School-based Programs Research Articles

Practices and Challenges of School-Based Feeding Program of Opol West District

The study examines the implementation of school-based feeding programs in the Opol West District for the 2023-2024 school year, focusing on practices and challenges. It aims to profile respondents, assess the level of practices and challenges, explore the relationship between these levels, and analyze differences in challenges based on respondent profiles. Using a descriptive survey approach, the study involved 162 class advisers managing feeding program beneficiaries, employing statistical tools like frequency, percentage, mean, and standard deviation for descriptive analysis, and Pearson-r and ANOVA for inferential analysis. The findings reveal that the feeding program was highly practiced, though challenges were identified, necessitating enhancements for better effectiveness and sustainability. A significant correlation was found between the level of practices and challenges, with differences in challenges based on respondent profiles, such as age, teaching experience, and position. The study concludes that addressing challenges, particularly in resource inventory, is crucial for the program's efficiency and sustainability. To improve the program, the study recommends that teachers pursue higher education, engage in workshops, and foster stakeholder involvement, parental participation, clear communication, and targeted resource allocation, alongside advanced staff training.

Operationalizing the Behaviour Change Wheel and APEASE criteria to co-develop recommendations with stakeholders to address barriers to school-based immunization programs

Introduction: School-based immunization programs offer an accessible route to routine vaccines for students. During the COVID-19 pandemic, school closures to comply with public health measures had a drastic effect on school-based immunization program delivery and associated vaccine uptake. We sought to integrate findings from a mixed methods study to co-develop evidence-based and theory-informed recommendations with a diverse group of stakeholders (i.e., decision makers, healthcare providers, school staff, parents and adolescent students) to address barriers to new and existing school-based immunization programs. Methods: Findings from a mixed methods study were integrated using a joint display and narrative summary. These findings were mapped through the Behaviour Change Wheel, a series of tools designed to facilitate the development of behaviour change interventions. Draft recommendations were provided to previous mixed methods study participants who consented to participating in future phases of the research study (n = 26). Feedback was captured using a Likert-scale survey of acceptability, practicality, effectiveness, affordability, safety and equity (APEASE) criteria, with feedback and additional insights captured using open-ended textboxes. Data was used to revise and finalize recommendations. Results: Applying the Behaviour Change Wheel, we drafted 26 evidence-based, theory-informed recommendations to address barriers to school-based immunization programs. Participants (n = 16) provided feedback, with half of the recommendations scoring 80% or higher across all six APEASE criteria. The remaining 13 recommendations received a moderate score across one or more criteria. Stakeholders identified a high level of interest in expanding the use of e-consent forms, expanding programming to offer a meningitis B vaccine, and recommendations to ease student anxiety. Conclusion: We co-developed a range of recommendations to improve school-based immunization programs with stakeholders using data generated from a mixed methods study. Implementation of any single or combination of recommendations will need to be tailored to local clinic procedures, school system and health system resources.

Refining the Universal, School-Based OurFutures Mental Health Program to Be Trauma Informed, Gender and Sexuality Diversity Affirmative, and Adherent to Proportionate Universalism: Mixed Methods Participatory Design Process.

Mental disorders are the leading cause of disease burden among youth. Effective prevention of mental disorders during adolescence is a critical public health strategy to reduce both individual and societal harms. Schools are an important setting for prevention; however, existing universal school-based mental health interventions have shown null, and occasionally iatrogenic, effects in preventing symptoms of common disorders, such as depression and anxiety. This study aims to report the adaptation process of an established, universal, school-based prevention program for depression and anxiety, OurFutures Mental Health. Using a 4-stage process; triangulating quantitative, qualitative, and evidence syntheses; and centering the voices of young people, the revised program is trauma-informed; lesbian, gay, bisexual, transgender, nonbinary, queer, questioning, and otherwise gender and sexuality diverse (LGBTQA+) affirmative; relevant to contemporary youth; and designed to tailor intervention dosage to those who need it most (proportionate universalism). Program adaptation occurred from April 2022 to July 2023 and involved 4 stages. Stage 1 comprised mixed methods analysis of student evaluation data (n=762; mean age 13.5, SD 0.62 y), collected immediately after delivering the OurFutures Mental Health program in a previous trial. Stage 2 consisted of 3 focus groups with high school students (n=39); regular meetings with a purpose-built, 8-member LGBTQA+ youth advisory committee; and 2 individual semistructured, in-depth interviews with LGBTQA+ young people via Zoom (Zoom Video Communications) or WhatsApp (Meta) text message. Stage 3 involved a clinical psychologist providing an in-depth review of all program materials with the view of enhancing readability, improving utility, and normalizing emotions while retaining key cognitive behavioral therapy elements. Finally, stage 4 involved fortnightly consultations among researchers and clinicians on the intervention adaptation, drawing on the latest evidence from existing literature in school-based prevention interventions, trauma-informed practice, and adolescent mental health. Drawing on feedback from youth, clinical psychologists, and expert youth mental health researchers, sourced from stages 1 to 4, a series of adaptations were made to the storylines, characters, and delivery of therapeutic content contained in the weekly manualized program content, classroom activities, and weekly student and teacher lesson summaries. The updated OurFutures Mental Health program is a trauma-informed, LBGTQA+ affirmative program aligned with the principles of proportionate universalism. The program adaptation responds to recent mixed findings on universal school-based mental health prevention programs, which include null, small beneficial, and small iatrogenic effects. The efficacy of the refined OurFutures Mental Health program is currently being tested through a cluster randomized controlled trial with up to 1400 students in 14 schools across Australia. It is hoped that the refined program will advance the current stalemate in universal school-based prevention of common mental disorders and ultimately improve the mental health and well-being of young people in schools.

Ultra-Processed Food Intake and Increased Risk of Obesity: A Narrative Review.

The prevalence of obesity has become a global health concern, with significant impacts on quality of life and mortality rates. Recent research has highlighted the role of ultra-processed foods (UPFs) in driving the obesity epidemic. UPFs undergo extensive processing, often containing high levels of sugars, fats, and additives, while lacking essential nutrients. Studies have linked UPF consumption to obesity and cardiometabolic diseases, underscoring the importance of dietary patterns rich in whole foods. Thus, the aim of this narrative review is to elucidate the correlation between ultra-processed foods and the increased trend of obesity and its related complications. These foods, prevalent in modern diets, contribute to nutritional deficiencies and excessive caloric intake, exacerbating obesity rates. Lifestyle factors such as busy schedules and quick meal management further drive UPF consumption, disrupting hunger regulation and promoting overeating. UPF consumption correlates with adverse health outcomes, including dyslipidemia, hypertension, and insulin resistance. Promoting whole, minimally processed foods and implementing school-based nutrition education programs are crucial steps. Also, numerous challenges exist, including unequal access to healthy foods, the industry's influence, and behavioral barriers to dietary change. Future research should explore innovative approaches, such as nutrigenomics and digital health technologies, to personalize interventions and evaluate policy effectiveness. Collaboration across disciplines and sectors will be vital to develop comprehensive solutions and improve public health outcomes globally.

Could school programs based on social-emotional learning prevent substance abuse among adolescents?

In this editorial, we comment on the article Adolescent suicide risk factors and the integration of social-emotional skills in school-based prevention programs by Liu et al . While the article focused on the issue of suicide and social-emotional learning programs as a possible intervention, we here discuss evidence of other reported outcomes and if it could be an effective way to prevent substance abuse among adolescents.

Reducing asthma attacks in disadvantaged school children with asthma: study protocol for a type 2 hybrid implementation-effectiveness trial (Better Asthma Control for Kids, BACK)

BackgroundAsthma is a leading cause of children’s hospitalizations, emergency department visits, and missed school days. Our school-based asthma intervention has reduced asthma exacerbations for children experiencing health disparities in the Denver Metropolitan Area, due partly to addressing care coordination for asthma and social determinants of health (SDOH), such as access to healthcare and medications. Limited dissemination of school-based asthma programs has occurred in other metropolitan and rural areas of Colorado. We formed and engaged community advisory boards in socioeconomically diverse regions of Colorado to develop two implementation strategy packages for delivering our school-based asthma intervention — now termed “Better Asthma Control for Kids (BACK)" — with tailoring to regional priorities, needs and resources.MethodsIn this proposed type 2 hybrid implementation-effectiveness trial, where the primary goal is equitable reach to families to reduce asthma disparities, we will compare two different packages of implementation strategies to deliver BACK across four Colorado regions. The two implementation packages to be compared are: 1) standard set of implementation strategies including Tailor and Adapt to context, Facilitation and Training termed, BACK-Standard (BACK-S); 2) BACK-S plus an enhanced implementation strategy, that incorporates network weaving with community partners and consumer engagement with school families, termed BACK-Enhanced (BACK-E). Our evaluation will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, including its Pragmatic Robust Implementation Sustainability Model (PRISM) determinants of implementation outcomes. Our central hypothesis is that our BACK-E implementation strategy will have significantly greater reach to eligible children/families than BACK-S (primary outcome) and that both BACK-E and BACK-S groups will have significantly reduced asthma exacerbation rates (“attacks”) and improved asthma control as compared to usual care.DiscussionWe expect both the BACK-S and BACK-E strategy packages will accelerate dissemination of our BACK program across the state – the comparative impact of BACK-S vs. BACK-E on reach and other RE-AIM outcomes may inform strategy selection for scaling BACK and other effective school-based programs to address chronic illness disparities.Trial registrationClinicaltrials.gov identifier: NCT06003569, registered on August 22, 2023, https://classic.clinicaltrials.gov/ct2/show/NCT06003569.

Perceived impacts of a school-based growth mindset programme ‘Mindset Teams’ in Scotland: a qualitative study

BackgroundTeachers as delivery agents within school-based mindset programmes is a potential intervention strategy for improving pupils’ outcomes. The Mindset Teams programme, utilises teachers as delivery agents, with an aim to improve learning resilience for health and attainment outcomes among schools in Scotland. This study examined the perceived impacts of the programme to develop a programme theory of change and refine an earlier co-produced logic model.MethodsAcross six intervention schools, one-to-one interviews were conducted with teachers (N = 18) and focus groups were conducted with 23 pupils aged 8-11-years. Fourteen stakeholders involved in programme provision, secondary school delivery, funding decisions or policy-related areas also participated in a one-to-one interview. Qualitative data were analysed using thematic analysis with a combined deductive and inductive coding approach.ResultsThemes were identified in relation to impacts on teachers (five themes), pupils (eight themes), and broader outcomes (two themes), with most themes discussed by teachers and wider stakeholders. Across data, findings highlighted the proposed mechanisms by which the programme was intending to produce impacts, largely through increasing teacher knowledge and facilitating a positive school environment. Themes demonstrated the breadth of perceived programme impacts, highlighting both attainment and wellbeing outcomes among pupils.ConclusionsFindings provide support for Mindset programmes focusing on the development of teachers’ mindsets, highlighting the resultant perceived impacts this can have on both teachers and pupils alike. Future research should seek to capture health and wellbeing measures alongside attainment data to fully explore programme impacts.

Suicidal Thoughts and Behaviors Among US Adolescents: The Cumulative Effects of Polysubstance Use Behaviors

Background: The linkage between substance use and youth suicidality is less developed due to the predominant focus on certain types of substances (e.g., alcohol consumption, prescription opioid misuse). This study examines polysubstance use and its mutual impact on suicidal thoughts and behaviors among US adolescents. Methods: Data from 2019 Youth Risk Behavior Survey were utilized. Associations between the concurrent use of five substances (cigarette, e-cigarette, alcohol, marijuana, and prescription opioid) and suicidality (suicidal thoughts, suicide plans, and suicide attempts) were measured by logistic regression models. The combined effect of polysubstance use on suicidality was further assessed by structural equation modeling. Results: About two in five (42.1%) adolescents used at least one type of substances in the past month and one in seven (13.5%) used three or more types concurrently (polysubstance use). Adolescents with polysubstance use behaviors were three to five times more likely to experience suicidal thoughts (OR=3.8, p < 0.05), make a suicide plan (OR=3.5, p < 0.05), or attempt suicide (OR=4.6, p < 0.05) than non-users. In the final structural model, polysubstance use and suicidality were significantly correlated with each other (β=0.37, p < 0.05). Collectively, polysubstance use explained about 14% of variance in youth suicidality. Conclusions: Polysubstance use shows a significant impact on youth suicidality. School-based health centers and educational programs are recommended to reduce substance use and suicidal behaviors among adolescents. Accessible mental health services and targeted treatments are needed for polysubstance users to mitigate their risk of suicide.

Health literacy pedagogies and assessment embedded in a school-based health education program

AbstractStudies have focused on the development of teachers’ Health Literacy (HL) pedagogies but have yet to focus on building teachers’ assessment capacity. The aims of this research study were three-fold: 1) professionally develop teachers to enhance the HL planned in a Health and Physical Education (HPE) program and assessment task; 2) validate a previously developed curricular model of HL assessment (rubric) using student work samples; 3) measure students HL learning using an adaptation of the validated rubric. Researchers used a descriptive single school case study, using a mixed methods approach in an Independent, coeducational early learning, primary and secondary day school in Sydney, Australia to work closely with participants to review the pedagogical knowledge, learning activities and assessment within a HPE program using Nutbeam’s three level HL hierarchy. Using Messick’s six aspects of construct validity testing of the rubric was completed using 20 sample assessment tasks, as well as receiving feedback on the adaptability and feasibility of the rubric. The validated rubric was then adapted to the assessment task to measure students’ HL. Results demonstrated that professional development had a positive impact on the development of planned HL pedagogies as shown by a 17% increase in planned critical HL learning activities. Findings suggest that the validated rubric is a feasible and adaptable tool that teachers can use to measure students’ HL. This is the first study to validate a curricular model of measuring HL. Future research needs to develop teachers’ HL capabilities and assessment literacy.

Equity-focused Monitoring and Evaluation and Performance of School-based Health Projects

The purpose of the study was to examine the influence of equity-focused monitoring and evaluation on performance of school-based health projects. The study objectives were to determine to what extend does equity-focused monitoring and evaluation influence performance of school-based health projects, to establish the key constructs that drive equitable implementation of health projects, and to determine which methodological designs are used and how they compare across existing studies. A search criteria protocol was developed and adopted for systematic literature review to identify the most current peer-reviewed journal articles published in English between January 2019 and April 2024 using Google scholar and PubMed database search engines. Search terms used were as follows; Equity, Inequity, equity-focused monitoring and evaluation, performance, school-based health program, Equity in health systems. Data extraction was performed using a pre-defined eligibility criterion and a pre-tested data abstraction form. Online database search yielded 25 studies out of which five met the inclusion criteria. Data were analysed using descriptive analysis. Study results suggest that equity-focused adaptation was widely conceptualized in literature but with limited description of how to operationalize monitoring and evaluation as a tool to advance equity and improve program performance. Of the five articles reviewed (n=5), inclusion of a collaborative design, anti-racism consideration, embedding priority population expertise, cultural safety, and values were identified as key constructs that drive equitable implementation of health projects. Methodological convergence was noted across all the articles (n=5) where purposive sampling method, stakeholders as the target population was adopted while four articles (n=4) also converged on mixed method study design. Divergence was reported in sample size and data analysis methods. We conclude that current studies have not exploited the potential influence of equity-focused monitoring and evaluation on performance of school-based health projects. Key constructs for equitable implementation and methodological designs are well grounded though with limited operationalization. The study recommends that there is a need in future for equity-focused monitoring and evaluation empirical studies to test operationalization of the conceptual and theoretical frameworks currently available in literature. This will help advance equity and performance of school-based health projects.

Prevalence and Pattern of Ocular Diseases Among Children Aged 7-14 Years Visiting a Tertiary Care Teaching Hospital in Central India.

Ocular morbidity in children hinders their overall development.The prevalence and pattern vary amongst countries as well as within a country. Many ocular diseases if diagnosed and treated on time can prevent ocular morbidity in children to a large extent. The aim of this study is to determine the prevalence and pattern of ocular diseases in children (7-14 years) presenting tothe All India Institute of Medical Sciences, Bhopal, a tertiary care teaching hospital in central India. This is a single-center, hospital-based cross-sectional study conducted from June 2018 to August 2019.A total of 1276 children between 7and 14 years of age were included. A thorough ocular examination was done and a diagnosis was noted. Statistical analysis was performed using Microsoft Excel, Version 2013 (Microsoft Corp., Redmond, WA) and IBM SPSS Statistics for Windows, Version 23 (IBM Corp., Armonk, NY).A p-value of <0.05 was considered significant. Results: Out of 1276 children, 505 (39.6%) were of 7-10 years while 771 (60.4%) were of 11-14 years. There were 563 females (44.1%) and 713 males (55.9%). The most common ocular morbidity was a refractive error, (653; 51.1%), it was significantly higher in the age group 11 to 14 years than in children of 7 to 10 years of age (p<0.03). The second most prevalent ocular morbidity was infection/inflammation of the adnexa (18.8%) of which males were affected more than females (p<0.0005). The other morbidities were squint and neuro-ophthalmological-related diseases (8.3%), followed by trauma (3%), congenital diseases (2.6%), amblyopia (2.4%), degenerative diseases (0.7%), neoplastic (< 0.01%), and miscellaneous disorders (1.6%). The majority of ocular disorders are preventable and treatable. The most common ocular morbidity in our study is refractive error. We recommend school-based screening programs for timely detection and correction of refractive error and to prevent amblyopia.

Narrowing ‘Bathtub Volunteerism’ in Singapore and Beyond Through High-quality Adolescent and Young Adult Volunteer Experiences

High-quality volunteerism experiences in adolescence are associated with higher volunteerism later in life, yet less is understood about contextualized features of these experiences, especially when school-based programmes are mandatory. Relatedly, narrowing ‘bathtub volunteerism’ (i.e., increasing postgraduation youth volunteerism and shortening the period between volunteer disengagement and resumption) remains a research gap. Therefore, using in-depth retrospective qualitative interviews with 50 young Singaporeans, we aimed to understand features of high-quality volunteer experiences in schools (among adolescents) and communities (among young adults). Findings indicated that within a national context of compulsory school-based volunteerism, ‘bathtub volunteerism’ was narrowed efficaciously when adolescents and young adults were exposed to high-quality school- and community-based volunteer experiences, respectively. High-quality school-based experiences granted student autonomy and facilitated empathy development. Community-based ones combined cause selectivity, personal meaning and close interpersonal relationships. Our findings offer insights to raise volunteerism rates by developing and propagating high-quality volunteer experiences.

Beyond Averages: Unpacking Disparities in School-Based Vaccination Coverage in Eastern Sydney: An Ecological Analysis.

School vaccination programs are crucial for achieving high immunisation coverage among adolescents, but substantial disparities exist across schools and regions. This ecological study aimed to determine associations between school characteristics and vaccination coverage for diphtheria-tetanus-acellular pertussis (dTpa) and human papillomavirus (HPV) vaccines among year 7 students in southeastern Sydney. An analysis of data from 70 mainstream schools participating in the 2019 South Eastern Sydney Local Health District School Vaccination Program utilised quasi-Poisson regression models to assess associations between vaccination coverage and school attendance, socio-educational status, Aboriginal enrolments, language background other than English (LBOTE), school sector (government, Catholic, or independent), and coeducation status. Median school coverage was 88% for dTpa, 88% for HPV-girls, and 86% for HPV-boys, with interquartile ranges of 82-93%, 84-92%, and 78-91%, respectively. Higher school attendance was associated with increased dTpa vaccination coverage (PR 1.14, 95% CI 1.02-1.27). Single-sex schools showed higher HPV vaccination coverage compared to coeducational schools for both girls (PR 2.24, 95% CI 2.04-2.46) and boys (PR 1.89, 95% CI 1.72-2.08). No significant associations were found for ICSEA, Aboriginal enrolments, LBOTE, or school sector. School attendance and coeducational status significantly influenced vaccination coverage, with differential impacts on dTpa and HPV vaccines. These findings highlight the need for targeted strategies to address disparities in school-based vaccination programs. Research using qualitative methods could be useful to understand the beliefs and attitudes contributing to these disparities in vaccine uptake so that programs can be tailored to maximise participation.

Two universal school-based prevention programs for depression and anxiety: 24-Month follow-up of an RCT

Background and objectivesTransdiagnostic approaches have been promoted as a means of maximising preventative effects across multiple problems with depression and anxiety suitable targets as they appear to have highly interconnected systems in pathology development and maintenance. This study investigated long-term effects of two universal school-based programs, Emotion Regulation (ER) and Behavioral Activation (BA), that sought to prevent depression and anxiety by targeting worry (a transdiagnostic feature) to promote resilience. MethodsThis follow-up study captured data from 162 of 316 initial students (aged 8–13; 52.2% female), from six Australian schools. The original study design cluster randomised students by school into BA, ER, or a usual class control. Intervention conditions consisted of 8 × 50-min weekly sessions. This study measured the effects of these interventions after 24 months on resilience, worry, depression, and anxiety. Resilience was also examined as a potential mediator. ResultsAt 24-month follow-up, there was no significant effect of either intervention on depression, anxiety, worry, or resilience levels. Significantly fewer participants in ER and BA met clinical thresholds for separation anxiety disorder (SAD) and obsessive-compulsive disorder (OCD) in the 24-month follow-up compared with baseline. No mediation effects were found. LimitationsAlthough self-report measures are common in universal, school-based research, this represents a study limitation. ConclusionsBoth interventions may provide limited long-term protective effects on SAD and OCD symptoms, which appear to have a shelf-life shorter than 24 months. To maintain program effects, refresher sessions at shorter intervals may be a consideration for future research.

Duale und schulische Berufsausbildungen in Deutschland: Schritte zu einem umfassenden Verständnis von beruflicher Bildung

ZusammenfassungDie berufliche Ausbildung in Deutschland wird auch heute noch häufig mit der dualen Ausbildung gleichgesetzt. Schulische Berufsausbildungen können im doppelten Sinn als Ausbildungen zweiter Klasse gesehen werden: Sie werden in Öffentlichkeit und Wissenschaft seltener wahrgenommen; geraten sie aber in den Blick, so wird oftmals angenommen, dass die (überwiegend weiblichen) Personen, die solche Ausbildungen absolvieren, im Vergleich zu dual Ausgebildeten schlechtere Arbeitsmarktchancen haben. Der Beitrag skizziert zunächst duale Ausbildungen, Ausbildungen an Schulen des Gesundheitswesens sowie Ausbildungen an Berufsfachschulen (unter gesonderter Betrachtung der Erzieher:innen) im gesellschaftlich-historischen Kontext und zeigt, wie dieser Kontext letztlich auch mit unzureichender Forschung zu den schulischen Ausbildungen einhergeht. Mit Daten des Nationalen Bildungspanels (NEPS) werden anschließend die Chancen von Absolvent:innen der verschiedenen Ausbildungssegmente beim Übergang in den Arbeitsmarkt analysiert (Dauer bis zur ersten Beschäftigung, Merkmale des ersten Beschäftigungsverhältnisses sowie Arbeitslosigkeit nach der ersten Beschäftigung). Im Ergebnis zeigt sich, dass die (nicht bundesweit, sondern per Ländergesetzgebung geregelten) Ausbildungen an Berufsfachschulen tatsächlich mit etwas schlechteren Arbeitsmarktchancen verknüpft sind. Auffällig ist das Profil der Erzieher:innen, die besonders häufig befristet beschäftigt sind. Mit Blick auf den Beschäftigungsbedarf der Zukunft sind mehr öffentliche Aufmerksamkeit und mehr staatliches Engagement für die schulische Berufsbildung dringend erforderlich.

Prevalence of Smoking Among School Students in Iraq.

Background Developing communities like Iraq are critical to building a good community environment. Many complex patterns of behaviors like smoking among adolescents have been exacerbated rapidly in the current era which led to changes in the Iraqi community's perspectives and life expectancy. This study aims to find out the prevalence of smoking among secondary school students in Iraq and their perceived contributing factors. Methods A cross-sectional study design was used with a representative sample of Iraqi school students recruited through a multistage cluster randomization from the Nineveh Governorate's intermediate and secondary schools to ensure the representation of the general public strata. A total of 330 students were randomly selected from eight schools distributed all over Mosul city (the center of Nineveh Governorate) and its boundaries semi-rural areas. Data collection utilized a standardized, anonymous questionnaire based on the Global Youth Tobacco Survey (GYTS) administered within classrooms with the researcher's presence. The questionnaire included questions related to sociodemographic characteristics of the students, smoking state, smoking types, frequency of smoking, relative smoking state, opinion on predisposing factors for initiation of smoking, and knowledge about hazards of smoking. Data analysis was done using SPSS version 26 to calculate frequency distribution with further logistic regression analysis was performed to identify statistically significant factors contributing to initiation of smoking among the student participants with p-value estimation of any compares considered significant below 0.05. Results Prevenance of all types of smoking was 24.5% from 330 students with 30% from 246 males and 7%from 84 females has been encountered. Hookah (Shisha) was the most prevalent type of smoking.About a third of the smoker sample reported smoking at least once daily. Peer pressure (OR=3.49, P< 0.001) or family smoking (OR=1.769, P=0.019) emerged as the strongest influence for initiation of smoking, besides stress (OR=2.23, P= 0.04) and personality traits like stammering and jealousy (OR=2.58, P= 0.013), (OR=2.22, P= 0.017, respectively) have also significant odds. Interestingly, media (movie star) influence played a significant role also. (OR=1.492, P= 0.045). Conclusion The prevalence of smoking among the study sample was 24.5 % out of 330 participating students. Significant influencing factors were found that raised the concern and necessitated the development of targeted interventions. Implementing evidence-based strategies, such as comprehensive school-based educational programs and smoke-free indoor air policies, can significantly improve public health outcomes.

Delivery platforms for reaching adolescents with nutrition interventions in low- and middle-income countries.

Adolescents in low- and middle-income countries (LMICs) are a vulnerable population given increased nutritional needs as puberty approaches. School-based nutrition programs exist in some settings, but the comprehensive provision of nutrition services requires knowledge of the mechanisms to reach out-of-school adolescents. A comprehensive scopingreview was performed using formal and informal search strategies to landscape all potential delivery platforms with nutrition services to reach adolescents. Peer-reviewed studies, institutional strategies, program evaluations, and programmatic reports in LMICs were reviewed, including gray literature. A total of 87 out of 270 identified publications and reports describing nutrition programs for adolescents were identified. Although nutrition programs targeted at adolescents were sparse, various innovative and inclusive delivery platforms were included, such as school feeding programs, school-based anemia control, and nutrition-friendly school initiatives; health facility-based, youth-friendly health and nutrition services; social safety nets targeted at adolescents; community-based approaches targeting youth development and peer education within youth centers and faith-based settings; and technology-based platforms, including digital health services and mass media communication sensitization and mobilization efforts. Existing delivery mechanisms and platforms in health and other sectors that target adolescents offer great potential to extend nutrition interventions to this vulnerable yet hard-to-reach population.

Initiatives and exposures associated with food security in remote and isolated communities: a scoping review.

Chronic household food insecurity (HFI) and lack of food availability and accessibility in isolated communities are longstanding public health crises. This review aims to paint a more fulsome picture of food security initiatives in remote and isolated communities by examining programs across circumpolar countries, Australia, and Aotearoa New Zealand. This synthesis of research will contribute to an understanding of what types of initiatives exist and aid in the identification of best practices. The authors conducted a scoping review identifying articles that include either (1) an evaluation of an initiative with a quantitative food security outcome in remote and isolated communities, or (2) quantitative associations between exposure factors with food security outcomes. Inclusion criteria included English and French articles focused on remote and isolated communities in Canada, the US, Australia, New Zealand, Sweden, Norway, Finland, Greenland, and Russia from January 1997 to July 2022. The article search yielded 1882 results, of which 96 fulfilled the inclusion criteria, including 26 studies evaluating initiatives, 66 studies evaluating exposure factors, and four studies that included both initiatives and exposure factors. The majority of the studies included in this review were conducted in Canada and Australia. No initiative studies conducted in Russia, Greenland, Norway, Finland, or Sweden fulfilled the criteria for inclusion in this review. The most common types of initiatives evaluated included school-based programs, market subsidies, and education initiatives, though a small number (<5) of other programs were evaluated, including traditional food programs and greenhouses. Though multiple programs resulted in lower food costs or increases in healthy food consumption in remote regions, the cost of a healthy diet in these areas remained high, as do levels of HFI. Factors associated with improved food security outcomes included higher income level, access to adequate housing, higher education level, access to transportation for harvesting, and the level of remoteness of a community. The studies included in this review also stressed the importance of access to and affordability of harvesting traditional foods in these regions. Those living in remote and isolated communities are particularly vulnerable to food insecurity and lack of access and availability of healthy foods, which are compounded by a variety of socioeconomic factors. This study highlights the lack of quantitative evaluations of food security initiatives in remote and isolated communities, as well as the wide variety in measured outcomes. Authors of several of the included articles note that community-led initiatives, with strong partnerships and local champions, were recommended in these populations, given the culturally and geographically diverse groups living in remote and isolated areas.

Impact of a Youth Sun Safety Educational Program.

Sun protection early in life is necessary to prevent skin cancer. Therefore, youth sun safety education is imperative. However, such programs have often failed to bring about behavioral change in youths. We evaluate a sun safety educational program's effectiveness in improving elementary school students' knowledge of sun safety, confidence in their ability to explain the importance of sun protection, and their understanding of sunscreen labels. A 1.5-hour program was conducted for the fourth-grade students. Forty-five of the 53 students participated in the study and completed the pre- and post-surveys, a response rate of 84%. These surveys were identical, consisting of four questions rated on a Likert scale to assess changes in the students' knowledge, confidence, and understanding regarding sun protection. The students overall had a statistically significant increase in their knowledge of sun safety and sun protective measures, confidence in their ability to explain the importance of sun protection, and their understanding of sunscreen labels. In alignment with the current literature, this study demonstrates the importance of school-based sun safety programs and notably shows that such programs can increase youths' understanding of sunscreen labels and confidence in explaining the importance of sun protection. It is our hope that the program will cause increased practice of sun protective behaviors among the students. Further research is needed to determine how effective such programs are in increasing the practice of sun protective behaviors in youths.

Child sexual abuse in Vietnam: A review of prevalence, risk factors, and prevention strategies

Child sexual abuse (CSA) is a severe global problem that has long-term psychological, physical, and societal effects for victims. This review looks at the prevalence, risk factors, and effects of CSA, with a specific emphasis on Vietnam. The frequency of CSA varies worldwide, with notable regional variations. In Vietnam, approximately 2,000 children are sexually abused each year, with females being disproportionately affected. Risk variables include age, gender, family dynamics, social level, and cultural norms. The review investigates the short- and long-term effects of CSA, which include mental health illnesses, physical health issues, and social difficulties. Prevention and intervention efforts, including as school-based education programs and parental involvement, show promise, but they encounter obstacles owing to cultural stigma and limited resources. The Vietnamese government has developed a variety of policies and legal frameworks to combat CSA, however gaps persist. This research emphasizes the importance of a multidimensional approach that involves broad education, substantial support services, and ongoing legislative improvements to effectively prevent and respond to CSA. Future study should focus on improving preventative strategies and assuring their long-term efficacy.