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BackgroundText messaging (short message service, SMS) is a widely accessible and potentially cost-effective medium for encouraging behavior change. Few studies have examined text messaging interventions to influence child health behaviors or explored parental perceptions of mobile technologies to support behavior change among children. ObjectiveOur aim was to examine parental acceptability and preferences for text messaging to support pediatric obesity-related behavior change. MethodsWe conducted focus groups and follow-up interviews with parents of overweight and obese children, aged 6-12 years, seen for “well-child” care in eastern Massachusetts. A professional moderator used a semistructured discussion guide and sample text messages to catalyze group discussions. Seven participants then received 3 weeks of text messages before a follow-up one-on-one telephone interview. All focus groups and interviews were recorded and transcribed verbatim. Using a framework analysis approach, we systematically coded and analyzed group and interview data to identify salient and convergent themes. ResultsWe reached thematic saturation after five focus groups and seven follow-up interviews with a total of 31 parents of diverse race/ethnicity and education levels. Parents were generally enthusiastic about receiving text messages to support healthy behaviors for their children and preferred them to paper or email communication because they are brief and difficult to ignore. Participants anticipated high responsiveness to messaging endorsed by their child’s doctor and indicated they would appreciate messages 2-3 times/week or more as long as content remains relevant. Suggestions for maintaining message relevance included providing specific strategies for implementation and personalizing information. Most felt the negative features of text messaging (eg, limited message size) could be overcome by providing links within messages to other media including email or websites. ConclusionsText messaging is a promising medium for supporting pediatric obesity-related behavior change. Parent perspectives could assist in the design of text-based interventions. Trial RegistrationClinicaltrials.gov NCT01565161; http://clinicaltrials.gov/show/NCT01565161 (Archived by WebCite at http://www.webcitation.org/6LSaqFyPP).

The purpose of the study is to assess the relationship between timing of adolescent development and risk factors for suicide. Nationally representative data from the Add Health survey were used. The relationship of sociodemographic characteristics, known risk factors, and physical developmental timing and cognitive developmental style to suicide attempt was assessed. Depression was a risk factor for suicide attempts in both 9th and 11th grade. Other risk factors differed. Use of illegal drugs, homosexual orientation, using public assistance, and physical development were the important risk factors for ninth graders. For 11th graders, sexual abuse, being in counseling, and being of "other" race or ethnicity (mainly Asian or Native American) were risk factors. The cognitive development variable of using a systematic problem-solving method was protective for 11th graders. Recognizing that risk factors for adolescent suicide attempts change over time and with developmental timing of puberty is an important factor for suicide prevention strategies. (Contains 5 tables.)

There are inconsistent findings about depression in Asians. This study examined risk factors for depression in Asian and Caucasian adolescents. Stratified bivariate secondary analyses of risk indicators and depressed mood were performed in this cross-sectional study of high school survey data (9th to 12th grades) from 2,542 students (198 Asian). Asians had a higher prevalence of depressed symptoms, but similar risk factors as Caucasians. Smoking and injury at work were major risk factors for depressed mood among Asians. Asian-specific risk factors for depression were being foreign-born and having a work-related injury. Asian and Caucasian teens have similar risk factors for depressed mood, though being foreign born and having a work-related injury are risk factors specific to Asian youth, possibly related to social-economic status. Providers of care in school, such as school nurses, can be important primary screeners of depression for Asian students in particular. (Contains 2 tables.)

Objectives: To determine relationships between physical fitness and academic achievement in diverse, urban public school children. Methods: This cross-sectional study used public school data from 2004 to 2005. Academic achievement was assessed as a passing score on Massachusetts Comprehensive Assessment System (MCAS) achievement tests in Mathematics (fourth, sixth, and eighth grade, n = 1103) and in English (fourth and seventh grade, n = 744). Fitness achievement was assessed as the number of physical fitness tests passed during physical education (PE). Multivariate logistic regression analyses were conducted to assess the probability of passing the MCAS tests, controlling for students' weight status (BMI z score), ethnicity, gender, grade, and socioeconomic status (school lunch enrollment). Results: The odds of passing both the MCAS Mathematics test and the MCAS English test increased as the number of fitness tests passed increased (p less than 0.0001 and p less than 0.05, respectively). Conclusions: Results show statistically significant relationships between fitness and academic achievement, though the direction of causation is not known. While more research is required, promoting fitness by increasing opportunities for physical activity during PE, recess, and out of school time may support academic achievement. (Contains 3 tables and 2 figures.)

In order to identify differences in risk factors for suicide attempts throughout adolescence, this study utilized a school-based survey of ninth (n = 1,192) and eleventh graders (N = 1,055). Suicide attempts were associated with cigarette and alcohol use, family violence, and depression for ninth graders and with illicit drug use, school violence, and sexual abuse for eleventh graders, while having friends was protective for both groups. Additionally, having more than one risk factor imparted an exponential risk for suicide attempts (ninth greater than eleventh graders). The differences detected are consistent with developmental changes of adolescence and represent important information for identification of at-risk youth.

Discusses partnerships between school-based health centers and school nurses, clarifying the role of school nurses and school-based health centers in the areas of collaboration, communication, and cooperation and examining obstacles to partnerships. Elements for successful collaboration are reviewed (clarifying roles, sharing leadership and program ownership, cooperative training and continuing education, negotiating conflict, and maintaining mutual support and respect.) (SM)