pilot nutrition education curriculum for parents of Head Start children ages 3-5, that focuses on cooking and SAM engagement strategies which parents can use to promote vegetables to their children. Needs assessment interviews were conducted to inform curriculum development within the framework of Social Cognitive Theory. The curriculum was pilot tested in parents (n=34) of preschool children enrolled in Head Start programs in northeast Georgia. Parental knowledge, self-efficacy, and acceptability were measured. Findings showed that SAM integration is acceptable to parents for introducing vegetables to young children with the goal of changing dietary behaviors. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

A growing awareness of the negative impact of childhood trauma and adversity on life outcomes has led many schools to seek out ways to become trauma-informed. School psychologists, given their expertise and scope of practice in schools, could be considered potential leaders in such a movement. Given a growing body of theoretical and empirical evidence that dissociation marks more complex forms of traumatic stress, a national survey was conducted to examine school psychologists' familiarity with the phenomenon of dissociation in the children they serve. A small sample (N = 41) consistent with National Association of School Psychologists (NASP) membership data provided initial findings in this area of practice. Despite rating themselves as being generally familiar with terms related to significant trauma (PTSD, ACEs, complex trauma, developmental trauma, toxic stress, and dissociation), a simple majority (greater than 50%) of the school psychologists sampled self-reported that they were unfamiliar with dissociation in their students in terms of knowledge, awareness, and ability to identify during observation. More than 80% were not confident in assessing nor comfortable educating teachers and parents about dissociation in children. Furthermore, fewer than half of the school psychologists sampled would consider dissociative problems as accounting for symptoms overlapping with other childhood disorders. A majority of the sample received little to no training exposure to the topic of dissociation, both inside and outside of graduate school, implying a need for enhanced training regarding the reality and usefulness of recognizing dissociation and complex trauma in children. These results point to a potential gap in familiarity with conceptual terms and practical know-how related to helping children with trauma-related dissociation. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

The urgent need to address the mental health needs of students in the United States has recently gained significant attention in the aftermath of the Coronavirus pandemic and recent school shootings. Alarmingly, studies show that only one-third of the children suffering from mental health behaviors will receive mental health services, and 80% of these students receive these services in the school setting (Lin & Bratton, 2015). Unfortunately, students struggling with internalizing behaviors often go unnoticed, leading to missed opportunities for early intervention, which can have adverse lasting impacts social-emotionally and academically. School counselors, often the primary source of counseling services, play a critical role in removing obstacles to academic achievement through developmentally appropriate and evidence-based interventions. Group Adlerian Play Therapy (GAdPT) is a developmentally appropriate, feasible, and efficient intervention for engaging students simultaneously, rooted in Alfred Adler's Theory of Individual Psychology. This randomized control trial examined the impact of Group Adlerian Play Therapy (GAdPT) compared to the waitlist control group (WG) with 94 fourth and fifth-grade students who qualified with clinical levels of internalizing behaviors. Forty-eight students were randomly assigned to GAdPT (treatment group), and forty-six were assigned to WG (waitlist group). The students in the treatment group received two 30-minute play therapy sessions per week for six weeks. Results from a two (group) by two (repeated measures) split plot ANOVA indicated that compared to the WG, the GAdPT group demonstrated statistically significant improvements on (a) internalizing behaviors at home, as reported by parents, (b) internalizing behaviors in the classroom, as reported by teachers, (c) reading scores, as recorded by a standardized reading assessment, and (b) math scores, as recorded by a standardized math assessment. GAdPT demonstrated a large effect size on all measures, indicating the clinical significance of the intervention. In summary, 73% of parents and 91% of teachers reported improvements in internalizing behaviors revealing the clinical significance of the results. The standardized assessments reported that 65% of students improved in reading and 67% in math, moving from below to on-grade level from pretest to post-test. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Background: School age children are expected to have a normal body mass index which is commensurate with their age group. The prevalence of childhood obesity and overweight is increasing in alarming rates in developing countries, with the highest rate in the Middle East region. School nurses' involvement in childhood obesity prevention practices will benefit children and their families in managing the epidemic of childhood obesity. However, there is no research addressing the role of school nurses in Saudi Arabia in preventing and managing childhood obesity. Purpose: The purpose of this qualitative study was to explore the critical factors that influence school nurses' knowledge, attitudes, and behaviors regarding childhood obesity prevention in Saudi private elementary schools. Philosophical Underpinnings: The grounded theory is based within the constructivist paradigm and has philosophical underpinnings of symbolic interactionism and pragmatism. Methods: This study was conducted using Charmaz's constructivist grounded theory approach. Semi-structured interviews were conducted to collect data from 11 school nurses from private elementary schools in Saudi Arabia. Data from the interviews were analyzed according to Charmaz's analytical process. Theoretical sampling was used to saturate developed categories. A focus group interview was conducted with three experts in the research topic to confirm the generated theory. Results: A conceptual theoretical framework was developed from the rich data collected from the research participants. Three categories ("Struggling, Avoiding, Competing Priorities:) and a core category ("Lacking Support") emerged to support the basic social process "Jumping Hurdles: A Pathway to Professional Growth." Conclusions: The study findings may be used to guide nursing education, practice, research, and health and public policy. The conceptual theoretical framework developed in this study can help in understanding the critical factors influencing school nurses' knowledge, attitudes, and behaviors regarding their role on childhood obesity prevention. Understanding these critical factors can help enhancing school nurses' role in childhood obesity prevention. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Childhood mental health issues are, and will continue to be, prevalent around the world. While many methods exist to help treat childhood mental health issues in community and school settings, there are barriers to treatment access. One specific area of concern in children's mental health is emotional regulation, particularly in schools. An inability to regulate emotions can be detrimental to the overall school success of children. However, the school setting is an optimal location to provide services to treat mental health concerns and emotion regulation issues in children. Currently, minimal research exists regarding the treatment of emotion regulation in schools and the use of gestalt therapy play groups in schools to treat emotion regulation. This qualitative phenomenological study was conducted to understand the perspectives of four students who participated in a six-week, twelve session gestalt therapy play group focused on emotion regulation. The four research participants who met criteria for this study engaged in two semi-structured audio-recorded interviews following participation in the gestalt therapy play groups. Transcript analysis brought out six themes which demonstrate participants' perspectives of the potential benefits and limitations to a gestalt therapy play group focused on emotion regulation in a school setting. Key findings from this study offer implications for school counselors, counselor educators, professional organizations, and funding sources. Last, recommendations for future research are discussed. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Depression is a mental health diagnosis that affects many children and adolescents each year. While traditional methods of treatment include therapy and medication, physical activity could also be used as an additional tool to help combat depressive symptoms. A total of 51 articles were found to address the possible benefits of physical activity for depression in children/adolescents. This systematic literature review discusses the following topics: general benefits of physical activity, the impact of parent and family support for children and adolescents, gender differences, intensity of activities, organized sports, screen use, sleep and previously reviewed analyses. In general, a body that engages in regular physical activities is less likely to report depressive symptoms. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Children in Hawai'i demonstrate the highest rates of oral caries in the nation due to multitude of factors, such as a lack of appropriate funding or education, absence of fluoridation in water systems, no local dental schools, and racial/ethnic/socioeconomic disparities. This quality improvement project aimed to increase confidence and knowledge levels in an educator in delivering oral health education to students and to also increase oral health exposure to students within an elementary public-school through the utilization of modules based on the American Dental Association. A training session was held with the participant to review the toolkit materials and method of teaching delivery. Levels of confidence, knowledge, attitudes, and beliefs surrounding the sustainability and effectiveness of the oral health toolkit were measured in the participant with pre-and-post surveys for comparative data. Oral health knowledge and learning retention performance for the students were also measured using responses from student module worksheets. Results indicated a 20% improvement effect in confidence levels in delivering oral health education to students in the participant, and an average of 80% performance in knowledge and learning retention for the students who participated in the learning modules. Although speculative, results from this small quality improvement project demonstrated that the oral health toolkit was effective at increasing confidence levels in teaching oral health education. Student responses demonstrate that there is a significant need to promote oral health among schoolchildren. Expansion of the toolkit to other schools are necessary in order to generalize the findings beyond this project sample while also allowing opportunities to assist educators in reducing oral health disparities in school-age children. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Obesity is an issue that negatively effects the health and wellbeing of children across the U.S. The problem addressed by this study was the increasing percentage of obesity among elementary students in a southeastern school district. Guided by Bandura's social learning theory, the purpose of this basic qualitative study was to explore the perceptions of elementary teachers about increasing student obesity and the challenges they faced in teaching students about health issues in the local school setting. Ten elementary teachers who had knowledge of nutrition and awareness of the student obesity and overweight issues at the study site participated in semistructured interviews. Data were analyzed using inductive, open coding to identify themes. Six themes emerged: (a) students are overweight and need nutrition instruction, (b) teachers are vital for modeling and empowering students to make healthy choices for lifelong impact, (c) teachers use various strategies to teach students health and nutrition, (d) school influence relates to providing free and healthy choices in the cafeteria, (e) schools need to involve and educate parents regarding nutrition, (f) teachers need resources, specifically for a garden. Findings suggest that teachers and school communities are an integral part of supporting student health and wellness aimed at overcoming childhood obesity. As a result, positive social change can occur by capitalizing on the critical role of the school community in educating students about nutrition through embedding health and wellness concepts into the school day, thereby empowering students with the knowledge and skills they need to lead a healthier lifestyle for a lifetime. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Introduction: Education is a social determinant of health, and its intersection with incarceration is a powerful nexus for well-being of students. Whether policies specific to student well-being are associated with exclusionary discipline, a documented risk factor for incarceration, is unknown. This study has three aims: (1) to identify whether there is an association between local school wellness policies' (LWPs) quality and exclusionary discipline incidents (EDIs) in Oregon high schools; (2) if the quality of specific policy domains (i.e., nutrition education and physical activity) is associated with EDIs; and (3) to determine if total LWP quality moderates the association between out of school suspensions and days missed due to suspension. Methods: Data for Oregon high schools' LWPs were collected in 2017 and cross-matched to public, school-level student demographic data from the Oregon Department of Education in 2017 and enrollment and suspension data from the Office of Civil Rights Data Collection were collected for 2017-2018 year. Including post hoc analyses, ten multiple regression models were created to examine variation in EDIs. All models were adjusted for relevant covariates.Results: Total LWP quality was not significantly associated with EDIs, nor was the quality of either Nutrition Education or Physical Education/Physical activity LWP domains. Post-hoc exploratory analyses revealed the strength of Standards for USDA Nutrition Programs and School Meals domain was negatively associated with EDIs (Cohen's f[superscript 2] = 0.05) as was comprehensiveness of the Wellness Promotion and Marketing domain (Cohen's f[superscript 2] = 0.15). The strength of Wellness Promotion and Marketing was positively associated with EDIs (Cohen's f[superscript 2] = 0.06). Total LWP quality was not associated with days missed due to suspension, and there was no moderating interaction detected. Conclusion: The quality of two specific LWP domains, rather than total LWP quality, may matter in regard to EDIs in Oregon high schools. Results could aid informed policy decision making for promoting health equity on district and state levels. Future research should identify if these associations are present in other states. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

It is estimated that less than 20% of young people worldwide are receiving the recommended 60 minutes of moderate-to-vigorous physical activity (MVPA) per day (Riley, Lubans, Holmes, & Morgan, 2014). Delaware and many other states around the country use FITNESSGRAM to assess students' overall physical fitness. The FITNESSGRAM® is a physical fitness assessment that uses criterion-referenced standards to evaluate students' physical fitness levels (The Cooper Institute, 2006). At Lord Baltimore Elementary School (LBES) in Ocean View, Delaware, FITNESSGRAM results have shown that not all students are able to achieve the healthy fitness zone (HFZ), the areas assessed by the FITNESSGRAM. The purpose of this dissertation project was to create a practical method of increasing physical activity levels during the school day, as well as investigate the effects of a fitness intervention on LBES fifth-grade students' performances on the FITNESSGRAM Fitness Assessment. The FITNESSGRAM Fitness Assessment pre-test was performed by all 5th-grade students (n = 113) in September of 2021. Upon completion of the pre-test, a video fitness intervention was conducted with all 5th-grade students at LBES. Intervention videos consisted of daily five minute workout videos led by the LBES physical education teacher. At the conclusion of the fitness intervention, students performed the FITNESSGRAM Fitness Assessment post-test in December 2021, using the same procedures as they had in the pre-test. FITNESSGRAM post-test data showed increases in combined overall scores in every category that was assessed. In addition, the percentage of students achieving the HFZ also increased in each fitness category that was assessed. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

The problem identified in this research was that the most-to-least (MTL) prompting strategies used for individuals with intellectual disability (ID) had not been consistently demonstrated in research for personal hygiene, specifically tooth brushing. It has been well known that people with ID acquire skills differently than typically developing individuals (Cengher et al., 2018). Difficulty with developing hygiene skills such as brushing teeth is not limited only to those with physical disabilities because individuals with ID can struggle with hygiene skills as well. MTL prompt fading procedures have been used to teach many skills to individuals with ID (Drummond, 2018). The design used in this research was a multiple-probe-across-participants design, which is defined as the current performance of the task to identify a starting point for instruction (Creswell, 2012). All probe sessions were nonconsequential and included no prompting. Two preintervention probe sessions were conducted for each participant prior to entry into the intervention. Probe sessions were conducted following mastery of each intervention objective. For each participant, once all intervention objectives were achieved, two maintenance probes were conducted. The maintenance phase entailed two probe sessions, consisting of eight nonconsequential trials each, to determine whether the participant continued to correctly brush teeth without prompting. The participants in this study did not gain independence in tooth-brushing skills using MTL prompt fading. Moreover, tooth-brushing skills were not maintained over time using MTL prompting. In this research, MTL prompt fading was ineffective in leading children with ID to independence with tooth-brushing skills. Results indicated that MTL prompting could be ideal to use as an intervention for children with ID and to improve maintenance of skills; however, the findings were inconclusive because one participant averaged one of eight steps in the probe session. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

The purpose of this case study was to examine how the K-5 elementary alternative program All Students Can Thrive (ASCT) used student-centered learning practices to influence the whole child. There is a lack of research on K-5 elementary alternative programs, such as ASCT, and specifically those that integrate student-centered learning practices to influence the whole child. Literature does not contain universally accepted interventions that are effective in the elementary alternative setting to help students return to the mainstream classroom setting better prepared to display appropriate behaviors when a student is removed from a mainstream classroom setting due to disruptive behaviors. The Association for Supervision and Curriculum Development (ASCD) has determined five major tenets that measure how educators influence the whole child and those are: healthy, safe, engaged, supported, and challenged (ASCD, 2022). These five tenets will serve as the theoretical framework for this research on the whole child and ASCD will function as the scientific authority on the whole child for the purposes this case study. Data collection strategies included interviews, field notes, and a document review. Analysis of data occurred in three phases: (a) coding themes from participant responses during interviews (b) analysis of interview field notes (c) document review. The analysis of the case study data was based on the theoretical proposition that educating the whole child involves children being healthy, safe, engaged, supported, and challenged (ASCD, 2022). The credibility of the analysis was protected by triangulation of data through the coding of interviews, interview field notes, and a document review. The results revealed that that all five tenets of the whole child were identified as a common theme or sub-theme from participant responses. Five common themes: (1) Engaged (2) Space to Thrive/Choices (3) Identify Needs/Skills (4) Confidence/Hope (5) Relationship and five sub-themes emerged from the analysis of data: (1) Challenged (2) Supported (3) Safe (4) Healthy (5) Communication. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Using theoretical sampling, focused on those who could best inform the theory, the participants in this study, all Latina women, consisted of two program "Tias" (Aunties), currently teaching and mentoring in the "Abuelas Preparando a los Ninos Para La Escuela" [Grandmothers Preparing the Children for School], or APPLE program, and 14 past graduates. The only education the program graduates had before APPLE was in their home countries prior to immigrating to the United States. Beginning with a description of the type of care they provided to children before they participated in the APPLE program, the participants explained how the structure and content of the program transformed their practice from mother/babysitter to teacher, enabling their children to function successfully in the Eurocentric system of schooling while otherwise maintaining their existing culture. Key to this transformation is a professional development program that condenses significant content knowledge of child development, child guidance, pediatric health and safety, curriculum studies, and business practices; all made accessible to the participants in a manner that connects with their emotions as well as their minds while making the learning engaging and fun. Despite evidence of altering the Latinx culture, the participants consider the transformation they experienced as an acculturative positive change in themselves and the educational care they provide for the children that in no way diminishes their culture; instead, they consider it an opportunity for them to improve society through their new knowledge. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

The problem addressed in the research study was that cyber bullying and traditional bullying continued to increase at the research site during the past 4 years. The purpose of the study was to determine the influences of mental health services that were designed to decrease the negative effects of both cyber and traditional bullying on adolescent clients' health and academic performance. This applied dissertation was designed to examine the experiences of cyber and traditional bullying victimization of adolescents' mental health and academic success, within a large southern state in the United States, to provide practical solutions to address the concerns that cyber and traditional bullying had on the mental health and academic success of students. With the enhancement and popularity of technology, bullying is on the increase (Castile, 2013). Through news outlets and social media, numerous videos demonstrate acts of bullying. Representatives and legislators have implemented policies and procedures to address bullying within the schools. However, the occurrence of bullying and cyberbullying was on a constant rise. A qualitative phenomenological study was completed to determine the effects of mental health services on the negative effects of cyber and traditional bullying among clients at a local mental health agency. The researcher used a survey protocol to examine the experiences of adolescent clients who have experienced bullying victimization. The survey consisted of 19 open-ended questions addressing bullying victimization and how it impacted their mental health and academic success. The sample consisted of 11 adolescents, between the ages of 10 and 19 years who were willing to participate. The results indicated that bullying victimization was pervasive among adolescent clients at the research site. Additionally, the findings of this study proved that cyber bullying and traditional bullying continued to increase at the research site during the past 4 years. The research also indicated that bullying victimization impeded mental health and academic performance of the participants. In summary, the researcher suggested further education and professional development workshops that were designed to clearly define bullying and provide adequate responses to bullying victimization. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

The purpose of this study is to examine the readiness of school districts in Suffolk County, New York, to implement a trauma-informed system to address the growing needs of mental health interventions in student populations. A review of the literature will show a historical prevalence of mental health providers and individual student interventions within the school building, or in partnership with community agencies. Recent literature shows an increase in school-related issues have origins in student trauma or adverse childhood experiences. The study will examine the issue by conducting a mixed method analysis, using a survey instrument and focus group interviews, of members of the Suffolk Directors of Guidance. Significance of the study will help districts who want to implement a systematic and districtwide approach to mitigating trauma-related student issues by identifying current readiness and examining gaps in preparation to implement the National Dropout Prevention Center's Trauma-Skilled Schools Model. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

The advances in medicine today have created an emerging population of student-survivors, school-aged children living with and/or recovering from serious health conditions (Bauman, 2010). Each school day in the United States, 46 young people, or the equivalent of two classrooms of students, learn they have cancer (Cure Search National Childhood Cancer Foundation, 2010). These statistics reflect the fact that cancer is one of the most chronic illnesses in childhood. Most serious childhood medical issues will have life-long ramifications. This qualitative research study is comprised of an in-depth review of the research literature and the responses and information gathered from two professionals. The purpose of the study is to identify common issues faced by student-survivors and to examine the relationship between psychosocial support and school performance. The results indicate that there is a commonality of psychosocial issues that affect this population. Chronically ill children are experiencing school related problems and the information being exchanged between the trinity of professionals, which includes-educators, medical professionals, and mental health professionals- to families is inconsistent and confusing thwarting access to resources. It can be concluded that the needs of this population are not being met in the traditional context of the public school system and that teachers are feeling ill prepared to serve them, but that positive school experiences, in one form or another, amidst childhood illness can provide the social structure necessary to alleviate the feelings of isolation and psychological distress commonly experienced. An appendix presents a Chart of Transcribed Expert Interview Responses.

This dissertation in practice sought to understand the major contributors to suicidal ideation and suicide attempts in preadolescent children as described by health professionals in Washington state. Interview participants, made up of mental health therapists in private and public practice, emergency room personnel, school psychiatrists, and nurses in psychiatric care were asked to describe the extent of depression/suicidal ideation in kindergarten through sixth grade. This single phase, phenomenological study resulted in four themes and two conclusions, from which the researcher was able to offer two proposed solutions. It is the hope of the researcher that this study will contribute to the field of education and mental health and help to decrease the number of preadolescent and adolescent suicide in Washington state and throughout the nation. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

This study sought to evaluate the school-based counseling services that were provided to 95 students as part of the Children First counseling program. The primary evaluation question focused on the effectiveness of the program in positively impacting traditionally underserved populations in the following domains: increasing social skills, decreasing problem behaviors, and increasing academic competence. A review of relevant literature revealed the impact of school-based services on decreasing barriers to mental health services and improving the coordination of care among agencies, specifically with underserved populations. The results of the evaluation study indicated that the Children First program is effectively preventing mental health issues and intervening with children experiencing such challenges, including those who are traditionally underserved. Implications for future research are discussed. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Background: Childhood obesity has become an epidemic in America, affecting millions of children from early childhood to adolescence. Childhood obesity rates have tripled in the last three decades (CDC, 2016b). Additionally, the obesity epidemic is reaching our nation's youngest children; it was recently reported that over 20% of 2- to 5-year-old children are overweight or obese (American Academy of Pediatrics [AAP], 2018). Arizona has the fourth highest childhood obesity rate in the nation, hence childhood obesity is a top health concern for this state (Alliance for a Healthier Generation, 2016). Obesity can lead to several adverse health outcomes, including high blood pressure, high cholesterol, cardiovascular disease, type 2 diabetes, and joint disorders. Poor nutrition and physical inactivity are highly correlated with obesity. Nutrition and physical activity promotion among children in clinic settings typically focuses on patient and parent education using verbal advice and written handouts. Current evidence shows that this has proven to be ineffective, as childhood obesity across all children continues to be alarmingly high (CDC, 2016b). Based on this evidence, there is a need for innovative educational methods, such as interactive technology, focused on healthy nutrition and physical activity to decrease current childhood obesity rates. Purpose: The purpose of this DNP project was to improve parent education about healthy nutrition and physical activity among preschool children in southwest Arizona by evaluating an interactive technology-based education tool for use as a preventive approach for childhood obesity. The aim of this project was to determine if parents of preschoolers found an interactive technology-based education tool understandable and actionable. Methods: A pilot study was conducted in which southwest Arizona parents of preschool aged children used the Patient Education Materials Assessment Tool for Audio/Visual (PEMAT-A/V) to evaluate the understandability and actionability of the interactive technology-based education tool, "Healthy Active Living for Families" (HALF) developed by the AAP (2017) (Shoemaker, Wolf, & Brach, 2013). An iPad was used to deliver the educational presentation to parents on healthy nutrition, appropriate physical activity, and healthy living information for preschool aged children. PEMAT-A/V questionnaires were scored and entered into IBM SPSS to determine mean understandability and actionability percent scores. Results: For this study, a PEMAT score of 70% for both understandability and actionability was used as the cutoff for acceptable scores, thus a 70% score or lower is considered lacking understandability and actionability. All parents except one scored the interactive educational presentation above 70% for understandability. The overall mean understandability score was 91% with a standard deviation of 12. Actionability was scored above 70% by eight parents and below 70% by two parents. The overall mean actionability percent score was 86% with a standard deviation of 25. Conclusion: Based on the high PEMAT scores it was found that an iPad delivered interactive educational tool on healthy living was found to be highly understandable and actionable by southwest Arizona parents of preschool children thus it is a useful innovative method of education that can potentially be utilized as a preventive approach to childhood obesity. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Given the societal expectation of high ethical standards for teachers, best practice suggests that teacher preparation programs employ real-world case scenarios in their ethics education. However, at present, the field lacks a thorough account of modern ethics code violations in the teaching profession from which preparation programs might draw case studies. The purpose of this study was to examine teacher licensure sanctions across multiple states in order to gain a clearer picture of ethics code violations in the modern teaching profession. Focusing on eight U.S. states, ten years of final orders of licensure sanction were examined (n = 8,765). These data were coded using ethical behavior descriptions from the "Model Code of Ethics for Educators" created by the National Association of State Directors of Teacher Education and Credentialing. Results were described in terms of teacher demographics, categories of ethics violating behaviors, and resultant sanctions. Findings indicated that the highest percentage of sanctioned educators were males, and a high percentage of sanctioned teachers held health and physical education licenses. The most common ethics violations involved non-school-related criminal activity, sexual misconduct with students, failure to disclose previous crimes or license sanctions, physical aggression toward students, and endangering student health or safety. These results suggest on-going value in society for teachers who are honest and who protect children. In addition to providing case study information, these results may help focus preparation program ethics instruction, with the goal of preventing the most common ethical violations. For states that choose to provide ethics training for in-service teachers, these results may provide baseline data for states to use as a gauge of change over time. The inconsistent nature of sanctioning results, both between states and within states, suggests that state licensing boards may be due for an examination and restructuring of teacher licensure sanctioning processes. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Mental health issues among school-aged children are a growing concern and subject of intervention and prevention studies nationwide. While several implementation and service delivery models exist for school-based mental health services (SBMHS) they are often localized, population or program specific, and do not adequately address the issues related to stigma. Building on Cook and Kilmer's 2012 article integrating community psychology principles and systems of care values, a review of the literature is conducted to identify issues and barriers from stigma in current school-based and mental health service delivery. Key guidelines and specific considerations are presented to address identified limitations and augment the current implementation models for collaborative SBMHS through the practical application of community psychology principles. The creation and function of a coalition in the spirit of collaboration uniquely provided by partnering systems of care & community psychology principles is a central component. While the main focus and application of these objectives is at the micro and exosystem levels for change, the local community and school, school district and state, they can also be integrated at the macrosystem level for initiatives, legislation, and policy changes. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Childhood obesity has become a national concern in the U.S. over the past decades. Offering quality physical education programs is one of the effective approaches of a variety of school-based physical interventions. To gain children's attention and their lack of interest in physical movement, physical education teachers have recently employed novel technologies, such as the iPad and exercise-related mobile applications. While many studies examined the effect of these devices on promoting individuals' physical activity in primary and fitness settings, few research was done on physical education settings. The purpose of this study was to examine the app-based physical education classes on children's physical activity and their psychosocial beliefs. Fourth and fifth grade children from two elementary schools (n = 157) participated in this study. Children from one school received a short-term app-based intervention while those from the other school participated in traditional physical education classes with limited technology use, serving as a comparison group. Children's sedentary, light and moderate-to-vigorous physical activity during physical education classes was measured with accelerometers. A battery of questionnaires was used to assess children's self-efficacy, outcome expectancy, social support, and enjoyment in physical education. Children in the app-based group spent approximately 21.3% of their class time on moderate-to-vigorous activity while children in the comparison group spent approximately 30.5% of their time. Both fell far below the recommended level of spending at least 50% of the class time on moderate-to-vigorous physical activity. The app-based group demonstrated significantly less increased percentage of time spent in both light physical activity (-6.2% vs. 4.2%), F (1, 154) = 97.7, p < 0.001, ?[subscript p, superscript 2] = 0.39, and moderate-to-vigorous physical activity (-8.6% vs. -1.6%), F (1, 154) = 31.4, p < 0.001,n [subscript p, superscript 2] = 0.17. The app-based group (14.8%) also had a significantly greater increased percentage of time in sedentary behavior than the comparison group (-2.6%), F (1, 154) = 110.6, p < 0.001,n[superscript 2] = 0.42. For children's beliefs, there was no significant differences in increases of all four beliefs between the app-based group and the comparison group. Correlation analyses of children's post-tests indicated that none of the children's beliefs was significantly associated with children's physical activity, while enjoyment significantly related to the percentage of time spent in moderate-to-vigorous physical activity in the comparison group. The results of the regression analyses indicated the four predictors explained 6.1% of the variance in children's post-test moderate-to-vigorous physical activity in the app-based group, R[superscript 2] = 0.06, F (4,66) = 1.07, p = 0.38. In the comparison group, the four predictors explained 9.4 % of the variance in the percentage of time spent in moderate-to-vigorous physical activity, but the model was also not significant, R[superscript 2] = 0.09, F (4, 73) =1.89, p = 0.12. It appears that the app-based physical education classes were not effective in improving elementary children's physical activity and psychosocial beliefs, possibly due to a learning curve. A longer intervention period may be needed to witness true effect of app-based physical education classes on promoting children's physical activity and beliefs. It is also recommended that children themselves have more opportunities to engage in group activities using iPads and apps to benefit more from the features such as video playback to receive feedback on their own movements. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Asthma is an inflammatory disorder (Koterba & Saltoun, 2012) and a common chronic condition of childhood (McCowan, Bryce, Neville, Crombie, & Clark, 1996) that can cause children to experience poorer academic outcomes (Stingone & Claudio, 2006), a lower quality of life (Everhart & Fiese, 2009), hospitalizations, and in some cases death (Center for Disease Control, [CDC], 2017). This mixed methods study explored the relationship of asthma, school attendance, grades in mathematics and reading, and the quality of life in predominantly minority children with asthma and in those without asthma. Data for this study was collected at the Children's National Health Systems (CNHS) in the District of Columbia. A total of 36 children without asthma and 30 children with asthma enrolled in the study at the hospital's Emergency Department (ED) and the Improving Pediatric Asthma Care in the District of Columbia (IMPACT DC) clinic. The children were in grades three to five, 8 to 11 years old, and attended schools in the District of Columbia Public Schools (DCPS) during the 2015-2016 school year. Descriptive statistics, t-tests, ANCOVA, ANOVA, Spearman ranked order correlations, and hierarchical multiple linear regression were used to analyze the data. The quantitative analysis indicated children with asthma visited the ED significantly more frequently than those without asthma (p < 0.001, d= 0.8). The quality of life scores were lower for children with asthma compared to those without asthma. Further, as asthma severity increased, the quality of life scores decreased. In addition, children without asthma reported more unexcused days and absence from school than those with asthma. Lastly, children without asthma achieved a lower GPA in mathematics and reading than those with asthma. The findings indicate asthma impacts the quality of life scores in children, and that further research is warranted to determine how asthma impacts academic performance in children. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

The purpose of this quantitative study was to examine the relationship between physical fitness, body mass index and academic performance in Hispanic children enrolled in grade 5 from a district in the Rio Grande Valley. A total of 547 participants were selected from 11 elementary schools from a school district in the Rio Grande Valley. The dependent variable, academic performance, was measured by children's gain score on the STAAR Progress Measure for Reading and Math assessments. The independent variables of physical fitness were measured by scores on cardiovascular fitness and body mass index from the FITNESSGRAM assessment. The literature review on the Conceptual Framework, Theoretical Model to Improve Health and Academic Performance, was identified as the framework for this study. This framework was based on a model of factors associated with improved health and academic performance. The factors included the correlation between physical activity, fitness, fatness, and academic achievement. The method of statistical and data analyses was multiple regression. The results revealed that body mass index was correlated with academic performance. Body mass index accounted for a statistically significant variance in math gains while time did not explain any significant variance in math. There was no correlation between reading gains and time and body mass index. The results by weight group revealed a significant correlation between time and reading gains for the normal weight group and a significant correlation between body mass index and math gains for the obese group. The results by gender revealed a positive and significant correlation between body mass index and math gains for females. These results suggest that at grade 5, consideration be given to body mass index levels of Hispanic children from low-income backgrounds. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Many children in U.S. K-12 schools struggle with childhood obesity. A healthy lifestyle taught in a child's early years is essential for student learning, and it can set the pace for healthy choices to be made in adulthood. The purpose of this exploratory case study was to explore the experiences of parents in Montgomery County, Ohio, who successfully improved their children's health and academic grades. The transtheoretical model of behavior change grounded this study to evaluate the willingness of children and adults to take action on new health and wellness behaviors that can lead them through the stages of change to action and maintenance. The study was guided by 1 overarching research question: What are the experiences of the parents who guided their children through lifestyle changes using local community health and wellness resources, and reported improved health and improved academics? Specifically, the research subquestions asked about the successes, challenges, and strategies applied. This case study targeted 6 parents who guided their 6th grade children for at least 6 months on changing their health and wellness habits. Qualitative data were gathered and coded from structured interviews listing noteworthy statements and identifying patterns. The data were analyzed using data reduction, data display, and conclusion drawing. According to the study's findings, children who ate healthy, got proper rest each night, and engaged in daily physical activity lost weight, felt better, and performed better in school. This study contributes to positive social change by providing parents with strategies to improve health and wellness and academics in their overweight children. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

The purpose of this study was to investigate the extent to which overweight and obesity are challenges among primary school children in Kinondoni and Njombe districts. The study sought to investigate those aspects in terms of prevalence, causes and impacts on social, health as well as children learning behaviours and outcomes. Systematic random sampling was used to select schools while stratified sampling and simple random sampling were used in selecting pupils and teachers. Measurement of weights and height were done to determine Body Mass Index (BMI), measurements of skinfolds were also done to determine body fat percentage. Questionnaires, semi-structured interview schedule and focus group discussion guides were also used. Findings revealed an average of 13.5% children, were overweight and obese. Economy status, household occupations, nutrition and inactivity were significant causes of overweight and obesity. Hypertension, excessive sweating, teasing and peer rejection were common to obese children. In addition, overweight and obese children were reported to underperform in academic and physical activities. The study revealed that overweight and obesity were not friendly healthy conditions to children, thus a need to work it out. The study suggests for establishment of education programs through mass Medias, to raise people's awareness on implications of obesity in children's health, social, and learning behaviours and outcomes. Seven appendixes are included: (1) Pupils' Questionnaires; (2) Pupils' Focus Group Discussion Guide; (3) Teachers' Interviews; (4) Number of Children and their Weight Status in both Rural and Urban Settings (BMI Results); (5) Percentage of Children According to their Weight Status and Performance Grades in the Classroom; (6) Factors Causing Overweight and Obesity among School Children and their Level of Significance; and (7) A Map of Kinondoni and Njombe Showing the Surveyed Schools. (Contains 12 tables and 11 figures.) [Funding for this study was provided by the Dar es Salaam University College of Education.]

As a result of their mobile lifestyle, migrant children experience a high degree of unpredictability in all aspects of their lives. This paper illustrates how the patterns of migrant families' moves put their children at even greater risk for educational problems than is true for other mobile student groups, such as dependents of U.S. military personnel. Migrant families tend to move more frequently and in more erratic patterns than military families. Other characteristics of migrant families and their lifestyle are identified that, when combined with mobility, make migrant children's needs unique, and more dire, than those of other marginalized student subgroups. These characteristics are (1) poverty, underemployment, low income, and child labor; (2) social and geographic isolation; (3) language and cultural barriers that impede migrant families' communication with schools and community service providers; (4) low level of parental education, which lessens parents' involvement in their children's education; (5) limited access to federal assistance; (6) illegal immigration status, which limits access to services; (7) lack of protection with regard to occupational safety and health, labor disputes, and child labor; and (8) poor health status of migrant children, including higher rates of work-related injuries, acute conditions, and infectious diseases. (Contains 45 references.) (SV)

Background: Over 40 million children participate in organized sport in the United States annually, but each day approximately 8,000 children are treated in emergency departments (EDs) due to sport-related injuries, resulting in over $925 million in health care costs. Exercise-based preventive training programs (PTPs) used as a team warm-up can reduce injuries dramatically but youth coaches do not commonly use PTPs. Understanding barriers and facilitators that drive PTP adoption and compliance at the youth sport level could dramatically enhance PTP dissemination and propagate injury reduction in athletes. Further, determining the relationship between coach compliance with PTPs and the effect on athlete injury risk is necessary to promote PTP adoption. Purpose: The purposes of this dissertation were to evaluate the impact of different educational strategies (Generalized, Tailored) on youth soccer and basketball coaches' behavior drivers for PTP implementation. A secondary purpose was to apply an implementation framework to different youth sport organizations to evaluate which areas of implementation may be more challenging. A final purpose was to evaluate the impact of a coaches' educational workshop on athlete movement technique following one season. Study Design: Cluster randomized controlled trial. Methods: Mixed methods approach. Youth soccer and basketball coaches volunteered to participate. Coaches were randomized by league into a Tailored or General workshop. We evaluated coaches' attitudes, subjective norms, perceived behavior control, and behavioral intention to adopt a PTP using a pre- and post-workshop survey consisting of Likert-scale and open-ended questions, as well as a post-season questionnaire to evaluate PTP implementation. Athletes completed a PRE and POST season movement assessment. Results: There were no significant differences between workshop groups on attitudes, subjective norms, perceived behavioral control, or behavioral intention to adopt. Establishing the administrative team was the most challenging framework step to complete. There were no significant differences between workshops on athlete movement technique from PRE to POST but there was a main effect for time (P=0.03). Conclusions: A generalized workshop design was as effective as a tailored workshop in increasing some aspects of coach injury prevention behavior as well as athlete movement technique. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Among the many children with mental health needs, few actually receive mental health services. The children who do receive services are often initially referred by teachers (Sciutto, Terjesen, & Frank, 2000). However, the potential influences of child characteristics, like symptoms, gender, ethnicity, and school professionals' attitudes on such referral decisions are not well understood. While the existing literature suggests that the students who are most often referred for services present with externalizing problems and are male, there has been little investigation regarding student race or ethnicity and teacher or school personnel referrals for mental health services. The present study used an online survey and vignettes to assess whether student symptoms, gender, and ethnicity influenced school professionals' recognition of child mental health issues and decision to refer the child for mental health services. Additionally, the school professionals' years of experience and attitudes toward child mental illness were explored. Participants included 297 teachers and other school personnel. Results indicated that participants' responses to externalizing symptoms, like ADHD, were influenced by the presence of clinically significant symptoms. With regard to internalizing symptoms, like GAD, participants' recognition and referral intentions were influenced by clinical symptoms and general attitudes about child mental health. There were no significant indications that student gender or ethnicity influenced participants' responses, which contradicts previous findings. This study highlights the need for continued research examining ways to support teachers and other school personnel with the common goal of supporting the mental health of students. Implications of the current findings and potential future directions in this area of research are further discussed. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

The purpose of this study is to provide innovative design criteria for urban playgrounds based on the principles of biophilic design. Derived from the biophilia hypothesis, biophilic design aims to provide humans with a positive contact with nature in a built environment. The biophilia hypothesis asserts that human's attachment with nature is a biological need, and it was used as a framework to demonstrate the crucial importance of a connection between humans and nature. The relationship between children and nature was explored through empirical studies, which reveal the importance of this connection for children's health. The analyses of empirical studies demonstrate children's preferences for spaces to play, which reinforces the idea that children like to play in natural environments. The playground's design overview was explored and it reveals that the design of many playgrounds today do not support children's overall development as they once did. Understanding that safety concerns became the primary driver for the design of the majority of contemporary playgrounds within the U.S., biophilic design is proposed as the basis for alternative guidelines to be applied to the design of playgrounds to benefit children. Based on the analysis of children's preferred spaces in which to play, sixteen biophilic design principles were selected as ideal to be applied to the overall playground site design and specific play elements of the playground. Due to the relative lack of available natural space in dense urban cities, private or public vacant lots were considered as available and a dense neighborhood in Honolulu was chosen for the application of this study. Through critical spatial analysis, vacant--or available--lots were identified as potential sites to apply this design. The spatial investigations of the biophilic design principles revealed opportunities to apply them to the overall playground site design and specific play elements of the playground. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

The health and wellness of children is a growing concern as the number of children that are unhealthy continues to increase. Schools can play a pivotal role in promoting wellness among children and teenagers through implementing school-wide wellness initiatives that provide students multiple opportunities to learn and use healthy behaviors (Center for Disease Control and Prevention, 2015a; Deschesnes, Martin, Hill, & A.J., 2003; United States Department of Health and Human Services, 2010). By using a case study methodology, this researcher sought to discover how one elementary school was incorporating a focus on school-wide wellness. The research focused on the effect of incorporating wellness in the curriculum, the teacher's instructional practices, and the school environment. The research was completed at one Miami-Dade County Public Elementary School. The ten participants included teachers and staff. The data was collected through observations by the researcher, questionnaires, interviews, and the collection of documents. Through the analysis of the multiple types of data that were collected, the researcher discussed wellness at the research site. This included information about the success of integrating wellness, the barriers to include wellness, and ways to improve the integration of wellness at the research site. The themes that emerged included negotiating curriculum standards and wellness, wellness integrated into school and classroom culture, parental involvement, nutrition, and wellness opportunities before and after school. The findings have the potential to raise the bar for improved wellness programs in schools. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

The purpose of this study was to determine Pennsylvania principals' perceptions and understanding of the physical and psychosocial impact of childhood obesity, whether they believe schools should be addressing the issue, who they feel should be leading efforts within schools, what actions they believe are taking place to address the issue within schools, their beliefs about the availability of resources to address the issue, and how they perceive legislative impact on the issue. The population included 2,626 Pennsylvania principals from various districts across the state. Three hundred fifty-four principals from various districts completed the online survey. Descriptive analysis of results was utilized to determine principals' perceptions. Results indicated principals were supportive of schools becoming involved in addressing childhood obesity but they felt factors outside of school were a major contributor to the epidemic. Sixty-four percent of principals indicated their school had implemented programs to reduce childhood obesity, but a more coordinated multi-component approach which involves all community stakeholders is needed. Overall, results suggested a sizeable difference between principals' perceptions of the role they felt people should be playing in addressing childhood obesity and the perceived role people are currently playing. Four of the groups displayed approximately a 20% discrepancy between expected and actual role. Three of the groups exhibited between a 40% to 60% disparity. Only one group revealed less than a 15% difference. Responses indicated that both resources and training related to obesity are lacking within schools. Sixty-four percent of principals indicated their school has initiated obesity interventions while 36% of principals indicated their school has provided assistance to parents of obese children. Results indicated that principals support wellness policy development and implementation and districts are working to do so. Principals perceived that obesity is affiliated with psychosocial and psychological issues and over half have encountered these obesity related issues within their schools. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

In this dissertation, I present three distinct essays in economics of education and health economics that can be read independently from one another. These studies investigate the non-pecuniary benefits of extended primary schooling in a developing country setting. I exploit the 1997 education reform in Republic of Turkey, which extended the duration of mandatory schooling from 5 to 8 years, to address the endogeneity of educational attainment levels of individuals. Chapter 2 provides robust evidence in favor of the argument that increasing the duration of mandatory primary education among women who have a low interest in receiving more schooling may have substantial non-pecuniary benefits in terms of the health of their offspring measured by birth weight outcomes and child mortality in developing country setting. In Chapter 3, I examine the impact of mandatory extended primary schooling on happiness of young adults. My analysis reveals that, for females, obtaining at least a middle school degree increases the likelihood of being happy and propensity of being satisfied with various life domains. Descriptive analysis suggests that being hopeful about one's future plays an important role behind this finding. For the case of males, although relatively imprecisely estimated, I find evidence that obtaining at least a middle school degree leads to a decline in happiness. Auxiliary analysis documents the imbalance between aspirations and attainments may be the reason behind this finding among men. In Chapter 4, I examine the impact of extended primary schooling on a set of health indicators among young individuals. In this study I document that; extending schooling may impact women and men differentially, and education does not necessarily promote health and health behaviors. More specifically, while increased education increases male body weight indicators (i.e., overweight, obese), it lowers the propensity of being overweight among women. Findings of this study also indicate that while the effect of extending primary schooling on smoking is positive among females, it's negative for the case of males. Further investigation suggests peer effects, and time use play important roles in explaining these findings. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

This practicum promoted community, school, and agency collaborative relationships to increase the access and affordability of comprehensive, culturally acceptable health care services and health promotion activities. The target population for these services and activities were high-risk, minority adolescents in grades 6 through 8 in two elementary schools serving Latino, African-American, Caucasian, and Asian-American students, including several immigrants. The primary partners were the local health center, Planned Parenthood, and school personnel. Public school nursing staff facilitated health assessments and access for students who needed services. The 8-month school-based Young Adolescent Health Project included health screenings, appointments, advocacy, transportation, education, dental and vision care, laboratory tests, management of chronic illnesses, gynecological/reproductive services, and individual counseling. Workshops and peer health education were used to teach health-promoting behavior. Additional strategies used to address issues of accessibility, availability, affordability, and acceptability included nontraditional outreach, a data management system, and the employment of bilingual and bicultural staff, with selected eighth graders serving on an advisory council. Evaluation of the project indicated that health assessments identified many unmet physical health needs of young adolescents. Identified mental health needs were addressed by counselors in the School Based Youth Service Program. Overall, this project resulted in increased accessibility to health care for this population. Subsequently, an information management system was developed to allow service providers to share relevant information about the medical needs of identified students, and existing relationships among partners were strengthened. (Six appendices include a Health History Assessment, Treatment Plan Contact Sheet, and a Parent Consent Form. Contains 36 references.) (KB)

Concerns about the quality of a before- and after-school program on an overseas military installation arose due to low staff morale, caregivers' lack of training and experience, and child behavior problems. This practicum project devised and implemented a 10-week training program to increase staff knowledge of developmentally appropriate practices and to provide them with guided practice in evaluation of program components. Caregivers were assisted, through reflective teaching and peer advising, in using their new knowledge to alter the children's activity environment. The training module topics were: (1) keeping children safe; (2) promoting good health and nutrition; (3) creating and using an environment for learning; (4) promoting physical development; (5) promoting cognitive development; (6) promoting communication; (7) promoting creativity; (8) building children's self-esteem; (9) promoting social development; (10) providing positive guidance; (11) working with families; (12) being an effective manager; and (13) maintaining a commitment to professionalism. Resources were also collected to assist staff in future planning. Evaluation results indicated that staff gained knowledge of developmentally appropriate practices and were able to implement changes to the daily schedule, the environment, and the activities. These adaptations resulted in children engaging in more appropriate activities throughout the program day, and an 80 percent decline in the number of child behavior problems. (Eleven appendices include a list of additional training materials and sample training activities. Contains 24 references.) (KDFB)

The relationship between pesticides in food and the occurrence of attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) in school age children is considered. Pesticides include chlorinated hydrocarbons and organic phosphates that are commonly present in fruits and vegetables, which are a large part of the diet of children. A literature review considers nutrition, pesticides, diagnosis of learning problems, links between pesticides and learning problems, and treatments for ADD and ADHD. The influence of diet on neurotransmitters is addressed. Medical research is cited that links damage to neurotransmitters in the brain's frontal lobes and ADD/ADHD. Evidence showing that pesticides can damage brain cells is also presented. Problems with the detection of pesticide residues in foods are acknowledged. The treatment of ADD/ADHD has commonly been to medicate the child with stimulant drugs that affect the body's neurotransmitter chemicals, as well as tricyclic antidepressants and tranquilizers. Dietary treatment, behavior modification, and stress reduction therapies may be additional treatment options. Additional questions and implications regarding pesticide use and ADD/ADHD are posed. (Contains 30 references.) (SW)

A study investigated the attitudes of Japanese breastfeeding mothers in the South Bay area in Los Angeles. The sample consisted of 20 Japanese mothers over the age of 18 who were born in Japan, who recently came to the United States, and whose youngest child has been breastfed for at least 6 months. Subjects were interviewed in their native language. The results indicated that unrestricted breastfeeding, night nursing while co-sleeping, and long term breastfeeding were practiced. The mothers tended to choose breastfeeding as a matter of course and did not feel shy when nursing in public. They felt that breastfeeding was important for them. In addition, the study indicated some barriers that interfere with their breastfeeding practices, such as cultural and nutritional conflicts and conflicting advice from professionals. Results suggested that knowing the psycho-social obstacles to breastfeeding in the United States can facilitate breastfeeding among ethnic minorities, and that the understanding of culturally appropriate childrearing practices--such as unrestricted nursing, late weaning, and co-sleeping--may be needed among medical professionals as well as mental health professionals. (The survey questionnaire is appended. Contains approximately 110 references.) (AA)

This practicum was designed to increase the quality of service in five day care centers in a metropolitan Florida county, as evidenced by increases in the Early Childhood Environmental Rating Scale (ECERS) scores of early childhood teacher participants. A 10-week teacher education program for 5 early childhood teachers was developed around Marilyn Segal's 1991 "All About Child Care: A Comprehensive Child Care Curriculum." Nine 4-hour classes focused on safety, health, the learning environment, communication strategies, physical development, cognitive development, creative development, self-concept, and social skills, while the 10th week of the program focused on the creation an individual resource files. Pre- and post-intervention ECERS scores were developed by observing the participants in their day care center classrooms. All five participants made significant improvements in their ECERS scores, especially in the areas of furnishings/displays and creative activities. Eight appendices provide ECERS pre- and post-test scores, total ECERS scores, profiles of participants, a professional development plan, a resource file, competency goal statement guidelines and checklist, implementation plan class agendas, and a comparison on pre- and post-test ECERS scores. Contains 49 references and a list of 6 videos. (MDM)

A practicum developed and implemented a nutrition and fitness program for 90 kindergarten and first-grade students in an urban elementary school. The program was designed to make parents, teachers, and students more aware of nutrition and physical fitness requirements for proper growth and development. The 33-week program included: (1) pretest parent and student surveys; (2) parent and teacher workshops; (3) classroom lessons and field trips on various food groups and types; (4) lessons on nutrition; (5) exercise activities; (6) meal preparation sessions; (7) a poster contest and fitness-health fair; (8) a parent breakfast planned and prepared by the students; and (9) a posttest parent and student survey. A comparison of pre- and postintervention survey results indicated a significant increase in the number of the students who would choose healthy foods for meals and snacks and liked to exercise. The data also revealed that parents became more aware of their children's nutrition and fitness needs after the program. (Nine appendixes contain copies of the pre- and posttest surveys, names and addresses of television networks, introductory and thank-you letters to parents, a list of nutritious snacks, and sample recipes. Contains 35 references.) (MDM)

This practicum paper describes the use of National Association for the Education of Young Children (NAEYC) accreditation self-study criteria in the expansion and revision of a staff handbook for a Florida preschool. The existing staff handbook and staff training programs were found to provide inadequate information on school health and safety procedures, employee benefit policies, and standard ethical practices expected from early childhood professionals. To address these deficiencies, a series of inservice training sessions were held to increase staff awareness in the three areas. Small group activities were used to involve the staff in solving hypothetical health and safety problems and ethical dilemmas. Employee benefits were explained in a separate inservice session. Documents drafted from the joint participation of administration and staff were included in an expanded and improved staff handbook. Post-training results from staff surveys and questionnaires indicated a substantial increase in staff awareness of health and safety procedures, employee benefit policies, and standard ethical practices. Thirteen appendices contain copies of various handouts used in the training sessions, staff questionnaires, and questionnaire results. (Contains 16 references.) (MDM)

This practicum was designed to create an organizational model that would set the stage for the creation of a comprehensive program of substance abuse treatment in a residential setting. The subject population was women ages 15 to 25 years, who had children or were pregnant and who demonstrated patterns of substance abusing behaviors. This writer developed a database professional organizations and practitioners to determine the feasibility of the suggested model treatment program. With the input received, a non-profit organization was created to formalize the basis for program development, long term and strategic planning and the meeting of all licensure requirements. Input was also received by graduate schools of social work and professionals in the substance abuse treatment field, focusing on the menu of services and treatment modalities. Analysis of the data and input collected revealed new possibilities for an organizational design to be used as the basis for a comprehensive treatment model. Through the implementation of the organizational design, it was determined that the comprehensive treatment model proposed would provide the broadest continuum of services offering the best chance for client success. (Author/RB)

A content-based curriculum in English as a Second Language (ESL) focusing on prenatal self-care is presented. The course was designed as a solution to the problem of inadequate prenatal care for limited-English-proficient Mexican immigrant women. The first three sections offer background information on and discussion of (1) content-based ESL instruction, including related methods, rationale, its use in different academic settings, issues in implementation, and adaptation to adult education; (2) the health needs of Mexican women, including cultural and practical barriers to use of health care and health services, and benefits of prenatal care; and (3) the rationale for and design of prenatal care instruction through content-based ESL, including educational benefits, materials, other prenatal care resources, adapting materials for content-based instruction, and design issues. The curriculum itself is then presented. It consists of lesson plans and 44 student handouts on these topics: the body, the fetus, going to the doctor, nutrition during pregnancy, giving birth, and well-baby care. Notes for the instructor and ideas for vocabulary exercises are included. A 100-item list of content and methodological resources is appended. (MSE) (Adjunct ERIC Clearinghouse on Literacy Education)

The problem of families' limited access to community early childhood services and information was addressed in this practicum. Negative outcomes for young children and their families in a northeastern city were attributed to difficulties in locating and providing services for the developmental needs of children between birth and age 5. The children were at risk for (1) substandard care; (2) abuse, neglect, or heightened family stress; and (3) school failure. The practicum aimed to help families negotiate services through a community-based referral procedure that used a "warm line" format. A key feature of the procedure was the outreach method, which used informal kinship and friendship networks, formal networks, and conventional public service announcements. The pluralistic nature of the community demanded diverse, holistic strategies. Outreach, coordination, and human resource development were other features of the implementation. The results were positive. Difficult-to-reach families responded to the outreach, received information, and shared it in their informal networks. Planning efforts that represented community needs were initiated. Eighty requests were processed through the procedures, and steps toward advocacy were taken through an early childhood services network. Appendices contain advertisements of nanny and child care listings, a survey pertaining to family matters, a referral form and log, a form for a weekly journal, letters, responses to implementation, and other related materials. Contains about 100 references. (Author/LB)