Eligible Schools Research Articles

Impact of meningococcal ACWY conjugate vaccines on pharyngeal carriage in adolescents: evidence for herd protection from the UK MenACWY programme

ObjectiveSerogroup W and Y invasive meningococcal disease increased globally from 2000 onwards. Responding to a rapid increase in serogroup W clonal complex 11 (W:cc11) invasive meningococcal disease, the UK replaced an adolescent booster dose of meningococcal C conjugate vaccine with quadrivalent MenACWY conjugate vaccine in 2015. By 2018, the vaccine coverage in the eligible school cohorts aged 14 to 19 years was 84%. We assessed the impact of the MenACWY vaccination programme on meningococcal carriage. MethodsAn observational study of culture-defined oropharyngeal meningococcal carriage prevalence before and after the start of the MenACWY vaccination programme in UK school students, aged 15 to 19 years, using two cross-sectional studies: 2014 to 2015 “UKMenCar4” and 2018 “Be on the TEAM” (ISRCTN75858406). ResultsA total of 10 625 participants preimplementation and 13 438 postimplementation were included. Carriage of genogroups C, W, and Y (combined) decreased from 2.03 to 0.71% (OR 0.34 [95% CI 0.27–0.44], p < 0.001). Carriage of genogroup B meningococci did not change (1.26% vs 1.23% [95% CI 0.77–1.22], p = 0.80) and genogroup C remained rare (n = 7/10 625 vs 17/13 438, p = 0.135). The proportion of serogroup positive isolates (i.e. those expressing capsule) decreased for genogroup W by 53.8% (95% CI -5.0 – 79.8, p = 0.016) and for genogroup Y by 30.1% (95% CI 8.946·3, p = 0.0025). DiscussionThe UK MenACWY vaccination programme reduced carriage acquisition of genogroup and serogroup Y and W meningococci and sustained low levels of genogroup C carriage. These data support the use of quadrivalent MenACWY conjugate vaccine for indirect (herd) protection.

Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial

BackgroundSystematic reviews suggest school-based mindfulness training (SBMT) shows promise in promoting student mental health.ObjectiveThe My Resilience in Adolescence (MYRIAD) Trial evaluated the effectiveness and cost-effectiveness of SBMT compared with teaching-as-usual...

P008 ArFoods in the Garden: A SNAP-Ed Educational/PSE Strategy

<h3>Objective</h3> To implement a nutrition, gardening-based pilot project in SNAP-Ed eligible schools that incorporates direct education, indirect education, and PSE <h3>Use of Theory or Research</h3> Studies show garden-based nutrition education combined with healthy food marketing has potential to improve children's diet quality and is associated with more positive food choices. <h3>Target Audience</h3> K-5th grade students, teachers in 4 SNAP-Ed eligible schools. <h3>Program Description</h3> University of Arkansas Division of Agriculture Cooperative Extension Service SNAP-Ed Program developed Arkansas Foods (ArFoods) to highlight locally grown foods. ArFoods consists of nutrition education posters, newsletters, and taste-testing activities that can be used alone or in conjunction with evidence-based curriculum. During Farm to School month 2021, ArFoods was used in school gardens. "ArFoods in the Garden" pilot project consisted of 34 individual events in 4 schools reaching 713 youth. Nutrition education posters featuring spinach were printed on corrugated plastic and used as crop markers. MyPlate resources were used, along with taste tests and physical activity breaks. Posters were displayed in cafeterias, and parent newsletters were sent home with students. <h3>Evaluation Methods</h3> Post-teacher survey used to assess value and effectiveness of pilot project, changes in eating habits of students and teachers, and PSE changes adopted. Students surveyed about whether they would try spinach again. <h3>Results</h3> All teachers (n = 6) reported the program was very valuable to their students; their students seemed more willing to try new foods. Among student respondents (n = 288), 80.9% indicated they would try spinach again. Among teachers, five (83%) reported because of program they were motivated to try new foods, eat healthier, and/or be more physically active; four (67%) reported making changes in classrooms. <h3>Conclusions</h3> This pilot project was an example of how multiple delivery methods (direct education, indirect education, policy, systems, and environmental) can be incorporated into SNAP-Ed approaches. The project was successful in increasing students' and teachers' willingness to try new healthy foods and/or be more physically active. <h3>Funding</h3> Supplemental Nutrition Assistance Program - Education

SARS-CoV-2 seroprevalence in children, parents and school personnel from June 2020 to April 2021: cohort study of 55 schools in Switzerland.

Few studies have directly examined the incidence or seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in children, parents and teachers from the same school communities. This study aimed to describe SARS-CoV-2 seroprevalence within cantonal districts and school communities in children, parents and school personnel in June-September 2020 and March-April 2021 in the canton of Zürich, Switzerland. We invited children from 55 randomly selected primary and secondary schools and 275 classes within them to participate in the Ciao Corona study in June-July 2020. Parents of the participating children and all school personnel were invited in August-September 2020. Eligible classes, parents and school personnel were tested again in March-April 2021. Venous blood was tested for SARS-CoV-2 serology. We collected sociodemographic information of the participants in online questionnaires on enrolment in the study. We excluded vaccinated adults and those with unverified vaccination status from the main analysis. Seroprevalence estimates were adjusted for test accuracy. We assessed the variability of seroprevalence within and across cantonal districts and school communities and compared it with the per capita cumulative incidence of confirmed SARS-CoV-2 infections. In June-September 2020, 2,473 children, 1,608 school personnel and 2,045 parents participated in the study. In June-September 2020, seroprevalence was low (4.4% to 5.8%) in all cohorts. In March-April 2021, seroprevalence in children and parents (18.1% and 20.9%) was slightly higher than in school personnel (16.9%). We observed a large variation in seroprevalence estimates of the three cohorts within and between districts and school communities, with the median ratio of children's seroprevalence to per capita confirmed cases in district inhabitants of 3.1 (interquartile range 2.6 to 3.9). Seroprevalence was lower in children in the upper school level and their parents, but not teachers. Children's seroprevalence was slightly higher in classes with infected main teachers and families with one infected parent and substantially higher in families with two infected parents. We observed similar seroprevalence in children and parents, somewhat lower in school personnel in March-April 2021 and striking variation between districts and school communities. Children's seroprevalence was higher in classes with infected main teachers and from families with infected parents.

School meal access and changes in meal participation during COVID-19 school closures: A stratified random sample of CalFresh Healthy Living Eligible school districts in California

The National School Lunch and School Breakfast programs are a nutrition safety net for millions of children in the United States, particularly children in households with lower incomes. During Spring 2020 COVID-19 school closures, schools served school meals through the Summer Meal Programs. Despite efforts to increase access, meal participation declined and food insecurity increased. We aimed to (1) describe meal program features as communicated in low-income California school districts’ on-line resources (2) examine associations between meal program features and change in meal participation between May 2019 and May 2020 and (3) evaluate equity by describing meal site coverage and placement relative to the size of priority populations. Data from district online resources and meal reimbursement claims were collected for a stratified, random sample of 190 CalFresh Healthy Living-eligible districts. Linear regression was used to examine associations between district meal program features and percent change in meal participation. Meal site location and density were examined in relation to the size of priority populations. In May 2020, compared to May 2019, total meals served decreased by a median 46%. There were gaps in the information provided in district online resources and low variation in measured district meal program features. These features explained little of the variation in the percent change in meal participation. A greater proportion of meal sites were placed in areas with larger priority populations, yet the density of sites was not proportionate to the priority populations’ sizes. Findings show actionable areas for improving meal access during school closures.

New York state announces funding to improve school MH

New York Gov. Kathy Hochul on March 31 announced up to $50 million in available funding for school districts to improve student access to mental health resources and assist students who have experienced trauma that has impacted their education, a news release stated. A Request for Proposals has been issued by the New York State Office of Mental Health, who will administer the program. A total of up to $10 million each year over five years will be available and distributed to eligible school districts. Awards shall not exceed $500,000 per applicant annually. Continued funding past the first year will be contingent on timely reporting, satisfactory progress in meeting chosen grant objectives, and the availability of funds.

Are UK medical schools using recommended national curricula for the teaching of clinical neuroscience?

BackgroundMedical schools are responsible for training medical students to recognise and commence management for a broad spectrum of diseases, including clinical neuroscience conditions. To guide medical schools on topics that should be taught, speciality bodies have produced speciality-based core curricula. It is unknown to what extent these guidelines are used in designing each medical school’s curriculum. This survey aimed at assessing the use of these guidelines in designing clinical neuroscience curricula. MethodsThis is a national survey. A 21-item questionnaire was sent to faculty members involved in the development of the clinical neuroscience curriculum in each medical school in the UK. Data collection occurred from1st September 2020–31 st August 2021. The Association of British Neurologists (ABN) and the Royal College of Surgeons England (RCSEng) guidelines were used as a benchmark. Descriptive statistics are reported. ResultsData was collected from 91.9% of eligible UK medical schools. 61.8% respondents were aware of ABN guidelines and 35.3% were aware of RCSEng guidelines. 17/28 (60.7%) topics recommended by the guidelines were taught in the neuroscience curricula of over 90% of the medical schools. Neurologists were involved in the design of the clinical neuroscience curriculum in 94.1% (n = 32/34) of medical schools, and neurosurgeons in 61.8%. Tutorials/seminars were used by all medical schools to teach clinical neuroscience content. Neurologists were involved in teaching at all schools and neurosurgeons in 70.6%. Objective Structured Clinical Examination (OSCE)/oral examinations and single best answer (SBA)/multiple-choice question (MCQ) tests were used in all medical schools as methods of assessment. ConclusionsThere is variation between medical schools on what clinical neuroscience topics are taught and by whom. Multi-modality educational delivery was evident. Some medical schools did not currently use, advertise, or recommend external clinical neuroscience educational resources; but there was support for future use of external resources including guidelines.

Protocol for a feasibility study of longitudinal surveys to assess the impact of policies on tobacco use among school-going adolescents in South Asia

Background: Smokeless tobacco (ST) use is common among youth in South Asia where 85% of the world's 300 million ST users live and use the most lethal ST forms. Little is known about the impact of tobacco control policies on the youth ST uptake in those countries. We planned to conduct longitudinal surveys among school going adolescents to evaluate existing tobacco control policies on tobacco uptake and use, and a feasibility study for that prospective, observational cohort study. Study objectives: (1) To demonstrate the feasibility of selection, recruitment and retention of schools and of study participants; (2) To assess the feasibility and acceptability of the study procedure and study tool (questionnaire); (3) To evaluate if the questionnaire can assess tobacco uptake and use, and their potential predictors. Methods and analysis: The feasibility study will be conducted in two administrative areas within each of three South Asian countries: Bangladesh, India and Pakistan. We will use both quantitative and qualitative data collection methods. Eight eligible schools will be randomly selected within purposively selected sub-districts from each country. We plan to conduct one baseline and one follow up survey among students of grade 6-8, one year apart. At each time point, data on tobacco uptake and potential predictors will be collected from students via self-administered questionnaires that were designed for the longitudinal study. The qualitative component will be embedded into the study with each round of data collection to assess the acceptability of the study instrument (questionnaire) and data collection methods, via focus group discussions with students and semi-structured interviews with schoolteachers. Recruitment and retention rates, completeness of the questionnaires, frequencies and associations of tobacco use and explanatory variables will be reported. Data gathered from the focus group and interviews will be analysed using the framework approach.

Protocol for a feasibility study of longitudinal surveys to assess the impact of policies on tobacco use among school-going adolescents in South Asia

Background: Smokeless tobacco (ST) use is common among youth in South Asia where 85% of the world’s 300 million ST users live and use the most lethal ST forms. Little is known about the impact of tobacco control policies on the youth ST uptake in those countries. We planned to conduct longitudinal surveys among school going adolescents to evaluate existing tobacco control policies on tobacco uptake and use, and a feasibility study for that prospective, observational cohort study. Study objectives: (1) To demonstrate the feasibility of selection, recruitment and retention of schools and of study participants; (2) To assess the feasibility and acceptability of the study procedure and study tool (questionnaire); (3) To evaluate if the questionnaire can assess tobacco uptake and use, and their potential predictors. Methods and analysis: The feasibility study will be conducted in two administrative areas within each of three South Asian countries: Bangladesh, India and Pakistan. We will use both quantitative and qualitative data collection methods. Eight eligible schools will be randomly selected within purposively selected sub-districts from each country. We plan to conduct one baseline and one follow up survey among students of grade 6-8, one year apart. At each time point, data on tobacco uptake and potential predictors will be collected from students via self-administered questionnaires that were designed for the longitudinal study. The qualitative component will be embedded into the study with each round of data collection to assess the acceptability of the study instrument (questionnaire) and data collection methods, via focus group discussions with students and semi-structured interviews with schoolteachers. Recruitment and retention rates, completeness of the questionnaires, frequencies and associations of tobacco use and explanatory variables will be reported. Data gathered from the focus group and interviews will be analysed using the framework approach.

Shifting meanings: The struggle over public funding of private schools in Alberta, Canada

The government of Alberta, Canada, has provided public funding to eligible private schools since 1967. This policy has always been contested, and in this article, we explain how we applied concepts from argumentative discourse theory and its attendant methodology, argumentative discourse analysis (ADA), to trace the debate over the policy since 1990. Argumentative discourse theory posits that policymaking involves struggles for discursive dominance wherein actors try to convince others to view the policy issue in a particular way. Drawing on 158 media articles, interviews, and secondary sources, we show that although some of the actors in the dispute have changed – and changed sides – their arguments have remained fairly consistent. However, their arguments’ meanings – and of the policy itself – have changed as the dominant discourse in the province shifted. Specifically, in response to the rise and predominance of neoliberalism in Alberta, supporters redefined the policy to fund private schools with public money as one that promoted choice and competition that would improve schooling. Opponents, on the other hand, recast the policy as part of a larger government effort to privatize public education. We demonstrate that argumentative discourse theory and ADA can be used to support the goals of critical policy analysis.

Breakfast After the Bell: The Effects of Expanding Access to School Breakfasts on the Weight and Achievement of Elementary School Children,

In response to lower utilization of school breakfast programs compared with school lunch programs, a number of school districts and states have mandated Breakfast After the Bell (BATB). BATB requires eligible schools to provide breakfast in the classroom each morning to all children, regardless of income. We show that there is an 11.6 percent increase in the prevalence of children who are overweight after such programs are implemented. Weights at the very low or very high end of the BMI distribution appear unaffected, however, and we find no evidence of an increase in the prevalence of obesity. Moreover, the effect is concentrated mostly on girls, low income, and black children. As for test scores, the effects tend to be positive, but not statistically significant among the early adopters of BATB programs.

Factors Associated with Universal Free School Meal Provision Adoption among US Public Schools

The Community Eligibility Provision (CEP) allows high-poverty schools participating in US Department of Agriculture meal programs to offer universal free school meals. Emerging evidence suggests benefits of CEP for student meal participation, behavior, and academic performance. Although CEP became available nationwide in 2014, in school year 2019-2020, one third of eligible schools were not participating. This study evaluates which school, district, and state factors are associated with CEP participation. Cross-sectional study comparing CEP-participating with eligible nonparticipating schools to assess the relationship between CEP participation and school, district, and state factors. US public schools eligible for CEP in school year 2017-2018 (n= 42,813). CEP participation. Penalized regression variable selection methods to determine which factors contribute information to the model. Generalized logistic regression to predict odds of CEP participation unadjusted and adjusted for each factor in the full sample and in stratified analyses by whether a state was part of the CEP phase-in period (early vs late implementing states). In the full sample, adjusted odds of CEP participation were greater in states where CEP had been available longer (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.34, 1.67). In late implementing states, adjusted odds of CEP participation were higher in schools with more students directly certified for free meals (OR in schools with 80%-89% vs 30%-39% directly certified: 19.32; 95% CI, 12.98, 28.76), Title I schools (OR, 1.85; 95% CI, 1.55, 2.21), and urban schools (OR suburban vs urban, 0.46; 95% CI, 0.36, 0.59). Differences by school level, enrollment, district size, student race/ethnicity, and geographic region also existed. Findings may help advocates, state agencies, and policymakers understand potential barriers to adoption and guide research exploring effective strategies to promote uptake. Future research should use qualitative and longitudinal designs to explore barriers to adoption, including cost and state and local policies.

The impact of an implementation intervention that increased school's delivery of a mandatory physical activity policy on student outcomes: A cluster-randomised controlled trial

ObjectivesAssess the impact of an implementation intervention on student's physical activity, health-related quality of life (HRQoL) and on-task behaviour. DesignA cluster-randomised controlled trial. MethodsFollowing baseline 61 eligible schools were randomised to a 12-month, implementation intervention to increase teacher scheduling of physical activity, or a waitlist control. Whole school-day and class-time physical activity of students from grades 2 and 3 (~ages 7 to 9) were measured via wrist-worn accelerometers and included: moderate-to-vigorous physical activity, light physical activity, sedentary behaviour and activity counts per minute. Children's health related quality of life (HRQoL) and out-of-school-hours physical activity was measured via parent-proxy surveys. Class level on-task behaviour was measured via teacher self-report surveys. Student and teacher obtained outcomes were measured at baseline and 12-month follow-up. Parent reported outcomes were measured at 12-month follow-up. Linear mixed models compared between group differences in outcomes. Differential effects by sex were explored for student and parent reported outcomes. ResultsData from 2485 students, 1220 parents and >500 teachers were analysed. There was no statistically significant between group differences in any of the outcomes, including accelerometer measured physical activity, out-of-school-hours physical activity, HRQoL, and on-task behaviour. A statistically significant differential effect by sex was found for sedentary behaviour across the whole school day (3.16 min, 95% CI: 0.19, 6.13; p = 0.028), with females illustrating a greater difference between groups than males. ConclusionsOnly negligible effects on student physical activity were found. Additional strategies including improving the quality of teacher's delivery of physical activity may be required to enhance effects.

An Internet Quiz Game Intervention for Adolescent Alcohol Drinking: A Clustered RCT

Interventions on adolescent drinking have yielded mixed results. We assessed the effectiveness of an Internet quiz game intervention compared to conventional health education. In this cluster randomized controlled trial with parallel group design, we randomly allocated 30 participating schools to the Internet quiz game intervention or the conventional health education (comparison) group, with 1:1 ratio. Students of Hong Kong secondary schools (aged 12-15 years) were recruited. The intervention was a 4-week Web-based quiz game competition in which participating students answered 1000 alcohol-related multiple-choice quiz questions. The comparison group received a printed promotional leaflet and hyperlinks to alcohol-related information. Of 30 eligible schools, 15 (4294 students) were randomly assigned to the Internet quiz game intervention group and 15 (3498 students) to the comparison group. Average age of participants was 13.30 years. No significant between-group differences were identified at baseline. Overall retention rate for students was 86.0%. At 1-month follow-up, fewer students in the intervention group reported drinking (9.8% vs 12.1%, risk ratio 0.79, 95% confidence interval [CI] 0.68 to 0.92; P = .003), and those who drank reported drinking less alcohol (standardized difference β -0.06, 95% CI -0.11 to -0.01; P = .02). Between-group differences remained statistically significant at 3-month follow-up (10.4% vs 11.6%, risk ratio 0.86, 95% CI 0.74 to 0.999; P = .048; β -0.06, 95% CI -0.11 to -0.01; P = .02). The Internet quiz game intervention reduced underage drinking by 21% at 1-month and 14% at 3-month follow-up compared with conventional health education.

Nudging Handwashing among Primary School Students in the Philippines: Evidence from a Cluster Randomized Trial.

Handwashing is key to preventing the transmission of various infectious diseases of which school-aged children are particularly susceptible. Traditional, information-messaging campaigns may increase handwashing awareness but have had limited success in promoting behavior change. Behavioral economics "nudges," which explicitly target the knowledge-behavior gap, is a promising alternative. We evaluate the impact of school-based nudges in the first fully powered cluster randomized controlled trial in the Philippines. Out of our sample of 132 eligible schools, we randomly assigned half to receive nudges, including contextual cues (painted footpath from toilet to handwashing station) and visible reminders (posters and eye sticker), and half to the control group. Four months after implementation, we measured handwashing with soap (HWWS) after toilet use among grades 1-6 students using direct observation and compared this outcome between treatment and control schools. We also assessed whether nudges increased soap availability. The intervention increased HWWS rates by 17.3% points (pp), [95% CI: 4.2, 30.4] in treatment schools from the control group mean of 11.7%. The effect size was comparable across gender and age groups. Access to functioning handwashing facilities with soap increased by 36% (+20.2 pp, 95% CI: 10.9, 29.4). Mediation analysis suggests the program simultaneously nudged students to wash hands with soap in classrooms that already had soap, and nudged teachers to provide soap where it was not already available. These findings demonstrate that behavioral nudges costing less than $70 per school can lead to significant increases in HWWS among students 4 months post-intervention.

Changes to objective structured clinical examinations (OSCE) at Australian medical schools in response to the COVID-19 pandemic

Introduction Objective Structured Clinical Examinations (OSCE) are used to assess clinical skills. We investigated how exit OSCEs changed in Australian medical schools in response to the COVID-19 pandemic. Materials and Methods The lead ACCLAiM assessment academic from 12 eligible Australian medical school members of the Australian Collaboration for Clinical Assessment in Medicine (ACCLAiM) received a 45-item semi-structured online questionnaire. Results All schools (12/12) responded. Exit OSCEs were not used by one school in 2019, and 3/11 schools in 2020. Of eight remaining schools, four reduced station numbers and testing time. The minimum OSCE testing time decreased from 64 min in 2019 to 54 min in 2020. Other modifications included: a completely online ‘e-OSCE’ (n = 1); hybrid delivery (n = 4); stations using: videos of patient encounters (n = 3), telephone calls (n = 2), skill completion without face-to-face patient encounters (n = 3). The proportion of stations involving physical examination reduced from 33% to 17%. Fewer examiners were required, and university faculty staff formed a higher proportion of examiners. Conclusions All schools changed their OSCEs in 2020 in response to COVID-19. Modifications varied from reducing station numbers and changing delivery methods to removing OSCE and complete assessment re-structuring. Several innovative methods of OSCE delivery were implemented to preserve OSCE validity and reliability whilst balancing feasibility.

Did School Meal Programs and SNAP Participation Improve Diet Quality of US Children from Low-Income Households: Evidence from NHANES 2013-2014?

Nutrition assistance programs such as school meals and the Supplemental Nutrition Assistance Program (SNAP) are designed to provide a safety net for the dietary intake of children from low-income families. However, compared with eligible non-participants, the relationship of diet quality with school meals only and school meals + SNAP is not well understood. The objectives of the study include: (1) To explore whether and to what extent nutrition assistance program participation (school meals only and school meals + SNAP) is related to diet quality; and (2) to examine the differences of diet quality between participating in school meals only, school meals + SNAP, or non-participation among American children. Children aged 5 to 18 years old from income eligible households who participated in the 2013–2014 National Health and Nutrition Examination Survey (NHANES) were included in this cross-sectional study (n = 1425). Diet quality was measured using the Healthy Eating Index (HEI)–2015 and its 13 subcomponents. A Rao-Scott Chi-square test, propensity scores approach, and Analysis of Covariance were performed. Covariates included age, sex, race/ethnicity, weight status, and family monthly poverty index. SAS survey procedures were used to incorporate the appropriate sample design weights. Participation in school meals + SNAP was not associated with higher diet quality compared to eligible non-participants or school meals-only participants. Participation in school meals + SNAP improved the intake of total dairy, but not added sugars or total vegetables compared to school meals only. Overall, school meal + SNAP participation did not significantly improve the overall diet quality of children in low-income households relative to comparable non-participants.

Supporting the Policy Implementation Performance of Public Primary School Leaders in Malaysia: A Confirmatory Factor Analysis (CFA) of Public Leadership

Policy implementation requires the act of translating the goals and objectives of policy into actions. Policy implementation is a difficult process because how policy actors and implementers act on the policy on a large scale may decide whether it succeeds or fails. There is a growing recognition that policies do not succeed or fail on their own, but instead due to a lack of leadership qualities in policy implementation. The study aims to develop and validate the instrument for measuring the public leadership construct of school leaders in Malaysia. The instrument was adapted from the previous study and modified to suit the current study. The study also added ten new items to complement the original instrument of public leadership initiated by Tummers and Knies (2016). The target population is school leaders in the national-type primary schools in Malaysia. A simple random sampling method was utilized to select a random sample of 381 participants from the sampling frame of eligible school leaders in the country. Content validity and exploratory factor analysis (EFA) was conducted on the instrument before the confirmatory factor analysis. The Confirmatory Factor Analysis (CFA) procedure confirmed the existence of four sub-constructs of the public leadership construct that are accountability leadership, rule-following/lawfulness leadership, political loyal leadership, and network governance leadership. The CFA process has deleted four items due to poor factor loading (less than 0.6). The fitness indexes for all fit categories have achieved the required level of a model fit. Meanwhile, the Average Variance Extracted (AVE) and Composite Reliability (CR), which reflect the convergent validity and construct reliability, respectively, have also achieved the required level of a model fit. Hence, the revised instrument for measuring the public leadership construct of school leaders in Malaysia is valid and reliable for use to determine the policy implementation performance of the public primary school leaders in Malaysia.

Assessment of Food Quality in School Canteens: A Comparative Quantitative Study between Primary and Secondary Schools in Malaysia

Schools are an important food environment to cultivate and promote healthy food choices and practices among children and adolescents. The aim of the present study was to assess the type and quality of food and beverages sold in school canteens in public primary and secondary schools in Kelantan, Malaysia. Eligible schools were randomly selected from the list of all schools and detailed information of all food and beverage items sold in the school canteens were collected during school days. Food and beverages were classified based on food groups derived from the Malaysian Food Dietary Guideline and the Recommended Foods for Healthy Cafeteria Guideline. An assessment of the traffic-light nutrition food-labelling system of the total sugar content in all pre-packaged foods was also undertaken. A total of 568 food items were identified, with secondary school canteens selling a greater proportion of food items than the primary schools (55.5% vs. 44.5%). In terms of the main food groups, grains and cereal products represented the largest food group served (33–36%), followed by beverages (21–25%) and confectionary and sweet foods (12–13%). In contrast, the vegetable and fruit group represented the smallest proportion of food items sold (1–3%). Comparisons between primary and secondary schools showed a similar trend and pattern of food types and quality of foods sold, except for animal-based foods. A greater percentage of food items in this category was found among secondary schools (12.1%) versus primary schools (6.7%). When total sugar content of all pre-packaged foods was quantified based on the traffic-light nutrition-labelling system, almost one-third of foods and beverages were classified as high (29.1%). Confectionary (19.1%) and flavoured milk and fruit drinks (10.0%) both exceeded the recommended sugar levels of >22.5 g per 100 g and >11.25 mL per 100 m L, respectively. Only one of these packaged foods and beverages (0.9%) was classified as a healthy food choice. About a quarter of the food items available in school canteens were classified as prohibited based on a new revised list of prohibited food and beverage items. These findings indicate that, despite the Guidelines, a large number of unhealthy food items are being sold in school canteens. Hence, interventions such as sustainable healthy school canteen menus should be implemented to promote healthy food choices amongst school-aged children.

The effect of technology funding on school-level student proficiency

This study presents new evidence on the effect of technology funding on school-level student proficiency. I exploit exogenous variation in school-level technology funding using the California Education Technology K-12 Voucher Program. The program provided eligible schools with technology vouchers to purchase qualifying hardware and software products and services. Using a regression discontinuity difference-in-difference design and data on voucher eligibility, voucher use, and school-level student proficiency, I find that voucher eligibility had no significant impact on school-level student proficiency, while voucher use had positive impacts on school-level student proficiency. The voucher use results are driven entirely by schools using the voucher funds for technology resources, but reallocating dollars initially earmarked for technology to other school inputs.