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INTRODUCTION: Pennsylvania's Student Assistance Program (SAP) began in the mid‐1980s to address student barriers to academic success. SAP teams, groups of trained school and community professionals, review referrals, and connect students to services. State leadership conducts an annual SAP team survey, but capacity to evaluate data and affect change is limited. In 2020, leadership partnered with [institution name] to collaboratively review the survey data. METHODS: Frequencies and percentages were calculated. Open responses were coded. Logistic regression models evaluated the association between SAP team size, team meeting frequency, and team maintenance. RESULTS: The 2019 to 2020 survey had 1003 respondents. Median number of SAP team members was 8 (range 1‐21). The majority (54%) indicated their SAP team met once per week/cycle for 30 to 90+ minutes. Larger teams met more often. Annual team maintenance occurred for 38% of teams, and was more common for larger teams. SAP team members identified mental health (68%), trauma (44%), and parent engagement (36%) as top training needs. CONCLUSIONS: An academic partnership successfully provided the capacity to review SAP survey responses, and informed evidenced‐based discussion of best practice guidelines and realignment of staff professional development opportunities. [ABSTRACT FROM AUTHOR]

Background: The whole school, whole community, whole child (WSCC) model suggests wellness councils, ongoing review of wellness policy, and a plan for evaluating set objectives are some of the key features needed to support school wellness infrastructure. This study explored the relationship between implementation of these infrastructure features and overall school wellness environment assessment scores among a sampling of Pennsylvania schools. Methods: The Healthy Champions program provides Pennsylvania schools an opportunity to self‐assess their wellness environments across several school wellness topics. Staff enrolled their school in the program by completing a self‐report electronic assessment. Enrollment data from the 2020/2021 program year were analyzed using the Kruskal‐Wallis test and linear fixed model to identify the impact of varied implementation levels across 3 wellness infrastructure activities. Interactions between these variables and overall assessment score were also analyzed. Results: Of the 645 Pennsylvania schools enrolled and analyzed, we observed higher mean wellness environment assessment scores (∆ 0.74 95% CI 0.40‐1.07; p < 0.001) among schools that reported some frequency of all 3 wellness infrastructure activities, compared to schools that reported no frequency for the activities. Implications: Schools with existing policies and practices related to the 3 wellness infrastructure activities should consider the degree of implementation to best support overall wellness in their school setting. Additional research to explore implementation barriers and supports is needed. Conclusions: Analyses indicated that overall wellness environment assessment scores are impacted by implementation thresholds for wellness council meeting frequency, revision of wellness policy, and review of student health promotion objectives. [ABSTRACT FROM AUTHOR]

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

• Little is known about parent perspectives of adolescent mental health peer support. • Of 985 parents, 33 % definitely favored peer support, especially Latinx parents. • Adolescent peer support may be an innovative approach to mental health disparities. Evidence-based adolescent peer support programs for suicide prevention have shown promise in schools through increased knowledge and acceptability of help-seeking. While multiple social contacts may influence adolescent help-seeking, parents are a major factor. Thus, parent backing for peer support programs is likely to influence their impact, but little is known regarding parent perspectives on such programs. In the context of a randomized clinical trial evaluating school-based depression screening, qualitative work indicated Pennsylvania parents held positive views of peer support programs. The objective of this study was to gain an understanding of parent perception of adolescent peer support programs at the national level. Cross-sectional US-based survey with the C.S. Mott Children's Hospital National Poll on Children's Health; 985 parents had a child 13–18 years-old and were eligible. Post-stratification weights were generated by survey vendor, Ipsos. Descriptive and bivariate results were calculated; logistic regression models controlled for parent demographics. Parents were 55 % female, 56 % White, 81 % employed, and 52 % with an income <$100 K. Backing for peer support programs was rated as 33 % definitely, 46 % probably, 14 % unsure, and 7 % would not support; 29 % reported existing peer support programming at their teen's school. Odds of "definitely/probably" versus "unsure/do not" support were greater among mothers versus fathers (OR 1.53 [95 % CI 1.08, 2.16]), Latinx versus White parents (OR 1.96 [95 % CI 1.15, 3.34]), and employed parents (OR 1.92 [95 % CI 1.25, 2.94]). Adding parent report of an existing program at their teen's school to the model retained the aforementioned variables with greater support among parents exposed to this programming OR 3.20 ([95 % CI 2.01, 5.08]). Conclusions. One-third of parents favored peer support programs, especially those previously exposed to this programming. Data suggest programs may appeal to Latinx families, presenting an innovative approach to mitigate mental health disparities. [ABSTRACT FROM AUTHOR]

Purpose: A correlation between iron deficiency anemia (IDA) and sudden sensorineural hearing loss (SNHL) was described in adults. In this study, we examined if there is a relationship between IDA and hearing loss in the pediatric population. Method: This was a retrospective cohort study of data collected from the Informatics for Integrating Biology and the Bedside database from 2011 to 2016. Children and adolescents 4-21 years old seen at Penn State Milton S. Hershey Medical Center, Hershey, PA, were examined for hearing loss and IDA status. Hearing loss was determined by International Classification of Disease-9 and -10 codes, and IDA was determined by both low hemoglobin and serum ferritin levels for age and sex. Results: We identified 20,113 patients. Prevalence of hearing loss and IDA was 1.7% and 2.3%, respectively. The prevalence of all hearing loss was 3.0% in the IDA cohort and 1.7% in those without IDA. Children and adolescents with IDA are at increased odds of developing SNHL (adjusted odds ratio: 3.67, 95% CI [1.60-7.30]). Conclusions: Children with IDA demonstrate increased likelihood of SNHL. Although correction of IDA in those with hearing loss has yet to be linked to improvements in hearing outcomes, screening for and correcting IDA among pediatric patients will positively affect overall health status. Supplemental material: https://doi.org/10.23641/asha.5087071 [ABSTRACT FROM AUTHOR]

High frequency hearing loss (HFHL), often related to hazardous noise, affects one in six U.S. adolescents. Yet, only 20 states include school-based hearing screens for adolescents. Only six states test multiple high frequencies. Study objectives were to (1) compare the sensitivity of state school-based hearing screens for adolescents to gold standard sound-treated booth testing and (2) consider the effect of adding multiple high frequencies and two-step screening on sensitivity/specificity. Of 134 eleventh-grade participants (2013–2014), 43 of the 134 (32%) did not pass sound-treated booth testing, and 27 of the 43 (63%) had HFHL. Sensitivity/specificity of the most common protocol (1,000, 2,000, 4,000 Hz at 20 dB HL) for these hearing losses was 25.6% (95% confidence interval [CI] = [13.5, 41.2]) and 85.7% (95% CI [76.8, 92.2]), respectively. A protocol including 500, 1,000, 2,000, 4,000, 6,000 Hz at 20 dB HL significantly improved sensitivity to 76.7% (95% CI [61.4, 88.2]), p < .001. Two-step screening maintained specificity (84.6%, 95% CI [75.5, 91.3]). Adolescent school-based hearing screen sensitivity improves with high frequencies. [ABSTRACT FROM AUTHOR]

The 2013 US Preventive Services Task Force report found insufficient evidence for pediatric blood pressure screening. This retrospective study evaluated the reliability of successive annual blood pressure screening of children for hypertension at the 3-, 4-, and 5-year-old health maintenance visits (January 1, 2010 to June 18, 2014). Of 328 patients, 290 (88%) were normotensive at all 3 visits. All elevated blood pressures (≥95th percentile) were stage 1. No patient was hypertensive (3 elevated measures). The extended concordance correlation coefficient indicated poor agreement for systolic (0.19, 95% CI −0.49 to 0.72) and diastolic (0.11, 95% CI −0.39 to 0.56) measurements. Blood pressure at the 3-year (κ −0.008, 95% CI −0.11 to 0.09), 4-year (κ 0.09, 95% CI −0.06 to 0.24), or 5-year (κ 0.08, 95% CI −0.05 to 0.20) visit was not associated with elevated blood pressures at the other 2 time points. In the preschool years, stage 1 elevated blood pressures do not correlate with hypertension and may be better managed by watchful waiting and parental reassurance. [ABSTRACT FROM AUTHOR]

BACKGROUND: Approximately 15% of children in the United States 6-19 years of age have hearing loss. Even mild, unilateral hearing loss may adversely affect educational success. In 2014, the Pennsylvania Department of Health (PA DOH) began updating the 2001 regulations on state-mandated school hearing screens. To inform the updates, a needs assessment was conducted with PA-certified school nurses (CSNs) regarding current screening practice and potential barriers to making changes. METHODS: A 42-item electronic survey of CSNs developed with pediatricians, audiologists, nurses, and the PA DOH was administered in October 2014. RESULTS: There were 536 completed surveys. Most CSNs (50.8%) screened 251-500 students annually. Only 35.8% strictly followed PA DOH protocol, while 51.6% followed protocol and added nonguideline frequencies. Over half of screens (60.2%) were conducted in places where other people were present. Most CSNs (82.5%) reported annual audiometer calibration, but 92.4% were unsure whether the calibration was exhaustive or limited. Reported barriers to change included time, cost, and staffing. CONCLUSIONS: As most CSNs added frequencies to the PA DOH hearing screen, an update with added frequencies should be well accepted. Clarification regarding test environment and exhaustive audiometer calibration is needed. Adherence to best practice may be optimized by addressing CSN reported barriers to change. [ABSTRACT FROM AUTHOR]

The study objective was to quantify sugar-sweetened beverage (SSB) offerings to children in Pennsylvania (PA) childcare centers and determine whether this information is communicated to parents. In October 2014, a SurveyMonkey link was sent to 4461 PA childcare centers. The 518 respondents represented 88% of PA counties. 279 centers (54%) serve SSBs. 330 (65%) of childcare centers provide parents a report of their child’s daily intake. Of 185 centers serving SSBs and providing a daily intake report, 91% include SSB consumption. In total, 38% of centers (103/272) offer but do not report SSB consumption. In 96% of centers, parents may request their child not receive SSBs. In conclusion, though more than half of PA childcare centers surveyed offer SSBs, those providing daily intake reports usually include SSB consumption. Requiring daily intake reports may be a strategy to increase parental awareness of items consumed outside the home. [ABSTRACT FROM AUTHOR]

Background: Iron deficiency anemia (IDA) affects 2%-5% of reproductive-age women. Screening is based on risk factors, such as a low-iron diet and menstruation. However, published IDA risk factors fail to consider age-related risks specific to adolescent women, potentially limiting identification of high-risk adolescents for objective testing. The goal of the study was to examine IDA risk factors in a nationally representative sample of younger (12-21 years) and older (22-49 years) reproductive-age women. Materials and Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2003-2010. IDA was defined using hemoglobin, ferritin, soluble transferrin receptor, standard NHANES laboratory measures. Sex-, age-, and race-specific hemoglobin values defined anemia. Iron deficiency was calculated using ferritin and soluble transferrin receptor in the body iron formula. Logistic regression assessed the association of potential risk factors (race, body mass index, poverty, iron intake, tobacco/nicotine exposure, physical activity, menses, and contraceptive use) with IDA in younger and older women. Results: The prevalence of IDA was 2.4% and 5.5% among younger and older women, respectively. Among younger women, contraceptive use was marginally protective from IDA (risk ratio 0.50, 95% confidence interval [CI] 0.25-1.00). Among older women, significant variables included Black race (risk ratio 2.31, 95% CI 1.33-4.02) and increased years menstruating (≥25 years vs. <25 years; risk ratio 1.93, 95% CI 0.99-3.76). Conclusions: Risk factors for IDA among older reproductive-age women do not apply to adolescent women. To better inform the timing and frequency of screening recommendations, further research must identify adolescent-specific IDA risk factors. [ABSTRACT FROM AUTHOR]

The article presents a study related to the analysis of the failure of office-based hearing screening questions for identifying adolescents at risk for hearing loss. It reveals that under the study, utility of questions by clinicians to identify high risk patient for hearing loss decided by Bright Futures, disease prevention initiative, and the American Academy of Pediatrics, was analysed. The result concluded that questions of Bright Futures were not associated with adolescent hearing loss.

The article presents a study which was carried out to compare the sensitivity and specificity of school hearing screening in Pennsylvania with hearing screening designed to detect adolescent hearing loss. The study was carried out in a single public high school in 2011. It concludes that current school hearing screens have low sensitivity for detecting adolescent hearing loss.

Background. Studies demonstrate gaps in anticipatory guidance during well-child visits, but none consider academic teaching hospitals where physician trainees also provide counseling. We prospectively assessed parental perception of anticipatory guidance at the outpatient clinic of an academic teaching hospital. Methods. Parents of patients newborn to <60 months old completed questionnaires regarding providers seen and anticipatory guidance preferences. Results. Of 204 parents, 40% saw the child’s primary attending alone. There was no association between providers seen and the number of topics covered. Seeing the child’s primary attending alone increased the odds that parents’ priority topics were covered compared with another attending (odds ratio [OR] = 0.31; 95% confidence interval [CI] = 0.11-0.90) or the addition of a resident (OR = 0.35; 95% CI = 0.16-0.77) or medical student (OR = 0.33; 95% CI = 0.12-0.90). Conclusions. Priority anticipatory guidance is covered only one third as often when the well-child visit is not conducted by the primary attending. When involving trainees, continuity of care and parental concerns must be emphasized. [ABSTRACT FROM PUBLISHER]