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PubMed2004

Reduced school dropout rates among adolescent mothers receiving school-based prenatal care.

BACKGROUND: Adolescent pregnancy is associated with increased school dropout rates. Dropping out amplifies the probability of persistent social and economic disadvantage. Whether school-based health centers might help reduce school absenteeism and dropout rates in this group has not been well studied. OBJECTIVE: To examine the association of school-based prenatal services on school attendance and dropout rates. METHODS: In this retrospective cohort study, using school rosters from an alternative school, we identified adolescents aged 18 years or younger who delivered a baby between July 1, 1995, and August 30, 1997, in Baltimore, Md. We linked school records spanning 3 years with medical records and birth certificates. School variables such as attendance and dropout rates were examined in relation to the teen's year of pregnancy and prenatal care setting (school-based vs non-school-based). Hierarchical logistic regression was used to examine effects of school-based prenatal care on dropout and promotion or graduation rates, with adjustment for baseline group differences. RESULTS: We identified 431 predominantly African American, low-income adolescents who attended the alternative school in their pregnancy school year. In the year prior to pregnancy, most performed poorly in school and had significant absenteeism. During their pregnancy school year, teens receiving school-based prenatal care were absent 12 fewer days, as compared with those receiving non-school-based care (P =.001), and their dropout rate was half that of those receiving non-school-based care (6% vs 15%; P =.02). Hierarchical logistic regression analyses, with adjustment for baseline prepregnancy differences, demonstrated that teens receiving school-based prenatal care were less likely to drop out of school during the pregnancy year (adjusted odds ratio, 0.39; 95% confidence interval, 0.15-0.99; P =.048). CONCLUSIONS: Absenteeism and dropout rates were reduced for pregnant adolescents receiving prenatal care at a school-based health center in an urban alternative school. Findings underscore the importance of funding and evaluating school-based health centers and other interventions that may ameliorate negative outcomes among childbearing adolescents.

Absenteeism↗
PubMed1995

[Comparison of behavioral and emotional problems related to school nonattendance in Japanese elementary and junior high school students].

An epidemiological survey was performed on 1,887 mothers of Japanese general elementary school children in the same school district as that for general junior high school students that was previously reported. The questionnaire consisted of two major parts; the former concerning school nonattendance problems from April to September in 1994, and the latter was a Japanese version of the Rutter parental questionnaire. The following findings were obtained: 1) About 12% of the children were absent from school for one day or more either without any justifiable reasons or due to a psychological reason. The rate of nonattendance did not differ significantly from the 13% figure for the junior high school students. 2) The percentage of children who missed more than 20% of scheduled days of school was 0.16% in this survey compared to the 0.65% for this entire school district, both of which surpassed the national figure of 0.13% (1993 fiscal year) in the annual report of the Japanese Ministry of Education. 3) The distinction of truancy from school refusal in the elementary school children was made more sharply than in the junior high school students. 4) The percentage of children who scored thirteen or more, the cutoff point of the Rutter parental questionnaire, was 8.6%, which is a rather low frequency in comparison to former reports in and outside Japan. While items relating to neurosis showed little difference between sexes, antisocial scores were higher in boys similar in tendency to junior high school students. In addition, the rate of positive responses to the Rutter parental questionnaire items were higher in the elementary school children, although those items showed less specific relation to school nonattendance than in the junior high school students. 5) Those in the school nonattendance group (n = 222) did not differ significantly from the school attendance group (n = 1367) in demographic characteristics such as sex, family size, total number of children and birth order. However, school grade, mother's school background and father's job category were significantly different. In addition, Rutter scores as well as neurotic and antisocial scores were much higher in the school nonattendance group. 6) Rutter scores, especially neurotic scores showed a rather high correlation to the number of nonattendance days, although not as high in magnitude as in the junior high school students. The school nonattendance group was divided into three groups, neurotic, antisocial and mixed. A rather strong relation between school nonattendance rate and the neurotic group (n = 77), and a qualitative difference between neurotic group and antisocial group (n = 56) were seen similar to the junior high school students.

Absenteeism↗
PubMed1998

The relationship of school breakfast to psychosocial and academic functioning: cross-sectional and longitudinal observations in an inner-city school sample.

OBJECTIVE: To determine if a relationship exists between participation in a school breakfast program and measures of psychosocial and academic functioning in school-aged children. METHODS: Information on participation in a school breakfast program, school record data, and in-depth interviews with parents and children were collected in 1 public school in Philadelphia, Pa, and 2 public schools in Baltimore, Md, prior to the implementation of a universally free (UF) breakfast program and again after the program had been in place for 4 months. One hundred thirty-three low-income students had complete data before and after the UF breakfast program on school breakfast participation and school-recorded measures, and 85 of these students had complete psychosocial interview data before and after the UF breakfast program. Teacher ratings of behavior before and after the UF breakfast program were available for 76 of these students. RESULTS: Schoolwide data showed that prior to the UF breakfast program, 240 (15%) of the 1627 students in the 3 schools were eating a school-supplied breakfast each day. Of the 133 students in the interview sample, 24 (18%) of the students ate a school-supplied breakfast often, 26 (20%) ate a school-supplied breakfast sometimes, and 83 (62%) ate a school-supplied breakfast rarely or never. Prior to the UF breakfast program, students who ate a school-supplied breakfast often or sometimes had significantly higher math scores and significantly lower scores on child-, parent-, and teacher-reported symptom questionnaires than children who ate a school-supplied breakfast rarely or never. At the end of the school term 4 months after the implementation of the UF breakfast program, school-supplied breakfast participation had nearly doubled and 429 (27%) of the 1612 children in the 3 schools were participating in the school breakfast program each day. In the interview sample, almost half of the children had increased their participation. Students who increased their participation in the school breakfast program had significantly greater increases in their math grades and significantly greater decreases in the rates of school absence and tardiness than children whose participation remained the same or decreased. Child and teacher ratings of psychosocial problems also decreased to a significantly greater degree for children with increased participation in the school breakfast program. CONCLUSION: Both cross-sectional and longitudinal data from this study provide strong evidence that higher rates of participation in school breakfast programs are associated in the short-term with improved student functioning on a broad range of psychosocial and academic measures.

Achievement↗
PubMed2005

School food policy at primary and secondary schools in Belgium-Flanders: does it influence young people's food habits?

OBJECTIVE: To describe the availability of food items at primary and secondary schools in Belgium-Flanders and to examine the influence of school food policy (availability of food items, school food rules, nutrition education programmes) and aggregated school socioeconomical status (AGG SES) on the consumption of fruit, soft drinks, crisps and sweets, using multilevel modelling. DESIGN, SETTING AND SUBJECTS: In spring 2002, 360 schools were invited to participate in the Health Behaviour in School-aged Children survey. In January 2003, the same schools were asked to complete a short school policy questionnaire. Pupils of 197 schools participated in the pupil survey (n=16560); 247 school principals completed the school questionnaire; for 157 schools data were available for both (n=12 360). RESULTS: Mineral water, fruit juice, chocolate milk, and soup were available in most schools. Whole fat milk was available in most primary schools; soft drinks, diet soft drinks and biscuits were available in most secondary schools. Fruit was available in 14% of primary and 26% of secondary schools. Assessment of the variation in the outcome variables revealed no significant between-school variation in primary schools, but considerable variation between secondary schools in the consumption of soft drinks, sweets and crisps (but not fruit). School characteristics explaining some of this school variance independent of pupil level characteristics were: for soft drinks: availability at the school, rules regarding the consumption of sweets and AGG SES; for sweets: AGG SES; and for crisps: rules regarding the consumption of savoury snacks and AGG SES. CONCLUSION: The results indicate that school food policy can have an impact on adolescents' food habits.

Adolescent↗
PubMed2005

Democratic school climate and sense of community in school: a multilevel analysis.

This study examines individual- and school-level predictors of sense of community in school among adolescents. Hierarchical linear modeling was used to examine the relationships between individual (demographics, control and monitoring by parents, and perception of democratic school climate), class, and school characteristics (mean democratic school climate, demographics, activities, school size, public/private governance of the school, and facilities) and students' sense of community in the school. Data were analyzed using a three-level model based on 4,092 10- to 18-year-old students nested within 248 classes (across three grade levels: 6th, 8th, and 10th grade level, where the median age was 11, 13, and 15, respectively) in 134 schools in the Veneto region of northeast Italy. Individual and contextual measures of the perception of a democratic school climate, modeled at the individual, class, and school levels simultaneously, were each significant predictor of school sense of community. More parental monitoring and less parental control were also predictive at the individual level. School-level SES predicted between school variation in sense of community, controlling for individual student SES and other student and school-level predictors. School size, facilities (physical spaces resources), level of interaction of the school with the community, public, or private governance, and number of extracurricular activities offered were all nonsignificant. The study demonstrates significant variation in school sense of community at the student, class, and school levels and the important role played by democratic school practices, such as student participation in making rules and organizing events, freedom of expression, and the perceived fairness of rules and teachers, in determining this variable.

Adolescent↗
PubMed2003

Evaluation of the Florida coordinated school health program pilot schools project.

The Florida Department of Education, with CDC funding, designed the Florida Coordinated School Health Program Pilot Schools Project (PSP) to encourage innovative approaches to promote coordinated school health programs (CSHP) in Florida schools. Each of eight pilot schools received $15,000 in project funding, three years of technical assistance including on-site and off-site assistance, a project office resource center, mailings of resource materials, needs assessment and evaluation assistance, and three PSP Summer Institutes. Project evaluators created a context evaluation, approaching each school independently as a "case study" to measure the school's progress in meeting goals established at baseline. Data were collected using the How Healthy is Your School? needs assessment instrument, a School Health Portfolio constructed by each school team, a Pilot Schools Project Team Member Survey instrument, midcourse team interviews, final team interviews, and performance indicator data obtained from pilot and control schools. The PSP posed two fundamental questions: "Can financial resources, professional training, and technical assistance enable individual schools to create and sustain a coordinated school health program?" and "What outcomes reasonably can one expect from a coordinated school health program, assuming programs receive adequate support over time?" First, activities at the eight schools confirmed that a coordinated school health programs can be established and sustained. Program strength and sustainability depend on long-term resources, qualified personnel, and administrative support. Second, though coordinated school health programs may improve school performance indicators, the PSP yielded insufficient evidence to support that belief. Future projects should include robust measurement and evaluation designs, thereby producing conclusive evidence about the influence of a coordinated school health program on such outcomes.

Adolescent↗
PubMed2004

Oral health status among 12-year-old children in primary schools participating in an oral health preventive school program in Phnom Penh City, Cambodia, 2002.

A cross-sectional survey was undertaken to assess dental caries status, knowledge, attitude and practice in oral health among 12-year-old primary schoolchildren participating in the Oral Health Preventive School Program (OHPSP) conducted since 1998 in Phnom Penh City, Cambodia. Schools were stratified into 3 groups by levels of cooperation (good, partial, and poor) with the OHPS program and samples of schools randomly selected from each group. A total sample size of 239 schoolchildren was randomly selected from the sampled schools. There were 79, 82, and 79 children from schools with good, partial, and poor cooperation, respectively. Dental caries status DMFT (Decayed Missing Filled teeth) and knowledge, attitude and practices in oral health were assessed from 21 January to 5 February 2002. Opinions of school directors toward the OHPS Program were evaluated by interview. The results showed the overall mean DMFT per person in schoolchildren in Phnom Penh City, Cambodia of 2.33 (95%CI=2.05-2.61) while mean DT(Decayed teeth) was 2.31 (95%CI=1.97-2.52) and mean MT (Missing teeth) and mean FT (Filled teeth) were 0.01 per person, which were quite small. Children from schools with good cooperation with the OHPSP had the lowest significant mean DMFT 1.62 (95%CI=1.25-1.98) compared to children from schools with partial and poor cooperation (Mean DMFT=2.67:95%CI=2.10-3.23, and 2.69:95%CI=2.19-3.19, respectively). There were no significant differences in levels of knowledge, attitude and practices in oral health among the 3 groups of schools, but the proportion of good practices was highest in good cooperation schools compared to the schools with partial and poor cooperation to the OHPSP (41.3%, 27.3%, and 31.3%, respectively). Among 35 school directors, the majority of them (97.1%) believed that the OHPS program can reduce the dental caries prevalence among schoolchildren. Only 20.0% agreed that parents of schoolchildren should pay money to the school for tooth brushes and tooth paste of their children for brushing after lunch at school. The remaining answers were, they were uncertain (37.1%) and disagree (42.9%) that the school should have to manage that donated money. Among them, 82.9% reported that the OHPS Program activities did not disturb their time at school; 65% of them agreed there should be volunteers to help the schools in implementing the activities of the program. The majority of school directors (97.1%) thought that oral health examinations for schoolchildren were necessary. The results of the study suggested a need for continuous monitoring and strengthening of activities and cooperation of the Oral Health Preventive School Program among primary schools in Phnom Penh City to reduce the prevalence of dental caries among primary schoolchildren in Phnom Penh City, Cambodia.

Cambodia↗
PubMedDate not supplied

The impact of an elementary school-based violence prevention program on visits to the school nurse.

INTRODUCTION: In Tucson, Arizona, an elementary school-based violence prevention program (PeaceBuilders) was implemented during the 1994-1995 school year. Anecdotal evidence from school nurses suggested that children were visiting the nurse less often following the implementation of the program. We examined nurses' logs to assess whether the program had an impact on visits to the school nurse. METHODS: For the school years 1993-1994 and 1994-1995, the weekly number of nurse visits for all reasons, all injuries, and injuries caused by fights in each of the four PeaceBuilders schools were compared with those for three control schools. As part of a planned evaluation, schools had been matched on demographic factors and randomly assigned as intervention or control schools. RESULTS: Between 1993-1994 and 1994-1995, the rate of visits/1,000 student days decreased 12.6% in the intervention schools while remaining unchanged in the comparison schools. The same trend was detected for injury-related visits. Rates of fighting-related injuries changed little in the intervention schools but increased 56.0% in the control schools. An analysis of covariance confirmed that injuries and visits to nurses decreased in intervention schools relative to control schools. CONCLUSIONS: These data indicate that in the intervention schools, injuries and visits to the school nurse decreased over the two-year period and that the intervention may have contributed to this change. They also suggest that visits to the school nurses' office may be a useful tool to evaluate some types of elementary school-based violence prevention programs.

Arizona↗
PubMed2006

Dietary effects of universal-free school breakfast: findings from the evaluation of the school breakfast program pilot project.

OBJECTIVE: To determine the effects of offering universal-free school breakfast in elementary schools on students' dietary outcomes. DESIGN: Experimental study with random assignment of 153 matched elementary schools in six school districts. Treatment schools offered universal-free school breakfast, and control schools continued to operate the traditional means-tested School Breakfast Program. Twenty-four-hour dietary recalls were collected from sample students near the end of the first year. SUBJECTS: About 30 students in second through sixth grades were randomly selected from each school (n=4,358). INTERVENTION: Free school breakfasts were made available to all students in treatment schools, regardless of family income, for three consecutive school years (2000-2001 to 2002-2003). MAIN OUTCOME MEASURES: Breakfast consumption and food and nutrient intake. STATISTICAL ANALYSES: Hierarchical mixed-models and logistic regression, adjusting for age, sex, minority status, and income eligibility for the regular school meal programs, were used to estimate effects. RESULTS: Despite a significant increase in school breakfast participation among sample students in treatment schools (from 16% to 40%, P<0.01), the rate of breakfast skipping did not differ between groups (4% overall). Treatment school students were more likely to consume a nutritionally substantive breakfast (P<0.01), but dietary intakes over 24 hours were essentially the same. CONCLUSIONS: Making universal-free school breakfast available in elementary schools did not change students' dietary outcomes after nearly 1 year. To improve children's diets overall, efforts should focus on ensuring all students have access to a healthful breakfast, at home or at school.

Body Weight↗
PubMed2005

Nutrition policy, food and drinks at school and after school care.

OBJECTIVE: The purpose of the paper is to describe food and drinks available in food stands or cantina at Danish schools and food and drinks provided at after school care institutions in Denmark. MATERIAL AND METHODS: The survey was performed in 1999 and self-administered postal questionnaires were sent to all private and public schools and all after school care institutions in Denmark. The participation rate was 70 at schools and 66 at after school care institutions. RESULTS: In total, 3% of schools and 4% of after school care institutions have a written policy on nutrition. All Danish children have access to milk at school and they can choose between milk with low and high content of fat. Vending machines are rare at schools and are not present at all at after school care institutions. Only 10% of schools offer children sugared carbonated drinks at food stands. Fruit is available daily in 35% of schools, at food stands, and in 18% of the schools, fruit is available on prescription. In after school care institutions, sweets and sugared carbonated drinks are rare. However, juice is served daily in 47% of after school care institutions. Most schools run the food stand at school for profit. CONCLUSION: The paper highlights the important aspects of the institutional level as one of six important levels as regards the prevention of obesity and an important level at which to act to increase nutrition habits in school children.

Beverages↗
PubMed2006

Emergency department visits for injury in school-aged children in the United States: a comparison of nonfatal injuries occurring within and outside of the school environment.

OBJECTIVES: To compare the demographic and injury characteristics of children visiting the emergency department (ED) for nonfatal injuries occurring at school with those of same-aged children who were injured outside of school. METHODS: Data from a stratified probability sample of U.S. hospitals providing emergency services in the National Electronic Injury Surveillance System (NEISS) were analyzed for 2001 and 2002. School and nonschool injury-related ED visits were analyzed for patients who were 5 through 19 years of age. RESULTS: There were an estimated 58,147,518 injury visits in all ages to the ED in 2001 and 2002. Injuries to school-aged children (ages 5-19) accounted for an estimated 15,405,392 (26%) visits overall, of which 1,859,215 occurred at school (16.5% of visits by school-aged children when location of injury was known). Males accounted for 63% of injuries at school; middle-school children (ages 10-14 yr) accounted for a significantly greater proportion of injuries (46%) than did primary- (5-9 yr, 24%) or secondary-school (15-19 yr, 30%) children (p < 0.001). In contrast, for injuries outside of school, secondary-school children were injured most (40%), followed by middle- (32%) and primary-aged children (27%). Nearly 11% of school injuries were classified as violent, whereas only 6.4% of the nonschool injuries in school-aged children were violent (p < 0.001). Similarly, sports injuries were significantly more common at school (53% of injuries) than outside of school (32.9%; p < 0.001). CONCLUSIONS: A significant proportion of injuries to school-aged children occur at school. Notable differences exist between the epidemiology of in- and out-of-school injuries. The nature of these injuries differs by age group. Efforts to reduce school injuries will require that these differences be examined further and incorporated into prevention initiatives.

Accidents↗
PubMed2003

Study on feelings of school avoidance, depression, and character tendencies among general junior high and high school students.

School refusal is a phenomenon that first drew attention in Japan around 1960 and it remains one of the major issues in child psychiatry today. Moreover, it is now said that there exists a large group of latent school refusers currently attending school but harboring feelings of school avoidance. To address this issue, a questionnaire survey was conducted on students enrolled in a junior high and high school affiliated with the Nagoya University School of Education. The questionnaire consisted of the Children's Depression Inventory (CDI), a scale for evaluating feelings of school avoidance (School Avoidance Scale), and a scale for assessment of personality characteristics associated with school refusal (School Refusal Personality Scale). The subjects were 425 first-year junior high to second-year high school students. Factor analysis of each scale revealed the CDI to consist of three factors: 'core depression', 'feelings of interpersonal maladaptation', and 'self-revulsion', and the School Avoidance Scale to consist of two factors: 'school dislike', and 'school avoidance'. The School Refusal Personality Scale consisted of three factors: 'obsessive-compulsive', 'passive/unsocial', and 'socially introverted'. Mean CDI score and standard deviation (SD) was 19.44 +/- 7.49, and that for 'feelings of school avoidance' was 20.18 +/- 5.61. The two subordinate factors of the School Avoidance Scale were intimately associated with both 'feelings of interpersonal maladaptation' and 'core depression' of the CDI, and negatively correlated with the 'obsessive-compulsive' factor of the School Refusal Personality Scale.

Adolescent↗
PubMed2004

An ecological study of caries experience, school performance and material deprivation in 5-year-old state primary school children.

AIM: To investigate whether measures of school performance and socioeconomic circumstances could be used as indicators of caries experience in 5-year-old Wandsworth state primary schoolchildren. DESIGN: An ecological study using aggregated caries data collected in the British Association for the Study of Community Dentistry (BASCD) Oral Health Survey of 5-year-old children (2001), Jarman scores generated from national census data and matched by school postcodes (1991), school performance results in English, mathematics and Linguistic Awareness of Reading Readiness test (LARR; literacy) and free school meals recipient data from the Local Education Authority, Research and Evaluation Unit (2001). SETTING: State primary schools in the London borough of Wandsworth, UK. SUBJECTS: All 55 Wandsworth state primary schools including 1968 5-year-old pupils. OUTCOME MEASURE: The school mean dmft score. RESULTS: Simple linear regression analysis demonstrated that school mean dmft was statistically significantly associated with all five explanatory variables: English (P = 0.001), mathematics (P = 0.002), LARR (P < 0.001), the percentage of children receiving free school meals (P < 0.001) and the school address Jarman score (P = 0.02). Stepwise multiple linear regression identified the LARR score and the percentage of children receiving free school meals as the strongest indicators of school mean dmft score explaining 41% of the variation in school mean dmft score. CONCLUSION: Early school performance results in English, mathematics and LARR, the percentage of children receiving free school meals and school address Jarman scores were good indicators of school mean dmft scores in 5-year-old children in the Wandsworth state primary schools.

Child, Preschool↗
PubMedDate not supplied

A statewide hepatitis B vaccination program for school children in Hawaii: vaccination series completion and participation rates over consecutive school years.

OBJECTIVE: The authors assessed a statewide school-based Hepatitis B (HepB) vaccination program for preadolescents in Hawaii over three consecutive school years. Factors assessed included number of schools and students participating and number of students receiving three doses of hepatitis B vaccine. METHODS: Records of the program, which targeted 4th and/or 5th graders in public and private schools, were reviewed for the period from 1996 to 1999. RESULTS: The proportion of participating schools increased from 76% of all schools in the state in School Year 1 to 94% in School Year 3. The proportion of children with completed consent forms who received three doses of HepB vaccine at school exceeded 80% throughout the project. In School Year 1, 10,003 (70%) of 14,333 children enrolled at participating schools received three vaccine doses in school; however, this proportion declined over subsequent school years to 51% (7,722/15,013) in School Year 2 and 24% (7,344/30,429) in School Year 3. A survey of 477 parents not consenting to school vaccination indicated that 84% of their children completed the vaccine series at a private provider office. CONCLUSION: Statewide school-based HepB vaccination campaigns for at-risk populations can result in a majority of children in targeted age groups receiving three doses of hepatitis B vaccine, though declining participation may be observed as uptake in the private sector increases.

Child↗
PubMed2000

[Frequency of use of school cafeterias in middle and high schools in 3 French districts].

Reports from the French Ministry of Education warn of a decrease in the use of school food services, especially in sensitive urban areas. They also suggest that this decline has led to cases of malnutrition. This article describes the characteristics of the current supply of school meals and measures the evolution of demand observed between 1992 and 1996 in relation to the economic situation of students' families. The study was carried out in 3 departments in France: Doubs, Herault, and Val de Marne. The administrators of all public and private middle and high schools in the 3 departments received a questionnaire asking them to describe the services offered in their cafeterias and to provide the corresponding statistical and accounting data. External food services near the schools were also taken into account. Seventy-nine percent of schools responded to the survey. Concerning the services offered, 91% of schools have their own cafeterias, of which 81% are managed by the schools. Concerning the evolution of utilisation, a significant decrease in the number of meals served in seen in middle schools. On the other hand, high schools have observed stable utilisation. The positive changes in utilisation are linked, in middle schools, to characteristics of the schools' internal food services (self-service, choice of main courses, modulation of seats). In high schools, positive changes in the utilisation of school services are linked to the lack of external food services near the schools. As middle schools and high schools control the logistics and management of food services offered to students, they are potentially in a position to influence a policy on this issue. The evolution in utilisation is very different among departments and between middle and high schools. While economic precariousness has a negative structural effect on utilisation, it doesn't seem to be a major factor in the evolution of the decrease observed over the past few years.

Accounting↗