School-based Programs Research Articles

Confronting the Crystal Meth Epidemic: Urgent Insights and Solutions

Crystal methamphetamine, or "ice," poses a significant public health threat, particularly in urban areas like Peshawar, where it has gained popularity among youth as a socially accepted "party drug." This editorial examines the factors driving its use, including peer influence and social normalization, which lead to compulsive consumption and severe health consequences. The drug's spread resembles a "contagious social virus," especially among educated and affluent young people. To address this epidemic, coordinated efforts are needed, including stricter legislation, public awareness campaigns, school-based education programs, and community support initiatives. Ongoing research is crucial for tracking trends and developing effective interventions to safeguard youth and community well-being.

Key influencers of mass drug administration implementation and scale-up: a social network analysis of soil-transmitted helminth intervention platforms in Benin, India, and Malawi

IntroductionLarge community-based public health programs, like mass drug administration (MDA), require coordination across many stakeholders. We used social network analysis (SNA) to systematically identify the network of stakeholders who influence delivery of school-based and community-wide MDA for soil-transmitted helminths (STH) in Benin, India, and Malawi and determine how network dynamics may impact implementation and scale-up across these delivery platforms.MethodsThis study was embedded within the implementation science research of the DeWorm3 Project, a hybrid clinical trial in Benin, India, & Malawi testing the feasibility of STH transmission interruption via community-wide MDA. Sites developed lists of stakeholders engaged in both MDA programs and indicated stakeholders’ attitudes towards the intervention and influence over intervention delivery. We developed digital sociograms for both MDA networks by site, comparing baseline vs. endline. We descriptively compared changes over time in stakeholder attitudes and influence and key SNA measures, including centrality, centralization, and density.ResultsAcross sites, we identified an expansive network of stakeholders involved in delivery of school-based (N= 139, 63, 58 vs. N=139, 162, 63) and community-wide MDA programs (N=52, 137, 54 vs. N=54, 136, 60) at baseline vs. endline in Benin, India, and Malawi, respectively. At both timepoints, a majority (>70%) of stakeholders held positive attitudes towards both programs. For both programs, stakeholders with the highest degree centrality scores (i.e., the most connected individuals) were those responsible for implementation such as community drug distributors or school teachers, while those with the highest betweenness centrality scores (i.e. those who controlled resource or information flow across networks) were responsible for policy-making & program leadership (e.g., NTD Program Managers). Low density scores indicated networks had poor overall connectedness due to minimal connectivity across administrative levels, while low centralization scores reflected stable networks where no single individual exhibited high control over resource flow.ConclusionDuring stages of innovation, redesign, or scale-up, analyzing the network of policymakers and implementers provides an opportunity to optimize effectiveness and efficiency of public health programs. Study findings provide useful insight for NTD policymakers and implementers in STH-endemic countries aiming to successfully interrupt STH transmission by transitioning from school-based to community-wide MDA.

Reading Skills Enhancement of Secondary Learners Amid Pandemic: Narrative Exposition of English Teachers in Focus

This study explored the expositions of English teachers in enhancing the reading skills of secondary learners amid the pandemic, particularly in Davao del Sur division, there were ten (10) English teachers who participated in the study. This study made use of a phenomenological approach to extract the ideas of the participants. The virtual in-depth interview was employed to gather some information as regards to their respective experiences as they implement school-based programs on the reading skills enhancement of secondary learners amid the pandemic. Using the thematic analysis, the following themes emerged: interrupted face-to-face reading program implementation, deteriorating reading abilities during the pandemic, and stalled parents' involvement in the reading development of children. The coping mechanisms of the English teachers in enhancing the reading skills of secondary learners were establishing a reading environment, strengthening parents' involvement in the reading program, and the use of technology-related reading lessons. The insights drawn from the findings of the study were: Upskilling and reskilling of teachers in enhancing the reading skills of learners, and Plan reading programs appropriate for remote learners. They may continuously be innovative in designing reading programs appropriate for every modality preferred by the learners. The teachers may continue upskilling themselves to address the gaps of every learner in the school that needed attention in terms of reading literacy. Attending webinars is an avenue to enhance their competency in being an effective reading teacher.

Feasibility study of the e-learning version of the "Journey of the Brave:" a universal anxiety-prevention program based on cognitive behavioral therapy.

School-based cognitive behavioral therapy (CBT) programs could contribute toward preventing anxiety disorders in children. However, setting aside class time for such programs is difficult. Internet-based CBT (I-CBT) is an efficient way to provide CBT. However, studies on I-CBT for anxiety prevention remain scarce, including I-CBT for school-based universal prevention programs. Therefore, we developed an e-learning version of a school-based anxiety-prevention CBT program, "Journey of the Brave," which was effective in Japan, to make it more flexible and accessible. This study evaluated its feasibility. We conducted a single-arm study based on 44 parents and children. Children aged 10-12years took the e-learning program at home. Parents and children responded to a questionnaire three times: before the learning (Pre), after the learning (Post), and three months later (FU: Follow-up). Feasibility was comprehensively evaluated through dropout rates, satisfaction and learning records, and changes in scores on psychological scales assessing anxiety symptoms, emotion-regulation skills, and children's emotional and behavioral problems. Of the 44 children, 42 started the e-learning, and 32 continued it (dropout rate of 23.8%). Furthermore, 83.9% of the children and 96.8% of the parents responded "agree" or "somewhat agree" regarding overall satisfaction. The parent-rated Spence Children's Anxiety Scale(SCAS) (SCAS-P) showed a significant decrease between Pre and FU (p = 0.014, 95% CI = (-9.22, -0.84)); however, the child-rated SCAS (SCAS-C) reduction was not significant (p = 0.08). The Emotion‑Regulation Skills Questionnaire (ERSQ) also increased significantly between Pre and FU (p = 0.045, 95% CI = (0.18, 18.31)). The Total Difficulties Score of the Strengths and Difficulties Questionnaire(SDQ) decreased significantly from Pre to Post (p = 0.025, 95% CI = (-3.62, -0.19)); however, it was not significantly different between Pre and FU (p = 0.67). The e-learning version showed low dropout rates and high satisfaction ratings from parents and children. Moreover, this study did not rule out the possibility that the program reduced children's anxiety and improved their emotional-regulation skills. Therefore, its potential and feasibility were indicated. UMIN, UMIN000049182, Registered 11 October 2022.

Community-based prevalence, intensity and risk factors associated with soil-transmitted helminthiases and intestinal schistosomiasis in Apojola, Ogun state, southwest Nigeria.

Soil-transmitted helminthiases (STH) and schistosomiasis are parasitic neglected tropical diseases (NTDs) of significant public health importance globally, including Nigeria. Urogenital schistosomiasis is highly endemic in Apojola, a rural community in Ogun State, southwest Nigeria, but data on STH and intestinal schistosomiasis in the neglected community are lacking. To determine the prevalence and intensity of STH and intestinal schistosomiasis and the risk factors associated with the infections in Apojola. The study was community-based and cross-sectional. A structured questionnaire was used to obtain information on socio-demographic, personal, and household WASH characteristics of the study population. Stool samples were collected and processed for parasitological examination using the triplicate Kato-Katz (K-K) smears. A total of 283 individuals (males, 50.2%; females, 49.8%) aged 3 to 65years (mean age ± S.D.: 19.6 ± 14.8years) participated in the study. No case of intestinal schistosomiasis was recorded in the study, while the overall prevalence of any STH was 38.2%: A. lumbricoides (24.0%) and hookworms (25.8%). Prevalence of infection was not significantly different between males and females for any STH (40.1% vs. 36.2%, χ2 = 0.473, p = 0.492); A. lumbricoides (23.2% vs. 22.7%, χ2 = 0.012, p = 0.913); or hookworms (28.2% vs. 23.4%; p = 0.360; χ2 = 0.839), but significantly varied with age for any STH (χ2 = 22.225, p = 0.002); A. lumbricoides (χ2 = 16.354, p = 0.022); or hookworms (χ2 = 20.001, p = 0.006). The intensity of infection was neither associated with gender nor age and was mostly light. Walking barefoot, toilet type (absent/bush), and irregular washing of fruits and/or vegetables before consumption were significantly associated with STH. Our data indicate that intestinal schistosomiasis is not prevalent in Apojola and that the community is a moderate-risk area for STH. Hence, the current annual preventive chemotherapy for STH (PC STH) with albendazole or mebendazole in school-aged children (SAC) through the school-based delivery programme should be extended to non-enrolled SAC and pre-SAC using other delivery platforms. This should be complemented with regular and effective health education campaigns as well as water, sanitation, and hygiene (WASH)-related interventions.

Expanding School-based Oral Health Programs in the Carolinas: Challenges and Opportunities

School-based oral health programs are an effective approach to population-based care and a stalwart of public health, especially in rural and underserved communities. Lessons learned during the COVID-19 pandemic have informed contemporary strategies and policies to ensure integration into the delicate dental safety net in the Carolinas.

Could be better: adolescent access to health information and care.

The purpose of this review is to examine how adolescents seek,and propose ways to helpadolescents access,health information and care despite the many barriers they face. • Adolescents encounter a broad range of barriers to access health information and care and turn to family members and friends, and search online, for health information. In addition, adolescents benefit from school-based health education programs and health centers that reduce barriers to healthcare access. • Adolescents engage in self-medication, including with cannabis use, to treat self-diagnosed illness or symptoms in a potentially harmful manner. • While many adolescents distrust health information shared on social media, recent evidence suggests adolescents are receptive to, and will change some beliefs, in response to health information posted on social media platforms.

Cultivating partnerships to incorporate health promotion modules into primary school curricula: a case study in France

School-based health promotion (HP) emerged from the settings-based approach. Children from disadvantaged neighborhoods benefit from HP in their school. Teachers deliver HP modules but need additional resources. This case study aimed to form a transdisciplinary partnership in a socially disadvantaged area to co-develop and embed HP modules into existing curricula. A 3-stage framework was used in this study. Stage 1 cultivated partnerships, reviewed evidence and existing data. Stage 2 generated ideas and co-developed HP modules. Stage 3 trialed the modules within primary school classrooms. Stage 1 resulted in a partnership between city authorities, a primary school and a comprehensive cancer center all located in the same community in France. The reviewed data and evidence provided 18 examples of school-based HP programs and showed that the school is in a highly disadvantaged neighborhood with a large immigrant population. Stage 2 developed 3 HP modules: “Taste and Science Week,” “Nutrition Weeks,” and “Breakfast Week,” each embedded as add-ins into existing math and science lessons and workshops. Finally, stage 3 trialed the modules in 10 first to fifth grade classrooms impacting 214 total students. Transdisciplinary partnerships help co-create and support evidence-driven HP programs. This collaborative approach enabled primary school teachers to effectively embed the HP modules into pre-existing math and science curricula. Families and volunteers are an integral part of successful HP programs however, limited participation was a challenge. Further research is needed to evaluate indicators such as student academic success and health behavior change.

Effect of a multicomponent school-based intervention with parental involvement on socioeconomic inequalities in smoking initiation: equity impact analysis of the TOPAS study

BackgroundAs prevalence of tobacco use falls, socioeconomic inequalities in tobacco use are increasing in many high-income countries. Evidence is lacking on the effect of preventive interventions on socioeconomic inequalities in...

Lifestyle intervention improves cardiometabolic profiles among children with metabolically healthy and metabolically unhealthy obesity

BackgroundIn recent years, there has been a surge of interest in the metabolic phenotype among children with obesity characterized by the absence of associated cardiometabolic risk factors (CRFs), known as metabolically healthy obesity (MHO), as opposed to those with metabolically unhealthy obesity (MUO). This study investigated the effect of lifestyle intervention on CRFs among children with MHO and MUO.MethodsA total of 102 school-aged children with obesity (54 girls and 48 boys) aged 8–16 years completed a 16-week school-based lifestyle modification intervention program, MyBFF@school Phase I. The intervention consisted of physical activity, healthy eating promotion, and psychological empowerment. MHO and MUO statuses were defined based on the 2018 consensus-based criteria. Fasting venous blood collection, body composition measurement, clinical assessment and physical fitness testing were conducted at baseline and at the end of week 16.ResultsAfter the intervention, the CRFs of the children with MUO improved with significant decreases in systolic (p < 0.001) and diastolic (p = 0.01) blood pressure and a significant increase in high-density lipoprotein cholesterol (HDL-C) (p = 0.005), while the CRFs of the children with MHO had a significant decrease in uric acid (p = 0.04). Additionally, 51.6% of the children with MHO transitioned to the MUO, while 26.8% of the children with MUO crossed over to the MHO at the end of the intervention. Furthermore, the odds of having high systolic blood pressure among children with MUO were 59% lower at week-16 than at baseline (OR = 0.41 (95% CI = 0.18, 0.92), p = 0.03).ConclusionsOur findings demonstrated that CRFs improved more prominently among children with MUO following the intervention. More importantly, our findings indicate that MHO in children is transient, hence, strategies to protect children against MUO are warranted.Trial registration: ClinicalTrials.gov NCT02212873.

The Buddy Program: High school students inform the design of a school-based peer support program for concussion

ABSTRACT Prior research provides little guidance on how to support return to school post-concussion. Peer support may be one strategy to enable adolescents to return to school post-concussion. The purpose of this study was to explore what high school students preferred in a school-based peer support program post-concussion. We conducted a qualitative instrumental case study in one high school in Calgary, Canada. Seven semi-structured focus groups were conducted with 53 high school students (16 boys, 36 girls, 1 preferring not to disclose gender; median age = 16 years, range = 15-18 years). All adolescents were enrolled in a sport medicine course and had either a history of concussion (n = 20) or were interested in supporting peers who had sustained a concussion (n = 33). Focus group questions aimed to solicit which factors the adolescents believed should be considered in the development of a post-concussion peer support program. We analyzed the focus group transcriptions using content analysis. Adolescents preferred a one-on-one Buddy Program. A one-on-one environment would provide a trusting and confidential relationship between the student with a concussion and their buddy. Peer support could include social support, advocacy support for academic accommodations, tutoring support, and concussion education. In future, the Buddy Program should be piloted in high schools.

School-based eating disorder prevention programmes and their impact on adolescent mental health: systematic review.

Growing evidence indicates an association between disordered eating and a range of mental health problems, including anxiety, depression and emotional dysregulation. This study aimed to explore whether reducing risk factors for eating disorders, such as body dissatisfaction and low self-esteem, through school-based programmes can enhance adolescent mental health. We searched PubMed, PsycINFO, EMBASE and Web of Science from the date of inception to 15 October 2023. Data were synthesised by using a systematic narrative synthesis framework, and formal assessments were conducted to assess the quality of the included studies. After title/abstract screening and full-text assessment, 13 articles met the pre-specified inclusion criteria, comprising a total of 14 studies (n = 5853). Notably, three studies encompassed multiple programmes, leading to the identification of 17 eating disorder prevention programmes. Among these programmes, seven (41%) employed dissonance-based approaches. Topics covered in the programmes included psychoeducation, body acceptance, sociocultural issues, nutrition and physical activities, self-esteem and stress coping. Ten (59%) of the programmes were effective in improving adolescent mental health. Six of the 14 studies (43%) did not specify follow-up time, and quality assessments found the majority to be of either high (five studies, 36%) or fair (eight studies, 57%) quality. The findings from the ten effective programmes consistently support the use of body acceptance strategies in improving the mental health of adolescent students. Brief interventions delivered by trained, non-licensed facilitators appear good for the sustainable implementation of in-school psychological services to support well-being among adolescents.

Mentorship of New(er) School-Based Speech-Language Pathologists Beyond the Clinical Fellowship: A Pilot Study

Purpose: The purpose of this pilot study was to explore the perspectives of school-based speech-language pathologists (SLPs) with varying levels of experience to identify the components of a postclinical fellow (CF) school-based speech-language pathology mentorship program, barriers to implementation, and potential solutions. Method: After seeking feedback from school-based SLPs, a survey was created and distributed via e-mail and national social media sites. Topics included gathering perspectives about experiences with school-based speech-language pathology mentorship, components of a possible post-CF mentorship program, barriers to implementation, and potential solutions. Results: Sixty-five school-based SLPs with varying years of experience responded to the survey. Results suggested that respondents felt a setting-specific post-CF school-based speech-language pathology mentorship program may be valuable. Time, compensation, and filling knowledge gaps were identified as both important components of a mentor program but also potential challenges to implementation. Conclusions: A post-CF school-based speech-language pathology mentorship program has the potential to be beneficial to both parties in tangible and intangible ways. SLPs appear to be interested in mentorship not only as a way to support future generations of SLPs but also for a sense of self-fulfillment and professional development. A formal mentorship program may operationalize support related to decision making, advocacy, paperwork, scheduling, and working through challenging cases.

Refractive Profiles in Children Receiving School-Based Eye Exams Following Vision Screening from a Large School-Based Vision Program in 2016 to 2022

ABSTRACT Purpose To describe refractive error findings and associated factors in students who received school-based eye exams following vision screenings. Methods Cross-sectional study of pre-kindergarten through 12th grade students who failed vision screening and underwent a school-based eye exam in the Northeast region of the United States during 2016–2022. Non-cycloplegic autorefraction and visual acuity measurements were used to categorize refractive error by type and severity. Main outcomes included any refractive error (at least −0.50D myopia, +0.50 hyperopia, 1.00D astigmatism, or 1.00D anisometropia), clinically significant refractive error (CSRE; more severe refractive error with decreased vision), and refractive amblyopia risk (RAR). Multivariable mixed-effects logistic regression was used to determine student- and school-level characteristics associated with refractive error outcomes. Results Of 103,159 included students who failed screening, 95,875 (92.9%) were analyzed. Overall prevalence of any refractive error was 94.2%, with 81.7% having CSRE. Pre-kindergarten & kindergarten students had the highest prevalence of CSRE (85.7%), which dropped to 77.0% by 3rd and 4th grade before rising with each higher grade level thereafter. Prevalence of RAR was 60.9% overall and highest in pre-kindergarten and kindergarten students (73.8%). Myopia was the most prevalent refractive error, followed by astigmatism, anisometropia, then hyperopia. The odds of hyperopia, astigmatism, and anisometropia decreased with higher grade level. Conclusion Over 80% of students who failed vision screening at a large school-based vision program had CSRE, and over 60% had RAR. Pre-kindergarten and kindergarten students had an especially high prevalence of RAR. Refractive error remained common in every grade level.

Caries Incidence in School-Based Prevention Programs in the Presence of Interval Censoring

Background/Objectives: School-based caries prevention can increase access to critical dental services and reduce oral health inequities. However, little is known regarding the incidence of dental caries in children participating in school caries prevention, and caries diagnosis is often interval censored. Methods: In this paper, we used data from a longitudinal, school-based, randomized clinical trial of minimally invasive treatments for dental caries to estimate the per-visit incidence rate and compare the hazard of dental caries in children receiving either silver diamine fluoride or glass ionomer dental sealants. To account for interval censoring, we used semiparametric transformation models for univariate failure time data and imputed caries incidence using G-imputation. Results: There were 3040 children that met inclusion criteria for analysis, 1516 (49.9%) of which were randomly assigned to receive silver diamine fluoride and 1524 (50.1%) were assigned to receive glass ionomer dental sealants and atraumatic restorations. There were no differences in the hazard of caries between treatments (HR = 0.99, 95% CI = 0.72, 1.24), while children with caries at baseline had a significant increase in the hazard of new caries (HR = 2.54, 95% CI = 2.26, 2.83) compared to those that were caries free. The per-visit caries incidence ranged from 4.8 to 11.1 at the individual level and increased with each successive study observation. Conclusions: School-based caries prevention can positively affect caries incidence, and the results can be used to inform future program design and implementation.

Chanting and meditation: an 8-week intervention to promote executive functions in school-age children

The present study investigated the effectiveness of a newly developed 8-week meditation program, which included chanting and meditation, on executive functions (EFs) in school-age children. Twenty-five students assigned to an experimental group participated in the meditation program, engaging in daily and weekly activities for 8 weeks. Another 25 students served as a control group and participated in regular school activities. Pretest and posttest assessments included the n-back task for working memory, the go/no-go task for inhibition, and the Wisconsin Card Sorting Test (WCST) for cognitive flexibility. A mixed repeated measures ANOVA was conducted to analyze interaction effects, within-group differences, and between-group differences. The experimental group demonstrated greater improvement compared to the control group across several measures: (1) reaction time in the 1-back task, (2) correct responses in the no-go condition of the go/no-go task, and (3) percentage of correct responses, errors, perseverative errors, non-perseverative errors, perseverative responses, and conceptual level responses in the WCST (p < 0.001). These findings underscore the potential benefits of an 8-week school-based meditation program incorporating chanting and meditation for enhancing EFs in school-age children.

Implementation and Performance of a Point-of-Care COVID-19 Test Program in 4,000 California Schools

To evaluate the feasibility and accuracy of an unprecedented COVID-19 antigen testing program in schools, which required a healthcare provider order, laboratory director, a Clinical Laboratory Improvement Amendments certificate of waiver, as well as training of school personnel. Descriptive report of a point-of-care, school-based antigen testing program in California from August 1st, 2021 through May 30, 2022, in which participants grades K-12 self-swabbed and school personnel performed testing. Participants included 944 009 students, personnel, and community members from 4022 California kindergarten through high schools. Outcomes measured include sensitivity and specificity (with polymerase chain reaction [PCR] as comparator) of the Abbott BinaxNOW antigen test, number of tests performed, and active infections identified. Of 102 022 paired PCR/antigen tests, the overall sensitivity and specificity for the antigen test was 81.2% (95% CI: 80.5%-81.8%) and 99.6% (95% CI: 99.5%-99.6%), respectively, using cycle threshold values<30. During January through March 2022, the highest prevalence period, the positive predictive value of antigen testing was 94.7% and the negative predictive value was 94.2%. Overall, 4022 school sites were enrolled and 3 987 840 million antigen tests were performed on 944 009 individuals. A total of 162 927 positive antigen tests were reported in 135 163 individuals (14.3% of persons tested). Rapidly implementing a school-based testing program in thousands of schools is feasible. Self-swabbing and testing by school personnel can yield accurate results. On-site COVID-19 testing is no longer necessary in schools, but this model provides a framework for future infectious disease threats.

School-based nutrition education programs alone are not cost-effective for preventing childhood obesity: A microsimulation study

Although interventions to change nutrition policies, systems, and environments (PSE) for children are generally cost-effective for preventing childhood obesity, existing evidence suggests that nutrition education curricula, without accompanying PSE changes, are more commonly implemented. Estimate the societal costs and potential for cost-effectiveness of three nutrition education curricula frequently implemented in U.S. public schools for childhood obesity prevention. In 2021, we searched for nutrition education curricula in the SNAP-Ed Toolkit, a catalogue of interventions for obesity prevention coordinated by the federal government. Standard costing methodologies estimated the societal costs from 2023-2032 of nationwide implementation of each identified curriculum. Using the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) microsimulation model, which projects the costs, healthcare costs saved, and cases of obesity prevented for childhood obesity prevention interventions, we conducted threshold analyses for each curriculum, estimating the cost per quality-adjusted life year (QALY) for a range of hypothetical effects on child body mass index (BMI) to determine how large of an effect each curriculum would need to have to meet a cost-effectiveness threshold of $150,000 per QALY. Three nutrition education curricula without PSE were identified from SNAP-Ed; none had evidence of an impact on obesity risk. From 2023 to 2032, the estimated implementation costs of the curricula nationwide ranged from $1.80 billion (95% UI: $1.79-$1.82 billion) to $3.48 billion (95% UI: $3.44-$3.51 billion). Each curriculum would have to reduce average child BMI by 0.10 kg/m2 or more-an effect size that has not been reported by any of the three curricula, or by more comprehensive existing prevention programs-to be considered cost-effective at this threshold. SNAP-Ed-endorsed nutrition education curricula alone are unlikely to be cost-effective for preventing childhood obesity. Continued efforts to implement interventions with strong evidence for effectiveness, including PSE approaches, are needed.

Associations between School-Based Vision Program Outcomes and School Characteristics in 410 Schools.

School-based vision programs (SBVPs) deliver vision care services directly to students at school, helping address disparities in access to pediatric vision care. We aim to evaluate the associations between SBVP outcomes and school-level characteristics. Retrospective cross-sectional data analysis PARTICIPANTS: Public schools with at least 50 SBVP-enrolled students 5 to 22 years old with complete demographic data. Schools with fewer than 60% of total grade levels served by the SBVP were excluded, resulting in a sample of 410 schools. Vision screening and eye exam data were extracted from Helen Keller International's United States Vision Program dataset from 2016 through 2022. Individual student data were aggregated to characterize each school's SBVP outcomes and analyzed with schools' publicly available socioeconomic and demographic data (student body race and ethnicity composition, proportion of students qualifying for free and reduced-price meals [FARM%], and proportion of English Language Learners). Descriptive statistics summarized SBVP outcomes. Fractional regression models were utilized to understand associations between SBVP outcomes and school characteristics. SBVP outcomes were rates of vision screening failure, eyeglasses prescription, and community eye care referral among each school's SBVP-enrolled students. We evaluated 151 (36.8%) elementary, 155 (37.8%) middle, and 104 (25.4%) high schools, with a median FARM% of 87.4% and a plurality of Hispanic students in 61.0% of schools. Overall median rates of vision screening failure, eyeglasses prescription, and referral were 38.4%, 25.2%, and 5.4%, respectively. High schools were associated with increased screening failure and eyeglasses prescription rates and a decrease in referral rate, compared with elementary schools. In multivariate analysis, each 10% increase in FARM% was associated with a 2.6% (95% confidence interval [CI]: 1.54-3.65), 1.8% (CI: 0.87-2.74), and 0.86% (CI: 0.36-1.36) increase in screening failure, eyeglasses prescription, and referral rates, respectively. There is significant vision care demand among public schools, especially those with student populations from lower socioeconomic backgrounds. SBVPs are important in bridging the gap in pediatric vision care access in such populations. Our findings demonstrated opportunities to allocate program staffing and equipment resources according to schools' anticipated needs, thus maximizing SBVPs' impact in delivering pediatric vision care.

Exploring Typologies of Domestic Violence Perpetrators: Insights into Male Patterns and Behaviours

Research into domestic violence has typically focused on the victims, who are usually female. However, shifting the focus to the male perpetrators creates opportunities for earlier intervention to stop the violence. By recognizing the early warning signs, police, community-based supports and governments can target interventions to prevent domestic violence before it escalates or even occurs. This policy brief examines the 10-year history of Calgary Police Service interactions with 934 Calgary men, aged 18 and above, who were eventually charged in domestic violence incidents in 2019. Based on their criminal and domestic encounters with police, the perpetrators fell into four typologies. Of the four groups, one had no history with police and the second had a criminal history but no non-criminal domestic encounters before the 2019 charge. The third group had a history of non-criminal domestic encounters, but no criminal history with police, while the fourth group had a record of both criminal charges and non-criminal domestic encounters with police. Only 27 per cent of the men in this study had no previous interactions with police. These trajectories and typologies reveal discernible increases in criminal activity and domestic encounters with police culminating in domestic violence charges. This information can help to focus legislation, policies and practices which can lead to preventing domestic violence, thus improving on the current model in which police and community organizations often respond to domestic violence only after the fact. Increased police interactions prior to a criminal conviction involving domestic violence mean there is a point at which early intervention may prevent a criminal incident of domestic violence from happening. Interventions can include providing access to counselling and supports while making online resources accessible to men at risk of becoming perpetrators and who are struggling with their behaviour in their intimate relationships. Other prevention efforts could include school-based programs and targeting male-dominated workplaces with domestic violence prevention efforts in order to avert potential first offences. The approach to domestic violence must shift. The victims’ responsibility to keep themselves safe needs to be augmented by a focus on stopping the individuals who perpetuate harm. Our ongoing research agenda is investigating the extent to which police, government and policy-makers may be able to use information about the behaviours and trajectories of offenders to intervene proactively and so prevent incidents of domestic violence from happening.