Problem behaviors in adolescents

A fifth or more of a nationally representative sample of school-attending adolescents report engaging in problem behaviors such as skipping school, using alcohol, fighting, shoplifting, and stealing. A smaller but significant number of adolescents report engaging in risky sexual behaviors. All of these behaviors have potentially serious consequences for adolescents, their family and friends, their school, and society. Nurses are in a unique position to help identify these behaviors in adolescents, educate school personnel about the behaviors, educate adolescents about the risks they face when they engage in these behaviors, and assist parents to access the resources they need to help children who may be engaging in these problem behaviors.

Advocating for a harm-minimization approach to drug education in Australian schools

The concept of using a harm-minimization approach to drug education in Australian schools has existed in both national and state government policy documents for over two decades. However, this approach appears to be ineffectively and inconsistently incorporated within the curriculum. Harm minimization emphasizes strategies that reduce the harms associated with drug use and prevent related health and social problems. Traditional drug education programs that promote abstinence as the only option may not be realistic and appear to have had limited success. School nurses in the state of Victoria have a significant role in improving both the understanding and adoption of this approach through advocacy, education, and their understanding of evidence-based practice.

Acceptability of a school-based intervention for the prevention of adolescent obesity

This article describes the development and pilot testing of a computer-based, multiple-behavior obesity prevention program for adolescents. Using the Transtheoretical Model as a framework, this intervention offers individualized feedback based on readiness to engage in physical activity, to consume fruits and vegetables, and to limit television viewing. Focus groups and interviews with students, teachers, school administrators, and experts guided the development. Forty-five students participated in a baseline intervention session and completed a 16-item acceptability measure. Ratings were positive, with item means ranging from 3.60-4.75 on a 5-point scale. Student responses to open-ended questions aided in the enhancement of the intervention, for which an effectiveness trial begins in September 2006. This formative work demonstrated the acceptability of this school-based intervention approach, which can be promoted and prescribed by school nurses. Further, if found effective, it can be disseminated as an efficient, low-cost, population-based approach designed to address the epidemic of obesity.

Providing asthma care in elementary schools: understanding barriers to determine best practices

School nurses play a critical role in the management of children's asthma, yet they face barriers in their efforts to deliver quality care. In this qualitative study involving focus groups with school nurses, we identified key barriers in order to inform best practices. School nurses identified 4 main barriers to effective asthma care in elementary schools: lack of education, lack of communication, lack of resources, and lack of respect. An analysis of the barriers suggests that best practices for asthma care in elementary school settings require collaborative strategies that involve schools, families, the community, and the healthcare profession.

Body piercing in school children: a review of the issues

Over recent years piercing of parts of the body other than the earlobes has become more common among school children. This article seeks to explore the issues raised by the practice, particularly for the school nurse, who may be involved in the management of children with body piercing in school. An overview of the different types of body piercing is provided, as well as a discussion of the legal aspects of body piercing in children under the age of 18. The infectious and non-infectious complications that may arise are examined. The article also addresses some of the psychological issues around body piercing, in particular exploring what motivates children to have a piercing done, and looks at the evidence that associates body piercing with high risk behaviours in this age group. Finally, the article provides practical guidance to healthcare professionals about managing children with body piercings, looking in particular at steps that can be taken to promote safe healing and the avoidance of complications.

School nurse practice: a decade of change

Good practice requires an evidence base and criteria for assessment, which was the subject of a scope review of school nurse practice across the four countries of the UK. The findings demonstrate a rich base of research into service practice, particularly in the last decade. School nursing practice has experienced a paradigm shift from a medical to a social model of care. The service now works from a public health ethos and has a preventive agenda. The focus is on the child rather than a service for schools and school nurses work in teams rather than alone. Under-resourcing continues to beleaguer school nurse practice and there are areas that need further study, particularly large-scale research into the costs and benefits of school nursing.

Helping teen mothers succeed

Because the success of teen mothers is enhanced by completing high school, school districts should give high priority to supporting teen mothers to remain in school and to graduate. This article reviews the literature on the educational attainment of these students, their school aspirations, and the policies affecting their education. Although teens often begin mothering with a range of educational and social disadvantages, many teen mothers recommit to school to enhance their future opportunities. Unfortunately, rising school aspirations among teen mothers often are undermined by competing demands and the lack of consistent family and school support. School nurses can support teen mothers' aspirations and contribute to their long-term success by linking them to resources and advocating for policies and practices that promote high school graduation.

Encouraging sun safety for children and adolescents

The rise in the number of cases of skin cancers, both melanomas and nonmelanomas, has prompted increased awareness and educational efforts to limit sun exposure. Because 80% of lifetime sun exposure occurs before the age of 18, educating parents and adolescents to incorporate sun-protective behaviors into daily routines is particularly important. Education of parents is essential to establishing healthy behavior patterns in children. Educational interventions are recommended that encourage the following: using sunscreen, wearing hats with wide brims and clothing that blocks or absorbs ultraviolet rays, using sunglasses that block ultraviolet radiation, and seeking shade. Continued efforts are important through adolescence to maintain the established behaviors. School nurses are in a position to affect the health education curriculum, as well as school policies that promote sun safety behaviors.

School health nursing services role in education: the No Child Left Behind Act of 2001

Public Law 107-110, the No Child Left Behind Act of 2001, represents the most sweeping reauthorization of the Elementary and Secondary Education Act since it was enacted in 1965. The goal of the No Child Left Behind Act is to improve the academic achievement of all American students so that they all meet their own state's standards for competence by 2014. The law focuses on closing the achievement gap that exists among the economically disadvantaged, those with limited English proficiency, racial/ethnic minorities, and students receiving special education services. The No Child Left Behind Act has created both support and controversy in education circles. Although the No Child Left Behind Act does not legislate the practice of school nursing, as professional staff working in schools, school nurses are affected indirectly by the heightened emphasis on accountability for achievement in public education. School nurses actively promote and support achievement for all students in specific ways and help to provide a safe school environment.

Health visitor or public health nurse? A Scottish study

The Scottish Executive and the National Health Service (NHS) have been consistently promoting 'public health nursing' as a new way forward in the community. In addition, since 2001 traditional health visitor and school nurse education programmes have been replaced by a single public health nurse training curriculum. However, many of the roles, responsibilities and job descriptions of clinical health visiting staff have remained unchanged within health board areas. This has led to apparent confusion among staff, both newly qualified and those already in post. This lack of clarity in policy and role prompted this research study, which set out to investigate the perceptions of the public health role of the health visitor within a health board area in Scotland. Initially, a review of the relevant literature was undertaken to provide in-depth background information on the topic, to enable a critical analysis of the current public health role of the health visitor. This analysis was further informed by obtaining qualitative and quantitative data via a questionnaire sent to 89 health visitors, to determine the attitudes and opinions of health visitors currently working within a Scottish health board area. Results from the study indicate that, despite the plethora of public health-related Scottish Executive publications and the changes in educational programmes, many health visitors still carry out what is perceived as a traditional role with mainly the under-five age group. The study also identified the need for clear direction in the public health role for health visitors, with many health visitors expressing a willingness to make changes to their current role.