Parent involvement in health concerns for youth: the issue of adolescent immunization

Parents play a primary role in the health and health education of their children. In particular, parent involvement in planning and promoting adolescent immunization campaigns is critical to successful efforts. Parents serve as their children's primary educators on health issues, but where can they get accurate health information? To help guide local PTA units in their programmatic efforts, the National PTA maintains positions and policy statements on multiple health issues: alcohol and other drug abuse; emergency preparedness; environmental issues; family life education; firearm safety; HIV prevention; health screenings; immunization (measles, mumps, rubella, and hepatitis B); lead poisoning; nutrition; protective helmet use; sexual assault prevention; TB testing; tobacco use and access; violence prevention; and youth suicide prevention. Likewise, the school-home partnership is key to promoting the health of adolescents. Comprehensive school health programs and integrated services are necessary to support parent and community efforts to promote adolescent health issues, including immunization programs. Techniques for effective parent involvement, based on the National Standards for Family/Parent Involvement issued by the National PTA January 1997, are discussed.     

Tennessee Lives Count: Statewide gatekeeper training for youth suicide prevention.

Youth suicide remains a significant public health problem in the United States. In 2004, the Garrett Lee Smith Memorial Act provided states and tribes with funding to implement and evaluate youth suicide prevention programs. The Tennessee Lives Count project was developed through a collaborative model at the state level and delivers an enhanced version of the Question, Persuade, Refer gatekeeper training program to individuals working with youth across the state. This article describes the development of the project and preliminary outcomes of 416 participants in child welfare, juvenile justice, health, and education systems at pretest, posttest, and 6-month follow-up. The findings suggest the training has an immediate and long-term impact on perceived knowledge of suicide prevention, self-efficacy, and attitudes about the inevitability of suicide. Policy and practice implications are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Low-dose computerized tomography of the jaw bone in pre-implantation diagnosis. Limits of dose reduction and accuracy of distance measurements

This commentary on the issues and challenges related to the provision of sex education in US schools opens by using a 1997 action of the Franklin County, North Carolina, school board as an example of the controversy. In this case, the school board ordered the removal of chapters on sex behavior, contraception, AIDS, and sexually transmitted diseases from its 9th grade health text book to comply with a new state law requiring public schools to teach sexual abstinence until marriage. While most US adults approve of sex education in schools, the abstinence-only movement has orchestrated a highly organized, successful campaign to remove information from schools and has garnered a $250 million commitment from the federal government to promote abstinence until marriage as part of welfare reform efforts. The commentary continues with a review of efforts to undermine sexuality education starting in the 1960s and sketches the current state of sex education efforts. The next section looks at the new strategy used by sex education opponents, which led them to refocus efforts on local school boards and state legislatures instead of national policies. Remaining topics include the other tactics used by sex education opponents, the heightened fear of teachers to discuss controversial subjects, the lack of teacher training to discuss sexuality, and the consequences of this situation in the classroom. Recommendations to redress this situation include improving professional training, forming local advisory committees, encouraging parental involvement, and promoting the benefits of comprehensive programs.     

Youth Risk Behavior Surveillance--United States, 1997. State and Local YRBSS Coordinators

Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, and are interrelated. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults--behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by the Centers for Disease Control and Prevention as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 33 state surveys, 3 territorial surveys, and 17 local surveys conducted among high school students from February through May 1997. In the United States, 73% of all deaths among youth and young adults 10-24 years of age result from only four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the national 1997 YRBSS demonstrate that many high school students engage in behaviors that increase their likelihood of death from these four causes--19.3% had rarely or never worn a seat belt; during the 30 days preceding the survey, 36.6% had ridden with a driver who had been drinking alcohol; 18.3% had carried a weapon during the 30 days preceding the survey; 50.8% had drunk alcohol during the 30 days preceding the survey; 26.2% had used marijuana during the 30 days preceding the survey; and 7.7% had attempted suicide during the 12 months preceding the survey. Substantial morbidity among school-age youth, young adults, and their children also result from unintended pregnancies and STDs, including HIV infection. YRBSS results indicate that in 1997, 48.4% of high school students had ever had sexual intercourse; 43.2% of sexually active students had not used a condom at last sexual intercourse; and 2.1% had ever injected an illegal drug. Of all deaths and substantial morbidity among adults greater than or equal to 25 years of age, 67% result from two causes--cardiovascular disease and cancer. Most of the risk behaviors associated with these causes of death are initiated during adolescence. In 1997, 36.4% of high school students had smoked cigarettes during the 30 days preceding the survey; 70.7% had not eaten five or more servings of fruits and vegetables during the day preceding the survey; and 72.6% had not attended physical education class daily. These YRBSS data are already being used by health and education officials to improve national, state, and local policies and programs to reduce risks associated with the leading causes of morbidity and mortality. YRBSS data also are being used to measure progress toward achieving 21 national health objectives and one of the eight National Education Goals.     

A music-based HIV prevention intervention for urban adolescents.

Objective: This research examines the process of conducting and evaluating a music-based HIV prevention intervention among urban adolescents, and is informed by the information, motivation, behavioral skills (IMB) model. Design: Musically talented opinion leaders were recruited to write, record, and distribute HIV prevention themed music to their peers to increase HIV prevention motivation, behavioral skills, and behaviors. In this 3-month field experiment, participants were 306 students enrolled in health classes at each of three large multiracial urban high schools (one treatment school; two control schools). Main Outcome Measures: Measures of HIV prevention information, motivation, behavioral skills, and behaviors, both pre- and postintervention. Results and Conclusion: Results indicate that the intervention influenced several aspects of HIV prevention motivation, behavioral skills, and condom use and HIV testing behaviors. This research demonstrates that the incorporation of music into HIV prevention interventions for adolescents has the potential to be effective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Can school teachers improve the management and prevention of skin disease? A pilot study based on head louse infestations in Guerrero, Mexico

BACKGROUND: The effect of health education provided by teachers, in three primary schools of Guerrero, Mexico, on the prevalence of head louse infestation was compared. METHODS: A cross-sectional survey and rapid appraisal methods were performed, including a child questionnaire and qualitative data from teachers and focus groups of mothers in the same schools. RESULTS: Nine hundred and forty-four students and 33 teachers were interviewed; a focus group discussion with 6-8 mothers per school was performed. In the self-diagnosis of pediculosis, the prevalence was 22% (range, 18%-33%) with a sensitivity of 68% and a specificity of 86%. In one school, 100% of the teachers applied a health program, whereas in the other two schools this percentage was only 20%. A child under 9 years of age who attended a school without information on health was 3.6 times more likely to have head louse infestation (OR = 3.6, CI 95% = 2.1-6) than a child of the same age who attended a school where information was given. In older children the effect and potential impact were lower. The difference between the two age groups is unlikely to be explained by chance (X2 het = 5.7, df = 1, p = 0.01). CONCLUSIONS: This study emphasizes the potential value of simple, but effective, health education provided by school teaching staff through liaison with patents in the amelioration of endemic disease.     

Personal and family backgrounds of first-year veterinary science students at the University of Queensland

OBJECTIVE: To provide information on changes in the social and educational backgrounds of veterinary students over a 10 year period in an effort to determine the extent to which they are representative of the community. METHODS: Questionnaires were completed by first-year veterinary students at The University of Queensland in 1985 and 1986 (152 students), and 1995 and 1996 (154), and the data were analysed using the SAS System for Windows. RESULTS: The gender ratio of first-year veterinary students was 50:50 (male:female) in 1985 and 1986 but 10 years later it had changed to 38:62. In 1985 and 1986 77% had come directly from school, with 43% of the total coming from government schools, 17% from Catholic schools and 34% from other private (independent) schools. A decade later the percentage coming directly from school had decreased to 40%, that from Independent schools increased to 45% and that from cities increased from 53% to 64%. The educational backgrounds of parents varied widely though a high percentage had university degrees; mothers had received less formal education than fathers, and the educational attainments of both parents were higher at the beginning than at the end of the study. More than half (57% initially; 67% 10 years later) the fathers were in professional or managerial occupations, and a similar number (50% initially; 48% 10 years later) of mothers were teachers, nurses or clerks. The number of males from country areas decreased from 26 to 16 over this period. CONCLUSION: These veterinary students differed from the community generally in that progressively more were female, more were from Independent schools, their parents had more formal education and more of their parents were in professional, managerial or clerical occupations.     

Rural school nurses' attitudes about AIDS and homosexuality

The AIDS epidemic has spread to rural areas of the United States. Conservative rural communities are facing the challenge of having children with HIV entering school. School nurses, as the only health care providers in the schools, are in a strong position to facilitate the education of children with HIV and to provide AIDS education to students, faculty, and parents. School nurses' knowledge and attitudes about AIDS and people with AIDS influence their effectiveness in prevention activities and care of HIV-infected children. This study examined the relationship between specific demographic, practice, and cultural variables and rural school nurses' attitudes about AIDS and homosexuality. Sixty-nine school nurses responded to a mailed questionnaire as part of a larger study of rural nurses. Results indicate attitudes about homosexuality were related to nurses' homosexual knowledge and religious beliefs while attitudes about AIDS were related to nurses' willingness to care for people with AIDS and feeling prepared to do so.     

Rethinking psychology and the schools: Implications of recent national policy.

Social reforms affecting society often are played out in America's schools. Within the past 3 years, the federal government and many states have passed massive social reforms, all of which affect schools, children, and families. This article explores 2 converging reform movements: education and health care reform. Education reform, which is addressed nationally in the Goals 2000: Educate America Act of 1994, the Improving America's Schools Act of 1994, the School-to-Work Opportunities Act of 1994, and the pending reauthorization of the Individuals With Disabilities Education Act (1994), is producing dramatic transformations at federal, state, and local levels. Although comprehensive national health care legislation has failed to gain passage, many states and national groups are promoting schools as health service delivery sites. Thus, social reform movements in education and health care are converging within the single social institution that touches the lives of every American citizen—the schools. This article explores the challenges and opportunities for psychology in addressing social reforms associated with the schools. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Phonological codes are early sources of constraint in visual semantic categorization

Current statistics show a marked increase in suicides among adolescents 15 to 19 years of age. The literature suggests an increase in the use of lethal methods such as firearms by young suicide attempters. Studies show that most adolescent suicide completers have never received mental health treatment, although the majority had exhibited psychiatric symptoms previous to their deaths. This review of the literature identifies the characteristics and precipitants of suicidal behavior among adolescents. The literature clearly indicates a need for suicide awareness and prevention programs and for the early identification of teenagers at risk for suicidal behaviors. The most logical location for suicide prevention programs and activities is in the schools where the greatest number of adolescents can be reached. The master's-prepared psychiatric mental health nurse in a consultive and collaborative role can be instrumental in the successful formation and execution of these programs. In a joint effort, school personnel and the psychiatric mental health nurse specialist may be able to decrease significantly the number of suicidal behaviors among adolescents.     

Prevention of AIDS: experience with adolescents from a state elementary school in Porto Allegre

This article refers to a participating experience in AIDS prevention with teenagers from 5th to 8th grade of a state elementary school, through workshops. This working method uses participating technics to allow relaxation, discussion and theme reflection by the group. The results obtained with this work of information and health education indicate the possibility of stimulating preventive acting development through reflection on the health-disease process, which involves HIV virus infection and comprehension of the disease extension and gravity for public health.     

AIDS education in Tanzania: promoting risk reduction among primary school children

OBJECTIVES: The purpose of this study was to test the effects of an education program in Tanzania designed to reduce children's risk of human immunodeficiency virus (HIV) infection and to improve their tolerance of and care for people with acquired immunodeficiency syndrome (AIDS). METHODS: A randomized controlled community trial including baseline and 12-month follow-up surveys was employed. Public primary schools in the Arusha and Kilimanjaro regions of Tanzania were stratified according to location and randomly assigned to intervention (n = 6) or comparison (n = 12) conditions. Of the 1063 sixth-grade students (average age: 13.6 years) who participated at baseline, 814 participated in the follow-up survey. RESULTS: At follow-up, statistically significant effects favoring the intervention group were observed for exposure to AIDS information and communication, AIDS knowledge, attitudes toward people with AIDS, and subjective norms and behavioral intentions toward having sexual intercourse. A consistent positive but nonsignificant trend was seen for attitudes toward having sexual intercourse and for initiation of sexual intercourse during the previous year (7% vs 17%). CONCLUSIONS: It is feasible and effective to train local teachers and health workers to provide HIV/AIDS education to Tanzanian primary school children.     

School nurses' skills in sexual health education

School nurses are often called on teach sexual health without being given any formal teacher training or support. This article describes a study of the experiences of 50 school nurses. The author suggests ways in which schools and their nurses could create supportive and complementary teaching partnerships for effective sex education.     

Medical clinics in junior high school: changing the model to meet demands

PURPOSE: To document the development of an initiative undertaken by the Columbia University School of Public Health to provide medical, mental health, and social services in inner city junior high school-based clinics. METHODS: Review of records, reports, and foundation proposals from 1984-1993. Site visits, interviews with clinic staff, school personnel, and students. RESULTS: Years of planning and community development produced four clinics in the Washington Heights area of New York City, the first school-based clinics located in junior high schools in the country. After seven years, the program has the capacity to serve over 4,000 students who present an overwhelming array of physical, psychological, social, and family problems. Almost 23,000 visits were made to the clinics this year: 49% for medical services, 38% for social services, and 13% for health education. As the demand multiplied, a form of triage was implemented that tracked the highest risk students into intensive individual and group interventions. Primary health screening, mental health services, and pregnancy prevention were identified among the critical needs in this deprived community. CONCLUSIONS: Over the years, the clinics have become integrated into the fabric of the schools. Strategies for working in urban junior high schools must be broad, encompassing medical and mental health services, group counseling, life planning and career orientation, along with enhancement of the total school and learning environment.     

Investigation of the effectiveness of a school-based suicide education program using three methodological approaches.

The study demonstrates how to conduct nonexperimental yet rigorous evaluation of suicide education programs when random assignment with control group design is not feasible under practical or ethical constraints. To achieve this goal, the authors show how rigorous evaluation of a school-based suicide education program (Raising Awareness of Personal Power [RAPP]) is conducted by means of three methodological approaches: the rolling group design, the internal referencing strategy, and the minimum competency approach. A total of 779 high school students in seven public high schools in Northern Colorado participated in the current study. Results based on the three approaches provide converging evidence that the RAPP program was effective not only in producing positive change in participants' knowledge, attitudes, and self-efficacy about suicide and suicide prevention, but also in reaching predetermined levels of knowledge and positive reactions to the program. Furthermore, the three approaches demonstrate practicality, usefulness, and rigorousness for future field evaluations if the formal experimental design could not be conducted in practice. Implications for program evaluation are further discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prognostic value of dipyridamole thallium-201 screening to minimize perioperative cardiac complications in diabetics undergoing kidney or kidney-pancreas transplantation

A survey of knowledge, attitude and practice (KAP) regarding human immunodeficiency virus infection was performed on 899 students from 3 government-administered high schools located in the Bangkok Metropolitan area. Initially, all students completed a written questionnaire (pre-test) regarding HIV/AIDS. Following this, they attended a slide lecture presentation given by a specialist physician. The same test questionnaire was then completed by the same students six weeks (post-test) later for comparison of their previous KAP. The subjects composed of male to female ratio equal to that of the median age 15-16 years old. Sixty-seven per cent of the subjects were living with their parents, 16.3 per cent with relatives and 15 per cent with friends. Ninety nine per cent of the subjects had received information on HIV/AIDS before enrollment to this study. The source of knowledge ranged from television (89.1%), teachers (81.6%), pamphlets (80.2%), newspapers (75%), radio (55%), health care workers (53.4%), friends (38.6%) and only 32.5 per cent from their parents. The subjects' knowledge about HIV/AIDS and risk factors in the post-test questionnaire was significantly increased (P < 0.001) from the pre-test status. However, their attitudes to an HIV infected person were not significantly changed in the post-test questionnaire: only the "attending school" question showed significantly (P < 0.05) increased numbers of agreement. Similarly, the attitudes and practices to prevent HIV infection were not significantly (P > 0.05) different between pre-test and post-test questionnaires. The result of this study is to recommend regular school-based programs of education to increase awareness of preventive strategies for HIV/AIDS and sexually transmitted diseases.     

Entry of US medical school graduates into family practice residencies: 1996-1997 and 3-year summary

BACKGROUND AND OBJECTIVES: This is the 16 report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family practice residency programs. Approximately 15.9% of the 16,029 graduates of the US medical schools between July 1995 and June 1996 were first-year family practice residents in October 1996, compared with 14.6% in 1995 and 13.4% in 1994. This is the highest percentage since 1980-1981 (12.8%), when this series of studies began. Medical school graduates from publicly funded medical schools were almost twice as likely to be first-year family practice residents in October 1996 than were residents from privately funded schools, 19.1% compared with 11.2%. The Mountain region reported the highest percentage of medical school graduates who were first-year residents in family practice programs in October 1996 at 24%; the Middle Atlantic and New England regions reported the lowest percentage at 11.4% and 9.9%, respectively. Nearly half of the medical school graduates (48.4%) entering a family practice residency program as first-year residents in October 1996 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family practice residency programs.     

The school psychologist's role in suicide prevention.

Suggests that the school psychologist's involvement in the issue of youth suicide spans primary, secondary, and tertiary prevention and working with the aftermath of a suicide or suicide attempt. Primary prevention activities involve supporting and delivering curricula educating youth about suicide, promoting social problem solving in the school milieu, screening all students for suicidal ideation, creating networks of peer helpers, working to reduce the availability of suicidal means, training school personnel to identify and refer potentially suicidal youth, and establishing interdisciplinary crisis response teams. Secondary prevention involves working with individuals and groups at risk (i.e., alternative education students, gay and lesbian youth, and minority youth) for engaging in suicidal behavior. Tertiary prevention requires swift treatment and referral, including services delivered following a suicide. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Crisis intervention after the suicide of a teacher.

Educational institutions increasingly are requesting the services of mental health professionals after a suicide has occurred. Although such communities have sustained sudden shock and loss, the contagious quality of suicide results in uncertainty about the most appropriate response. We describe an intervention occurring after the suicide of an elementary school teacher. The intervention included a meeting with faculty, classroom discussions with the students most directly affected, and the availability of the school psychologist for individual meetings. In addition, a memorial service was held at the school. We argue that such a broad, multifaceted response contributes to the healing process and serves to minimize mental health difficulties after such an event. (PsycINFO Database Record (c) 2010 APA, all rights reserved)