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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 ([delta] 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.

Background: From a range of perspectives, scholars have demonstrated the value of school-based health centers (SBHCs) in recent decades, but few studies have examined the logistics of establishing SBHCs. Methods: Semi-structured interviews were conducted with 9 hospital and 6 school employees involved in a network of SBHCs. After common themes were identified, cluster analysis was performed. Finally, quotes were identified within each thematic cluster for further qualitative analysis. Results: The most prominent themes were (1) differences in physical space (between schools and clinical settings), (2) collaboration and communication, and (3) privacy and compliance. Implications For School Health Policy, Practice, and Equity: This study points to several high yield considerations for the practice of SBHCs. First, we identified three distinct needs: (1) clear funding streams for construction costs for health services on school grounds, (2) improved understanding of SBHC space needs, and (3) blueprints for collaborating within SBHCs. Second, this study points to a future in which new-build and renovated schools should include space for SBHCs. Conclusions: This qualitative thematic analysis provides a picture of health and educational professionals engaged in creative, collaborative, and adaptive work to meet children's health care needs within SBHCs, but also highlights the challenges of navigating physical space, compliance, and collaboration within SBHCs.

Background: Case investigation and contact tracing (CI/CT) are important public health tools to interrupt COVID-19 transmission. Our study aims to understand how parents and school staff perceive COVID-19 CI/CT. Methods: Using a mixed methods approach, we distributed a community survey and conducted 15 focus group discussions (FGDs) in English and Spanish between December 2020 and March 2021 with 20 parents and 22 staff from schools in San Diego County ZIP Codes with COVID-19 rates in the top quintile as of August 2020. Results: One in 4 survey respondents reported that they would be reluctant to participate in CI/CT. FGDs revealed themes of mistrust in government authorities, overburdened institutions, unfamiliarity with CI/CT, and uncertainty about its reliability. School community members emphasized that parents trust schools to be involved in CI/CT efforts, but schools are overwhelmed with this added responsibility. Conclusions: Investing in schools as community hubs is necessary so they can become important partners in prevention and mitigation in public health.

Background: The closure of schools in response to COVID-19 compromised access to essential meals for many students. The Emergency Meals-to-You program, a public/private partnership, was set up to address this challenge. More than 38.7 million meals were delivered between April and August 2020. This study explores lessons learned and identifies strategies for strengthening food access and security at schools and beyond. Methods: Qualitative research methods were used. This included interviews and focus groups with participants involved in setting up and delivering the Emergency Meals-to-You program. Data were thematically analyzed using key phrases, ideas, and concepts, and interpreted. Results: The program leveraged a multisectoral approach. Components relied on each other and included: schools, public/private partnership, eligibility, relationships, experience, centralized communication, food quality and branding, logistics, and transport. Strategies identified to strengthen food access focused on integration with emergency management structures, understanding food needs at the school level, building a fully procurable menu, and allowing distribution to be rapidly scaled. Conclusions: The lessons identified and strategies recommended provide a framework for working across the emergency management spectrum (school to national level) to strengthen food access and availability for students and their families affected by a pandemic, disaster, or crisis situation.

Background: Previous research on the correlates of unintentional school injuries is based on either process or cross-sectional data. This study aims at approaching the causal effects of risk-seeking behavior, mental health problems, physical activity, and exposure to bullying on unintentional injuries in the school environment by relying on longitudinal survey data. Methods: The data comes from a German panel survey, including more than 10,000 students. We estimate fixed-effects regression models that only take into account the variation within participants and are therefore most suitable for establishing causal inferences. Results: We find an increase in risk-seeking behavior on the individual level to yield an increase in students' likelihood to suffer injuries during physical education and on the schoolyard or in the school building. The same holds true for an increase in mental health problems. Finally, students who expand their degree of physical activity in club sports also show a higher risk of unintentional injuries. Conclusions: Interventions aimed at reducing too risky behavior and mental health problems may help prevent unintentional injuries in the school environment. Since students who increase their activities in club sports are also more prone to school injuries, preventive efforts should include this group of adolescents as well.

Background: Bullying is a public health issue with long-term effects for victims. This study investigated if there was an association between pedagogical and social school climate and student-reported bullying victimization, which dimensions of pedagogical and social school climate were associated with bullying, and if these associations were modified by individual-level social factors. Methods: The study had a cross-sectional multilevel design with individual-level data on bullying from 3311 students nested in 94 schools over 3 consecutive school years. School climate was measured with student and teacher questionnaires, aggregated at the school level. The association between school climate and bullying victimization was estimated with multilevel mixed-model logistic regression. Results: In schools with the most favorable school climate, fewer students reported being bullied. This was especially evident when school climate was measured with the student instrument. Students in schools with favorable climate had an adjusted odds ratio of bullying of 0.74 (95% CI: 0.55-1.00) compared to students in schools with the worst climate. Results from the teacher instrument were in the same direction, but less consistent. Conclusions: Improvement in school climate has the potential to affect students both academically, and socially, as well as decrease the prevalence of bullying.

Background: Unintentional injuries are the leading cause of youth morbidity. However, limited nationally representative data are available to characterize the occurrence of unintentional injuries at US schools. Given this paucity, we characterized secular trends in unintentional injuries at schools that led to emergency department (ED) visits. Methods: A retrospective analysis of the National Electronic Injury Surveillance System-All Injury Program from 2001 to 2013 compared injuries occurring at schools to injuries occurring elsewhere in youth ages 5-18 years. Incidence rates were calculated using weighted frequency estimates as numerators and US population estimates as denominators. Results: School injuries accounted for 21% of unintentional injury-related ED visits, with an estimated annual incidence rate of 1385 injuries per 100,000 5- to 18-year-olds. Middle school-aged youth (10-13 years) had the highest annual incidence rate (1640 per 100,000 youth) compared with younger and older counterparts. School injuries were more likely to be due to sports/recreation than nonschool injuries (55% vs 41%, p < 0.0001). Importantly, no detectable change in incidence rates of school injuries between 2001 and 2013 was found (p = 0.11). Conclusions: Stagnant annual incidence rates of unintentional injuries at schools and large numbers of school-based injuries demonstrate that school-based injuries are a notable opportunity for future prevention efforts.

Background: Schools are particularly vulnerable to pests, but integrated pest management (IPM) can address pest problems. This study describes IPM policies and practices and the extent to which they are associated with school characteristics. Methods: We analyzed data from the 2014 School Health Policies and Practices Study, a nationally representative survey of schools in the United States (N = 568, response rate = 69%). Pairwise comparisons assessed differences in pest prevention strategies by school characteristics. Results: Nationwide, 55.3% of schools conducted campus-wide inspections for pests at least monthly; 35.6% of schools notified staff, students, and families prior to each application of pesticides; and 56.1% of schools required custodial or maintenance staff to receive training on pest management practices that limit the use of pesticides. During the 12 months before the study, 46.5% of schools almost always or always used spot treatments and baiting rather than widespread applications of pesticides, and 36.8% of schools almost always or always marked indoor and outdoor areas that had been treated with pesticides. No clear pattern emerged for school characteristics associated with IPM policies and practices. Conclusions: The variation in implementation of IPM-related policies and practices suggest opportunities for targeted education among school staff about IPM principles.

Background: Understanding how school personnel can best support students' development of communication skills around feelings is critical to long-term health outcomes. The measurement of emotion socialization in schools facilitates future research in this area; we review existing measures of emotion socialization to assess their applicability to school-based health studies. Methods: A content analysis of four emotion socialization measures was conducted. Inclusion criteria included: high frequency of use in prior research, established documentation of validity and reliability, and sufficient description of measurement procedures. Results: Four dimensions emerged as particularly salient to a measure's future relevance and applicability to school-based health studies: (1) methods of measurement; (2) mode and agent of socialization; (3) type of emotion; and (4) structure versus function of socializing behavior. Conclusion: Future measurement strategies should address (1) the structures of emotion socializing processes; (2) diverse socializing agents such as teachers, peers, and administrators; (3) the intended functions of such processes; (4) student perceptions of and responses to such processes; and (5) the complex interactions of these factors across contexts. Strategies attending to these components will permit future studies of school-based emotion socializing processes to determine how they enhance health and reduce health risks.

Background: No overarching federal agencies or policies are responsible for ensuring environmental health at schools in the United States, potentially allowing many inequities for low-income and minority communities to persist. This article examines emergent research, policy, and practice-based efforts that may be used to identify and address environmental justice at school. Methods: A brief literature review was conducted to understand (1) major mental, behavioral, and physical outcomes associated with environmental risk for school-aged children and (2) current research methods for assessing these relationships. Documents prepared by government agencies, school districts, and advocacy groups were also collected and synthesized to improve understanding of the state of planning and policies for maintaining or improving school environments. Results: Environmental risk can manifest in diverse ways such as mold, poor air quality, poor community design, or contaminated playgrounds. Deeply rooted in national and state structures of school funding and planning, such risks can lead to outcomes including respiratory illness, poor performance in school, and reduced levels of physical activity. With growing attention to these concerns, methods for measuring environmental risks and underlying disparities have advanced tremendously in the last few decades, yet development of innovative research approaches may be necessary to further advance and evaluate appropriate interventions. Conclusions: Environmental injustice is generally unacknowledged during decision-making in US school districts. Continued dialogue reflective of translatable science is necessary to support school districts with limited funding in ensuring safe, healthy environments for learning.

Background: Health insurance coverage increases access to health care. There has been an erosion of employer-based health insurance and a concomitant rise in children covered by public health insurance programs, yet more than 8 million children are still without health insurance coverage. Methods: This study was a national survey to assess the perceptions of State Child Health Insurance Program (SCHIP) directors (N = 51) regarding schools assisting students in obtaining public health insurance. This study examined the perceived benefits of and barriers to working with school systems and the perceived benefits to schools in assisting students to enroll in SCHIPs and what SCHIP activities were actually being conducted with school systems. Results: The majority (78%) of SCHIPs had been working with school systems for more than a year. Perceived benefits of working with schools were greater access to SCHIP-eligible children (75%), assistance with meeting mandates to cover all SCHIP-eligible children (65%), and greater ability of state agencies to identify SCHIP-eligible children (58%). A majority of the directors did not identify any of the potential barrier items. The directors cited the following benefits to schools in helping enroll students in public health insurance programs: reduces the number of students with untreated health problems (80%), reduces student absenteeism rates (68%), improves student attention and concentration during school (58%), and reduces the number of students being held back in school because of health problems (53%). Discussion: The perceived benefits derived from schools assisting in enrolling eligible students into SCHIPs are congruent with the mission of schools. Schools need to become proactive in helping to establish a healthy student body, which is more likely to be an academically successful body. (Contains 5 tables.)

Background: Recruiting schools into a matched-pair randomized control trial (MP-RCT) to evaluate the efficacy of a school-level prevention program presents challenges for researchers. We considered which of 2 procedures would be most effective for recruiting schools into the study and assigning them to conditions. In 1 procedure (recruit and match/randomize), we would recruit schools and match them prior to randomization, and in the other (match/randomize and recruitment), we would match schools and randomize them prior to recruitment. Method: We considered how each procedure impacted the randomization process and our ability to recruit schools into the study. After implementing the selected procedure, the equivalence of both treatment and control group schools and the participating and nonparticipating schools on school demographic variables was evaluated. Results: We decided on the recruit and match/randomize procedure because we thought it would provide the opportunity to build rapport with the schools and prepare them for the randomization process, thereby increasing the likelihood that they would accept their randomly assigned conditions. Neither the treatment and control group schools nor the participating and nonparticipating schools exhibited statistically significant differences from each other on any of the school demographic variables. Conclusions: Recruitment of schools prior to matching and randomization in an MP-RCT may facilitate the recruitment of schools and thus enhance both the statistical power and the representativeness of study findings. Future research would benefit from the consideration of a broader range of variables (eg, readiness to implement a comprehensive prevention program) both in matching schools and in evaluating their representativeness to nonparticipating schools. (Contains 2 tables and 1 figure.)

School mental health programs are increasingly prominent in the United States and in other countries, but funding remains tentative. This article describes a partnership between a school mental health program and an outpatient mental health center, and considers the larger goal of promoting sustainability and increasing revenue. Issues related to using fee-for-service revenue to support school mental health are explored, and strategies for promoting effective partnerships are discussed. Recommendations for programs facing the challenge of incorporating fee-for-service activities into their current model of service provision are provided.

A mental health program in the schools is described which uses a nurse trained in mental health, with the support of a psychiatrist, to coordinate a mental health team and act as a liaison between the school and the health professionals, to assess referrals and arrange team meetings to plan interventions. (JMF)

By working together parents, teachers, and physicians can strengthen the help given to handicapped students. (JD)

School nurses are advised to change their programs from crisis-oriented health care to active case finding and preventive care. (JMF)

A program in the schools for screening children suffering from hypertension is described. (JMF)

BACKGROUND: In 2013, the Chicago Public Schools (CPS) district passed a policy requiring schools to deliver comprehensive sexual health education (SHE) to all K‐12th grade students. A performance improvement case study was conducted in the 2019‐2020 school year to evaluate the implementation of the policy and identify lessons learned to support implementation in schools. METHODS: Key informant interviews were conducted with 11 school principals and 29 teachers to discuss SHE implementation at their school. Interviews were recorded, transcribed, and analyzed to assess school and classroom factors that affect implementation. Themes that cut across these factors were then identified and summarized by 2 evaluators. RESULTS: The following themes were identified across key informant interviews: (a) principal prioritization of SHE helps ensure SHE is implemented, (b) the expansion of school and teacher capacity facilitates SHE implementation, and (c) the creation of accountability mechanisms in classrooms and schools fosters adherence to SHE policy. CONCLUSIONS: Principals play a crucial role in building capacity to deliver SHE and ensuring SHE accountability mechanisms are implemented in their school. CPS is using these findings to adjust technical assistance and resources provided to principals and SHE instructors. [ABSTRACT FROM AUTHOR]

BACKGROUND: The origin of inequalities in health outcomes has been explained by health selection and social causation models. Health selection processes operate particularly at school age. We study, if student allocation to teaching groups with aptitude tests (selective vs general class) differentiates adolescents by health behaviors and mental health. METHODS: Finnish schoolchildren 12‐13 years from 12 selective classes, n = 248; 41 general classes, n = 703 answered a questionnaire on addictive products (tobacco, snus, alcohol, and energy drinks), digital media use, and mental health (health complaints, anxiety, and depression). Structural equation modeling was conducted to identify structures between outcomes, SEP (socioeconomic position), class type, and academic performance. RESULTS: Students in the selective classes reported less addictive digital media and addictive products use than students in the general classes. Differences in academic performance or SEP between the class types did not solely explain these differences. Mental health was not related to the class type. SEP was indirectly associated with health behaviors via the class type and academic performance. CONCLUSIONS: Selecting students to permanent teaching groups with aptitude tests differentiates students according to risky health behaviors. The impact of education policies using student grouping should also be evaluated in terms of students' health. [ABSTRACT FROM AUTHOR]

BACKGROUND: At the onset of the COVID‐19 pandemic, schools closed across the United States. Given the impact of virtual learning and lost access to school resources, schools eventually reopened with COVID‐19 mitigation protocols in place. This qualitative study sought to understand parental perceptions of school‐based COVID‐19 mitigation strategies. METHODS: Using a phenomenology approach, nine focus groups were completed with 40 parents of children in grades K‐8 representing eight Maryland counties. Based on acceptance of masking policies (as indicated on a survey), parents were sorted into 2 groups—lower and higher masking acceptance. A thematic analysis was conducted for each group and themes were compared between the 2 groups. RESULTS: The main themes were related to parents' general sentiments regarding COVID‐19, compliance, pandemic‐related changes over time, changes in personal opinions, and in‐person learning. Both groups described challenges related to inconsistent COVID‐19 mitigation policies and practices, the challenges of rapid and frequent changes in guidelines during the pandemic, and the benefits of in‐person learning. CONCLUSIONS: Parents of elementary and middle school children, regardless of general acceptance of masking policies, shared concerns about implementation and guidance regarding school‐based mitigation strategies. [ABSTRACT FROM AUTHOR]

BACKGROUND: Psychosocial support provision in schools is a promising strategy for overcoming barriers to accessing mental health care. This study aimed to assess teachers' knowledge, attitudes, practices, skills, and perceived barriers in providing psychosocial support to students in Jordan. METHODS: The sample included teachers working in public schools, private schools, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) schools, and Zaatari camp schools, as well as non‐formal education centers. The study utilized a multi‐stage stratified cluster sampling technique to select a nationally representative sample. RESULTS: A total of 549 teachers were included, and only 25.2% have ever received mental health training. Most teachers reported a high level of good and acceptable knowledge of psychosocial support and had a positive attitude toward the provision of psychosocial support, however, about a quarter (25.5%) agreed on feeling nervous in discussing students' psychosocial problems with their parents or school administrators. The least enacted practice was the systematic engagement with parents, school administration, and other community resources in students' well‐being (sometimes, 31.6%; rarely, 20.4%). Gaps in skills were mainly in communicating with external resources and parents. The main barriers included parents' misunderstanding of teachers' role in providing psychosocial support to students (56.8%), lack of integration of psychosocial support in the curriculum (55.6%), and challenges in identifying students with psychosocial problems due to large class sizes (54.3%). CONCLUSION: The results show that gaps extend beyond the individual level of teachers to the community level. School‐based psychosocial support interventions must consider the multiple factors that influence their implementation at multiple levels, including the individual, relational, community, and societal levels. [ABSTRACT FROM AUTHOR]

BACKGROUND: School Resource Officer (SRO) programs do not reduce school violence and increase school discipline. We describe the use of a culturally responsive framework to form a school community collaborative among students, parents, staff, administrators, and law enforcement to reform an SRO program, promote school safety, and reduce punitive measures. METHODS: Members of a participating school district, a local county, and a university collaborated. Adapting an identified culturally responsive model, a racially/ethnically diverse school community co‐developed and implemented a School Community Collaborative (SCC) to address a school safety priority (SRO program reform). The main outcomes were SCC model development and implementation, policy change, and school community feedback. RESULTS: Sixteen community members participated in the 5‐week SCC with students, staff, law enforcement, and parents. The SCC revised the district's SRO memorandum of understanding (MOU) with law enforcement. Participants reported favorable feedback, and 89% reported the inclusion of diverse voices. CONCLUSIONS: Co‐development and implementation of an SCC process with schools were feasible. School SCC participated in a community‐engaged evaluation and revision of an MOU. [ABSTRACT FROM AUTHOR]

BACKGROUND: Middle and high school students who are involved in caregiving for aging, chronically ill, and/or disabled family members report more learning challenges compared to their non‐caregiving peers. However, little is known about how many students miss school to take care of someone else, and which students are most likely to have this experience. Such knowledge could reveal an important, largely unrecognized reason for school absences and educational disparities. METHODS: Our research‐practice partnership surveyed middle‐and‐high schoolers across Rhode Island public schools in 2022. RESULTS: Among 55,746 students (45% White non‐Latinx; 21% Latinx; 45% girls), 13.80% reported they had missed school to take care of someone else, with up to 35% in some districts. Students who missed school for caregiving were disproportionately girls, non‐binary, transgender, or preferred not to report gender, older youth, and from historically marginalized racial and ethnic groups, and from urban districts. CONCLUSIONS: Children's experiences caregiving for others may be an important and overlooked contributor to absenteeism and achievement gaps, especially in urban areas. We suggest school policies to better serve these students. [ABSTRACT FROM AUTHOR]

BACKGROUND: School Resource Officer (SRO) programs do not reduce school violence and increase school discipline. We describe the use of a culturally responsive framework to form a school community collaborative among students, parents, staff, administrators, and law enforcement to reform an SRO program, promote school safety, and reduce punitive measures. METHODS: Members of a participating school district, a local county, and a university collaborated. Adapting an identified culturally responsive model, a racially/ethnically diverse school community co‐developed and implemented a School Community Collaborative (SCC) to address a school safety priority (SRO program reform). The main outcomes were SCC model development and implementation, policy change, and school community feedback. RESULTS: Sixteen community members participated in the 5‐week SCC with students, staff, law enforcement, and parents. The SCC revised the district's SRO memorandum of understanding (MOU) with law enforcement. Participants reported favorable feedback, and 89% reported the inclusion of diverse voices. CONCLUSIONS: Co‐development and implementation of an SCC process with schools were feasible. School SCC participated in a community‐engaged evaluation and revision of an MOU. [ABSTRACT FROM AUTHOR]

BACKGROUND: School‐based health centers (SBHCs) have the capability to overcome youth barriers to care. Virtual care programs (VCP) facilitate connection between school nurse and off‐site SBHC providers and can increase the reach of SBHCs. This project aimed to examine Denver Public School nurses' perspectives of a pilot VCP. METHODS: Thirteen semi‐structured qualitative interviews were conducted and coded using an inductive approach to identify key themes. RESULTS: Four major themes emerged: (1) obtaining consent, finding space, and capacity are challenges and nurses have suggestions; (2) nurses enjoy feeling like a valued member of a health care team, and providing additional resources to students; (3) nurses perceive benefits in providing free, efficient, higher level of care; (4) adopting novel technology is a facilitator and challenge; limitations included space and privacy. CONCLUSIONS: Key findings can be utilized to further inform practice. [ABSTRACT FROM AUTHOR]

BACKGROUND: Medicaid is a key policy lever for expanding access to mental health services and supports for children in schools, especially low‐income and minority children. This study examines how Medicaid finances mental health promotion and prevention (tier 1), screening and selected interventions (tier 2), and treatment (tier 3) in schools, informing policy recommendations to expand school mental health. METHODS: Seventeen key informant interviews were conducted virtually from March to October 2022 with research, practice, and policy leaders in school mental health and Medicaid. Interview transcripts were thematically coded to inform recommendations. RESULTS: Interview themes included that Medicaid is a key funder of mental health services, primarily in tier 3, and that braiding and blending funds is necessary to support services across all tiers in schools. Interviewees underscored the need to expand tier 2 in schools, to expand and diversify the behavioral health workforce (including via non‐licensed providers, aligning school‐employed provider licensure and billing requirements and building school‐community referral relationships), strengthen teaming structures (including state children's cabinets, student case management, and education/Medicaid agency coordination), and leverage technical assistance and training to speed up adoption of new policies (including via guidance and templates that facilitate billing for school health services). CONCLUSIONS: Policymakers, practitioners, and advocates can use these findings to identify policies and strategies to expand school mental health and reduce inequities. [ABSTRACT FROM AUTHOR]

BACKGROUND: Suicide is a leading cause of death for adolescents, and school connectedness is a potential, modifiable protective factor for suicide. We sought to examine if school connectedness protected against suicide among high school students and if potential moderators affected the relationship between school connectedness and suicide. METHODS: We searched online databases (PubMed, EMBASE, CINAHL, and PsycINFO) on December 12, 2021, for studies that examined the effects of school connectedness on suicide among high school students. RESULTS: This systematic review identified 34 studies that examined the effects of school connectedness on adolescent suicidality. Results indicated mixed findings of school connectedness on suicidality. Among studies that assessed a suicide ideation outcome, 73.3% found that school connectedness protected against suicide. Among studies that assessed a suicide attempts outcome, 50% found that school connectedness protected against suicide. Most included studies did not control for notable variables in their final models, such as sleep, impulsivity, substance use, or depression. No studies examined moderators of school connectedness and suicide. CONCLUSIONS: School connectedness is somewhat protective of suicidality, and more protective of suicidal ideation than suicide attempts. Researchers should examine the construct of school connectedness among modern youth to better understand school connectedness and suicide. [ABSTRACT FROM AUTHOR]

BACKGROUND: Adoption of the Whole School, Whole Community, Whole Child (WSCC) model has been slowed by a lack of available tools to support implementation. The Wellness School Assessment Tool (WellSAT) WSCC is an online assessment tool that allows schools to evaluate the alignment of their policies with the WSCC model. This study assesses the usability of the WellSAT WSCC. METHODS: Using a convergent mixed methods design, we collected qualitative and quantitative data from 5 school‐based participants with roles in development and evaluation of policy. Participants explored the platform while engaging in a think‐aloud procedure and scored a sample policy using the platform. They also completed the System Usability Scale and responded to open‐ended questions about the usability of the platform. RESULTS: Participants rated the WellSAT WSCC as an above‐average user experience, but data suggested several areas for improvement, including improved instructions, enhanced visual design of the platform, and guidance for subsequent policy changes. CONCLUSION: The WellSAT WSCC provides an above‐average user experience but can be improved to increase user experience. These improvements increase the potential for greater use to facilitate integration of the WSCC model into school policy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Insufficient sleep is a growing public health concern. Thirty percent of Canadian children and youth are not meeting national sleep recommendations. Inadequate sleep can negatively influence students' academics and physical and psychosocial health. Schools have been identified as ideal health promotion settings to influence children's health including their sleep behaviors. The objective of this study was to explore teachers' perspectives on sleep behaviors and their role in school‐based sleep promotion. METHODS: Nineteen elementary teachers were purposively sampled from the greater Edmonton area, Alberta, Canada. Interpretive description was used as the guiding method, and data were generated through one‐on‐one semi‐structured interviews. Inductive descriptive thematic analysis was used to identify interview themes. RESULTS: Three themes related to teachers' perspectives on sleep behaviors and school‐based sleep promotion were identified: the importance of students' sleep, prioritizing sleep as part of teaching and learning, and a culture of healthy sleep habits. CONCLUSIONS: This study found that teachers considered sleep to be essential for elementary students' academic success and wellbeing, and a whole school approach was necessary to support a healthy sleep culture in schools. [ABSTRACT FROM AUTHOR]

BackgroundAdolescent behaviors and academic outcomes are thought to be shaped by school climate. We sought to identify longitudinal associations between school climate measures and downstream health and academic outcomes.MethodsData from a longitudinal survey of public high school students in Los Angeles were analyzed. Eleventh-grade health and academic outcomes (dependent variables, eg, substance use, delinquency, risky sex, bullying, standardized exams, college matriculation), were modeled as a function of 10th-grade school climate measures (independent variables: institutional environment, student-teacher relationships, disciplinary style), controlling for baseline outcome measures and student/parental covariates.ResultsThe 1114 student respondents (87.8% retention), were 46% male, 90% Latinx, 87% born in the United States, and 40% native English speakers. Greater school order and teacher respect for students were associated with lower odds of multiple high risk behaviors including 30-day alcohol use (odds ratio [OR] 0.81; 95% confidence interval [CI] [0.72, 0.92] and OR 0.73; [0.62, 0.85]) and 30-day cannabis use (OR 0.74; [0.59, 0.91] and OR 0.76; [0.63, 0.92]). Neglectful disciplinary style was associated with multiple poor health and academic outcomes while permissive disciplinary style was associated with favorable academic outcomes.Implications for school health policy, practice, and equitySchool health practitioners may prospectively leverage school environment, teacher-student relationships, and disciplinary style to promote health and learning.ConclusionsOur findings identify specific modifiable aspects of the school environment with critical implications for life course health.

BackgroundLittle is known regarding utilization of school-based health centers (SBHCs) during prolonged school closures, such as those that occurred during the COVID-19 pandemic. We sought to compare SBHC utilization before and after pandemic-related school closures across a network of SBHCs affiliated with a large Southern Californian urban school district.MethodsWe conducted a secondary analysis of encounter data extracted from electronic health records from 12 SBHCs that remained open despite school closures, including patient demographics and diagnostic and billing codes. We used the Clinical Classifications Software Refined to group encounters for common primary care conditions. Utilization before and during pandemic-related school closures was compared using logistic regression with cluster-robust standard errors to account for clustering within clinics, after adjusting for month of encounter.ResultsDuring the pandemic, study SBHCs conducted 52,530 encounters and maintained ∼4040 encounters/month. The frequency of encounters for annual preventative health exams increased for school-aged patients but decreased for other age groups while the frequency of encounters for mental health problems increased for all age groups.Implications for school health policy, practice, and equityDespite pandemic-related school closures, SBHCs appeared play a critical role in providing primary care to vulnerable communities.ConclusionsSBHCs may hold value beyond their co-location with academic instruction.

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: In the United States (U.S.), 77% of school district leaders reported that their students had fallen behind in their social‐emotional development due to COVID‐19 school closures. Although research has measured indicators of social‐emotional well‐being from the perspective of other informants, little is known about student perceptions of perceived changes in their socioemotional competencies and, to a lesser degree, their nonacademic needs. AIMS: The current study examined middle school students' nonacademic needs, perceptions of socioemotional competencies, and predictors of "socioemotional loss." MATERIALS & METHODS: The authors utilized secondary data from 395 middle school students gathered in August 2020 and November 2020 in one large middle school in the southern region of the U.S. Multivariate and linear regression analyses explored students' nonacademic needs, assessed changes in perceptions of their socioemotional competencies over time, and identified predictors of "socioemotional loss" during the "return to learn" period. RESULTS: Our findings indicated that 3% to 14% of students reported nonacademic needs, with the greatest needs related to food, housing, and healthcare. Further, 48% of students reported perceived losses in their socioemotional competencies, and students formerly receiving school‐based support services were those most affected (71% vs. 46%, p =.01). Among the subgroup reporting losses, living in a single‐parent household significantly predicted socioemotional loss (β = −.16, p =.02). DISCUSSION: School‐based practitioners, including educators, policymakers, social workers, and mental health providers, can utilize these findings to deliver interventions to students that experienced hardships during the pandemic. CONCLUSION: Responding to these risks will be critical as schools adapt and intervene in response to the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Families in high‐risk communities for COVID‐19 transmission experienced a disproportionate burden during the pandemic. This study assessed these families' needs, changes in children's well‐being, and perceptions related to the pandemic. Methods: Four online surveys were administered January 2021 to September 2021 to parents of students, enrolled in parochial, kindergarten‐eighth grade schools in Chicago neighborhoods with higher COVID‐19 incidence rates by ZIP code, compared to the city average, and higher resource need. Results: The response rate was 69.1% (n = 186 of 269) in the baseline survey; and other surveys were at 1 (n = 151), 3 (n = 145), and 5 months (n = 154). Of the sample, 83% of parents identified as Hispanic/Latinx with a mean age of 38.3 years (SD: 8.5). Approximately a quarter of parents reported difficulty paying cable and internet bills (26%) and paying utilities (25%). Parents reported children as happy (94% and 95%, p =.59) and hopeful (96% and 95%, p =.74) at 1‐month (February to May 2021) and 5‐month surveys (June to September 2021). Parents also reported fewer children were irritable (29% vs 19%, p =.03), felt lonely (17% vs 10%, p =.03), and felt isolated (28% vs 9%, p <.001) between those survey waves. The majority (67%) of parents felt that their child had no difficulty wearing a mask in public. Conclusions: In this longitudinal study, Chicago parents rated children's well‐being highly and reported a decrease in negative emotions over time. The areas of need identified may be particularly relevant for outreach and providing resources to Hispanic/Latino families in future emergencies or global health threats. [ABSTRACT FROM AUTHOR]

Background: Exclusionary discipline (ED) has long been an educational equity concern, but its relationship with student health and protective factors is less understood. Methods: Using population‐based public school student data (N = 82,216), we examined associations between past‐month ED and positive depression and anxiety screening instrument results. We also assessed whether each of 9 potential protective factors moderated the ED‐mental health relationship by testing interaction effects. Results: Over 1 in 10 youth experienced past‐month ED, with variation by sex, gender identity, special education status, poverty, region, race/ethnicity, and adverse childhood experiences. Net of sociodemographic factors, youth who experienced ED had higher likelihood for current depression (adjusted odds ratio [AOR]: 1.64, 95% confidence interval [CI]: 1.55, 1.73) and anxiety (AOR: 1.49, 95% CI: 1.41, 1.58) symptoms. Significant associations were robust across 5 racial/ethnic groups, except for anxiety among American Indian/Alaska Native youth. Individual, interpersonal, and school‐level protective factors appeared to mitigate depression and anxiety regardless of disciplinary experience. Implications for School Health Policy, Practice, and Equity: Our findings document ED disproportionality and possible ramifications for emotional well‐being. Conclusions: In concert with structural efforts to reduce reliance on ED, strategies that bolster protective factors may support youth already impacted by ED and/or mental health problems. [ABSTRACT FROM AUTHOR]

Objectives: With optimized antiretroviral treatment youth living with HIV (YLH) now spend most of their time in schools, making schools an important venue to optimize outcomes. We evaluated school support for YLH. Methods: We conducted surveys with public secondary/high schools in 3 Kenyan counties (Nairobi, Homa Bay, and Kajiado) to determine policies and training related to HIV. Chi‐squared tests and Poisson regression were used to compare policy availability and staff training by county HIV prevalence and school type. Results: Of 512 schools in the 3 counties, we surveyed 100. The majority (60%) of schools surveyed had boarding facilities. The median student population was 406 (IQR: 200, 775). Only half (49%) of schools had medication use policies; more in boarding than day schools (65% vs 30%, p =.003). While most schools (82%) had clinic attendance policies; policy availability was higher in higher HIV prevalence counties (Homa Bay [100%], Nairobi [82%], Kajiado [56%], p <.05). Overall, 64% had confidentiality policies with higher policy availability in higher HIV prevalence regions (p <.05). Few schools had staff trained in HIV‐related topics: HIV prevention (37%), HIV treatment (18%), HIV stigma reduction (36%). Few were trained in confidentiality (41%), psychosocial support (40%), or mental health (26%). Compared to day schools, boarding school were more likely to have staff trained in HIV prevention (prevalence ratio: 2.1 [95% confidence interval 1.0, 4.0], p =.037). Conclusion: In this survey of Kenyan schools, there were notable gaps in HIV care policy availability and training, despite high HIV burden. Development and implementation of national school HIV policies and staff training as well as strengthening clinic and family support may improve outcomes for YLH. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic increased already high rates of student mental health concerns and further underscored inequities and disparities in access to services and care. As schools continue to address the effects of the pandemic, they must prioritize student mental health and well‐being. In this commentary, using feedback from the Maryland School Health Council, we present the connection between mental health in school and the Whole School, Whole Community, Whole Child (WSCC) model, a school health model commonly employed by schools and school districts. In doing so, we aim to highlight how school districts can use this model to address child mental health needs across a multi‐tiered system of support. [ABSTRACT FROM AUTHOR]

Background: Grief and loss are common experiences for children and adolescents, particularly during the COVID‐19 pandemic. Educators feel unprepared to support grieving students due to lack of training. We studied educator experiences receiving grief‐sensitive training as part of the grief‐sensitive schools initiative (GSSI), which provides grief‐sensitive training, online video‐based and print resources, and a financial grant to schools and school districts for use in supporting grieving students. Methods: Fourteen New York and Florida educators who received GSSI training participated in small focus groups or semi‐structured interviews on their experiences receiving GSSI training and supporting grieving students during the pandemic. Transcripts were analyzed using grounded‐theory analysis. Results: Emergent themes included increased confidence engaging grieving students, the desire for recurring trainings, the value of receiving training from an expert on pediatric grief and loss and the opportunity to ask questions, the need for grief‐sensitive training to reflect the cultural diversity of school communities, the unique losses experienced by students during the pandemic, and compassion fatigue and burnout in educators. Implications for School Health Policy, Practice, and Equity: Policymakers should recognize the effects of grief on students' learning and development and collaborate with educators to develop resources. Conclusions: Educators found GSSI training useful in supporting grieving students, particularly during the pandemic. [ABSTRACT FROM AUTHOR]

The article focuses on the consequences of the COVID-19 pandemic on education, addressing disparities in learning, mental health challenges, and the imperative for schools to prepare for future pandemics. Topics discussed include the impact on students from diverse socioeconomic backgrounds, the role of technology in education, and proposed strategies, including infrastructure improvements and mental health resources, to ensure effective responses to future health crises.

BACKGROUND: COVID‐19 screening testing (ST) can detect asymptomatic or pre‐symptomatic cases, allowing for prompt identification of cases and close contacts. This study examined parents' and school staffs' knowledge and attitudes toward to a pilot school‐based ST program in a school district in southern Arizona. METHODS: In May 2021, online surveys to parents and school staff were administered to examine attitudes toward ST and impacts of the COVID‐19 pandemic. Unweighted percent estimates were calculated, and bivariate differences were examined by demographics. Associations were assessed using chi‐square tests and logistic regression. RESULTS: The survey had response rates of 10% (606/6085) and 22% (187/849) among parents and staff, respectively. Approximately one‐third of responding parents (35%) would or already allow their child to participate in school‐based ST, 37% would not participate; 28% were unsure. Among responding staff, 46% would or already participate in ST, 33% would not; 21% were unsure. The top concern (38%) among responding staff was taking job‐related leave if testing positive. CONCLUSION: Schools work to balance the needs of students, families, and staff by implementing supportive and flexible policies and practices founded on buy‐in and acceptance from their communities [ABSTRACT FROM AUTHOR]

OBJECTIVE: Despite widespread availability of COVID‐19 vaccines, millions of Americans have not received the recommended vaccine doses. In the District of Columbia (DC), COVID‐19 vaccination rates are lowest among residents who are Non‐Hispanic (NH) Black and among school‐aged children. We assessed COVID‐19 vaccine hesitancy among staff and parents of students in DC K‐12 public and public charter schools. METHODS: We conducted a telephone‐based survey from February 6 to April 16, 2022 to staff, students, and parents of students who participated in school‐based COVID‐19 screening testing. COVID‐19‐related survey items included: vaccination status, reasons for not getting vaccinated, perceived vaccine access, and trusted COVID‐19 information sources. Utilizing time‐to‐event analyses, we evaluated differences across demographic groups. RESULTS: The interview response rate was 25.8% (308/1193). Most unvaccinated participants were NH Black and ages 5 to 11 years. Median time from vaccine eligibility to uptake was 236 days for NH Black participants vs. 10 days for NH White participants. Vaccine safety was the top concern among unvaccinated participants. Government and healthcare providers were the most trusted COVID‐19 information sources. CONCLUSIONS: Differences in timing of vaccine uptake among respondents and greater vaccine hesitancy among NH Black participants compared to other racial/ethnic groups highlight a need for continued tailored outreach and communication using trusted sources to convey the importance, benefits, and safety of COVID‐19 vaccination. [ABSTRACT FROM AUTHOR]

BACKGROUND: teen Mental Health First Aid (tMHFA) is an Australian school‐based universal program for grade 10 to 12 students. tMHFA teaches teens how to recognize and respond to a peer in crisis or experiencing mental health concerns. METHODS: Schools implementing tMHFA in 2019 and 2020 were propensity score matched, yielding a sample of instructors (n = 130) and students (n = 1915) in 44 high schools in 24 American states. Effectiveness and acceptability were assessed with student surveys at baseline and after implementation. RESULTS: There were significant findings for primary outcomes, including improved helpful first aid intentions (Cohen ds = 0.57 to 0.58), confidence supporting a peer (ds = 0.19 to 0.31); the number of adults rated as helpful (ds = 0.37 to 0.44); and reductions in stigmatizing beliefs (ds = 0.21 to 0.40) and "harmful first aid intentions" (ds = 0.11 to 0.42). Instructors and students rated the program favorably with students sharing improvements on their recognition and responses to mental health problems and crises. CONCLUSION: tMHFA is an effective, feasible, and scalable training program for increasing mental health literacy and decreasing mental health stigma in adolescents in the short term, consistent with trials of tMHFA in Australian adolescents. [ABSTRACT FROM AUTHOR]

The article focuses on parental rights laws and their impact on mental health services and counseling for adolescents. Topics include the adoption of such laws in various states, the potential challenges they pose to adolescents seeking mental health services, and the need for clarity in existing laws to empower clinicians and school counselors in providing necessary services while addressing parental consent requirements and confidentiality concerns.