Susan K. Telljohann

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.

The Effect of a Monetary Incentive in Increasing the Return Rate of a Survey to Family Physicians

The barrage of requests family physicians receive to complete mail surveys often results in physicians who are unwilling, or unable due to time constraints, to complete each survey they receive. Thus, to obtain an acceptable response rate, state-of-the-art mail survey techniques must be used. This article reports the results of the use of a modest(

Principals’ Perceptions and Practices of School Bullying Prevention Activities

1) monetary incentive to increase a survey response rate. A random sample of 600 American Academy of Family Physicians members were mailed a survey of firearm safety counseling; half received a

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

1 incentive whereas the remaining half served as a control group. The response rate in the incentive group was 63% compared to 45% in the control group [X2 (1, N = 251) = 16.0, p < .0011. Further, the use of the incentive appears to be more cost-effective than a thirdfollow-up (postcard reminder) mailing.

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

The purpose of this study was to examine principals’ perceptions and practices regarding bullying prevention. A survey instrument was developed to assess principals’ stages of change and perceived barriers regarding selected bullying prevention activities as well as the effectiveness of bullying prevention activities. Of a national random sample of 700 principalsto which the survey was mailed, 55% responded. None of the school-based bullying prevention activities were being done by more than one in five schools even though principals perceived there to be no barriers regarding these activities. Characteristics that affected the offering of these activities included number of perceived barriers to implementing the activity, whether the principal had received violence/bullying prevention training, perceptions regarding the extent of bullying, and the number of bullying problems reported to them. The findings suggest that preprofessional training and continuing education are needed to educate principals regarding this area.

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

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.

Clinical Psychologists’ Firearm Risk Management Perceptions and Practices

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.

Access to school health services: differences between full-time and part-time school nurses.

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.

Adolescent Smoking Cessation Services of School-Based Health Centers

The purpose of this study was to investigate the current perceptions and practices of discussing firearm risk management with patients diagnosed with selected mental health problems. A three-wave survey was mailed to a national random sample of clinical psychologists and 339 responded (62%). The majority (78.5%) believed firearm safety issues were greater among those with mental health problems. However, the majority of clinical psychologists did not have a routine system for identifying patients with access to firearms (78.2%). Additionally, the majority (78.8%) reported they did not routinely chart or keep a record of whether patients owned or had access to firearms. About one-half (51.6%) of the clinical psychologists reported they would initiate firearm safety counseling if the patients were assessed as at risk for self-harm or harm to others. Almost half (46%) of clinical psychologists reported not receiving any information on firearm safety issues. Thus, the findings of this study suggest that a more formal role regarding anticipatory guidance on firearms is needed in the professional training of clinical psychologists.

High school health-education teachers' perceptions and practices related to teaching HIV prevention.

This study examined differences in student access to health services between schools with nurses 2 days/week (n = 7) compared to schools with nurses 5 days/week (n = 7). The study found statistically significant differences in numbers of nurse visits per 100 students. Of the 30 health conditions/activities investigated, 28 were statistically significantly higher with full-time school nurses than with part-time school nurses. It would be expected that 5-day/week nurses would be involved in health service activities 2.5 times as often as 2-day/week nurses. However, this study found that 21 of the 30 health service activities in schools with 5-day/week nurses were accessed by students more often than the expected 2.5 times that of the schools with nurses 2 days/week. This suggests a significant unmet need for access to health care services in schools with only 2-day/week nurses.