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BACKGROUND: Asthma is a leading cause of children's hospitalizations, emergency department visits, and missed school days. Our school-based asthma intervention has reduced asthma exacerbations for children experiencing health disparities in the Denver Metropolitan Area, due partly to addressing care coordination for asthma and social determinants of health (SDOH), such as access to healthcare and medications. Limited dissemination of school-based asthma programs has occurred in other metropolitan and rural areas of Colorado. We formed and engaged community advisory boards in socioeconomically diverse regions of Colorado to develop two implementation strategy packages for delivering our school-based asthma intervention - now termed "Better Asthma Control for Kids (BACK)" - with tailoring to regional priorities, needs and resources. METHODS: In this proposed type 2 hybrid implementation-effectiveness trial, where the primary goal is equitable reach to families to reduce asthma disparities, we will compare two different packages of implementation strategies to deliver BACK across four Colorado regions. The two implementation packages to be compared are: 1) standard set of implementation strategies including Tailor and Adapt to context, Facilitation and Training termed, BACK-Standard (BACK-S); 2) BACK-S plus an enhanced implementation strategy, that incorporates network weaving with community partners and consumer engagement with school families, termed BACK-Enhanced (BACK-E). Our evaluation will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, including its Pragmatic Robust Implementation Sustainability Model (PRISM) determinants of implementation outcomes. Our central hypothesis is that our BACK-E implementation strategy will have significantly greater reach to eligible children/families than BACK-S (primary outcome) and that both BACK-E and BACK-S groups will have significantly reduced asthma exacerbation rates ("attacks") and improved asthma control as compared to usual care. DISCUSSION: We expect both the BACK-S and BACK-E strategy packages will accelerate dissemination of our BACK program across the state - the comparative impact of BACK-S vs. BACK-E on reach and other RE-AIM outcomes may inform strategy selection for scaling BACK and other effective school-based programs to address chronic illness disparities. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT06003569, registered on August 22, 2023, https://classic. CLINICALTRIALS: gov/ct2/show/NCT06003569 .

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Federal law requires school health leaders to ensure meaningful access to language resources to promote optimal health and education outcomes. This paper aims to inform all stakeholders, including decision-makers, about the importance of developing language access plans and policies. Multiple sources and legal guidelines provide a comprehensive overview of the issue. Including an examination of current practices and challenges that school nurses encounter, specifically regarding language resources, guidance is offered to elucidate meaningful language access policies that ensure equitable access to school health services. Supporting meaningful language access includes providing school nurses with qualified interpretation and translation services to care for those who do not speak, read, or write in English or have limitations with the English language. Additionally, local and state agencies may implement language access services requirements and enforce compliance with a language access plan to meet federal funding requirements.

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AIM: To explore the experiences of health visits within the school health services from the perspective of adolescents with migration experiences. DESIGN: A descriptive qualitative study. METHODS: Data were collected using focus groups and semi-structured individual interviews with adolescents with migration experiences aged 13-17 years old. Analysis was conducted using reflexive thematic analysis. RESULTS: The results described adolescents reading the signs in the guided interaction between them and the school nurses. Reading the signs illustrated the adolescents' continuous interpretation of the interaction with the school nurse, and their decisions on how to respond throughout the health visit. These interpretations influenced the adolescents' shifting willingness to talk about their health and how they adapted to the space of participation provided by the school nurse. The interpretation also influenced their experiences of health visits as focusing on their health without making them feel singled out. CONCLUSION: Although individual considerations might be warranted in health visits with adolescents with migration experiences, the results indicate that similarities in intrapersonal communication in various encounters between adolescents and health professionals might be greater than any differences. Healthcare encounters with adolescents with migration experiences might thus need to be conducted with an awareness that adolescents read the signs in the guided interaction and that similarities in this interaction are greater than any differences.

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OBJECTIVE: Our goal is to examine gaps in self-carry, asthma emergency protocol, and stock inhaler policy knowledge in Illinois schools. DESIGN: A 30-item REDCap cross-sectional survey developed by a team of stakeholders was disseminated. Questions assessed policy knowledge, awareness, and practices regarding asthma emergency protocols, self-carry, and stock inhalers. SAMPLE: Participants were Illinois school nurses belonging to a governmental organization listserv. MEASUREMENTS: Analysis utilized Chi-square tests, descriptive statistics, and t-tests. RESULTS: Nurses reported 36% of students on average self-carried asthma medication. Thirty percent of nurses were not aware of their emergency asthma policy and only 60% reported having an emergency asthma protocol in their school(s). Fifty-four percent of nurses were aware of stock inhaler programming. Of the 10.3% who reported a stock inhaler program, a lower frequency reported calling 911 for asthma emergencies. Perceived school asthma prevalence varied from 0%-87%. CONCLUSIONS: Our survey demonstrates large variation in knowledge and implementation of school-based asthma health policy. This is likely due to variations in health policy education dissemination. Future efforts should focus on the dissemination and implementation of school-based asthma health policies to improve their more universal adoption and better support school-based asthma management.

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In Japan, pediatric urinary screening in schools for asymptomatic hematuria and proteinuria began in 1974 and has been very successful in detecting asymptomatic kidney diseases at an early stage. While the American Academy of Pediatrics recommended discontinuing urinalysis as a public health service in 2007, urinary screening in Japan has proven extremely successful in reducing the incidence of kidney failure with replacement therapy in children and young adults, especially through the early treatment of glomerulonephritis, such as immunoglobulin A nephropathy. Furthermore, the positivity rate on urinary screening in Japan is significantly lower than in the United States where the rate of false positive results is typically very high. Japan's seamless and efficient pediatric urinary screening may be a helpful example for other countries as well. However, the present investigation revealed several, unresolved problems with the system. For example, the methods used varied in terms of their cutoff point, additional examinations, and types of detailed testing. In Japan, various urinary screening methods are being tested to optimize the system for national use. Recently, the authors also recommended a system of detailed examinations, including beta-2 microglobulin testing and ultrasonography, to detect congenital anomalies of the kidney and urinary tract, the most common, underlying disease in kidney failure with replacement therapy, which is often overlooked until the symptoms have become grave. While school urinary screening has been ongoing for about 50 years and should be continued, improvements should also be made to it as needed.

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Representations of migrants influence how they are perceived by others. Hence, how children who have migrated or whose parents have migrated (Children in Migrant Families: CMFs) are represented in clinical practice guidelines (CPGs) for Swedish school health services (SHS) may influence how they are perceived by school nurses. Thus, this study aimed to explore representations of CMFs in school nurses' CPGs. Data consisted of 130 CPGs from municipalities in Sweden. Documents were analyzed using the "What is the Problem Represented to be" (WPR) approach - an analytic strategy for investigating embedded assumptions of "problems". In the analysis, Sarah Ahmed's work on "strangers" and "strangeness" was applied. In the CPGs, the CMFs and their health were repeatedly mentioned in conjunction with the need for particular or additional actions, efforts, or routines when assessing or discussing their health, to a degree beyond what is "usually" provided. This need was motivated by representing the CMFs and their health as being the same, yet different in relation to "Swedish" children in general. Thus, the children were not only represented as different, but they were "foreignized". These representations of difference and foreignness placed the children on a continuum in relation to what is recognized as "familiar" in their health, and constructed elastic boundaries between the strange and the familiar. By illustrating how these boundaries were used for difference-making between "familiar" and "strange", this study showed how CMFs are alternately represented as similar and different, and foreignized while provided with SHS aiming to make them "familiar".

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Introduction: An increasing number of schools are recognizing the importance of addressing students' mental health based on the association with educational outcomes and long-term health. The school organization and the members of the school staff play important but, in several ways, challenging roles in this work. The purpose of this study was to explore views of staff from schools and school health services on mental ill health among students and their own role in detecting and managing it. Methods: A qualitative study was conducted in a sparsely populated municipality in northern Sweden. In total, 40 participants from three secondary schools and the school health services participated either in focus groups or individual interviews. Participants were teachers, assistants, school nurses, school counselors and psychologists. Data were analyzed using thematic analysis. Results: The analysis revealed the main theme Student mental ill health: an increasing problem handled with insufficient resources and two subthemes, i.e., Uncertainty in interpreting students' signs of mental ill health and the need to clarify roles and establish a supportive organization. Conclusions: It was concluded that school staff were uncertain regarding how to interpret signs of mental ill health among students and required better knowledge and more resources to help students with mental ill health. A clearer organization and consensus regarding support for students with mental ill health were also necessary in light of the division of responsibilities between school staff and the school health services.

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BACKGROUND: As students returned to school, school nurses were responsible for infection control, communication, and the preparation of supplies and facilities. School nurses in the Pacific Northwest US demonstrated a higher prevalence of mental health symptoms in the years since the pandemic began, suggesting that their experience may have been unique. OBJECTIVE: This study aimed to explore the stressors of school nurses in the Pacific Northwest at two time points. DESIGN: This study is a qualitative, descriptive analysis of anonymous survey responses collected in June of 2021 (n = 333) and between October and December 2021 (n = 284). SAMPLE: Self-identifying school nurses working in K-12 schools in Washington State were invited to participate. MEASUREMENTS: Participants completed open-ended survey questions designed to elicit their experiences during the pandemic. RESULTS: Four themes emerged from the data: (1) isolation from administration and the school community, (2) COVID-19-related workload, (3) disorganized and inconsistent communication, and (4) concern for students, themselves, and others. CONCLUSIONS: School nurses played a vital public health role during the pandemic. However, their effectiveness may not have been fully utilized and sometimes undermined. Lastly, our findings highlight the difficulties encountered in implementing the changing scientific and public health guidance during the pandemic.

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BACKGROUND: State-level leadership and conditions are instrumental to local and regional comprehensive school mental health system (CSMHS) quality, sustainability, and growth. However, systematic documentation of state-level school mental health (SMH) policy, infrastructure, funding, and practice is limited. METHODS: Using a multi-phase, multi-method process, we developed the State School Mental Health Profile (State Profile) to offer a comprehensive landscape of state SMH efforts. State leaders in 25 states completed the State Profile once over a 3-year data collection period. Mixed methods results are reported in 8 domains. RESULTS: State education agencies were reportedly most involved in SMH technical assistance, advocacy, leadership, funding, and service provision, with mental health agencies reported as second most involved. Nearly half of state respondents reported having a state-level SMH director or coordinator. Policies with the greatest perceived impact require implementation of and funding for SMH services and supports. Despite leveraging multiple sources of funding, most states emphasized lack of funding as a primary barrier to establishing CSMHSs. All states reported staffing shortages. CONCLUSION: The State Profile can assist multi-agency state leadership teams to self-assess policy, infrastructure, and resources to support CSMHSs statewide. Findings point to areas of opportunity to advance equity across resource allocation, service provision, and policy development.

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INTRODUCTION: ROSSEY is a community-academic partnership aiming to develop and test a COVID-19 risk communication intervention for elementary school students and families in Yakima County, Washington. We describe the ROSSEY study protocol that will be implemented in the Yakima School District. METHODS: Aim 1 is to identify the community's social, ethical, and behavioral needs and resources for students to return to school and maintain onsite learning. We will conduct semi-structured interviews with students and school employees and focus groups with parents. Aim 2 is to evaluate the effectiveness of risk communication on students' school attendance. We will conduct a cluster randomized control trial. We will enroll 14 Yakima School District elementary schools with 900 student participants and randomize the schools into the COVID-19 risk communication intervention or control group. Aim 3 will assess implementation of the risk communication intervention and schools' COVID-19 mitigation strategies. We will use the RE-AIM framework to guide this work, which will entail conducting semi-structured interviews with students and school employees and focus groups with parents. DISCUSSION: Implementation of science-based risk communication can educate the community on the benefits and safety of COVID-19 testing and vaccination. Risk communication may also inform families about the role of COVID-19 testing and vaccines as part of mitigation strategies to allow for safe in-person learning. Schools have extraordinary influence to promote children's health through policy and practice change. Study findings will provide evidence to facilitate policy decisions and best practices at schools that facilitate adoption of COVID-19 risk communication. TRIAL REGISTRATION: ClinicalTrials.govNCT04859699. Registered on April 26, 2021.

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PURPOSE: To estimate variation in emotional and behavioural problems between primary schools in Bradford, an ethnically diverse and relatively deprived city in the UK. METHODS: We did a cross-sectional analysis of data collected from 2017 to 2021 as part of the 'Born In Bradford' birth cohort study. We used multilevel linear regression in which the dependent variable was the Strengths and Difficulties Questionnaire (SDQ) total score, with a random intercept for schools. We adjusted for pupil-level characteristics including age, ethnicity, socioeconomic status, and parental mental health. RESULTS: The study included 5,036 participants from 135 schools. Participants were aged 7-11 years and 56% were of Pakistani heritage. The mean SDQ score was 8.84 out of a maximum 40. We estimated that the standard deviation in school-level scores was 1.41 (95% CI 1.11-1.74) and 5.49% (95% CI 3.19-9.37%) of variation was explained at school level. After adjusting for pupil characteristics, the standard deviation of school-level scores was 1.04 (95% CI 0.76-1.32) and 3.51% (95% CI 1.75-6.18%) of variation was explained at school level. Simulation suggested that a primary school with 396 pupils at the middle of the distribution has 63 pupils (95% CI 49-78) with a 'raised' SDQ score of 15 + /40; and shifting a school from the lower to the upper quartile would prevent 26 cases (95% CI 5-46). CONCLUSION: The prevalence of emotional and behavioural problems varies between schools. This is partially explained by pupil characteristics; though residual variation in adjusted scores may suggest that schools have a differential impact on mental wellbeing.

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BACKGROUND: School-based health centers (SBHCs) are ideal settings to address social needs of youth and families. Case managers can play a vital role in social care interventions. METHODS: We piloted a program to incorporate a Case Manager into the care team of 1 SBHC serving 2 local schools with over 900 students and their surrounding communities. This project's purpose was to evaluate program feasibility, utilization, and acceptability. Our mixed-methods evaluation included analyses of data from electronic health records, client satisfaction surveys, and staff interviews. RESULTS: During the 6-month pilot, the Case Manager served 133 clients (about one third of all SBHC clients served) through 593 contacts. Most contacts included referrals to support services (90%) and 37% addressed newcomer immigrant adjustment. All 37 respondents to the satisfaction survey during the 3-month administration period (44% response rate) reported that the Case Manager made them feel comfortable asking for help; 95% reported getting the help they needed. The 7 SBHC staff interviewed shared many program benefits, including increased time for clinical services. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Inequities in children's health and educational achievement are influenced by structural factors. Results from our pilot program demonstrate that SBHCs may be well-positioned to deliver social care interventions and that case managers enhance the ability to deliver quality care. CONCLUSIONS: School-based programs to address unmet social needs are critical to supporting learning and wellness for all youth. Robust studies are needed to further test the impacts of case management in SBHCs.

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Objective@#To understand the current situation and regulatory effectiveness of daylighting and artificial lighting in primary and secondary school classrooms in Shanghai, so as to provide a basis for enhancing the visual environment of school classrooms.@*Methods@#From April 2021 to December 2023, the daylighting and artificial lighting conditions of classrooms in 1 735 regular primary and secondary schools currently in operation in Shanghai were monitored, and the qualified rate of each indicator was calculated. The Chisquare test or Fisher exact probability method were used to compare the differences in qualification rates across different educational stages, regions, school type, both before and after the implementation of regulatory measures. The regulatory measures included convene interview, propaganda and education, supervision order, supervisory opinion paper, rectification requests and offenses and punishment.@*Results@#The qualified rate of daylighting and artificial lighting in primary and secondary school classrooms was 30.1%, with a qualified daylighting rate of 85.6% and a qualified artificial lighting rate of 32.9%. There was no statistically significant differences in the qualified rate of daylighting and artificial lighting in primary and secondary schools (32.4%，28.1%；χ2=3.76，P＞0.05). However, statistically significant differences were found in the qualified rate of daylighting and artificial lighting in urban and rural school classrooms (32.6%，26.7%), as well as in public and private schools (31.4%, 20.6%) (χ2=6.99，9.92，P＜0.05). Following the implementation of regulatory measures, the qualified rate of classroom daylighting and artificial lighting improved from 30.1% to 83.2%, while the respective qualified rates of daylighting and artificial lighting increased from 85.6% to 91.1% and 32.9% to 90.5%. Compared to the preimplementation period, the qualified rate of classroom daylighting and artificial lighting, as well as the respective rates of daylighting and artificial lighting, all showed statistically significant differences after the implementation of regulatory measures (χ2=995.29，25.34，1 219.87，P<0.01).@*Conclusions@#Effective regulatory measures can promote enhanced classroom daylighting and artificial lighting. Attention should be paid to improving classroom artificial lighting, in order to provide students with enhanced visual environment.

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Objective@#To understand the trend of changes of hygiene status in the teaching environment among primary and secondary schools in Beijing City during 2016-2020, so as to provide basis for further improving the teaching environment and campus hygiene conditions in primary and secondary schools.@*Methods@#A proportional systematic sampling method covered over 50% of schools selected annually in Beijing from 2016 to 2019, and 34% were selected in 2020. Two representative classrooms were selected from each selected school for testing based on their structure and other factors, with 6 196 classrooms supervised, from 2016 to 2020,1 330,1 312,1 384,1 322,848 classrooms were monitored for each year.@*Results@#From 2016 to 2020, the overall lighting qualification rate of classrooms (lighting coefficient 72.8%, window to floor area ratio 41.8%, rear wall reflectance ratio 42.2%, blackboard reflection ratio 37.4%), the overall qualification rate of average blackboard illumination and uniformity (50.6%, 34.9 %), and the overall qualification rate of desk and chair allocation (58.6%) were all below 80%. The overall qualification rate of per capita classroom area (87.5%), blackboard size (83.2%), average desk illumination ( 80.1% ), average desk illumination and uniformity (82.9%), the distance between lamp and desk (99.1%), carbon dioxide ( 86.6% ), temperature (84.9%), and noise (96.6%) were all above 80%. The following indicators, blackboard size, the distance between lamp and desk, average blackboard illumination, lighting coefficient, blackboard reflectance, rear wall reflectance, carbon dioxide, temperature, and noise ( χ 2=78.38, 9.71, 11.76, 320.59, 37.63, 58.45, 236.45, 1 347.56, 101.97), had statistically significance between years. Among those indicators, the qualified rates of blackboard size, blackboard reflectance, lighting coefficient, and noise had been increasing year by year ( χ 2 trend =69.98, 15.82, 240.02, 5.77) ( P <0.05). The qualified rates of per capita classroom area, window to floor area ratio, and blackboard reflection ratio in primary schools (81.6%, 39.8%, 36.3%) were all lower than those in secondary schools (94.9%, 44.5%, 40.3%) ( χ 2=246.32, 12.03, 10.51, P <0.05). The qualified rates of blackboard size, average blackboard illumination, average blackboard illumination and uniformity, and desk and chair allocation (89.3%, 55.6% , 36.0%, and 60.2%) were all higher than those in secondary schools (75.4%, 44.1%, 33.3%, and 56.5%) ( χ 2=209.33, 78.41, 4.44, 8.22) ( P <0.05). The qualified rates of average desk illumination and uniformity, average blackboard illumination, rear wall reflectance ratio, desk and chair allocation, carbon dioxide, temperature, and noise indicators in urban area (82.9%, 84.1% , 51.9%, 45.0%, 60.9%, 91.2%, 89.5%, 97.8%) were all higher than those in suburban area (77.3%, 81.7%, 49.2%, 39.5%, 56.3%, 82.3%, 80.4%, 95.5%) ( χ 2=31.16, 6.28, 4.36, 16.40, 13.39, 105.29, 98.23, 24.66， P <0.05). The qualified rates of the distance between lamp and desk, lighting coefficient, window to floor area ratio, blackboard size, blackboard reflection ratio, average blackboard illumination and uniformity, and per capita classroom area in urban areas (98.8%, 65.2%, 34.3%, 76.7%, 35.9%, 30.1%, 84.6%) were all lower than those in suburban areas (99.4%, 81.4%, 49.8%, 89.7%, 40.2%, 39.6%, 90.3%) ( χ 2=6.80, 171.67, 132.43, 188.46 , 12.45, 60.28, 44.82) ( P <0.05).@*Conclusions@#The main problems in the teaching environment of schools in Beijing are classroom lighting, as well as desk and chair allocation. The findings suggest technical rationality and operability of relevant standard should be considered when under revision, and standard training and supervision management should be strengthened, with the aim of teaching environment improvement.

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ABSTRACT 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.

RESUMEN Objetivos: comprender las percepciones de los profesionales de la salud y la educación sobre las dificultades de aprendizaje de los niños en las escuelas públicas. Métodos: investigación cualitativa, del tipo acción participativa, vinculada al Itinerario de Investigación de Paulo Freire. Participaron 45 profesionales, a través de entrevistas y un Círculo Virtual de Cultura. El análisis se desarrolló a través de una atenta lectura, reflexión e interpretación de los temas destacados. Resultados: los profesionales discutieron la (in)visibilidad de las dificultades de aprendizaje, las estrategias y los recursos en el sector educativo y la búsqueda de soluciones en el sector salud. Se encontró que la producción de quejas relacionadas con el aprendizaje escolar se atribuye predominantemente como un problema individual del niño o de su familia, eximiendo a la institución educativa de este proceso. Consideraciones Finales: urge una mayor inversión en políticas de formación y desarrollo profesional para facilitar la coordinación entre sectores, con miras a superar modelos pedagógicos y sanitarios obsoletos.

RESUMO Objetivos: conhecer as percepções dos profissionais da saúde e da educação acerca da dificuldade de aprendizagem de crianças da rede pública de ensino. Métodos: pesquisa qualitativa, do tipo ação participante, articulada ao Itinerário de Pesquisa de Paulo Freire. Participaram 45 profissionais, por meio de entrevistas e um Círculo de Cultura Virtual. A análise desenvolveu-se na leitura cuidadosa, reflexão e interpretação dos temas destacados. Resultados: os profissionais dialogaram sobre a (in)visibilidade da dificuldade de aprendizagem, as estratégias e os recursos do setor educacional e a busca por resolutividade no setor saúde. Verificou-se que a produção das queixas relacionadas à aprendizagem escolar está atribuída predominantemente como problema individual da criança ou de sua família, isentando a instituição educacional desse processo. Considerações Finais: é premente maior investimento em políticas de formação e aperfeiçoamento dos profissionais para propiciar a articulação entre os setores, com vistas a superar modelos pedagógicos e de saúde ultrapassados.

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ABSTRACT Objective: to describe the process of developing, validating and assessing an educational booklet to prevent transphobic bullying at school. Method: this is a methodological study, carried out from February to December 2022 at a public school in João Pessoa, Paraíba, Brazil. The educational booklet was developed in accordance with the methodological trajectory proposed by Echer, and submitted to content validity and semantic assessment by expert judges and Elementary School II teachers, respectively. In data analysis, content validity and Intraclass Correlation Coefficients were used, in addition to semantic agreement index. Results: the educational booklet had its content validated with a validity coefficient of 0.981 and an Intraclass Correlation Coefficient of 0.833 for the set of items in the assessment instrument. In semantic assessment, teachers considered the booklet understandable, with a minimum agreement level of 94%. Conclusion: the booklet developed was considered valid by judges, to be used with teachers, individually and in continuing education or health actions, in order to contribute to preventing transphobic bullying at school.

RESUMEN Objetivo: describir el proceso de desarrollo, validación y evaluación de una cartilla educativa para prevenir el acoso escolar transfóbico. Método: se trata de un estudio metodológico, realizado de febrero a diciembre de 2022 en una escuela pública de João Pessoa, Paraíba, Brazil. La cartilla educativa fue elaborada de acuerdo con la trayectoria metodológica propuesta por Echer, y sometida a validación de contenido y evaluación semántica por jueces expertos y docentes de la Escuela Primaria II, respectivamente. En el análisis de los datos, se utilizaron los coeficientes de validez de contenido y de correlación intraclase, y el índice de concordancia semántica. Resultados: la cartilla educativa tuvo su contenido validado con un coeficiente de validez de 0,981 y un coeficiente de correlación intraclase de 0,833 para el conjunto de ítems del instrumento de evaluación. En la evaluación semántica, los docentes consideraron comprensible el cuadernillo, con un nivel mínimo de acuerdo del 94%. Conclusión: la cartilla desarrollada fue considerada válida por los jueces, para ser utilizada con docentes, de manera individual y en acciones de educación continua o de salud, con el fin de contribuir a la prevención del acoso escolar transfóbico en la escuela.

RESUMO Objetivo: Descrever o processo de desenvolvimento, validação e avaliação de cartilha educacional para prevenção do bullying transfóbico na escola. Método: Trata-se de um estudo metodológico, realizado no período de fevereiro a dezembro de 2022 em uma escola pública de João Pessoa, Paraíba, Brasil. A cartilha educacional foi desenvolvida de acordo com a trajetória metodológica proposta por Echer, e submetida à validação de conteúdo e avaliação semântica por juízes especialistas e professores do Ensino Fundamental II, respectivamente. Na análise dos dados, utilizaram-se os coeficientes de validade de conteúdo e correlação intraclasse, e o índice de concordância semântica. Resultados: A cartilha educacional teve seu conteúdo validado com coeficiente de validade de 0,981 e coeficiente de correlação intraclasse de 0,833 para o conjunto de itens do instrumento de avaliação. Na avaliação semântica, os professores consideraram a cartilha compreensível, com nível de concordância mínima de 94%. Conclusão: A cartilha desenvolvida foi considerada válida por juízes, para ser utilizada com professores, de forma individual e em ações de educação permanente ou em saúde, a fim de contribuir na prevenção do bullying transfóbico na escola.

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Resumo Este artigo tem como objetivo compreender, pelo uso do Photovoice, as representações de bullying presentes entre adolescentes escolares do ensino médio. Trata-se de um estudo qualitativo, realizado com 54 adolescentes da rede pública de ensino do estado do Paraná, organizados em seis grupos focais. Os dados foram coletados mediante a técnica participativa Photovoice e submetidos à análise de conteúdo proposta por Bardin. Da análise dos dados emergiram três categorias: "Bullying estético, homofóbico e de gênero: estratégias subversivas", "Os efeitos danosos do bullying" e "O diálogo interdisciplinar como estratégia de prevenção e combate ao bullying". Com os resultados, foi possível evidenciar que a prática do bullying acontece a partir das dissonâncias entre agressores e vítimas, com insultos à condição de conformação corporal, orientação sexual, identidade de gênero, entre outros. Por essa razão, é preciso viabilizar ações articuladas entre educação e saúde para o diálogo e escuta a respeito do bullying na comunidade escolar, com vistas a seu enfrentamento, prevenção e proteção, almejando, sobretudo, o respeito e valorização das diferenças.

Abstract This article aims to understand, by using Photovoice, the representations of bulling among high school adolescents. This is a qualitative study, conducted with 54 adolescents from the public school system of the state of Paraná, organized into six focus groups. The data were collected using the Photovoice participatory technique and submitted to content analysis proposed by Bardin. Three categories emerged from the data analysis: "Esthetic, homophobic, and gender bullying: subversive strategies", "The harmful effects of bullying", and "Interdisciplinary dialogue as a strategy to prevent and combat bullying." With the results, it was possible to evidence that the practice of bullying happens from dissonances between aggressors and victims, with insults to the condition of body conformation, sexual orientation, gender identity, among others. For this reason, it is necessary to enable articulated actions between education and health for dialogue and listening about bullying in the school community, with a view to coping with it, prevent it, and protect against it, seeking above all the respect and appreciation of differences.

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School-based health centers (SBHCs) are associated with numerous positive aspects of student health services. Many schools in the United States (US) do not have transparent policies on chronic health condition (CHC) management. Of particular concern is the underreporting of the delivery of health services in U.S. schools concerning CHC management and its relationship with the presence or absence of a SBHC. Data from the 2020 School Health Profiles (SHP) Survey were examined in New York public secondary schools. Specific health services were reviewed, together with the presence or absence of a SBHC, including daily medication administration, stock rescue medication, case management services, community partners, chronic disease-specific education, and assurance that students with CHCs were enrolled in an insurance program. A significantly greater proportion of schools with a SBHC compared with schools without a SBHC provided: (1) daily medication administration (92.9% vs. 86.5%; p < .001), (2) stock or rescue medication (84.9% vs. 77.4%; p < .001), (3) case management services (83.1% vs. 67.2%; p < .001), (4) disease-specific education for families (63.1% vs. 57.2%; p = .022), (5) student and family connection to community health services (84.2% vs. 76.5%; p < .001), and (6) ensured that a protocol existed whereby students with a CHC were enrolled in an insurance plan if eligible (79.6% vs. 66.8%; p < .001). Findings suggest that data on a national scale include essential facts for states to consider concerning school health policies and practices. Additional research should examine the intricacy of elements connected with school-based health care to understand better the care provided to children with CHCs.

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Educational communities have the potential to project themselves as transforming niches of living conditions around the identification of health needs and the search for alternatives to solve them. Withinthe framework of the Master's in Public Health at the Universidad de La Sabana, progress has been made in strategies to generate this link, through support in the formulation of a community health program in an educational environment, based on the adaptation of the model PrecedeProcede, a method to plan, conduct and evaluate health education interventions. Taking into account the above, the objective of this article is to reflect on the contributions of the model for the formulation of community health programs in educational settings, regarding primary health care and the policies of healthy educational settings, considering that they are referents regulations in the Colombian territory. In summary, this model is considered a favorable option for the formulation of health programs in the educational context because it privileges community participation, addresses contextualized problems and gives the possibility for students to integrate from an early age and educational communities to become social managers of their own health.(AU)

Las comunidades educativas tienen el potencial de proyectarse como nichos transformadores de las condiciones de vida en torno a la identificación de las necesidades en salud y la búsqueda de alternativas para resolverlas. En el marco de la maestría en Salud Pública de la Universidad de La Sabana se ha avanzado en estrategias para generar este vínculo, a través del acompañamiento en la formulación de un programa de salud comunitaria en un entorno educativo, basados en la adaptación del modelo Precede-Procede, un método para planear, conducir y evaluar intervenciones de educación para la salud. Teniendo en cuenta lo anterior, el objetivo de este artículo es reflexionar sobre los aportes del modelo para la formulación de programas de salud comunitaria en entornos educativos, a propósito de la atención primaria de salud y las políticas de entornos educativos saludables, considerando que son referentes normativos en el territorio colombiano. En síntesis, dicho modelo se considera una opción favorable para la formulación de programas de salud en el contexto educativo porque privilegia la participación comunitaria, aborda problemáticas contextualizadas y da la posibilidad para que desde edades tempranas se integren estudiantes y las comunidades educativas se constituyan como gestoras sociales de su propia salud.(AU)

As comunidades educativas têm potencial para se projetarem como nichos transformadores das condições de vida em torno da identificação das necessidades de saúde e da busca de alternativas para solucionálas. No âmbito do Mestrado em Saúde Pública da Universidad de La Sabana, avançou-se nas estratégias para gerar este vínculo, através do apoio na formulação de um programa de saúde comunitária em ambiente educativo, baseado na adaptação do modelo Precede -Proceder, um método para planejar, conduzir e avaliar intervenções de educação em saúde. Levando em conta o exposto, o objetivo deste artigo é refletir sobre as contribuições do modelo para a formulação de programas de saúde comunitária em ambientes educativos, no que diz respeito à atenção primária à saúde e às políticas de ambientes educativos saudáveis, considerando que são normas de referência em território colombiano. Em síntese, esse modelo é considerado uma opção favorável para a formulação de programas de saúde no contexto educacional, pois privilegia a participação da comunidade, aborda problemas contextualizados e dá a possibilidade de os alunos se integrarem desde cedo e comunidades educativas em formação gestores sociais de sua própria saúde.(AU)

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BACKGROUND: Norwegian school health services received a national best-practice guideline in 2017. To promote healthy life skills and identify adolescents needing support, the guideline includes strong recommendations for individual consultations with all 8th graders and increased collaboration with schools. To help implement the recommendations, a blended implementation strategy (SchoolHealth) was co-created with school nurses, students, and stakeholders. SchoolHealth consists of three implementation elements: Digital dialog and administration tool (audit and feedback +), Dialog support (external consultation), and Collaboration materials (targeted dissemination). This hybrid study will test the main and combined effects of the elements on guideline fidelity and effectiveness. METHODS: The GuideMe study is a factorial cluster randomized controlled trial examining SchoolHealth's effectiveness on guideline fidelity and guideline effectiveness goals. Forty Norwegian secondary schools will be randomized to eight different combinations of the elements in SchoolHealth. Participants will include school nurses and school personnel from these schools, and 8th grade students (n = 1200). Primary outcomes are school nurses' fidelity to the guidelines and student's ability to cope with their life (i.e., health literacy, positive health behaviors and self-efficacy). Quantitative methods will be used to test effects and mechanisms, while mixed- and qualitative methods will be used to explore mechanisms, experiences, and other phenomena in depth. Participants will complete digital questionnaires at the start and end of the schoolyear, and after the consultation during the schoolyear. The study will run in two waves, each lasting for one school year. The multifactorial design allows testing of interactions and main effects due to equal distribution of all factors within each main effect. Sustainment and scale-up of optimized SchoolHealth elements using national infrastructure are simultaneously prepared. DISCUSSION: The study will investigate possible effects of the implementation elements in isolation and in combination, and hypothesized implementation mechanisms. In-depth study of user experiences will inform improvements to elements in SchoolHealth. The results will yield causal knowledge about implementation strategies and the mechanisms through which they assert effects. Mixed-methods will provide insights into how and when the elements work. Optimizing guideline implementation elements can support adolescents in a crucial life phase. TRAIL REGISTRATION: ISRCTN24173836. Registration date 8 August 2022.

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