The History of US Menstrual Health, School Nurses, and the Future of Menstrual Health Equity

In the United States, adolescents suffer from inadequate menstrual health, meaning that adolescents are unprepared for menarche, lack the practical resources they need to comfortably and confidently manage menstruation, and receive inadequate health education and care for menstrual pain and disorders. In this article, we provide a historical analysis of the role of school nurses in addressing menstruation from the early 20th century up to the present day. We contextualize the current realities of school nursing and menstrual health education and clinical support. We argue that the decentralized US school system, a cultural aversion to open discussion about menstruation, and the outsized influence of commercial menstrual product manufacturers have hampered the ability of school nurses to deliver menstrual health education along with menstrual health support. Finally, we discuss implications for today's schooling experiences as well as recommendations for how to support school nurses in aligning our national approach to menstrual health toward the public health perspective of menstrual equity. (Am J Public Health. Published online ahead of print July 18, 2024:e1-e6. https://doi.org/10.2105/AJPH.2024.307705).

Chronic Health Condition Management and School-Based Health Centers in New York: Findings From the 2020 School Health Profiles Survey

School-based health centers (SBHCs) are associated with numerous positive aspects of student health services. Many schools in the United States (US) do not have transparent policies on chronic health condition (CHC) management. Of particular concern is the underreporting of the delivery of health services in U.S. schools concerning CHC management and its relationship with the presence or absence of a SBHC. Data from the 2020 School Health Profiles (SHP) Survey were examined in New York public secondary schools. Specific health services were reviewed, together with the presence or absence of a SBHC, including daily medication administration, stock rescue medication, case management services, community partners, chronic disease-specific education, and assurance that students with CHCs were enrolled in an insurance program. A significantly greater proportion of schools with a SBHC compared with schools without a SBHC provided: (1) daily medication administration (92.9% vs. 86.5%; p < .001), (2) stock or rescue medication (84.9% vs. 77.4%; p < .001), (3) case management services (83.1% vs. 67.2%; p < .001), (4) disease-specific education for families (63.1% vs. 57.2%; p = .022), (5) student and family connection to community health services (84.2% vs. 76.5%; p < .001), and (6) ensured that a protocol existed whereby students with a CHC were enrolled in an insurance plan if eligible (79.6% vs. 66.8%; p < .001). Findings suggest that data on a national scale include essential facts for states to consider concerning school health policies and practices. Additional research should examine the intricacy of elements connected with school-based health care to understand better the care provided to children with CHCs.

Perceived Role of the School Nurse in Providing Pertinent COVID-19 Information to the School Community: Experiences of Public Health Graduate Students With School-Aged Children

The COVID-19 pandemic has been a major disruptor to school systems across the United States since March 2020. As a result, school nurses have had to adapt to these uncertain times. Previous research has demonstrated the impact of school nurses on student health; however, less is known about their role in educating the broader school community about COVID-19 prevention. In Spring 2022, four focus groups were conducted with public health graduate students with school-aged children, to assess perceptions of COVID-19 and public health emergency preparedness communication. MAXQDA was used for thematic analysis. School nurses were viewed as a credible source of COVID-19 information, especially for those who do not have access to healthcare services. While the primary role of school nurses is to provide health services to students, they also have the capacity to provide the community with vital public health emergency preparedness information.

Learning from the Past and Moving Forward: Implementing School Nursing Research Priorities

The editorial "School nursing research and research implementation priorities," highlights how the National Association of School Nurses (NASN) research priorities are crucial to moving school nursing and school health research forward. In this editorial we echo the importance of school nurses reading and understanding published articles in The Journal of School Nursing and contributing to research that informs school nursing practice. Each of the NASNs research priorities is vital to the science supporting school nursing practice. We encourage school nurses and researchers, and implementation scientists to partner to contribute school nursing evidence that guides the specialties' practice and informs policy to positively impact student health and education outcomes.

Using Local School Wellness Policies to Build a Culture of Health for Students With Chronic Health Conditions: The School Nurse Role

Local school wellness policies (LWP) guide school districts' efforts to establish school environments that promote students' health, well-being, and ability to learn that include school U.S. Department of Agriculture nutrition and physical activity requirements. Looking through the lens of the Whole School, Whole Community, Whole Child model and NASN's Framework for 21st Century School Nursing Practice™, LWP can be expanded beyond the tradition focus of nutrition and physical activity to address the health and academic needs of students with chronic health conditions. School nurses need to be actively involved on district wellness councils as schools prepare to conduct their required triennial assessment of current LWP equipped with an understanding of the Alliance for a Healthier Generations' updated model wellness policy and NASN's supplemental wellness policy language to address management of students with chronic health conditions.