Journal of School Health最新文献

{"title":"From Policy to Practice: School Stakeholder Perspectives on Alternative Breakfast Implementation in Utah","authors":"Devin Killian,&nbsp;J. Mitchell Vaterlaus,&nbsp;Sophia Galleguillos,&nbsp;Haley Hoelzer,&nbsp;Lori Andersen Spruance","doi":"10.1111/josh.70215","DOIUrl":"https://doi.org/10.1111/josh.70215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The School Breakfast Program (SBP) provides academic and nutritional benefits to U.S. children. In Utah, the Start Smart Utah policy requires schools with higher proportions of students from low-income backgrounds to adopt alternative breakfast models. Research suggests policy adoption does not guarantee effective implementation. This study examined school stakeholders' perspectives on implementing Start Smart Utah.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This qualitative study recruited Utah school stakeholders (<i>n</i> = 32) whose schools were required to implement an alternative breakfast model under Start Smart Utah. A semi-structured interview guide explored implementation experiences and perceived support. Interviews were analyzed using reliability thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five themes were constructed: (a) supporting students through school breakfast, (b) initial implementation: shifting strategies and support, (c) student participation in school breakfast, (d) tensions among quality, choice, and waste, and (e) recommendations for strengthening alternative breakfast models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Findings show that clear communication, adequate resources, and stakeholder engagement are essential for policy success. Embedding funding, training, and feedback mechanisms can improve implementation and equity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SBPs remain vital to student well-being and academic success. Start Smart Utah shows that expanding access through policy can yield benefits, but success depends on implementation realities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148783851","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":"Secular Trends in Physical Activity, Sedentary Behavior, and Weight Status Among South Korean Adolescents During 2017–2024","authors":"Yunmin Han,&nbsp;Younghwan Choi,&nbsp;Sungjae Yoon,&nbsp;Doyoung Gwak,&nbsp;Eun-Young Lee,&nbsp;Yeon Soo Kim","doi":"10.1111/josh.70214","DOIUrl":"https://doi.org/10.1111/josh.70214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We examined trends in physical activity (PA), sedentary behavior (SB), and weight status among Korean adolescents across the COVID-19 period and assessed subgroup disparities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed nationally representative data from the 2017 to 2024 Korea youth risk behavior web-based survey (<i>N</i> = 417,243; mean age, 15.0 years). PA adherence followed World Health Organization recommendations; SB adherence was defined as ≤ 2 h/day of recreational screen time; and weight status used the 2017 Korean Growth Chart BMI percentiles. Weighted estimates and Joinpoint regression quantified annual percent changes (APCs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Underweight and obesity both increased. Underweight rose particularly among girls (APC, 6.7%), whereas obesity was more prevalent among boys (14.7%; APC, 3.2%) and high school students (13.3%; APC, 3.2%). PA adherence increased over the study period (APC, 4.0%) but remained low, especially in girls (2.4% vs. 8.6% in boys). SB adherence declined from 36.1% in 2017 to 19.2% in 2020 and partially recovered by 2024 (24.5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Schools should adopt gender-sensitive strategies to increase daily PA and reduce recreational SB, prioritizing girls and high school students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>From 2017 to 2024, weight polarization worsened among Korean adolescents, underscoring the need for equitable school-based interventions targeting PA, SB, and weight-related disparities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148783850","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":"A Therapeutic Greenhouse Model for School-Based Health","authors":"Nicole Casbarro,&nbsp;Pina M. Violano","doi":"10.1111/josh.70218","DOIUrl":"https://doi.org/10.1111/josh.70218","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Therapeutic Greenhouse Program, located at an elementary school in an underserved community, offers a sustainable and reproducible model for school-based garden programming. Developed by a school-based health center, the program integrates medical and behavioral health services within an alternative therapeutic environment. It has been maintained since 2020 through strong partnerships with school staff, families, and community organizations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Contributions to Practice</h3>\u0000 \u0000 <p>The program bridges hands-on food literacy education with clinical care delivery. Elementary school children engage in structured sessions that combine nutrition education, experiential learning, and behavioral health support within the garden setting. Close collaboration with teachers and community partners embeds the program into the daily school routine, fostering a multidisciplinary approach to student wellness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>This model supports policies that expand school-based health services into nontraditional care environments. It demonstrates the feasibility of interdisciplinary collaboration in delivering integrated, experiential health education. Furthermore, the program advances health equity by providing inclusive, nonstigmatizing access to health promotion and fresh food.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>By leveraging billable services, strategic partnerships, volunteer engagement, and small-scale revenue generation, the program provides a financially sustainable and replicable framework for integrating healthcare and education in school settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148783793","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 Association Between School Physical Education Practices and School Level Socioeconomic Status","authors":"Sam Biver,&nbsp;Ben D. Kern,&nbsp;Hans van der Mars,&nbsp;Enbal Shacham","doi":"10.1111/josh.70217","DOIUrl":"10.1111/josh.70217","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Youth physical activity in the United States remains low, with disparities by socioeconomic status (SES). Physical education (PE) is an effective structural intervention, yet implementation is below recommendations. This study examines whether elementary school SES is associated with the implementation of recommended PE practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Elementary school data from School Health Map were merged with National Center for Education Statistics data to fit four mixed-effects logistic models with SES and locale as fixed effects and state as a random intercept. Outcomes were four recommended PE practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Schools with lower SES had higher odds of meeting recommended weekly instructional minutes compared to high-SES schools. However, low-SES schools also had higher odds of allowing students to be withheld from PE for disciplinary or academic reasons and lower odds of employing qualified PE teachers. State-level factors appeared to influence physical education minutes, class size, and teacher qualifications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Addressing disparities in PE practices will require coordinated state, district, and school-level efforts that go beyond weekly instructional time to prevent withholding PE, ensure manageable class sizes, and support qualified teachers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Low-SES schools met PE minutes more often, but other equity gaps remained.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70217","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764864","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":"Trends in Pediatric Mental Health-Related Emergency Department Visits During the School Year and School Breaks","authors":"Lora Henderson Smith,&nbsp;Genevieve R. Lyons,&nbsp;Hector A. Hernandez Laines,&nbsp;Natalie Hendrickson,&nbsp;Ethan Bachert,&nbsp;Moira Smith","doi":"10.1111/josh.70211","DOIUrl":"10.1111/josh.70211","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We examined patient and visit trends in pediatric emergency department (ED) usage during the school year and summer breaks before, during, and after the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We extracted data on mental health-related visits to the ED of an academic medical center from 2018 to 2023 among youth aged 5–18. Data were visualized, and overall visit frequency was modeled via piecewise linear regression. Odds ratios were estimated for characteristics associated with suicidal ideation and inpatient admission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of <i>n</i> = 2536 unique individuals had 3358 ED encounters resulting in a mental health-related diagnosis. Visit frequency was flat from August 2018 to a nadir in August 2020, followed by an increase. Female patients had increased odds of ED visits (OR = 1.45; 95% CI: 1.24–1.69) compared to males. Visits during school breaks were associated with increased odds of inpatient admission compared to visits during school sessions (OR = 1.30; 95% CI: 1.08–1.56).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Schools are an important site for mental health promotion and can collaborate with EDs and community providers to support students before breaks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Students may experience a decrease in school-related stress during breaks, but a lack of access to school-based mental health support may be one factor related to increased ED visits requiring inpatient admissions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708446","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":"Cumulative Adverse Childhood Experiences (ACEs) and School Outcomes During Adolescence: A Scoping Review","authors":"Sarah A. Stoddard,&nbsp;Chelsea R. Moore,&nbsp;Carri S. Polick,&nbsp;Joshua M. Moss","doi":"10.1111/josh.70209","DOIUrl":"10.1111/josh.70209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emerging literature suggests cumulative adverse childhood experiences (ACEs), potentially traumatic experiences before age 18, are associated with poor school outcomes. This scoping review assessed the state of the literature on the association between cumulative ACEs and adolescent school outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA-ScR guidelines, four databases were searched. Two independent reviewers screened 7188 titles and abstracts, then 112 articles in full. Twenty-four articles met eligibility criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Findings overwhelmingly supported a negative association between cumulative ACEs and school outcomes. Cumulative ACEs were associated with reduced likelihood of high school completion (<i>n</i> = 8), poor academic performance (<i>n</i> = 7), and school disengagement (<i>n</i> = 8). Nine studies identified mediational pathways between ACEs and school outcomes via biopsychosocial processes, mental/behavioral health, and school processes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Findings underscore the importance of early identification strategies and preventive school health approaches that address trauma exposure to improve academic trajectories and reduce downstream educational disengagement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ACEs are negatively associated with school outcomes. Although additional research is needed, this review indicates that intervening on behavioral health and factors like school engagement, absenteeism, and academic achievement could result in improved school outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708450","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-Based Interventions That Address Students' Unmet Material Needs: A Scoping Review","authors":"Rebeccah Sokol,&nbsp;Victor Medina Del Toro,&nbsp;Grayson Sewall,&nbsp;Alexandra Swirsky,&nbsp;Michelle Degli Esposti,&nbsp;Bryan Victor,&nbsp;Poco Kernsmith,&nbsp;Justin Heinze,&nbsp;Judith Smith","doi":"10.1111/josh.70207","DOIUrl":"https://doi.org/10.1111/josh.70207","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Unmet material needs disrupt student learning and behavior. Some school-based programs address these needs, but we know less about their impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a scoping review of studies published between 2013 and 2023 in the United States that evaluated school-based strategies to address unmet material needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>We included 55 studies and identified four intervention types: providing food, delivering healthcare, connecting families to resources, and offering transportation. Researchers have evaluated these interventions for school performance, participation, and safety. Most studies evaluated the effects of providing food on school performance (<i>n</i> = 21) and participation (<i>n</i> = 19), with mixed findings. Several studies evaluated the effects of providing healthcare on school performance (<i>n</i> = 14) and participation (<i>n</i> = 10), with overall supportive findings. There was limited evidence on connecting families to resources (<i>n</i> = 4) or offering transportation (<i>n</i> = 2). Across all interventions, only a few studies (<i>n</i> = 7) evaluated effects on school safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>School-based healthcare can benefit school performance and participation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The field has focused on the effects of providing food and healthcare on school participation and performance. We can gain a more comprehensive understanding of school-based strategies to address unmet material needs by (1) evaluating interventions beyond these two types, and (2) considering additional outcomes such as safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.70207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148695888","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":"Soda and Sports Drink Consumption and Life Stressors Among High School Students: Youth Risk Behavior Survey, 2023","authors":"Ann M. Goding Sauer,&nbsp;Ryan Saelee,&nbsp;Samantha L. Pierce,&nbsp;Caitlin L. Merlo,&nbsp;Jessica R. Hunter,&nbsp;Julie L. Self","doi":"10.1111/josh.70201","DOIUrl":"10.1111/josh.70201","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Life stressors might influence health behaviors, including frequent sugar-sweetened beverage (SSB) consumption. We described associations between life stressors and soda/sports drink (SD) consumption among US high school students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We tested associations between life stressors and daily (≥ 1 time/day) and heavy daily (≥ 3 time/day) consumption of soda/SD using the 2023 national Youth Risk Behavior Survey (daily <i>n</i> = 12,308; heavy daily <i>n</i> = 11,980). We calculated prevalence ratios (aPRs) and 95% confidence intervals (CI) adjusted for grade, sex, weight perception, and race and ethnicity. Not experiencing the stressor was the reference group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Daily consumption was significantly higher among those who experienced unstable housing (aPR = 1.6, 95% CI = 1.2, 2.2), lacking a household adult trying to meet basic needs (aPR = 1.3, 95% CI = 1.1, 1.5), bullying at school (aPR = 1.3, 95% CI = 1.2, 1.4), missing school due to safety concerns (aPR = 1.3, 95% CI = 1.1, 1.5), or feeling unfairly disciplined at school (aPR = 1.2, 95% CI = 1.1, 1.3). Results for heavy daily consumption were similar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice and Equity</h3>\u0000 \u0000 <p>Initiatives to reduce soda/SD consumption could benefit students with relatively high consumption prevalence, including those experiencing life stressors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of consuming soda/SD was higher among US high school students who experienced life stressors than those who did not.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674543","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":"Unrecognized Sleep Difficulties and Caregiver Awareness at School Entry: A Population-Based Study of First-Grade Children","authors":"Rosário Correia,&nbsp;Paulo Infante,&nbsp;Elena Felipe Castaño","doi":"10.1111/josh.70213","DOIUrl":"10.1111/josh.70213","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sleep difficulties are common in childhood and affect behavior, emotional regulation, and school functioning, yet are often unrecognized by caregivers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This population-based, repeated cross-sectional study included 1168 first-grade children (6–7 years) in Évora, Portugal. Sleep was assessed using the Portuguese Children's Sleep Habits Questionnaire (CSHQ-PT) and a structured family questionnaire. Associations with sociodemographic and family factors were examined using multivariable logistic regression; short sleep duration was analyzed using penalized logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across cohorts, 46%–49% of children met the criterion for clinically significant sleep disturbance (SDI ≥ 48). Bedtime resistance, daytime sleepiness, and sleep-related anxiety were the most prevalent difficulties. Fewer than 10% of caregivers reported sleep problems, even among affected children. Clinically significant sleep disturbance was associated with caregiver education and later dinner timing, while longer commuting distance was associated with short sleep duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Findings support brief sleep screening and family-oriented sleep health guidance at school entry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Many children begin primary school with unrecognized sleep difficulties, highlighting the value of integrating sleep health into early school health frameworks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671284","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":"Perceived Role Responsibility, Self-Efficacy, and Education Needs of School Nurses Providing Mental Health Services: A Nationwide Survey","authors":"Hsing-Yi Yu,&nbsp;Chun-Hsia Huang,&nbsp;Yung-Chao Shen,&nbsp;Hui-Ling Lin,&nbsp;Li-Chun Chang","doi":"10.1111/josh.70210","DOIUrl":"10.1111/josh.70210","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>School nurses increasingly support student mental health, yet how perceived role responsibility and self-efficacy shape continuing education needs remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A nationwide cross-sectional online survey was conducted in Taiwan using probability proportional to size sampling. Among 658 selected school nurses, 305 responded (46.4%). A 33-item questionnaire assessed perceived role responsibility, self-efficacy, and continuing education needs across six competency domains. Multivariable linear regression identified predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most nurses lacked prior psychiatric/psychology work experience (74.4%). Perceived role responsibility and self-efficacy were highest for referral/resource mapping and crisis response/safety assessment, and lowest for psychotropic medication management/monitoring. Continuing education needs were high, particularly for crisis response/safety assessment and identification/assessment. Perceived role responsibility was the only significant predictor of continuing education needs, explaining 29.4% of the variance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Training should prioritize role-focused interventions and standardized protocols for crisis response/safety assessment and identification/assessment, with clear medication-related coordination guidance to reduce role ambiguity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>School nurses' perceived role responsibility drives continuing education needs; training should strengthen role clarity alongside skills.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50059,"journal":{"name":"Journal of School Health","volume":"96 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664890","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}