M. Di Toma, F. Buono, Nicola Rascio, C. Baiardi, E. Manca, Guido Fares, Ernesto Fascia, A. Campanozzi
{"title":"Reduction in Pediatric Emergency Department Admissions during Lockdown: Just Fear of COVID-19?","authors":"M. Di Toma, F. Buono, Nicola Rascio, C. Baiardi, E. Manca, Guido Fares, Ernesto Fascia, A. Campanozzi","doi":"10.14485/hbpr.8.6.7","DOIUrl":"https://doi.org/10.14485/hbpr.8.6.7","url":null,"abstract":"Objective: Italy was the first European nation to undergo a general lockdown as a means of containing the COVID-19 pandemic. In that period, a significant reduction in pediatric accesses to emergency rooms (ERs) was reported. In this study, we evaluated whether, in addition to the fear of infection, the reduced ER visits were also an indirect indicator of reduced incidence of common seasonal viruses. Methods: Sales data for pediatric formulations of antipyretics and probiotics from 27 pharmacies were evaluated, during March-May 2020, and compared to sales during the same period in 2019. Pediatric accesses in the emergency department (ED) also were evaluated. Results: The median number of antipyretics and probiotics sold per pharmacy was respectively 152 (IQR = 144) and 55 (IQR = 52) in 2019; during the same period of 2020 it was 77.5 (IQR = 60) (p < .001) and 27 (IQR = 44) (p < .05). In the March-May period of 2019, the number of pediatric accesses was 1004, whereas in the same period of 2020 it was 143, a reduction of 85.76% (p < .001). Conclusions: We found a statistically significant reduction in pediatric admissions to the ED during the lockdown, but that this reduction could largely be due to a reduction in seasonal viral disease as an effect of social distancing, mask use, and frequent hand-washing, as mandated by healthcare dispositions.","PeriodicalId":44486,"journal":{"name":"Health Behavior and Policy Review","volume":"1 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41368754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valerie Muehleman, Carey J. Fitzgerald, Shae Gantt, Brenda Hughes, Lydia Breland, Alan Warren, Swati Debroy
{"title":"Salad Bar Use among Middle School Children in a Socio-economically Disadvantaged Rural County","authors":"Valerie Muehleman, Carey J. Fitzgerald, Shae Gantt, Brenda Hughes, Lydia Breland, Alan Warren, Swati Debroy","doi":"10.14485/hbpr.8.6.11","DOIUrl":"https://doi.org/10.14485/hbpr.8.6.11","url":null,"abstract":"Objective: Our objective in this study was to inform policymakers if including a salad bar in school cafeterias in the district would serve all subgroups of students equally. Methods: A salad bar was implemented during the 2016-2017 academic year in a rural low-income county middle-school. Halfway through, a “healthy lifestyle” educational campaign was presented. Students’ gender, race, and body mass index (BMI) were recorded along with their choice of daily lunch item. Results: Overall, 528 middle schoolers participated in this program. Students opted to consume salad for approximately 5.73 days out of the 123 days that salad was served. The educational campaign had no effect on salad bar use. There was no gender difference in frequency of salad bar use. African- American students consumed significantly more salad than Hispanic students, and marginally more salad than white students. Students classified as normal weight (by BMI percentile) chose the salad bar option more frequently than obese students. Conclusions: Salad bar was the least popular food choice, and popularity of the salad bar decreased over time. The educational campaign designed to increase salad bar use had no effect. These results can help guide future interventions in low-income rural communities.","PeriodicalId":44486,"journal":{"name":"Health Behavior and Policy Review","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41486010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Keyondra Brooks, W. Rapp, Jennifer Ogleby, Mattherw Shepherd
{"title":"That Pop-Up Restaurant: Innovation in a Summer Feeding Program","authors":"Keyondra Brooks, W. Rapp, Jennifer Ogleby, Mattherw Shepherd","doi":"10.14485/hbpr.8.6.12","DOIUrl":"https://doi.org/10.14485/hbpr.8.6.12","url":null,"abstract":"Objective: That Pop-Up Restaurant Summer Food Service Program (SFSP) was a federally reimbursed program that first served healthy meals to families in a rural Kansas community during the summer of 2017. The program aimed to empower communities to address child hunger by reducing stigma concerning food assistance and providing high-quality, nutritious meals to families. This pilot was developed to increase low utilization rates of summer feeding programs. Methods: An ecological approach was implemented to engage students and families. Program innovations included an open menu ordering format with paid adult meals and proper food storage while maintaining USDA’s nutritional requirements. Additionally, the menu options exceeded fruit and vegetable requirements. Results: On average, 9.6% of youth who participated in the free and reduced-price lunch programs participated daily in summer nutrition during the 2016-2017 school year (FRAC, 2019). Comparatively, That Pop-Up Restaurant’s pilot had over 25% of eligible youth participate in the program one or more times. Conclusions: That Pop-Up Restaurant summer food service program showed promising results for the target population and program developers aim to replicate the program in various communities.","PeriodicalId":44486,"journal":{"name":"Health Behavior and Policy Review","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48739751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. An, Danyi Li, Marjorie Cole, Katherine Park, M. Ji, Aaron R Lyon, Neil White
{"title":"Barriers and Diabetes Care Quality in Public Schools in the United States","authors":"R. An, Danyi Li, Marjorie Cole, Katherine Park, M. Ji, Aaron R Lyon, Neil White","doi":"10.14485/hbpr.8.6.3","DOIUrl":"https://doi.org/10.14485/hbpr.8.6.3","url":null,"abstract":"Objective: In this study, we examined the influence of multi-level barriers on school diabetes care quality. Methods: We administered an online survey to nurses in Missouri K-12 schools (N = 245). We assessed 57 potential barriers in 5 domains (at individual, school, community, social/ cultural, and political/economic levels). We developed 38 criteria for care quality based on the National Institute of Diabetes and Digestive and Kidney Diseases’ school diabetes care guidelines. We carried out structural equation modeling to examine the effect of barriers on school diabetes care quality. Results: School nurses’ heavy workloads, teachers’/parents’ lack of training/knowledge on evidence-based practices, and lack of funding from government, districts, and schools serving disadvantaged or rural populations were among the key barriers to school diabetes care. Deficiencies in care quality were identified in areas including knowledge/training, communication, school policies, resources and environment, physical activity engagement among students with diabetes, school nurses’ diabetes management practices, and trained diabetes practitioners’ responsibilities. School diabetes care barriers, overall, were inversely associated with care quality; one standard deviation increase in the barriers was associated with a 0.163 (95% confidence interval = 0.002- 0.324) standard-deviation decrease in care quality. Conclusions: Multi-level policy interventions are called upon to address these barriers to improve care quality and ensure the healthy growth of students with diabetes.","PeriodicalId":44486,"journal":{"name":"Health Behavior and Policy Review","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44359508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perceived Barriers to and Recommendations for Cessation among Poly-tobacco-using Young Adults","authors":"Daisy Le, G. D’Souza, Rebkha Atnafou, M. Moran","doi":"10.14485/hbpr.8.6.1","DOIUrl":"https://doi.org/10.14485/hbpr.8.6.1","url":null,"abstract":"Objective: Young adult tobacco users are at an increased risk for using non-cigarette tobacco products and have high poly-use rates. We interviewed poly-tobacco-using young adults from an urban community to explore characteristics associated with their poly-tobacco use, perceived barriers to tobacco cessation, and recommendations for and interest in cessation programs. Methods: We conducted 17 focus group discussions with 97 poly-tobacco-using young adults. Interviews were analyzed using framework analysis and quantitative surveys were analyzed using descriptive statistics. Results: All participants reported a history of tobacco product poly-use, and 85% reported poly-use in the past 30 days. Study results indicate that this population faces multiple barriers to cessation (eg, influence of social network, easy access, anxiety management, belief in self-control, boredom), but that there is interest in utilizing mobile-based interventions and social media for cessation attempts, ultimately allowing them to manage cessation in their own time, and in a way that is more fitting with their lifestyle. Conclusions: To work toward eliminating tobacco-related cancer disparities, we must understand social and environmental factors that influence tobacco use among underserved populations so that primary prevention strategies to prevent smoking initiation may be implemented. Equally important are secondary prevention strategies that develop more targeted, effective smoking cessation interventions.","PeriodicalId":44486,"journal":{"name":"Health Behavior and Policy Review","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49185323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatemeh Bastami, F. Mostafavi, Arash Ardalan, Fereshteh Zamani-Alavijeh
{"title":"Development and Psychometric Assessment of Questionnaires for Evaluation of Social Support for Healthy Breakfast and Snack Consumption","authors":"Fatemeh Bastami, F. Mostafavi, Arash Ardalan, Fereshteh Zamani-Alavijeh","doi":"10.14485/hbpr.8.6.6","DOIUrl":"https://doi.org/10.14485/hbpr.8.6.6","url":null,"abstract":"Objective: Social support is one of the predictors of nutrition behaviors. Therefore, measuring and improving the level of support is necessary to improve students’ nutritional status. The purpose of this study was to design instruments and evaluate their psychometric properties for the evaluation of social support for breakfast and snack consumption. Methods: This methodological study was carried out from 2016 to 2018. The qualitative phase was performed in 3 Iranian cities: Isfahan, Khorramabad and Tehran. The quantitative phase was completed in Isfahan only. Initially, 2 questionnaires were developed using the results of the qualitative research. Subsequently, we assessed the face, content, and construct validity of both instruments. Results: The maternal support questionnaire consisted of 3 dimensions, including mother-sponsored support, family life pattern, and school-based collaboration, which explained 55.35% of the instrument’s variance. The school support questionnaire comprised 2 dimensions including informational support and instrumental support, which explained 54.52% of the variance in the results. Conclusions: These instruments can be used to measure and improve social support by designing, implementing, and evaluating community-based campaigns and interventions to improve breakfast consumption and snacking behaviors among children and youth at home and in school.","PeriodicalId":44486,"journal":{"name":"Health Behavior and Policy Review","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49600430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Teran, Julia Kononowicz, Stephanie Kuhlmann, Julian A. Dedeaux, K. Harris
{"title":"The Impact of COVID-19 on Pre-K-12 Students and Staff in a Mid-sized Metropolitan Area","authors":"P. Teran, Julia Kononowicz, Stephanie Kuhlmann, Julian A. Dedeaux, K. Harris","doi":"10.14485/hbpr.8.6.8","DOIUrl":"https://doi.org/10.14485/hbpr.8.6.8","url":null,"abstract":"Objective: During fall 2020, schools used a variety of learning modes based on anticipated risk of viral transmission within schools. Methods: De-identified SARS-CoV-2 data from 11 school districts in the Wichita, Kansas metropolitan area from August 1 to November 15, 2020, was collated for analysis. The Sedgwick County Health Department (SCHD) and Kansas Department of Health and Environment (KDHE) databases were accessed for community-level and contact tracing data. Results: Altogether, 13,573 staff and 54,479 students receiving full or partial on-site (hybrid) education were included. Few students (1.4%) or staff (4.7%) tested positive for SARSCoV- 2. District rates varied from 0.1% to 3.3% in students and 0.7% to 8.7% in staff. Students in grades 9-12 had a higher rate of positive tests and cases were more likely linked to school-based exposure. Staff rate by grade level did not show an identifiable trend; staff rates were higher in nonattendance centers. Conclusions: Low SARS-CoV-2 student case rates suggests on-site learning formats may be appropriate. School trends reflected community rate reinforcing that communitylevel interventions are necessary to decrease transmission. As new variants arise, transmission characteristics must be studied. Health and education partnership is important to ensure the greatest well-being for students and staff.","PeriodicalId":44486,"journal":{"name":"Health Behavior and Policy Review","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42309563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Geierstanger, Jordan Snyder, Hayley Love, Andrea Shore, J. Schlitt
{"title":"Hallways to Health: School Health Beyond School-Based Health Center Walls","authors":"S. Geierstanger, Jordan Snyder, Hayley Love, Andrea Shore, J. Schlitt","doi":"10.14485/hbpr.8.6.2","DOIUrl":"https://doi.org/10.14485/hbpr.8.6.2","url":null,"abstract":"Objective: In this paper, we describe the implementation and outcomes of an initiative that engaged school-based health centers (SBHCs) in a learning community to create programmatic and policy school health changes beyond the health center walls. Methods: Sixty respondents completed impact surveys and 13 coalitions completed progress reports to document schoolwide wellness efforts and outcomes in stakeholder engagement, student healthy eating and active living, student social and emotional wellness, and school staff wellness. Results: Respondents reported pre- to post-intervention improvements in stakeholder engagement, including school administration promotion of school health policies (from 64% to 95%), and teacher participation in SBHC sponsored activities (from 63% to 98%). They reported schoolwide policy and programmatic achievements including increased opportunities for physical activity for students during school hours (from 55% to 85%), access to behavioral health counseling and support services to all students, either on-site or through referrals (from 62% to 89%), and offering healthy food or nutrition education to staff (from 10% to 73%). Conclusions: SBHC staff, school employees, and community members can work collaboratively to assess student physical and mental health needs, and develop and implement school policies and programs beyond the clinic walls.","PeriodicalId":44486,"journal":{"name":"Health Behavior and Policy Review","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48953832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel Nelson, Kathleen J. Porter, Kelly Shomo, S. Curwood, S. Misyak
{"title":"A Content Analysis of Implementation Strategies Chosen by Virginia School Nutrition Directors","authors":"Rachel Nelson, Kathleen J. Porter, Kelly Shomo, S. Curwood, S. Misyak","doi":"10.14485/hbpr.8.6.9","DOIUrl":"https://doi.org/10.14485/hbpr.8.6.9","url":null,"abstract":"Objective: School-based interventions are common approaches to address childhood obesity; however, there is little understanding of strategies that can foster their implementation into schools. In this study, we aimed to identify goals and the specific strategies selected by school nutrition directors (SNDs) in Virginia to execute school-based interventions. Methods: Between 2018 and 2019, SNDs in Virginia participated in Team Nutrition workshops through which they created action plans. We carried out a content analysis of 132 action plans collected from 100 school divisions. We developed codes deductively and inductively. The codes captured plan completion, goals, and strategies. Each plan was independently coded by 2 coders. Results: Action plans included 1.2 goals (SD = 0.54) and 3.9 strategies per goal (SD = 2.1). Goals were most commonly related to improving menus or increasing participation in the school meal programs. The strategies varied based on the goals. However, obtaining buy-in from school personnel and students was the most commonly included goal (64.4%) across plans. The level of action plan completion decreased with each subsequent section of the worksheet. Conclusions: Emerging patterns identified in this study suggest SNDs’ strategy selection is based on goals and that trainings should be tailored to promote the development of skills required to execute optimal strategies.","PeriodicalId":44486,"journal":{"name":"Health Behavior and Policy Review","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49229034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effective Elements of School-based Provision for the Promotion of Healthy Lifestyles: A European Delphi Study","authors":"R. Bailey, I. Glibo, C. Scheuer","doi":"10.14485/hbpr.8.6.5","DOIUrl":"https://doi.org/10.14485/hbpr.8.6.5","url":null,"abstract":"Objective: Schools can serve as settings for promoting their student health, although it is necessary to identify the key elements of provision to leverage change. This study’s objective was to develop a Europe-based list of the elements of learning and health support systems judged by a group of experts to be most effective in influencing school student healthy lifestyles education. Methods: A 3-stage Delphi study involving a group of 18 Europe-based subject specialists was used to articulate shared expert opinions on the main research question: what are the most effective elements of learning and health support systems influencing school students’ healthy lifestyles education? Over 3 rounds of data-gathering, experts were asked to assess the effectiveness of 25 specific elements. Results: The 3 rounds resulted in the following ranked list: Physical Education (PE), Staff Professional Development, Healthy School Policies, Active Recess, Family & Community Engagement, Healthy Eating, Physical Activity in Classroom Lessons, and Active Transport. Conclusions: Cautious of overly generalizing from the results, we suggest the findings offer useful information for evidence-based programs, as well as future research that explores the necessary components of health promotion in schools.","PeriodicalId":44486,"journal":{"name":"Health Behavior and Policy Review","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46030426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}