Perceived Role of the School Nurse in Providing Pertinent COVID-19 Information to the School Community: Experiences of Public Health Graduate Students With School-Aged Children.

The COVID-19 pandemic has been a major disruptor to school systems across the United States since March 2020. As a result, school nurses have had to adapt to these uncertain times. Previous research has demonstrated the impact of school nurses on student health; however, less is known about their role in educating the broader school community about COVID-19 prevention. In Spring 2022, four focus groups were conducted with public health graduate students with school-aged children, to assess perceptions of COVID-19 and public health emergency preparedness communication. MAXQDA was used for thematic analysis. School nurses were viewed as a credible source of COVID-19 information, especially for those who do not have access to healthcare services. While the primary role of school nurses is to provide health services to students, they also have the capacity to provide the community with vital public health emergency preparedness information.

The Relationship of School Connectedness to Adolescents' Engagement in Co-Occurring Health Risks: A Meta-Analytic Review.

School connectedness is an important factor in the lives of youth and are a leverage point for optimizing youth's social, emotional, and physical health. This study presents a meta-analysis examining the relationship between school connectedness and four health domains that are prevalent in adolescence, have implications for adult health, and often co-occur: mental health, sexual health, violence, and high-risk substance use. Ninety articles published between 2009 and 2019 were included in the analysis. The study found that school connectedness had a protective average effect size across all health domains (Hedges' g = -0.345, p-value<0.001). When examined separately, school connectedness had a significant protective relationship with substance use (g = -0.379, p < 0.001), mental health (Hedges' g = -0.358, p < 0.001), violence (Hedges' g = -0.318, p < 0.001), sexual health (Hedges' g = -0.145, p < 0.001), and with co-occurring risks (Hedges' g = -0.331, p < 0.001). These results provide strong evidence that school connectedness has the potential to prevent and mitigate multiple health risks during adolescence.

Student-Reported School Safety Perceptions, Connectedness, and Absenteeism Following a Multiple-Fatality School Shooting - Broward County, Florida, February 14-21, 2018.

From July 2009 to June 2018, the rates of multiple-victim, school-associated homicides in the United States fluctuated substantially, with evidence of a significant increase in recent years (1). Data on the effects of such incidents on students' school attendance and perceptions of safety and connectedness are limited (2,3) but important. This study used data from a neighboring within-district school before and after a multiple-fatality shooting at Marjory Stoneman Douglas High School in Parkland, Florida, on February 14, 2018. Self-administered questionnaires were completed by one group of students on February 14 just before the shooting (575) and another group during February 15-21 (502); demographics for these groups appeared similar. Linear and logistic regression analyses controlling for demographic characteristics explored differences between groups for safety-related perceptions or experiences, school connectedness, and absenteeism. Compared with students surveyed before the shooting, students surveyed in the days immediately following the shooting had lower odds of feeling safe at school, higher odds of absenteeism, and higher school connectedness scores. Findings suggest the shooting had an immediate, sizeable effect on safety perceptions and absenteeism among students in a neighboring school. Findings also suggest higher school connectedness following the shooting. Further study of school connectedness, including how to enhance and sustain it, might help schools and communities better respond to traumatic events in the community.

School district-provided supports to enhance sexual health education among middle and high school health education teachers.

Schools support teachers in their professional learning, just as teachers support students in their learning. To accomplish this, schools can provide support systems that enhance teachers' knowledge, comfort, and instructional skills. This study examined the impact of two district-provided supports (curriculum and professional development) on sexual health instruction among middle and high school health education teachers. Data were abstracted and analyzed using inductive coding from 24 teacher interviews (2015-2016). Findings illustrate outcomes from both curriculum and PD on teachers' self-reported knowledge, comfort, and skills. The district-provided supports appeared to contribute to improved teachers' self-efficacy in delivering sexual health education.

Sex Differences in School Safety and Bullying Experiences Among Sexual Minority Youth.

Schools play an integral role in creating safe, supportive environments for students, especially for sexual minority youth (SMY). Using 2016 questionnaire data from seven high schools in a Florida school district, we obtained a sample of 1,364 SMY. Logistic regressions controlling for sex (as applicable), age, grade, race/ethnicity, and school explored differences between SMY and nonsexual minority youth (non-SMY). Sex differences related to school environment perceptions and experiences related to safety, bullying, and hearing homophobic remarks were also explored. SMY were more likely than non-SMY to report several negative school environment perceptions and experiences. Where differences existed within SMY, male SMY were more likely than female SMY to have missed school in the past 30 days (odds ratio [ OR] = 1.66, p = .03), report avoiding spaces at school due to safety concerns ( OR = 1.38, p = .02), and report hearing homophobic remarks from teachers ( OR = 2.00, p = .01). Implications for school nursing are discussed.

Local-Community Interests and South Carolinian Newspapers' Coverage of Smoke-Free Policies.

In this quantitative content analysis, we assess how smoke-free policies are presented in South Carolinian newspapers. In particular, this study examines the extent to which newspapers' coverage of smoke free-policies has represented the interests of their local communities. We compare newspapers in the communities whose economy relies heavily on the tourism and hospitality industry (The Post & Courier in Charleston and The Sun News in Myrtle Beach) and newspapers elsewhere (The State in Columbia and The Greenville News in Greenville), and see whether there are meaningful differences between the newspapers in the way they portray smoke-free policies, particularly in terms of their selective uses of news sources and key arguments. Our findings indicate that South Carolinian newspapers portrayed smoke-free policies largely as a political issue. Many political reasons to either support or oppose the policies were found in almost two out of three articles. We also found that The Post & Courier and The Sun News were more likely than The State and The Greenville News to make arguments against smoke-free policies, and this was particularly so when they were talking about economic impacts of the policies. Public health and media advocacy implications are discussed in detail.

Schools.

Sexual and gender minority (SGM) youth are at disproportionate risk for HIV. Schools play an integral role in educating young people about sexual health in addition to providing sexual health services. This qualitative study examined SGM youths' perception of school sexual health education and services. A total of 42 self-identified African American SGM males participated in focus groups or in an in-depth interview. Qualitative findings revealed that schools are missing the opportunity to educate SGM youth about sexual health. Youth participants noted several barriers to accessing sexual health education and services at schools including limited, targeted health information and school nurses not being knowledgeable of health issues that impact SGM youth. Participants noted that school sexual health services are not adequately marketed to students and sometimes do not include testing for HIV and other sexually transmitted diseases. Suggestions for future research and implications for school nurses and sexual health services are discussed.

The Importance of School Staff Referrals and Follow-Up in Connecting High School Students to HIV and STD Testing.

This study examined predictors of having received HIV and sexually transmitted disease (STD) testing and having been referred by school staff for HIV/STD testing. In 2014, students in seven high schools completed paper-and-pencil questionnaires assessing demographic characteristics, sexual behavior, referrals for HIV/STD testing, and HIV/STD testing. The analytic sample ( n = 11,303) was 50.7% female, 40.7% Hispanic/Latino, 34.7% Black/African American (non-Hispanic), and mean age was 15.86 ( SD = 1.22). After controlling for demographic characteristics, significant predictors of reporting having been tested for HIV or STDs were reporting having received a referral for HIV/STD testing (odds ratio [ OR] = 3.18; 95% CI = [2.14, 4.70]) and reporting staff following-up on the referral ( OR = 3.29; 95% CI = [1.31, 8.23]). Students reporting referrals had significantly higher odds of being male ( OR = 2.49; 95% CI = [1.70, 3.65]), "other" or multiracial (non-Hispanic; compared to White, non-Hispanic; OR = 2.72; 95% CI = [1.35, 5.46]), sexual minority ( OR = 3.80; 95% CI = [2.57, 5.62]), and sexually experienced ( OR = 2.58; 95% CI = [1.76, 3.795]). School staff referrals with follow-up may increase HIV/STD testing among students.

HIV information needs of parents of young men who have sex with men.

OBJECTIVE: Young men who have sex with men (YMSM) have unique health concerns, including high rates of HIV infection. To prevent HIV, YMSM need credible information from trusted sources, specifically parents. Little is known about what health information resources parents of YMSM need to communicate with their child about HIV prevention. The primary objective of this study was to examine the proxy health information seeking behaviours of parents of YMSM and to identify information resources that parents need to communicate with their YMSM identified child about HIV prevention. METHODS: Qualitative findings were grouped into four categories: parents' current health information sources; barriers to seeking health information; parents' health information needs; and recommendations for delivery of health information for parents. Ten in-depth interviews were conducted with parents of YMSM. RESULTS: Parents reported consulting physicians and the Internet for HIV/AIDS information. They reported finding limited information targeted towards parents of YMSM and provided suggestions for improving the delivery of health information including training, websites and the local news. CONCLUSIONS: Delivery of tailored HIV prevention information to parents may be effective in helping combat HIV among YMSM. Given that YMSM bear the greatest burden for HIV, this study highlights the need to include parents of YMSM in future interventions aimed at reducing YMSM's risk of HIV/AIDS.

Health journalists' perceptions of their communities and implications for the delivery of health information in the news.

Journalists have a unique opportunity to educate the community about public health and health care. In order for health communication messages to be effective, characteristics of the intended audience must be considered. Limited attention has been given to health journalists' perceptions of their target communities and little is known about how journalists' perceptions may impact the delivery of health information in the news. Fifteen in-depth telephone interviews were conducted with health journalists from varying geographic regions and media market sizes. Interview questions examined health journalists' perceptions of their target communities, the content and delivery of their health-related stories, and the current state of health journalism. Interviews were audio-recorded for transcription and thematic analysis. Health journalists perceived their audiences to be primarily mothers and adults with limited education. Participants reported they often used personal stories and strong headlines to engage their communities. They also stated that their news stories were quite technical and may not have been written at an appropriate reading level for their audience. When asked about the current state of health journalism, participants reported that there were areas for improvement. Journalists stated that increased collaborations with public health practitioners would improve their own understanding of health and medical information and allow them to develop health news content that was more appropriate for their target communities.

Beliefs and communication practices regarding cognitive functioning among consumers and primary care providers in the United States, 2009.

INTRODUCTION: Limited research has examined primary care providers' communication with patients about maintaining cognitive functioning. Our study's objective was to compare the perceptions of consumers and primary care providers related to beliefs and communication practices about lifestyle behaviors beneficial for overall health and for maintaining cognitive functioning. METHODS: In 2009, we submitted 10 questions to Porter Novelli's HealthStyles survey and 6 questions to their DocStyles survey. We compared consumers' (n = 4,728) and providers' (n = 1,250) beliefs, practices, and information sources related to maintaining health and cognitive functioning. We made comparisons using nonparametric statistics. RESULTS: Approximately 76% of consumers considered their health to be good or very good; 73.4% were concerned or very concerned about the possibility that their memory may worsen with age. Women were significantly more concerned than men, and white consumers were more concerned than black and Hispanic consumers. Consumers reported they believed that intellectual stimulation (86.6%), physical activity (82.6%), and healthful diet (82.5%) prevented or delayed cognitive impairment. Providers reported advising patients to reduce cognitive impairment risk through physical activity (85.9%), intellectual stimulation (80.3%), and social involvement (67.4%). Few consumers (7.8%) reported receiving this information from providers but reported learning about strategies to maintain memory, primarily from television (50.1%), magazines (44.1%), and newspapers (33.7%). CONCLUSION: Providers reported advising patients about how to reduce risks of cognitive impairment. Consumers reported receiving this information from other sources. Findings suggest a need to examine and assess media messages and to better understand patient-provider communication about cognitive functioning.

Prostate cancer guidelines on Web 2.0-based sites: the screening dilemma continues online.

Little is known about prostate cancer (PrCA) screening information on participatory, interactive, and consumer-generated websites collectively referred to as Web 2.0. A content analysis was conducted of PrCA resources on four highly trafficked Web 2.0 social bookmarking sites. A total of 127 webpages were analyzed. Most content was from news websites (48.9%) and blogs (37.8%). PrCA screening was mentioned on 95.3% of pages; only 30.7% discussed the prostate-specific antigen test. Less than half (43.8%) mentioned current screening guidelines. PrCA content is inconsistent on Web 2.0 sites. Future research should assess the readability and usability of Web 2.0 cancer resources.

African American men's understanding and perceptions about prostate cancer: why multiple dimensions of health literacy are important in cancer communication.

Prostate cancer (PrCA) is the most diagnosed cancer among men in the United States, especially among African American (AA) men. The purpose of this formative study was to explore the implications of applying Nutbeam's multidimensional health literacy framework to AA men's understanding of PrCA information. Participants were 25 AA men aged 45 and older in South Carolina. Their functional health literacy was assessed using two modified Cloze tests and the Shortened Test of Functional Health Literacy in Adults (S-TOFHLA). Men also participated in interviews or focus groups during which they were asked questions about PrCA risk, prevention, and screening. Transcripts were reviewed for recurrent themes and analyzed qualitatively using NVivo7. Mean S-TOFHLA was 28.28 (+/-1.98), implying "adequate" comprehension. Mean Cloze was .71 (+/-.05) for a Grade 8 document and .66 (+/-.04) for a Grade 13 document, also showing "adequate" comprehension. Cloze scores for the Grade 8 resource were lower for participants with less education (P = .047). Despite having satisfactory literacy test scores, results from interviews and focus groups revealed participants' limited understanding and misconceptions about PrCA risk. Many wanted information about screening and family history delivered word-of-mouth by AA women and church pastors as few of them had ever received or actively sought out PrCA resources. Using Nutbeam's framework, gaps in health literacy which were not adequately captured by the validated tools emerged during the interviews and focus groups. Study findings provide important implications for PrCA communication with AA men to correct misperceptions about cancer risk and motivate preventive behaviors.

Prostate cancer communication strategies recommended by older African-American men in South Carolina: a qualitative analysis.

BACKGROUND: Mortality from prostate cancer (PrCA) in African-American (AA) men is significantly higher than in European-American (EA) men. METHODS: Purposive sampling identified 25 AA men >or=45 years for interviews/focus groups. Participants were asked about cancer information-seeking behaviors, capacity to use information, and recommendations for messages and message delivery. Transcripts were analyzed for themes about PrCA communication. RESULTS: Barriers to information seeking were fear, poor resources, and limited family communication. Participants requested messages stressing men's "ownership" of PrCA delivered "word-of-mouth" by clergymen, AA women, and AA PrCA survivors. CONCLUSIONS: Direct and timely messages about PrCA should be developed for AA men.

The Influence of Health Education Teacher Characteristics on Students' Health-Related Knowledge Gains.

BACKGROUND: Studies have examined relationships between teacher characteristics and student achievement in courses such as math and science. This study is among the first to examine effects of teacher characteristics on student knowledge in a health course. METHODS: Student (N = 6143) pretest and posttest data were linked to teacher (N = 67) data. Changes in student knowledge scores from pre- to postcourse were explored using mixed-effects linear models. Teacher characteristics included professional development (PD) attendance, having a dedicated classroom, certification type, educational background, years' experience, and athletic coaching status. RESULTS: Teacher characteristics associated with greater student knowledge gains included: being certified to teach health versus not certified (p < .001), having a dedicated classroom versus no classroom (p = .017), and for middle school teachers, having attended ≥3 PD sessions versus ≤2 (p = .023). Less knowledge gain was associated with teachers that coached versus noncoaches (p = .040) and having a health degree versus no health degree (p = .049). Post hoc analyses revealed the negative effect of health degree was only significant among coaches (p = .026). CONCLUSIONS: Findings suggest opportunities for maximizing student knowledge gains through tailored selection of health teachers and provision of appropriate teaching support.

How Is Literacy Being Defined and Measured in Dementia Research? A Scoping Review.

Literacy plays an important role in Alzheimer's disease and related dementias (ADRD); however, less is known about how literacy is being used and defined in ADRD studies. This study reviewed terminology being used to describe types and definitions of literacy and instruments used to assess literacy in ADRD research. Among the 219 studies retrieved from 3 databases, 50 met our inclusion criteria. Literacy terms used in ADRD studies varied: literacy (n = 28), health literacy (n = 9), and dementia literacy (n = 7) were the most often used terms, followed by financial literacy (n = 4), dementia knowledge (n = 3), AD knowledge (n = 2), mental health literacy (n = 2), AD literacy, digital literacy, health literacy about incontinence, and financial knowledge (n = 1 each). Thirty studies did not define literacy terms used. Among the 20 studies defining literacy, definitions were inconsistent across studies even when they used the same term. Surveys (n = 30), open-ended questions, vignettes, or focus groups (n = 10), self-perceived (n = 3) or interviewer assessed (n = 1) literacy levels were used to assess literacy. Ten studies did not specify literacy measurement. Various literacies have been examined in ADRD research with unclear definitions and some inadequate measures. Well-defined terms with valid measures are needed to better understand the role of literacies in ADRD research.

Key factors influencing comfort in delivering and receiving sexual health education: Middle school student and teacher perspectives.

Sexual health education (SHE) provides students with knowledge and skills to establish healthy relationships, understand sexual development, and prevent risk behaviors; therefore, it is critical to understand how to optimize the delivery and receipt of this education. Using a grounded theory approach, interviews with middle school health education teachers (n=13) and focus groups with students (n=41) were conducted to examine factors that influence perceived comfort delivering and receiving SHE in a public school district. Findings identified key barriers including disruptive behavior, insufficient time, and lack of dedicated classrooms. Some key facilitators to comfort included professional development and establishing ground rules.

What are older Latinos told about physical activity and cognition? A content analysis of a top-circulating magazine.

OBJECTIVES: Physical activity (PA) may reduce risk of developing Alzheimer's disease (AD). The objectives of this study were to: (a) Compare the content of English and Spanish PA-focused articles in American Association of Retired Persons (AARP) magazines; and (b) Determine whether these articles discuss PA as a potential correlate of AD. METHOD: AARP (English) and AARP Segunda Juventud (Spanish) magazines were assessed for PA coverage from 2009 to 2010. Articles were analyzed using nonparametric tests. RESULTS: A total of 63 articles discussed PA (48 English; 15 Spanish). In AARP English, 70.8% of articles discussed formal exercise, while 53.3% of Spanish articles discussed formal exercise. Only three English articles mentioned that PA has the potential to reduce risk of AD. No Spanish articles mentioned this association. DISCUSSION: Spanish content did not adequately present cognitive health information. Culturally appropriate media coverage is needed to inform diverse populations about cognitive health and risks of AD.