School-level Participation Research Articles

High Technology Use at Bedtime Doubles Risk for Sleep Insufficiency

Source: Stine F, Collier DN, Fang X, et al. Impact of body mass index, socioeconomic status, and bedtime technology use on sleep duration in adolescents [published online ahead of print September 25, 2021). Clin Pediatr (Phila). doi:10.1177/00099228211047791Investigators from East Carolina University, Greenville, NC, conducted a cross-sectional study to evaluate the association of use of technology prior to going to bed and insufficient sleep. Study participants were children enrolled in the seventh grade in the fall of 2017 at 1 of 47 schools in 10 counties in North Carolina who were participating a school-based wellness program. Data were analyzed on those children in the program who had height and weight measured for BMI determination and who completed a questionnaire on sleep and technology use. Participant sex and race data also were collected. Socioeconomic status was approximated for each participant by school-level participation in the National School Lunch Program (NSLP), with higher percentages of participation indicative of lower SES. The primary study outcome was insufficient sleep, defined as a self-report of sleeping <8 hours/night. The main exposure of interest was high technology use (TU), which was based on a student reporting use of a form of technology within 1 hour of trying to go to sleep either “a few nights each week,” or “every night or almost every night.” The bivariate association between insufficient sleep and self-report of having a TV in the bedroom, being overweight (BMI ≥85th and <95th percentile for age) or obese (BMI >95th percentile for age), sex, race, and SES also were evaluated using chi-square tests. Logistic regression was used to determine the independent association of these variables and insufficient sleep.Data were analyzed on 3,956 seventh graders, of whom 38.7% reported getting insufficient sleep (<8 hours/night), 83.1% reported high TU, and 72.9% reported having a TV in their bedroom. There were no significant differences in reporting insufficient sleep by sex (P = 0.116), or race (P = 0.160), and these characteristics were not included in the multivariate model. In the multivariate logistic model, high TU was an independent predictor of insufficient sleep (OR, 0.53; 95% CI, 0.46, 0.61), indicating that the risk of sleep <8 hours/night was almost twice as high in those with high TU. Having a TV in the bedroom (OR, 0.82; 95% CI, 0.70, 0.95) and being obese (OR, 0.82; 95% CI, 0.70, 0.95) also were significantly associated with sleeping <8 hours/night. There was no significant association between being overweight and insufficient sleep (OR, 0.85; 95% CI, 0.71, 1.01), but children in schools with higher participation in the NSLP were at significantly increased risk for reporting <8 hour/night of sleep.The authors conclude that seventh graders reporting high bedtime TU were at increased risk for insufficient sleep.Dr Candee has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.Adolescent sleep deprivation is a growing health problem with profound consequences, including depressed mood, cognitive impairment, behavioral dysregulation, and poor school performance.1 This problem is in large part related to the availability and use of electronic devices at bedtime.2The investigators of the current study found that more than a third of nearly 4,000 seventh graders in rural North Carolina were not getting sufficient sleep. Those with high TU within 1 hour of trying to go to sleep were nearly twice as likely (as those with lower TU) to be getting <8 hours of sleep per night. Having a TV in the bedroom, obesity, and lower SES also were associated with a higher likelihood of sleep insufficiency. The study results fortify those of previous studies showing that portable devices have more deleterious effects on sleep than those that are not (eg, a TV).3The investigators’ findings are strengthened by the large sample size. Potential weaknesses include the use of the national school lunch program as a surrogate for the SES level of the entire school (rather than tracking by individual participants), the use of self-reported health data, and the use of a single question to capture sleep duration despite adolescent propensity for weekend catch-up sleep. The results of another recently published study showed that greater electronic device use at bedtime was not only associated with delayed sleep onset and decreased sleep duration but also with overall sleep disturbance symptom severity.4If seventh graders in rural North Carolina aren’t getting enough sleep, it stands to argue that older adolescents attending high school in more urban settings with increased access to phones/technology are likely not getting enough sleep either. More counseling on the importance of sleep hygiene and the impact of electronic device use upon sleep is needed in order to help adolescents and their families prioritize and protect sleep duration.High bedtime technology use in adolescents is a significant risk factor for insufficient sleep and is a modifiable behavior.

Characteristics of e-Cigarette Use Behaviors Among US Youth, 2020

Comprehensive surveillance of e-cigarette use behaviors among youth is important for informing strategies to address this public health epidemic. To characterize e-cigarette use behaviors among US youth in 2020. The 2020 National Youth Tobacco Survey, a nationally representative, cross-sectional, school-based survey of middle school (grades 6-8) and high school (grades 9-12) students, was conducted from January 16, 2020, to March 16, 2020. A total of 14 531 students from 180 schools participated in the 2020 survey, yielding a corresponding student-level participation rate of 87.4% and school-level participation rate of 49.9%. The overall response rate, a product of the school-level and student-level participation rates, was 43.6%. Current (past 30-day) e-cigarette use. Self-reported current e-cigarette use behaviors (frequency of use, usual e-cigarette brand, and access source) by school level and flavored e-cigarette use and flavor types among current e-cigarette users by school level and device type. Prevalence estimates were weighted to account for the complex survey design. Overall, 14 531 students completed the survey, including 7330 female students and 7133 male students with self-reported grade level and sex. In 2020, 19.6% (95% CI, 17.2%-22.2%) of high school students and 4.7% (95% CI, 3.6%-6.0%) of middle school students reported current e-cigarette use. Among them, 38.9% (95% CI, 35.2%-42.6%) of high school users and 20.0% (95% CI, 16.0%-24.8%) of middle school users reported e-cigarette use on 20 to 30 days within the past 30 days. Among current users, JUUL was the most commonly reported usual brand (high school: 25.4%; 95% CI, 18.8%-33.4%; middle school: 35.1%; 95% CI, 27.9%-43.1%). Among current users, the most common source of obtaining e-cigarettes was from a friend (high school: 57.1%; 95% CI, 52.6%-61.4%; middle school: 58.9%; 95% CI, 51.4%-66.1%). Among current users, 84.7% (95% CI, 82.2%-86.9%) of high school students and 73.9% (95% CI, 66.9%-79.8%) of middle school students reported flavored e-cigarette use. Fruit-flavored e-cigarettes were the most commonly reported flavor among current exclusive e-cigarette users of prefilled pods or cartridges (67.3%; 95% CI, 60.9%-73.0%), disposable e-cigarettes (85.8%; 95% CI, 79.8%-90.3%), and tank-based devices (82.7%; 95% CI, 68.9%-91.1%), followed by mint-flavored e-cigarettes. These results suggest that although current e-cigarette use decreased during 2019 to 2020, overall prevalence, frequent use, and flavored e-cigarette use remained high. Continued actions are warranted to prevent and reduce e-cigarette use among US youth.

Impact of the Community Eligibility Provision on meal counts and participation in Pennsylvania and Maryland National School Lunch Programs.

To determine whether school-level participation in the federal Community Eligibility Provision (CEP), which provides free school lunch to all students, is associated with school meal participation rates. Participation in school meals is important for decreasing food insecurity and improving child health and well-being. Quasi-experimental evaluation using negative binomial regression to predict meal count rates per student-year overall and by reimbursement level adjusted for proportion eligible for free and reduced-price lunch (FR eligibility) and operating days. Schools (grades kindergarten to 12th) participating in the National School Lunch Program (NSLP) in Maryland and Pennsylvania, USA, from the 2013-2015 (n 1762) and 2016-2017 (n 2379) school years. Administrative, school-level data on school lunch counts and student enrolment. CEP was associated with a non-significant 6 % higher total NSLP meal count adjusting for FR eligibility, enrolment and operating days (rate ratio = 1·06, 95 % CI 0·98, 1·14). After controlling for participation rates in the year prior to CEP implementation, the programme was associated with a significant 8 % increase in meal counts (rate ratio = 1·08, 95 % CI 1·03, 1·12). In both analyses, CEP was associated with lower FR meal participation and substantial increases in paid meal participation. School-level implementation of CEP is associated with increases in total school meal participation. Current funding structures may prevent broader adoption of the programme by schools with fewer students eligible for FR meals.

A Group Randomized Intervention Trial Increases Participation in the School Breakfast Program in 16 Rural High Schools in Minnesota

BackgroundBreakfast consumption is associated with better diet quality and healthier weights, yet many adolescents miss breakfast. Nationally, 17.1% of students participate in the School Breakfast Program (SBP). Only 10% of high school students participate. ObjectiveOur aim was to evaluate an environmental intervention to increase SBP participation in high schools. DesignA group randomized trial was carried out from 2012 to 2015. Participants/settingNinth- and 10th-grade students enrolled in 16 rural schools in Minnesota (median 387 students) were randomized to intervention or control condition. InterventionA school-based intervention that included two key components was implemented over a 12-month period. One component focused on increasing SBP participation by increasing student access to school breakfast through changes in school breakfast service practices (eg, serving breakfast from a grab-n-go cart in the atrium; expanding breakfast service times). The other component focused on promoting school breakfast through student-directed marketing campaigns. Main outcome measureChange in school-level participation in the SBP was assessed between baseline (among ninth and tenth graders) and follow-up (among tenth and eleventh graders). School meal and attendance records were used to assess change in school-level participation rates in the SBP. Statistical analysesThe Wilcoxon test was used for analysis of difference in change in mean SBP participation rate by experimental group. ResultsThe median change in SBP participation rate between baseline and follow-up was 3% (interquartile range=13.5%) among the eight schools in the intervention group and 0.5% (interquartile range=0.7%) among the eight schools in the control group. This difference in change between groups was statistically significant (Wilcoxon test, P=0.03). The intervention effect increased throughout the intervention period, with change in mean SBP participation rate by the end of the school year reaching 10.3% (95% CI 3.0 to 17.6). However, among the intervention schools, the change in mean SBP participation rates was highly variable (range=–0.8% to 24.8%). ConclusionsInterventions designed to improve access to the SBP by reducing environmental and social barriers have potential to increase participation among high school students.

Relations of participation in organized activities to smoking and drinking among Japanese youth: contextual effects of structural social capital in high school.

This cross-sectional study examined the effect of school-level structural social capital on smoking and drinking among Japanese youth. Self-administered anonymous questionnaires were distributed to 3248 students at 29 high schools across Okinawa, Japan in 2008. Structural social capital was measured by students' participation in organized activities: student council, extracurricular activities, volunteer activities, community sports clubs, and youth associations. Contextual-level social capital was measured by aggregated school-level individual responses. At the individual level, extracurricular activity participation was negatively associated with smoking and drinking, whereas participation in youth associations was positively associated with smoking and drinking. School-level extracurricular activity participation was negatively associated with smoking among boys, whereas school-level participation in youth associations was positively associated with smoking among boys and girls and drinking among boys. This study suggests that structural social capital measured by participation in organized activities, especially extracurricular activities, might be an important way for youths to attain good health. This study also supports the idea that particular type of activities, such as youth associations, can lead to the so-called "dark side of social capital".

Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes

Background: Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents.Objective: The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years.Method: A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6–9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups.Results: Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group.Conclusions: Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby.

Teachers’ perceptions of education for democratic citizenship in schools with transnational youth: A comparative study in the UK and Denmark

As a consequence of globalization and increased immigration, scholars call for reconceptualizations of citizenship and empirical studies to ascertain how citizenship education is enacted in schools serving youth from immigration backgrounds. This study addresses these needs by interviewing civic educators in purposefully selected secondary schools in Denmark and England and Scotland in the United Kingdom. Using data from semi-structured teacher interviews, complemented by classroom observations, the study revealed examples of civic teaching reflective of distinct civic cultures and global trends. In the British schools in the study, the extent to which citizenship was emphasized varied considerably. One school did much to promote local and global civic activism, whereas others emphasized school level participation and charity fundraising. Democratic participation in groups, support for the Danish welfare system, and valuing free expression featured strongly in the Danish schools in the study. Across countries, students were taught about human rights, global issues, and international organizations. Additionally, teachers identified opportunities and challenges in civic teaching for transnational students.

Youth tobacco access: trends and policy implications

ObjectiveWe examined whether the supply routes via which New Zealand adolescents aged 14–15 years accessed tobacco had changed during a period of dynamic policy activity.SettingWe analysed data from seven consecutive...

A review of community participation in school governance: An emerging culture in Australian education

United States. Decentralisation of education to the local levels and governance by local education authorities is a concept that was developed in England and Wales. Even though the Australian education systems have been greatly influenced by the British and American models, they have long resisted change and continued with the centralisation of power and authority at State level and control of the school systems by the bureaucrats. Several attempts to decentralise education to local authority or regional levels had little success. However, since the mid 1970s, a new concept of decentralisation of education to regional levels with devolution of significant power and authority to school level and community participation in school governance has been emerging as a new culture in Australian school systems. While there are different definitions of 'community participation in school based governance', conceptually, it can be viewed as a formal alteration of governance structures, and a form of decentralisation that identifies the individual school as the primary unit of improvement and relies on the redistribution of decision-making authority through which improvements in schools might be stimulated and sustained. For this purpose, varying degrees of formal authority to make decisions in the domains of school's mission, goals, priorities, policies relating to financial, material and human resources as well as budgets are being transferred to the school level. For the purpose of exercising this power and authority, some formal structure known as a 'council' or 'board' consisting of the principal and the representatives of the teachers, parents, community and in some cases students is created so that school level participants can be directly involved in school-wide decision making. The devolution of power and the creation of the new