Isolated Voices: Perspectives of Teachers, School Nurses, and Administrators Regarding Implementation of Sexual Health Education Policy.

BackgroundComprehensive sexual health education (SHE) reduces risky sexual behavior and increases protective behavior in adolescents. It is important to understand how professionals responsible for implementing SHE policy interpret state and local policy and what influences their commitment to formal SHE policy implementation.MethodsThis descriptive study explored content and delivery of SHE policy in a rural, southwestern state with high levels of poverty, unintended adolescent pregnancy, and sexually transmitted infections. The social ecological model (SEM) was used to better understand levels of influence on the implementation of SHE policy.ResultsWe conducted telephone surveys with 38 teachers, 63 nurses, and 21 administrators in public secondary schools. There was substantial local variability in the scope and content of SHE curricula. Respondents identified significant barriers to the delivery of SHE content and minimal evaluation of whether educational objectives were met. Based on participant responses, community and organizational SEM levels had the greatest influence on SHE policy implementation, although examples of all SEM levels were identified.ConclusionsGiven perceived challenges regarding subject matter, successful SHE implementation at the local level requires committed stakeholders working in concert at the school and community levels, backed by strong policy commitment at the state level

An Underpinning of School Inequities: Asthma Absences and Lost Revenue in California Schools.

BACKGROUND:Asthma is epidemic in many locations in the United States. Asthma exacerbations pose serious health and education risks for students through school absences, school dropout, and introduction to the juvenile justice system. Accurate school district-level asthma data, currently in short supply, would enable early interventions that focus on specific geographic areas and racial and ethnic subgroups that have higher asthma prevalence. METHODS:To support the development of better local level data systems, we used two California student databases, as well as state education and financial databases, to develop two models to estimate school absences and to extrapolate their economic impact in lost school revenue. RESULTS:Analysis demonstrated subpopulations that are appropriate for early intervention: African American elementary school boys have 9.4 average absences per year, higher than other primary racial and ethnic groups. Students who miss ≥3 school days due to asthma account for $26 million of lost revenue. CONCLUSIONS:Accurate local level asthma data can identify subpopulations of students for whom environmental and treatment programs can be employed to reduce asthma absences and other related outcomes, and to reduce currently lost school revenues. Such programs also may diminish other asthma-related school inequities

The Double Bind of School Nurses and Policy Implementation: Intersecting the Street-Level Bureaucracy Framework and Teaching Sexual Health Education.

As described in the Framework for 21st Century School Nursing Practice, school nurses bridge the realities of health and education policy within the school community every day. This role is inclusive of helping teach sexual health education (SHE) to students. We were interested in characterizing how school nurses navigate requirements of health education policy to provide their students with the SHE content that they need. Using data from a larger study, we organized a subset of school nurse data within the street-level bureaucracy framework to better understand the many challenges school nurses face in implementing SHE policy. School nurses' involvement in SHE policy implementation was congruent with characteristics of the framework. This included using their professional discretion to manage dilemmas, working with inadequate resources, unclear policy expectations, lack of support, and ambiguous policy goals. Trusted relationships with teachers and students helped school nurses with their SHE policy implementation responsibilities

Adolescent School-Based Sex Education: Using Developmental Neuroscience to Guide New Directions for Policy and Practice

Abstract While school-based sex education is one of the key program and policy solutions to improve adolescent sexual health outcomes, new efforts are needed to strengthen its overall impact. The cognitive, hormonal, emotional, and physical changes that accompany the onset of puberty and occur throughout the teenage years play a significant role in aspects of adolescent sexual risk taking. Thus, one approach to advancing current understanding of these complex issues is to leverage emerging knowledge in developmental affective neuroscience over the past 15 years, which suggests some potentially promising innovations that may inform new educational directions to improve adolescent sexual health. Exploring the conceptual and empirical advances in understanding adolescent brain development through the lens of the conceptualization, implementation, and evaluation of sex education, this article provides new perspectives that encourage the testing of innovative approaches to sex education policy and practice

Impact of Gender on Separation-Reunification Experiences of Latino Adolescent Immigrants

Many Latino immigrants who enter the US in late childhood or adolescence are reunifying with parents after lengthy separations, and yet there is limited research on this process from their point of view. This article discusses the impact of gender relations on family re-engagement and immigrant adaptation of young men and young women. Young people were interviewed as part of a grounded theory study exploring the process of family separation and reunification for Latino immigrant adolescents who have been separated from their parents for at least four years during immigration. Focus groups, individual interviews and participant observation were used to gather data from 20 Mexican and Central American immigrant adolescents, 12 young men and 8 young women. Participants reported a range of personal and family beliefs about gender roles and their impact on separation and reunification, Young men reported greater exposure to violence, generally had less access to health care, and reported more emotional isolation from families and peers than young women. Fathers and adult male role models were missing from most of their lives, and this absence was particularly difficult for young men. Young women reported greater skills and persistence in emotional re-engagement with their families in the United States.Beaucoup d'immigrés latinos entrés aux Etats-Unis à la fin de l'enfance ou au début de l'adolescence retrouvent leurs parents après une longue période de séparation, et pourtant il n'existe que très peu d'études sur ce sujet relatant leur point de vue. Cet article traite de l'impact des rapports de genre sur le regroupement familial et l'adaptation des jeunes hommes et femmes immigrés. Des jeunes ont été interrogés dans le cadre d'une étude basée sur la théorie ancrée qui analysait le processus de séparation et de regroupement familial chez les adolescents immigrés latinos qui avaient été séparés de leurs parents pendant au moins quatre ans durant la période d'immigration. Des groupes cibles, des entretiens individuels et l'observation des participants ont permis de recueillir des données auprès de 20 adolescents immigrés originaires du Mexique et d'Amérique Centrale, dont 12 jeunes hommes et 8 jeunes femmes. Les participants ont décrit un ensemble de croyances personnelles et familiales sur les rôles sexuels, et leur impact sur la séparation et le regroupement familial. Les jeunes hommes ont ainsi déclaré être plus exposés à la violence, avoir généralement un accès aux soins plus limité, et souffrir d'une plus grande isolation émotionnelle vis-à-vis de leurs familles et de leurs pairs que les jeunes femmes. Les pères et les modèles adultes masculins étaient pour la plupart absents de leur vie, et cette absence était particulièrement difficile à vivre pour les jeunes hommes. Les jeunes femmes ont quant à elles montré plus de capacités et de persévérance dans le réengagement émotionnel avec leurs familles aux Etats-Unis.Muchos inmigrantes latinos que entran en Estados Unidos al final de su infancia o en su adolescencia  se reunifican con sus padres después de largos periodos de separación. Sin embargo, existen muy pocos estudios sobre este proceso desde su punto de vista. Este artículo analiza el impacto de las relaciones de género en la reunificación familiar y la adaptación como inmigrantes de hombres y mujeres jóvenes. Se entrevistó a chicos y chicas en el marco de un estudio de teoría fundamentada que explora el proceso de la separación familiar y su posterior reunificación en el caso de inmigrantes latinos adolescentes que han sido separados de sus padres durante al menos cuatro años en el transcurso de la inmigración. Se utilizaron reuniones de grupo, entrevistas individuales y observaciones para recabar datos de 20 inmigrantes adolescentes mexicanos y centroamericanos, 12 chicos y 8 chicas. Los participantes reflejaban diversas creencias personales y familiares sobre los roles de género y su impacto en la separación y reunificación. Los chicos reflejaron una mayor exposición a la violencia, un acceso más limitado en general a la asistencia sanitaria y un mayor aislamiento emocional de sus familias y compañeros que las chicas. En sus familias no había referencias paternas o de adultos masculinos y esta ausencia resultaba especialmente difícil para los chicos. Las chicas, en cambio, mostraron mayores habilidades y persistencia en la reunificación emocional con sus familias en suelo estadounidense

Impact of Gender on Separation-Reunification Experiences of Latino Adolescent Immigrants

Many Latino immigrants who enter the US in late childhood or adolescence are reunifying with parents after lengthy separations, and yet there is limited research on this process from their point of view. This article discusses the impact of gender relations on family re-engagement and immigrant adaptation of young men and young women. Young people were interviewed as part of a grounded theory study exploring the process of family separation and reunification for Latino immigrant adolescents who have been separated from their parents for at least four years during immigration. Focus groups, individual interviews and participant observation were used to gather data from 20 Mexican and Central American immigrant adolescents, 12 young men and 8 young women. Participants reported a range of personal and family beliefs about gender roles and their impact on separation and reunification, Young men reported greater exposure to violence, generally had less access to health care, and reported more emotional isolation from families and peers than young women. Fathers and adult male role models were missing from most of their lives, and this absence was particularly difficult for young men. Young women reported greater skills and persistence in emotional re-engagement with their families in the United States.Beaucoup d'immigrés latinos entrés aux Etats-Unis à la fin de l'enfance ou au début de l'adolescence retrouvent leurs parents après une longue période de séparation, et pourtant il n'existe que très peu d'études sur ce sujet relatant leur point de vue. Cet article traite de l'impact des rapports de genre sur le regroupement familial et l'adaptation des jeunes hommes et femmes immigrés. Des jeunes ont été interrogés dans le cadre d'une étude basée sur la théorie ancrée qui analysait le processus de séparation et de regroupement familial chez les adolescents immigrés latinos qui avaient été séparés de leurs parents pendant au moins quatre ans durant la période d'immigration. Des groupes cibles, des entretiens individuels et l'observation des participants ont permis de recueillir des données auprès de 20 adolescents immigrés originaires du Mexique et d'Amérique Centrale, dont 12 jeunes hommes et 8 jeunes femmes. Les participants ont décrit un ensemble de croyances personnelles et familiales sur les rôles sexuels, et leur impact sur la séparation et le regroupement familial. Les jeunes hommes ont ainsi déclaré être plus exposés à la violence, avoir généralement un accès aux soins plus limité, et souffrir d'une plus grande isolation émotionnelle vis-à-vis de leurs familles et de leurs pairs que les jeunes femmes. Les pères et les modèles adultes masculins étaient pour la plupart absents de leur vie, et cette absence était particulièrement difficile à vivre pour les jeunes hommes. Les jeunes femmes ont quant à elles montré plus de capacités et de persévérance dans le réengagement émotionnel avec leurs familles aux Etats-Unis.Muchos inmigrantes latinos que entran en Estados Unidos al final de su infancia o en su adolescencia  se reunifican con sus padres después de largos periodos de separación. Sin embargo, existen muy pocos estudios sobre este proceso desde su punto de vista. Este artículo analiza el impacto de las relaciones de género en la reunificación familiar y la adaptación como inmigrantes de hombres y mujeres jóvenes. Se entrevistó a chicos y chicas en el marco de un estudio de teoría fundamentada que explora el proceso de la separación familiar y su posterior reunificación en el caso de inmigrantes latinos adolescentes que han sido separados de sus padres durante al menos cuatro años en el transcurso de la inmigración. Se utilizaron reuniones de grupo, entrevistas individuales y observaciones para recabar datos de 20 inmigrantes adolescentes mexicanos y centroamericanos, 12 chicos y 8 chicas. Los participantes reflejaban diversas creencias personales y familiares sobre los roles de género y su impacto en la separación y reunificación. Los chicos reflejaron una mayor exposición a la violencia, un acceso más limitado en general a la asistencia sanitaria y un mayor aislamiento emocional de sus familias y compañeros que las chicas. En sus familias no había referencias paternas o de adultos masculinos y esta ausencia resultaba especialmente difícil para los chicos. Las chicas, en cambio, mostraron mayores habilidades y persistencia en la reunificación emocional con sus familias en suelo estadounidense

Challenges to generating political prioritization for adolescent sexual and reproductive health in Kenya: A qualitative study.

BackgroundDespite the high burden of adverse adolescent sexual and reproductive health (SRH) outcomes, it has remained a low political priority in Kenya. We examined factors that have shaped the lack of current political prioritization of adolescent SRH service provision.MethodsWe used the Shiffman and Smith policy framework consisting of four categories-actor power, ideas, political contexts, and issue characteristics-to analyse factors that have shaped political prioritization of adolescent SRH. We undertook semi-structured interviews with 14 members of adolescent SRH networks between February and April 2019 at the national level and conducted thematic analysis of the interviews.FindingsSeveral factors hinder the attainment of political priority for adolescent SRH in Kenya. On actor power, the adolescent SRH community was diverse and united in adoption of international norms and policies, but lacked policy entrepreneurs to provide strong leadership, and policy windows were often missed. Regarding ideas, community members lacked consensus on a cohesive public positioning of the problem. On issue characteristics, the perception of adolescents as lacking political power made politicians reluctant to act on the existing data on the severity of adolescent SRH. There was also a lack of consensus on the nature of interventions to be implemented. Pertaining to political contexts, sectoral funding by donors and government treasury brought about tension within the different government ministries resulting in siloed approaches, lack of coordination and overall inefficiency. However, the SRH community has several strengths that augur well for future political support. These include the diverse multi-sectoral background of its members, commitment to improving adolescent SRH, and the potential to link with other health priorities such as maternal health and HIV/AIDS.ConclusionIn order to increase political attention to adolescent SRH in Kenya, there is an urgent need for policy actors to: 1) create a more cohesive community of advocates across sectors, 2) develop a clearer public positioning of adolescent SRH, 3) agree on a set of precise approaches that will resonate with the political system, and 4) identify and nurture policy entrepreneurs to facilitate the coupling of adolescent SRH with potential solutions when windows of opportunity arise

Teachers as Healthy Beverage Role Models: Relationship of Student and Teacher Beverage Choices in Elementary Schools.

Schools are a key setting for curbing student intake of sugar-sweetened beverages (SSBs). While studies suggest that restrictions on SSBs, increased access to healthier beverages, and education about the importance of drinking water instead of SSBs can promote healthier beverage patterns among students, there is little known about the impact that teachers' own beverage choices can have on those of their students. Data were drawn from cross-sectional surveys administered as part of a larger evaluation of a drinking water access and promotion intervention in public elementary schools in the San Francisco Bay Area region of California. Descriptive statistics were used to examine teacher (n = 56) and student (n = 1176) self-reported beverage consumption at school. Mixed-effects logistic regression was used to examine associations between teacher and student beverage intake adjusting for clustering of students by teacher. Teachers were also surveyed via open-ended questions about strategies to increase student water consumption at school. Nearly all teachers reported drinking water during the school day (95%), often in front of students. Teacher SSB intake was rare (9%). Students whose teachers drank water in front of their classes were significantly more likely to report drinking water during the school day. Teachers tend to select healthy beverages at work and may serve as role models to encourage student consumption of water instead of SSBs