Faculty Bibliography

To test the hypothesis that participation in the School Breakfast Program by low-income children is associated with improvements in standardized achievement test scores and in rates of absence and tardiness, children in grades 3 through 6 were studied in the Lawrence, Mass, public schools, where the School Breakfast Program was begun at the start of the second semester 1986-1987 school year. The changes in scores on a standardized achievement test and in rates of absence and tardiness before and after the implementation of the School Breakfast Program for children participating in the program were compared with those of children who also qualified but did not participate. Controlling for other factors, participation in the School Breakfast Program contributed positively to the 1987 Comprehensive Tests of Basic Skills battery total scale score and negatively to 1987 tardiness and absence rates. These findings suggest that participation in the School Breakfast Program is associated with significant improvements in academic functioning among low-income elementary school children

As a preliminary step in the development of a school-based educational intervention to promote bicycle helmet use among children, focus group encounters were conducted with fourth, fifth, and sixth graders at three elementary schools in the Boston, Mass, area. Analysis of transcripts of encounter tape recordings indicated that (1) the prevalence of helmet ownership and use was low, (2) children were concerned that helmet use would invite derision from their peers, and (3) children tended to respect other children who wore helmets. We concluded that focus groups can be useful in conceptualizing health education interventions and suggest that school-based peer-led bicycle helmet programs may be effective in developing normative change toward helmet use among elementary schoolchildren

The divorce rate in the United States is currently half the rate of marriages. Whether this rate will continue is not known. Millions of American children have already experienced their parents' divorce and millions more are likely to share the experience in the future. This makes divorce a problem that frequently appears in a pediatrician's patient population. Most children of divorce will experience it at the least as a potent transient stress that disrupts virtually all aspects of their lives. Many will accommodate to their new life circumstances successfully, but a substantial percentage will suffer long-term negative effects. Many of the problems of these children and their families can be anticipated, prevented, or alleviated by thoughtful and timely intervention. The pediatrician can be helpful by serving as the child's advocate, offering anticipatory guidance, helping the family weather the turmoil of the acute stage, screening for maladjustment or maladaptive behavior of children and parents, providing counseling, and referring the children and family for more specialized mental health input when indicated

Intentional violence is a leading cause of mortality among teenagers and young adults. Whereas violence-related mortality is fairly well recognized among medical practitioners, the literature contains little information regarding violence-related morbidity or medically oriented approaches to preventing violence. Violence-related morbidity data for adolescents from one community revealed that 50% of the male respondents experienced at least one pushing or shoving fight per year, and that by age 16 25% had already been threatened by a weapon. These findings provided the impetus to incorporate regular violence counseling into the routine health care maintenance of adolescents at one health center. Our approach to violence-prevention counseling, obtaining a history of violence, and devising a treatment plan is described and advocated