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Objectives: Reports of unsafe school drinking water in the United States highlight the importance of ensuring school water is safe for consumption. Our objectives were to describe (1) results from our recent school drinking water sampling of 5 common contaminants, (2) school-level factors associated with exceedances of various water quality standards, and (3) recommendations., Methods: We collected and analyzed drinking water samples from at least 3 sources in 83 schools from a representative sample of California public schools from 2017 through 2022. We used multivariate logistic regression to examine school-level factors associated with lead in drinking water exceedances at the American Academy of Pediatrics (AAP) recommendation level (1 part per billion [ppb]) and state action-level exceedances of other contaminants (lead, copper, arsenic, nitrate, and hexavalent chromium)., Results: No schools had state action-level violations for arsenic or nitrate; however, 4% had ≥1 tap that exceeded either the proposed 10 ppb action level for hexavalent chromium or the 1300 ppb action level for copper. Of first-draw lead samples, 4% of schools had ≥1 tap that exceeded the California action level of 15 ppb, 18% exceeded the US Food and Drug Administration (FDA) bottled water standard of 5 ppb, and 75% exceeded the AAP 1 ppb recommendation. After turning on the tap and flushing water for 45 seconds, 2%, 10%, and 33% of schools exceeded the same standards, respectively. We found no significant differences in demographic characteristics between schools with and without FDA or AAP exceedances., Conclusions: Enforcing stricter lead action levels (<5 ppb) will markedly increase remediation costs. Continued sampling, testing, and remediation efforts are necessary to ensure drinking water meets safety standards in US schools., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The COVID-19 pandemic prompted widespread closures of primary and secondary schools. Routine testing of asymptomatic students and staff members, as part of a comprehensive mitigation program, can help schools open safely. "Pooling in a pod" is a public health surveillance strategy whereby testing cohorts (pods) are based on social relationships and physical proximity. Pooled testing provides a single laboratory test result for the entire pod, rather than a separate result for each person in the pod. During the 2020-2021 school year, an independent preschool-grade 12 school in Washington, DC, used pooling in a pod for weekly on-site point-of-care testing of all staff members and students. Staff members and older students self-collected anterior nares samples, and trained staff members collected samples from younger students. Overall, 12 885 samples were tested in 1737 pools for 863 students and 264 staff members from November 30, 2020, through April 30, 2021. The average pool size was 7.4 people. The average time from sample collection to pool test result was 40 minutes. The direct testing cost per person per week was $24.24, including swabs. During the study period, 4 surveillance test pools received positive test results for COVID-19. A post-launch survey found most parents (90.3%), students (93.4%), and staff members (98.8%) were willing to participate in pooled testing with confirmatory tests for pool members who received a positive test result. The proportion of students in remote learning decreased by 62.2% for students in grades 6-12 ( P < .001) and by 92.4% for students in preschool to grade 5 after program initiation ( P < .001). Pooling in a pod is a feasible, cost-effective surveillance strategy that may facilitate safe, sustainable, in-person schooling during a pandemic.

Introduction: In the United Arab Emirates, an alarming rate of 19% obesity among adolescents, associated with poor lifestyle, is apparent. Diet and exercise self-efficacy could influence adolescents' engagement in healthy behaviors. This study evaluates adolescents' perceptions of diet and exercise self-efficacy and explores the impact of parents and schools on self-efficacy. Method : A cluster sampling approach in cross-sectional design was used to recruit 610 school adolescents (Grades 7-12) over a 6-month period. Information on sociodemographics, lifestyle, parents, and schools was explored. Self-efficacy was assessed using The Eating Habits and Exercise Confidence Survey. Results: Participants reported moderate diet and exercise self-efficacy. Diet self-efficacy was predicted by parental support, eating breakfast and meals regularly at home, and prohibiting soft drinks. School support and frequency of weekly exercise classes predicted exercise self-efficacy; p values ≤.05. Discussion: Cultural knowledge and collaboration are essential to promote self-efficacy in multiethnic adolescents in the United Arab Emirates.

The Association of Schools and Programs of Public Health convened a Task Force on Zero Tolerance of Harassment and Discrimination in 2019 to develop a policy statement and strategies for addressing harassment of all types in institutions offering public health education. We outline the premises and scholarly foundation for the development of the Statement of Commitment to Zero Tolerance of Harassment and Discrimination, the statement itself, and future plans for realizing the aspiration established in the statement. The development of this living document is predicated on the belief that it is the core responsibility of academic institutions to build the knowledge and that it is the responsibility of leaders, namely deans of schools of public health and directors of public health programs, to lead in building the shared knowledge and insist on the practices that create institutions for a better future free of harassment and discrimination. Our statement is informed by the knowledge that aggressions in the form of harassment and discrimination undermine the health and well-being of individuals, the public, and populations.

The 2015 passage of the Every Student Succeeds Act (ESSA) provides state education agencies with more local control over educational planning, requires development of state accountability plans, and provides opportunities for advocacy surrounding school nursing-sensitive indicators of student success. Federal Title I, II, and IV funds are available for state and local education agency utilization in meeting educational needs of impoverished students and for development of high-quality instructional and support personnel. As Specialized Instructional Support Personnel, school nurses can utilize ESSA Title funding to positively impact chronic absenteeism, school climate, and school nurse staffing. ESSA can be a resource for funding school health services and professional education. This article will assist school nurses in better understanding ESSA and how funding is allocated to states and local education agencies.

Previous research has demonstrated the importance of ensuring that programs are implemented as intended by program developers in order to achieve desired program effects. The current study examined implementation fidelity of Pathways to Health (Pathways), a newly developed obesity prevention program for fourth- through sixth-grade children. We explored the associations between self-reported and observed implementation fidelity scores and whether implementation fidelity differed across the first 2 years of program implementation. Additionally, we examined whether implementation fidelity affected program outcomes and whether teacher beliefs were associated with implementation fidelity. The program was better received, and implementation fidelity had more effects on program outcomes in fifth grade than in fourth grade. Findings suggest that implementation in school-based obesity programs may affect junk food intake and intentions to eat healthfully and exercise. School support was associated with implementation fidelity, suggesting that prevention programs may benefit from including a component that boosts school-wide support., (© The Author(s) 2013.)

Background: Randomized experiments are often considered the strongest designs to study the impact of educational interventions. Perhaps the most prevalent class of designs used in large-scale education experiments is the cluster randomized design in which entire schools are assigned to treatments. In cluster randomized trials that assign schools to treatments within a set of school districts, the statistical power of the test for treatment effects depends on the within-district school-level intraclass correlation (ICC). Hedges and Hedberg (2014) recently computed within-district ICC values in 11 states using three-level models (students in schools in districts) that pooled results across all the districts within each state. Although values from these analyses are useful when working with a representative sample of districts, they may be misleading for other samples of districts because the magnitude of ICCs appears to be related to district size. To plan studies with small or nonrepresentative samples of districts, better information are needed about the relation of within-district school-level ICCs to district size., Objective: Our objective is to explore the relation between district size and within-district ICCs to provide reference values for math and reading achievement for Grades 3-8 by district size, poverty level, and urbanicity level. These values are not derived from pooling across all districts within a state as in previous work but are based on the direct calculation of within-district school-level ICCs for each school district., Research Design: We use mixed models to estimate over 7,000 district-specific ICCs for math and reading achievement in 11 states and for Grades 3-8. We then perform a random effects meta-analysis on the estimated within-district ICCs. Our analysis is performed by grade and subject for different strata designated by district size (number of schools), urbanicity, and poverty rates., (© The Author(s) 2014.)

Research on the motivation of stakeholders to integrate physical activity into daily school life is limited. The purpose was to examine the motivation of stakeholders to participate in a world record physical activity event and whether motivation was associated with future intention to use activity breaks during the daily school life and future participation in a similar event. After the 2012 JAM (Just-a-Minute) World Record event, 686 adults (591 women; 76.1% participated for children <10 years) completed measures of motivational regulations and future intention to (a) use the activity breaks and (b) participate in the event. High intrinsic motivation and low extrinsic motivation and amotivation for participation in the next event were reported. Hierarchical regression analysis, controlling for age, gender, and occupation, showed that intrinsic forms of motivation positively predicted, whereas amotivation negatively predicted, future intention to participate in the event and use the activity breaks. Multivariate analyses of variance revealed that school-related participants were more intrinsically motivated and intended to use the activity breaks and repeat the event more than those who were not affiliated with a school. Nonschool participants reported higher extrinsic motivation and amotivation than school-related participants., (© 2014 Society for Public Health Education.)

Against the background of evidence for links between ill-health and prejudice, in this article we discuss how to promote inclusive communities in contexts of diversity. A brief critical overview of dominant psychological approaches to prejudice reduction reveals the apolitical nature of these approaches, and thus, we argue for a more contextual and political model on how to promote inclusive communities. Drawing on examples of different school practices on cultural diversity from across England, we argue that we need to develop a perspective that connects local contexts of everyday practice, resistance and agency to the institutional and structural realities of prejudice.

It is the position of the National Association of School Nurses that data on children's deaths in school should be recorded, analyzed, and reported at the local, state, and national levels. The systematic review of data on child deaths is necessary to drive interventions and policies that will decrease mortality from injuries, violence, acute illness, and chronic disease in the school setting (Bergren, 2010; Christian & Sege, 2010).

Education is an important factor in health equity, but many students still do not complete high school. A focus on the school context rather than on individual problems might help to create a supportive environment for health and learning. In this study we explored factors that promote health and learning from the perspective of vocational and low-achieving high school students in Sweden. We used grounded theory with a constructivist orientation, informed and sensitized by the concept of salutogenesis. Students from a school in a mid-sized municipality in Sweden participated, and we collected data using the photovoice method and interviews. Students identified general factors as significant to their well-being and success in school. The main theme, "promoting driving forces for health and learning," emerged from the categories "longing to be seen by teachers," "longing for support," and "longing for recuperation."

Driven by environmental and parent activists, government agencies are paying increasing attention to the issue of PCBs in in-place caulk, particularly in school buildings. At the same time, there is insufficient consideration of the school maintenance workers and contractors who maintain and replace PCB caulk, even though they may constitute the school population with the highest exposures and risks. This commentary briefly assesses recent PCB-related developments at the U. S. Occupational Safety and Health Administration (OSHA), U. S. Environmental Protection Agency (EPA), and the New York State Education Department from an occupational health perspective.

Several school performance indices were evaluated using achievement data from multiple longitudinally matched middle school student cohorts in a large district in the southwestern United States. Measures designed to index the within-cohort achievement status and growth of students as well as the status and growth-based changes that occur over years between different student cohorts were studied. Within- and between-cohort status and growth-based estimates of school performance were generated by applying simple and relatively complex statistical models to the longitudinal time-series data obtained on students. Results indicated that within-cohort status-based estimates were closely related to student demographics and between-cohort estimates were associated with cohort enrollment size and initial performance level. These results suggest that schools may often be rewarded and penalized on the basis of factors over which school personnel have limited or no control. Implications for the measurement and evaluation of school performance are discussed.

This article presents a health intervention-research project done with workers in Brazilian public schools. Health, as we understand it, is linked both to the way in which we live and to our capacity to change that way of life. We emphasize the critical importance of initiating dialogue between research professionals and workers (co-investigators) in order to understand and transform work situations. We highlight the effects of debates about gender relations that led to work transformations. Such debates made it easier for workers and researchers to understand that men and women experience job requirements differently. We found that some staff favored reproduction of a sexually differentiated school system. These debates also allowed male and female workers to make their family members aware of difficulties in their work, unknown to society in general. We considered how to expand this research process, including examples of how the work was transformed.

The educational sector exposes its primarily female work force to numerous psychosocial risk factors. At the request of the education workers', ergonomists developed a participatory research project in order to understand the determinants of the difficulties experienced by special education technicians. These technicians work with students presenting behavioral and learning difficulties as well as developmental and mental health problems. Eighteen technicians were interviewed and the work of seven technicians and two teachers was observed. Technicians prevent and manage crisis situations and help students acquire social skills. Coordination with teachers is made difficult by the fact that most technicians work part time, part year, and many technicians' work areas and classrooms are physically distant one from another. Most technicians change schools each year and must continually reconstruct work teams. Management strategies and poorly adapted working spaces can have important repercussions on coordination among educators and on technicians' capacity to help students and prevent aggressive behavior.

This article discusses the findings of Focus Group Discussions (FGDs) that were conducted as a formative assessment for Project MYTRI (Mobilizing Youth for Tobacco Related Initiatives in India), a randomized, multicomponent, school-based trial to prevent and control tobacco use among youth in India. Forty-eight FGDs were conducted with students (N=435) in sixth and eighth grades in six schools in Delhi, India. Key findings include: (a) students in government schools reported as "consumers" of tobacco, whereas students in private schools reported as "commentators"; (b) parents and peers have a strong influence on youth tobacco use; (c) chewing gutkha is considered less harmful and more accessible than smoking cigarettes; (d) schools are not promoting tobacco control activities; and (e) students were enthusiastic about the role government should play in tobacco control. These findings are being used to develop a comprehensive intervention program to prevent and control tobacco use among Indian youth.

Management of medications in school is one of the critical roles that school nurses carry out in the school setting. In recent years, parents have come to question the medication procedures that school districts follow. Parents question why a physician's order is required for school personnel to provide over-the-counter (OTC) medications to their child at school. How do school districts balance the safety of students with the needs of parents wanting their children to have access to OTC medications at school? Following legal guidelines helps to reduce the risk for school nurses. Through the development and utilization of Nursing Standardized Protocols, high school nurses are able to provide nonprescription analgesics for specific common student complaints such as noninjury headaches and dysmenorrhea. On the basis of nursing knowledge and judgment, school nurses provide this service, which results in students returning to class quickly, feeling better, and being ready to learn.

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.

Objective: Northern Ireland has a high prevalence of childhood dental caries, reflecting heavy consumption of cariogenic snack foods. To develop a policy to promote and facilitate healthier eating, researchers, practitioners, and the school community formed a partnership, together creating the Boost Better Breaks (BBB) school-based policy. The policy was developed with and supported by dieticians, health promotion officers, teachers, school meal advisors, and local suppliers of school milk. Eighty percent of primary schools and preschool groups within the Southern Health and Social Services Board are involved in the program, which permits the consumption of only milk and fruit at break time., Methods: The authors assessed the effectiveness of the partnership using data from its first two years., Results: Results of the first two years of evaluation are positive. Initial findings indicate that the program had a positive effect in increasing the mean number of sound teeth in children attending schools in areas in which socioeconomic conditions are poor., Conclusion: This initiative suggests that collaboration can facilitate improvement in children's dental health and that careful targeting of the policy to schools in poor areas has the potential to narrow disparities.

This report describes a 2-year, longitudinal study of one school district's effort to link site-based, collaborative evaluation with formal, centralized program evaluation. Participants formed a research team in partnership with a local university. Team members assisted leadership teams in identifying issues for informal, site-based assessments and then used the information to monitor progress toward established goals. Participants collaborated in designing and conducting informal assessments of student achievement, school climate and safety, discipline, and parent involvement. Leadership teams used these data in developing their school improvement plans. Researchers and administrators used these data to revise the districtwide survey. At the end of the 2-year cycle, analysis of school improvement plans showed that collaborative evaluation is creating a connection between dialogue and data. These 17 middle schools are approaching school improvement in a more integrated fashion by actively involving key stakeholders (students, parents, and teachers) in the evaluation process.

Open-air schools were initiated in 1908 and maintained through the 1930s to treat children with tuberculosis while meeting their educational needs. During this period, treatment of tuberculosis was accomplished in sanitoriums where patients, both adults and children, were isolated and exposed to fresh air and rest. Isolating and institutionalizing children made it difficult for them to obtain schooling. The open-air schools were seen as a method of educating children with tuberculosis while treating them with fresh air, rest, and nutritious food. Although early reports of the effects of open-air schools were positive, student outcome studies reported conflicting results. Some student health outcomes improved, but reports of academic outcomes were inconsistent, leading to their closure between 1938 and 1941. Nursing roles were limited, but nurses were well prepared to participate in the open-air schools by providing health education, maintaining health records, monitoring student health outcomes, and coordinating the services provided to the students. Nurses can learn from our history and hopefully avoid the missed opportunities of yesteryear.

Healthy People 2010 objectives call for meals and snacks served in schools to contribute to overall diets that meet federal dietary guidelines. Sales in schools of foods and drinks high in calories and low in nutrients undermine this health objective, as well as participation in the more nutritious, federally sponsored, school lunch programs. Competitive foods also undermine nutrition information taught in the classroom. Lucrative contracts between school districts and soft drink companies for exclusive rights to sell one brand are the latest development in the increasing commercialization of school food. These contracts, intended to elicit brand loyalty among young children who have a lifetime of purchases ahead of them, are especially questionable because they place schools in the position of "pushing" soft drink consumption. "Pouring rights" contracts deserve attention from public health professionals concerned about the nutritional quality of children's diets.

The authors analyze the association between psychosocial factors in the school environment and pupils' health and self-worth in a sample of 538 pupils (264 girls and 274 boys) in the third and the sixth grades. High control in combination with low demand at school was associated with the best health status in relation to somatic problems, stress, tiredness, and feelings of self-worth. In a multiple regression analysis, problems in relations with classmates were the most recurrent psychosocial factor associated with ill-health. Some gender differences were found in school-related health. Lack of control at school affected self-worth among girls only. In the third grade and among boys in the sixth grade, high demands were an explanatory factor for the health outcome. Foreign background, divorced parents, high achievement, and low relational orientation, as well as disorderly and rowdy classes, were also of importance for somatic ill-health and stress among girls. Older girls became more relationally oriented, while boys became more achievement-oriented. The authors conclude that the pupils' somatic health and self-worth were affected by psychosocial factors at school, even when adjustment was made for social background.