Increasing the Delivery of Preventive Health Services in Public Education

The delivery of prevention services to children and adolescents through traditional healthcare settings is challenging for a variety of reasons. Parent- and community-focused services are typically not reimbursable in traditional medical settings, and personal healthcare services are often designed for acute and chronic medical treatment rather than prevention. To provide preventive services in a setting that reaches the widest population, those interested in public health and prevention often turn to school settings. This paper proposes that an equitable, efficient manner in which to promote health across the life course is to integrate efforts from public health, primary care, and public education through the delivery of preventive healthcare services, in particular, in the education system. Such an integration of systems will require a concerted effort on the part of various stakeholders, as well as a shared vision to promote child health via community and institutional stakeholder partnerships. This paper includes (1) examination of some key system features necessary for delivery of preventive services that improve child outcomes; (2) a review of the features of some common models of school health services for their relevance to prevention services; and (3) policy and implementation strategy recommendations to further the delivery of preventive services in schools. These recommendations include the development of common metrics for health outcomes reporting, facilitated data sharing of these metrics, shared organization incentives for integration, and improved reimbursement and funding opportunities

Attention Performance in an Epidemiological Sample of Urban Children: The Role of Gender and Verbal Intelligence

We administered a comprehensive attentional battery to an epidemiologically defined sample of 435 first and second-grade children to assess the influence of gender and verbal intelligence on attention. The battery included three versions of the continuous performance test (CPT), two digit cancellation tasks, three subtests from the WISC-R, and the Wisconsin Card Sorting Test. The results indicated that both gender and intelligence had an impact on attentional performance. Girls performed better than boys; they made fewer errors on the CPT and obtained higher scores on the digit cancellation task and the Coding subtest of the WISC-R. Children with higher verbal intelligence also performed better on the attentional tests, but this advantage was not observed across measures or levels of performance. For example, children with limited verbal skills performed significantly worse than their peers only in measures with high processing demands(the degraded CPT and the distraction version of the digit cancellation task)

The Course of Aggression in First-Grade Children with and without Comorbid Anxious Symptoms

We studied the course of aggressive behavior in an epidemiologically defined sample of first graders with and without comorbid anxious symptoms. Our primary purpose in doing so was to understand whether the stability of aggression in young children was attenuated or strengthened in the presence of comorbid anxiety. Previous studies of older children and adolescents had produced equivocal findings in this regard. Data on anxious symptoms were obtained through an interview of the children, whereas aggressive behavior was assessed through the use of a teacher interview and peer nominations. Assessments were performed in the fall and spring of first grade. In contrast to children classified as aggressive alone in the fall of first grade, boys and girls classified as aggressive and anxious in the fall of first grade were significantly more likely to be classified as aggressive in the spring in terms of teacher ratings and/or peer nominations of aggression. Thus our findings suggest that the link between early and later aggression may be strengthened in the presence of comorbid anxious symptoms, rather than attenuated. Future studies are needed to identify the mechanisms by which the course of aggression is influenced by the presence of comorbid anxiety

Woodlawn Mental Health Longitudinal Community Epidemiological Project, 1966-1976

The purpose of the study was to prospectively investigate the mental health of children as they enter first grade and progress through their early school years and into adolescence with a particular focus on the evolving role of such environmental influences as family structure, school atmosphere, and neighborhood on psychological well-being. Investigators were especially interested in identifying factors associated with increased risk of adolescent substance dependence and abuse and determining and designing preventive interventions for subsequent substance dependence and abuse. The original sample consisted of four cohorts of first grade African American children residing in a poor urban community on the south side of Chicago. Cohorts were enrolled annually 1964 through 1967. The third cohort of first graders (1966-1967) also included interviews with the participants' mothers; they were followed-up in 1976 when the children were teenagers. Clinical measures (e.g.,"How I feel" schedule; Mother Symptom Inventory) assessed the child's and mother's reported functioning and experience of symptoms. Educational measures were included to evaluate child's aptitude, readiness for learning, and classroom performance. Family structure and organization were assessed through an interview with mother. At the adolescent follow-up, a questionnaire assessed frequency of drug use, reports of family practices and values regarding affection and rules, self-reported delinquency, sexual behavior and attitudes. The Murray Archive holds additional analogue materials for this study (a core sample of 1242 children, with additional data on approximately 200 more participants; also data for 1388 mothers at Time I [1966] and 939 mothers at Time III [1976]). If you would like to access this material, please apply to use the data. Follow-up of study participants is not possible. Use of data requires submission of a two to three page research proposal for review and approval by a screening committee