Injury Prevention Programming in Missouri Schools

BACKGROUND:  School-age children are more likely to be seriously affected by injury than any other health threat. School nurses serve a critical function for injury control, both in treating injuries and preventing injury events within and away from school. The coordinated school health model (CSHM) addresses issues related to child and adolescent health and emphasizes the development of lifelong healthy habits and avoidance of health/behavioral decisions which will have adverse effects on health. The objective of the study was to describe the injury control efforts of school nurses in Missouri public schools, with specific interest in the degree to which the presence of a CSHM was associated with injury prevention activities.

METHODS:  A representative, State-wide online survey, developed in collaboration with a subcommittee of the Missouri Injury and Violence Prevention Advisory Committee (MIVPAC) to learn about injury prevention activities in Missouri schools, was administered to all 1,568 Missouri school nurses during May, 2011. Descriptive statistics were computed and chi-square tests were used to compare proportions between those schools with and without a CSHM.

RESULTS:  Of the 1,568 nurses invited, 884 responded (56%) and geographically represented the state of Missouri. A majority of nurses use a system to keep track of injuries (88.9%), know how to address patterns of injury (69.5%), and often review available information to look for patterns of injury (67.1%). A significant difference between schools with and without a CSHM was observed for knowing how to address patterns (p<.001) and reviewing information (p<.001). When asked to rank the priority of 13 injuries for the school, playground injuries and falls (50.4%) were of most concern to school nurses, followed by sports injuries (17.8%). Many injury topics were covered in a class setting, with bullying, drug use, and playground safety leading the list. In many cases, schools with a CSHM were more likely to spend class time covering injury topics than those without a CSHM. Significant differences between schools with and without a CSHM were also observed for opinions about injury prevention efforts: understand the process for adding injury prevention topics to curriculum (p<.001), school supports professional development (p<.001), injury prevention activities change from year to year (p<.001), and injury prevention programs meet the needs of the community (p<.05).

CONCLUSIONS:  Our results indicate that school nurses are highly involved with injury prevention efforts. The presence of a CSHM is positively associated with aspects of injury control in Missouri schools.