Sexual Health Education and Family Planning: A Vital Component of the Healthy Start Program

The paper will describe the Healthy Start program as a comprehensive sex education program and implications for preventing subsequent adolescent pregnancies.

Characteristics of the Commission on Accreditation of Allied Health Education Programs or National Athletic Trainers' Association -accredited athletic training programs associated with first -attempt passing rates on the NATABOC examination

Athletic training is an allied health profession recognized by the American Medical Association requiring certification by examination. There are two routes towards certification as an athletic trainer: attending a university with an accredited athletic training program or with an internship program By 2004, the only route towards certification will be by attending a Commission on Accreditation of Allied Health Education Programs (CAAHEP) or National Athletic Trainers' Association (NATA) accredited athletic training program. CAAHEP looks at passing rates on the NATA Board of Certification (NATABOC) examination when granting accreditation. This study examined characteristics of programs associated with first time passing rates. ^ Directors from 39 CAAHEP or NATA accredited athletic training programs completed a descriptive 17-question survey regarding academic characteristics, faculty characteristics, and program characteristics. Analysis used Spearman's rho correlation coefficient, with significance of p = <.05. Four program directors were interviewed to gather additional insight. ^ There were three program characteristics that showed a significant positive association with first attempt passing rates: the number of full-time and part-time approved clinical instructors (ACIs), and the number of students in the program. Further investigation found a statistically significant association between a low ratio of ACIs to athletic training students and first time passing rates. ACIs are certified athletic trainers (ATCs) who have received special training in order to supervise athletic training students. CAAHEP mandates a 1:8 ratio of ATCs to athletic training student. This study showed that a smaller ratio of ATC to student in combination with ACI training was significantly associated with higher first time passing rates. The number of courses above the required 13 delineated by the Education Council showed a significant negative association with first attempt passing rates. ^ Universities seeking or maintaining accreditation should incorporate characteristics associated with a higher passing rate on the NATABOC examination. Characteristics include utilizing a large number of full-time and part-time ACIs, admitting a large number of students into the program while maintaining a low ACI to athletic training student ratio, and offering curricula that focuses on the 13 courses that have been deemed relevant to the athletic training curriculum by the Education Council. ^

The effects of health education on student health -related behaviors

During their transitional period from childhood to adulthood, adolescents engage in risk-taking behaviors that become public health concerns. It is important for school health education professionals to design instructional programs that focus on adolescents' developmental needs and foster healthier lifestyles. The goal of health education is to help students acquire health skills that are necessary to succeed in school and in life. This is especially important because the increase in teenagers' risky behaviors can affect their health, well being, and eventually the course of their lives. ^ This study examined the effects of health education on health-related behaviors of public high school students. A multivariate analysis of variance was conducted to determine whether the comprehensive approach based on The Jessors' Problem Behavior Theory (PBT) had a greater impact on adolescents' risk-taking behaviors than the traditional approach. After 18 weeks of health instruction using one of these approaches, the Youth Risk Behavior Survey (YRBS) was administered to measure the level of subjects' self-reported behaviors in six categories of adolescent risky behaviors: the use of tobacco; the use of alcohol and other drugs; engagement in injurious activities; consumption of unhealthy diet; an inadequate level of participation in physical activities; and engagement in risky sexual activities. ^ The results of this study did not support the hypothesis that using the comprehensive health education approach was more influential than the traditional health education approach in improving students' health-risk behaviors. Further research studies based on bio-psychosocial theories are needed to develop and evaluate methods of instruction and delivery of health skills. ^

A State and Territorial Survey Regarding Utilization of Environmental Health Shelter Assessments during Disasters, and a Secondary Analysis of Available Shelter Assessment Data

Disasters are complex events characterized by damage to key infrastructure and population displacements into disaster shelters. Assessing the living environment in shelters during disasters is a crucial health security concern. Until now, jurisdictional knowledge and preparedness on those assessment methods, or deficiencies found in shelters is limited. A cross-sectional survey (STUSA survey) ascertained knowledge and preparedness for those assessments in all 50 states, DC, and 5 US territories. Descriptive analysis of overall knowledge and preparedness was performed. Fisher’s exact statistics analyzed differences between two groups: jurisdiction type and population size. Two logistic regression models analyzed earthquakes and hurricane risks as predictors of knowledge and preparedness. A convenience sample of state shelter assessments records (n=116) was analyzed to describe environmental health deficiencies found during selected events. Overall, 55 (98%) of jurisdictions responded (states and territories) and appeared to be knowledgeable of these assessments (states 92%, territories 100%, p = 1.000), and engaged in disaster planning with shelter partners (states 96%, territories 83%, p = 0.564). Few had shelter assessment procedures (states 53%, territories 50%, p = 1.000); or training in disaster shelter assessments (states 41%, 60% territories, p = 0.638). Knowledge or preparedness was not predicted by disaster risks, population size, and jurisdiction type in neither model. Knowledge: hurricane (Adjusted OR 0.69, 95% C.I. 0.06-7.88); earthquake (OR 0.82, 95% C.I. 0.17-4.06); and both risks (OR 1.44, 95% C.I. 0.24-8.63); preparedness model: hurricane (OR 1.91, 95% C.I. 0.06-20.69); earthquake (OR 0.47, 95% C.I. 0.7-3.17); and both risks (OR 0.50, 95% C.I. 0.06-3.94). Environmental health deficiencies documented in shelter assessments occurred mostly in: sanitation (30%); facility (17%); food (15%); and sleeping areas (12%); and during ice storms and tornadoes. More research is needed in the area of environmental health assessments of disaster shelters, particularly, in those areas that may provide better insight into the living environment of all shelter occupants and potential effects in disaster morbidity and mortality. Also, to evaluate the effectiveness and usefulness of these assessments methods and the data available on environmental health deficiencies in risk management to protect those at greater risk in shelter facilities during disasters.

Teachers' knowledge, awareness, and pedagogy of global education in secondary schools

In 1979, the Florida State Board of Education approved the teaching of global education in the state of Florida. The purpose of this study was to examine the factors that contributed to teachers' global knowledge, global mindedness, and pedagogy in global education. The Hanvey model of teaching from a global perspective was the theoretical framework for the study. ^ A total of 90 secondary teachers from Miami-Dade County Public Schools were randomly selected and placed in three groups: Globally Oriented Social Studies Program (GOSSE), Non-Globally Oriented Social Studies Program (non-GOSSE), and Teachers Who Teach Other Subjects (TWTOS). Seven teachers, two of whom team-taught a class, were selected for classroom observations and interviews. A mixed methods design that combined quantitative and qualitative data was used. ANOVA and Chi square techniques were used to determine whether the factors that contributed to teachers' global knowledge and global mindedness differ among groups. Classroom observations and interviews were conducted to determine whether the instructional strategies differ among the seven selected teachers. ^ The findings of the study show that teachers who were trained in teaching from a global perspective differed in their global knowledge and used more appropriate instructional strategies than teachers who were not trained in teaching global perspectives. There was no significant difference in the combined global knowledge of the non-GOSSE and TWTOS groups when compared with the GOSSE group. There was no significant difference in the combined global knowledge of the GOSSE and non-GOSSE groups when compared with the TWTOS group. There was no significant difference among the teachers in their global mindedness. Observation and interview data indicate that current events, role-playing, simulations, open-ended discussion, debates, and projects were the predominant instructional strategies used by globally trained teachers. Cable networks, Internet, magazines, and newspapers were found to be the dominant tools for teaching global education. ^ This study concluded that teachers who were trained in globally oriented programs had more global knowledge than teachers who were not. It is recommended that teacher education programs should incorporate a global perspective in the preparation of social studies teachers, with particular attention to developing their global attitudes. ^

Impact of a comprehensive nutrition and lifestyle education intervention on body weight and health-related outcomes in morbidly-obese Hispanic-Americans following laparoscopic Roux-en-Y gastric bypass

As morbid obesity increasingly affects Hispanic-Americans, the incidence of Roux-en-Y gastric bypass procedures (RYGB) among this population rises. Prospective research on the impact of postoperative educational interventions focused on Hispanic- Americans is needed to prevent premature weight loss plateau, weight regain, nutritional deficiencies, and relapse of obesity-related comorbidities. This randomized-controlled study evaluated the impact of a comprehensive nutrition and lifestyle education intervention (6 biweekly postoperative sessions that incorporated motivational strategies for behavioral change) as compared to a non-comprehensive approach (printed guidelines for healthy lifestyle). The variables to consider are body weight, obesity-related comorbidities (depression, diabetes, dyslipidemia, and others), nutrient status, physical activity, and eating habits in 144 morbidly-obese adult Hispanic-Americans 6 to 12 months following RYGB. Patients were randomly assigned to either the comprehensive intervention (n=72) or the comparison group (n=72). Participants (mean age 44.5 ± 13.5 years) were mainly Cuban-born females (83.3%). Intervention sessions attendance was 64%. At 12 months, both groups lost weight significantly, but those in the comprehensive intervention experienced greater excess weight loss than those in the comparison group (80% vs. 64% from preoperative excess weight, P<.001). Intervention participants were significantly more involved in physical activity (+ 14 min/week vs. – 4 min/week), had decreased depression, joint illness, and required less medication for comorbidities than comparison participants. Additionally, those in the comprehensive intervention had sustained supplement intake experiencing less folate deficiency (P=.014). The non-comprehensive intervention group significantly decreased their protein and supplement intake compared to the intervention group. Patients in the comprehensive intervention had significantly better eating habits reflected by fewer episodes of dumping syndrome, constipation, and night eating, than those in the comparison group who reported greater eating in response to negative emotions (P=.003). These findings support the importance of a comprehensive educational approach to achieve more effective weight reduction and health-related outcomes to prevent relapse of obesity-related comorbidities and nutritional deficiencies in Hispanic-Americans 6 to 12 months following RYGB.

Health changes in Hispanic older adults in a Spanish arthritis self -management education program

Arthritis is the most common chronic condition affecting older people and is a major cause of limited activity. Arthritis education programs in English have demonstrated a positive impact on health but these programs have not reached the Hispanic communities where arthritis is the leading cause of disability. Minorities, such as Hispanics, have traditionally been reluctant to pursue self-help programs, and have been identified as an under-served population in terms of medical care. This study examined the effectiveness of one community health adult education program targeting Hispanic older adults with arthritis, the Spanish Arthritis Self Management Education Program (SASMEP), by evaluating changes in the participants' general health, pain, disability, self-efficacy, health perceptions, frequency of physician visits, and exercise. A pre and post control group experimental design and analyses of covariance were used to determine the pre and post differences in health status and health behaviors for a group participating in the SASMEP and a group who did not using gender and age as covariates. A repeated measures design was also used, and repeated measures analyses of variance and post hoc tests were done on health status and health behavior data collected pre, post and one-year post education to determine long-term differences. ^ Results indicated the participants' health status significantly improved in general health, significantly decreased in pain, and significantly decreased in arthritic disability immediately following the education. Self-efficacy and health perceptions increased for both groups but not significantly. The participants' health behaviors showed significantly fewer physician visits and significantly increased time spent performing stretching and strengthening exercise and time spent performing aerobic exercise. No group differences were found in the frequency of arthritis physician visits. ^ The improvements seen immediately after the SASMEP participation were not reflected in the post one-year scores. No significant differences were found for the participants' health status or health behaviors one year following the education. Health status and health behaviors did not return below baseline scores after one year suggesting the participants' health, although not improved, did not deteriorate. Therefore, the SASMEP education provided short-term health benefits for older Hispanic adults with arthritis, but not long-term health benefits. ^

Implications of a theoretical framework on stress and burnout for the development of graduate nursing education curricula

This study had two purposes: (a) to develop a theoretical framework integrating and synthesizing findings of prior research regarding stress and burnout among critical care nurses (CCRNs), and (b) to validate the theoretical framework with an empirical study to assure a theory/research based teaching-learning process for graduate courses preparing nursing clinical specialists and administrators.^ The methods used to test the theoretical framework included: (a) adopting instruments with reported validity, (b) conducting a pilot study, (c) revising instruments using results of the pilot study and following concurrence of a panel of experts, and (d) establishing correlations within predetermined parameters. The reliability of the tool was determined through the use of Cronbach's Alpha Coefficient with a resulting range from.68 to.88 for all measures.^ The findings supported all the research hypotheses. Correlations were established at r =.23 for statistically significant alphas at the.01 level and r =.16 for alphas.05. The conclusions indicated three areas of strong correlation among the theoretical variables: (a) work environment stressor antecedents and specific stressor events were correlated significantly with subjective work stress and burnout; (b) subjective work stress (perceived work related stress) was a function of the work environment stressor antecedents and specific stressor events, and (c) emotional exhaustion, the first phase of burnout, was confirmed to be related to stressor antecedents and specific stressor events. This dimension was found to be a function of the work environment stressor antecedents, modified by the individual characteristics of work and non-work related social support, non-work daily stress, and the number of hours worked per week. The implications of the study for nursing graduate curricula, nursing practice and nursing education were discussed. Recommendations for further research were enumerated. ^

The usefulness and appropriateness of a federalist perspective as a theoretical construct for the study of government and civics at the secondary level

This dissertation is the formulation of an argument for the incorporation of a liberated federalism perspective as the foundational theoretical construct for the teaching and study of American government and civics at the secondary level. The argument asserts that the history of the nation, in terms of its basic view of government, has developed from a traditional federalist view to a natural rights view. Instruction of government and politics has paralleled that development. The argument further asserts that the current dependence on the natural rights perspective has contributed and helped legitimize, however unintentionally, the excessive levels of individualism, self-absorption, and uncivil behavior that is being experienced in our society today.^ The argumentation follows the dialectic form presented by Hegel of thesis, antithesis, and synthesis. That is, the thesis argues that the traditional federalist perspective would serve as a viable construct for the teaching of government and civics. In this portion of the argument, the republican model of political reality is presented. The antithesis promotes the natural rights perspective and relies on the political systems model for its theoretical approach. Finally, the synthesis argues that a liberated federalism perspective should be the foundational construct. Here, the argument presents its own model as a theoretical construct that is designed to assist teachers and curriculum materials writers in the development of American government and civics lessons and materials. ^

The relationship between the teacher's experience, the teacher's college major, and the teacher's level of education in predicting classroom attitudes in high school science students

A review of the literature reveals few research has attempted to demonstrate if a relationship exists between the type of teacher training a science teacher has received and the perceived attitudes of his/her students. Some of the teacher preparation factors examined in this study include the college major chosen by the science teacher, the highest degree earned, the number of years of teaching experience, the type of science course taught, and the grade level taught by the teacher. This study examined how the various factors mentioned, could influence the behaviors which are characteristic of the teacher, and how these behaviors could be reflective in the classroom environment experienced by the students.^ The instrument used in the study was the Classroom Environment Scale (CES), Real Form. The measured classroom environment was broken down into three separate dimensions, with three components within each dimension in the CES. Multiple Regression statistical analyses examined how components of the teachers' education influenced the perceived dimensions of the classroom environment from the students.^ The study occurred in Miami-Dade County Florida, with a predominantly urban high school student population. There were 40 secondary science teachers involved, each with an average of 30 students. The total number of students sampled in the study was 1200. The teachers who participated in the study taught the entire range of secondary science courses offered at this large school district. All teachers were selected by the researcher so that a balance would occur in the sample between teachers who were education major versus science major. Additionally, the researcher selected teachers so that a balance occurred in regards to the different levels of college degrees earned among those involved in the study.^ Several research questions sought to determine if there was significant difference between the type of the educational background obtained by secondary science teachers and the students' perception of the classroom environment. Other research questions sought to determine if there were significant differences in the students' perceptions of the classroom environment for secondary science teachers who taught biological content, or non-biological content sciences. An additional research question sought to evaluate if the grade level taught would affect the students' perception of the classroom environment. (Abstract shortened by UMI.) ^

The effect of vocational education on high school students in a large urban multicultural school district

The completion of and graduation from high school is a major problem that must be resolved. A 6% random sample of the students (1,059) who were in the 9th grade in Miami-Dade Public Schools, a large urban school district, September 1992, were selected for this study. The sample was divided into 2 groups, advanced academic and general track students. Each group was then divided into vocational and non-vocational. A causal comparative design was used to evaluate the results for graduate vs. non-graduate. The indicators were the program of study, attendance, standardized test scores, grade point average, ethnicity and gender. It was found that both advanced academic and general track students had significantly higher graduation rates at the .01 level when a vocational education program was part of their studies. All of the other indicators did not show any significant differences. If we arc to improve students educational outcomes and reduce the dropout rate, vocational education should be part of every student's education.^

A study of leadership behaviors for Breaking Ranks leaders in public secondary schools

This research will investigate what it will take to develop principals who will embrace the recommendations of reform as proposed by National Association of Secondary School Principals (NASSP, 1996) in the Breaking Ranks document. Breaking Ranks is based on the belief that it is within the dynamics of the school culture that principals must gain insight into strategies for improving the schools for which they are held responsible. Given this context, it is important to examine perspectives that are held by principals who lead schools that embrace the concepts of reform as proposed by NASSP, thereby, could be deemed “Breaking Ranks” schools. It is within these schools that the new role of the principal develops. NASSP has identified seven key recommendations for leadership development; “attributes that need nourishing” (p. 12) for the success of school reform. The seven recommendations are included in Breaking Ranks. ^ The purpose of this study is to identify and describe how principals put the seven recommendations into practice as they function in their schools. In addition, this study will gather information on the characteristics, support, skills, and training these principals identify as critical aspects and components of their success. This is a study of principal leadership at four high school sites where “Breaking Ranks” principals have been identified. ^ This research plan will be designed to utilize an inquiry-based process with a panel of experts and four “Breaking Ranks” principals. This study will describe: (1) how a panel of experts identify what they believe needs to be done in order to put the recommendations of the Breaking Ranks document into practice and their identification of principals who are breaking ranks; (2) how identified principals say they have been able to put the recommendations of the Breaking Ranks document into practice; (3) How both groups identify and describe: (a) the characteristics and behaviors of a “Breaking Ranks” principal; (b) the new leadership skills as described by the seven recommendations identified in the Breaking Ranks document; (c) the support necessary in order to meet the recommendations in the Breaking Ranks document; and (d) The training needed in order to become “Breaking Ranks” principals; and (4) how the process of creating “Breaking Ranks” principals can be described by experts who have studied it theoretically and principals who have demonstrated it in their schools. ^

What secondary English to speakers of other languages (ESOL) teachers know about social and academic language and instructional strategies for limited English proficient students

The purpose of this study was to examine what secondary English to Speakers of Other Languages (ESOL) teachers understand about social and academic language, what instructional strategies they use for Limited English Proficient (LEP) students, and how these concepts are operationalized in their daily practice. ^ This was a mixed method study incorporating both quantitative and qualitative data collection and interpretation. Written questionnaires and individual interviews addressed the questions on teachers' definitions of social and academic language and their strategy use. Classroom observations provided verification of their definitions and their descriptions of instruction for academic language. ^ Findings indicated that teachers' definitions of social and academic language were still developing and that there were ambiguities in identifying examples of social and academic language. The use of graphic organizers or visual supports, groups or peer partners, role play or drama, and modeling were the strategies teachers consistently listed for beginner, intermediate, advanced and multiple level classes. Additionally, teachers' descriptions of their instruction were congruent with what was observed in their classroom practice. ^ It appeared that this population of secondary ESOL teachers was in the process of evolving their definitions of social and academic language and were at different stages in this evolution. Teachers' definitions of language influenced their instruction. Furthermore, those who had clear constructs of language were able to operationalize them in their classroom instruction. ^