Background: Adolescents with overweight or obesity are at greater risk of having physical and psychosocial consequences. With increased disparities and inadequate literature on prevalence of adolescent weight status in rural Appalachia, there is potential for further complications. Unfortunately, adolescent obesity treatment options are often…

Background: We sought to determine the impact of school gardens and nutrition education on student fruit and vegetable consumption from limited-income communities in Alabama. Methods: Third grade students at 99 Alabama schools with and without gardens on-site were randomized to receive either nutrition education or to a wait-list control group.…

Background: In rural communities, understanding and improving school climate may benefit youth facing unique contextual challenges to well-being. As education research rarely focuses on rural schools, we aimed to examine school climate and student well-being with a particular focus on rural schools, compared to suburban schools. Methods:…

Background: School breakfast is an important nutritional component of a student's day. Many schools operate a school breakfast program, but high schools have low rates of participation. This study aimed to investigate the economic impact on school food service, of expanding the school breakfast program to increase participation in high schools.…

Background: In rural areas with health professional workforce shortages, telehealth offers an opportunity to address service gaps and meet the health needs of students. Few studies have examined telehealth implementation in rural schools. This study explores facilitators and barriers to the implementation of telehealth programs in rural schools…

Background: In this study, we examined moderate-to-vigorous physical activity (MVPA) of children in a school district serving children from low-income and minority households. Methods: This observational study was conducted in 8 rural elementary schools in South Carolina. Children (N = 719, age = 7.7 years, 48.0% girls, 88.0% African American)…

Background: Few studies examine why rural public schools have weaker policies and practices related to school nutrition environments compared to their urban counterparts. It is important to understand this disparity because federal school meal standards aim for children to access health-promoting nutrition environments. In this study, we identify…

Background: Childhood malnutrition is commonplace among poor rural communities in China. In 2012, China launched its first nationwide school-feeding program (SFP) to address this problem. This study examines the prevalence of malnutrition before and after the SFP and identifies possible reasons for the trends observed. Methods: Ordinary least…

Background: Adolescents frequently miss breakfast which may impact cognitive, academic, and health outcomes. This analysis describes the effect of a trial to assess school level changes to increase breakfast consumption on grade point average (GPA). Methods: Sixteen rural Minnesota high schools were randomized to a policy and environmental change…

Background: Mental health services in the United States public schools are an important component of the academic success of a student. Not all schools, however, have the necessary personnel and funding to offer such services. Methods: In this paper, we provide an analysis of data collected from schools in 3 geographic locations. Comparisons were…

Background: Concerns have been raised about the consequences of the COVID-19 pandemic on the mental health of adolescents during an important developmental and social period in their lives. This study examines the mental health impact of the pandemic on high school students shortly after closure of public schools in spring 2020, and whether this…

Background: Research on relationships between lifestyle behaviors and adiposity in school youth is potentially important for identifying subgroups at risk. This study evaluates the associations between waist circumference (WC) and objective measures of sedentary behavior (SB) in a sample of rural school adolescents. Methods: The sample included…

Background: Many students do not receive return to learn (RTL) services upon return to academics following a concussion. Methods: Using a mixed-methods approach, we conducted a survey of RTL practices and experiences in Washington State schools between January 2015 and June 2015. We then held a statewide summit of RTL stakeholders and used a…

Background: Previous studies of urban school-based health centers (SBHCs) have shown that SBHCs decrease emergency department (ED) utilization. This study seeks to evaluate the effect of SBHCs on ED utilization in a rural setting. Methods: This retrospective, controlled, quasi-experimental study used an ED patient data set from the Bassett…

Background: Practical tools are needed that reliably measure the complex physical activity (PA) and nutrition environments of elementary schools that influence children's health and learning behaviors for obesity prevention. The School Physical Activity and Nutrition-Environment Tool (SPAN-ET) was developed and beta tested in 6 rural Oregon…