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      Challenges and lessons learned in recruiting participants for school-based disease prevention programs during COVID-19

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          Abstract

          Schools provide an ideal setting for delivery of disease prevention programs due to the ability to deliver health education and counseling, including health behavior interventions, to large numbers of students. However, the remote and hybrid learning models that arose during the coronavirus (COVID-19) pandemic created obstacles to these efforts. In this article, we provide insights on collaborating with schools to deliver disease prevention programming during the height of the COVID-19 pandemic, and in subsequent years. We illustrate these strategies by drawing upon our firsthand research experiences engaging high schools in a school-based cancer prevention trial focused on sun safety. Delivery of a cluster-randomized trial of a school-based skin cancer prevention program was initiated in the spring of 2020 at the onset of the COVID-19 pandemic in the U.S. We present multilevel evaluation data on strategies used to reach schools remotely and share lessons learned that may inform similar approaches moving forward during times of crises. Although the COVID-19 pandemic interrupted school-based recruitment for this trial, enrollment improved one year later and did not appear to differ between rural and urban schools. Recruitment strategies and trial-related procedures were modified to address new challenges brought about by the pandemic. Despite the COVID-19 crisis altering US classrooms, disease prevention programming can continue to be offered within schools, given close community partnerships and new adaptations to the ways in which such programming and research are conducted.

          Highlights

          • Implementing School-based Recruitment for Skin Cancer Prevention Trial During COVID-19: Challenges and Lessons Learned.

          • Maintaining community ties in crises supports continued public health collaboration.

          • Policies may change in crises, requiring adaptations for school-based programming.

          • Crises can be occasions to modify programming, possibly improving future delivery.

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          Most cited references21

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          Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19 : A Meta-analysis

          Emerging research suggests that the global prevalence of child and adolescent mental illness has increased considerably during COVID-19. However, substantial variability in prevalence rates have been reported across the literature.
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            Learning loss due to school closures during the COVID-19 pandemic

            School closures have been a common tool in the battle against COVID-19. Yet, their costs and benefits remain insufficiently known. We use a natural experiment that occurred as national examinations in The Netherlands took place before and after lockdown to evaluate the impact of school closures on students’ learning. The Netherlands is interesting as a “best-case” scenario, with a short lockdown, equitable school funding, and world-leading rates of broadband access. Despite favorable conditions, we find that students made little or no progress while learning from home. Learning loss was most pronounced among students from disadvantaged homes. Suspension of face-to-face instruction in schools during the COVID-19 pandemic has led to concerns about consequences for students’ learning. So far, data to study this question have been limited. Here we evaluate the effect of school closures on primary school performance using exceptionally rich data from The Netherlands ( n ≈ 350,000). We use the fact that national examinations took place before and after lockdown and compare progress during this period to the same period in the 3 previous years. The Netherlands underwent only a relatively short lockdown (8 wk) and features an equitable system of school funding and the world’s highest rate of broadband access. Still, our results reveal a learning loss of about 3 percentile points or 0.08 standard deviations. The effect is equivalent to one-fifth of a school year, the same period that schools remained closed. Losses are up to 60% larger among students from less-educated homes, confirming worries about the uneven toll of the pandemic on children and families. Investigating mechanisms, we find that most of the effect reflects the cumulative impact of knowledge learned rather than transitory influences on the day of testing. Results remain robust when balancing on the estimated propensity of treatment and using maximum-entropy weights or with fixed-effects specifications that compare students within the same school and family. The findings imply that students made little or no progress while learning from home and suggest losses even larger in countries with weaker infrastructure or longer school closures.
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              School Closures During Social Lockdown and Mental Health, Health Behaviors, and Well-being Among Children and Adolescents During the First COVID-19 Wave : A Systematic Review

              School closures as part of broader social lockdown measures during the COVID-19 pandemic may be associated with the health and well-being of children and adolescents.
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                Author and article information

                Contributors
                Journal
                Contemp Clin Trials Commun
                Contemp Clin Trials Commun
                Contemporary Clinical Trials Communications
                Elsevier
                2451-8654
                24 November 2024
                December 2024
                24 November 2024
                : 42
                : 101399
                Affiliations
                [a ]Cancer Control and Population Sciences Division, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Dr, Salt Lake City, UT, 84112, USA
                [b ]Department of Dermatology, University of Utah, HELIX Bldg. 5050, 30 N Mario Capecchi Dr., Salt Lake City, UT, 84103, USA
                [c ]School of Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT, 84132, USA
                [d ]Department of Communication, University of Utah, 255 S Central Campus Dr., Rm 2400, Salt Lake City, UT, 84112, USA
                [e ]Klein Buendel, Inc., 1667 Cole Blvd STE 220, Lakewood, CO, 80401, USA
                [f ]Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
                [g ]Department of Population Health Sciences, University of Utah, Williams Building, Room 1N410, 295 Chipeta Way, Salt Lake City, 84112, Utah, USA
                [h ]Georgetown Lombardi Cancer Center, Georgetown University, 3800 Reservoir Rd NW, Washington DC., 20007, USA
                Author notes
                [* ]Corresponding author. Circle of Hope Dr, Rm 4509, Salt Lake City, UT, 84112, USA. Yelena.Wu@ 123456utah.edu
                Article
                S2451-8654(24)00146-7 101399
                10.1016/j.conctc.2024.101399
                11652739
                39698166
                693da352-8932-45df-ad2c-9615e94f0e42
                © 2024 The Authors. Published by Elsevier Inc.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 18 July 2024
                : 18 October 2024
                : 23 November 2024
                Categories
                Article

                school,randomized-controlled trial,skin cancer,prevention,youths

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