Enhancing the Capacity of School Nurses to Reduce Excessive Anxiety in Children: Development of the CALM Intervention

Abstract

PROBLEM Excessive anxiety is among the most common psychiatric problems facing youth. Because anxious youth tend to have somatic complaints, many seek help from the school nurse. Thus, school nurses are in an ideal position to provide early intervention. This study addresses this problem and describes the plans to develop and test a new intervention (Child Anxiety Learning Modules; CALM), delivered by school nurses, to reduce child anxiety and improve academic functioning. METHODS An iterative development process including consultation with an expert panel, two open trials, and a pilot randomized controlled study comparing CALM to usual care is proposed. Feedback will be solicited from all participants during each phase and data on outcome measures will be provided by children, parents, teachers, and independent evaluators. FINDINGS Data will be collected on intervention satisfaction and feasibility. Primary outcomes that include child anxiety symptoms, classroom behavior, and school performance (e.g., attendance, grades, standardized test scores) will be collected at pre- and post-interventions and at a 3-month follow-up evaluation. CONCLUSIONS Pediatric anxiety is a common problem that school nurses frequently encounter. Consequently, they are well positioned to play a key role in enhancing access to behavioral health interventions to reduce anxiety and may therefore make a significant positive public health impact.

Research Priorities for School Nursing in the United Arab Emirates (UAE)

“…The remaining priorities identified in this study are also of importance to schoolchildren and school nursing practice, something well supported by previous studies (Dobrin, 2007; Drake et al, 2015; Hacker & Wessel, 1998; Kraft & Eriksson, 2015; Lightfoot & Bines, 2000; Wainwright, Thomas, & Jones, 2000; Wright, Giger, Norris, & Suro, 2013). Dobrin (2007) and Kraft and Eriksson (2015) reported that school nurses can play a key role in the identification and prevention of the child abuse, something that was confirmed by participants in this study.…”

“…Dobrin (2007) and Kraft and Eriksson (2015) reported that school nurses can play a key role in the identification and prevention of the child abuse, something that was confirmed by participants in this study. Also Drake, Stewart, Muggeo, and Ginsburg (2015) confirm that school nurses frequently encounter children with anxiety, and that they are well placed to address this issue. Finally, Wright, Giger, Norris, and Suro (2013) reported that school nurses can contribute significantly through their interventions to the enhancement of physical activity of schoolchildren thus reducing their body mass index and improving their health.…”

“…A growing number of studies report various health-care interventions targeting multiple health problems and issues facing schoolchildren. These include weight management strategies, managing chronic conditions such as asthma and diabetes, assessment and management of child abuse cases among others (Al-Yateem, Attia, AlYafei, Mohammed, & Mustafa, 2015; Drake, Stewart, Muggeo, & Ginsburg, 2015; Faro, Ingersoll, Fiore, & Ippolito, 2005; Hanson, Aleman, Hart, & Yawn, 2013; Kraft & Eriksson, 2015; Kubik & Lee, 2013; Mäenpää, Paavilainen, Åstedt-Kurki, & Åstedt-Kurki, 2013).…”

Mental health literacy of school nurses in the United Arab Emirates

“…those with chronic conditions, an ability to respond effectively to both promote mental health and to recognize developing mental illness is essential. The importance of the school nurse role in addressing both physical and mental health needs of students is well documented [ 5 , 20 , 27 , 41 ].…”

School Nurse Perceptions of Student Anxiety

“…With the expanding role of school nurses, and with excessive anxiety being the main mental health issue in their students, providing school nurses with specific training has potential to optimize school resources and care. Our own work, currently underway, is examining the feasibility of a six-session school nurse delivered intervention for anxious children based on the core components of CBT (Drake, Stewart, Muggeo, & Ginsburg, 2015). Preliminary data on the feasibility and acceptability of the intervention (referred to as Child Anxiety Learning Modules [CALM]) indicate that school nurses found CALM helpful and were able to meet individually with students despite their competing demands (with administrative support).…”