Systematic review of the associations of SWPBS with exclusionary discipline and disproportionality in U.S. schools.

In response to patterns of educational inequity, many schools implement system-wide behavioral frameworks to reduce exclusionary discipline. School-wide positive behavior supports (SWPBS) is one such framework that seeks to support socially appropriate behavior by enhancing the capacity of schools to implement research-validated practices. However, there remains to be a systematic analysis of the extent to which SWPBS improves educational equity by reducing disparities in exclusionary discipline. The purpose of the systematic review was to evaluate research on the association of SWPBS with exclusionary discipline and racial discipline disproportionality. In total, 42 articles met the full inclusion criteria of a literature search conducted between 2018 and 2020. Study results were mixed regarding whether SWPBS was associated with reductions in exclusionary discipline and only a few studies provided evidence that SWPBS helps reduce exclusionary discipline disproportionality. Limitations of this research signal a need for attention to both data disaggregation and root causes of continued disproportionate discipline practices.

The health behaviors differences among male and female school-age adolescents in the Middle East and North Africa region countries: a meta-analysis of the Global School-based Student Health Survey data.

Background: Understanding gender disparities in adolescent health behaviors is crucial for developing targeted health promotion strategies. This study uses data from the Global School-based Student Health Survey (GSHS) across 17 MENA countries to analyze gender differences in adolescent health behaviors, aiming to provide a comprehensive overview for both boys and girls. Methods: This meta-analysis incorporates data from recent years of the GSHS, covering 17 MENA countries. The objective was to assess and compare health behaviors between adolescent girls and boys. A random-effects model was employed to calculate odds ratios for gender comparisons in these behaviors. Statistical analyses and modeling were performed using JAMOVI software. Results: In most MENA countries, boys consumed more vegetables compared to girls. Girls were less likely to frequent fast food establishments (OR = 0.82, 95% CI: 0.69-0.98) and generally exhibited better self-care behaviors. Boys reported a higher prevalence of physical altercations (OR = 2.18, 95% CI: 1.88-2.51) and were more involved in fights (OR = 3.00, 95% CI: 2.46-3.67). Girls were more likely to miss school without permission and were consistently described as kinder and more helpful across various income levels. However, in some countries such as Oman and Tunisia, boys missed school more frequently. There were no significant gender differences in parental oversight of homework or knowledge of students' activities, but girls were reported to have stronger parental relationships and better parental understanding of their problems and free time, with exceptions in Morocco and the Palestinian Territory-Gaza. Boys were more likely to engage in smoking (OR = 3.57, 95% CI: 2.69-4.76) and other substance use. Conversely, girls reported higher levels of physical inactivity and loneliness, but also demonstrated greater kindness and helpfulness in school settings and stronger parental relationships. Conclusion: Policymakers in the MENA region should develop and implement gender-specific interventions targeting key areas such as hygiene practices, physical activity, and substance use. By focusing on these targeted strategies, they can address the distinct health behaviors and needs of both boys and girls. Effective interventions in these areas are crucial for improving overall health outcomes and promoting healthier lifestyles, thereby enhancing adolescent health and well-being across the region.

Uptake of Human Papilloma Virus Vaccination and Associated Factors Among Female Students Attending Secondary Schools in South West Shoa, Oromia, Ethiopia, 2022.

BACKGROUND: Human papillomavirus (HPV) vaccination is one of the key preventative measures for cervical cancer, provided that effective vaccine uptake is employed. However, HPV vaccine uptake is low in settings with limited resources such as low- and middle-income countries. OBJECTIVES: To assesses the uptake of HPV vaccine and associated factors among female students attending secondary schools in South West Shoa Zone, Oromia, Ethiopia, 2022. METHODS: A cross-sectional study was conducted in secondary schools of South West Shoa Zone between November 1st to November 30th 2022. A multi-stage sampling technique was employed among 634 female students attending secondary schools. Data were collected by self-administered structured questionnaires, entered into Epi-info version 7.2.2.6, and exported to SPSS version 25 for statistical analysis. Bivariable analyses were considered for Multivariable analysis. Adjusted odds ratio (AOR) along with 95% confidence levels were estimated to assess the strength of the association, and a P value <0.05 was considered to indicate statistical significance. RESULTS: The proportion of HPV vaccine uptake was 31.65% (95% CI, 25-38). Having adequate knowledge AOR = 8.51 (95% CI = 4.57-15.84), living in rural area AOR = 0.25 (95% CI = 0.15-0.42), having older sibling AOR = 4.07(95% = 2.50-6.63), mother's educational level (Diploma and above) AOR = 4.08 (95% CI = 1.75-9.49), and secondary education AOR = 3.98 (95% CI = 1.87-8.48) were significantly associated with HPV vaccine uptake among female students attending secondary schools in South West Shoa Zone, Oromia, Ethiopia. CONCLUSIONS: The study revealed that HPV vaccine uptake was very low among female students attending secondary schools in South West Shoa Zone, Oromia, Ethiopia. Adequate knowledge, having older sibling, living in rural area, and having mothers with higher educational level were significantly associated with HPV vaccine uptake. All concerned bodies should work jointly to enhance the uptake of HPV vaccination among female students.

The human papilloma virus vaccine is one of the key preventative measures for cervical cancer. However, the vaccine uptake is low in resources limiting settings. The problem is particularly increasing in low and middle-income countries. Aimed at assessing the uptake of human papilloma virus vaccine and associated factors among female students attending secondary schools in South West Shoa Zone, Oromia, Ethiopia, 2022. In current study there was a very low uptake of human papilloma virus vaccine among female students attending secondary schools. Adequate knowledge, having older sibling, living in rural area and having mothers of diploma and above educational level and secondary educational level was significantly associated with the uptake of the HPV vaccine uptake. All concerned bodies should work jointly to enhance the uptake of human papilloma virus vaccination among female students.

Mechanism Linking Cigarette Pack Factors, Point-of-Sale Marketing and Individual Factors With Smoking Intention Among School-Going Adolescents.

CONTEXT: Tobacco usage accounts for one of the most preventable causes of death. OBJECTIVE: This study aimed to explore mechanisms linking cigarette pack factors, point-of-sale marketing, and individual factors (psychological reactant trait) to predict smoking intention among school-going adolescents. DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional study conducted among 6 urban secondary schools. A pretested and validated self-administered questionnaire was used. Data analysis for structural equation modeling was done using SMART-PLS v3.2.8. MAIN OUTCOME MEASURE: The main outcome measure was to determine the direct and indirect effects of cigarette pack factors, point-of-sale marketing, and individual factors (psychological reactant trait) to predict smoking intention among school-going adolescents in a theory-based model. RESULTS: A total of 386 adolescents fulfilling the inclusion criteria participated. Pictorial warning message reactance (ß = .153, P  ≤ .001), pack receptivity of conventional pack (ß = .297, P  = .004), and psychological reactant trait (ß = .174, P  ≤ .001) were positively related to smoking intention. Pictorial warning negative affect (ß = -.153, P  = .001) was negatively related to smoking intention. The psychological reactant trait was positively related to message reactance (ß = .340, P  ≤ .001). However, recall exposure to point-of-sale marketing and pack appraisal of conventional pack was not positively related to smoking intention (ß = .038, P  = .22 and ß = -.026, P  = .39, respectively). Pictorial warning message reactance also positively mediates the relationship between psychological reactant trait and smoking intention (ß = 0.05, p = .001). The model has strong predictive power. CONCLUSION: In conclusion, cigarette pack factors and psychological reactant traits are essential in predicting smoking intention. Hence, policymakers should consider these factors in developing smoking policies.

The Role of Professional Development and Technical Assistance in Supporting Implementation of COVID-19 Prevention Strategies in K-12 Schools.

CONTEXT: Schools vary in their capacity to implement recommended strategies to prevent infectious diseases, such as COVID-19. Professional development (PD) and technical assistance (TA) are well-established tools used to strengthen school capacity and infrastructure for healthier school environments. OBJECTIVE: The authors examined the relationship between PD and TA received by districts and schools and their implementation of COVID-19 prevention strategies during the 2020-2021 school year. DESIGN AND SETTING: We conducted a descriptive analysis of survey responses collected during Spring 2021 from selected districts and schools in 9 participating states. The survey assessed the implementation of 10 COVID-19 prevention strategies recommended by the Centers for Disease Control and Prevention and whether district or school staff received PD and/or TA on topics related to COVID-19 during the same year. PARTICIPANTS: Survey responses were received from designated contacts in 310 districts and 931 schools across 9 states. MAIN OUTCOME MEASURES: The dependent variable was the number of COVID-19 prevention strategies that were reported as "in place" by each district and school ranging from 0 to 10. RESULTS: On average, districts and schools reported implementing 7 of 10 recommended COVID-19 prevention strategies during the 2020-2021 school year. Schools that received PD on at least 1 of 12 topics reported implementing 7.61 COVID-19 prevention strategies, whereas schools that did not receive PD reported implementing 6.34 strategies. Similarly, schools that received TA on at least 1 topic reported higher COVID-19 implementation scores (7.51) than schools that did not receive any TA (7.20). CONCLUSIONS: Findings reveal a positive relationship between receiving PD and/or TA and implementation of COVID-19 prevention strategies in school settings.

Association between bullying at school and tooth loss among 15-19-year-olds from southern Brazil.

This study aimed to investigate the association between bullying at school and tooth loss in southern Brazilian adolescents. This population-based cross-sectional study included a representative sample of 15-19-year-old students attending high schools in Santa Maria, southern Brazil. Data on sociodemographic and behavioral variables were collected through questionnaires. Contextual data on bullying at school was provided by educational institutions (bullying episodes in the previous year: 'no,' 'sometimes,' or 'often'). Tooth loss was clinically assessed by the M component of the DMFT index, modeled as a discrete variable. Multilevel Poisson regression was used, and rate ratios (RR) and 95% confidence intervals (CI) were estimated. The prevalence of tooth loss was 9.2% (95%CI = 7.5-10.8). Adolescents who attended the schools where bullying events often occurred had 0.39 (95%CI = 0.33-0.45) missing teeth, on average, in contrast to an average of 0.14 (95%CI = 0.08-0.19) among those whose schools did not experience bullying in the previous year. After adjusting for important cofactors, the contextual variable of bullying at school remained significantly associated with the study outcome. Adolescents who attended schools where bullying frequently occurred were 2.49-fold more likely to have an additional missing tooth than those whose school did not experience bullying in the previous year (RR = 2.49, 95%CI = 1.37-4.51, p = 0.003). In conclusion, the frequent bullying episodes at school were associated with more permanent teeth lost due to caries in this population. Hence, improving the school environment may improve the oral health of adolescents.

How long-term changes in neighborhood and school racial composition shape children's behavior problems.

Relatively few neighborhood-focused studies explicitly model the relationship between neighborhood change- i.e., racial change within a neighborhood-and individual mental health, instead focusing on the current composition of the neighborhood or on the outcomes of individuals that switch neighborhood contexts via moves. Further, while neighborhoods and schools are interconnected, researchers tend to focus on only one of these contexts in their work. Combining family and student data from the Panel Study of Income Dynamics (PSID) with multiple waves of neighborhood and school administrative data, our study extends current scholarship in this area by explicitly focusing on the relationship between exposure to neighborhood and school racial change-i.e., change occurring within the neighborhood or school in the prior decade-and the behavior problems of current students. We further analyze how associations vary: 1) by student race; 2) between newcomers to the neighborhood and those that lived in the neighborhood as it underwent demographic change; 3) and in neighborhoods with higher proportions of same-race residents. Our findings suggest that the relationship between local neighborhood contexts and the behavioral problems of children is nuanced and depends on the racial trajectories-change or stability-of neighborhoods, schools, and the interaction of both. Compared to longer-term residents, White newcomers tended to have more behavioral problems across racially changing and stable neighborhoods alike, regardless of the racial trajectories observed in the local school. Our results align with past work documenting the protective effect of same-race peers for Black children. Conversely, we find White students exhibit greater behavioral problems in settings with very high proportions of same-race peers, particularly in neighborhoods and schools that are simultaneously becoming increasingly racially isolated.

Trajectories of school absences across compulsory schooling and their impact on children's academic achievement: An analysis based on linked longitudinal survey and school administrative data.

Prior research has identified that school absences harm children's academic achievement. However, this literature is focused on brief periods or single school years and does not consistently account for the dynamic nature of absences across multiple school years. This study examined dynamic trajectories of children's authorised and unauthorised absences throughout their compulsory school career in England. It investigated the consequences of these absence trajectories for children's achievement at the end of compulsory schooling. We analyse linked administrative data on children's absences and achievement from the National Pupil Database and survey data from the Millennium Cohort Study for a representative sample of children born in 2000/2001 in England (N = 7218). We used k-means clustering for longitudinal data to identify joint authorised-unauthorised absence trajectories throughout compulsory schooling and a regression-with-residuals approach to examine the link between absence trajectories and achievement. We identified five distinct absence trajectories: (1) 'Consistently Low Absences', (2) 'Consistently Moderate Authorised Absences', (3) 'Moderately Increasing Unauthorised Absences', (4) 'Strongly Increasing Unauthorised Absences', and (5) 'Strongly Increasing Authorised Absences'. We found substantial differences between trajectory groups in GCSE achievement, even when accounting for significant risk factors of school absences. Compared to 'Consistently Low Absences', 'Strongly Increasing Unauthorised Absences' reduced achievement by -1.23 to -1.48 standard deviations, while 'Strongly Increasing Authorised Absences' reduced achievement by -0.72 to -1.00 SD for our continuous outcomes. 'Moderately Increasing Unauthorised Absences' (-0.61 to -0.70 SD) and 'Consistently Moderate Authorised Absences' (-0.13 to -0.21 SD) also negatively affected achievement compared to 'Consistently Low Absences'. Our research underscores the critical importance of examining entire trajectories of absenteeism and differentiating between types of absences to fully grasp their associations with academic outcomes and design targeted interventions accordingly.

School Bullying Victimization and Depression Symptoms in Adolescents: The Mediating Role of Internet Addiction and Moderating Role of Living Areas.

School bullying and depression are both serious social and public health problems among adolescents. Prior studies indicated a correlation between bullying and depression. However, the potential moderators remain largely unexplored. This study aimed to identify the mediating effect of Internet addiction and the moderating effect of living in urban or rural areas in the relationship between school bullying victimization and depression symptoms among Chinese adolescents. This cross-sectional study of adolescents was conducted using two-stage random cluster sampling of students in urban and rural public high schools in China. A moderated mediation model was constructed to uncover the underlying mechanism of school bullying victimization and depression symptoms. A total of 2,376 adolescents (52.65% females, mean age ± SD a 14.69 ± 1.76 years) were included in the study. The prevalence of clinical depression symptoms with a cut-off value of 16 on the Center for Epidemiological Studies Depression Scale (CES-D) was 21.76% (95% CI: 20.15, 23.46), and with a cut-off value of 20 on the CES-D was 13.85% (95% CI: 12.51, 15.30) for overall. Our findings indicated a significant positive association between school bullying victimization and depression symptoms (p < 0.01) and a significant mediating effect of Internet addiction in the association between school bullying victimization and depression symptoms (indirect effect = 1.143, 95% CI: 0.677, 1.609; percentage of mediation: 16.7%, 95% CI: 10.3, 23.1). This indirect relationship was partially moderated by the living in urban or rural areas in the mediation process. Specifically, the effect of school bullying victimization on Internet addiction was greater among urban adolescents (simple slope: 0.774, 95% CI: 0.524, 1.024, p < 0.01) than among rural adolescents (simple slope: 0.337, 95% CI: 0.132, 0.543, p < 0.01), but moderating effect of urban-rural areas was not significant on the relationship between Internet addiction and depression symptoms. These findings highlight the mediating role of Internet addiction and the moderating role of living areas in school bullying victimization and adolescents' depression symptoms, which provide evidence for social work, mental health services, and policy interventions for adolescents in China.

Prevalence of sickness presenteeism and associated factors among primary school teachers in Gondar city, northwest Ethiopia.

Background: Sickness presenteeism, the phenomenon of people going to work despite being ill, is an occupational and psychosocial condition that hurts both the health of workers and organizational productivity. It negatively affects health, increases health-related costs, and the risk of contagious diseases. Primary school teachers are particularly vulnerable to this problem, although little is known about its scope and associated factors. This study aimed to determine the prevalence and factors associated with sickness presenteeism among school teachers in Northwest Ethiopia. Methods: An institution-based cross-sectional study was employed and the study period was from April 18 to May 18, 2023. A sample of 633 primary school teachers was recruited using two-stage stratified random sampling. Data were collected using structured self-administered questionnaires. Epi-data version 4.6 and STATA version 14 were used for data entry and analysis, respectively. Binary logistic regression analysis was used. A multivariable logistic regression model with an adjusted odds ratio was fitted for statistical significance. Results: A total of 603 school teachers participated in this study, with a response rate of 95.26%. The overall prevalence of sickness presenteeism in the last 12 months was 54.7% (N = 330) [95% CI (50.9, 58.7)]. Private school teachers [AOR: 2.21, 95% CI (1.14, 4.28)], low supervisor support [AOR: 1.53, 95% CI (1.06, 2.20)], lack of staff replacement availability [AOR: 2.74, 95% CI (1.85, 4.06)], low colleague support [AOR: 2.17, 95% CI (1.40, 3.37)], unsuitable household conditions [AOR: 1.49, 95% CI (1.08, 2.34)], and strict attendance control [AOR: 2.54, 95% CI (1.67, 3.85)] were factors significantly associated with sickness presenteeism. Conclusion: The prevalence of sickness presenteeism was relatively high among primary school teachers because of factors such as low support from supervisors and colleagues, strict attendance control, lack of staff replacement, unsuitable household conditions, and private school type. Strategies to promote teachers' health include fostering a culture of support and collaboration among colleagues, recruiting adequate staff, and implementing liberal attendance policies.

The prevalence of headache disorders in children and adolescents in Benin: a schools-based study.

BACKGROUND: A global schools-based programme within the Global Campaign against Headache is estimating the burden of headache in children (6-11 years) and adolescents (12-17 years), cluster-sampling the world by conducting national studies in all world regions. Its purpose is to complement population-based studies in adults, adding to knowledge of the burden of headache and informing educational and health policies. This study in Benin was the third in the programme from sub-Saharan Africa (SSA). METHODS: We followed the generic protocol for the global study. In a cross-sectional survey, the child and adolescent versions of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) structured questionnaire were administered to pupils within their classes in 16 schools selected from across the country to be representative of its diversities. Headache diagnostic questions were based on ICHD-3 criteria but for the inclusion of undifferentiated headache (UdH). RESULTS: Very large proportions of pupils were absent on the survey days. The sampled population defined by class registers totalled 11,802 pupils, of whom only 2,488 were present. A further 193 pupils (or their parents) declined the survey. The surveyed sampled (N = 2,295; males 1,156 [50.4%], females 1,139 [49.6%]) included 1,081 children (47.1%) and 1,214 adolescents (52.9%), with a non-participating proportion (193/2,488) of 7.8%. Headache ever was reported by 97.3% of the sample. Age- and gender-adjusted 1-year prevalences, according to responses given, were 53.4% for migraine (almost three quarters of this being probable migraine), 21.3% for tension-type headache, 8.2% for UdH, 1.0% for probable medication-overuse headache (pMOH) and 2.6% for other headache on ≥ 15 days/month (H15+). Both pMOH and other H15 + were substantially more prevalent among adolescents. CONCLUSION: The finding for migraine is anomalous, but, within this series of studies, the same was found in Zambia and similar in Ethiopia, both in SSA. While many cases identified as probable migraine, especially among children, might better have been diagnosed as UdH, the true prevalence of migraine almost certainly exceeds 21%. Regardless of diagnosis, headache is very common among children and adolescents in Benin. The study sounds an alarm with regard to pMOH as a developing problem pre-adulthood.

School-level intra-cluster correlation coefficients and autocorrelations for children's accelerometer-measured physical activity in England by age and gender.

BACKGROUND: Randomised, cluster-based study designs in schools are commonly used to evaluate children's physical activity interventions. Sample size estimation relies on accurate estimation of the intra-cluster correlation coefficient (ICC), but published estimates, especially using accelerometry-measured physical activity, are few and vary depending on physical activity outcome and participant age. Less commonly-used cluster-based designs, such as stepped wedge designs, also need to account for correlations over time, e.g. cluster autocorrelation (CAC) and individual autocorrelation (IAC), but no estimates are currently available. This paper estimates the school-level ICC, CAC and IAC for England children's accelerometer-measured physical activity outcomes by age group and gender, to inform the design of future school-based cluster trials. METHODS: Data were pooled from seven large English datasets of accelerometer-measured physical activity data between 2002-18 (> 13,500 pupils, 540 primary and secondary schools). Linear mixed effect models estimated ICCs for weekday and whole week for minutes spent in moderate-to-vigorous physical activity (MVPA) and being sedentary for different age groups, stratified by gender. The CAC (1,252 schools) and IAC (34,923 pupils) were estimated by length of follow-up from pooled longitudinal data. RESULTS: School-level ICCs for weekday MVPA were higher in primary schools (from 0.07 (95% CI: 0.05, 0.10) to 0.08 (95% CI: 0.06, 0.11)) compared to secondary (from 0.04 (95% CI: 0.03, 0.07) to (95% CI: 0.04, 0.10)). Girls' ICCs were similar for primary and secondary schools, but boys' were lower in secondary. For all ages, combined the CAC was 0.60 (95% CI: 0.44-0.72), and the IAC was 0.46 (95% CI: 0.42-0.49), irrespective of follow-up time. Estimates were higher for MVPA vs sedentary time, and for weekdays vs the whole week. CONCLUSIONS: Adequately powered studies are important to evidence effective physical activity strategies. Our estimates of the ICC, CAC and IAC may be used to plan future school-based physical activity evaluations and were fairly consistent across a range of ages and settings, suggesting that results may be applied to other high income countries with similar school physical activity provision. It is important to use estimates appropriate to the study design, and that match the intended study population as closely as possible.

Toothbrushing frequency among children and adolescents in 72 countries: Findings from the Global School-based Student Health Survey.

BACKGROUND: Toothbrushing twice daily is essential for maintaining oral hygiene, which is a cornerstone of overall health. This is particularly important during childhood and adolescence, when lifelong habits are established. Nevertheless, many children and adolescents worldwide face challenges in maintaining good oral health due to limited access to resources and education. OBJECTIVES: This study used nationally representative samples from the Global School-based Student Health Survey (GSHS) (2010-2019) to determine the frequency of toothbrushing among school-going students (N = 266,113) in 72 countries. MATERIAL AND METHODS: The country-specific sample size ranged from 130 in Tokelau to 25,408 in Malaysia. The outcome variable was the frequency of brushing or cleaning teeth once daily within the past 30 days prior to the survey. Bivariate analysis was conducted following a descriptive study to determine the frequency of toothbrushing or cleaning across different age groups (≤12, 13, 14, 15, ≥16 years), sexes, World Health Organization (WHO) regions, and gross domestic product (GDP) per capita quintiles. RESULTS: The overall proportion of males to females in the sample was 50.9:49.1. In 45 countries or territories (62.5%), the proportion of participants who reported brushing their teeth at least once a day was above 90%. Participants from 10 countries or territories (13.9%) reported never or rarely brushing their teeth. In 69 countries or territories (95.8%), male students were more likely than female students to never or rarely brush their teeth. The highest rate of individuals who never or rarely brush their teeth (32.1%) was reported in the Eastern Mediterranean Region. In comparison, the Region of the Americas had the highest frequency of brushing twice or more daily (82.9%). CONCLUSIONS: Educational interventions focused on dental health implemented in schools and aimed at early adolescents have the potential to promote the formation of healthy habits, which may lead to improved well-being over both short and long terms.

Adolescents' risky sexual behaviours and practices: Implications for sexuality education implementation in Zambia.

BACKGROUND:  Adolescents' risky sexual behaviours (RSB) are detrimental to their sexual and reproductive health (SRH) well-being and present a serious public health threat, particularly in low- and middle-income countries (LMICs). AIM:  This study aims to assess RSB among Grade 12 school-going adolescents after exposure to comprehensive sexuality education (CSE). SETTING:  This study was conducted in Kitwe district, Zambia. METHODS:  This cross-sectional study included 807 Grade 12 pupils at 13 selected secondary schools. Data were collected using a structured questionnaire. Proportionate probability sampling involving 13 schools was employed. Risky sexual behaviours binary outcome variables were based on transactional sex, sex while drunk, multiple sexual partners, age-disparate sexual relationships, and condomless sex. We conducted univariate and bivariate analyses to summarise sociodemographic factors and fitted binary and multivariable logistic regression models. RESULTS:  The prevalence of RSB was 40.4%. Drinking alcohol (adjusted odds ratio [AOR] = 20.825; 95% CI [6.7-64.489]); ever had sex (AOR = 9.024; 95% CI [1.953-41.704]); school location (AOR = 6.50; 95% CI [1.61-26.24]); living with mother only (AOR = 4.820; 95% CI [1.328-17.493]); sex (male) (AOR = 2.632; 95% CI [1.469-4.713]), watching pornography (AOR = 1.745; 95% CI [1008-3.021]); religion (AOR = 0.472; 95% CI [0.250-0.891]) and attending religious functions (AOR = 0.317; 95% CI [0.118-0.848]) were significantly associated with RSB. Of the sexually active pupils, 221 (67.7%), 64 (19.6%) and 41 (12.5%) were in the low, medium and high-risk categories, respectively. CONCLUSION:  Close to half of the respondents engaged in RSB. This is a significant number that needs intervention. The CSE programme needs to be linked with structural programmes that address the social drivers of RSB among adolescents.Contribution: The study provides a backdrop for evaluating current CSE strategies in LMICs.

Assessing sociodemographic disparities in HPV vaccine uptake among grade 6 and 9 students in the Vancouver Coastal Health region.

PURPOSE: To identify sociodemographic factors associated with HPV vaccine uptake in a universal, in-school HPV vaccination program, among grade 6 and 9 students in the regional health authority of Vancouver Coastal Health (VCH), British Columbia (BC), Canada during the 2021/22 school year. VCH operates within the southwest corner of the province of BC serving a mix of urban and rural regions. HPV vaccine is offered in school to all grade 6 students using a two-dose series, with catch up immunizations offered to students in grade 9. METHODS: We conducted a cross-sectional study of grade 6 and 9 students enrolled in VCH schools for the 2021/22 school year, who also resided within the VCH region. We modelled the associations between sociodemographic explanatory variables (individual-level and group-level) and fully vaccinated outcome using a cross-classified (non-nested) multilevel model. RESULTS: Among the 17,939 students eligible, 74 % were fully vaccinated for HPV. Immunization coverage was associated with grade, geographic area of residence, school category, social and material deprivation. We demonstrated that grade modified the association between material deprivation and being fully vaccinated. Grade 9 students, including those residing in more materially deprived neighbourhoods, had substantially higher odds (OR 2.01 [95 % CI 1.08, 3.75]) of being fully vaccinated relative to grade 6 students in the least materially deprived neighbourhoods. CONCLUSIONS: Though publicly funded HPV vaccine is offered to all students in grade 6 and 9, in a space that maximizes programmatic access, sociodemographic factors associated with under-immunized populations were identified. This information can be leveraged for strategic targeting of resources to underimmunized schools or students to mitigate impacts. The repeat offering of HPV vaccine in an older grade (grade 9 in BC) is a key programmatic strategy to reach under-immunized populations and should be complemented by other creative approaches.

Prevalence of developmental dyslexia among primary school children in Arab countries: a systematic review and meta-analysis.

BACKGROUND: Dyslexia is one of the most common learning disabilities. It poses challenges in reading skills development and can have a lasting impact in other areas of learning. AIMS: To investigate the prevalence of developmental dyslexia among primary school children aged 6-13 in Arab countries, and to explore associations with gender and residency. METHOD: Following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, we included studies up to December 2023 that were found in English and Arabic research database searches. Random-effects proportional meta-analyses determined the prevalence of dyslexia in Arab countries, with a direct comparison between girls and boys using odds ratios. RESULTS: The meta-analysis included 18 studies with 30,243 participants: eight studies (44 %) from Egypt, four (22 %) from Saudi Arabia, and six (34 %) from other Arab countries. The pooled prevalence of dyslexia for children aged 6-13 in these studies was 11 %. The odds ratio for girls vs. boys was 0.85 (95 %). Geographical variations were notable, with eight studies (44 %) from Asia and ten (56 %) from Africa. Eight studies (44 %) were from the Gulf region, while ten (56 %) were from non-Gulf region. Prevalence of dyslexia was significantly higher in Arab countries in Asia (24 %) than in Africa (12 %), and the prevalence in non-Gulf countries was 13 % which was nearly half in comparison to Gulf countries (24 %). CONCLUSIONS: The prevalence rates of dyslexia in primary school children varies across the Arab world, with higher rates among boys, Arab countries in Asia, and Gulf countries. Further research is needed to include both genders and standardized diagnostics across more Arab countries to understand and address dyslexia effectively.

Disability and the stratification of post-secondary pathways: Evidence from a large administrative linkage.

Research has linked disability to differential experiences and outcomes for students at multiple levels of education. To date, however, available data sources have prevented comprehensive analyses of the statistical relationship between disability and the pathways traveled by students through Ontario post-secondary education (PSE). Through this study, we examine this topic by leveraging a large multifaceted linkage that brings together rich administrative data from the Toronto District School Board (Grades 9-12), Ontario college and university enrollment records (2009-2018), as well as government student loans and tax records. We use these data to statistically model differences in the PSE pathways traveled by more than 33,000 TDSB students. Our analyses identify statistically significant differences in the likelihood that students with/without disabilities will travel certain PSE pathways. However, such differences shrink drastically once we control for high school-level factors (e.g., academic performance, absenteeism). We elaborate on the importance of these findings for both social stratification researchers and policymakers.

La recherche a établi un lien entre le handicap et les différences d'expériences et de résultats pour les étudiants à plusieurs niveaux d'enseignement. Toutefois, jusqu'à présent, les sources de données disponibles n'ont pas permis d'effectuer des analyses complètes de la relation statistique entre le handicap et les parcours suivis par les étudiants tout au long de leurs études postsecondaires (PSE) en Ontario. Dans le cadre de cette étude, nous examinons ce sujet en tirant parti d'un vaste couplage à facettes multiples qui rassemble de riches données administratives provenant du Toronto District School Board (9e­12e année), des dossiers d'inscription des collèges et universités de l'Ontario (2009­2018), ainsi que des prêts étudiants du gouvernement et des dossiers fiscaux. Nous utilisons ces données pour modéliser statistiquement les différences dans les parcours d'études postsecondaires suivis par plus de 33 000 élèves du TDSB. Nos analyses mettent en évidence des différences statistiquement significatives dans la probabilité que les étudiants handicapés et non handicapés empruntent certains itinéraires d'études postsecondaires. Cependant, ces différences diminuent considérablement une fois que nous contrôlons les facteurs liés au niveau secondaire (par exemple, les résultats scolaires, l'absentéisme). Nous expliquons l'importance de ces résultats pour les chercheurs en stratification sociale et les décideurs politiques.

Mobile App Intervention to Reduce Substance Use, Gambling, and Digital Media Use in Vocational School Students: Exploratory Analysis of the Intervention Arm of a Randomized Controlled Trial.

BACKGROUND: During adolescence, substance use and digital media exposure usually peak and can become major health risks. Prevention activities are mainly implemented in the regular school setting, and youth outside this system are not reached. A mobile app ("Meine Zeit ohne") has been developed specifically for vocational students and encourages participants to voluntarily reduce or abstain from a self-chosen addictive behavior including the use of a substance, gambling, or a media-related habit such as gaming or social media use for 2 weeks. Results from a randomized study indicate a significant impact on health-promoting behavior change after using the app. This exploratory study focuses on the intervention arm of this study, focusing on acceptance and differential effectiveness. OBJECTIVE: The aims of this study were (1) to examine the characteristics of participants who used the app, (2) to explore the effectiveness of the mobile intervention depending on how the app was used and depending on participants' characteristics, and (3) to study how variations in app use were related to participants' baseline characteristics. METHODS: Log data from study participants in the intervention group were analyzed including the frequency of app use (in days), selection of a specific challenge, and personal relevance (ie, the user was above a predefined risk score for a certain addictive behavior) of challenge selection ("congruent use": eg, a smoker selected a challenge related to reducing or quitting smoking). Dichotomous outcomes (change vs no change) referred to past-month substance use, gambling, and media-related behaviors. The relationship between these variables was analyzed using binary, multilevel, mixed-effects logistic regression models. RESULTS: The intervention group consisted of 2367 vocational students, and 1458 (61.6%; mean age 19.0, SD 3.5 years; 830/1458, 56.9% male) of them provided full data. Of these 1458 students, 894 (61.3%) started a challenge and could be included in the analysis (mean 18.7, SD 3.5 years; 363/894, 40.6% female). Of these 894 students, 466 (52.1%) were considered frequent app users with more than 4 days of active use over the 2-week period. The challenge area most often chosen in the analyzed sample was related to social media use (332/894, 37.1%). A total of 407 (45.5%) of the 894 students selected a challenge in a behavioral domain of personal relevance. The effects of app use on outcomes were higher when the area of individual challenge choice was equal to the area of behavior change, challenge choice was related to a behavior of personal relevance, and the individual risk of engaging in different addictive behaviors was high. CONCLUSIONS: The domain-specific effectiveness of the program was confirmed with no spillover between behavioral domains. Effectiveness appeared to be dependent on app use and users' characteristics. TRIAL REGISTRATION: German Clinical Trials Register DRKS00023788; https://tinyurl.com/4pzpjkmj. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-022-06231-x.

Improving Data-Driven Decision Making for Primary Prevention: Providing Data Interpretation Resources to Schools and Communities in Colorado.

Communities are increasingly interested in primary prevention efforts to reduce health inequities. However, few communities can access local data on social determinants of health and many do not have the skills or training to interpret data to inform decision making on appropriate strategies that impact social determinants of health. A population-based youth health survey administered to middle and high school students, such as exists in most states in the United States, can assess health behaviors and risk and protective factors. The schools and school districts that participate are provided with reports of results and data interpretation resources that support their understanding of risk and protective factors to inform local decision making and action. Other states can similarly provide local data and resources on risk and protective factors to help communities collaborate on primary prevention efforts that achieve health equity.

Relationship between childhood trauma and non-suicidal self-injury in high school students: the mediating role of the stress perception and the moderating role of teacher-student relationship.

This study delves into the correlation between childhood trauma and non-suicidal self-injury (NSSI) behaviors among high school students. Additionally, it examines the mediating role of stress perception and the moderating role of the teacher-student relationship in this association. A questionnaire survey was administered to 1,329 high school students in Yunnan Province to assess childhood trauma, NSSI behaviors, and stress perception. Firstly, the survey revealed a 12% prevalence of NSSI, with girls exhibiting a higher occurrence compared to boys (OR = 0.413, 95% CI: 0.280-0.609). Secondly, childhood trauma emerged as a significant predictor of NSSI behavior, irrespective of gender or whether the individual was an only child (r = 0.17, P < 0.01). Thirdly, stress perception functioned as a mediator in the relationship between childhood trauma and NSSI among high school students (t = 4.65, P < 0.01). The mediation effect occupies 26.56% of the total effect. Furthermore, the teacher-student relationship moderated the mediating effect of stress perception on the link between childhood trauma and NSSI (ß = 0.0736, P < 0.01). Notably, individuals with strong teacher-student relationships exhibited a significant elevation in stress perception upon exposure to childhood trauma. The findings of this study support a moderated mediation model in the association between childhood trauma and NSSI, suggesting profound implications for the development of targeted interventions and prevention strategies among high school students.