School Health Team Research Articles

A model to facilitate collaborative social support for pregnant students in secondary schools.

Pregnancy among secondary school students remains a public health problem and is associated with school dropout as well as poor maternal and child health outcomes. Schools in South Africa no longer expel pregnant students as was the case before 2000. Instead, the government encourages them to remain in class to complete their education, but pregnant students often face stigma, and some drop out of school as a result. To remain in class and access antenatal care, pregnant students require social support from teachers, parents and professional nurses. Unfortunately, teachers, parents and professional nurses support pregnant students on an ad hoc basis, and this calls for a model to facilitate collaborative social support. The purpose of this paper is to present and describe a model to facilitate collaborative social support for pregnant students attending secondary schools in South Africa, using the model description steps of Chinn and Kramer. The model is designed as a tool to enable pregnant students to remain in school, attend antenatal care and in the end, deliver healthy babies. The professional nurse, as a member and leader of the school health team which visits secondary schools to provide a package of school health services, is the agent or facilitator of the model.

Effect of Nursing Intervention Program on stress and competence of Parents of Attention Deficit Hyperactivity Disorders Children

Background: The Attention-Deficit/Hyperactivity-Disorder (ADHD) is a common neurobehavioral childhood problem with negative impacts on child and parents. The aim of this study was to evaluate the effect of a nursing intervention program on stress and competence of parents of ADHD children. Subjects M child-related, parent-related, and total PSI (p<0.001). ADHD improved among 78% after the intervention (p<0.001). Statistically significant negative correlations were found between the scores of parents’ satisfaction, competence, and PSOC from one side and each of the child-related, parent-related, PSI, and ADHD scores. In conclusion, the implementation of an educational intervention to the parents of children with ADHD is effective in improving their parenting satisfaction, efficacy, and PSOC, with reduction in their stress, and improvement of child abnormal behaviors. Recommendations: It is recommended to apply the developed program in the study settings for more improvements. The school health team needs to be trained in screening and early detection, with counseling clinics for parents of ADHD children.

Competency-Based Framework and Continuing Education for Preparing a Skilled School Health Workforce for Asthma Care: The Colorado Experience.

School health teams commonly address the needs of students with asthma, which requires specific knowledge and skills. To develop a skilled school health team, a competency-based framework for managing asthma in schools was developed. A modified Delphi with 31 panelists was completed. Consensus (≥80% agreement) was reached for all 148 items regarding the appropriateness as a minimum competency for asthma care in schools. The resultant Colorado Competency Framework for Asthma Care in Schools guided the development and pilot testing of a continuing education curriculum for school nurses. Pre- and postassessments demonstrated significant improvements in knowledge and self-confidence related to asthma care in schools and inhaler technique skills. This work is the first to use a consensus process to identify a framework of minimum competencies for providing asthma care in schools. This framework informed a continuing education curriculum that resulted in improved knowledge, confidence, and skills for school nurses.

Escovagem de dentes em ambiente escolar e redução do índice de placa bacteriana: avaliação da efetividade de um projeto de saúde oral

Facing the high prevalence of dental caries in Portuguese children, the school health team of Oliveira do Bairro county (district of Aveiro) launched an health education project (Mr. Tooth Project), during 2012/13, intended to preschool age (3‐6 years) and consisting in the implementation of tooth brushing at school.The study aimed to estimate the reduction of dental plaque in children covered by this project in order to evaluate its effectiveness on dental caries's reduction.A quasi‐experimental study was developed and the individual dental plaque index was evaluated before and after Mr Tooth Project implementation (nbefore=256; nafter=190).Prevalence of caries estimated before the beginning of the intervention was 32.8% (95% CI: 27.0% ‐ 38.6%). The reduction of dental plaque index found between evaluations was 2.45 (95% CI: 2.38‐2.51). A positive association between dental plaque index reduction and number of decayed, missing and filled teeth due to caries, and also with initial dental plaque index, was demonstrated. A negative association between dental plaque index reduction and interval between evaluations was also found.The results pointed to the effectiveness of school health programs that promotes daily tooth brushing at school and suggest the need to evaluate intervention projects span in order to optimize resources for its development.

Barriers and Facilitators to Sustaining School Health Teams in Coordinated School Health Programs.

Coordinated school health (CSH) programs address multiple factors related to students' overall health, thereby increasing their physical and mental readiness to learn. A formative evaluation of three school districts in 2010-2011 examined strategies for sustaining the school health teams (SHTs) that lead CSH efforts. Qualitative data from 39 interviews and 13 focus groups revealed facilitators and barriers for sustaining SHTs. Quantitative data from 68 questionnaires completed by SHT members and school principals examined factors associated with having more active SHTs and district and school characteristics SHT members believed to be important to their schools' efforts to implement CSH. Facilitators of sustaining SHTs included administrative support, staff engagement in the SHT, and shared goals and responsibility. Barriers to sustaining SHTs included limited time and competing priorities, budget and funding constraints, and staff turnover. Findings provide valuable insight into challenges and potential solutions for improving the sustainability of SHTs to enable them to better support CSH efforts.

The Absent Victim: Schools’ Assessment of the “Victimization Process”

The present study examines how a number of Swedish schools define and categorize students who have been exposed to different forms of violent or abusive acts in school. The study will shed light on how categorizations and forms of explanation used in the schools by professionals emerge from central institutional and professional discourses. The data are gathered from interviews with key officials and observations from school health team meetings. The results indicate a tendency toward more and detailed legal regulations concerning how schools act and react in relation to violent behavior.

Health Protecting and Health Promoting Behaviors Among Preparatory School Students in Zagazig City

Background. Adolescents’ lifestyle change can be facilitated through a combination of learning experiences that enhance awareness, increase motivation, and build skills. The aim of this study was to describe the health protecting and health promoting behaviors among preparatory school students in Zagazig city. This study was aimed to identify the most common health-related modified and non-modified behaviors and how they effect on wellness of the preparatory school students. Research design: A descriptive cross-sectional design was used to carry out the study. Setting: in a preparatory school in Kafr Mohamed Gawish at Zagazig city on 150 male and female students aged 12 to 15 recruited through stratified cluster random sampling. Tools: The data were collected using an interview questionnaire. →(Please, give some info regarding questionnaire; it is self-structured? Validated? Self-administrative? How is it scoring? Additionally, how the behavior was assessed? (Cut-off 60%). Tools: Two tools, the first tool (the data collection tool consisted of an interview questionnaire consisted two parts, socio-demographic characteristics, and medical history) and the second tool (a health promoting lifestyle questionnaire, in addition to a section asking students about the topics they suggest for personal growth. Results: The study results showed that approximately two thirds of adolescent preparatory school students from middle class families in rural areas had adequate total wellness behavior. The wellness behaviors' areas of most deficiency were those of exercise and mental activity, whereas the best areas were those of medication use, environmental, social, and spiritual aspects. Students' total wellness was significantly influenced by higher mother education, and lower crowding index, as well as the history of chronic diseases and previous surgery. Some of the wellness behavior aspects were also affected by students' age, gender, and father education. Conclusion and summary: Multivariate analysis identified → (Not in conclusion section) mother education as the only significant independent factor positively influencing adolescent's total wellness score. Students need to know more about topics related to nutrition, exercise, and anxiety. The wellness behaviors' areas of most deficiency are those of exercise and mental activity, whereas the best areas were those of medication use, environmental, social, and spiritual aspects. Recommendations: School health team should construct and implement special nutritional education intervention programs, promote physical exercise, and develop a hotline service for adolescents' health

Factors Influencing Compliance with Oral Hygiene Practices Among Upper Primary School Children at Eldoret Town in Uasin Gishu County, Kenya

Oral health is an important part of general health of body while poor oral hygiene can be a source of many diseases and especially among children. Compliance with practices enhances oral health, individual self esteem, social acceptability among the peers and general health. The practices that prevent and reduce oral diseases include tooth brushing; tooth flossing; use of fluoridated toothpaste for brushing and mouth rinsing and lower consumption of sugary foods and beverages. Regular dental visits are a practice that helps in early detection and prevention of dental diseases. Several factors influence compliance with oral hygiene practices among the children. The study was done to investigate factors that influence compliance with oral hygiene practices among upper primary school children at Eldoret Town. First and foremost the study established the compliance of the children with oral hygiene practices. Specifically factors considered in this study were family and school characteristics. The research design was a descriptive cross-section survey conducted in four primary schools in Eldoret Town of Uasin Gishu County, Kenya. The sample comprised three hundred and sixteen (316) upper primary school children. Results showed that majority (70.3%) of the respondents brushed their teeth using toothbrush twice daily and 63.6% used fluoridated toothpaste. Only 24.3% used dental floss while 54.6% had never visited a dentist for checkups in-spite of having knowledge. There was a significant correlation between compliance with oral hygiene practices and family and school characteristics (r=0.425, p<0.001 and r=0.238, p<0.001) respectively. The study concluded that children in upper primary school were compliant with tooth brushing using fluoridated toothpaste. However, they were non-compliant with the use of dental floss and going for dental check-up. The study also concluded that family characteristics (role models, motivation/encouragement, financial ability) and school characteristics (oral health curriculum, teachers trained in oral health, working school health team, safe environment with adequate water, free from unhealthy foods) influenced the compliance with oral hygiene practices of children.

Impact of "+Contigo" training on the knowledge and attitudes of health care professionals about suicide.

OBJECTIVES: to evaluate the results of "+Contigo" training, developed by nurses and directed at 66 health professionals of integrated school health teams in Primary Health Care. METHOD: quantitative with data collection through the Suicide Behavior Attitude Questionnaire, administered before and after the training. RESULTS: significant increases were observed in suicide prevention knowledge and in changing attitudes of health professionals towards individuals with suicidal behavior. CONCLUSION: these results allow us to affirm that nurses hold scientific and pedagogical knowledge that grant them a privileged position in the health teams, to develop training aimed at health professionals involved in suicide prevention.

Facilitators to promoting health in schools: is school health climate the key?

Schools can promote healthy eating in adolescents. This study used a qualitative approach to examine barriers and facilitators to healthy eating in schools. Case studies were conducted with 8 low-income Michigan middle schools. Interviews were conducted with 1 administrator, the food service director, and 1 member of the coordinated school health team at each school. Barriers included budgetary constraints leading to low prioritization of health initiatives; availability of unhealthy competitive foods; and perceptions that students would not eat healthy foods. Schools had made improvements to foods and increased nutrition education. Support from administrators, teamwork among staff, and acknowledging student preferences facilitated positive changes. Schools with a key set of characteristics, (presence of a coordinated school health team, nutrition policies, and a school health champion) made more improvements. The set of key characteristics identified in successful schools may represent a school's health climate. While models of school climate have been utilized in the educational field in relation to academic outcomes, a health-specific model of school climate would be useful in guiding school health practitioners and researchers and may improve the effectiveness of interventions aimed at improving student dietary intake and other health behaviors.

Pattern of Tobacco Consumption and Influencing Factors among Male School Children in Riyadh, Saudi Arabia

This study aimed at studying tobacco consumption patterns among male school children in Riyadh. Methods: A cross-sectional survey was carried out on 5961 male school children, using a modified WHO-GYTS questionnaire. Results: Smoking data was available for 4693(83%) children, among whom 483(10.3%; 95% CI:9.4-11.2%) reported being “current smokers”. Logistic regression reflected independent risk factors for tobacco use to include: educational stage (OR=3.1-4.4 for high school), school type (OR=6.2 for governmental-general compared to private schools), smoking household member (father / mother / brother / friends) (OR=1.5–25.7). Recommendations: Raising awareness of children is important for saving them from taking up the habit and assisting smokers to quit. The school health team should be playing important dual roles: directly for children and indirectly through empowering their teachers in combating tobacco use campaigns. Male school children are mostly affected by their peers, fathers and brothers. Thus, parents and siblings should be role models for their children / siblings, respectively, by not smoking themselves.

Overweight, obesity, underweight and stunting in female primary school learners in rural KwaZulu-Natal, South Africa

Malnutrition substantially impacts the health outcomes of children. Globally, the childhood prevalence of overweight and obesity has increased, while underweight and stunting (though decreasing) continues to pose a major public health challenge. In low- to middle-income countries, a mixed pattern of over- and undernutrition (nutritional transition) can exist in communities. To describe the prevalence of malnutrition among female learners in the Nongoma and Ceza districts in Zululand, KwaZulu-Natal (KZN). We performed a secondary analysis of anthropometric data collected during the 2011 HPV Vaccination Demonstration Project. School health teams, comprising trained nurses, measured the height (in cm) and weight (in kg) of 963 female learners in 31 primary schools. Internationally accepted standardised measures were used as cut-offs for defining overweight, obesity, underweight and stunting. We found evidence of both under- and overnutrition. Overall, 9% of female learners were overweight, 3.8% obese, 4% underweight and 9.2% stunted (using WHO/NCHS criteria). The highest levels of stunting were in the 11 - 12-year age groups, of underweight in the 10-year age group, of overweight and obesity in the 9 - 10-year age groups. Moreover, a proportion of underweight (17.4%), overweight (11.1%) and obese (22.9%) learners were also stunted. Our study describes the prevalence of overweight and obesity, wasting and stunting of female learners in KZN and suggests the presence of a nutritional transition in these rural communities; however, further studies are needed. Our findings emphasise the need for health promotion and education programs in schools.

Implications of new safeguarding guidance on school nursing

„ „Taking action to enable all children to have the best outcomes. This definition clearly places safeguarding in the realm of health care providers, and even more clearly in the defined role of child-centred public health staff (i.e. school health teams). However, the guidance is heavily focused on legislation and implementing legislation; and as such describes the lead role of the local authority (LA) children’s social worker and social work team. While the processes and protocols to be followed are to be locally developed and defined, a minimum standards set applies to all of these policies and procedures, outlining clearly who will do what, when and why—and how this activity will be monitored and measured. There is a defined expectation that a local authority children’s social worker must make a decision about the type of response required from any referral, and provide a response to the referrer within 1 working day of the referral being received. Children’s social workers are a relatively small group (in 2010 there were 19 975 full time equivalent social workers,

High uptake of Gardasil vaccine among 9 - 12-year-old schoolgirls participating in an HPV vaccination demonstration project in KwaZulu-Natal Province

Cervical cancer is linked to infection of the cervix by oncogenic human papillomavirus (HPV) subtypes. The quadrivalent Gardasil vaccine (against HPV types 6, 11, 16, 18), recommended in girls 9 - 12 years of age, has been shown to be safe, immunogenic and efficacious, with minimal or no side-effects. To demonstrate the capacity of school health teams to carry out vaccinations within a school environment. To assess the uptake of 3 doses of the vaccine, document lessons learnt and provide recommendations for a national rollout of school-based HPV vaccination for learners. Female learners (age 9 - 12 years) from 31 primary schools in Nongoma and Ceza districts (KwaZulu-Natal province, South Africa) were identified for inclusion in the vaccination programme. The 3 doses of vaccine were administered by existing school health teams. Education and training sessions were held with all stakeholders: provincial departments of health and education; school health teams; primary healthcare nurses; hospital doctors and nurses; private practitioners; school principals, teachers and governing bodies; parents; and community and traditional leaders. The overall uptake of the vaccine was found to be high: 99.7%, 97.9% and 97.8% for the first, second and third doses respectively (N = 963). No adverse events were attributed to the HPV vaccine. This project demonstrated the successful implementation of HPV vaccination among learners (ages 9 - 12 years) using school health teams.

The Role of the School Nurse

The care of children and young people is an important part of the role of the GP. As well as promoting the health of children and young people during contacts, GPs may refer children and their families to other health professionals for targeted interventions. Over the past few years, there has been considerable research concerned with the health of children and young people and policy drivers emphasizing a multi-agency approach. Most recently, the government has introduced ‘The Healthy Child Programme 0–19 years' (HCP) which provides further guidance on the commissioning of children's services. This article sets out to provide a greater understanding of the HCP (5–19 years) and the role of the school nurse within the school health team. This insight will assist GPs in understanding how best to support the unique needs of children and young people and the families who care for them as required in the GP curriculum.

Managing Diabetes Effectively in the School Setting

For the nation’s 215,000 children and adolescents with diabetes, major advances in diabetes management, medical research, and technology mean a brighter future. At the same time, young people with diabetes face unique and sometimes dangerous immediate challenges due to sometimes unpredictable glucose levels. As the number of students with diabetes increases, and diabetes care technologies change and require more intense diabetes management in school and at home, school nurses face new and ongoing challenges in providing care to students with diabetes. The updated 2010 edition of Helping the Student With Diabetes Succeed: A Guide for School Personnel, published by the National Diabetes Education Program (NDEP), is now available. The purpose of the guide is to educate school personnel about effective diabetes management. The guide also shares a framework and a set of practices, based on the school health team approach, that enable schools to ensure a safe learning environment for students with diabetes, particularly those who use insulin to control the disease (all students with type 1 and most with type 2 diabetes). In this article, we provide sample case studies and answers to frequently asked questions to help school nurses put the NDEP school guide information into practice in the school setting.

Assessing and evaluating students on placement

The role of the practice teacher is pivotal in supporting the development of students undertaking Nursing and Midwifery Council (NMC) approved Specialist Community Public Health (SCPHN), School Nursing programmes. It is a mandatory requirement that students of school nursing are supported and assessed by a named practice teacher, who must have met the requirements defined within the practice teacher standard ( NMC, 2008a ). In the fourth article of this series Faith Muir and Sarah Sherwin discuss the practice teacher’s role in assessing and evaluating SCPHN students on placement with the school health team.

Implementation of the e-Bug Project in Portugal

In Portugal, the need for health educational campaigns to reduce antibiotic misuse, and the implementation of handwashing and hygiene measures to reduce cross-transmission have become national priorities. The implementation of the e-Bug Project in our country has been conducted by the Directorate-General for Health as the beneficiary entity of the Project, in partnership with the Ministry of Education. The involvement of the operational structures of both ministries in the development of the Project has been guaranteed from the beginning. We have translated and produced 6000 junior and senior e-Bug packs, and started to distribute them to science teachers, health education coordinators and school health teams from all over the country, who were identified as stakeholders and registered as e-Bug users in an e-learning platform from the Ministry of Education. Portugal is deeply interested in the long-term sustainability of the e-Bug Project. Portuguese schools and the Portuguese e-Bug team will continue to support this initiative to benefit the health education of Portuguese children.

A situational analysis for the implementation of the National School Health Policy in KwaZulu-Natal

The South African National School Health Policy was launched in 2003 to improve pupils' health by linking school visits by nurses and other health providers with the intersectoral collaboration required for health promoting schools. In KwaZulu-Natal, the policy required that various parties collaborate in order to ensure the successful implementation of the policy. This study examines the status of provincial departments and district level groups and their capacity to contribute to this partnership. It is a situational analysis that includes interviews, a questionnaire and focus group discussions. The results reveal issues that need addressing before the policy can be successfully implemented, including staffing, transport for the School Health Teams and further training of these teams and the teachers. Given the health issues faced by South Africans, especially the quadruple burden of disease, it is imperative that the School Health Policy be comprehensively implemented in KwaZulu-Natal.

Assessing the learning needs of students

The role of the practice teacher is pivotal in supporting the development of students undertaking Nursing and Midwifery Council (NMC) approved Specialist Community Public Health (SCPHN), School Nursing programmes. It is a mandatory requirement that students of school nursing are supported and assessed by a named practice teacher, who must have met the requirements defined within the practice teacher standard ( NMC, 2008 ). In the third article of this series Sarah Sherwin and Liz Stevenson discuss the role of the practice teacher in assessing the learning needs of students on placement with the school health team.