Perspectives of primary school teachers on the capacity of schools to support post-pandemic health needs emerging among school-age children.

BACKGROUND: This study aimed to explore the impact of the COVID-19 pandemic on capacity building for health promotion in primary schools from the perspectives of primary school teachers. METHODS: A cross-sectional observational study was conducted via an anonymous online survey between February and May 2022. Three-quarters (n2460) of all schools in the Republic of Ireland were invited to participate. Demographics such as gender, teaching experience, school type and delivering equality of opportunity in schools (DEIS) designation were collected. Perceived capacity for health promotion was measured on a 10-point Likert scale. Facilitators and barriers related to health promotion and aspects of child health prioritised for health promotion in the 2 years after restrictions eased were explored via closed- and open-ended questions. RESULTS: Of the 595 responses, 493 were eligible for analysis. Participants were based in schools in every county in the Republic of Ireland, with most (85.4%, n421) being female. Almost a third (30.5%, n150) were 11-20 years post-qualification, and a quarter (25.2%, n124) had over 30 years' teaching experience. Mean capacity for school-based health promotion pre-pandemic was moderate, at 6.6 ± 2.2 on a 10-point scale. Mean capacity in spring 2022 decreased significantly (p < 0.001) to 4.1 ± 2.4, indicating poor capacity. Capacity ratings did not significantly differ by school type (p = 0.31), socioeconomic designation (p = 0.27) or years post-qualification (p = 0.08). Capacity decrements were most frequently (49.7%, n245) attributed to organisational factors, while individual and community-level factors were cited by 27.6% (n136) and 21.5% (n106) of respondents, respectively. Healthy eating significantly (p < 0.001) decreased as a priority for health promotion between pre-pandemic times (76.3%, n376) and spring 2022 (23.1%, n114). Mental health significantly (p < 0.01) increased as a priority, being listed by 38.1% (n188) as a priority pre-pandemic and doubling to 72.6% (n358) in spring 2022. CONCLUSIONS: Fostering a holistic approach to health promotion in schools remains a challenge. Further efforts are needed to support schools to implement sustainable and balanced systems of health promotion.

Development and Utility of an Interactive Online Dashboard for Monitoring Data Collection and Data Processing During a School-Based Health Survey.

We built an interactive online dashboard using Google Looker Studio to monitor data collection and data processing activities during the Adolescent Health Survey (AHS) 2022, a large-scale nationwide survey conducted among school-going adolescents in Malaysia. Through user testing and training, refinements were made to the initial dashboard, resulting in a more streamlined and concise dashboard design. The dashboard comprised 2 pages that provided key metrics on the progress of data collection and data processing, respectively. The introduction of the dashboard enhanced the quality and ease of weekly progress reporting during meetings of the survey's central coordinating team, while its drill-down and filtering functionalities helped us detect arising issues early and supported collaborative problem-solving. Research teams coordinating comparable school-based health surveys are invited to duplicate the dashboard using Looker Studio's built-in "Make a copy" function and customize it further based on their country- or survey-specific requirements.

Qualitative multi-stakeholder evaluation of the adoption, implementation and sustainment of the school-based dietary intervention "Jump-in".

BACKGROUND: Comprehensive school-based programs applying the WHO Health Promoting School Model have the potential to initiate and sustain behavior change and impact health. However, since they often include intervention efforts on a school's policies, physical environment, curriculum, health care and involving parents and communities, they significantly 'intrude' on a complex system that is aimed primarily at education, not health promotion. More insights into and concrete strategies are therefore needed regarding their adoption, implementation, and sustainment processes to address the challenge to sustainable implementation of HPS initiatives in a primarily educational setting. This study consequently evaluates adoption, implementation and sustainment processes of Amsterdam's Jump-in healthy nutrition HPS intervention from a multi-stakeholder perspective. METHODS: We conducted semi-structured interviews and focus groups with all involved stakeholders (n = 131), i.e., Jump-in health promotion professionals (n = 5), school principals (n = 7), at-school Jump-in coordinators (n = 7), teachers (n = 20), parents (n = 50, 9 groups) and children (n = 42, 7 groups) from 10 primary schools that enrolled in Jump-in in the school year 2016-2017. Included schools had a higher prevalence of overweight and/or obesity than the Dutch average and they were all located in Amsterdam's low-SEP neighborhoods. Data were analyzed using a directed content analysis, in which the Determinants of Innovation Model was used for obtaining theory-based predetermined codes, supplemented with new codes emerging from the data. RESULTS: During intervention adoption, all stakeholders emphasized the importance of parental support, and accompanying workshops and promotional materials. Additionally, parents and teachers indicated that a shared responsibility for children's health and nuanced framing of health messages were important. During implementation, all stakeholders needed clear guidelines and support structures. Teachers and children highlighted the importance of peer influence, social norms, and uniform application of guidelines. School staff also found further tailoring of the intervention and dealing with financial constraints important. For long-term intervention sustainment, incorporating the intervention policies into the school statutes was crucial according to health promotion professionals. CONCLUSIONS: This qualitative evaluation provides valuable insights into factors influencing the adoption, implementation, and sustainment processes of dietary interventions, such as the importance of transparent and consistent intervention guidelines, clear communication regarding the rationale behind intervention guidelines, and, stakeholders' involvement in decision-making.

Maryland School Health partners' Perspectives on the Impact of COVID-19 on School Health Services for Grades K-12.

BACKGROUND: The COVID-19 pandemic disrupted routine school operations, including school health programs. This study aims to describe the pandemic's impact on school health service delivery from the perspective of Maryland school health partners. METHODS: We conducted semi-structured interviews with health service representatives from public schools (K-12) between July and December 2021. Interviews were recorded, transcribed, and coded through an iterative process to develop analytic themes. RESULTS: Twenty school health partners from 15 Maryland school districts participated. Participants identified key impacts of COVID-19 on school health: (1) COVID-19 disrupted delivery of services such as dental, mental health, and preventative care, (2) COVID-19 necessitated changes in service delivery platforms, (3) COVID-19 affected school health staff through increased responsibilities and staffing shortages, and (4) COVID-19 prompted schools to become hubs for community outreach and health education. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Consideration of school health service disruptions and the increased demands on service providers may inform future priorities for school administrators, health departments, and policymakers. CONCLUSIONS: COVID-19 impacted the timing and method of service delivery as well as the roles of school health staff and schools themselves in public health and education.

Secondary School State Athletic Association Health and Safety Policy Development Processes.

BACKGROUND: The National Federation of State High School Associations provides recommendations regarding health and safety policies; however, policy development is governed at the state level. Given interstate differences in governance, the primary purpose was to describe processes that State High School Athletic Associations (SHSAAs) utilize to develop a new policy. The secondary objective was to determine what methods associations use to implement new policies. METHODS: A cross-sectional survey requested SHSAA (n = 51) representatives to report how athlete health and safety policies are introduced, revised, approved, and implemented within their state. The 22-question survey was developed to gather variables for the aims of the study. Descriptive statistics were calculated for each survey item. RESULTS: Of states who responded (n = 33), most reported a 2-committee (n = 24, 72.7%) process for developing and vetting policies, with initiation from the Sports Medicine Advisory Committee (n = 27, 81.8%), followed by an executive-level committee (n = 18, 66.7%). States reported total time from policy initiation to final approval ranged from 2 weeks to over 12 months. When a new policy was approved, most states indicated implementation began with an e-mail (n = 24, 72.7%) sent to Athletic Directors (n = 26, 78.8%). School principal or district superintendent were reported as the position in charge of compliance (36.4%, n = 12). CONCLUSIONS: Most SHSAAs use a 2-step process to write and review an athlete health and safety policy before approval. SHSAAs that require a longer policy development time could delay the implementation of important health measures. SHSAAs could consider additional communication methods to ensure information reaches all stakeholders.

A Model of Community Health Worker Integration into Schools: Community-based Participatory Research in Action.

BACKGROUND: Schools are rich sites for collaborations between health and educational sectors. OBJECTIVES: To identify lessons learned from formation of a community-academic partnership and application of community-based participatory research (CBPR) to develop a model that integrates community health workers into schools. METHODS: Individuals from an academic medical center, a large public school district, and a community-based research institute applied CBPR principles to reimagine schools as a place for improving the health of children. LESSONS LEARNED: Three lessons emerged. Leveraging each team member's expertise centered the partnership on community strengths, co-learning, and stakeholder engagement. Adherence to CBPR's principles of power sharing and equity helped navigate the challenges of collaboration between large institutions. Early focus on sustainability helped address unexpected issues, build capacity, and boost advocacy. CONCLUSIONS: This partnership demonstrates how CBPR fosters conditions in which equitable partnerships between research institutions and public schools can thrive to promote childhood health.

Learning difficulties in school children: health and education professionals' perceptions.

OBJECTIVES: to understand health and education professionals' perceptions regarding children's learning difficulties in public schools. METHODS: qualitative research, of the participatory action type, linked to Paulo Freire's Research Itinerary. Forty-five professionals participated, through interviews and a Virtual Culture Circle. The analysis was developed through careful reading, reflection and interpretation of highlighted topics. RESULTS: professionals discussed the (in)visibility of learning difficulties, strategies and resources in the educational sector and the search for solutions in the health sector. It was found that the production of complaints related to school learning is attributed predominantly as an individual problem of children or their family, exempting the educational institution from this process. FINAL CONSIDERATIONS: greater investment in professional training and development policies is urgently needed to facilitate coordination between sectors, with a view to overcoming outdated pedagogical and health models.

Positive school climate and strong school identification as protective factors of adolescent mental health and learning engagement: A longitudinal investigation before and during COVID-19.

The COVID-19 pandemic resulted in significant disruptions for children and youth around the world, especially given school closures and shifts in teaching modes (on-line and hybrid). However, the impact of these disruptions remains unclear given data limitations such as a reliance on cross-sectional and/or short-interval surveys as well as a lack of broad indicators of key outcomes of interest. The current research employs a quasi-experimental design by using an Australian four-year longitudinal survey with student responses from Grade 7 to 10 (aged 12-15 years old) (N = 8,735 from 20 schools) in one education jurisdiction. Responses are available pre-pandemic (2018 and 2019) and during the pandemic (2020 and 2021). Importantly the survey included measures of well-being, mental health and learning engagement as well as potential known school-environment factors that could buffer against adversity: school climate and school identification. The findings were generally in line with key hypotheses; 1) during COVID-19 students' learning engagement and well-being significantly declined and 2) students with more positive school climate or stronger school identification pre-COVID-19 fared better through the disruption of the pandemic. However, these same students suffered from a steeper decline in well-being and engagement which may be explained through the impact of losing meaningful social or group connections. This decline was evident after controlling for gender, academic grade (as a proxy of age), parental education, and socioeconomic status. It is concluded that investing in the social environment of schools is important in crisis preparedness and can facilitate better crisis response among youth.

The effect of silent eating during school lunchtime on COVID-19 outbreaks.

Silent eating-no talking during mealtimes-has been used as a measure to reduce the spread of the COVID-19 infection because the emission of droplets during conversations has been considered a risk factor for spreading the virus. Japan implemented silent eating during school lunchtimes in May 2020, and it remained in effect until November 2022. However, concerns have been raised regarding its potential negative effects on children's well-being and educational attainment. More importantly, no study to date has examined its effectiveness in reducing the risk of COVID-19 outbreaks. This study aims to address this important knowledge gap by examining the impact of silent eating on the risk of COVID-19 outbreaks. In November 2022, the Japanese government announced that silent eating in public schools was no longer needed, which resulted in discontinuation of the measure in some schools while other schools maintained it. Taking advantage of this cancelation of the silent eating requirement as a natural experiment, we investigated whether silent eating was associated with a reduced risk of COVID-19 outbreaks. We measured the probability of class closures in public schools (the government's guidelines required class closure when more than one child was infected with COVID-19) by applying a Difference-in-Differences model with two-way fixed effects to panel data. We found no evidence that silent eating was associated with a reduced probability of class closures. Heterogeneity analysis also revealed that our findings did not vary by school characteristics. Our findings indicate that policymakers should be cautious about using silent eating at schools as a potential lever to control outbreaks of infectious diseases.

Engaging School Communities During COVID-19: The Role of School Nurses.

We explored the role of school nurses during the COVID-19 pandemic by conducting interviews and focus groups with them in 2022 and 2023 in an urban public school district. Findings indicated that school nurses played an essential public health role in engaging the school community, overseeing COVID-19 testing, and enforcing risk mitigation strategies during the pandemic. Our results contribute to understanding school nurses' experiences during the pandemic and highlight the need for training and support for their vital role. (Am J Public Health. 2024;114(S5):S402-S404. https://doi.org/10.2105/AJPH.2024.307591).

Formative evaluation of a STEAM and nutrition education summer program for low-income youth.

In-depth formative evaluations are vital for curriculum development and program planning but are often not conducted before a program pilots. A formative evaluation of Project stRIde was conducted to gain insight from experts and identify revisions to the curriculum. Project stRIde is a science, technology, engineering, arts, and mathematics (STEAM) and nutrition-based curriculum developed for 4th and 5th grade students from low-income and diverse families. Nine experts spanning the fields of nutrition education, cultural competency, elementary education, summer programs, and STEAM outreach were recruited to participate in an expert content review (ECR) survey and virtual interviews. Seven core themes were identified: effectively promoting student engagement, increased guidance or support needed, activity too difficult for age, time, confidence in teaching lessons, cultural appropriateness, and strengths of curriculum in promoting STEAM education and innovation. Across the lessons, all reviewers agreed that the lessons were accurate, incorporated STEAM concepts, and were culturally appropriate for this population. Future major edits to the curriculum include creating supplemental videos, modifying some activities for age level, and incorporating more opportunities for participant engagement. Overall, an ECR is an effective way to examine a program's strengths and limitations and should be included in the beginning stages of program planning.

Implementation of a Transdiagnostic Universal Prevention Program on Anxiety in Junior High School Students After School Closure During the COVID-19 Pandemic.

School closures due to the coronavirus disease 2019 (COVID-19) pandemic have worsened mental health problems for children and adolescents worldwide. We aimed to examine the follow-up effectiveness of a transdiagnostic universal prevention program for anxiety of junior high school students after a nationwide school closure during the COVID-19 outbreak in Japan. A total of 117 junior high school students were included in the analysis. We used the Unified Universal Prevention Program for Diverse Disorders (Up2-D2) program; the Up2-D2 comprises cognitive-behavioral and positive psychological interventions provided over twelve 45-minute sessions. The program was originally implemented between June and July 2020, immediately after pandemic-related school closures had ended in Japan. The program assessments were based on students' responses to a questionnaire incorporating five scales to measure indicators such as internalizing and externalizing problems. Assessments were carried out before, immediately after, two-month, and six-month after implementing the program. Mixed models for the whole sample showed small anxiety improvement effects immediately post-intervention and two-month, and six-month assessments (g = -0.25, g = -0.44, and g = -0.30, respectively). The anxiety reducing effects were even greater for the higher-anxiety group at the post-, 2-month, and 6-month assessments (g = -1.48; g = -1.59; g = -1.06, respectively). Although there was no control group, these results indicate that the transdiagnostic universal prevention intervention reduce only anxiety, but not other outcomes (depression, anger, and self-efficacy) in junior high students returning to school following school closures related to the COVID-19 pandemic in Japan.

Qualidade de vida de professores de educação física da região da grande Florianópolis, Brasil / Quality of life of physical education teachers in grande Florianópolis mesoregion, Brazil

RESUMO A discussão sobre os fatores que podem influenciar a qualidade de vida (QV) de professores de Educação Física é importante no cenário atual de transformações sociais acelaradas que refletem no contexto educacional. Com o objetivo de verificar a associação entre QV e características sociodemográficas, aplicou-se questionários de dados sociodemográficos e de qualidade de vida (Whoqol-bref) a 298 professores de Educação Física da educação básica da região da Grande Florianópolis, Santa Catarina, Brasil. Utilizou-se no tratamento de dados, os testes Qui-quadrado, Mann-Whitney e Kruskal Wallis, com post hoc de Dunn (p<0,05). Os professores de Educação Física apresentaram escores regulares na QV geral, maiores valores de escores no domínio das relações sociais e menores valores no domínio físico. As características como sexo, ciclos vitais, tempo de serviço na rede, turno de trabalho, número populacional e Índice de Desenvolvimento Humano dos municípios foram associados à QV geral e aos domínios físico, psicológico e ambiental. Conclui-se que a QV está associada as características sociodemográficas dos professores de Educação Física e que estas devem ser levadas em considerações no planejamento e na gestão educacional no ensino básico.

ABSTRACT Based on the current scenario of accelerating social changes that reflect on the educational context, the discussion on the factors that might influence the quality of life (QOL) of Physical Education teachers is important. With the purpose of evaluating the association between QOL and sociodemographic characteristics, questionnaires on socio-demographic data and quality of life (WHOQOL-bref) were applied to 298 Physical Education teachers of Basic Education in Grande Florianópolis mesoregion, state of Santa Cantarina, Brazil. The Chi-square, Mann-Whitney and Kruskal Wallis tests with Dunn's post hoc method (p <0.05) were used for data analysis. The Physical Education teachers showed regular scores related to the general QOL; higher values for the social relations domain and lower ones for the physical domain. Some characteristics, such as sex, vital cycles, length of service in the school system, work shift, population number and the Human Development Index (HDI) of the municipalities were correlated with general QOL, as well as with the physical, psychological and environmental domains. It is concluded that QOL is associated with the socio-demographic characteristics of Physical Education teachers; thus, this should be taken into consideration when thinking of educational planning and management in Basic Education.

Voleibol escolar: caracterização das escolas/municípios participantes dos jogos escolares de Santa Catarina / School volleyball: characterization of the schools/municipalities participating in the Santa Catarina school games

RESUMO O ambiente escolar tem contribuído no processo de desenvolvimento esportivo, especialmente pela oferta diversificada de atividades nas aulas de Educação Física e em projetos extracurriculares voltados às modalidades esportivas. O trabalho realizado com as equipes escolares de voleibol no estado de Santa Catarina tem sido altamente reconhecido ao longo dos anos, porém há poucas evidências sobre as escolas que têm contribuído na formação de jogadores de voleibol no cenário catarinense. Assim, o objetivo do estudo foi caracterizar as escolas participantes dos Jogos Escolares de Santa Catarina (JESC) de voleibol. Realizou-se a análise documental dos boletins dos JESC disponibilizados pela Fundação Catarinense de Esporte (FESPORTE). As evidências revelaram que os estabelecimentos de ensino com maiores participações e conquistas, em ambas as categorias investigadas, são escolas de educação básica da rede estadual, seguidas pelas instituições de ensino da rede privada e, em menor número, por escolas municipais. Enquanto na categoria feminina as escolas estão localizadas em sua grande maioria nas regiões Leste-Norte e Sul, na categoria masculina concentram-se na região Centro-oeste, especialmente em cidades de pequeno e médio porte, com elevado Índice de Desenvolvimento Humano (IDH).

ABSTRACT The school environment has contributed to the sports development process, especially due to the diversified offer of activities in Physical Education classes and extracurricular projects focused on sports. The work done with school volleyball teams in the state of Santa Catarina has been highly recognized over the years, but there is little evidence about schools that have contributed to the training of volleyball players in the Santa Catarina scenario. Thus, this study aimed to characterize the schools participating in the Jogos Escolares de Santa Catarina (JESC, Santa Catarina School Games) of volleyball. The documentary analysis of the JESC bulletins provided by the Fundação Catarinense de Esporte (FESPORTE, Santa Catarina Sports Foundation) was carried out. The evidence revealed that the educational establishments with the highest participation and achievements in both categories investigated were basic education schools of the state school system, followed by private educational institutions and, to a lesser extent, municipal schools. While in the women's group, the schools were mostly located in the East-North and South regions, in the men's group, they were concentrated in the Midwest region, especially in small and medium-sized cities with high Human Development Indices (HDIs).

Turkey's transition to face-to-face schooling during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic majorly disrupted conventional schooling and many countries maintained educational services through distance education. The duration of school closures in Turkey was longer than most OECD countries, thus Turkey prioritized school reopenings in the 2021-2022 academic year to mitigate possible negative outcomes of closures. Here we study the compatibility of implications for school reopenings in Turkey with these practices and assess the first semester of face-to-face schooling. METHODS: We have used document analysis to present and compare the practices in Turkey with international practices. We also used a comparative approach to assess the coherence between policies in Turkey and international suggestions. RESULTS: We find that vaccination rates of teachers and education staff are quite high in Turkey. Other practices, mandatory face masks, class-based closures and quarantine policies, are also in agreement with international practices. These steps are supported with frequent cleaning and ventilation of school environments, as well as with social distancing measures in schools. DISCUSSION: Consequently, the rate of daily closed classrooms has been kept below 1%, and the patterns of closures and openings are in general agreement with the changes of positive cases in the Turkish society. The net rate of closed classrooms decreased with the decline of quarantine days in Turkey. We hope that these insights will inform about school openings and contribute to best practices for face-to-face schooling.

Interactional quality in middle schools: Latent profiles and their associations with teacher, classroom, and school compositional factors.

High quality teacher-student interactions are critical for the healthy social-emotional, behavioral, and academic development of middle school students. However, few studies have explored patterns of teacher-student interactions in middle school classrooms or the relation between teacher-, classroom-, and school-level factors and patterns of interaction. The current study employed latent profile analyses (LPA) to identify patterns of teacher-student interactional quality in a sample of 334 teachers from 41 schools serving middle school students within the Mid-Atlantic region of the U.S. Three distinct profiles of teacher-student interactional quality were identified that were characteristic of higher, lower, and intermediate quality and were differentially related to teacher, classroom, and school characteristics. Compared to classrooms with lower interactional quality, classrooms with "higher" or "intermediate" profiles were more likely to be taught by early career teachers, to have higher rates of observed student cooperation, and to be in schools in rural fringe areas. Classrooms with lower interactional quality were more likely to have larger student-to-teacher ratios and higher rates of student disruptive behaviors than classrooms with intermediate interactional quality and to be in schools with a higher percentage of out-of-school suspensions than classrooms with higher interactional quality. These findings suggest that interventions at the teacher, classroom, and school levels may promote positive teacher-student interactions, such as consultation to support teachers' effective classroom management, alternatives to out-of-school suspensions, and smaller student-to-teacher ratios.

Model-Estimated Association Between Simulated US Elementary School-Related SARS-CoV-2 Transmission, Mitigation Interventions, and Vaccine Coverage Across Local Incidence Levels.

Importance: With recent surges in COVID-19 incidence and vaccine authorization for children aged 5 to 11 years, elementary schools face decisions about requirements for masking and other mitigation measures. These decisions require explicit determination of community objectives (eg, acceptable risk level for in-school SARS-CoV-2 transmission) and quantitative estimates of the consequences of changing mitigation measures. Objective: To estimate the association between adding or removing in-school mitigation measures (eg, masks) and COVID-19 outcomes within an elementary school community at varying student vaccination and local incidence rates. Design, Setting, and Participants: This decision analytic model used an agent-based model to simulate SARS-CoV-2 transmission within a school community, with a simulated population of students, teachers and staff, and their household members (ie, immediate school community). Transmission was evaluated for a range of observed local COVID-19 incidence (0-50 cases per 100 000 residents per day, assuming 33% of all infections detected). The population used in the model reflected the mean size of a US elementary school, including 638 students and 60 educators and staff members in 6 grades with 5 classes per grade. Exposures: Variant infectiousness (representing wild-type virus, Alpha variant, and Delta variant), mitigation effectiveness (0%-100% reduction in the in-school secondary attack rate, representing increasingly intensive combinations of mitigations including masking and ventilation), and student vaccination levels were varied. Main Outcomes and Measures: The main outcomes were (1) probability of at least 1 in-school transmission per month and (2) mean increase in total infections per month among the immediate school community associated with a reduction in mitigation; multiple decision thresholds were estimated for objectives associated with each outcome. Sensitivity analyses on adult vaccination uptake, vaccination effectiveness, and testing approaches (for selected scenarios) were conducted. Results: With student vaccination coverage of 70% or less and moderate assumptions about mitigation effectiveness (eg, masking), mitigation could only be reduced when local case incidence was 14 or fewer cases per 100 000 residents per day to keep the mean additional cases associated with reducing mitigation to 5 or fewer cases per month. To keep the probability of any in-school transmission to less than 50% per month, the local case incidence would have to be 4 or fewer cases per 100 000 residents per day. Conclusions and Relevance: In this study, in-school mitigation measures (eg, masks) and student vaccinations were associated with substantial reductions in transmissions and infections, but the level of reduction varied across local incidence. These findings underscore the potential role for responsive plans that deploy mitigation strategies based on local COVID-19 incidence, vaccine uptake, and explicit consideration of community objectives.

Model-based evaluation of alternative reactive class closure strategies against COVID-19.

There are contrasting results concerning the effect of reactive school closure on SARS-CoV-2 transmission. To shed light on this controversy, we developed a data-driven computational model of SARS-CoV-2 transmission. We found that by reactively closing classes based on syndromic surveillance, SARS-CoV-2 infections are reduced by no more than 17.3% (95%CI: 8.0-26.8%), due to the low probability of timely identification of infections in the young population. We thus investigated an alternative triggering mechanism based on repeated screening of students using antigen tests. Depending on the contribution of schools to transmission, this strategy can greatly reduce COVID-19 burden even when school contribution to transmission and immunity in the population is low. Moving forward, the adoption of antigen-based screenings in schools could be instrumental to limit COVID-19 burden while vaccines continue to be rolled out.

Teacher and school staff perspectives on their role in school-based vision programs.

OBJECTIVE: School-based vision programs (SBVPs) are one approach to increase access to vision care by providing vision screenings, eye examinations, and eyeglasses directly in schools. Few studies report on the perspectives of teachers and staff, who are important stakeholders, on SBVPs. We examined teacher and staff perspectives on their involvement in SBVPs. DESIGN: Qualitative study using focus groups. PARTICIPANTS: Teachers and staff at Baltimore and Chicago public schools served by SBVPs between 2016 and 2018. METHODS: We conducted 21 semistructured focus groups with 117 teachers and staff in 10 Baltimore and 11 Chicago public preK-12 schools that participated in SBVPs. Sessions were recorded, transcribed, and coded using inductive thematic analysis. RESULTS: Participants identified 2 main themes regarding teacher and staff involvement in SBVPs: (i) program outreach, including using multiple communication modalities to engage parents, explaining program details to families, and helping with program consent form return and (ii) promoting vision health, including identifying vision problems in the classroom, encouraging eyeglasses wear, and supporting eyeglasses maintenance. Participants also discussed limitations in capacity to partake in these activities. CONCLUSION: Teachers interact with parents and students throughout the SBVP process, undertaking important roles in outreach and health promotion to ensure uptake of SBVP services. SBVPs and other school-based health programs should explore strategies to support teachers in the roles they fill to optimize program impact.