Joseph A. Dake

Prevalence and Correlates of Sexting Behavior in Adolescents

The purpose of this study was to assess the prevalence of sexting among sixth through twelfth grade students and its correlations with other risk behaviors. The survey was conducted in 35 different schools in a midwestern state. Overall, 17% of students engaged in sexting, which varied significantly by age (3% of 12-year-olds to 32% of 18-year-olds). Adjusted odds ratios found statistically significant correlations between sexting and sexual behaviors, substance use behaviors, emotional health behaviors, and time spent texting. Sexting should be addressed by parents, teachers, and mental health professionals who interact with adolescents.

Adolescents’ Sleep Behaviors and Perceptions of Sleep

BACKGROUND Sleep duration affects the health of children and adolescents. Shorter sleep durations have been associated with poorer academic performance, unintentional injuries, and obesity in adolescents. This study extends our understanding of how adolescents perceive and deal with their sleep issues. METHODS General education classes were randomly selected from a convenience sample of three high schools in the Midwest. Three hundred eighty-four ninth- to twelfth-grade students (57%) completed a self-administered valid and reliable questionnaire on sleep behaviors and perceptions of sleep. RESULTS Most respondents (91.9%) obtained inadequate sleep (<or= 9 hours) on most school nights of the week, with 10% reporting less than 6 hours of sleep each week night. The majority indicated that not getting enough sleep had the following effects on them: being more tired during the day (93.7%), having difficulty paying attention (83.6%), lower grades (60.8%), increase in stress (59.0%), and having difficulty getting along with others (57.7%). Some students reported engaging in harmful behaviors to help them sleep: taking sleeping pills (6.0%), smoking a cigarette to relax (5.7%), and drinking alcohol in the evening (2.9%). Students who received fewer hours of sleep were significantly more likely to report being stressed (p = .02) and were more likely to be overweight (p = .04). CONCLUSIONS Inadequate sleep time may be contributing to adolescent health problems such as increased stress and obesity. Findings indicate a need for sleep hygiene education for adolescents and their parents. A long-term solution to chronic sleep deprivation among high school students could include delaying high school start times, such as was done successfully in the Minneapolis Public School District.

Factors Associated with State Variations in Homicide, Suicide, and Unintentional Firearm Deaths

This study examined the relationship of 16 variables with homicide, suicide, and unintentional firearm deaths. This cross-sectional analysis, using adjusted partial correlation coefficients, found that state-level firearm homicide rates significantly varied by the prevalence of firearms and by percent of the population which was African American. Whereas, state-level variations in firearm suicide mortality significantly varied by firearm prevalence, per capita alcohol consumption, percent of the population which was African American, and level of urbanization. None of the variables were significantly (p ≤ .05) related to state-level variations in unintentional firearm mortality. Furthermore, state gun laws had only a limited effect on firearm-related homicide deaths. Although the current study cannot determine causation, firearm mortality in its various forms is most commonly related to the prevalence of firearms and the percent of the population that is African American.

Effect of Full-Time versus Part-Time School Nurses on Attendance of Elementary Students with Asthma

Asthma, the most common chronic disease in children today, is the leading cause of absenteeism among students. It accounts for nearly 20 million lost school days annually. This study examined whether full-time (5 days per week) or part-time (2 days per week) school nurses would have a differential effect on the frequency of absences among elementary school students with asthma. This study found that students with asthma who were poor or who were African American and in schools with full-time nurses missed significantly fewer days (3 days, or 23% fewer missed days) than did their counterparts with asthma in schools with part-time nurses.

Elementary School Nurses’ Perceptions of Student Bullying

The aim of this study was to assess elementary school nurses’ perceptions of student bullying, actions when they encounter bullies or victims, and perceived level of preparation for dealing with this problem. School nurses identified the most common barriers to dealing with bullying, which included bullying taking place where the nurse is not supervising (49%), someone else in the school being more qualified to address bullying (41%), not having enough time (26%), and not being prepared to handle the problem (25%). Only 14% stated that there were no barriers to dealing with student bullying. School nurses believed that the most effective means to reduce school bullying were consistent discipline and improved supervision. However, these perceptions are not in line with current research, which indicates that the most effective method to reduce bullying is to create a whole-school atmosphere to prevent the problem from occurring.

Assets as predictors of suicide attempts in African American inner-city youths

OBJECTIVE To assess whether developmental assets and risk-taking behaviors, as measured by the Search Institute instrument, were related to attempted suicide in African American, inner-city youth. METHODS Survey of 336 African American, inner-city youths. RESULTS Significant odds ratios were found for 4 asset questions and for 11 risk-taking behavior questions by attempted suicide behavior. The odds ratios ranged from 2.4 to 6.4 in magnitude. The percent of variation in suicide-attempt behavior explained by the asset questions (14.6% and 19.6%) was explained by the risk-taking behavior/high-risk behavior pattern questions. CONCLUSIONS The risk-taking behavior items were better predictors of suicide behavior than were the developmental asset items for the African American youth.

Elementary School Nurses’ Perceptions and Practices Regarding Body Mass Index Measurement in School Children

This study examines elementary school nurses’ perceived efficacy expectations, perceived barriers, and perceived benefits to measuring body mass index (BMI) in students in schools with mandated BMI policies versus schools without mandated policies. Of the 2,629 school nurses participating in the study, 67% believe nurses should measure BMI in schools, 62% believe BMI results should be sent home, and 81% believe nurses should be designing programs to help children address overweight issues. In schools with a BMI assessment mandate, the nurses’ efficacy expectations are statistically significantly greater and nurses’ perceptions of barriers to measuring BMI are significantly lower. The most common perceived barriers to measuring BMI are inadequate school resources (57.6%) and inadequate or inappropriate parental responses (55.2%). Obese school nurses perceive significantly more barriers to measuring youths’ BMIs than do nonobese school nurses. Having mandates has a positive influence on school nurses and their measurement of BMI and increases the likelihood that nurses will measure BMI.

Mail Survey Return Rates Published in Health Education Journals: An Issue of External Validity.

Abstract This study assessed mail survey return rates published in seven general health education journals for the 13-year period, 1990–2002: American Journal of Health Behavior, American Journal of Health Education, American Journal of Health Promotion, Health Education & Behavior, Health Education Research, Journal of American College Health, and the Journal of School Health. A significant difference in mail survey return rates across the seven journals was found. Also, published mail survey return rates significantly increased from 1990–1995 (M=61.8%) to 1997–2002 (M=65.5%). All of the journals had published a noteworthy percentage (10–26%) of their mailed survey research studies with return rates of less than 50%. Finally, there was not a significant association between sample size and return rates of published mail survey studies. Researchers reporting mail survey research results in health education journals should expect to have return rates of 60% or greater. Yet, such return rates may still be considered a significant threat to the external validity of the findings.

Selected Ethical Issues in Research and Publication: Perceptions of Health Education Faculty

A national random sample of 195 university health education faculty at graduate degree–granting programs completed a 31-item survey with regard to their perceptions of ethical issues in research and publishing. Most respondents were male (57%), tenured (75%), had graduate faculty status (92%), had presented original research at conferences (85%), and had published articles in health education journals (89%). Faculty members were requested to assess whether 21 scenarios dealing with ethical issues in research and publishing were ethical, unethical, questionable, or not an ethical issue. Of the scenarios, 3 were considered ethical and 7 unethical by the majority of respondents. The perceptions of how ethical the remaining 11 scenarios were varied considerably. Perceptions of the ethical scenarios did not differ among respondents by sex, academic rank, years taught as a faculty member, whether the department taught units/classes on research ethics, or whether the respondents were from doctoral-level versus master’s-level programs.

Providing assistance to the victims of adolescent dating violence: a national assessment of school nurses' practices.

BACKGROUND This study assessed the perceptions and practices of school nurses regarding adolescent dating violence (ADV). METHODS The membership list of the National Association of School Nurses was used to identify a national random cross-sectional sample of high school nurses in the United States (N = 750). A valid and reliable survey instrument was developed and a 3-wave postal mailing procedure was used to maximize the return rate (57%). RESULTS Most school nurses (86.4%) reported that they did not have a protocol in their schools to respond to an incident of ADV. The majority of nurses reported that in the past 2 years, training to assist victims of ADV had not been provided to personnel in their schools (88.1%) and their schools did not conduct periodic student surveys that include questions on teen dating abuse behaviors (71.5%). Nurses who had a school protocol for responding to an incident of ADV perceived significantly fewer barriers to assisting victims of ADV and assisted more victims. Over half (55.3%) of high school nurses reported assisting a victim of ADV in the past 2 years. CONCLUSION Nurses appear to need more training in ADV. In addition, nurses found a number of barriers (eg, lack of training on ADV, lack of time, and lack of private space) to assisting student victims of ADV. Schools need to establish a means for assessing the status of ADV in their student population. Schools also need to provide in-service education for school personnel regarding prevention, assessment, and interdiction of ADV.