Providing context to the implementation of health promoting schools: A case study

PurposeIssues related to program context are important components of population health interventions and particularly among complex, adaptive initiatives in schools. Health Promoting Schools (HPS) is a global approach to support early development of healthy behaviors among children and youth. The purpose of this study was to explicate the practical and contextual processes that influenced implementation of HPS in schools in Nova Scotia (Canada).MethodsUsing a case-study approach, data was collected using interviews (n = 14) with principals, teachers and parents, observations collected during school visits and document review in five diverse schools.ResultsCase study schools reported a variety of HPS practices and three key themes emerged that provided context to the processes that facilitated their implementation. The results suggest that although school characteristics (theme 1), like staff allocation, physical location and resources, are important, these barriers can be mitigated by building organizational capacity (theme 2) and establishing a supportive school community culture (theme 3).ConclusionsThe study provided insight to the variability in implementation by describing how contextual barriers were experienced and mitigated by schools. Establishing a broad system to support HPS, with collaboration across health and education sectors, could help to progress adoption, implementation and sustainability of HPS.     

Experience with a drug screening program at a school of pharmacy

Abstract Substance use and abuse among pharmacy students is a concern of pharmacy schools, boards of pharmacy, and training sites alike. Pharmacy students must complete approximately 30% of their academic coursework in experiential settings such as community pharmacies, hospitals, and other health systems as part of any accredited pharmacy school's curriculum, and these training sites are starting to require drug testing of pharmacy students as part of their contractual agreements with schools of pharmacy. The authors describe the implementation of a mandatory random urine drug screening program at their school as well as the changes that occurred owing to assessment of the program. The authors report the basic results to date of the drug screening program. The authors also speculate on secondary benefits of the drug screening program. Finally, the authors describe current and future evaluations that they are undertaking regarding this program.     

Experience With a Drug Screening Program at a School of Pharmacy

Abstract

Substance use and abuse among pharmacy students is a concern of pharmacy schools, boards of pharmacy, and training sites alike. Pharmacy students must complete approximately 30% of their academic coursework in experiential settings such as community pharmacies, hospitals, and other health systems as part of any accredited pharmacy school's curriculum, and these training sites are starting to require drug testing of pharmacy students as part of their contractual agreements with schools of pharmacy. The authors describe the implementation of a mandatory random urine drug screening program at their school as well as the changes that occurred owing to assessment of the program. The authors report the basic results to date of the drug screening program. The authors also speculate on secondary benefits of the drug screening program. Finally, the authors describe current and future evaluations that they are undertaking regarding this program.     

Current Implementation of and Opinions and Concerns Regarding Suicide Education for Social Work Undergraduate Students in Japan: A Cross-Sectional Study

This study explored the current implementation status of and opinions and concerns regarding suicide education at schools of social work in Japan. We conducted a survey of faculty members who taught at least one of the social work subjects. About half the respondents had given a lecture of some kind on suicide, and more than 80% agreed that suicide is an important topic to include in social work program curricula. However, more than half indicated they did not have enough knowledge or skills to teach students about suicide, and more than 60% were concerned about adverse psychological effects of suicide education on students. Our findings highlight the importance of providing faculty members with guidelines for teaching students about suicide.     

Case study of a health optimizing physical education-based comprehensive school physical activity program

In this article, we report a qualitative case study, in which we examined enablers and barriers related to the development, implementation, and sustainability of a comprehensive school physical activity program (CSPAP) aligned with the Health Optimizing Physical Education (HOPE) curriculum model at a middle school. Literature on program-diffusion and school-university partnerships guided data collection and analysis. Data sources included semi-structured interviews with the program implementation team (n = 9) and the school’s health and physical education teachers (n = 7); a focus group interview with students; documents (e.g., lesson plans), and observations. Constant comparison techniques were used to code and draw out themes from the data. Findings revealed the extensive effort needed for program implementation and highlighted the importance of strong external support mechanisms, conducting needs assessments, and training teachers to market physical activity programming. Partnerships may provide critical support for schools in their efforts to generate and sustain CSPAPs.     

Suicide prevention in the dot com era: technological aspects of a university suicide prevention program

Western Michigan University's Suicide Prevention Program utilizes multiple technological components, including an online training course, a Web site, and 2 social networking Web site profiles, as integral aspects of a comprehensive program. This article discusses the development, maintenance, use, and impact of the technological aspects of this program, which complement other program activities in meeting program goals. The Web site and use of social networking Web sites have been very well received by members of the university and wider community. Although initial outcomes of each component are positive, low participation in the online training course has limited the usefulness of pretest-posttest comparisons. It is thought that other campus suicide prevention programs may benefit from using technology as a primary method in their suicide prevention programming efforts.     

Turkish School Counselors’ Experiences of Reporting Child Sexual Abuse: A Brief Report

This article reports results from a qualitative study conducted with a purposive sample of 25 Turkish school counselors who reported child sexual abuse. Participants were asked to identify resources they consulted, describe how they felt, and identify sources of support and barriers in the reporting process. The laws (68%) were the most consulted resource, while negative feelings (84%) were cited the most. The most cited sources of support were colleagues, lawyers, and school principals (20% each), while school principals also ranked first as barriers (44%), followed by incest victims’ families (32%). Participants predominantly desired safety and security of the reporter ensured (48%). Implications for a more functional child protection system and a reporter-friendly legal system in Turkey are discussed.     

Experimental and pragmatic approaches to the incidence of adolescent suicide

Since the early 1960s, the incidence of adolescent suicide has been increasing at an alarming rate. In response, social science researchers working in both the experimental and pragmatic epistemological paradigms have been studying the processes involved in this phenomenon and developing suicide prevention and suicide response programs in schools. In this article we review general issues involved in the contrasting and, at times, conflicting approaches taken by experimental and pragmatic researchers to adolescent suicide. These issues are then illustrated in a case study in which experimental and pragmatic proponents worked together on an evaluation of a school-based suicide education program.     

近年来我国大学生自杀心理剖析

研究自杀大学生的心理变化过程,对预防大学生自杀具有积极的作用。对大学生自杀案例进行剖析的结果表明,大学生自杀行为“因穷至卑”和“因穷自杀”现象不明显;不同原因自杀的心理动机存在差异,并且主要集中在“情感挫折”、“学习就业压力”、“个人心理障碍”、“家庭原因”和“生理健康”5类。自杀大学生的心理状态随着自杀意念的发生发展呈现一定的规律性,他们在实施自杀的过程中都经历了复杂的心理过程。     

Career Development and Workforce Preparation: Educational Policy Versus School Practice

A multistate survey of public high schools revealed general unfamiliarity among principals and counselors with national workforce preparation policies as represented by the SCANS Report (Secretary's Commission on Achieving Necessary Skills, 1991) and the National Career Development Guidelines (National Occupational Information Coordinating Committee, 1989); a lack of commitment to career development program outcomes for all student groups, particularly those at risk of dropping out; uneven delivery of services, with least attention to cultural diversity outcomes; and underutilization of counselors. The article concludes with an examination of the historical and cultural forces operating for and against sustained efforts in workforce preparation programs.     

Evaluation of a comprehensive elementary school curriculum-based drug education program

This study was designed to evaluate the effectiveness of a province-wide chemical abuse prevention education program for grades two through six. Two separate studies were conducted. Study 1 measured pre- and post-scores on a test with 1101 experimental and 991 control subjects in a quasi-experimental design. Study 2 surveyed 500 elementary school teachers on their opinions and practices regarding drug education, and on the prevalence of the program in schools. The study found that: 1) students had a high initial knowledge level; 2) students showed modest but statistically significant knowledge gains for urban schools and grades three, four, and five of rural schools; 3) the program was most effective with students with a low base knowledge; 4) an estimated 20 to 30 percent of Manitoba elementary teachers had been in-serviced and/or were using the program across the province; and 5) the program was received well among teachers.     

Suicide Prevention in the Dot Com Era: Technological Aspects of a University Suicide Prevention Program

Abstract

Western Michigan University's Suicide Prevention Program utilizes multiple technological components, including an online training course, a Web site, and 2 social networking Web site profiles, as integral aspects of a comprehensive program. This article discusses the development, maintenance, use, and impact of the technological aspects of this program, which complement other program activities in meeting program goals. The Web site and use of social networking Web sites have been very well received by members of the university and wider community. Although initial outcomes of each component are positive, low participation in the online training course has limited the usefulness of pretest–posttest comparisons. It is thought that other campus suicide prevention programs may benefit from using technology as a primary method in their suicide prevention programming efforts.     

A review of school-based suicide prevention interventions in South Korea, 1995–2015

Adolescent suicide behavior is a serious social concern in South Korea, and there is a current lack of knowledge regarding the overall strengths and weaknesses of school-based suicide prevention interventions (SPI) for this group. The aim of this study was to review the benefits of and barriers to effective implementation of existing SPI for adolescents in South Korea. A review of school-based SPI was performed using the PsycINFO, PubMed, ERIC, KoreaMed, RISS, KISS, and NDSL electronic databases. Among the identified publications, 18 were subsequently included in this review and were classified into three approach types: universal (seven studies), selective (four studies), and indicated (seven studies). Major health outcomes associated with adolescent suicide have been suggested, but different outcomes from SPI have been found. The health-related benefits of these interventions were decreases in suicide risk from depression, aggression, and suicide ideation, and increases in the protective factors of self-esteem, confidence, social relationships, and respect for the value of life. Barriers to successful implementation of SPI included less consideration of the effectiveness of SPI treatment duration, minimal or no follow-up monitoring, low participation due to parents' prejudices against mental health, and underdeveloped referral systems. The findings from this review suggest that there is a need to revise existing SPI programs in the future to take into account of cultural sensitivity. The resulting programs should be useful to researchers, therapists, school staff, parents, and legislators in South Korea.     

ViSC Social Competence Program

The ViSC Social Competence Program has been implemented in Austrian schools within the scope of a national strategy plan, Together Against Violence. The program is a primary preventive program designed for grades 5 to 8. The prevention of aggression and bullying is defined as a school development task, and the initial implementation of the program lasts one school year. The program consists of universal and specific actions that are implemented through in-school teacher training and a class project for students. The program was evaluated with a randomized intervention control group design. Data were collected from teachers and students. Results suggest that the program reduces aggression in schools.     

Preventing child abuse: a review of community-based projects II: Issues arising from reviews and future directions

Detailed examination of evaluated community programmes for the prevention of physical child abuse and neglect shows that success depends on matching the skills of the staff to the needs of the families. The relative inefficiency of risk screening and attrition from prevention programmes argues for comprehensive as well as focused aspects of programmes and variation in which is available. Sexual abuse prevention programmes have usually been implemented in schools but are more successful when the focus includes bullying and when children and parents are also actively involved. This is also true of bullying programmes. In establishing risk for abuse, more effective methods are required to assess aspects of family life that are not readily observable, including involved but non-resident adult males. It is important not only to approach abuse prevention by intervening in different ways and at different points in the network of processes within and around the family, but also to find cost-effective ways of sustaining preventative efforts. © 1998 John Wiley & Sons, Ltd.     

The role of psychiatric nurse faculty in establishing a campus suicide prevention program

Suicide among college students has received increased national attention over the past few decades, partly due to the publicity regarding high-profile suicide events on college campuses throughout the United States and its territories. Currently, suicide is identified as the second-leading cause of death in college students. Due to federal legislation such as the Garrett Lee Smith Memorial Act of 2004, many college campuses have been able to establish suicide prevention programs. This article describes how a psychiatric nurse faculty member successfully established a comprehensive suicide prevention program that was initially supported by grant funds from the Garrett Lee Smith Memorial Act.     

Differences by gender, ethnicity, and acculturation in the efficacy of the keepin' it REAL model prevention program

This study examined whether the efficacy of keepin' it REAL, a model program for substance use prevention in schools, was moderated by gender, ethnicity, and acculturation. Gender differences in program efficacy may arise through boys' higher risk of drug use, inadequate attention to girls' developmental issues, or cultural factors like polarized gender expectations. Data came from a randomized trial in 35 Phoenix, Arizona, middle schools involving 4,622 mostly Latino 7th graders. Using multi-level mixed models and multiple imputation missing techniques, results for the total sample showed no gender differences in program effects on recent substance use, but the program was more effective in fostering boys' than girls' anti-drug norms. Subgroup analyses demonstrated several more beneficial program effects for boys than girls (less alcohol and cigarette use and stronger anti-drug norms), but only among less acculturated Latinos. There were no gender differences in program effects among more acculturated Latinos, nor among non-Latino whites.     

Cigarette smoking, friendship factors, and social norm perceptions among central and Eastern European high school students

Studies investigating smoking behavior among adolescents living in post-communistic Central-European countries are sparse. This study focused on the relationship between cigarette smoking, certain friendship factors, and social norm perceptions among 1,886 Central-Eastern European adolescents from high schools in Hungary, Slovakia, Czech Republic, and Romania. Smoking behavior was related to having friends who smoke, ease or difficulty making new friends, time spent with friends after school and during evenings, and estimations of the prevalence of smoking by schoolmates. Because these youth appear to overestimate the prevalence of smoking by schoolmates, the use of a norms-correction strategy may have potential merit in smoking prevention efforts targeting these adolescents. Smoking prevention and reduction are critical issues for Central-Eastern European youth because they appear to smoke cigarettes at a high rate.     

Attendance problems and disciplinary procedures in Nebraska schools

STUDY PURPOSE: School principals were surveyed in rural and urban Nebraska schools to compare policies and procedures on school attendance, and to contrast the use of disciplinary procedures for attendance, violence and substance abuse. METHODS: A survey was sent to a 50 percent random sample of Nebraska schools. Respondent school addresses in metropolitan statistical areas (MSA) areas were categorized as urban, and non-MSA respondents were classified as rural area schools. RESULTS: Of the 680 surveys mailed, 464 (68.2 percent) completed surveys were returned. Overall, 86.2 percent of respondents were from rural schools and 13.8 percent from urban schools. A list of disciplinary problems and procedures was reported for a first-time offense by rural and urban schools. Both an "occasional attendance problem" and a "chronic attendance problem" were most frequently addressed through parent contact in both urban and rural areas. For "fighting with another student," rural schools most commonly reported discipline by teacher, followed by discipline by principal and parent contact. In urban schools, discipline by principal was most common. For "using drugs other than alcohol or tobacco at school" in both areas, disciplinary procedures included parent contact and short-term suspension. A list of disciplinary problems and procedures was also reported for a second-time offense and third-time offense. For "fighting with another student," the most commonly reported procedure was discipline by principal and parent contact for a second-time offense, followed by short-term suspension and long-term suspension for a third-time offense. For "using drugs other than alcohol or tobacco at school," for a second time offense was long-term suspension and semester expulsion for a third-time offense. Principals were also asked in an open-response format, what program or procedures were currently in place to prevent violence in their school. Common responses were "conflict resolution training," followed by "the Boys Town social skills and behaviors model" and "a zero tolerance policy." CONCLUSIONS: School principals generally reported similar disciplinary actions for most disciplinary problems. For recurrent offenses and for serious problems, principals generally used tougher disciplinary procedures. Some of the discrepancies in disciplinary actions, however, suggest the need for consistent enforcement and communication of policies for both urban and rural schools.