The Impact of a High School-Based Positive Youth Development Program on Sexual Health Outcomes: Results from a Randomized Controlled Trial

BACKGROUND

Although positive youth development (PYD) programs have demonstrated effectiveness in improving adolescent reproductive health outcomes, there is a lack of evidence on effective school-based interventions designed especially for high school settings. This study examined the efficacy of Peer Group Connection (PGC-HS), a school-based PYD program, in improving sexual health outcomes for high school participants.

METHODS

A total of 1523 ninth-grade students at 18 schools were randomly assigned to be offered PGC-HS or a classes-as-usual control condition during 2016 to 2017 and 2017 to 2018 school years. Impacts were assessed on three confirmatory and 6 exploratory outcomes via self-reported participant questionnaire data collected at the beginning of 10th grade.

RESULTS

Although the offer of PGC-HS had no statistically detectable effect on confirmatory behavioral outcomes (sexual initiation, frequency of sex, and number of sexual partners) at 10th grade follow-up, causal impact estimates indicate that PGC-HS participants were less likely than control participants to ever have had vaginal sex. PGC-HS participants also scored higher on decision-making skills and perceived connection to peer connectedness.

CONCLUSIONS

Results suggest that by building social and emotional skills and helping students form supportive peer relationships, PGC-HS may encourage students to make healthier choices and avoid risky behaviors during a critical period in high school, thus, reducing the risk of pregnancy.

The importance of school in the management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): issues identified by adolescents and their families

Paediatric Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) is a disabling condition. Schools play a key role in adolescents' experiences with managing ME/CFS. However, little is known about the experiences of adolescents with ME/CFS (and their families) in schools. This paper is an incidental qualitative study, which combines data from two independent ME/CFS studies: study 1 researched ethnic minority adolescents with ME/CFS; study 2 explored Acceptance and Commitment Therapy for adolescents with ME/CFS who had not recovered after one year. Participants included: adolescents with ME/CFS; their families; and medical professionals (ME/CFS specialists and non-specialists). Adolescents, their families, and ME/CFS medical professionals were recruited from a UK specialist paediatric ME/CFS service. Non-ME/CFS medical professionals were recruited from the same region. Semi-structured qualitative interviews and focus groups were undertaken. Participants' views on schools from each study were combined and thematic analysis was used to identify themes. Fifteen adolescents with ME/CFS (11-17 years old), sixteen family members, and ten medical professionals (GPs, school nurses and ME/CFS specialists) were interviewed. Four key themes were found: (1) adolescents identified school was important for aiding ME/CFS recovery, especially educationally and socially; (2) families described varying levels of support from schools and local authorities with help managing ME/CFS - some described significant practical and emotional difficulties to accessing education, whereas others recounted examples of positive supportive strategies, particularly when teachers had previous experience or knowledge of ME/CFS; (3) parents thought three-way communication between schools, healthcare and families could improve support; (4) participants felt schools were an appropriate place for knowledge building and raising awareness of ME/CFS amongst teachers and pupils, to aid improved supportive measures. In conclusion, this paper provides rich data that highlights the importance of education and the realistic fears and hurdles for adolescents with ME/CFS remaining engaged in education and the impact on their future. Some families described positive strategies in school, which were viewed as helpful to manage ME/CFS in the classroom. These strategies could be implemented alongside knowledge building initiatives and improved communication between healthcare and education. There is a need to further investigate useful strategies and determine how teachers can be best supported in implementing them.

Estimated reductions in added sugar intake among U.S. children and youth in response to sugar reduction targets

BACKGROUND

In 2021, the National Salt and Sugar Reduction Initiative (NSSRI) released voluntary sugar reduction targets for packaged foods and drinks in the United States (U.S).

OBJECTIVE

The objectives of this study were to describe trends in added sugar intake from NSSRI foods and beverages among children and youth and estimate possible reductions if industry were to meet the targets.

DESIGN

This study consisted of cross-sectional and trend analyses of demographic and 24-hour dietary recall data from eight survey cycles (2003-2004 to 2017-2018) of the National Health and Nutrition Examination Survey (NHANES).

PARTICIPANTS/SETTING

The study sample included 23,248 children and youth (aged 2-19 years).

MAIN OUTCOME MEASURES

The main outcome measure was the percent of daily calories from added sugar for foods and beverages in NSSRI categories.

STATISTICAL ANALYSES PERFORMED

Foods and beverages reported by participants were mapped to one of the NSSRI's categories or coded as a non-NSSRI item. Trends over time in added sugar intake were assessed using regression models. To assess possible reductions in added sugar intake if industry were to meet the targets, sales-weighted mean percent reductions for 2023 and 2026 targets were applied to NSSRI items in the 2017-2018 NHANES data. Results were examined overall and by demographic characteristics.

RESULTS

From 2003-2004 to 2017-2018, added sugar intake from NSSRI foods and beverages declined, but consumption remained high. In 2017-2018, NSSRI categories accounted for 70% of U.S. child and youth added sugar intake. If industry met the NSSRI targets, U.S. children and youth would consume 7% (2023 targets) to 21% (2026 targets) less added sugar.

CONCLUSIONS

While added sugar intake from NSSRI foods and drinks has declined over the past decade, added sugar intake from all sources remains high and consumption of added sugar from certain NSSRI categories has remained steady over time. If met, the NSSRI targets are expected to result in meaningful reductions in added sugar intake for U.S. children and youth.

Effectiveness of the POWER Program in Improving Physical Activity and Executive Function in Fifth Grade Students

BACKGROUND

High volumes of school-based sedentary time may impact academic achievement and executive function negatively. This study evaluated a multimodal classroom program's (POWER) effect on fifth graders' physical activity (PA) and executive function.

METHODS

Six 5th grade classes (3 = intervention [POW]; 3 = waitlist control [CONT]) in 2 diverse New Jersey schools participated. Data were collected before, during, and post-intervention. PA was assessed via accelerometer, executive function by NIH Toolbox, and academic achievement via standardized math tests. The POW principal, teachers, and select students participated in follow-up interviews. Group comparisons were made by multivariate repeated-measures ANOVA and linear regression.

RESULTS

PA decreased in both groups over time, but POW's post-intervention class-time PA was significantly higher than CONT's. POW's NIH Toolbox score increased 3 percentiles more than CONT's. Intervention fidelity was associated with significantly higher scores for one NIH Toolbox test. Student math test scores increased significantly for both schools, but there was no significant main effect for group. POW's feedback was positive, with the principal reporting fewer disciplinary referrals and teachers and students conveying positive growth.

CONCLUSIONS

Overall, POW's positive changes and the favorable reception of POWER support POWER'S ability to improve children's socioemotional and physical health.

In Their Own Words: Resources Needed by School Nurses to Facilitate Student Immunization Compliance

BACKGROUND

All 50 states have school-entry immunization requirements, and many also allow exemptions based on medical and non-medical reasons. School nurses are responsible for managing student immunization compliance based on state policies, but lack standardized resources and guidance.

METHODS

Pennsylvania school nurses (N = 21) participated in semi-structured interviews regarding their strategies for communication and management of student immunization information, along with resources needed for practice improvement. Data were analyzed using descriptive content analysis.

RESULTS

Nurses reported similarities in timelines used for communication of immunization requirements, but differences in mechanisms used to secure and manage immunization records. Nurses reported a need for clarity regarding exclusions and exemption policy implementation and requested standardized resources and guidance for navigating immunization compliance.

CONCLUSIONS

A need exists for standardized processes that support immunization compliance. Furthermore, nurses highlighted a need for additional training and enhanced networks to develop creative strategies for promoting immunization uptake among families.

Intra-and Interpersonal Factors Buffer the Relationship Between Food Insecurity and Mental Well-Being Among Middle Schoolers

BACKGROUND

Food insecurity (FI) is a significant predictor of feelings of isolation in children, as well as suicide ideation and depression. Using a census of public middle school-aged children, we seek to determine whether FI is associated with suicide ideation and feelings of hopelessness and how individual and school community factors can alleviate or exacerbate this relationship.

METHODS

We analyzed data from the 2015 Youth Risk Behavior Surveillance Survey, conducted statewide by the Vermont Department of Health and administered to all public middle schoolers (N = 13,648). Questions were asked about FI, suicidal thoughts, feelings of hopelessness, perceptions of teaching and community care, physical activity, breakfast consumption, and demographics. Bivariate and cross-tabular analyses were conducted in SPSS, and regressions and Sobel tests were conducted in STATA.

RESULTS

Results show that FI is associated with decreases in psychological well-being as measured by suicide ideation and feelings of hopelessness in students. However, students who reported eating breakfast regularly, feeling connected to their community or having a positive relationship with a teacher had significantly lower instances of suicide ideation and hopelessness.

CONCLUSION

Suicide prevention programs should focus on enhancing community connection and student-teacher relationships and increasing funding for breakfast programs in schools.

Socio-Ecological Factors Associated With Students' Perceived Impact of an Evidence-Based Sexual Health Education Curriculum

BACKGROUND

Although schools often implement evidence-based sexual health education programs to address sexual and reproductive health disparities, multiple factors may influence program effectiveness.

METHODS

Using student-reported perceived impact measures as a proxy for program effectiveness, we employed a socio-ecological approach to examine student, teacher, school, and district factors associated with greater perceived impact of It's Your Game (IYG), an evidence-based middle school sexual health education program. The student sample was 58.7% female, 51.8% Hispanic, mean age 13.2 years, from 73 middle schools. We assessed students' (N = 4531) perceived impact of IYG on healthy decision-making (α = 0.75) and sexual communication (α = 0.71); satisfaction with IYG activities and teacher; and demographics. We assessed teachers' (N = 56) self-efficacy to teach IYG, perceived administrative support, implementation barriers, and demographics. School and district data were abstracted from state records. We used multilevel logistic regression to estimate associations between independent variables and student-reported perceived impact.

RESULTS

In final multivariate models, students' demographics (sex, β = 0.06, SE = 0.015), satisfaction with IYG (β = 0.21, SE = 0.012), and their IYG teacher (β = 0.18, SE = 0.013) (all p = .000) were significantly associated with perceived impact on healthy decision-making. Similar findings resulted for sexual communication. No other variables were significantly associated with perceived impact.

CONCLUSIONS

Helping schools select age-appropriate, culturally relevant programs, and facilitate supportive learning environments may enhance the perceived impact of sexual health education programs.

Bullying Environment Moderates the Relationship Between Exercise and Mental Health in Bullied US Children

BACKGROUND

Exercise reduces the odds of sadness and suicidality in bullied students, but the role of the bullying environment on this relationship remains unknown.

METHODS

Using combined data from the 2013 and 2015 Youth Risk Behavior Survey (N = 29,207), adjusted logistic regression models estimated odds ratios between exercise, sadness, and suicidal ideation and attempt, stratified by bullying exposure (electronically/at school).

RESULTS

Overall, 40.2% of students bullied at school and 48.3% of students bullied electronically reported feeling sad, compared to 22.6% of those not bullied. Bullied students were 2-3 times more likely to report suicidal ideation, and 3-4 times more likely to report suicidal attempt, regardless of bullying context. Students who were bullied at school and exercised 4-7 days per week had lower odds of sadness (adjusted odds ratio [AOR]: 0.64; 95% confidence interval [CI]: 0.51-0.81), suicidal ideation (AOR: 0.66; 95% CI: 0.53-82), and suicidal attempt (AOR: 0.69; 95% CI: 0.48-0.98) compared to those who exercised 0-3 days. There were no protective effects of exercise for students bullied electronically.

CONCLUSIONS

Exercise reduced sadness and suicidality in adolescents bullied at school but not for students who were cyberbullied. Bullying environment should be a primary consideration in school mental health treatment and maintenance paradigms.

A Qualitative Investigation of Factors that Influence School Employee Health Behaviors: Implications for Wellness Programming

BACKGROUND

Employee health promotion in the elementary school setting can support students' health and academic success. School employees can serve as role models, yet evidence suggests poor health in this population. We identified factors that influence school employee health behaviors to inform subsequent development of employee wellness programs.

METHODS

Focus groups (10 groups, total N = 62) and interviews (N = 5) were conducted with school employees. Participants were recruited from schools in socioeconomically disadvantaged, racially diverse districts in Massachusetts. We used a socioecological framework to identify multi-level factors that influence employee health behaviors. Factors were characterized as supports (+) or barriers (-) to health-promoting behaviors.

RESULTS

Eight themes highlighted the importance of an organizational culture that sustains successful employee wellness programming. Intrapersonal themes included: High Stress (+/-), Desire to Adopt Healthy Behaviors (+), and Sufficient Health Knowledge (+). Interpersonal themes included: Strong Social Network (+) and a Desire to Role Model (+). Organizational themes included: Demanding Job (-), Lack of Wellness Culture (-), and Unhealthy Food (-).

CONCLUSIONS

Our findings suggest that this population would be receptive to wellness programming. Promising strategies include supporting a dedicated wellness champion and creating recognizable top down wellness support for employees.

Evaluation of an Intervention to Increase Physical Activity in Low-Income, Urban Middle Schools

BACKGROUND

Physical education (PE) can provide opportunities to engage in daily moderate-to-vigorous physical activity (MVPA), but MVPA levels in many classes are low. This study examines MVPA during middle school PE lessons before and after receiving the SPARK (Sports, Play, and Active Recreation for Kids) program.

METHODS

Sixteen schools were enrolled in the study. PE teachers at eight schools received the intervention. PE lessons at all schools (N = 561) were observed over 2 years. Hierarchical linear regression models examined the effect of the intervention on the amount and consistency of MVPA and sedentary behavior.

RESULTS

An average of 13.7% of observed class time was spent in MVPA (approximately 5 minutes of a 60-minute class), compared to 27.5% of time spent sedentary. There was no evidence that the curriculum resulted in increased MVPA or consistent MVPA, or that it decreased sedentary behavior. Findings also suggested that contextual factors may contribute to physical activity levels in PE.

CONCLUSIONS

Mixed evaluation findings of the SPARK middle school curriculum demonstrate that an out-of-the-box curriculum does not have the same results in all contexts. Implications for school health are described based upon findings. Further research is needed to identify effective strategies to increase MVPA for adolescents both in and outside of PE.

Digital Food and Beverage Marketing Environments in a National Sample of Middle Schools: Implications for Policy and Practice

BACKGROUND

One promising approach to influence nutrition behavior is to limit food and beverage marketing to children. Children are a lucrative market and schools may be an effective setting in which to intervene. Studies have shown that marketing in schools is prevalent but little is known about digital marketing (DM) to students in the school setting.

METHODS

We used an online survey to assess DM environments in a national sample of middle schools.

RESULTS

Our findings demonstrate that students are exposed to marketing through school devices. Gaps in school district, school and classroom policy and practice lead to student exposure to food and beverage marketing.

CONCLUSIONS

Our data point to actionable policy and practice change at the school district, individual school, and classroom levels that could help limit unwanted and harmful food and beverage marketing to youth.

School-Based Mental Health Promotion and Prevention Program "Turn 2 Us" Reduces Mental Health Risk Behaviors in Urban, Minority Youth

BACKGROUND

Turn 2 Us (T2U) is an elementary school-based mental health promotion and prevention program in New York City. It targets fourth- and fifth-grade students at risk for social/emotional and behavioral problems and provides a range of services to students, staff, and parents. The purpose of this study is to determine if T2U decreases internalizing and externalizing behaviors in participating students.

METHODS

Teachers measured students' symptoms before and after participation using the strengths and difficulties questionnaire (SDQ). Change in the total SDQ score was analyzed using Wilcoxon rank-sum nonparametric testing. We assessed the effects of covariates on the score change with linear regression models.

RESULTS

The 185 unique students who participated in the intervention showed a significant improvement in total SDQ score (Z = -4.107, p < .001). Students who were at higher risk prior to the intervention showed greatest improvement in behaviors. None of the covariates assessed affected the change in SDQ score. Regression models showed that higher initial SDQ scores predicted higher post-intervention SDQ scores (β = 0.681, p < .001).

CONCLUSION

T2U significantly decreased internalizing and externalizing behaviors in participating students, with the greatest impact for highest risk students. This study helps validate T2U's unique and comprehensive approach.

An Evaluation of an Unstructured and Structured Approach to Increasing Recess Physical Activity

BACKGROUND

The purpose of this study was to evaluate an unstructured and a structured program designed to increase physical activity (PA). The unstructured program increased the amount of equipment during recess, whereas the structured program introduced activities to students.

METHODS

PA was observed using the System for Observing Play and Leisure Activity in Youth (SOPLAY) in two school districts in Colorado. Researchers recorded baseline and follow-up observations for sedentary activity, moderate PA, and vigorous PA, as well as for available equipment for the unstructured program. Observations from schools were aggregated for data analyses at the district level.

RESULTS

For the program increasing equipment, moderate PA and vigorous PA increased, while sedentary behavior decreased. For the structured program, moderate PA and vigorous PA did not increase, whereas sedentary behaviors increased following the program.

CONCLUSIONS

Other variables are likely influencing student PA during recess, such as teachers' interaction with students or the fidelity of the program. Results indicate that funding and implementing a program aimed at increasing PA will not necessarily accomplish that goal, and additional research should be performed to determine the best practice for increasing PA.

Getting at Mode Share: Comparing 3 Methods of Travel Mode Measurement for School Travel Research

BACKGROUND

Mode share is an important metric for active school travel programs. Common methods for measuring mode share include Hands Up surveys and family surveys, but these require teacher and parental involvement. We used these methods as part of an evaluation of a school-based bicycle training program, and added a novel observational count approach. This paper compares mode share results across the 3 methods.

METHODS

We collected data over 2015-2017 at 16 elementary schools. Our outcome of interest was mode share (walk, drive, and bicycle).

RESULTS

We found variations in travel mode estimates between methods and across schools. Overall most school journeys were made by walking (55.7% by observational counts, 46.3% by Hands Up surveys, and 51.5% by family surveys) or car (42.5%, 51.4%, and 46.2%, respectively), and a small proportion by bicycle (1.8%, 2.3%, and 2.2%, respectively). At individual schools, Hands Up and family survey results were similar; there was less agreement between these and observational counts.

CONCLUSION

School travel practitioners face pragmatic choices in data collection. Observational counts are a nonintrusive method suited for school-wide travel patterns. Hands up and family surveys may be more appropriate for assessing differences between classrooms, ages, or family characteristics.

A Case Study of a New State Model for Assessing Local Wellness Policies

BACKGROUND

In 2016, the United States Department of Agriculture issued a final rule to strengthen local wellness policies (LWPs). As school districts pursue compliance, states can provide critical guidance by leveraging support from intermediary programs such as the Supplemental Nutrition Assistance Program-Education (SNAP-Ed). After Arizona SNAP-Ed piloted a statewide model for assessing LWPs, we evaluated that model by exploring local SNAP-Ed agency experiences with the pilot. Our case study objectives were to determine the model's feasibility and utility from the perspective of local agencies supporting school districts during LWP review and revision.

METHODS

We used open-ended semistructured interviews with the 13 local SNAP-Ed agencies who engaged in each LWP assessment phase and analyzed data using constant comparative analysis.

RESULTS

Participants found the model feasible and useful. Five themes emerged, 3 of which tracked strongly with successful LWP review and revision: local agency staff comprehension, the openness of local agency staff and district/school personnel to the process, and the local agency's engagement of the district/school throughout the process.

CONCLUSIONS

Leveraging local agency support can be an effective strategy to improving LWPs, given understanding, buy-in, and staff engagement. Findings can inform agencies seeking to engage intermediaries in LWP assessment and revision.

Effectiveness of the Adolescent Depression Awareness Program (ADAP) on Depression Literacy and Mental Health Treatment

BACKGROUND

Analysis of data from a NIMH-supported study was conducted to evaluate the effectiveness of the Adolescent Depression Awareness Program (ADAP) in promoting depression literacy and help-seeking behavior.

METHODS

Eighteen Pennsylvania schools were matched on size, sex, race, test scores, median income, and free/reduced lunch status. Schools randomized to the intervention implemented ADAP as a compulsory part of the schools health curriculum, while control schools collected study measures.

RESULTS

Post-randomization analysis revealed no significant differences by sex on the pre-assessments between intervention and control schools. In the intervention schools, a total of 1427 students received ADAP. Written parental consent and adolescent assent was obtained from 33.7% students. The online REDCap survey was completed by 41.78% of the consenting students. The Adolescent Depression Knowledge Questionnaire (ADKQ) findings suggest that ADAP significantly improved depression knowledge (Est. =1.07, SE =.25, p < .001), compared to those in the control group. ADAP was found to facilitate help-seeking behavior by student report in those participating in the REDCap survey 4 months following the ADAP curriculum.

CONCLUSIONS

Results of the survey suggests that ADAP facilitates help-seeking behaviors in teens. This study supports the efficacy of a teacher delivered school-based universal prevention program, ADAP, on depression literacy.

Teachers' Perceived and Desired Roles in Nutrition Education

BACKGROUND

Elementary teachers have the potential to influence children's eating habits. This study examined teacher views and practices regarding nutrition education.

METHODS

An online survey was administered to K-6 teachers (N = 628) in 55 public elementary schools in a large city in the western United States. Three indices were created based on responses. Indices included: (1) attitudes and beliefs about nutrition education; (2) self-efficacy regarding nutrition education; and (3) personal health behaviors. Relationships between indices, classroom practices, and teacher characteristics were tested. Teacher comments were categorized into themes.

RESULTS

Most teachers agreed they can make a difference in the eating behaviors of their students (68%). Correlations between hours of nutrition taught and teachers' attitudes and beliefs (r = .37, p < .01), nutrition self-efficacy (r = .38, p < .01), and personal health practices (r = .15, p < .01) were weak, yet statistically significant. Number of years teaching was inversely related to frequency of food rewards (r = -119, p < .01). Few teachers (21%) agreed they have support to teach nutrition in the classroom.

CONCLUSION

Teachers understand the importance of nutrition education but provision is limited by competing demands. Teachers suggest tailored nutrition materials, qualified nutrition personnel, and school stakeholder support to promote nutrition education.

Explaining the positive relationship between fourth-grade children's body mass index and energy intake at school-provided meals (breakfast and lunch)

BACKGROUND

A 2010 publication showed a positive relationship between children's body mass index (BMI) and energy intake at school-provided meals (as assessed by direct meal observations). To help explain that relationship, we investigated 7 outcome variables concerning aspects of school-provided meals: energy content of items selected, number of meal components selected, number of meal components eaten, amounts eaten of standardized school-meal portions, energy intake from flavored milk, energy intake received in trades, and energy content given in trades.

METHODS

Fourth-grade children (N = 465) from Columbia, SC, were observed eating school-provided breakfast and lunch on 1 to 4 days per child. Researchers measured children's weight and height. For daily values at school meals, a generalized linear model was fit with BMI (dependent variable) and the 7 outcome variables, sex, and age (independent variables).

RESULTS

BMI was positively related to amounts eaten of standardized school-meal portions (p < .0001) and increased 8.45 kg/m(2) per serving, controlling for other variables in the model. BMI was positively related to energy intake from flavored milk (p = .0041) and increased 0.347 kg/m(2) for every 100 kcal consumed. BMI was negatively related to energy intake received in trades (p = .0003) and decreased 0.468 kg/m(2) for every 100 kcal received. BMI was not significantly related to 4 outcome variables.

CONCLUSIONS

Knowing that relationships between BMI and actual consumption, not selection, at school-provided meals explained the (previously found) positive relationship between BMI and energy intake at school-provided meals is helpful for school-based obesity interventions.

Elementary school personnel's perceptions on childhood obesity: pervasiveness and facilitating factors

BACKGROUND

Researchers in numerous disciplines have investigated the effects of the school environment on childhood obesity (CHO), one of the greatest current health concerns in the United States. There is a gap in current empirical evidence, however, on school personnel's perspectives of this issue. This study examined school personnel's perceptions of obesity as a problem among school-aged children and their views on factors contributing to obesity.

METHODS

Thirty-one semistructured interviews were conducted with elementary school personnel (teachers, administrators, and support staff) from 5 rural schools with a predominantly Hispanic (58.18%) and Black (30.24%) student population. The constant comparison method was used to identify emergent themes.

RESULTS

All but one participant considered obesity to be a problem among elementary children. Factors facilitating obesity most frequently cited by school personnel were home environment, poor nutrition, child control of dietary choices, child inactivity, and entertainment electronics.

CONCLUSIONS

Child control of dietary choices in both home and school environments was identified as a major contributor to obesity. Further exploration of this control is warranted to understand the complexity of this dynamic and its potential link to CHO.

Examining how neighborhood disadvantage influences trajectories of adolescent violence: a look at social bonding and psychological distress

BACKGROUND

To understand how neighborhoods influence the development of youth violence, we investigated intrapersonal mediators of the relationship between neighborhood disadvantage and youth violence trajectories between ages 11 and 18. The hypothesized mediators included indicators of social bonding (belief in conventional values, involvement in school activities, religious engagement, and commitment to traditional goals) and psychological distress.

METHODS

The sample (N = 5118) was 50% female and 52% Caucasian. Data from a 5-wave panel study spanning ages 11 to 18 were analyzed using sex-stratified multilevel growth curves.

RESULTS

Neighborhood disadvantage was associated with higher levels of violence perpetrated by girls, lower belief in conventional values for both girls and boys, less commitment to traditional goals by girls, and higher levels of psychological distress reported by girls. Sobel tests identified 3 significant mediators of the effects of neighborhood disadvantage on girls' violence trajectories: belief in conventional values, commitment to traditional goals, and psychological distress. The only significant mediator of the relationship between neighborhood disadvantage and boys' violence trajectories was belief in conventional values. The effects of neighborhood disadvantage on violence trajectories were not fully mediated; in fact, results suggested that suppression effects, or inconsistent mediation, may exist.

CONCLUSIONS

The results emphasize the importance of both contextual and intrapersonal attributes in understanding the development of violence among school-aged youth. Early school-based and community-level prevention initiatives that promote social bonding and address mental health needs may help reduce the impact of youth violence, particularly for girls.

The relationship of school absenteeism with body mass index, academic achievement, and socioeconomic status among fourth-grade children

BACKGROUND

Data from a school-based study concerning fourth-grade children's dietary recall accuracy were linked with data from the South Carolina Department of Education (SCDE) through the South Carolina Budget and Control Board Office of Research and Statistics (ORS) to investigate the relationships of children's school absenteeism with body mass index (BMI), academic achievement, and socioeconomic status (SES).

METHODS

Data for all variables were available for 920 fourth-grade children during 2 school years (2005-2006, 2006-2007). Number of school days absent for each child and eligibility for free/reduced-price school meals (SES measure) were provided to ORS by SCDE. Children's weight and height were measured by research staff; age/sex-specific BMI percentile was calculated and grouped into categories. For academic achievement, Palmetto Achievement Challenge Tests scores were provided by the school district. The associations of absenteeism with BMI, academic achievement, SES, and school year were investigated with logistic binomial models using the modified sandwich variance estimator to adjust for multiple outcomes within schools.

RESULTS

The relationships between absenteeism and each of BMI percentile category and SES were not significant (all coefficient p values > .118). The relationship between absenteeism and academic achievement was inversely significant (p value < .0001; coefficient = -.087).

CONCLUSIONS

These results support the inverse relationship between absenteeism and academic achievement that was expected and has been found by other researchers. The lack of significant results concerning the relationships between absenteeism and both BMI and SES differs from earlier, limited research. More research to investigate these relationships is needed.