Journal of School Health最新文献

{"title":"Classroom Movement Breaks in Relation to Health and Academic Outcomes: An Umbrella Review.","authors":"Nan Dou, Hao Lei, Raquel Arbaiza, Leah E Chapman, Ann Kuhn, Juliana F W Cohen, Erin R Hager","doi":"10.1111/josh.70252","DOIUrl":"10.1111/josh.70252","url":null,"abstract":"<p><strong>Background: </strong>Classroom movement breaks (CMBs) reduce school-day sedentary time. This umbrella review synthesized evidence on health and academic benefits of CMBs among school-aged children and explored outcomes by race, ethnicity, and socioeconomic status (SES).</p><p><strong>Methods: </strong>A systematic search of systematic reviews and meta-analyses up to April 2024 was conducted in five databases. Reviews examining CMBs' impacts on health and/or academic outcomes were included. Study quality was assessed using AMSTAR2.</p><p><strong>Findings: </strong>Sixteen reviews examined PA (physical activity; n = 12), classroom behaviors (n = 5), academics (n = 9, 4-overall and 6-domain-specific academics), cognition (n = 8), and health (n = 5). All PA-outcome reviews reported benefits. Most reviews reported improved classroom behaviors (3/5), cognition (6/8), and overall academics (3/4). Findings were mixed for domain-specific academics and inconclusive for health. Methodological quality of all reviews was rated as low/critically low. Few reviews assessed differences by race, ethnicity, or SES.</p><p><strong>Implications for school health policy, practice, and equity: </strong>Although CMBs showed potential benefits, recommendations for school implementation should be made with caution. Equity impacts remain understudied.</p><p><strong>Conclusions: </strong>CMBs may benefit students' activity, classroom behaviors, overall academics, and cognition, but evidence for subject-specific academics and health remained mixed or inconclusive. Current findings should be interpreted cautiously. Future research should address low methodological quality, utilize long-term designs, incorporate uniform CMBs interventions/outcome measures, and address equity gaps.</p>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 10","pages":"e70252"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128799","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":"School Nurses' Perceptions of Mental Health Responsibilities Within School Nursing Practice: A Q Methodology Study.","authors":"Travis E Lewis, Deby E Tyndall, Mitzi C Pestaner","doi":"10.1111/josh.70242","DOIUrl":"10.1111/josh.70242","url":null,"abstract":"<p><strong>Background: </strong>School nurses frequently encounter student mental health concerns, but little is known about how they prioritize mental health responsibilities relative to other nursing duties and local team structures.</p><p><strong>Methods: </strong>This Q methodology study examined shared viewpoints about school nurse duties that most support positive student and school outcomes. Seventy nurses from six rural, high-poverty US school districts ranked 25 duties aligned with the National Association of School Nurses framework. Q sorts were analyzed using centroid extraction and Varimax rotation; post-sort comments informed viewpoint interpretation.</p><p><strong>Results: </strong>A three-viewpoint solution explained 71% of the variance, with 52 nurses loading significantly. Viewpoint 1 prioritized suicide-risk response and mental health work as safety responsibilities. Viewpoint 2 emphasized medical expertise and crisis-oriented mental health involvement. Viewpoint 3 prioritized planning and care coordination while ranking direct mental health duties lower.</p><p><strong>Implications for school health policy, practice, and equity: </strong>Findings support clear role expectations, aligned referral and crisis protocols, appropriate staffing, and targeted professional learning for school nurse participation in mental health teams.</p><p><strong>Conclusions: </strong>Nurses agreed on core safety duties but differed in how mental health responsibilities fit within routine school nursing practice.</p>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 10","pages":"e70242"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076551","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":"Increasing Equitable Access to Effective Youth Mental Health Interventions Through Multitiered Systems of Support (MTSS).","authors":"Brittany Patterson, Malena A Nygaard, Aijah K B Goodwin, Julianna Casella, Nancy Lever","doi":"10.1111/josh.70245","DOIUrl":"10.1111/josh.70245","url":null,"abstract":"<p><strong>Background: </strong>Youth mental health concerns are rising and often present as internalizing or externalizing behaviors that can lead to a host of negative academic, social, and health outcomes, especially for marginalized students. Despite the growing mental health needs, many youth face barriers to accessing traditional mental health care, highlighting the importance of school-based mental health services.</p><p><strong>Contributions to theory: </strong>This paper contributes to understanding Multitiered Systems of Support (MTSS), an evidence-based framework, by reviewing its application within the school context and opportunities to increase students' equitable access to mental health supports.</p><p><strong>Implications for school health policy, practice, and equity: </strong>This paper provides recommendations for evidence-based screening measures and some evidence-based prevention and intervention services that can be utilized and delivered in schools. Implications for how workforce diversity, professional development, and supportive policies can strengthen MTSS implementation by promoting inclusive, trauma-informed care and fostering collaboration among schools, families, and communities to enhance student well-being and equity are also reviewed.</p><p><strong>Conclusions: </strong>School-based mental health services that utilize MTSS and center equity are imperative for addressing the rising mental health concerns among youth.</p>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 10","pages":"e70245"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117431","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":"The Link Between Whole-School Physical Activity Opportunities and Academic Achievement","authors":"Jongseon Kim,&nbsp;Kahyun Nam,&nbsp;Pamela Hodges Kulinna,&nbsp;Brandon Lyons,&nbsp;Allison Poulos","doi":"10.1111/josh.70247","DOIUrl":"https://doi.org/10.1111/josh.70247","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>School-based physical activity is generally not detrimental to academic performance and may provide modest benefits. Yet, less is known about whether whole-school physical activity opportunities, rather than specific programs or settings, are associated with academic achievement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This repeated cross-sectional study examined whether survey-reported Physical Education, recess, and wellness/health practices and policies were associated with school-level percentages of students meeting or exceeding state proficiency standards in English Language Arts and Mathematics. Data were collected from elementary school teachers in Arizona, United States, between 2021 and 2024 (<i>N</i> = 550). Hierarchical regression models adjusted for enrollment and survey year and tested whether associations varied by school-level socioeconomic status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>More whole-school physical activity opportunities were associated with higher percentages of students meeting or exceeding state proficiency standards in English Language Arts (<i>b</i> = 4.26, <i>p</i> &lt; 0.01) and Mathematics (<i>b</i> = 3.17, <i>p</i> &lt; 0.05). Associations did not differ by school-level socioeconomic status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>The positive association between supportive whole-school physical activity opportunities and academic achievement was observed across socioeconomic contexts, suggesting that increasing access may support student health and learning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Supportive whole-school physical activity opportunities were modestly related to achievement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146923","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":"School-Based Access to and Delivery of Oral Health Care","authors":"Mary E. Northridge,&nbsp;Lynn Gargano,&nbsp;Margaret K. Mason","doi":"10.1111/josh.70241","DOIUrl":"10.1111/josh.70241","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Given the importance of oral health to overall health, inclusive evidence-based interventions to improve health care access, quality of life, and learning and development through school-based delivery of oral health care are needed for all children, including those with special needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Contributions to Practice</h3>\u0000 \u0000 <p>Integrated delivery of school- and community-based health care holds the potential to improve the health and lives of children and adolescents. Team-based approaches are effective in ensuring continuity of care on-site in schools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Greater attention to ensuring socioeconomically disadvantaged students gain access to school-based delivery of dental services and adolescent priorities (periodontal disease, dental erosion, and misalignment of the upper and lower teeth) may enhance oral health care for these underserved groups. Long-term tracking of oral health outcomes (caries-free rate, oral health-related quality of life) and educational success (attendance/graduation rates, grade point averages) would bolster the case for school-based delivery of integrated health care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>School-based oral health programs provide comprehensive on-site care, including topical fluoride application and sealant placement to prevent dental caries. Involving parents and teachers in program activities emphasizes the importance of oral health to overall health both at home and in school.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13622390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076531","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":"Advancing School-Based Efforts to Reduce Trauma and Violence Influences on Youth","authors":"Jerica Knox,&nbsp;Tiffany Beason,&nbsp;Sara B. Johnson","doi":"10.1111/josh.70238","DOIUrl":"10.1111/josh.70238","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Trauma and violence exposure are critical barriers to educational equity, affecting student mental health and academic achievement. Despite growing attention to trauma-informed practices in schools, implementation remains uneven and often overlooks the complexity of trauma experiences or their systemic roots.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Contributions to Theory</h3>\u0000 \u0000 <p>Grounded in and extending Basch's (2011) framework for prioritizing health conditions to reduce educational disparities, this paper synthesizes lessons learned and proposes a path forward for school-based trauma prevention and intervention. We identify three key opportunities: (1) expanding school-based trauma definitions to include chronic and identity-based stressors such as racialized trauma and immigration-related adversity; (2) leveraging comprehensive, school-wide frameworks to support infrastructure development, cross-sector partnerships, and sustainable implementation; and (3) elevating secondary traumatic stress as a core concern within trauma-informed systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Schools can use public health-oriented frameworks to align trauma-informed practices with equity goals. Key actions include conducting inclusive needs assessments, providing culturally responsive professional development, fostering cross-sector partnerships, and embedding policies that support educator wellness and prevent secondary traumatic stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>By broadening definitions, centering equity, and supporting staff well-being, schools can create trauma-informed systems that are sustainable, responsive, and healing-centered.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13622387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076542","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":"Strengthening Partnerships in School-Based Substance Use Prevention and Intervention for Adolescents","authors":"Julianna Casella,&nbsp;Aijah K. B. Goodwin,&nbsp;Nancy Lever,&nbsp;Cindy M. Schaeffer","doi":"10.1111/josh.70248","DOIUrl":"10.1111/josh.70248","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adolescent substance use remains a significant concern for student health, well-being, and academic outcomes, yet fewer than 4% of youth who need treatment receive it. Schools are a critical, but underutilized setting, for adolescent substance use prevention and intervention. While Multi-Tiered Systems of Support (MTSS) provide a useful framework, meaningful engagement of youth, families, schools, and communities is crucial for effective and equitable systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Contributions to Theory</h3>\u0000 \u0000 <p>This paper asserts that youth-family-school-community partnerships should serve as the core foundation of effective school-based substance use programming. Drawing on Ecological System Theory and bridging school mental health and substance use literature, this paper proposes a framework that centers partnership, equity, and engagement within MTSS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice and Equity</h3>\u0000 \u0000 <p>School policy should prioritize funding and infrastructure that promotes genuine youth, family, school, and community collaboration, including telehealth options, flexible scheduling, and hiring school-based mental health staff. These efforts can help to improve equitable access to multi-tiered school substance use services for youth and families.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Partnerships among youth, families, schools, and communities should be central to school-based substance use programming to support the development of effective and equitable school mental health systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13622385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076460","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":"Clearer Vision, Brighter Futures: Addressing Unmet Pediatric Eye Care Needs Through School-Based Vision Programs","authors":"YuQing Xu,&nbsp;Xinxing Guo,&nbsp;Megan Collins","doi":"10.1111/josh.70237","DOIUrl":"10.1111/josh.70237","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vision impairment affects approximately 1 in 4 school-aged children in the United States, and yet challenges in connecting to care exist. Poor vision has been linked to diminished academic performance, social development challenges, and poor mental health. School-based vision programs (SBVPs), which typically provide vision screenings, eye exams, and eyeglasses directly in schools, are one promising avenue to improve access to care, especially in underserved communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Contributions to Theory</h3>\u0000 \u0000 <p>Vision is a foundational component of both health and educational equity, and SBVPs are interventions that address gaps in access to care for disadvantaged populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>SBVPs would benefit from better integration with school health services and more robust systems to coordinate referrals to eye care providers. States should monitor the impact of SBVPs on access to care. Implementation and expansion of SBVPs should prioritize under-resourced schools and students who face the greatest access barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Evidence for the impact of SBVPs in addressing unmet eye care needs among our most vulnerable students is robust. Evidence-based policy, financing, data infrastructure, and community partnerships are needed to embed vision care in school health to advance both health and educational equity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13622389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076525","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":"Estimating VO2max With the Timed Mile Run: An Updated Equation for Today's Youth","authors":"Lynn Gao,&nbsp;Veronica Berrocal,&nbsp;Amanda Woodworth,&nbsp;Hannah R. Thompson,&nbsp;Margaret Schneider","doi":"10.1111/josh.70246","DOIUrl":"https://doi.org/10.1111/josh.70246","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>School-based physical fitness testing (SB-PFT) is an important tool to address youth physical inactivity. However, the widely used Fitnessgram equation that converts timed mile run performance into estimates of cardiorespiratory fitness (VO₂max) may not be valid for today's diverse US adolescent population. This study evaluated its validity, developed updated prediction equations, and examined the effect of omitting sex and/or BMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A diverse sample of middle school students (<i>n</i> = 177) provided demographic information and timed mile run data and completed lab-based VO₂max testing. Prediction accuracy for the Fitnessgram equation and newly-developed equations was assessed using root mean square error (RMSE), Pearson's correlation, and sensitivity and specificity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this diverse sample, all four new VO₂max prediction equations outperformed the Fitnessgram equation, including equations excluding sex and/or BMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>When evaluated on a diverse sample of adolescents, the Fitnessgram misclassifies many adolescents as being in the healthy fitness zone despite having cardiorespiratory fitness levels associated with elevated health risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Fitnessgram VO₂max prediction equation should be updated to reflect contemporary US demographics and schools' concerns about collecting BMI data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048420","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":"Why Safety Planning Matters in School Social Events: Lessons From a Special Education Case","authors":"Şerife Demirdağlı","doi":"10.1111/josh.70240","DOIUrl":"10.1111/josh.70240","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emergencies during school social activities are often overlooked, as these events are typically assumed to be covered by general safety plans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study examined an emergency during a school-wide social event in a special education school using qualitative interviews. Data were collected from 32 school personnel and analyzed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results highlight four areas: (1) planning gaps, (2) panic response, (3) event conditions, and (4) limited organizational learning. School social activities function as temporary risk ecologies in which spatial, sensory, and relational factors reshape roles, coordination, and safety management. Preparedness remained narrowly classroom-based and did not translate into organizational change following the event.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Schools should implement event-specific safety protocols with clearly defined roles, coordinated supervision, and contingency planning for nonclassroom settings, with explicit attention to accessibility and differentiated support in special education contexts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>School safety planning must move beyond routine classroom assumptions and incorporate event-specific operational structures that address coordination, accessibility, supervision, and adaptive decision-making during school social events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041700","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}