ABSTRACT
BACKGROUND: The Centers for Disease Control and Prevention (CDC) has called for tobacco-free school (TFS) policies. In South Dakota (SD), a rural state with a large American Indian population, collaboration between state agencies focused on development and dissemination of a model TFS policy in 2008. This study explored the current status of TFS policies in statewide SD school districts. METHODS: Tobacco policies were requested from all SD school district administrators. A 26-point checklist based on CDC TFS policy guidelines was used to evaluate policies. Follow-up interviews were conducted with selected superintendents. RESULTS: Policies were received from 144 of 217 districts (66% response). Participation was higher for public districts than tribal/Bureau of Indian Education (BIE) districts and nonpublic districts. The overall mean policy score was 11.6 (SD 5.1). Public school districts had the highest mean (12.3) followed by nonpublic (8.9) and tribal/BIE (7.5). In a subset of districts with a large American Indian population (>30%), policy scores were lower for those located on reservation or tribal lands compared with other locations. Barriers to policy development were identified as time and staff expertise. CONCLUSIONS: There is a need to improve statewide TFS policies. A district report card with recommendations for improvement and a resource guide were developed and disseminated.
Subject(s)
Health Policy , Indians, North American/statistics & numerical data , Schools/standards , Smoking Prevention , Tobacco Smoke Pollution/prevention & control , Tobacco Use Disorder/prevention & control , Administrative Personnel , Centers for Disease Control and Prevention, U.S. , Cross-Sectional Studies , Curriculum , Humans , Interviews as Topic , Organizational Policy , Smoking/ethnology , South Dakota/epidemiology , Tobacco Use Disorder/ethnology , United States , WorkforceABSTRACT
Heart failure requiring urgent therapy represents a burgeoning health care burden. Although acute heart failure syndromes are commonly defined as a change in chronic heart failure signs and symptoms requiring urgent therapy, the presentation, development, and response to treatment is highly dependent on individual patient characteristics. This heterogeneity has led to challenges in interpreting widely differing study methods, including eligibility requirements and outcome measures. To improve interpretation of results and translate such information to better patient care, it is essential to present an accurate description of the patient population and study design. Based on existing recommendations and expert consensus, the authors present standardized reporting criteria to improve interpretability of research in this challenging cohort.
