Drug education practice: results of an observational study.
(17/1031)
Understanding normative practice in drug education is a key to identifying means of improving preventive intervention outcomes. In this paper, we report findings of an observational study in which drug education in multiple periods of 146 middle school classes was categorized minute-by-minute according to the type of instruction provided to students. Results indicate that nearly half of all drug education focused on providing students with knowledge. Alternative methods, particularly those that have shown programmatic effectiveness, and those that address risk and protective factors known to be highly predictive of drug use onset, were relatively ignored. Further, teachers showed relatively low consistency in understanding concepts other than knowledge based on comparisons of their ratings of intended instructions with those of trained observers. Nonetheless, there is evidence that some teachers systematically attempted to address drug prevention from either a social influence or an affective education perspective. These findings suggest that if improvements in the effectiveness of drug education are to be seen in the future, a relatively radical transformation of approaches to teaching will be needed. (+info)
Student-school bonding and adolescent problem behavior.
(18/1031)
Adolescent problem behavior, including substance use, school misconduct and delinquency, is a national concern. Implicit in the concept of middle school is the recognition that students who develop positive social bonds with their school are more likely to perform well academically, and refrain from misconduct and other antisocial behavior. However, little scientific attention has been given to the complex interactions between middle school students and the school environment. Prior to implementing a middle school problem behavior prevention program we conducted a survey in the seven middle schools in one US school district. Out of 4668 grade 6-8 students enrolled, 4263 (91.3%) completed the survey. Student-school bonding was positively correlated with school adjustment (r = 0.49) and perceived school climate (r = 0.77), but inversely correlated with problem behavior (r = -0.39 to -0.43). Problem behavior was significantly higher (P < 0.001) among males than females and among students in higher grades. Conversely, school bonding, climate and adjustment were significantly higher (P < 0.001) among females than males, but declined significantly from one grade to the next. The data support the conclusion that school bonding is associated with problem behavior. We describe the development of a multiple-component intervention in middle schools designed to increase student-school bonding and prevent problem behavior. (+info)
The Denver school-based adolescent hepatitis B vaccination program: a cost analysis with risk simulation.
(19/1031)
OBJECTIVES: This study sought to compare the cost-effectiveness of a school-based hepatitis B vaccine delivery program with that of a vaccine delivery program associated with a network health maintenance organization (HMO). METHODS: The vaccination program enrolled 3359 sixth-grade students from 18 middle schools in Denver, Colo. Immunization status and direct and indirect program costs were compiled. The sensitivity of the outcomes was assessed by simulation methods. RESULTS: The per-dose cost-effectiveness ratio for the school-based delivery system was $31. This cost-effectiveness ratio remained stable when the model was simulated with costs that were underestimated or overestimated by 20%. In the network HMO, the direct cost per dose was $68 and the societal cost was $118 when the child's father worked full-time and the mother worked part-time. There is less than a 5% chance that the network HMO-based vaccination program could be more cost-effective than the school-based program. CONCLUSIONS: The cost per dose of the school-based program was significantly less than that of the network HMO-based program, because in the school program government-purchased vaccine was available at a lower cost and parents did not incur work-loss costs. (+info)
Effectiveness of a social influences smoking prevention program as a function of provider type, training method, and school risk.
(20/1031)
OBJECTIVES: This study determined the effect of provider (nurse or teacher) and training method (workshop or self-preparation) on outcomes of a social influences smoking prevention program. METHODS: One hundred elementary schools were stratified by school risk score (high risk = high smoking rate among senior students) and assigned randomly to conditions: (1) teacher/self-preparation, (2) teacher/workshop, (3) nurse/self-preparation, (4) nurse/workshop, and (5) control. Intervention occurred in grades 6 to 8. Smoking status at the end of grade 8 was the primary endpoint variable. RESULTS: Intervention reduced grade 8 smoking rates in high-risk schools (smoking rates of 26.9% in control vs 16.0% in intervention schools) but not in low-risk schools. There were no significant differences in outcome as a function of training method and no significant differences in outcome between teacher-provided and nurse-provided interventions in high- and medium-risk schools. Although nurses achieved better outcomes than did teachers in low-risk schools, neither provider type achieved outcomes superior to the control condition in those schools. CONCLUSIONS: Workshop training did not affect outcomes. Teachers and nurses were equally effective providers. Results suggest that programming should target high-risk schools. (+info)
School based screening for hypothyroidism in Down's syndrome by dried blood spot TSH measurement.
(21/1031)
OBJECTIVE: To determine the feasibility of annual hypothyroid screening of children with Down's syndrome by measuring thyroid stimulating hormone (TSH) on dried blood spots at school, and to describe the outcome in positive children. DESIGN: Establishment of a register of school children with Down's syndrome, and procedures for obtaining permission from parents, annual capillary blood samples, TSH measurement, and clinical assessment of children with TSH values > 10 mU/litre. SUBJECTS: All school age children with Down's syndrome within Lanarkshire and Glasgow Health Boards during 1996-7 and 1997-8. RESULTS: 200 of 214 school children with Down's syndrome were screened. Four of the unscreened children were receiving thyroxine treatment, and only 5 remained unscreened by default. 15 of the 200 children had capillary TSH > 10 mU/litre, and all but 1 had evidence of Hashimoto's thyroiditis. Seven of the 15 children started thyroxine treatment immediately, 6 with a pronounced rise in venous TSH and subnormal free thyroxine (fT4), and one with mildly raised TSH and normal fT4 but symptoms suggesting hypothyroidism. Eight children with mildly raised venous TSH and normal fT4 were left untreated; 1 year after testing positive, fT4 remained > 9 pmol/litre in all cases, but 4 children were started on thyroxine because of a rise in TSH. TSH fell in 3 of the 4 remaining children and there was a marginal rise in 1; all remain untreated. The prevalence of thyroid disease in this population is >/= 8.9%. CONCLUSION: Dried blood spot TSH measurement is effective for detecting hypothyroidism in Down's syndrome and capillary sampling is easily performed at school. The existing programme could be extended to the whole of Scotland within a few years. (+info)
Health problems in teenage daily smokers versus nonsmokers, Norway, 1995-1997: the Nord-Trondelag Health Study.
(22/1031)
Increased morbidity among teenage smokers has been reported, but specific current health problems and medication use other than of alcohol and narcotics have received less attention. The aim of this study was to examine the association between health problems and daily smoking in teenagers. Ninety percent of all teenagers attending junior high or high schools participated in a cross-sectional study conducted in Nord-Trondelag County, Norway, 1995-1997; included were 8,040 students aged 13-18 years. Information on smoking habits, health problems, medication use, and use of health services was obtained in schools by self-administered questionnaire and by interview. Fifty-five percent of boys and 57% of girls had tried smoking, and 9% and 11%, respectively, reported current daily smoking. When compared with boys and girls who had never smoked, daily smoking among both sexes and all age groups was associated with significantly poorer perceived health, respiratory symptoms, headache, neck and shoulder pain, stomachache, nausea, frequent heartbeats, nervousness/restlessness, and sleep problems. Daily smokers used more medications and health services. Daily smoking by adolescents is already associated with multiple somatic health problems. Whether or not the association is causal, daily smoking identifies a group of adolescents with health problems for whom preventive strategies should also include medical and social support. (+info)
Planning chemotherapy based schistosomiasis control: validation of a mathematical model using data on Schistosoma haematobium from Pemba, Tanzania.
(23/1031)
A mathematical model, based on a deterministic differential equation framework, has been developed to predict the impact of community chemotherapy programmes for human schistosomiasis. Here, this model is validated using data collected from a long-term control programme for urinary schistosomiasis on the island of Pemba, Zanzibar, United Republic of Tanzania, initiated in 1986 and still ongoing, in which schoolchildren were offered praziquantel chemotherapy every 6 months. Prevalence of infection and blood in urine were monitored in all the schools (total 26000 children from 60 schools) and more detailed data were collected in selected evaluation schools. Model predictions were run by using the initial prevalence as input. The predictions were very close to the observed decreases in prevalence and in prevalence of blood in urine. The correspondence improved further when the data were combined, going from single school level to district, and when the entire data set was combined. The accuracy of the predictions suggests that this model could be used as a tool to predict the consequences of chemotherapy control programmes. It is currently in press as a Windows software package under the name of 'EpiSchisto'. (+info)
School-based scalds prevention: reaching children and their families.
(24/1031)
Preventing children's thermal injuries requires changes to both the home environment and the behaviour of family members. Two pilot studies were undertaken of a school-based programme that taught children aged 7-11 years about burns and scalds hazards, and encouraged changes to the home environment and family practices through a take-home exercise. Both studies took place at ethnically diverse schools from low/middle-income areas of Waitakere City, New Zealand. Study 1 involved 55 children who received the programme, and Study 2 involved 64 children who received the programme and 71 children from a control school. The children's ability to identify the burns and scalds hazards illustrated in a series of pictures was measured before and after the programme. Children who received the programme showed considerable improvement in hazard identification at the post-test, while children at the control school showed minimal improvement. The take-home exercise was completed by 85% of the children and their families in Study 1, and 61% of the participants from the intervention school in Study 2. In both studies families reported positive safety changes as a result of the programme. The programme appeared equally effective with all the ethnic groups involved. Future development of the programme is discussed. (+info)