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For many children of color, the cumulative impact of pre-existing stressors, disparities, and pandemic-related losses has contributed to a toxic level of stress. Toxic stress can disrupt healthy brain development making children vulnerable to physical and mental health problems. School nurses are the primary health professionals who interact with children daily during the academic year, which positions them to identify risk factors within the social determinants of health that contribute to the development of toxic stress. The Toxic Stress Schema (TSS) provides a framework for assessment and care planning related to social determinants of health and potential sources of stress and/or buffering support for the physical and mental well-being of children. A case study approach is used to demonstrate the application of the TSS to school nursing and provide the basis for conceptualizing a plan of care and identifying resources to support the child's physical and mental health.

Purpose: COVID‐19 and other recent infectious disease outbreaks have highlighted the urgency of robust, resilient health systems. We may now have the opportunity to reform the flawed health care system that made COVID‐19 far more damaging in the United States (U.S.) than necessary. Design and Methods: Guided by the World Health Organization (WHO) Health System Building Blocks framework (WHO, 2007) and the socio‐ecological model (e.g., McLeroy et al., 1988), we identified challenges in and strengths of the U.S.' handling of the pandemic, lessons learned, and policy implications for more resilient future health care delivery in the U.S. Using the aforementioned frameworks, we identified crucial, intertwined domains that have influenced and been influenced by health care delivery in the U.S. during the COVID‐19 pandemic through a review and analysis of the COVID‐19 literature and the collective expertise of a panel of research and clinical experts. An iterative process using a modified Delphi technique was used to reach consensus. Findings Four critically important, inter‐related domains needing improvement individually, interpersonally, within communities, and for critical public policy reform were identified: Social determinants of health, mental health, communication, and the nursing workforce. Conclusions: The four domains identified in this analysis demonstrate the challenges generated or intensified by the COVID‐19 pandemic, their dynamic interconnectedness, and the critical importance of health equity to resilient health systems, an effective pandemic response, and better health for all. Clinical relevance: The novel coronavirus is unlikely to be the last pandemic in the U.S. and globally. To control COVID‐19 and prevent unnecessary suffering and social and economic damage from future pandemics, the U.S. will need to improve its capacity to protect the public's health. Complex problems require multi‐level solutions across critical domains. The COVID‐19 pandemic has underscored four interrelated domains that reveal and compound deep underlying problems in the socioeconomic structure and health care system of the U.S. In so doing, however, the pandemic illuminates the way toward reforms that could improve our ability not only to cope with likely future epidemics but also to better serve the health care needs of the entire population. This article highlights the pressing need for multi‐level individual, interpersonal, community, and public policy reforms to improve clinical care and public health outcomes in the current COVID‐19 pandemic and future pandemics, and offers recommendations to achieve these aims. [ABSTRACT FROM AUTHOR]

In recognition of the important role that fathers play in the lives of young children in Haiti, a public health organization instituted fathers' clubs in 1994 as a strategy to improve the health outcomes of children. Fathers' clubs focus on child and family health education. To evaluate the effectiveness of fathers' clubs, we examined the health of children born in Haitian villages with and without active fathers' clubs and compared results for the two groups. The presence of a fathers' club in a child's birth village had a positive effect on vaccination status, growth monitoring, and vitamin A supplementation after we controlled for socioeconomic status, time. and the quality of the village health agent. Child weights and mortality were not affected by the fathers' clubs. (Am J Public Health. 2010:100:201-204. doi: 10.2105/AJPH.2008.152439)

The risk of alcohol related harm is experienced disproportionality by young people aged 15–24 years. Harmful use of alcohol has serious effects on individual physical and mental wellbeing and is considered by the World Health Organization to be one of the main risk factors for poor health globally. It is crucial to understand the factors that influence drinking behavior in young people in order to inform prevention strategies to prevent problematic drinking. This is particularly paramount during the transition into young adulthood (around 18–25 years), when risky health behaviors are likely to become embedded. This pilot study adopted a qualitative descriptive methodology that facilitates exploration of what young people say about their own experiences and behavior, as it relates to SNS use and alcohol consumption. Semi-structured interviews were conducted in Newcastle, NSW Australia. An inductive, semantic approach to thematic analysis was selected to analyze the data as this method supported the exploratory nature of the pilot study and ensured that the themes identified were strongly linked to the data. Four main organizing themes that arose from the collected data were: organizing friends; safety amongst friends, planning not to plan; and different event – different plans. All of the participants stated they preferred to use Facebook Messenger™ to connect and share in a group conversation with peers. Convenience, cost and accessibility emerged as the main reasons for using SNSs to plan nights out. Planning for a night out using SNSs allows young people to impulsively plan and change plans – making planning fluid and asynchronous. To date, despite the global use of SNSs, the influence of SNSs in young adults' planning for events during which alcohol is served is relatively unknown. This pilot study gives us a some understanding of how young people use SNSs to plan and prepare for a night out where alcohol is served. Further research needs to be conducted to determine whether SNSs can be used effectively to promote health behavior change or be used as forums for advice seeking and support when attending events where alcohol is served, with the ultimate goal of lowering risky behaviors and thereby improving health outcomes for young people. [ABSTRACT FROM AUTHOR]

Adolescents with asthma are influenced by peers and family. The objective was to better understand family social support and test its association with medication adherence, asthma control, and Emergency Department (ED) use. This study is a cross-sectional secondary data analysis from a randomized controlled trial with urban adolescents from three U.S. cities. Participants (12-20 years old) with asthma completed the Perceived Family Support Scale (PFS) and Horne's Medication Adherence Report Scale (MARS). Data from both tools were classified into 2 categories- high and low (< 25th percentile) perceived family support and high (total score >10) and low medication adherence, respectively. Chi-square statistic and logistic regression were used for analysis. Of the 371 participants, the majority were young (96% ≤ 17 years), African American or Bi-racial (85%), and Medicaid-insured (72%); over one-third had maternal family history of asthma. Among those on a controller medication (n = 270), only 37% reported its use ≥8 days over 2 weeks. Asthma control was poor with 50% categorized "not well controlled," 34% "very poorly controlled." Participants responded positively to most social support items. One item, providing and receiving social support to and from family members, was less often positively reported. Low medication adherence was significantly associated with lower perceived social support (p = 0.018). This study underscores the importance of family social support in understanding the extent of adolescents' self-management, particularly medication adherence. [ABSTRACT FROM AUTHOR]

Harmful use of alcohol has serious effects on public health and is considered a significant risk factor for poor health. mHealth technology promotes health behavior change and enhances health through increased social opportunities for encouragement and support. It remains unknown whether these types of applications directly influence the health status of young people in reducing harmful levels of alcohol consumption. The purpose of this systematic review is to examine current evidence on the effectiveness of mHealth technology use in positively influencing alcohol-related behaviors of young people without known alcohol addiction. Relevant articles published from 2005 to January 2017 were identified through electronic searches of eight databases. Studies with interventions delivered by mHealth (social networking sites, SMS and mobile phone applications) to young people aged 12–26 years were included. Outcome measures were alcohol use, reduction in alcohol consumption or behavior change. Eighteen studies met the inclusion criteria. Interventions varied in design, participant characteristics, settings, length and outcome measures. Ten studies reported some effectiveness related to interventions with nine reporting a reduction in alcohol consumption. Use of mHealth, particularly text messaging (documented as SMS), was found to be an acceptable, affordable and effective way to deliver messages about reducing alcohol consumption to young people. Further research using adequately powered sample sizes in varied settings, with adequate periods of intervention and follow-up, underpinned by theoretical perspectives incorporating behavior change in young people's use of alcohol, is needed. [ABSTRACT FROM AUTHOR]

In this paper we compare the fidelity of a Peer‐Led Asthma Self‐Management Program for Adolescents (PLASMA) and its attention control. A randomized controlled trial involving two groups—the PLASMA group and the attention control group—was conducted between 2015 and 2018. Adolescents 12–17 years old (N = 259) in three cities in the United States received asthma self‐management education implemented at a day camp, followed by bi‐monthly, follow‐up contact for 12 months. Thirty‐five peer leaders and six adult educators implemented education sessions for the PLASMA and the attention control groups, respectively. The intervention was the peer‐led delivery of the content instead of the educational content itself. This study compares the extent to which the education sessions and follow‐up contacts were implemented in accordance with the study protocol by the peer and adult educators. Most topics on asthma knowledge and skills (85–95%) were delivered as intended at an adequate pace in both groups. Peer leaders missed more content in the psychosocial domain than adult educators—14% versus 0%, respectively (t = −3.7; p =.010). PLASMA participants reported high content and time fidelity for all education sessions (94% to 97.6%). Greater success in bimonthly follow‐up contacts was reported in the attention control groups, with 4.6 (± 1.5) contacts on average compared to 2.6 (±2.02) in the PLASMA groups (t = 9.02; p <.001). Most components of the asthma self‐management program were implemented with high fidelity in both groups. The relatively low fidelity in delivering psychosocial content and performing follow‐up contacts in the PLASMA groups underscores the need for intensive training to enhance peer leaders' competency with managing these aspects of PLASMA to maximize fidelity. Peer leaders can implement asthma self‐management educational components of the intervention with high fidelity similar to adult educators. [ABSTRACT FROM AUTHOR]