Background: COVID-19 disrupted children’s lives, leading to higher levels of anxiety and depression. Mental health related visits for children aged 5-11 years old increased by 24% from 2019-2020. Seven per 100,000 persons aged 10-19 years old died by suicide in 2018-2019. More than 100,000 American children witnessed a school shooting, which has been associated with higher rates of antidepressant use, school absenteeism, and decreased likelihood of completing high school. The need for a quick, accurate assessment of a child’s wellbeing is therefore essential for early recognition and intervention. We have developed the first picture screening tool Pediatric Wellbeing Picture Scale^© (PWBPS) for grades 3-5 that allows children regardless of literacy, language skill, and developmental levels to be screened.

Methods: Focus groups were conducted to develop the tool. Through use of thematic analysis, a 10-item, 3-point picture Likert scale was developed. Face and content validity was completed. Test-retest reliability was conducted (N=50). Parallel forms reliability testing is currently being conducted (N=~300) and will be included in the presentation.

Results: Pearson correlation indicates strong correlation between test 1, 2 (r=.534), test 1, 3 (r=.488), test 2, 3 (r=.593). P<.001, 2-tailed, for all correlations. Cronbach’s alpha coefficient for all three tests (.744, .736, .815, respectively). This tool can be completed in less than 5 minutes.

Conclusion: The PWBPS is a valid and reliable tool allowing for quick and accurate assessments of a child’s wellbeing, allowing for timely and early intervention. Early intervention is key in reducing negative effects of poor mental wellbeing.

Background/Purpose

In the U.S. over 20% of female and 10% of male youth annually experience teen dating violence (TDV), which has significant short- and long-term health consequences. Among teens experiencing TDV, almost half report that at least one incident occurred at school. Although Iowa does not require TDV prevention education, many schools choose to implement some TDV programming. The objective of this project was to understand current TDV programming in Iowa schools through the perspective of school nurses and staff.

Methods

A short email survey was distributed to school nurses across the state requesting they share the survey with others in their schools who may play a role in TDV prevention and intervention. Frequencies and bivariate results are presented.

Results/Outcomes

Survey respondents represented Iowa elementary, middle, and high school staff, 47% of which were nurses. Most (61.5%) respondents agreed that TDV was a problem, while 33.1% were unsure. Almost 80% reported that either their students do not receive or were unsure if they receive TDV education. Less than 5% reported that the school offers staff continuing education on TDV prevention. Only 12% reported their school having a protocol for responding to a student TDV disclosure.

Conclusions

The perceived severity of TDV does not seem to be matched with school prevention and response programming. Many nurses and staff are unsure of how the school addresses the issue. Supporting schools to implement comprehensive programming is imperative.

Learning objectives

Describe perceptions of school staff regarding TDV programming across school settings

Background: Schools are critical settings for providing skills-based health education to adolescents; yet the extent that school health education skills safeguard mental health remains understudied. We examine associations between perceived usefulness of school health education skills and indicators of mental health.

Methods: Adolescents aged 15-17 years (n=471) from the AmeriSpeak® Teen Panel were surveyed on exposures to school health education and usefulness of health skills, specifically: knowing how to get trusted information and services [HES1]; understanding how factors influence health [HES2]; communicating to improve health [HES3]; decision-making to change behaviors [HES4]; and encouraging others to practice healthy behaviors [HES5]. Outcomes included indicators of mental health literacy and overall mental health. We estimated these relationships with multiple logistic regression, adjusted odds ratios (OR), and 95% confidence intervals (CI); controlling for demographics.

Results: Students who reported perceived usefulness in all health skills, except HES2, were more likely to seek mental health information and talk with a healthcare provider. Students who perceived HES3 (OR=4.33 [95% CI:1.38-13.61]) and HES5 (OR=3.90 [1.21-12.58]) as useful were more confident in accessing mental health resources. Students who perceived HES3 (OR=0.34 [0.17-0.69]), HES4 (OR=0.40 [0.18-0.93]), and HES5 (OR=0.47 [0.24-0.94]) as useful were less likely to report poor mental health (with HES5 also significantly related to HES1) and that mental health interfered with activities. Demographic differences were found.

Conclusion: Most health skills were positively associated with mental health-seeking behaviors and health outcomes. School health education using skills-based approaches can help adolescents gain knowledge and skills for safeguarding mental health.

Background/ Issue

Active shooter drills are used widely throughout schools in the United States, with more than 92% of public schools having an active shooter plan. These drills require K-12 students to imagine a violent scenario and respond accordingly. That said, students report perceiving that active shooter drills increase fear and helplessness, do not teach practical steps on how to respond, and do not actually increase feelings of safety. Recent research also indicates increases in student-level stress, anxiety, and depression following active shooter drills.

Description

The purpose of this presentation is to describe the efficacy of mind-body practices to reduce stress reactivity and recovery in elementary-aged students following active shooter safety drills. In addition, this presentation will equip elementary school administrators, teachers, and staff with mind-body techniques to reduce student stress immediately following active shooter safety drills.

Lessons Learned

Attendees will learn to describe the efficacy of mind-body practices to reduce stress reactivity and recovery in elementary-aged students. Attendees will also be able to list and name practical techniques, including age-appropriate classroom physical activity breaks, mindfulness-based breathing, and social-emotional strategies to implement in school settings.

Implications/Recommendations

Implications of implementation include evidence-based strategies that have been shown to reduce child and adolescents reactivity and recovery to stressful situations. Strategies may also be extrapolated to other emergency drills (e.g., fire, natural disaster, bomb threat, etc.) and modified to best fit individual classrooms and grade levels.

Background: Mental health is associated with student academic success and completion. To better connect students to campus and community resources, we aimed to understand the barriers and facilitators to service use.

Methods: In 2022, 2,000 public university students in New York City completed a survey. Those who agreed to be recontacted were screened for having two or more unmet essential needs (food, housing, mental health, health care) and contacted for an interview. The interview guide included questions about the need for and receipt of services for unmet essential needs, including mental health. Thus far, 15 virtual in-depth interviews have been completed; recruitment is ongoing. Researchers transcribed interviews and analyzed text using techniques informed by grounded theory. Two analysts coded each transcript and discrepancies were resolved with a third analyst.

Results: Reasons for not seeking mental health support included not being sure where to go, not being aware that services exist on campus and not knowing or being comfortable asking for support. The timing of service availability was also critical for working students. Students reported seeking support from family and friends in lieu of professional mental health counseling. Advisors connected students to services and offered emotional support. Reputation and experience with other services affected students’ interest in using mental health services.

Conclusions: Awareness and access to mental health support is needed for public university students. Open conversations about mental health would help reduce the stigma of seeking services. Advisors can help students navigate complex campus-based programming and connect them to support.

Introduction – In a post-covid world, there is a need to support high school teachers and adolescents due to both encounters chronic stress, anxiety, and burnout. A community-academic partnership with multi-sector partners developed resources and support within a multimedia virtual space. This presentation aims to communicate the formative evaluation findings regarding the types of resources that support teacher wellness.

Methods – Partnership discussions determined that resources are needed in the following areas: 1. Standards, 2. Teaching Perspective, 3. Trauma-informed teaching, 4. Teacher Boundaries, and 5. Meaning in Teaching Profession. The partnership conducted a conference-based listening session and key informant interviews with five experienced teachers to gain perspectives on the five identified resource areas. Additional listening sessions and interviews with teachers and adolescents are scheduled.

Results: Teachers acknowledged that stress and strain had become the status quo among teachers and students in a post-covid world. Teachers discussed the need to identify and develop support systems to support students’ mental health and find healthy outlets for well-being. Other teachers struggle with moral injury, burnout, and loss of meaning. There was a universal agreement that more resources are needed to support the mental well-being of all engaged in the educational enterprise.

Implications – Multisector public health partnerships can support the school and community health. Good evidence shows that teachers desire innovative supports and resources to help their longevity in their positions. More research to develop accessible and high-quality resources is needed.

Background: Many students travel to school with an invisible suitcase. They drag it from class to class and its contents weigh them down because it is stuffed with trauma, adverse childhood experiences (ACEs), poverty, socioeconomic disparities, and more. These silent and detrimental issues often go unnoticed and unseen and impact their learning, social, and health outcomes. The COVID-19 pandemic has exacerbated the grave limitations and barriers of the education system regarding equity, social justice, and resources.

Description: Since returning to the classroom, research has indicated an increase in classroom disruptions, a decline in student academic performance and the need for more mental health support for both students and educators. ACEs and other detrimental issues affect attention, memory, and cognition, making it more difficult to learn and be successful.

Lessons Learned: Student performance and educational attainment spans beyond just academic intellect and ability but intersects with external and environmental factors. Unfortunately, school systems are not adequately structured to address these underlying causes and risk factors.

Recommendations: Our study developed a research-based, academic analytics software to improve student academic, mental, and behavioral health outcomes. The tool provides predictive analytics that will analyze cultural synchronization among students and teachers, identify mental and behavioral needs of students within a school, identify variations in perception of student behavior issues among students, teachers, and parents, and evaluate students’ academic performance concerning various variables. We recommend future research that utilizes this tool to help advance our understanding and framing of ACEs and other detrimental pipelines as a public health concern.

Background

Health is influenced by settings where people live, learn, work, and play. In Bexar County, Texas, 21% of children live in poverty, 62% are eligible for free/reduced-price lunch, 10% are uninsured, and reading and math scores are on average below grade level. These social determinants of health can lead to preventable health disparities, morbidity, and mortality. The school-based health program at University Health (SBHP) addresses these outcomes through a comprehensive care delivery system, innovative pilot programs, and community partnerships.

Description

The SBHP operates five brick and mortar clinics, 18 Tytocare telehealth devices, and one mobile unit in partnership with four school districts that serve over 150,000 students. More than 80% of patients served reside in neighborhoods with a social vulnerability index of 0.75 or greater. The program is staffed by a physician–medical director, nurse practitioners, physician assistants, medical assistants, licensed vocational nurses, and community outreach specialists. This team delivers primary care, mental health services, immunizations, referrals to specialty care, and connections to social workers. The mobile unit brings healthcare to neighborhoods that lack access, and Tytocare allows school nurses to facilitate a real-time, physical exam and virtually connect students and staff with SBHP clinicians.

Lessons learned

The SBHP’s population health approach, use of health information systems, community partnerships and outreach efforts, continuous quality improvement, and multi-disciplinary team can enhance academic achievement, and help achieve health equity in under-served communities.

Recommendations

Communities should invest in school-based health centers as a vehicle to address social determinants of health and mitigate health disparities.