Journal of School Health (J SCHOOL HEALTH)

Publications in this journal

• Article: Teaching Healthful Food Choices to Elementary School Students and Their Parents: The Nutrition Detectives[TM] Program

  David L. Katz, Catherine S. Katz, Judith A. Treu, Jesse Reynolds, Valentine Njike, Jennifer Walker, Erica Smith, Jennifer Michael
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  ABSTRACT: Background: The purpose of this study was to evaluate the effects of a nutrition education program designed to teach elementary school students and their parents, and to distinguish between more healthful and less healthful choices in diverse food categories. Methods: Three schools were assigned to receive the Nutrition Detectives[TM] program and 2 comparable schools served as controls. A total of 1180 second, third, and fourth grade elementary school students were included, with 628 students in the intervention and 552 in the control group. The program, delivered by physical education instructors over several sessions totaling less than 2 hours, taught the children how to read food labels and detect marketing deceptions, while learning to identify and choose healthful foods. Parents were introduced to the program through written materials sent home and at school functions. Assessments included a food label quiz, dietary pattern, and body mass index (BMI). Results: Students in intervention schools showed a significant increase in nutrition label literacy (p less than 0.01). Third grade students showed the most improvement, 23% (p less than 0.01). The parents of intervention group students also showed a significant increase in nutrition label literacy by 8% (p less than 0.01). Total caloric, sodium, and total sugar intake decreased nonsignificantly among students in the intervention group (p greater than 0.05). BMI did not change over the short duration of the study. Conclusions: Nutrition Detectives effectively enhances the ability of students and their parents to identify more nutritious food choices. Further evaluation of the program and its potential to influence dietary pattern, BMI, and health outcomes in students and their families is warranted. (Contains 3 tables and 1 figure.)
  Journal of School Health 12/2010;
• Article: This is your future: a case study approach to foster health literacy.

  Rebecca A Brey, Susan E Clark, Molly S Wantz
  Journal of School Health 07/2008; 78(6):351-5.
• Article: The HPV vaccine: framing the arguments FOR and AGAINST mandatory vaccination of all middle school girls.

  Cheryl A Vamos, Robert J McDermott, Ellen M Daley
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  ABSTRACT: Human papillomavirus (HPV), the virus responsible for cervical cancer, is the most common viral sexually transmitted infection in the United States. A vaccine was approved in 2006 that is effective in preventing the types of HPV responsible for 70% of cervical cancers and 90% of genital warts. Proposals for routine and mandatory HPV vaccination of girls have become sources of controversy for parents of school-aged youth, legislators, members of the medical community, and the public at large. The purpose of this article was to articulate the arguments used by advocates who either oppose or endorse routine, mandatory administration of the vaccine to school-aged girls, thereby assisting school health personnel in being effective participants in framing the relevant issues. Controversy is grounded in moral, religious, political, economic, and sociocultural arguments including whether concerns that the vaccine increases sexual risk taking, sends mixed messages about abstaining from sexual intercourse, usurps parental authority, and increases the potential for development of new health disparities are offset by the value of administering a cost-effective, age-appropriate public health measure targeting a life-threatening problem. Careful consideration of the medical evidence and public health implications is critical but understanding the context of the debate is no less important to the task of responding to public concerns. School health personnel have a role in the discussion about HPV immunization. Being able to articulate the arguments presented herein can help authorities' responsiveness to parents and community groups as the dialogue about this particular health issue evolves further.
  Journal of School Health 07/2008; 78(6):302-9.
• Article: Factors influencing openness to future smoking among nonsmoking adolescents.

  Dong-Chul Seo, Mohammad R Torabi, Amy E Weaver
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  ABSTRACT: To investigate the correlates of youth tobacco use in terms of nonsmoking adolescents' openness to future smoking, a secondary analysis of the 2000 and 2004 Indiana Youth Tobacco Survey (IYTS) was conducted. A representative sample of 1416 public high school students in grades 9-12 and 1516 public middle school students in grades 6-8 (71.44% and 72.53% response rates, respectively) were surveyed in 2000, and 3433 public high school students and 1990 public middle school students (63.04% and 65.44% response rates, respectively) were surveyed in 2004. Seventy-four percent of students in 2000 were not open to future smoking and 77% were not open in 2004. The adolescent cohort in 2004 became more exposed to antitobacco messages and less exposed to protobacco messages and environmental tobacco smoke (ETS) compared with their counterpart in 2000. Whereas gender, grade, race/ethnicity, and exposure to antitobacco messages were insignificant predictors for openness to future smoking, exposure to ETS either in homes or in cars was a strong predictor for openness to future smoking (the higher the exposure to ETS, the more open to future smoking) in both unadjusted and adjusted multivariate models. Exposure to protobacco messages had a greater effect on openness to future smoking than exposure to antitobacco messages. The rate of transition from openness to future smoking to tobacco use initiation is higher among white adolescents than among minority adolescents. More efforts should be made to reduce adolescents' exposure to ETS and protobacco messages.
  Journal of School Health 07/2008; 78(6):328-36; quiz 356-8.
• Article: Summer issues of the journal and a fond farewell.

  James H Price
  Journal of School Health 07/2008; 78(6):301.
• Article: Prevalence of tobacco use among students aged 13-15 years in Health Ministers' Council/Gulf Cooperation Council Member States, 2001-2004.

  Ahmad Moh'd Al-Mulla, Sahar Abdou Helmy, Jawad Al-Lawati, Sami Al Nasser, Salah Ali Abdel Rahman, Ayesha Almutawa, Bassam Abi Saab, Abdullah Mohammed Al-Bedah, Abdullah Mohamed Al-Rabeah, Ahmed Ali Bahaj, Fatimah El-Awa, Charles W Warren, Nathan R Jones, Samira Asma
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  ABSTRACT: This article examines differences and similarities in adolescent tobacco use among Member States of the Health Ministers' Council for the Gulf Cooperation Council (HMC/GCC) using Global Youth Tobacco Survey (GYTS) data. Nationally representative samples of students in grades associated with ages 13-15 in Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, United Arab Emirates, and Yemen. Schools were selected proportional to enrollment size, classes were randomly selected within participating schools, and all students in selected classes were eligible to participate. GYTS results confirmed that boys are significantly more likely than girls to smoke cigarettes or use shisha (water pipe). Students had higher rates of tobacco use than adults in Bahrain, Oman, and United Arab Emirates. For boys and girls, shisha use was higher than cigarette smoking in almost all countries. Susceptibility to initiate smoking among never smokers was higher than current cigarette smoking in all countries. Exposure to secondhand smoke in public places was greater than 30%, direct protobacco advertising exposure was greater than 70% on billboards and in newspapers, and more than 10% of students were influenced by indirect advertising. Finally, less than half of the students were taught in school about the dangers of tobacco use in the past year. For boys and girls, high prevalence of cigarette smoking, high prevalence of shisha use, and high susceptibility of never smokers to initiate smoking in the next year are troubling indicators for the future of chronic disease and tobacco-related mortality in the Member States of the HMC/GCC.
  Journal of School Health 07/2008; 78(6):337-43.
• Article: Factors influencing teachers' implementation of an innovative tobacco prevention curriculum for multiethnic youth: Project SPLASH.

  Angela Sy, Karen Glanz
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  ABSTRACT: The effectiveness of school-based tobacco use prevention programs depends on proper implementation. This study examined factors associated with teachers' implementation of a smoking prevention curriculum in a cluster randomized trial called Project SPLASH (Smoking Prevention Launch Among Students in Hawaii). A process evaluation was conducted and a cross-condition comparison used to examine whether teacher characteristics, teacher training, external facilitators and barriers, teacher attitudes, and curriculum attributes were associated with the dose of teacher implementation in the intervention and control arms of the study. Data were collected from a total of 62 middle school teachers in 20 public schools in Hawaii, during the 2000-2001 and 2001-2002 school years. Sources included teacher questionnaires and interviews. Chi-square test and t test revealed that implementation dose was related to teachers' disciplinary backgrounds and skills and student enjoyment of the curriculum. Content analysis, within case, and cross-case analyses of qualitative data revealed that implementing the curriculum in a year long class schedule and high teacher self-efficacy supported implementation, while high perceived curriculum complexity was associated with less complete implementation. The results have implications for research, school health promotion practice, and the implementation of evidence-based youth tobacco use prevention curricula.
  Journal of School Health 06/2008; 78(5):264-73.
• Article: Perceived competence in addressing student substance abuse: a national survey of middle school counselors.

  Jason J Burrow-Sanchez, Adriana L Lopez, Clark P Slagle
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  ABSTRACT: Student substance abuse is a serious concern for middle school personnel. School counselors are most likely to deliver mental health services, including substance abuse, in school settings. However, limited research is available on the perceived competence of middle school counselors for addressing student substance abuse concerns. The main purpose of this study was to determine how middle school counselors perceive their training in 9 competence areas related to student substance abuse. A secondary aim of this study was to identify which training areas counselors indicate as being most needed to address student substance abuse. A survey study was conducted that included a national sample of 283 middle school counselors. Analysis of variance was used to determine differences between 9 competency areas rated by counselors. Further analysis was conducted to determine which training areas were most important to counselors. Counselors varied in their perceived competence depending on the specific area of student substance abuse; however, they were clearly able to identify the most important areas of training needed. Overall, the findings from this study indicate that middle school counselors require more training in the area of student substance abuse. Specifically, this study provides information on the most important areas of training as identified by counselors.
  Journal of School Health 06/2008; 78(5):280-6.
• Article: Prevalence of students with symptoms of depression among high school students in a district of western Turkey: an epidemiological study.

  Alaaddin Unsal, Unal Ayranci
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  ABSTRACT: To determine the factors affecting the prevalence of depression and also to present some pertinent comments concerning prevention of depression among high school students. This study was deemed important and relevant due to the increasing importance of depression among high school students. A sample of students aged 14-19 years from the 6 high schools of 1 district of western Turkey were surveyed. The students selected were all attending the school during March and April 2006. The Beck Depression Inventory was used as a screening test. During the study, a total of 846 students completed the survey. Of the study group, 51.9% (439) were male and 48.1% (407) female, with an age average of 16.3 +/- 1.1 years. According to the scale, the prevalence of depression was 30.7% (n = 260), 22.6% for males (n = 99) and 39.6% for females (n = 161). The most depression was seen in males (22.6%), those with any kind of physical problem (37.3%), those with diseases necessitating the use of medication (51.1%), those with acne vulgaris (35.2%), and those having previously experienced any kind of problem (47.3%). These results highlight not only the need for students' parents and teachers to be well informed on the subject of depression in terms of students' health but also the need for more education programs to be aimed at students relating to the problems they may experience during the period of adolescence. Furthermore, these results show that students identified as depressed should be referred for an appropriate diagnosis to specialized psychiatry centers.
  Journal of School Health 06/2008; 78(5):287-93.
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  Article: Changing nutrition standards in schools: the emerging impact on school revenue.

  Christopher M Wharton, Michael Long, Marlene B Schwartz
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  ABSTRACT: Although great focus has been placed on nutritional and other consequences of changes in food-related policies within schools, few reports exist describing the impact of such changes on school revenue. This review provides an overview of the few revenue-related studies published recently, as well as information from a sampling of state reports on the subject. A systematic review of the literature was conducted. Four peer-reviewed papers and 3 state-based reports were identified that assessed the impact on revenues of either targeted policy changes or overarching, district-wide changes in food-related policies. Thus far, few data exist to substantiate the concern that changes in nutrition standards in schools lead to a loss in total revenue. An interesting phenomenon of increased participation in the National School Lunch Program was noted in a number of reports and might play a role in buffering financial losses. A renewed focus on school policies related to health provides the opportunity for researchers to investigate how nutrition-related policy change can affect, if at all, food service and overall school revenues.
  Journal of School Health 06/2008; 78(5):245-51.
• Article: Black, Hispanic, and white girls' perceptions of environmental and social support and enjoyment of physical activity.

  Mira Grieser, Dianne Neumark-Sztainer, Brit I Saksvig, Jung-Sun Lee, Gwen M Felton, Martha Y Kubik
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  ABSTRACT: This study examines the differences among black, Hispanic, and white adolescent girls in their perceptions surrounding physical activity (PA), including support within the school climate, friend and family social support, and personal enjoyment. Participants included 1466 sixth-grade girls from 36 middle schools across the United States. Participants were 20% black, 21% Hispanic, 47% white, and 12% of other or mixed races. Multivariate analyses were performed on each scale, adjusting for body mass index and free and reduced-price lunch status. Results showed racial differences on several variables. Black girls, compared with white girls, perceived significantly lower PA enjoyment (p<.001) and teacher support for PA (p=.004). Hispanic girls experienced less PA enjoyment (p=.003) and perceived less support for PA from boys (p=.001) and their families (p=.008) than white girls. Black girls reported significantly higher levels of physical education (PE) enjoyment than did white girls (p=.003). Differences in perceived PA support and enjoyment across race raise questions about why these differences exist and how best to address disparities within interventions.
  Journal of School Health 06/2008; 78(6):314-20.
• Article: Adolescents' sexually transmitted disease protective attitudes predict sexually transmitted disease acquisition in early adulthood.

  Richard A Crosby, Fred Danner
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  ABSTRACT: Estimates suggest that about 48% of nearly 19 million cases of sexually transmitted diseases (STDs) occurring annually in the United States are acquired by persons aged 15-24 years. The purpose of this study was to test the hypothesis that adolescents' attitudes about protecting themselves from STDs predict their laboratory-confirmed prevalence of STDs in early adulthood. Wave 3 of the National Longitudinal Study of Adolescent Health assessed Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. This wave 3 data were regressed on data collected in wave 1 (when those followed were teens). A single-item measure (with a 5-point response option) assessed adolescents' attitude: "It would be a big hassle to do the things necessary to completely protect yourself from getting an STD." Valid urine specimens were provided by 8297 adolescents who also completed the self-reported measures needed for this study. Overall, 6.4% of the weighted sample tested positive for at least 1 of the 3 STDs. Controlling for age, gender, minority status, and age of sexual debut (all of which are well-established predictors of STD prevalence), attitude toward STD protection achieved significance (P<.001). Each additional point on the 5-point scale increased adolescents' odds of testing positive for an STD in early adulthood by about 13%. Of interest, the attitudinal measure did not interact with any of the other variables. Findings provide evidence suggesting that safer sex programs may benefit adolescents by fostering positive attitudes toward practices that avert STD acquisition.
  Journal of School Health 06/2008; 78(6):310-3.
• Article: Psychometric evaluation of the child-adolescent teasing scale.

  Judith A Vessey, June A Horowitz, Karen L Carlson, Mary Duffy
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  ABSTRACT: This article presents the psychometric evaluation of the Child-Adolescent Teasing Scale (CATS), an instrument to be used as a screening measure with middle school students. A 70-item scale was initially derived from qualitative data obtained from focus groups comprised of middle school students. A diverse sample of participants (N=764) then completed the CATS and the Piers-Harris Children's Self-Concept Scale (PHCSCS); their mothers completed the Pediatric Symptom Checklist (PSC) and a demographic information form. A psychometric sample (N=666) without missing data was used for subsequent analyses. Principal components analysis resulted in a 32-item, 4-factor solution: Personality & Behavior Teasing (14 items), Family & Environment Teasing (7 items), School-Related Teasing (9 items), and Teasing About My Body (2 items). The standardized Cronbach's alpha for the final version was .94 and ranged from .83 to .90 for the subscales. The CATS's content validity, initially ascertained a priori by experts, was re-reviewed upon the instrument's refinement and supported. One-tailed t tests of mean differences between low- and high-scoring CATS groups on the PSC (t=-3.41, p<.03) and the PHCSCS (t=-11.39, p<.001) and supported the CATS's criterion-related validity. The 4-factor, 32-item CATS is psychometrically defensible and has demonstrated potential as a screening measure to identify students who are at risk from distressing teasing.
  Journal of School Health 06/2008; 78(6):344-50.
• Article: Childhood obesity in a South Florida elementary school.

  John E Lewis, Charlie Filpes
  Journal of School Health 06/2008; 78(5):243-4.
• Article: Relationship between physical disabilities or long-term health problems and health risk behaviors or conditions among US high school students.

  Sherry Everett Jones, Donald J Lollar
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  ABSTRACT: This study explores the relationship between self-reported physical disabilities or long-term health problems and health risk behaviors or adverse health conditions (self-reported engagement in violent behaviors, attempted suicide, cigarette smoking, alcohol and other drug use, sexual activity, physical activity, dietary behaviors, self-reported overweight [based on height and weight], physical health, and mental health) among US high school students. Data were from the Centers for Disease Control and Prevention's 2005 national Youth Risk Behavior Survey, a cross-sectional paper-and-pencil survey collected from a representative sample of public and private high school students (grades 9 through 12) in the United States. Significantly more students with physical disabilities or long-term health problems than without described their health as fair or poor and reported being in a physical fight, being forced to have sexual intercourse, feeling sad or hopeless, seriously considering and attempting suicide, cigarette smoking, using alcohol and marijuana, engaging in sexual activity, using computers 3 or more hours per day, and being overweight (for all, p < or = .05). For none of the health risk behaviors analyzed were the rates significantly lower among students with physical disabilities or long-term health problems than among other students. Young people who live with physical disabilities or long-term health problems may be at greater risk for poor health outcomes. Public health and school health programs, with guidance from health care providers, need to work with these adolescents and their families to develop and implement appropriate interventions, with particular emphasis on promoting mental health.
  Journal of School Health 06/2008; 78(5):252-7; quiz 298-9.
• Article: The lack of motor vehicle occupant restraint use in children arriving at school.

  Kathryn D Emery, S Glenn Faries
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  ABSTRACT: Motor vehicle crashes are the leading cause of mortality for children aged 4-14 in the United States. Many children are driven daily to school, increasing their exposure to potential injury, especially if they are not appropriately restrained. Observing the level of motor vehicle occupant restraint (MVOR) use upon school arrival could lead to valuable information for the development of an injury prevention program targeted to this population. This study compares the rate of MVOR use upon arrival to elementary schools with that at regional intersections. One hundred thirty-five census tracts in the Denver, Colorado, area were identified and combined into 5 regions. Within each region, 1 controlled intersection and 1 elementary school were observed. Observations were conducted for 1 hour at each of these locations. At intersections, 618 children in private vehicles were observed. MVOR use rate was 71.2% (440/618). At schools, 665 children in private vehicles were observed. MVOR use was 24.8% (165/665). Children arriving at school were less likely to be restrained than those observed at intersections (relative risk: 0.35, 95% CI: 0.30-0.40). Children at elementary schools showed substantially lower MVOR use rates than those observed at controlled intersections. Further investigation is imperative to determine the reason behind the low use of MVOR in children being transported to school. Based on the reasons elicited, interventions emphasizing the importance of always using MVOR can be developed and tailored to meet the educational needs of parents transporting their children to school in private vehicles.
  Journal of School Health 06/2008; 78(5):274-9.
• Article: Physical activity behaviors and emotional self-efficacy: is there a relationship for adolescents?

  Robert F Valois, M Renée Umstattd, Keith J Zullig, Raheem J Paxton
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  ABSTRACT: This study explored relationships between physical activity (PA) behaviors and emotional self-efficacy (ESE) in a statewide sample of public high school adolescents in South Carolina (n=3836). The Center for Disease Control Youth Risk Behavior Survey PA items and an adolescent ESE scale were used. Logistic regression analyses and multivariate models constructed separately, revealed significant race by gender findings. Results suggest that reduced vigorous PA (past 7 days), moderate PA (past 7 days), strengthening/toning exercises (past 7 days), and playing on sport teams (past 12 months) were associated (p<or=.05) with reduced ESE for specific race/gender groups. Results have implications for school- and community-based mental health services and PA programs for adolescents. Measures of ESE as a component of comprehensive assessments of adolescent mental health and PA behaviors in fieldwork, research, and program-evaluation efforts should be considered.
  Journal of School Health 06/2008; 78(6):321-7.
• Article: The varied circumstances prompting requests for emergency contraception at school-based clinics.

  Abbey Sidebottom, Patricia A Harrison, Amidon Donna, Katie Finnegan
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  ABSTRACT: Little is known about the circumstances that prompt teenagers to request emergency contraception (EC). This evaluation was designed to refine the EC clinical protocol and improve pregnancy prevention efforts in high school-based clinics by analyzing information on EC use and subsequent contraception use of EC patients. Sites included 5 clinics located at mainstream, racially diverse, and urban high schools. Nursing staff documented all EC-related visits during the 2002-2003 school year on a standardized form. These forms and additional information were collected from chart reviews. EC was requested in 113 instances involving 91 students and dispensed in all but 4 instances. The most frequently reported circumstance prompting an EC request was the use of no protection (37.2%), followed by a condom mishap (27.4%) and questionable protection from a hormonal method (23.9%). Anxiety despite adequate protection from a hormonal method (9.7%) or a condom (1.8%) accounted for the remaining cases. Although the clinical protocol included a follow-up appointment 2 weeks after receipt of EC, 39.5% of EC users failed to keep this appointment. The chart review revealed that hormonal contraception was eventually initiated following two thirds (68.0%) of the EC instances that involved either no protection or only a condom. Because young EC seekers vary considerably in terms of sexual experience, contraceptive use consistency, and pregnancy risk, individualized risk assessment and counseling are essential. The EC visit may be an optimal time to encourage initiation or reinstitution of hormonal methods of birth control.
  Journal of School Health 06/2008; 78(5):258-63.
• Article: An outbreak of itching in an elementary school-a case of mass psychogenic response.

  Heather Halvorson, Janet Crooks, Daniel A Lahart, Katherine P Farrell
  Journal of School Health 06/2008; 78(5):294-7.