Availability of school health services for young children

A survey to assess availability of school health services was distributed to 221 directors of Schools of the 21st Century, an educational model that provides integrated services to children and families. Of this distribution, 126 (57%) surveys were returned; 88% of respondents reported they provided some type of school health services for their students; 75% of schools had access to school nursing services, yet only 33% had a school nurse on-site; 50% had less than daily access to a school nurse. Despite a high reported prevalence of physical and mental health problems, other services such as acute care, nutrition counseling, dental screenings, or mental health services were provided less frequently. Barriers perceived as problematic for schools providing health services included inadequate funding, limited parental awareness, and opposition by school or community members. Respondents believed transportation, limited financial resources, and inadequate health insurance were barriers to care for children and families. Among this sample of schools, school health services varied in availability and comprehensiveness. Educators, health providers, and parents must work together to provide improved school health services for children.

Mental health in schools: expanded opportunities for school nurses

Emerging trends are reshaping the work of school nurses and other school service personnel. With respect to direct service and consultation, school nurses increasingly are called upon to deal with psychosocial and mental health problems. Beyond that, school nurses must continue to actuate their roles as advocates, catalysts, brokers, and facilitators of the type of reforms that can effectively address barriers to student learning and promote healthy development. Continuing education is seen as key to enabling school nurses to build capacity for such roles and functions. The newly formed Center for Mental Health in Schools at the University of California, Los Angeles (UCLA) hopes to be of assistance in this respect. This presentation highlights the Center's orientation to mental health in schools and offers a draft outline for related continuing education.

The future of community nursing in the United Kingdom: district nursing, health visiting and school nursing

This paper examines the future of community nursing, within the wider framework of a rapidly changing National Health Service. The research was commissioned by the Community Performance Review Network, as part of a series of comparative studies between community healthcare NHS trusts. Three questionnaires were sent to 24 trusts, covering three of the community nursing services; district nursing, health visiting and school nursing. Of the 24 trusts involved in the network, 22 responded to some or all of the questionnaires. A wide range of management structures and working practices were found between trusts, but several common themes and issues of concern emerged. For district nurses, these included the shift from secondary to primary care and the changing demands of the client population served, with increasing numbers of elderly and chronically disabled patients. This led to anxiety over the communication between different providers of care, such as community, acute and social services, and the skills mix and training requirements for nurses. Health visitors and school nurses were concerned about being marginalized in the move towards integrated primary health care teams. As the emphasis changes from treating illness to health promotion, concern was expressed about how performance could be measured on the less quantifiable outcomes of preventative care, and hence how jobs could be justified to purchasers of health care. A central theme was the potential role of the nurse practitioner in provision of primary care, and this formed a focus for other anxieties concerning both the current situation and future of community nursing services.

The dangers of cutting school nursing services

This article highlights the important role played by the school nursing service. it stresses the need for school nurses to collect and analyse data so that they are able to provide evidence of their effectiveness. It also warns against the long-term implications for the nation as a whole, and its youth in particular, if nursing cuts are made in the interests only of short-term expediency.

New Jersey school nurses' perceptions of school-based, prenatal nutrition education

This study used formative evaluation to identify channels and barriers to providing ongoing dietary guidance to pregnant teens in New Jersey. In phase one, 14 health and social service professionals participated in a focus group or interview about nutrition services for pregnant teens. Participants identified school nurses as potential providers of early and continuous dietary counseling to pregnant teen-agers, but delineated barriers to establishments and effectiveness of school-based, prenatal nutrition education. In phase two, school nurses were surveyed to assess their interest in, and perceptions of barriers to, providing nutrition education to pregnant adolescents. Two-hundred fifty-three nurses (71%) returned completed questionnaires. Results indicated that a significant proportion perceived a need for, and were interested in providing, nutrition education to pregnant students. Results from this formative research are being used to guide development of a school-based nutrition education program for pregnant teen-agers in New Jersey.

A cardiovascular risk reduction program for the classroom

A quasi-experimental, longitudinal study was conducted to test the effectiveness over a 1-year period of a cardiovascular risk reduction program for school-age children. The effectiveness of the program was measured with the children's knowledge of physiology of the heart and cardiovascular risk factors, their health habits, and their physical measurements. Ninety-eight children between the ages of 9 and 12 years participated in the study. The experimental group received a series of five 40-minute sessions on physiology of the heart, smoking, hypertension, diet, and physical activity. Short-term effectiveness of the program was found for the children's knowledge of physiology of the heart and smoking. Long-term effectiveness was found for running activity.

Brief nurse consultations for preventing alcohol use among urban school youth

This study examined the effects of brief nurse consultations in preventing alcohol use among inner-city youth. Participants included 138 sixth-eighth grade students attending an inner-city public school in Jacksonville, Florida. Subjects were randomly assigned by computer to either the intervention (STARS program) or a control group. Baseline and three-month post-tests were conducted at the target school site. A significant difference was found on heavy alcohol use with intervention subjects showing a reduction and control subjects an increase in heavy drinking (t = -2.33, 120df, p = .02). No differences were found between groups on other alcohol use measures. This study's findings indicate that a series of brief nurse consultations appear to reduce heavy alcohol consumption among urban school youth.