Journal of School Health最新文献

{"title":"A Call for States to Level the Playing Field in School Recess","authors":"William V. Massey, Catherine L. Ramstetter, Julie McCleery, Reegan von Wildenradt","doi":"10.1111/josh.70032","DOIUrl":"10.1111/josh.70032","url":null,"abstract":"","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 8","pages":"668-671"},"PeriodicalIF":1.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Appearance Matter? Students' Perceived Body Size, Physical Appearance, and Attraction to Physical Activity at Recess","authors":"Danielle J. Belcher,&nbsp;Megan B. Stellino,&nbsp;Dannon Cox,&nbsp;William V. Massey","doi":"10.1111/josh.70035","DOIUrl":"10.1111/josh.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Various psychosocial variables are critical predictors of students' recess experiences. It is still relatively unknown how self-perceptions of bullying and body size impact recess physical activity (PA) for certain groups of students. The purpose of this study was to examine group differences and relationships in levels of appearance-related victimization, physical self-perceptions, and attraction to PA at recess among various self-identified body-size and gender identity students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Students in 3rd—5th grades (<i>N</i> = 787, 49.3% male, 56.1% regular body size, 46.4% 4th grade, 27.3% Hispanic) completed surveys that included demographics, one self-reported body size question, perceived victimization scale, physical appearance subscale of the Self-Perception Profile for Children, and the Children's Attraction to Physical Activity (CAPA) scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Group difference analyses showed that gender nonconforming (<i>p</i> = 0.030, <i>p</i> &lt; 0.001) and smaller body size students (<i>p</i> &lt; 0.001, <i>p</i> = 0.001) had significantly lower perceptions of physical appearance and attraction to physical activity compared to their peers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Students' gender identity and perceived body size are a meaningful focus of recess interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings provide evidence that in addition to physical appearance perceptions, body size and gender may diminish students' attraction to PA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 8","pages":"631-638"},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Adult Support in Mitigating Students' Feelings of Unwelcomeness at Recess*","authors":"Jim P. Arnold,&nbsp;Megan B. Stellino,&nbsp;Nazlı Özkoca,&nbsp;Danielle J. Belcher,&nbsp;William V. Massey","doi":"10.1111/josh.70029","DOIUrl":"10.1111/josh.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Researchers have documented that recess quality is critical to understanding outcomes, with supportive adults and positive peer interactions being critical components. The purpose of this study was to examine the experiences of students feeling unwelcome or uncomfortable during recess and to examine how perceptions of adult support impact those experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 483 elementary school students were surveyed at four time points across one school year. Students reported feelings of being unwelcome or uncomfortable at recess and their perceptions of adult support. Data were analyzed using descriptive statistics and longitudinal binary logistic regression to identify trends, demographic predictors, and the role of adult support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The percentage of students who reported feeling unwelcome or uncomfortable at recess decreased from 47.7% to 34.6%. Students who reported increased perceptions of adult support across the school year were 76.3% less likely to report feeling unwelcome or uncomfortable at the end of the year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Schools should adopt policies and programs that prioritize intentional adult participation to foster inclusivity and improve recess quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adult support plays a vital role in creating high-quality recess environments, including reducing students' feelings of being unwelcome or uncomfortable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 8","pages":"604-611"},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“It's a Fine Line”: Parent and Educator Perceptions on the Effects of Adolescent Digital Media Use on Mental Health","authors":"Adam M. McCready,&nbsp;Katherine C. Rohn","doi":"10.1111/josh.70028","DOIUrl":"10.1111/josh.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Parents and educators are concerned about adolescents' social media use and how it affects their mental health. It is unclear how these adults perceive how social media use affects adolescent mental health or view the role of schools in addressing these effects. We explored how adults define social media, perceive the effects of social media use on adolescents' mental health, and view the role of schools in addressing student social media use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study draws on a thematic analysis of 19 focus groups with 71 participants. Participants included parents, administrators, teachers, and health professionals of middle and high school students across four Connecticut school districts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three themes emerged in the study: adults conflate student digital media and social media use, they view student social media use as a double-edged sword related to mental health, and student digital media use policies without multi-pronged educational interventions to promote digital citizenship will likely not change digital media habits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Educators and researchers should consider reframing social media as digital media in interventions and research and developing or enhancing multi-pronged educational interventions to promote digital citizenship among students and adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 7","pages":"532-541"},"PeriodicalIF":1.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"After Mandates End: Complex Decision Making Regarding COVID-19 Masking in San Diego Elementary Schools Through the Social Ecological Model","authors":"Ashkan Hassani,&nbsp;Marlene Flores,&nbsp;Sam Streuli,&nbsp;Yan Jiang,&nbsp;Alison Wishard Guerra,&nbsp;Rebecca Fielding-Miller","doi":"10.1111/josh.70026","DOIUrl":"10.1111/josh.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>While mask mandates are unlikely to return in the event of a major resurgence in COVID-19 or another major respiratory disease surge, voluntary masking still shows promise. This ethnographic study seeks to understand the masking decision-making processes of parents and children in the diverse San Diego region, including US–Mexico Border school districts and military housing school communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted 19 interviews with parents and their young children focused on COVID-19 efforts at their child's school in English and Spanish and collected detailed field notes on masking culture from over 60 systematic observations from elementary schools across San Diego County from December 2021 to May 2022. We conducted analysis using Dedoose, including multiple rounds of coding and ongoing consensus meetings between researchers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Guided by the social ecological model (SEM), we categorized the results into the following categories: Children's Attitudes and Behaviors, Parent Belief and Influence, School Culture, and District/School Mask Mandates. Each level of the SEM influenced individual and family masking behavior. In our data, School Culture in particular differentiated schools in mask adherence and encouraged masking after state mandates ended.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice and Equity</h3>\u0000 \u0000 <p>Masking does not need to end with mandates. Masking has been proven to reduce COVID-19 transmission, and school health policies should consider encouraging masking beyond mandates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Adapting health messaging to the local context, partnering with trusted community champions, and building trust across governmental, school, and public health entities can improve the effectiveness of public health messaging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 8","pages":"597-603"},"PeriodicalIF":1.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities for Policy Progress: The Role of Schools in Minimizing, Mitigating, or Perpetuating Weight-Based Stigma","authors":"Samantha Turner,&nbsp;Emma D'Arpino","doi":"10.1111/josh.70034","DOIUrl":"10.1111/josh.70034","url":null,"abstract":"<div>\u0000 \u0000 <p>Weight stigma profoundly impacts the mental, emotional, and physical well-being of children and adolescents in larger bodies. As pivotal social environments, schools may unintentionally reinforce weight stigma via policies and practices. This paper examines three key policy strategies to mitigate weight stigma in school settings: adopting weight-neutral approaches in nutrition and physical education, implementing equitable screening and referral for eating disorders, and de-implementing body mass index (BMI) screenings. A review of existing evidence highlights the potential of these strategies to reduce stigma, promote inclusive health practices, and improve student outcomes. Weight-neutral education can minimize biases in health curricula and foster healthier perceptions of body image. Universal screening for eating disorders addresses diagnostic disparities, particularly for youth in larger bodies, who are often overlooked despite significant health risks. Removal of BMI screenings emerges as the most impactful and feasible approach, given its association with increased body dissatisfaction and limited efficacy in improving health outcomes. By implementing these evidence-based practices, schools can foster an equitable and supportive environment for all students, emphasizing holistic health over weight-centric metrics. As trusted institutions, schools have the unique capacity to lead systemic efforts to combat weight stigma and promote inclusivity across broader societal contexts.</p>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 7","pages":"560-565"},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Promise of School-Based Health Centers to Enhance Youth Mental Health Equity","authors":"Anne E. Bowen,&nbsp;S. Andrew Garbacz,&nbsp;Ellen C. Anderson,&nbsp;Madeline Wadington,&nbsp;Katie Eklund","doi":"10.1111/josh.70024","DOIUrl":"10.1111/josh.70024","url":null,"abstract":"&lt;p&gt;Youth mental health needs are of high concern nationwide [&lt;span&gt;1, 2&lt;/span&gt;]. Amplifying these concerns, traditionally medically underserved groups are at elevated risk of lacking access to mental healthcare and experiencing poor mental health outcomes. For instance, Black and Latine/Hispanic children are less likely to be seen by mental health specialists than White children [&lt;span&gt;3&lt;/span&gt;]. Psychiatric emergency department use, a proxy measurement for lack of access to preventative care, is highest among Black children [&lt;span&gt;4&lt;/span&gt;] and is increasing more rapidly among Latine/Hispanic youth compared to their White peers [&lt;span&gt;5&lt;/span&gt;]. Black youth aged 5–12 years are twice as likely to die by suicide as same-aged White youth [&lt;span&gt;4&lt;/span&gt;]. In 2020, more than half of sexual and gender minority youth who sought access to mental healthcare were unable to receive services [&lt;span&gt;6&lt;/span&gt;]. Social drivers of health (SDOH; e.g., living conditions, traumatic exposures) are root causes of disparities; inequitable distributions of SDOH lead to lower healthcare access and higher disease burden among marginalized communities [&lt;span&gt;7&lt;/span&gt;]. The effects of SDOH, in combination with long-standing societal inequities and interpersonal biases, have perpetuated poor mental health outcomes for disadvantaged social groups [&lt;span&gt;8&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;If left untreated, mental illness is likely to persist into adulthood, leading to long-term consequences [&lt;span&gt;9&lt;/span&gt;]. Parent mental illness is associated with an increased lifetime risk of mental illness for their children and negative effects on child development [&lt;span&gt;10&lt;/span&gt;]. This cascade can lead to disparities that persist across generations. Yet, childhood health prevention and intervention services protect against negative health, educational, and economic outcomes for adults [&lt;span&gt;8&lt;/span&gt;]; thus, early healthcare for traditionally underserved youth may have the potential to alleviate generational disparities [&lt;span&gt;11&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Public health programs that reduce racial, ethnic, and socioeconomic health disparities typically achieve this goal by addressing SDOH for medically underserved groups, through programs such as early childhood education, parental support, and income assistance [&lt;span&gt;8&lt;/span&gt;]. The structural nature of these interventions leverages community partnerships and emphasizes collaboration to alter social, physical, economic, and/or political environments to advance health equity [&lt;span&gt;12, 13&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;One such structural intervention is the provision of healthcare within schools to reduce access barriers, such as high costs, lack of transportation, and difficulty navigating the healthcare system [&lt;span&gt;14&lt;/span&gt;]. School-based health centers (i.e., school and community health or hospital partnerships; SBHCs) provide comprehensive healthcare, including primary healthcare and often specialty care, delivered by multidisciplinary healthcare teams, to students in s","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 7","pages":"566-570"},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Replication of a Comprehensive Sexual Health Education Curriculum in Rural Latino Communities","authors":"Nancy F. Berglas,&nbsp;Abigail Gutmann-Gonzalez,&nbsp;Kayla Wilson,&nbsp;Martha J. Decker","doi":"10.1111/josh.70018","DOIUrl":"10.1111/josh.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>School-based, comprehensive sexual health education is an important strategy for addressing the needs of youth in rural communities. However, few evidence-based programs have been developed specifically for or with rural youth, thus raising questions of their applicability and acceptability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From September 2021 to January 2023, we replicated the Positive Prevention PLUS curriculum with 9th and 10th grade students in two predominantly Latino rural communities in Fresno County, California. We designed an implementation evaluation that used daily attendance data and pretest/posttest student surveys to assess program dosage and reach, short-term changes in knowledge and awareness of local services, and participant satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Health educators implemented the program with 1233 students, who attended an average of 92% of sessions. Students responded positively, with most reporting the program to be very or somewhat interesting (94%) and useful (97%). Statistically significant increases were noted in short-term outcomes, including sexual health knowledge, awareness of local sexual health services, and willingness to seek services when needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Comprehensive sexual health education can be successfully implemented with Latino youth in rural communities, with evidence of strong attendance, program satisfaction, and positive change in short-term outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 7","pages":"490-497"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activating Critical Resource Theory for School-Based Mental Health Staffing","authors":"Angela Pollard,&nbsp;Jill D. Sharkey","doi":"10.1111/josh.70017","DOIUrl":"10.1111/josh.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Critical resource theory (CReT) provides a framework for the examination and reform of public finance policy. Funding policies for staffing school-based mental health providers have a substantial impact on the structure of service delivery and the ability of youth (and their families) to access much-needed supports in an era of growing mental health needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using CReT, this integrative literature review examines the existing policies and practices of funding for staffing school-based mental health providers. It synthesizes the historical context of United States school finance policy and the current state of school-based mental health systems to identify opportunities for future research, policy, and practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The history of residential segregation by race and a complex system of funding sources and allocation methods presents significant barriers for equitable, adequate, and sustainable funding of school mental health staff. However, applying CReT to existing literature revealed sources of funding that can be leveraged and coordinated to provide the necessary staff for school mental health teams.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>An application of CReT with mixed methods and participatory action research designs can support communities in securing the resources to staff adequate mental health systems through informed advocacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 7","pages":"542-548"},"PeriodicalIF":1.8,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigation and Physical Activity Behaviors Among School-Aged Children During the SARS-CoV-2 Pandemic","authors":"Nanette Lopez,&nbsp;Kristal Herrera,&nbsp;Josie Carter,&nbsp;Shlomit Radom-Aizik,&nbsp;Kai Zheng,&nbsp;Steve Palmer,&nbsp;Dan Cooper","doi":"10.1111/josh.70023","DOIUrl":"10.1111/josh.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The COVID-19 pandemic closed schools to in-person learning across the United States, resulting in unintended increases in sedentary behavior among children. Individual states maintained different mitigation policies, potentially affecting activity behaviors. This study examined student mitigation behavior and sedentary time during school in one Arizona and one California county once schools reopened.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Physical distancing, mask wearing, and physical activity were observed during physical education, recess, and lunch using the Systematic Observation of COVID-19 Mitigation (SOCOM). Fisher's exact test was used to calculate differences by state, sex, and schools' Title I status (i.e., federal funding provided to schools with ≥ 40% of children served identified as low-income).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mask wearing and physical distancing differed by state, sex, and Title I status. California students generally adhered to mitigation requirements at higher rates than Arizona students; however, California students were generally less active during recess and physical education than Arizona students. Differences in mitigation behaviors were also observed by Title I school status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications and Conclusions</h3>\u0000 \u0000 <p>California students exhibited stricter adherence to mitigation guidelines and were more sedentary. The relationship between mask mandates and students' behaviors varied between states, emphasizing the need for interventions, policies, and improved physical activity assessment based on local contexts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"95 7","pages":"522-531"},"PeriodicalIF":1.8,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}