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Journal: The Journal of school nursing : the official publication of the National Association of School Nurses

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This mixed-methods community-based participatory pilot study examined the feasibility and preliminary efficacy of group obesity management visits offered through school-based health centers. The study was implemented through an academic-community partnership in three school health centers serving primarily Latinx and African American youth. Participants ( n = 71) completed pre- and post-surveys about intention to change diet and exercise habits, knowledge and self-efficacy related to healthy eating, and social support. Focus groups were conducted after the intervention and 18 months later. Group visits were feasible and highly valued by study participants. Quantitative results showed a significant decrease in soda consumption, increased support from classmates, and an increased number of exercise days. In focus groups, youth endorsed cooking, tasting, and shopping activities, noted the importance of family involvement in behavior change, and stated that stress reduction mindfulness exercises helped to change eating habits. Implications for school-based health care and school nursing are discussed.

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Stakeholders often misunderstand the role of the school nurse resulting in underutilization or elimination of school nurse positions. Social media and school nurse websites are recommended to increase school nurse visibility and change the public narrative of school nursing.

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This study purpose was to investigate sex differences in multilevel factors associated with smoking experimentation and age of initiation among Korean adolescents. Based on the ecological model, this cross-sectional study used data from the 2016 Korea Youth Risk Behavior Web-Based Survey ( N = 65,528). Among 33,803 males (51.6%) and 31,725 females (48.4%), a greater proportion of males (21.9%) than females (7.1%) engaged in smoking experimentation. Males started smoking earlier than females (males: 12.7 years, females: 12.9 years, respectively, p < .05). In both sex groups, common factors associated with smoking were age, depression, suicidal ideation, academic achievement, household economic status, and having friends smoking and a specific person to talk with about their personal concern (all p values <.05). There were significant sex differences in psychological, family, and school factors of smoking initiation and experimentation. It is necessary to develop smoking interventions considering both individual and environmental factors with sex-specific strategies.

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This cross-sectional study examined the mediating role of three reasoned action approach (RAA) constructs-attitudes, perceived social pressure, and perceived behavioral control-on the relationship between peer networks and intention to consume unhealthy food. The authors examined self-reported data of a sample of 277 adolescents from public and private schools in Lima, Peru. Results revealed a total mediating effect of the reasoned action constructs; yet attitudes and perceived behavioral control, but not perceived social pressure (injunctive and descriptive norms), mediated the relationship between peer network and intention to consume unhealthy food. Explanations for these results are discussed in light of social cognitive theory and Ajzen and Fishbein’s postulates about specific attitudes. Finally, we discuss how school nurses can take advantage of RAA variables to influence food environments, use peer networks for reducing unhealthy food consumption, and organize workshops to inform parents about the mechanisms that promote junk food intake.

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Recurrent pain and school failures are common problems in children visiting the school nurses office. The overall aim of the current study was to investigate the relationship between recurrent pain and academic achievement in school-aged children. Literature was searched in seven electronic databases and in relevant bibliographies. Study selection, data extraction, and study and evidence quality assessments were performed systematically with standardized tools. Twenty-one studies met the inclusion criteria and 13 verified an association between recurrent pain (headache, stomachache, and musculoskeletal pain) and negative academic achievement. Two longitudinal studies indicated a likely causal effect of pain on academic achievement. All studies had substantial methodological drawbacks and the overall quality of the evidence for the identified associations was low. Thus, children’s lack of success in school may be partly attributed to recurrent pain problems. However, more high-quality studies are needed, including on the direction of the association and its moderators and mediators.

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Research supports recess, however, playground injuries are prevalent with more than 200,000 cases per year requiring medical attention. School playgrounds are among the leading location for injury. The purpose was to identify the safety and risk factors of playground environments and impact attenuation characteristics of surfacing materials. Results demonstrated 46% playground spaces protected students from traffic. Results found 75% of playgrounds were exposed to full sun, and unitary surface materials were up to 49°F warmer than the air temperature. There was an increase in the probability of risk whether equipment height was over 9 ft for loose fill surfacing materials or over 6 ft for unitary surfaces. Loose strings or ropes looped over equipment were found on 23% of playgrounds. This study provides discussion and data pertaining to numerous aspects of playground safety. Strategies for school nurses are shared to shape policies and education for playground safety practices.

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The empirical evidence from previous studies has demonstrated that school nurses are effective in assisting children and families to address health concerns, reduce absenteeism, and provide children with the opportunity to reach their potential academically. Impoverished children and those with disabilities and chronic illness are at risk of school failure. An integrative review was undertaken to critique the research between 2002 and 2018 that addressed the influence of school nurses on academic outcomes such as absenteeism, missed class time, grades, and test scores. The findings of the review suggest that the presence of a school nurse is associated with reduced absenteeism and missed class time but not with academic achievement. Overall, the research in this area is weak and future research using more rigorous study designs, examining broader school nurse roles, and long-term academic outcomes is indicated to evaluate the impact of school nurses on educational outcomes.

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To assess the prevalence of weight misperception in American adolescents and its association with diet and physical activity behaviors, Youth Risk Behavior Survey data were utilized for this study. Based on reported and perceived weight, adolescents in the study were grouped into four categories (true negative [52.4%] = normal body mass index [BMI]/accurate weight perception; false negative [11.3%] = high BMI/weight misperception; false positive [11.6%] = normal BMI/weight misperception; and true positive [24.8%] = high BMI/accurate weight perception). Diet and physical activity of adolescents were compared in these categories. A total of 12,016 participants were included in our analysis (74.9% aged 15-17 years, 54.5% Whites, 52% females). Almost a third (31.8%) were overweight and obese, and more than a fifth (22.9%) misperceived their weight (11.6% overestimated and 11.3% underestimated their weight). In a gender-stratified analysis, the odds of avoiding a healthy diet and physical inactivity were higher among those with body weight misperception.

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Bullying has been linked to adolescent suicidal behavior. With dramatic increases in social media use among youth, understanding the influence of cyberbullying on adolescent suicidal behavior has become central to prevention efforts. This study examined the potential protective role of school connectedness in the relationship between cyberbullying and suicide risk behavior. Data were from 93 adolescents participating in a longitudinal study of an intervention to prevent health-risk behavior including suicidal behavior. Hierarchical logistic regression was used to examine the influence of cyberbullying and school connectedness on adolescent suicidal behavior. Findings indicated that being a victim of cyberbullying, but not a perpetrator, was associated with increased risk of suicide and that connections to school moderated this relationship in that, among youth who were victims of cyberbullying, those more connected to school were less likely to report suicidal behavior. Implications for school-based suicide prevention and school nurse practice are discussed.

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School nurses often play large roles in implementation of school vaccination requirements aimed at controlling the spread of communicable disease. We analyzed the association between the presence of a school nurse and school-level vaccination rates in Arizona. Using school-level data from Arizona sixth-grade schools ( n = 749), we regressed average sixth-grade school-level immunization rates on presence of a school nurse (registered nurse [RN] or licensed practical nurse [LPN]) and school-level socioeconomic status (SES), controlling for other school- and district-level characteristics. Schools with a nurse had higher overall vaccination rates than those without a nurse (96.1% vs. 95.0%, p < .01). For schools in the lowest SES quartile, the presence of a school nurse was associated with approximately 2 percentage point higher immunization rates. These findings add to the growing literature that defines the impact of school nurses on student health status and outcomes, emphasizing the value of school nurses, especially in lower SES schools.