Australia's first religiously affiliated medical school.
Recently, we published an outline of concerns about the opening of Australia's first religiously affiliated medical school. A litany of spirited responses followed.
Accreditation↗
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School connectedness in the health behavior in school-aged children study: the role of student, school, and school neighborhood characteristics.
School connectedness includes liking school and positive relations with teachers and peers. School connectedness is associated with a variety of positive health outcomes. The goal of this study was to identify characteristics of students, schools, and school neighborhoods that are related to school connectedness. In the Health Behavior in School-Aged Children (HBSC) Study, school connectedness was reported by 13,207 students (grades 6-10) in 340 schools. HBSC measured a variety of student characteristics. Characteristics of schools were culled from data maintained by Quality Education Data, and school neighborhood characteristics were derived from the 2000 decennial census. Associations between connectedness and student, school, and school neighborhood characteristics were estimated using hierarchical linear models. Characteristics of students, schools, and school neighborhoods were associated with school connectedness. Connectedness was greater among younger students, females, students with better academic performance and greater extracurricular involvement, students with greater self-rated physical attractiveness, students with more friends, students from 2-parent families, and students whose parents were more involved with school. Connectedness was greater in smaller schools, more racially homogeneous schools, and schools with more students from relatively wealthy households. School connectedness was higher in neighborhoods with a greater percentage of non-US citizens. As the percent of renters in the neighborhood increased beyond 20%, school connectedness tended to decrease. The findings point to possible strategies for fostering school connectedness.
Adolescent↗
From concept to practice: using the School Health Index to create healthy school environments in Rhode Island elementary schools.
INTRODUCTION: The prevalence of childhood obesity is increasing, and schools are ideal places to support healthy eating and physical activity. In 2000, the Centers for Disease Control and Prevention (CDC) developed the School Health Index, a self-assessment and planning tool that helps schools evaluate and improve physical activity and nutrition programs and policies. Although many state education agencies, health departments, and individual schools have used the School Health Index, few systematic evaluations of the tool have been performed. We examined the physical activity and nutrition environments in Rhode Island's public elementary schools with high and low minority student enrollments and evaluated a school-based environmental and policy intervention that included implementation of the School Health Index. METHODS: As part of a CDC Division of Nutrition and Physical Activity cooperative agreement awarded to the Rhode Island Department of Health, we conducted a needs assessment of 102 elementary schools and implemented an intervention in four inner-city elementary schools. In phase 1, we analyzed the Rhode Island Needs Assessment Tool (RINAT), a telephone survey of principals in approximately 50% of all Rhode Island public elementary schools in the state during the 2001-2002 school year (n = 102). Comparisons of the nutrition and physical activity environments of schools with low and high minority enrollment were calculated by cross-tabulation with the chi-square test. In phase 2, we used process and outcome evaluation data to assess the use of the School Health Index in creating healthier environments in schools. Our intervention--Eat Healthy and Get Active!--involved implementing three of the eight School Health Index modules in four Rhode Island elementary schools. RESULTS: Survey data revealed that schools with high minority enrollment (student enrollment of > or =10% black, > or =25% Hispanic, or both) offered few programs supporting healthy eating and physical activity (P < .05). Schools with high and low minority enrollment both offered nonnutritious foods and beverages. Process evaluation data revealed that 1) principals play a pivotal role on School Health Index teams, 2) schoolwide validation of a team's small successes is crucial for sustaining a commitment to healthy lifestyle policies and programs, and 3) external facilitators are essential for implementation success. Outcome data showed that all schools developed at least one policy or environmental strategy to create a healthy school environment. Only two schools implemented immediate changes. CONCLUSION: Needs assessment, external facilitation, and evaluation are the foundation for sustainable school-based policies. Although the School Health Index is universally perceived as a user-friendly assessment tool, implementation is likely to be less successful in schools with low staff morale, budgetary constraints, and inconsistent administrator support.
Child↗
Facilitating change in school health: a qualitative study of schools' experiences using the School Health Index.
INTRODUCTION: As school-based efforts increase to address the epidemic of childhood obesity, a priority for health professionals and educators will be to identify effective tools appropriate for use in schools to help guide health promotion programs and policies. This article describes the results of a qualitative research study examining school staff and community members' experiences working with the Centers for Disease Control and Prevention's School Health Index, a self-assessment and planning tool that addresses nutrition and physical activity. METHODS: In-depth interviews were carried out with faculty, staff, and community collaborators in nine public schools that were using the School Health Index to develop nutrition and physical activity initiatives for students. Interviews were conducted twice: once after a school had completed the School Health Index and once approximately 1 year later. Transcript data from interviews with 34 participants were analyzed using thematic analysis. RESULTS: Findings indicated that school experiences differed markedly depending on whether they received help from an outside facilitator to work with the School Health Index. Unlike staff in schools working on their own, school staff working with outside facilitators described completing the School Health Index in a collaborative way, creating action plans, and working as a team to implement health promotion initiatives. In addition, the involvement of an outside facilitator supported schools in undertaking more complex tasks with a greater degree of collaboration across the school and local communities in order to achieve goals. CONCLUSION: Outside facilitators may significantly enhance schools' efforts to work with the School Health Index and influence the organizational strategies they use to implement health promotion initiatives.
Centers for Disease Control and Prevention, U.S.↗
The Peterborough Schools Nutrition Project: a multiple intervention programme to improve school-based eating in secondary schools.
OBJECTIVE: To evaluate over two years the effectiveness of multiple interventions targeted at lunches in secondary schools with the aim of increasing the consumption of healthier foods by children during the school day. DESIGN: Controlled comparison study of two intervention schools targeted with multiple interventions to increase both the availability and the number of pupils consuming healthier foods, and one control school with no interventions but with the same observations over a two-year period. SETTING: Three secondary schools in Peterborough, England. SUBJECTS: Secondary school children in the three schools taking school lunches between 1996 and 1998. RESULTS: School Food Groups (SFGs) were set up in both intervention schools. All catering interventions were actioned via the SFGs. Of the food availability targets, only the target to increase the availability of high-fibre bread in both intervention schools was met. The availability of food items at the control school remained stable. The proportion of pupils consuming fruit and vegetables/salad was very low in all schools at baseline. There were positive changes for consumption of fruit and non-fried potato in one intervention school, and for high-fibre bread and non-cream cakes at the other in the short term, but only that for high-fibre bread was close to being sustained at the end of the two years. The dietary consumption target for vegetables/salad was achieved by the final monitoring period in one school. CONCLUSION: Overall there were no significant changes in school-based eating at the end of the study. Some positive changes were made, with some of the dietary targets being achieved at an early stage but not sustained. Ultimately this study has shown how difficult it is to achieve sustained dietary changes in the eating habits of secondary school children, even with considerable input.
Adolescent↗
School lunch and snacking patterns among high school students: associations with school food environment and policies.
OBJECTIVES: This study examined associations between high school students' lunch patterns and vending machine purchases and the school food environment and policies. METHODS: A randomly selected sample of 1088 high school students from 20 schools completed surveys about their lunch practices and vending machine purchases. School food policies were assessed by principal and food director surveys. The number of vending machines and their hours of operation were assessed by trained research staff. RESULTS: Students at schools with open campus policies during lunchtime were significantly more likely to eat lunch at a fast food restaurant than students at schools with closed campus policies (0.7 days/week vs. 0.2 days/week, p < .001). Student snack food purchases at school were significantly associated with the number of snack machines at schools (p < .001) and policies about the types of food that can be sold. In schools with policies, students reported making snack food purchases an average of 0.5 +/- 1.1 days/week as compared to an average of 0.9 +/- 1.3 days/week in schools without policies (p < .001). In schools in which soft drink machines were turned off during lunch time, students purchased soft drinks from vending machines 1.4 +/- 1.6 days/week as compared to 1.9 +/- 1.8 days/week in schools in which soft drink machines were turned on during lunch (p = .040). CONCLUSION: School food policies that decrease access to foods high in fats and sugars are associated with less frequent purchase of these items in school among high school students. Schools should examine their food-related policies and decrease access to foods that are low in nutrients and high in fats and sugars.
Journal Article↗
Lessons learned from Action Schools! BC--an 'active school' model to promote physical activity in elementary schools.
The 'active school' model offers promise for promoting school-based physical activity (PA); however, few intervention trials have evaluated its effectiveness. Thus, our purpose was to: (1) describe Action Schools! BC (AS! BC) and its implementation (fidelity and feasibility) and (2) evaluate the impact of AS! BC on school provision of PA. Ten elementary schools were randomly assigned to one of the three conditions: Usual Practice (UP, three schools), Liaison (LS, four schools) or Champion (CS, three schools). Teachers in LS and CS schools received AS! BC training and resources but differed on the level of facilitation provided. UP schools continued with regular PA. Delivery of PA during the 11-month intervention was assessed with weekly Activity Logs and intervention fidelity and feasibility were assessed using Action Plans, workshop evaluations, teacher surveys and focus groups with administrators, teachers, parents and students. Physical activity delivered was significantly greater in LS (+67.4 min/week; 95% CI: 18.7-116.1) and CS (+55.2 min/week; 95% CI: 26.4-83.9) schools than UP schools. Analysis of Action Plans and Activity Logs showed fidelity to the model and moderate levels of compliance (75%). Teachers were highly satisfied with training and support. Benefits of AS! BC included positive changes in the children and school climate, including provision of resources, improved communication and program flexibility. These results support the use of the 'active school' model to positively alter the school environment. The AS! BC model was effective, providing more opportunities for "more children to be more active more often" and as such has the potential to provide health benefits to elementary school children.
British Columbia↗
Swedish school nurses' view of school health care utilization, causes and management of recurrent headaches among school children.
The present survey was addressed to a representative, nationwide sample of Swedish school nurses and 174 (69%) responded. They were asked about their views on: (i) the most usual problems for students that prompt attendance at school nurses' offices; (ii) the causes and management of school children's headaches and (iii) the school nurses' own education with respect to headaches. Headaches were reported to be one of the most common problems among adolescents visiting the school nurses' offices and tension-type headaches were regarded as a more serious school health problem, compared with migraine. Various stressors such as family and peer problems were regarded as important causes of recurrent headaches. In addition, the school nurses mentioned too little physical activity, sleep problems and poor eating habits as related factors, in particular among students with tension-type headaches. Common management approaches used by the school nurses were to provide information about headaches or supportive discussion, recommend follow-up visits, perform vision tests and refer students to a school physician. About one-fifth to one-third of the school nurses often gave analgesic medication to students because of headaches, most commonly used were paracetamol followed by various NSAIDs. Most of the school nurses regarded relaxation training as an "effective or very effective" treatment for both migraine and tension-type headaches, whereas palliative and prophylactic drug treatments were seen as more effective for migraine. It is suggested that school nurses, who often provide the first line of treatment for school children and adolescents with recurrent headaches, also should administer a cost-effective treatment such as relaxation training in school settings, where many of the headache episodes occur. However, school nurses also need to be properly trained to ensure quality in delivering such treatment approaches.
Analgesics↗
Science school and culture school: improving the efficiency of high school science teaching in a system of mass science education.
Educational expansion in western countries has been achieved mainly by adding years to full-time education; however, this process has probably reduced efficiency. Sooner or later, efficiency must improve, with a greater educational attainment per year. Future societies will probably wish more people to study science throughout high school (aged c. 11-19 years) and the first college degree. 'Science' may be defined as any abstract, systematic and research-based discipline: including mathematics, statistics and the natural sciences, economics, music theory, linguistics, and the conceptual or quantitative social sciences. Since formal teaching is usually necessary to learn science, science education should be regarded as the core function of high schools. One standard way to improve efficiency is the 'division of labour', with increased specialization of function. Modern schools are already specialized: teachers are specialized according to age-group taught, subject matter expertise, and administrative responsibilities. School students are stratified by age and academic aptitude. I propose a further institutional division of school function between science education, and cultural education (including education in arts, sports, ethics, social interaction and good citizenship). Existing schools might split into 'science school' and 'culture school', reflected in distinct buildings and zones, separate administrative structures, and the recruitment of differently-specialized teaching personnel. Science school would be distinguished by its focus on education in disciplines which promote abstract systematic cognition. All students would spend some part of each day (how much would depend on their aptitude and motivation) in the 'science school'; experiencing a traditional-style, didactic, disciplined and rigorous academic education. The remainder of the students' time at school would be spent in the cultural division, which would focus on broader aspects, and aim to generate a more rounded and social individual. For this to happen depends upon a recognition that science is relatively difficult to teach, requiring non-spontaneous and un-natural cognitive processes from students. Furthermore, it is much easier to learn science when young--if science is missed at school, it can be difficult or impossible to make up the ground later. Modern schools currently try to do too many things, and end-up doing none very well: the one big thing all schools should do for all students is to teach them science. For this to happen, schools need to specialize in their core function.
Adolescent↗
Effects of in-school and tailored out-of-school smoking prevention among Dutch vocational school students.
This paper evaluates a smoking prevention intervention aimed at vocational school students, consisting of an existing Dutch in-school program (three lessons each lasting 50 min) and a computer-based tailored out-of-school program (three tailored letters with smoking prevention messages mailed to students' homes). Nineteen schools that already participated in the in-school program were randomly assigned to the in-school or to the combined in-school and out-of-school condition. The remaining 17 schools were randomly assigned to the out-of-school condition or to the control group. Effect outcomes were assessed at 6, 12 and 18 months after a pre-test, and were based on initiation among never-smokers and continuation among ever-smokers. Twelve months after the pre-test (post-test 2), the in-school intervention was successful in preventing vocational school students from continuing to smoke, compared with students in the control condition [odds ratio (OR) = 0.49; 95% confidence interval (CI) = 0.29-0.84]. Eighteen months after the pre-test (post-test 3), the tailored out-of-school intervention was successful in preventing smoking initiation, compared with students in the control condition (OR = 0.42; 95% CI = 0.18-0.96). The effect of the combined approach was not larger than the sum of the effects of the in-school and the out-of-school effects.
Adolescent↗
Working to keep school children healthy: the complementary roles of school staff and school nurses.
BACKGROUND: Against a background of future uncertainty for school nursing and little previous research, this study aimed to identify and describe the distinctive role of the school nurse in working to keep school children healthy. Particular attention was paid to the 'interface' between nursing and the health-related work of teachers. The research was carried out in four health authority areas in England. METHODS: Seventy-eight semi-structured interviews were carried out with a range of respondents: school nurses, school Heads and teachers, health authority purchasers and NHS Trust managers. Seven focus group discussions were held with parents and eight with young people of secondary school age. RESULTS: Four key elements of the school nurse role were identified: safeguarding the health and welfare of children; health promotion; a pupils' confidante; and family support. In each of these aspects of work, nurses and teachers had shared or complementary roles. An over-arching role for the school nurse as 'health adviser' to pupils, parents and teachers was also identified. Despite these common elements, emphasis in the practice of individual school nurses varied widely. Difficulties for school nurses in developing their role were identified. Parents and young people saw school as an appropriate setting for health-related work. CONCLUSION: The research identified key components of the school nursing role and the complementary roles of nurses and school staff. To optimize school nurses' contribution to child health, a more strategic approach is required, in partnership with education, along with research into the effectiveness of school nursing interventions.
Adolescent↗
The relationship between school health councils and school health policies and programs in US schools.
This study analyzed data from the School Health Policies and Programs Study (SHPPS) 2000 to examine the relationship between school health councils and selected school health policies and programs. SHPPS 2000 collected data from faculty and staff in a nationally representative sample of schools. About two-thirds (65.7%) of US schools have school health councils. Schools with councils were significantly more likely than schools without councils to report policies and programs related to health services, mental health and social services, faculty and staff health promotion, and family and community involvement. Schools with councils were as likely as schools without councils to report policies and programs related to health education, physical education, and food service. Although school health councils are associated with the presence of some key school health policies and programs, a council does not guarantee a school will have all important school health policies and programs in place.
Advisory Committees↗
[Role of school lunch in primary school education: a trial analysis of school teachers' views using an open-ended questionnaire].
We tried to analyze synthetically teachers' view points associated with health education and roles of school lunch in primary education. For this purpose, a survey using an open-ended questionnaire consisting of eight items relating to health education in the school curriculum was carried out in 100 teachers of ten public primary schools. Subjects were asked to describe their view regarding the following eight items: 1) health and physical guidance education, 2) school lunch guidance education, 3) pupils' attitude toward their own health and nutrition, 4) health education, 5) role of school lunch in education, 6) future subjects of health education, 7) class room lesson related to school lunch, 8) guidance in case of pupil with unbalanced dieting and food avoidance. Subjects described their own opinions on an open-ended questionnaire response sheet. Keywords in individual descriptions were selected, rearranged and classified into categories according to their own meanings, and each of the selected keywords were used as the dummy variable. To assess individual opinions synthetically, a principal component analysis was then applied to the variables collected through the teachers' descriptions, and four factors were extracted. The results were as follows. 1) Four factors obtained from the repeated principal component analysis were summarized as; roles of health education and school lunch program (the first principal component), cooperation with nurse-teachers and those in charge of lunch service (the second principal component), time allocation for health education in home-room activity and lunch time (the third principal component) and contents of health education and school lunch guidance and their future plan (the fourth principal component). 2) Teachers regarded the role of school lunch in primary education as providing daily supply of nutrients, teaching of table manners and building up friendships with classmates, health education and food and nutrition education, and developing food preferences through eating lunch together with classmates. 3) Significant positive correlation was observed between "the teachers' opinion about the role of school lunch of providing opportunity to learn good behavior for food preferences through eating lunch together with classmates" and the first principal component "roles of health education and school lunch program" (r = 0.39, p < 0.01). The variable "the role of school lunch is health education and food and nutrition education" showed positive correlation with the principle component "cooperation with nurse-teachers and those in charge of lunch service" (r = 0.27, p < 0.01). Interesting relationships obtained were that teachers with longer educational experience tended to place importance in health education and food and nutrition education as the role of school lunch, and that male teachers regarded the roles of school lunch more importantly for future education in primary education than female teachers did.
Adult↗
Pedometer steps in primary school-aged children: a comparison of school-based and out-of-school activity.
While studies of the physical activity habits of New Zealand children have been carried out, the findings have been restricted by the use of proxy and self-report measures and limited to total overall daily activity. Objective measurement of children's in-school and out-of school physical activity using pedometry is likely to provide more accurate data on habitual daily activity. To date, no such data are available for New Zealand children. In the present study, children from school years 1-6 (girls, n=46; boys, n=45) at a New Zealand primary school wore a Yamax Digiwalker SW-200 pedometer to record school-based and out-of-school steps over a 3-day period. Mean daily steps for the overall sample were 14 333 (S.D.=4110). Boys (X=15 606; S.D.=4601) were significantly more active than girls (X=13 031; S.D.=3079) (p=.00). Mean steps were also significantly higher in older age groups for both boys (p=.03) and in particular, girls (p=.00). Of note, for the overall sample, steps taken out of school made up 52.4% of total daily steps. Girls (53.6%) and boys (51.3%) took a similar proportion of their overall daily steps outside of the school environment. While a significant difference was found between the most and least active tertiles in steps taken during both during school hours (p=.00) and outside of school hours (p=.00), the most active third of the sample completed significantly more of their daily steps outside of school (55.1%) than did their least active (46.7%) counterparts (p=.00). These results suggest that physical activity outside of the school environment is a key contributor to a child's overall level of physical activity, reinforcing the need for interventions targeting the family and community as well as the school environment.
Age Factors↗
[School climate and psychological symptoms--correlations between school stress, sense of coherence and physical-psychological impairment in high school students].
The research project "Health Promotion and School Culture" investigated associations between school climate, school stress, sense of coherence and physical/psychological symptoms in high school students. 565 students, aged 15 to 20 from two high schools (Gymnasium) in the canton of Zurich took part in the study. Assessment measures included questionnaires on school climate (FUK 7-10), school stress, sense of coherence (SOC-13), physical (GBB-24) and psychological symptomatology (SCL-90-R, ADS-K). 166 of the students also participated in a standardised psychiatric interview (DIA-X). Results revealed significant associations between 1. school climate and school stress, 2. biographical risk and protective factors and sense of coherence, 3. school stress and sense of coherence, and 4. school-stress and sense of coherence on the one side and symptomatology on the other. The results are discussed in terms of Karasek and Theorell's (1990) three dimensional stress model. Finally, the need for health promotion in school, especially in classes of high school, is addressed.
Adolescent↗
School violence, substance use, and availability of illegal drugs on school property among US high school students.
To determine if school violence is associated with substance use and availability of illegal drugs at school, this study examined data from the 1995 Youth Risk Behavior Survey, a nationally representative sample of 10,904 high school students. Adjusted odds ratios were calculated to describe the associations of tobacco, alcohol, and marijuana use (on and off school property), and availability of illegal drugs at school with five indicators of school violence--weapon-carrying, physical fighting, having property stolen or damaged, being threatened or injured, and being absent from school because of feeling unsafe. School violence indicators increased with the number of substances used and the location of use (on school property vs. off school property). School violence was associated with availability of illegal drugs at school, even among students who did not use substances. These findings suggest a need for coordinated violence and substance use prevention programs for youth in school and community settings.
Adolescent↗
School meals, school milk and height of primary school children in England and Scotland in the eighties.
In a nutritional surveillance system of primary school children in England and Scotland we assessed the possible effects on height gain of changes in school meals and school milk policies following the 1980 Education Act (No. 2). Mean height and height gain were estimated separately for English and Scottish samples from 1982 to 1984, and for a selective sample of inner city areas with a high proportion of ethnic minorities from 1983 to 1985 in children from 5.00 to 9.99 years. Children receiving free school meals were smaller than children paying for school meals or receiving a meal prepared elsewhere, while children receiving free school milk were of similar stature to other children in the study. The rate of growth was assessed in children receiving school meals or lunches prepared at home, and in those for whom arrangements changed during the study period; it was also assessed in those children for whom school milk was available, not available, or for whom the provision changed. No consistent association was found between provision of school meals or school milk and the rate of growth in the three samples studied when stratified according to poverty status and ethnic background. We conclude that this observational study does not provide any evidence that the current availability of school meals or school milk increases the rate of growth of primary school children in any social stratum.
Animals↗
School climate, observed risky behaviors, and victimization as predictors of high school students' fear and judgments of school violence as a problem.
The primary aim of this study is to explore how school-related variables predict high school students' subjective judgements of school violence. Using a nationally representative sample (Israel) of 3,518 high school-aged youth, this study tested the hypotheses that (a) students' personal fear of attending school due to violence and (b) students' assessment of a school violence problem are best understood as separate conceptual constructs. The findings support the proposition that student fear of attending school and assessments of school violence as a problem are influenced by different types of school-related variables. Student fear of attending school due to violence was directly related to experiences of personal victimization by students and school staff. In contrast with fear, students'judgements of their schools' overall violence problem were directly associated with the variables of school climate, observed risk behaviors, and personal victimization. Implications for policy, theory, and future research are highlighted.
Absenteeism↗