School-Based and Community-Based Gun Safety Educational Strategies for Injury Prevention

AbstractCommunity-based environmental education is an important part of the sustainability project. Along with regulation and market-based instruments, adult learning and education in non-formal settings consistently features in the sustainability strategies advocated and implemented by government, community and industry entities.Community-situated environmental education programs often feature didactic “messaging”™, public awareness and community-based social marketing approaches. Clearly, these approaches have limited capacity to stimulate the social learning necessary to reorient toward sustainability. Popular education provides a framework to break from these dominant modes of environmental communication and education and achieve outcomes of a different order. Popular educators build curriculum from the daily lives of community members, address their social, political and structural change priorities, and emphasise collective rather than individual learning. Their work creates opportunities for education as social action, education for social action, and learning through social action.Case studies from Australia and the United States highlight opportunities for community educators to draw on the traditions and practices of popular education. Residents of contaminated communities organise “toxic tours”™ to bolster their campaigns for remediation. Residents and conservationists concerned about freeway construction incorporate learning strategies in their campaign plan to enhance peer learning, mentoring and prospects of long-term success. Advocacy organisations and research institutions work together to create formal and informal educational programs to strengthen and learn from social action. The principles derived from these case studies offer a starting point for collaboration and action research.

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The Evidence on School-Based Health Centers: A Review

Global Pediatric Health ◽

10.1177/2333794x19828745 ◽

2019 ◽

Vol 6 ◽

pp. 2333794X1982874 ◽

Cited By ~ 8

Author(s):

Michael Arenson ◽

Philip J. Hudson ◽

NaeHyung Lee ◽

Betty Lai

Keyword(s):

Health Equity ◽

Care Delivery ◽

Evidence Synthesis ◽

Opportunity To Learn ◽

The United States ◽

Health Centers ◽

Access To Health Services ◽

Dual Roles ◽

School Based ◽

School Based Health Centers

Context. Pediatricians working toward health equity require health care delivery mechanisms that take on dual roles: mitigating the health effects of a maladaptive social ecosystem while simultaneously working to improve the ecosystem itself. School-based health centers (SBHCs) perform these dual roles by providing medical, mental/behavioral, dental, and vision care directly in schools where young people spend the majority of their time, maximizing their opportunity to learn and grow. Evidence Acquisition. Databases were searched extensively for research studies published between January 2000 and December 2018. Evidence Synthesis. The authors began with 3 recent high-impact reviews that covered SBHC history, health outcomes, cost-benefit, and impact on health equity. Informed by these articles, the authors organized the evidence into 4 broad categories of impact: Financial, Physical Health (including medical, vision, and dental), Mental Health, and Educational Outcomes. Using these 4 categories, the authors then performed a robust literature search using PubMed for studies that fit into these themes. Conclusions. SBHCs increase access to health services for children, families, and communities, which ultimately leads to positive short- and long-term outcomes in service of a broad range of stakeholders. Educational impact requires further attention on both outcomes and methodological approaches. Three current public health topics of importance were identified that SBHCs might be well-suited to address: Youth Gun Violence, Adverse Childhood Experiences, and the Health of American Indian/Alaskan Native communities in the United States.

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What will it take? Using an Implementation Research Framework to Identify Facilitators and Barriers in Implementing a School-Based Referral System for Sexual Health Services

10.21203/rs.2.10738/v1 ◽

2019 ◽

Author(s):

Emily Leung ◽

Kathryn J. Wanner ◽

Lindsay Senter ◽

Amanda Brown ◽

Dawn Middleton

Keyword(s):

Health Services ◽

Sexual Health ◽

Implementation Research ◽

Critical Role ◽

The United States ◽

Successful Implementation ◽

Community Based ◽

School Based ◽

Student Access

Abstract Background:Across the United States (U.S.), sexually-transmitted infections and unintended pregnancy rates are alarmingly high among youth. Schools play a critical role in improving access to sexual health services (SHS) due to their proximity and access to youth. Schools can increase student access to services by creating referral systems (RS) to link students to school- and community-based SHS. From 2013-2018, the Centers for Disease Control and Prevention’s Division of Adolescent and School Health funded 17 Local Education Agencies (LEA) to partner with priority schools, and other stakeholders, to develop and implement RS to increase student access to SHS. CAI served as the Technical Assistance Center, providing capacity building to the LEA. CAI conducted a case study at two large urban LEA to elucidate factors that influence RS implementation in 2016-2017. Methods:This mixed-methods case study included interviewing and surveying 19 LEA and community-based healthcare (CBH) staff in the Southeastern (n=9) and Western U.S. (n=10). Key constructs from the Consolidated Framework for Implementation Research (CFIR) framework guided the methodology and analysis. Consensus qualitative research coding methods were applied to the interviews. We also distributed a quantitative survey to collect participants’ perceived difficulty in implementing and sustaining RS; data was analyzed using descriptive statistics. Results:Interviewees reported strong beliefs that school-based RS can help students achieve better academic outcomes. We identified several contextual key factors across the five CFIR domains that influenced successful implementation and integration of an RS including: enforcing state and district policies, strong LEA and CBH collaboration, positive school culture towards adolescent health, knowledgeable and supportive staff, leveraging of existing resources and staffing structures, and influential district and school building-level leadership and champions. Notably, this case study challenged our initial assumptions that RS are easily implemented in states with comprehensive SHS policies. Rather, our conversations revealed how districts and local-level policies have significant influence to either impede or promote those policies. Conclusions:Using an implementation science lens, this study describes key contextual factors and lessons learned to implementing an RS. Other schools may wish to consider these influencing factors to optimize integration of RS-related evidence-based practices, systems, and policies in their districts.

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What will it take? Using an Implementation Research Framework to Identify Facilitators and Barriers in Implementing a School-Based Referral System for Sexual Health Services

10.21203/rs.2.10738/v3 ◽

2020 ◽

Author(s):

Emily Leung ◽

Kathryn J. Wanner ◽

Lindsay Senter ◽

Amanda Brown ◽

Dawn Middleton

Keyword(s):

Health Services ◽

Sexual Health ◽

Unintended Pregnancy ◽

Implementation Research ◽

Contextual Factors ◽

The United States ◽

Successful Implementation ◽

Community Based ◽

School Based ◽

Student Access

Abstract Background Across the United States, sexually transmitted infections and unintended pregnancy rates are alarmingly high among youth. Schools, due to their proximity and access to youth, can increase student access to sexual health services (SHS) by creating referral systems (RS) to link students to school- and community-based SHS. From 2013-2018, the Centers for Disease Control and Prevention’s Division of Adolescent and School Health funded 17 Local Education Agencies (LEA) to partner with priority schools and stakeholders to develop and implement RS to increase student access to SHS. Cicatelli Associates Inc. (CAI) was funded to provide capacity-building to LEA. In 2016-2017, CAI conducted case studies at two LEA, both large and urban sites, but representing different geographical and political contexts, to elucidate factors that influence RS implementation. Methods Nineteen LEA and community-based healthcare (CBH) staff were interviewed in the Southeastern (n=9) and Western U.S. (n=10). Key constructs (e.g., leadership engagement, resources, state and district policies) across the five domains of the Consolidated Framework for Implementation Research (CFIR) framework guided the methodology and analysis. Qualitative data was analyzed using the Framework Method and contextual factors and themes that led to RS implementation were identified. Results Interviewees strongly believed that school-based RS can decrease STI, HIV and unintended pregnancy and increase students’ educational attainment. We identified the following contextual key factors that facilitate successful implementation and integration of an RS: enforcing state and district policies, strong LEA and CBH collaboration, positive school culture towards adolescent health, knowledgeable and supportive staff, leveraging of existing resources and staffing structures, and influential district and school building-level leadership and champions. Notably, this case study challenged our initial assumptions that RS are easily implemented in states with comprehensive SHS policies. Rather, our conversations revealed how districts and local-level policies can have significant impact and influence to impede or promote those policies. Conclusions Through the use of the CFIR framework, the interviews identified important contextual factors and themes associated with LEAs’ implementation barriers and facilitators. The study’s results present key recommendations that other LEA can consider to optimize integration of RS-related evidence-based practices, systems, and policies in their districts.

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The Significance of School-based Programs, School-based Activities, and Community-Based Activities Against Marijuana Use Among Adolescents

Journal of Drug Issues ◽

10.1177/00220426211037272 ◽

2021 ◽

pp. 002204262110372

Author(s):

Ngoc N. Nguyen

Keyword(s):

United States ◽

Asian American ◽

Binary Logistic Regression ◽

Marijuana Use ◽

The United States ◽

Binary Logistic Regression Analysis ◽

Community Based ◽

School Based ◽

Main Effects ◽

The Impact

Background: Marijuana use among adolescents is concerning in the United States, meanwhile, the effectiveness of school-based programs is inconclusive. This study examines the impact of school-based programs, school-based activities, and community-based activities on marijuana use among adolescents. Methods: A binary logistic regression analysis was conducted, using a sample of 16,509 adolescents (age = 12 to 17, male = 51.3%, White = 60.1%, Hispanic = 21.4%, African American = 14.7%, and Asian American = 3.9%) from the 2013 National Survey on Drug Use and Health (NSDUH). Results: Results of the main effects revealed that school-based programs, school-based activities, and community-based activities were deterrent factors against marijuana use among adolescents. Adolescents are less likely to use marijuana if they participate in school-based programs, school-based activities, and community-based activities. Conclusion: The findings of this study have implications for schools and those making educational policy.

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A Systematic Review of Alternative Nicotine Delivery System (ANDS)-Based Interventions on Smoking-Related Health Outcomes Among Marginalised Population Groups.

10.21203/rs.3.rs-1048408/v1 ◽

2021 ◽

Author(s):

Florian Scheibein ◽

Martina Gooney ◽

Adrian Jones ◽

Evan Matthews ◽

Kevin McGirr ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Evidence Synthesis ◽

Experimental Studies ◽

Delivery Systems ◽

People Who Use Drugs ◽

People Living With Hiv ◽

Smoking Reduction ◽

Nicotine Delivery ◽

Best Evidence Synthesis

Abstract Background: Smoking and smoking-related disease is endemic amongst many marginalised populations such as people experiencing homelessness, people who use drugs, people living with HIV, sex workers and members of the LGBTQ+, Indigenous, Traveller and migrant communities. Alternative Nicotine Delivery Systems (ANDS)-based interventions including those using Nicotine Replacement Therapy (NRT) and Electronic Nicotine Delivery Systems (ENDS) show promise in supporting people to reduce their smoking. However, little is known about ANDS-based smoking reduction interventions with marginalised populations. This systematic review provides a best evidence synthesis of ANDS-based smoking reduction interventions to address this gap.Methods:A systematic review protocol was registered on PROSPERO (CRD42020158832) and literature review conducted through MEDLINE/PubMed, CINAHL, EMBASE, OVID SP, ScienceDirect and Google Scholar. The primary outcomes of cigarette smoking, and biochemical validation of abstinence were reported. Secondary outcomes reported included physical health, mental health and other outcomes.Results: Twenty-Nine studies were included in this review. Thirteen of the included studies were randomised controlled trials (RCTs) (n= 2828) and 16 studies were quasi controlled studies (n=1172). The sample size across the studies ranged from 9 to 775 participants. The mean reported age of participants ranged from 32.4 to 56.9 years old with an overall mean age of 39.55. A minority of study participants identified as female (33.43%; with two studies not reporting gender). A range of ANDS-interventions were found to be effective in reducing smoking amongst a range of marginalised groups. However, the overall quality of both the controlled and quasi experimental studies, as evaluated using the JBI Appraisal Tool, was found to be low.Conclusions: Studies are often evaluated as homogenous interventions although they are frequently a group of interventions and lack power analysis of the effects of individual components of the intervention effect. Several studies suggest potential mental health benefits consequent of ANDS-based intervention, though this effect is poorly explored. There is a current lack of RCTs related to ANDS-based smoking related interventions with people experiencing homelessness. Similarly, there is a lack of properly controlled RCTs exploring the use of ENDS with marginalised populations. Future studies should aim to address these deficits.

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What will it take? Using an Implementation Research Framework to Identify Facilitators and Barriers in Implementing a School-Based Referral System for Sexual Health Services

10.21203/rs.2.10738/v2 ◽

2020 ◽

Author(s):

Emily Leung ◽

Kathryn J. Wanner ◽

Lindsay Senter ◽

Amanda Brown ◽

Dawn Middleton

Keyword(s):

Health Services ◽

Sexual Health ◽

Unintended Pregnancy ◽

Implementation Research ◽

Contextual Factors ◽

The United States ◽

Successful Implementation ◽

Community Based ◽

School Based ◽

Student Access

Abstract Background Across the United States, sexually transmitted infections and unintended pregnancy rates are alarmingly high among youth. Schools, due to their proximity and access to youth, can increase student access to sexual health services (SHS) by creating referral systems (RS) to link students to school- and community-based SHS. From 2013-2018, the Centers for Disease Control and Prevention’s Division of Adolescent and School Health funded 17 Local Education Agencies (LEA) to partner with priority schools and stakeholders to develop and implement RS to increase student access to SHS. Cicatelli Associates Inc. (CAI) was funded to provide capacity-building to LEA. In 2016-2017, CAI conducted case studies at two LEA, both large and urban sites, but representing different geographical and political contexts, to elucidate factors that influence RS implementation. Methods Nineteen LEA and community-based healthcare (CBH) staff were interviewed in the Southeastern (n=9) and Western U.S. (n=10). Key constructs (e.g., leadership engagement, resources, state and district policies) across the five domains of the Consolidated Framework for Implementation Research (CFIR) framework guided the methodology and analysis. Qualitative data was analyzed using the Framework Method and contextual factors and themes that led to RS implementation were identified. Results Interviewees strongly believed that school-based RS can decrease STI, HIV and unintended pregnancy and increase students’ educational attainment. We identified the following contextual key factors that facilitate successful implementation and integration of an RS: enforcing state and district policies, strong LEA and CBH collaboration, positive school culture towards adolescent health, knowledgeable and supportive staff, leveraging of existing resources and staffing structures, and influential district and school building-level leadership and champions. Notably, this case study challenged our initial assumptions that RS are easily implemented in states with comprehensive SHS policies. Rather, our conversations revealed how districts and local-level policies can have significant impact and influence to impede or promote those policies. Conclusions Through the use of the CFIR framework, the interviews identified important contextual factors and themes associated with LEAs’ implementation barriers and facilitators. The study’s results present key recommendations that other LEA can consider to optimize integration of RS-related evidence-based practices, systems, and policies in their districts.

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School-Based Speech-Language Pathologists' Perceived Self-Efficacy in Conducting Multidimensional Treatment With Children Who Stutter

Language Speech and Hearing Services in Schools ◽

10.1044/2020_lshss-20-00044 ◽

2020 ◽

Vol 51 (4) ◽

pp. 1172-1186

Author(s):

Carolina Beita-Ell ◽

Michael P. Boyle

Keyword(s):

Self Efficacy ◽

Clinical Training ◽

Online Survey ◽

The United States ◽

Comfort Level ◽

Social Emotional ◽

Speech Language Pathologists ◽

Fluency Disorders ◽

Cognitive Components ◽

School Based

Purpose The purposes of this study were to examine the self-efficacy of school-based speech-language pathologists (SLPs) in conducting multidimensional treatment with children who stutter (CWS) and to identify correlates of self-efficacy in treating speech-related, social, emotional, and cognitive domains of stuttering. Method Three hundred twenty randomly selected school-based SLPs across the United States responded to an online survey that contained self-efficacy scales related to speech, social, emotional, and cognitive components of stuttering. These ratings were analyzed in relation to participants' beliefs about stuttering treatment and their comfort level in treating CWS, perceived success in therapy, and empathy levels, in addition to their academic and clinical training in fluency disorders as well as demographic information. Results Overall, SLPs reported moderate levels of self-efficacy on each self-efficacy scale and on a measure of total self-efficacy. Significant positive associations were observed between SLPs' self-efficacy perceptions and their comfort level in treating CWS, self-reported success in treatment, beliefs about the importance of multidimensional treatment, and self-reported empathy. There were some discrepancies between what SLPs believed was important to address in stuttering therapy and how they measured success in therapy. Conclusions Among school-based SLPs, self-efficacy for treating school-age CWS with a multidimensional approach appears stronger than previously reported; however, more progress in training and experience is needed for SLPs to feel highly self-efficacious in these areas. Continuing to improve clinician self-efficacy for stuttering treatment through improved academic training and increased clinical experiences should remain a high priority in order to enhance outcomes for CWS. Supplemental Material https://doi.org/10.23641/asha.12978194

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