Effect of full-time versus part-time school nurses on attendance of elementary students with asthma

Asthma, the most common chronic disease in children today, is the leading cause of absenteeism among students. It accounts for nearly 20 million lost school days annually. This study examined whether full-time (5 days per week) or part-time (2 days per week) school nurses would have a differential effect on the frequency of absences among elementary school students with asthma. This study found that students with asthma who were poor or who were African American and in schools with full-time nurses missed significantly fewer days (3 days, or 23% fewer missed days) than did their counterparts with asthma in schools with part-time nurses.

Health Department Activities Regarding Nonmotorized Small-Wheel Forms of Recreation

The Stages of Change Model and perceived benefits and barriers to providing injury prevention activities for nonmotorized small-wheel forms of recreation by local health departments were used to determine the status of injury prevention activity. A questionnaire mailed to a national random sample of 600 health departments resulted in a response rate of 67%. Approximately 10% of health departments were in the action and maintenance stages of the Stages of Change Model in relation to nonmotorized small-wheel forms of recreation, while the majority (70%) was in the precontemplation stage. More than 98% of health departments agreed that there were benefits to providing nonmotorized small-wheel forms of recreation injury prevention activities, including "decrease injury," "increase likelihood of wearing recommended safety equipment," and "increase awareness of injury." The vast majority (96%) of health departments believed there were barriers to providing injury prevention activities, including lack of financial resources, not enough expertise, and not enough time.

Perceptions of nursing faculty regarding ethical issues in nursing research

A major premise of any research activity is that ethical conduct will be identified and observed during the research process. Yet a comprehensive review of the nursing literature failed to find any research assessing nurses' perceptions of ethical issues related to authorship, publication, reporting results, or funding. This study assessed nursing faculty members' perceptions of ethical scenarios related to the areas of authorship, publication, reporting results, and funding. A 34-item questionnaire, consisting of ethical issues related to research, was mailed to a national random sample of nursing faculty who were teaching at graduate degree-granting institutions. A three-wave mailing was used to maximize response rate. A total of 388 nurses responded to the survey (77.6% response rate). Less than half of the respondents reported that content included in their curriculum was related to the issues under study. Respondents' perceptions of the ethical scenarios varied. A majority of the respondents considered six of the scenarios ethical, eight unethical, one questionable, and one not an ethical issue. Five of the scenarios received widely varied responses. Faculty members who had chaired student dissertations found three questionnaire items significantly (p < .05) more unethical than faculty members who had not chaired dissertations. Faculty teaching in programs in which the highest degree offered was a doctorate found two items unethical significantly more often than faculty teaching at programs in which the highest degree offered was a master's degree. Results of this study demonstrate the potential that students are not being taught necessary issues related to ethical authorship and publication practices. Faculty members themselves may not have had the education needed to educate their own students in the area of research ethics.

Continuing-education needs of public health educators: their perspectives

The objective of the study described in this article was to determine the perceived continuing-education needs of employed public health educators. A three-wave mailing of a questionnaire was sent to a national sample of 500 public health educators who were asked to rate their preparation on 41 subcompetencies. Of 299 returned surveys (63%), 149 indicated that they were not currently practicing public health educators. Thus, analysis was based on 150 respondents. Six subcompetencies were perceived by 25% or more of the respondents as topics in which they needed more training. Health educators reported a need for continuing education, focused primarily on administration and evaluation of programs and applying appropriate research principles. Furthermore, the public health educators overwhelmingly preferred to attend a conference or workshop (85%) as their method of obtaining further continuing education. Health education programs and professional organizations need to take note of the identified continuing-education needs when developing future educational programs to adequately update health educators.

Elementary school secretaries' experiences and perceptions of administering prescription medication

This study assessed elementary school secretaries' (n = 385) experiences and perceptions with student prescription medication. Sixty-nine percent (n = 246) reported dispensing student medication, and this group represents the focus of this study. One in four secretaries reported not receiving any training regarding administration of student medication. Of those who were trained, 28% received training of less than one hour, and 24% received training of one to two hours duration. Secretaries generally disliked the responsibility of dispensing medication to students, but felt prepared to do so. Most (63%) administered student medication five days per week. The most commonly administered categories included attention deficit/hyperactivity medication (92%), asthma medication (87%), and antibiotics (68%). Most (85%) reported they had made no medication errors during the past year.

Teacher perceptions and practices regarding school bullying prevention

This study examined a national random sample of teachers regarding their perceptions and practices concerning school bullying prevention activities. A total of 359 of 700 (52.4%) teachers responded. Most (86.3%) teachers had serious talks with both the bully and victim. Less than one-third set aside classroom time to discuss bullying (31.7%) or involved students in creating classroom rules against bullying (31.2%). Most perceived no barriers to implementing these activities. Teachers perceived post-bullying activities as the most effective means of reducing bullying problems, followed by improved student supervision, and by environmental bullying prevention activities. The findings suggest that preprofessional and continuing education are needed to improve teacher knowledge about effective classroom-based bullying prevention activities.

Pediatricians' perceptions and practices regarding prevention and treatment of type 2 diabetes mellitus in children and adolescents

OBJECTIVE

To assess pediatricians' perceptions and practices regarding the prevention and treatment of type 2 diabetes mellitus in children and adolescents in a cross-sectional study.

DESIGN

A 3-wave mailing of a questionnaire to 550 pediatricians. Descriptive statistics, analysis of variance, and logistic regression were used for data analyses.

SETTING

A national random sample of pediatricians who work in private practice, hospital settings, and/or clinics.

RESULTS

Every 1 in 9 respondents referred their patients with type 2 diabetes mellitus for exercise, while most pediatricians referred their patients for dietary interventions (62.3%) and educational services (62.6%). Pediatricians who were confident during counseling and follow-up were significantly (P =.02) more likely than pediatricians who were less confident to refer their patients for exercise, dietary interventions, and educational services. Of the respondents, 15.3% perceived they were well prepared to counsel and provide follow-up to patients with type 2 diabetes mellitus. The leading perceived barriers to counseling and follow-up were inadequate time for counseling, poor adherence of patients, lack of family support, lack of familiarity of clinical practice recommendations, and lack of health care insurance coverage.

CONCLUSIONS

Pediatricians who had a higher perceived confidence level and who perceived they were better prepared for the counseling and follow-up of patients with type 2 diabetes mellitus had a greater potential to positively affect their diabetic patients. Improving continuing medical education and residency-based programs is imperative to adequately address the emerging epidemic of type 2 diabetes mellitus in children and adolescents.

The nature and extent of bullying at school

In elementary schools, the prevalence of bullying ranges from 11.3% in Finland to 49.8% in Ireland. The only United States study of elementary students found that 19% were bullied. Bullying behavior declines as students progress through the grades. School bullying is associated with numerous physical, mental, and social detriments. A relationship also exists between student bullying behavior and school issues such as academic achievement, school bonding, and absenteeism. Prevention of school bullying should become a priority issue for schools. The most effective methods of bullying reduction involve a whole school approach. This method includes assessing the problem, planning school conference days, providing better supervision at recess, forming a bullying prevention coordinating group, encouraging parent-teacher meetings, establishing classroom rules against bullying, holding classroom meetings about bullying, requiring talks with the bullies and victims, and scheduling talks with the parents of involved students. Finally, this review suggests further studies needed to help ameliorate the bullying problem in US schools.

Adolescent smoking cessation services of school-based health centers

A national sample of 390 junior and senior high school-based centers were mailed an 18-item survey to assess their institutional stages of change regarding smoking cessation education, referral, and prescription nicotine replacement therapy (NRT) services and their perceived barriers and benefits regarding the provision of these services. Nearly half were in the maintenance stage for cessation education programs, one-third were in maintenance stage for referral services, and 12% were in the maintenance stage for NRT. The most frequently cited perceived benefits included an increased awareness of short- and long-term effects of smoking (education programs and referral services) and increasing student access to cessation methods (NRT). The greatest barriers cited were a lack of financial resources (education programs), problems with student transportation (referral services), and staff not having the authority to provide prescription services (NRT). School-based centers can do more to help stop adolescents from using tobacco.

Elementary school teachers' techniques of responding to student questions regarding sexuality issues

Fifth- and sixth-grade elementary school teachers' (n = 277) techniques of responding to students' human sexuality-related questions were assessed. Few teachers (34%) reported receiving formal training in sexuality education. The most commonly asked student questions dealt with STDs, puberty, homosexuality, pregnancy, and abortion. Teachers' willingness to answer sexually-related questions in front of the class varied (73% to 14%) by content of the question. There were no questions on the questionnaire in which more than one in five teachers would choose not to answer. The most common questions the teachers identified they would not respond to dealt with topics such as abortion, masturbation, homosexuality, and issues about the male genitals. Finally, none of the questions was perceived by more than one in eight of the teachers as questions they would not be allowed to answer.

Survey return rates using a covering letter signed by a graduate student or faculty member

This study assessed differences in response rate when the author of a survey was identified as a graduate student or a faculty member. A survey on research ethics was mailed to 500 nurse faculty members with half of the covering letters signed as a graduate student and half signed as a faculty member. There were 388 (78%) out of a possible 495 surveys returned. The response rate was 78% for graduate student and 77% for faculty identifications, not significant by chi-square test.

Urban elementary school students' perceptions of fighting behavior and concerns for personal safety

This study assessed urban elementary school students' experience with weapon carrying and violence, concerns for personal safety, and perceptions of passive and direct interventions in resolving fights. The survey was completed by 1,912 urban students in the fourth and fifth grades. This cross-sectional study found that one in 12 students reported weapon carrying one or more times during the past month. One-third indicated that they would hit peers back if struck by them. One-quarter of students did not feel safe going to or from school, and 23%-43% worried about being physically attacked in or around school. Adjusted odds ratios and 95% confidence intervals were calculated using logistic regression. Significant associations were found between the independent variables of age, race, gender, and academic success (grades) and the dependent variables of weapon carrying, hitting a peer back, concerns of safety, and passive solutions or direct interventions for peer fighting.

Primary grade teachers' knowledge and perceptions of head lice

This study examined primary grade teachers' knowledge of head lice, perceived self-efficacy in dealing with head lice, and preferred resources of additional information on head lice. Survey data from a three-wave mailing (M = 292; 60%) found that teachers needed more knowledge regarding head lice and were significantly more knowledgeable as teaching experience increased. A plurality (46%) had high efficacy expectations scores regarding their ability to control the spread of head lice. Most (71%) primary teachers reported they received most of their head lice information from school nurses. Most (63%) said they would like more information on how to prevent head lice infestation, and they wanted the information in the form of videotapes (68%) and brochures (51%). Only 23% provided yearly instruction regarding head lice.

Predictors of sixth graders engaging in sexual intercourse

Researchers explored factors related to sixth graders' sexual behavior. First, level of sexual behavior and sexual behavior intentions were examined. Second, health-related risk behaviors and constructs from Social Support and Social Cognitive theories were analyzed based on race and gender to determine their predictive value for sixth graders engaging in sexual intercourse. Findings indicated that very few sixth graders engaged in sexual intercourse or in high-risk behaviors such as smoking. Of the risk factors examined, smoking was the highest predictor of engaging in sexual intercourse for all categories of race and gender. Of the constructs, Efficacy Expectations consistently predicted engaging in sexual intercourse for all race and gender categories.

Mothers' perceptions of factors influencing violence in schools

This study investigated mothers' perceptions of factors contributing to school violence. Of 345 mothers, 225 (65%) from urban public schools and 120 (35%) from suburban public schools, significant differences in perceptions of school violence were found on the enabling factors subscale for school location. Urban school mothers were significantly more likely than suburban mothers to attribute violence problems at their child's school to the lack of dress codes, violent messages in rap music, and poor parent/teacher communication. Significant differences in perceptions of school violence were found on the reinforcing factor subscale for school location, income, family structure, and race. Mothers of low- and middle-income, single parents, and African Americans were much more optimistic about the possibility that violence prevention programs for students, parents, and teachers would work well to stop or reduce school violence than were higher-income, married, and White mothers. These mothers also were more likely to believe it was acceptable for their child to fight at school than were their counterparts.

High school health teachers' perceived self-efficacy in identifying students at risk for suicide

A national random sample of 228 high school health teachers completed a 45-item survey to examine their perceived self-efficacy regarding adolescent suicide. Most respondents were female, White, and held master's degrees. Most believed it was their role to recognize students at risk for suicide, believed that if they did recognize students at risk it would reduce the chances that the student would commit suicide, and believed that one of the most important things they could do would be to prevent a suicidal student from committing suicide. However, only 9% believed they could recognize a student at risk for suicide. High efficacy expectations scores were associated with working at a school that offered an inservice program on adolescent suicide, included teaching about suicide prevention in the curriculum, and had a crisis intervention team. This study suggests that teacher health education programs should spend more time on developing the skills necessary to identify students at risk. In addition, a comprehensive school suicide prevention program is strongly encouraged for all high schools.

School nurses' perceptions of and experience with school health research

This survey examined school nurses' perceptions of and experience with school health research. A random sample of school nurses who were either members of the school nurse section of the American School Health Association (ASHA) or members of the National Association of School Nurses (NASN) comprised the sample (n = 590). The response rate was 81%; the nurses were all females. A plurality held masters degrees (40%) and had worked an average of 12.0 years as a school nurse. Most (67%) were employed at the elementary school level. Slightly more than one-third (37%) had ever been involved in a research study as a school nurse. Perceived barriers to engaging in research were lack of time, clerical help, and money. Perceived benefits of school nurses engaging in research were: adds new knowledge on school nursing issues (97%), benefits the health care of children at school (93%), and helps peers do their job better (86%). School nurses also indicated they would become involved in research if someone would assist them (78%).

Junior high school students' perceptions regarding nonconsensual sexual behavior

This study assessed early adolescents' attitudes and perceptions regarding nonconsensual sexual activity. A total of 371 surveys (94% return rate) was completed. More than one-third of respondents (35%) reported they had engaged in sexual intercourse; 17% reported having been sexually coerced by a teen-ager; 19% reported feeling pressure from their friends to have intercourse; 7% reported having been sexually coerced by an adult; and 6% reported having sexually coerced someone else. Students also demonstrated lack of knowledge regarding nonconsensual sexual behaviors. Analysis of variance tests determined if knowledge (KN), attitudes (AT), behavioral intentions (BI), and locus of control (LC) changed across specific background and demographic variables. One background variable (having been sexually coerced by a teen-ager) was associated with high risk orientation (lower scores) on all four subscales. Lower scores also were associated with being male (KN, AT, BI), having sexually coerced someone else (KN, AT, BI), having been sexually coerced by an adult (AT, BI), and having engaged in sexual intercourse (AT, BI).

Evaluation of a three-year urban elementary school tobacco prevention program

The longitudinal study compared effects of varying amounts of tobacco instruction (one, two, and three years) on the knowledge, attitudes, and behavioral intentions of urban elementary students. A three-year, fourth-through-sixth grade tobacco prevention curriculum was developed based on the Centers for Disease Control and Prevention's Guidelines for School Health Programs to Prevent Tobacco Use and Addiction. The curriculum comprised five, 45-minute lessons per year. The same trained instructor taught the curriculum all three years. Six intervention schools were taught the curriculum, and two control schools were not. A 49-item questionnaire was used to assess tobacco knowledge, attitudes, and behavioral intentions. The experimental group's posttest knowledge and attitude scores were significantly higher than the control group's posttest scores. No significant differences occurred in posttest behavioral intention scores between the control and intervention groups.

An informational versus monetary incentive in increasing physicians' response rates

This study examined return rates for a cancer prevention survey by pediatricians in relation to an informational booklet versus a monetary incentive in the first of a three-wave mailing. Of the 300 surveys sent which included an informational booklet incentive, 189 (64%) were returned. Of the 300 surveys sent which included a $1.00 incentive 227 (79%) were returned, indicating the $1.00 incentive was more effective than the informational incentive in increasing return rates in this sample of physicians.

Sun protection counseling by pediatricians

OBJECTIVE

To establish a national baseline regarding pediatricians' sun protection counseling perceptions and behaviors.

INTERVENTIONS

A survey was mailed to a random sample of 600 pediatricians selected from the 1996 American Academy of Pediatrics Directory using a 3-wave mailing technique to maximize the response rate. The 3-wave mailing resulted in 414 returned surveys of 583 surveys (17 surveys were nondeliverable) (a 71% response rate).

RESULTS

Most (60%) of the pediatricians lacked formal training on how to counsel parents and children about sun protection. Approximately 3 (78%) of 4 indicated that not enough time was spent in their residency program on how to educate parents and children about sun protection. Greater than half (60%) of the respondents indicated that they usually (47%) or always (13%) counseled about sun protection. Seventy-seven percent of the respondents indicated that pediatricians have a professional responsibility to counsel parents and children about sun protection.

CONCLUSIONS

The results of this investigation suggest that most pediatricians surveyed believed that they had a professional responsibility to counsel about sun protection and that such counseling would be effective in decreasing skin cancer and the number of sunburns. Although most had not had training on sun protection counseling in their residency program, 6 of 10 indicated that they usually or always counseled about sun protection. Sun protection counseling training in residency programs can potentially extend pediatricians' knowledge of skin cancer and the importance of a broad spectrum of preventive measures, as well as increase their ability to counsel about such measures.