Johnson Karen E, Thurman Whitney A, Hoskote Ashwini R, Maughan Erin D
The University of Texas at Austin, School of Nursing, Austin, TX, USA.
George Mason University School of Nursing, Fairfax, VA, USA.
J Sch Nurs. 2025 Aug;41(4):478-495. doi: 10.1177/10598405231195655. Epub 2023 Aug 30.
Students in alternative high schools (AHSs) have higher levels of substance use and risky sexual behaviors than students in traditional high schools. In this mixed methods study, we examine school nurses' efforts in Texas AHSs to address substance use and sexual/reproductive health. The nurses addressed substance use and sexual reproductive health mostly at the individual level, after students initiated risky behaviors. Nurses' efforts were influenced by district, school, and community factors (e.g., understaffing, outdated programs that weren't evidence-based or tailored to AHS students' behaviors, and family involvement). Usually, nurses were not practicing to their full scope as outlined by the National Association of School Nurses Framework. Substance use was a common reason for AHS placement and could contribute to the school-to-prison pipeline, and AHSs did not always have Narcan on campus to address drug overdoses. Our findings suggest implications for providing equitable health services to this underserved, understudied student population.
替代高中（Alternative High Schools，AHSs）的学生比传统高中的学生有更高水平的物质使用和危险性行为。在这项混合方法研究中，我们考察了德克萨斯州替代高中的学校护士在解决物质使用以及性/生殖健康问题方面所做的努力。护士们大多是在学生开始出现危险行为后，在个体层面解决物质使用和性生殖健康问题。护士们的努力受到学区、学校和社区因素的影响（例如人员不足、缺乏循证或未针对替代高中学生行为量身定制的过时项目，以及家庭参与情况）。通常，护士们并未按照美国学校护士协会框架所概述的那样充分发挥其职能。物质使用是学生进入替代高中的常见原因，并且可能导致从学校到监狱的通道，而且替代高中校园内并不总是备有纳洛酮来应对药物过量情况。我们的研究结果表明了为这一服务不足、研究较少的学生群体提供公平健康服务的意义。
