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Since the inception of the 1974 Education for all Handicapped Children legislation, the number of students referred and placed in special education has been steadily rising. The largest increase is in the learning disabilities category. With the reauthorization of the Individuals with Disabilities Education Improvement Act of 2004 and the federal requirements for schools under the No Child Left Behind law, schools are required to take a closer look at their rising special education numbers and identify alternative solutions for children's needs other than a certain placement in special education. There are different levels of variables that influence a teacher's decision to refer a student to special education. This study aimed to understand the mesosystem school variables that influence this process. Using two scales, the Organizational Health Inventory for Elementary Schools (OHI-E) and the Collective Efficacy Scale (CE-Scale) this study used purposive sampling to survey ten elementary school faculties in a large suburban district in Virginia. LD prevalence rates were collected for all elementary schools in the district. Data was analyzed to answer the following questions: (a) How does school organizational health correlate with the number of students referred to special education in a given school? (b) How does collective teacher efficacy correlate to the number of students referred for special education services? The overall return rate for the survey was 87% with 490 teacher surveys completed. Teachers did not have many teaching years in their buildings. Teachers with twelve or more teaching years experience were more likely to refer students to special education. Collective teacher efficacy scores were correlated to school health scores but not to LD prevalence rates. Higher institutional integrity was seen in smaller schools. Title I schools did not correlate with higher LD prevalence rates. Two variables predicted referrals to special education; years teaching in combination with teacher efficacy resulted in greater referrals to special education. The findings of this study may aid educational leaders in making sound changes within school environments to affect the school's LD prevalence rate, addressing particularly teacher efficacy and referral habits of more experienced teachers. / Ed. D.

Objective: Measure the association between School Health Index (SHI) scores and student health outcomes related to physical activity (PA) and nutrition. Design: Cross-sectional design utilized to collect SHI scores and administer questionnaires regarding nutrition and PA behaviors, knowledge and the home environment in 5 counties of southwest Virginia. Participants: Staff, administrators and students (grades 4, 7, 10; n = 1094) in 27 schools in 5 school divisions. Main Outcome Measures: SHI scores were obtained from school surveys while LWP score, student BMI percentile and fitness (mile run, PACER) measures were obtained from school data. The School Physical Activity and Nutrition questionnaire was used to measure student nutrition, PA behaviors and knowledge, and the home food environment was measured through a validated questionnaire. Analysis: Two-sided Pearson's correlation (p<0.05) measuring associations between SHI score and student health outcomes of BMI percentile, one mile/PACER, nutrition and PA behaviors and health knowledge and beliefs. Results: SHI was negatively correlated with BMI percentile for 4th grade students (-0.472, p<0.001) and positively correlated with BMI percentile for 8th grade students (0.679, p<0.001). SHI was positively correlated with 4th grade mile run (0.412, p<0.001), 8th grade mile run (0.218, p<0.001) and 4thgrade PACER (0.414, p<0.001). Conclusion: Behavioral influences are multifactorial and factors outside the school environment may affect the correlations between these variables. Application: Data concerning the influence of the school health environment can be used towards making evidence-based changes to school health programs. / Master of Science

Abstract Dawn Arlotta (The Effects of HealthMPowers on the Levels of Physical Activity among Students in 13 Georgia Public Schools) (Under the direction of Dr. Marshall Kreuter and Dr. Derek Shendell) Objectives. This study evaluated a school based health and physical education program conducted in nine elementary and four middle schools in seven Metro-Atlanta school districts in Georgia. HealthMPowers served 5,644 students last year and approximately 15,000 students over the 3 year intervention. Methods. Quantitative programmatic data were collected by HealthMPowers before the intervention started (pre, 2004) and again three years later (post, 2007). HealthMPowers worked with these schools for the entire three year period and collected post Program Design and post-intervention fitness data in spring 2007. Results. The nine participating elementary schools each demonstrated an increase in student fitness levels for the fourth and fifth grades. The four middle schools demonstrated an increase in student fitness levels in at least one grade, which varied by school. Conclusion. Our findings suggested school programs can be effective in increasing physical activity and fitness scores and supports broader implementation of known successful programs. INDEX WORDS: Physical Activity, Youth, School Health Index, Coordinated School Health Program, Obesity, FITNESSGRAM, Physical Fitness Testing, Physical Education.

Aim: The overall aim of this thesis is to explore School health nursing through school nurses’ descriptions of schoolchildren’s health and to analyse factors influencing the recording of school-children’s health in the School Health Record (SHR). An additional aim is to evaluate fam-ily nursing interventions as a tool for the school nurses in the School Health Service (SHS). Methods: The thesis comprises four papers. A combination of qualitative and quantita-tive methods was used through individual interviews with a strategic sample of school nurses (n=12) (PI), a national survey to a representative sample of school nurses (n=129) (PII, III) and the implementation of family nursing models developed in Canada with girls in their early ad-olescence with recurrent health complaints and their families (n=4) in co-operation with their school nurses (n=2) (PIV). The Strengths and Difficulties Questionnaire (SDQ) was used as pre and post test. Evaluation interviews were conducted with the families and the nurses separate-ly. Qualitative content analyses were used to analyze the interview text with the school nurs-es and the families. Manifest content analysis was used to analyze the free text answers of the survey and the evaluation interview with the school nurses. Descriptive statistical analyses were used to describe demographic data in all four papers. The SDQ was hand-scored statistically. Findings: The findings showed that nurses judged the schoolchildren’s mental health as dete-riorated, especially in socially disadvantaged areas and more generally among girls expressed as psychosomatic symptoms. Individual factors related to lifestyle affected the schoolchildren’s physical health, and the mental health was, to a large extent, affected by the school environ-ment and family relations. The latter seemed to be the most important factor affecting school-children’s mental health. The basis for the school nurses judgement of the physical health was health check-ups and the health dialogues. Spontaneous visits were more commonly used to judge the mental health. Recording schoolchildren’s mental health was a challenge for school nurses. Difficulties were related to ethical considerations, tradition, lack of time and the im-proper structure of the SHR. Fears of marking the schoolchild for life related to the schoolchild itself, the parents or to other authorities/successive caregivers were brought up as hinders for recording mental and social health. Family sessions may be useful within the profession when handling recurrent health complaints among adolescence girls. The girls and their families ex-perienced relief, they felt confirmed and that their feelings and reactions were normal in that situation. The families became aware of their own strengths and possibilities and this was sup-ported by the SDQ which showed an increased well-being. The school nurses valued this way of working and meant that the sessions seemed to start a changing process within the families. Conclusions: The results indicate that school nurses have a deep knowledge about schoolchil-dren’s health which is not used to its full potential in a public health perspective. However, the experienced difficulties recording schoolchildren’s mental health seem obvious, which would de-mand developing the SHR for the needs of today. Family sessions in SHS with the school nurse as a collaborator with the family seemed useful and may be transferable to other health problems expressed by the schoolchildren. Bronfenbrenner’s ecological systems theory and other models for health determinants are used to illustrate the school nurse as a mediator working on the bridge over different health streams with schoolchildren’s health on an individual and a population level.

ABSTRACT Lifestyle factors related to overweight, obesity, and Type 2 diabetes are currently in the forefront of health issues affecting children and adolescents. Schools have been considered important venues for disseminating health education and promotion programs. Some investigators, however, contend that school-based programs have only seen modest success over the last two decades. Typically short-term, school-based interventions do not address program sustainability or larger social issues such as socioeconomic status (SES). A growing body of literature suggests there is value in collaborative efforts between university researchers and communities as these relationships can help build the capacity of the school and community. The Coordinated School Health Program (CSHP) model was developed as a mechanism to build the organizational capacity of schools to facilitate, integrate and sustain health education and promotion efforts to improve the health of youth in our nation. The purpose of the current study was to assess a mid-western middle school's capacity to sustain a previously implemented Type 2 diabetes prevention program. An instrumental case study design was utilized. A total of 19 interviews were conducted. Additionally, observations and documents related to school policies and procedures were reviewed. The four infrastructures of the CSHP framework were used as predetermined categories into which data were coded. This study found that there was potential for the school to sustain the Type 2 diabetes program within the framework of the CSHP Model. The school already had in place five of the eight CSHP components. The three remaining components could be implemented if several issues were addressed. First, there were many myths and misconceptions regarding the purpose and costs of a CSHP. Education for district administrators, school faculty and staff, as well as the community, would be vital. Concerns regarding personnel to implement a CSHP were expressed. A dedicated health course would also need to be implemented. When planning health related interventions that will be implemented in school-based settings researchers should seriously consider implementing a CSHP prior to employing their short-term programs. If programs can be planned with sustainability in mind, there is potential for greater health outcomes for school-aged children and adolescents.

Aim: The overall aim of this thesis is to explore School health nursing through school nurses’ descriptions of school children’s health and to analyse factors influencing the recording of schoolchildren’s health in the School Health Record (SHR). An additional aim is to evaluate family nursing interventions as a tool for the school nurses in the School Health Service (SHS).Methods: The thesis comprises four papers. A combination of qualitative and quantitative methods was used through individual interviews with a strategic sample of school nurses (n=12) (PI), a national survey to a representative sample of school nurses (n=129) (PII, III) and the implementation of family nursing models developed in Canada with girls in their early adolescence with recurrent health complaints and their families (n=4) in co-operation with their school nurses (n=2) (PIV). The Strengths and Difficulties Questionnaire (SDQ) was used as pre and post test. Evaluation interviews were conducted with the families and the nurses separately. Qualitative content analyses were used to analyze the interview text with the school nurses and the families. Manifest content analysis was used to analyze the free text answers of the survey and the evaluation interview with the school nurses. Descriptive statistical analyses were used to describe demographic data in all four papers. The SDQ was hand-scored statistically.Findings: The findings showed that nurses judged the schoolchildren’s mental health as deteriorated, especially in socially disadvantaged areas and more generally among girls expressed as psychosomatic symptoms. Individual factors related to lifestyle affected the schoolchildren’s physical health, and the mental health was, to a large extent, affected by the school environment and family relations. The latter seemed to be the most important factor affecting schoolchildren’s mental health. The basis for the school nurses judgement of the physical health was health check-ups and the health dialogues. Spontaneous visits were more commonly used to judge the mental health. Recording schoolchildren’s mental health was a challenge for school nurses. Difficulties were related to ethical considerations, tradition, lack of time and the improper structure of the SHR. Fears of marking the schoolchild for life related to the schoolchild itself, the parents or to other authorities/successive caregivers were brought up as hinders for recording mental and social health. Family sessions may be useful within the profession when handling recurrent health complaints among adolescence girls. The girls and their families experienced relief, they felt confirmed and that their feelings and reactions were normal in that situation. The families became aware of their own strengths and possibilities and this was supported by the SDQ which showed an increased well-being. The school nurses valued this way of working and meant that the sessions seemed to start a changing process within the families.Conclusions: The results indicate that school nurses have a deep knowledge about schoolchildren’s health which is not used to its full potential in a public health perspective. However, the experienced difficulties recording schoolchildren’s mental health seem obvious, which would demand developing the SHR for the needs of today. Family sessions in SHS with the school nurse as a collaborator with the family seemed useful and may be transferable to other health problems expressed by the schoolchildren. Bronfenbrenner’s ecological systems theory and other models for health determinants are used to illustrate the school nurse as a mediator working on the bridge over different health streams with schoolchildren’s health on an individual and a population level. / Syfte: Avhandlingens övergripande syfte är att undersöka skolsköterskors uppfattning om skolbarns hälsa och att analysera faktorer som påverkar dokumentation av skolbarns hälsa i skolhälsovårdsjournalen. Ett ytterligare syfte är att utvärdera modeller för familjeinterventioner som redskap för skolsköterskor i skolhälsovård.Metoder: Avhandlingen består av fyra delarbeten. En kombination av kvalitativa och kvantitativa metoder användes. I delarbete I genomfördes intervjuer med ett strategiskt urval av skolsköterskor (n=12). Intervjuerna analyserades med kvalitativ innehållsanalys. I delarbeten II och III distribuerades en nationell enkät till ett representativt urval av Sveriges skolsköterskor (n=129). Manifest innehållsanalys användes vid analys av de öppna frågorna. I delarbete IV genomfördes en interventionsstudie med familjesamtal, inspirerad av modeller för familjefokuserad omvårdnad utvecklade i Kanada. Skolflickor i tidig adolescens med återkommande subjektiva hälsoproblem (n=4) och deras föräldrar i samarbete med deras verksamma skolsköterskor (n=2) ingick i studien. Separata utvärderingsintervjuer genomfördes med familjer och skolsköterskor. Intervjuerna analyserades med kvalitativ och manifest innehållsanalys respektive. The Strengths and Difficulties Questionnaire (SDQ) användes som före/efter test vid interventionen och resultatet bearbetades statistiskt manuellt. Deskriptiv statistik användes för analys av demografisk data i samtliga delarbeten.Resultat: Resultatet visade att skolsköterskorna bedömde skolbarnens mentala hälsa som försämrad särskilt bland flickor och i socioekonomiskt utsatta områden. Individuella livsstilsfaktorer påverkade skolbarnens fysiska hälsa och den mentala hälsan var i stor utsträckning påverkad av skolmiljö och familjerelationer. Det sistnämnda verkade vara den mest betydelsefulla påverkansfaktorn för skolbarnens mentala hälsa. Bedömningen av den fysiska hälsan baserades på hälsokontroller och hälsosamtal medan spontana besök var vanligare för bedömning av den mentala hälsan. Dokumentation av mentala hälsa var en utmaning för skolsköterskorna. Svårigheterna kunde relateras till etiska överväganden, tradition och tidsbrist samt till skolhälsovårdsjournalens struktur som inte ansågs uppfylla dagens krav. Skolsköterskorna uttryckte en rädsla för att journalanteckningarna skulle märka skolbarnet för livet. Framtida tolkningar relaterade till skolbarnet själv, föräldrar eller andra/påföljande vårdgivare uttrycktes som hinder för att dokumentera mental och social hälsa. Familjesamtal visade sig vara användbara i skolhälsovården. De medverkande flickorna och deras familjer kände sig bekräftade i att deras känslor och reaktioner var normala. De sade sig bli medvetna om egna styrkor och möjligheter vilket styrktes av SDQ som visade ett ökat välbefinnande efter sammankomsterna, både hos skolbarnen och hos föräldrarna. Skolsköterskorna var positiva till att arbeta med familjesamtal och upplevde sig mer som samverkanspartner än som expert. Samtalen ledde till att en förändringsprocess startade i familjerna enligt skolsköterskorna.Slutsatser: Resultatet indikerar att skolsköterskor har en djup kunskap om skolbarns hälsa som sannolikt kunde tas tillvara på ett bättre sätt ur ett folkhälsoperspektiv på såväl nationell som lokal nivå. Behovet av att utveckla skolhälsovårdsjournalen efter dagens behov och fördjupad kunskap om de upplevda svårigheterna att dokumentera skolbarns mentala hälsa är uppenbar. Familjesamtal, där skolsköterskan intar en roll som samverkanspartner, visade sig användbara och kan sannolikt överföras till andra hälsoproblem bland skolbarn. Bronfenbrenners utvecklingsekologiska systemteori och andra modeller för hälsodeterminanter används för att illustrera skolsköterskans arbete med skolbarns hälsa på såväl en individuell nivå som folkhälsonivå.

INTRODUÇÃO: A falta da correção óptica recentemente foi reconhecida como importante causa de baixa visão e parece ser um problema fácil de ser resolvido com o uso de óculos. No entanto, a falta da correção óptica é um problema complexo do seu diagnóstico ao tratamento, envolvendo a procura e alcance da assistência médica, além da confecção e uso dos óculos. OBJETIVOS: Determinar a frequência da necessidade de correção óptica em escolares; determinar a influência do absenteísmo no estudo da frequência da necessidade de correção óptica e suas causas; determinar o impacto da reconvocação dos faltosos na cobertura do atendimento oftalmológico; verificar cobertura oftalmológica prévia; verificar uso da correção óptica prescrita e causas de abandono de óculos. MÉTODO: Foi realizado um estudo transversal analítico. Escolares de 7 a 10 anos do ensino público de Guarulhos foram triados e encaminhados para exame oftalmológico na Campanha Olho no Olho 2006 e 2007. RESULTADOS: Foram triados 40.197 escolares e encaminhados 11.741 escolares com suspeita de problemas visuais. O absenteísmo na primeira convocação foi 42.5% e na reconvocação foi 62.2%. A Campanha alcançou 73.6% dos escolares encaminhados. A reconvocação ampliou a cobertura do projeto em 16.1%. A falta de orientação (não ter recebido aviso ou guia de encaminhamento) foi a razão mais frequente (35.6%) alegada para o não comparecimento, seguida de trabalho (20.6%) e doença (12.4%). A necessidade de óculos não foi fator associado ao comparecimento. Para 60.2% dos escolares foi a primeira oportunidade de exame ocular, sendo que 27.3% procuraram mas não tiveram acesso a consulta médica. Dos 1.379 escolares que já haviam feito exame, 48.3% utilizaram o SUS e 1.029 receberam prescrição de óculos em exame prévio. Destes, 899 (87.4%) fizeram os óculos e apenas 590 (57.3%) usavam os óculos no dia do exame. Dos óculos doados na Campanha, 84.7% dos escolares utilizavam a correção óptica após um ano. A estimativa da frequência da necessidade de correção óptica, na população estudada, foi de 6.9%. CONCLUSÕES: O erro refracional não corrigido foi a maior causa de baixa acuidade visual entre os escolares. A Campanha foi a primeira oportunidade de exame ocular para a maioria dos escolares. Existe uma parcela de pais que não leva seus filhos para exame, mesmo com oferecimento de facilidades (acesso, transporte, alimentação, duas oportunidades diferentes de exame gratuito realizado em fins de semana e doação de óculos). O absenteísmo poderia ser evitado em 87,1% dos casos, com melhor estruturação da primeira convocação. A reconvocação não é recomendada quando os recursos financeiros são escassos / INTRODUCTION: The lack of optical correction was recently recognized as an important cause of low vision and it seems to be an easy problem to be solved with the use of spectacles. However, it is a complex problem from its diagnosis to treatment, which includes medical assistance searching and finding, and spectacles acquisition and use. PURPOSES: To determine the frequency of optical correction need; to determine the impact of the recall of those absent in the ophthalmologic service coverage and its causes; to check the previous ophthalmologic coverage; to check the use of the prescribed optical correction and causes to neglect the use of spectacles. METHOD: An analytical cross-sectional study was conducted. Students between 7 and 10 years old of public education from Guarulhos were screened and referred to ophthalmologic exam in the Eye to Eye Campaign 2006 and 2007. RESULTS: 40.197 students were screened and 11.741 (29,2%) were referred with suspicion of visual problems. The absenteeism in the first call was 42.5% and in the recall 62.2%. The Campaign reached 73.6% of the referred students. The recall expanded the project coverage in 16.1%. The lack of guidelines (parents did not receive notification or referral guide) was the most frequent reason (35.6%) provided by parents for the non attendance, followed by work (20.6%) and disease (12.4%). The need of glasses was not related to the attendance. For 60.2% of the students, it was the first opportunity for ophthalmological exam, whereby 27.3% searched but did not have access to a medical visit. Among the 1.379 students who had already performed an exam, 48.3% used the Public Health System and 1.029 received prescription of glasses in the previous exam. From those, 899 (87.4%) made their glasses and only 590 (57.3%) were wearing glasses on the day of the exam. From the donated spectacles in the Campaign, 84.7% of the students were using the donated optical correction after one year. The estimate of optical correction need within the studied population was 6.9%. CONCLUSIONS: The uncorrected refractive error was the main cause of low visual acuity among students. The Campaign was the first opportunity of ocular exam for most of them. A significant number of parents did not take their children for ophthalmological exams, even when facilities (access, free transportation, meal, two different opportunities of free exam over the weekend and spectacle donation) were offered. For 87.1% of the absenteeism cases, the difficulties could have been overcome via improved structuring of the first call. A recall is not recommended when financial resources are low

Made available in DSpace on 2017-07-10T14:17:19Z (GMT). No. of bitstreams: 1 Gilson_ silva.pdf: 4464162 bytes, checksum: c573dcc95dd33cd17067510f8e04cb9f (MD5) Previous issue date: 2016-08-25 / The School Health Program (Programa Saúde na Escola - PSE) established in 2007 by the Ministries of Health and Education, aims to increase access of the school community to health services, contribute to the integral formation of students through promotion, prevention and health care, and address vulnerabilities that could compromise the full development of children, adolescents and youth. The aim of this study was to analyze the actions for the implementation of the School Health Program in municipalities of the Regional Education Center of Cascavel / PR and the 10th Region of Health in Paraná, in the view of managers. The specific objectives were to recognize the action planning, monitoring and evaluation for the development of PSE, from the understanding of managers; characterize the actions developed in PSE in the municipal districts studied, and identify the relationship between the sectors involved in the implementation of PSE. It is an exploratory study, conducted through field research. Quantitative data were collected, available on the website of the Ministry of Education in accordance with the municipalities, and qualitative data through interviews with managers of the PSE of the Departments of Education and Health, as well as records in field diaries. Quantitative data were divided into tables and frequency tables; those that were produced in interviews and field diaries were submitted to content analysis in the form of thematic analysis. After this process the data were subjected to triangulation sources as a method of analysis. Research subjects were 15 managers, eight from the area of health, seven from education. It is important to note that among the health managers were nurses, and between education managers were pedagogues. Triangulation of sources showed the activities for planning, evaluation and monitoring of the PSE, as well as the actions undertaken in the development of PSE and the intersectoral approach experienced by managers in the development of PSE. Important to note is that the evaluation of growth and development of students is the most frequent objective set in component I. Among the PSE components, the weakest is component III, used for the training of those involved in the program, and is also the least developed and yet to be agreed. It was concluded that the PSE is deployed in the cities studied, however, at various stages. Managers say that they feel prepared for the development of PSE, which is in contradiction with the data available in SIMEC (Integrated Planning, Budget and Finance of the Ministry of Education in Brazil) where the actions for training were less evident. Municipalities have been engaged in development activities in order to ensure comprehensive care, so that the intersectoral approach has become an important strategy for the implementation of welfare and educational activities directed at the health of schoolchildren. However, the actions of component I were the most visible, which may indicate that the focus remains on the biological aspect to implement the PSE in the studied reality. / O Programa Saúde na Escola (PSE), instituído em 2007, pelos Ministérios da Saúde e da Educação, objetiva ampliar o acesso da comunidade escolar aos serviços de saúde, contribuir para a formação integral dos estudantes, por meio de ações de promoção, prevenção e atenção à saúde, e enfrentar as vulnerabilidades que podem comprometer o pleno desenvolvimento de crianças, adolescentes e jovens. O objetivo geral deste estudo foi analisar as ações para implantação do Programa Saúde na Escola, em municípios do Núcleo Regional de Educação Cascavel/PR e da 10ª Regional de Saúde no Paraná, na ótica dos gestores; os objetivos específicos foram reconhecer as ações de planejamento, avaliação e monitoramento para o desenvolvimento do PSE, a partir da compreensão dos gestores; caracterizar as ações desenvolvidas no PSE, nos municípios estudados, e identificar a relação entre os setores envolvidos na implantação do PSE. Trata-se de estudo exploratório, realizado por meio de pesquisa de campo. Foram coletados dados quantitativos, disponíveis no site do Ministério da Educação, em termos de pactuações dos municípios, e dados qualitativos, por meio de entrevistas com os gestores do Programa Saúde na Escola das Secretarias de Educação e Saúde, além de registros em diários de campo. Os dados quantitativos foram distribuídos em quadros e em tabelas de frequência; aqueles que foram produzidos nas entrevistas e nos diários de campo submeteram-se à análise de conteúdo na modalidade de análise temática. Após este processo foram submetidos à triangulação de fontes, como método de análise. Foram sujeitos de pesquisa 15 gestores, oito da área da saúde, sete da educação. Destacam-se, entre os gestores da saúde, os enfermeiros e, entre os da educação, os pedagogos. A triangulação das fontes mostrou as atividades para o planejamento, avaliação e monitoramento do PSE, bem como as ações levadas a efeito no desenvolvimento do PSE e a intersetorialidade vivenciada pelos gestores no desenvolvimento do PSE. Destacaram-se as ações previstas no componente I, voltadas para a avaliação do crescimento e desenvolvimento dos escolares como as mais frequentes. Dentre os componentes do PSE, o de maior fragilidade é o componente III, para a formação dos envolvidos no programa, configurando-se no menos pactuado e desenvolvido. Conclui-se que o PSE está implantado nos municípios estudados, porém, em estágios diferenciados. Os gestores afirmam que se sentem preparados para o desenvolvimento do PSE, o que está em contradição com os dados disponíveis no Simec, em que as ações para formação foram as menos evidenciadas. Os municípios têm se empenhado no desenvolvimento de ações, com vistas a garantir a integralidade da assistência, de forma que a intersetorialidade tornou-se uma estratégia importante para implementação de ações assistenciais e educativas, direcionadas para a saúde dos escolares. Entretanto, as ações do componente I foram as mais visibilizadas, o que pode indicar que persiste o foco no aspecto biológico ao se implementar o PSE na realidade estudada.

INTRODUÇÃO: A falta da correção óptica recentemente foi reconhecida como importante causa de baixa visão e parece ser um problema fácil de ser resolvido com o uso de óculos. No entanto, a falta da correção óptica é um problema complexo do seu diagnóstico ao tratamento, envolvendo a procura e alcance da assistência médica, além da confecção e uso dos óculos. OBJETIVOS: Determinar a frequência da necessidade de correção óptica em escolares; determinar a influência do absenteísmo no estudo da frequência da necessidade de correção óptica e suas causas; determinar o impacto da reconvocação dos faltosos na cobertura do atendimento oftalmológico; verificar cobertura oftalmológica prévia; verificar uso da correção óptica prescrita e causas de abandono de óculos. MÉTODO: Foi realizado um estudo transversal analítico. Escolares de 7 a 10 anos do ensino público de Guarulhos foram triados e encaminhados para exame oftalmológico na Campanha Olho no Olho 2006 e 2007. RESULTADOS: Foram triados 40.197 escolares e encaminhados 11.741 escolares com suspeita de problemas visuais. O absenteísmo na primeira convocação foi 42.5% e na reconvocação foi 62.2%. A Campanha alcançou 73.6% dos escolares encaminhados. A reconvocação ampliou a cobertura do projeto em 16.1%. A falta de orientação (não ter recebido aviso ou guia de encaminhamento) foi a razão mais frequente (35.6%) alegada para o não comparecimento, seguida de trabalho (20.6%) e doença (12.4%). A necessidade de óculos não foi fator associado ao comparecimento. Para 60.2% dos escolares foi a primeira oportunidade de exame ocular, sendo que 27.3% procuraram mas não tiveram acesso a consulta médica. Dos 1.379 escolares que já haviam feito exame, 48.3% utilizaram o SUS e 1.029 receberam prescrição de óculos em exame prévio. Destes, 899 (87.4%) fizeram os óculos e apenas 590 (57.3%) usavam os óculos no dia do exame. Dos óculos doados na Campanha, 84.7% dos escolares utilizavam a correção óptica após um ano. A estimativa da frequência da necessidade de correção óptica, na população estudada, foi de 6.9%. CONCLUSÕES: O erro refracional não corrigido foi a maior causa de baixa acuidade visual entre os escolares. A Campanha foi a primeira oportunidade de exame ocular para a maioria dos escolares. Existe uma parcela de pais que não leva seus filhos para exame, mesmo com oferecimento de facilidades (acesso, transporte, alimentação, duas oportunidades diferentes de exame gratuito realizado em fins de semana e doação de óculos). O absenteísmo poderia ser evitado em 87,1% dos casos, com melhor estruturação da primeira convocação. A reconvocação não é recomendada quando os recursos financeiros são escassos / INTRODUCTION: The lack of optical correction was recently recognized as an important cause of low vision and it seems to be an easy problem to be solved with the use of spectacles. However, it is a complex problem from its diagnosis to treatment, which includes medical assistance searching and finding, and spectacles acquisition and use. PURPOSES: To determine the frequency of optical correction need; to determine the impact of the recall of those absent in the ophthalmologic service coverage and its causes; to check the previous ophthalmologic coverage; to check the use of the prescribed optical correction and causes to neglect the use of spectacles. METHOD: An analytical cross-sectional study was conducted. Students between 7 and 10 years old of public education from Guarulhos were screened and referred to ophthalmologic exam in the Eye to Eye Campaign 2006 and 2007. RESULTS: 40.197 students were screened and 11.741 (29,2%) were referred with suspicion of visual problems. The absenteeism in the first call was 42.5% and in the recall 62.2%. The Campaign reached 73.6% of the referred students. The recall expanded the project coverage in 16.1%. The lack of guidelines (parents did not receive notification or referral guide) was the most frequent reason (35.6%) provided by parents for the non attendance, followed by work (20.6%) and disease (12.4%). The need of glasses was not related to the attendance. For 60.2% of the students, it was the first opportunity for ophthalmological exam, whereby 27.3% searched but did not have access to a medical visit. Among the 1.379 students who had already performed an exam, 48.3% used the Public Health System and 1.029 received prescription of glasses in the previous exam. From those, 899 (87.4%) made their glasses and only 590 (57.3%) were wearing glasses on the day of the exam. From the donated spectacles in the Campaign, 84.7% of the students were using the donated optical correction after one year. The estimate of optical correction need within the studied population was 6.9%. CONCLUSIONS: The uncorrected refractive error was the main cause of low visual acuity among students. The Campaign was the first opportunity of ocular exam for most of them. A significant number of parents did not take their children for ophthalmological exams, even when facilities (access, free transportation, meal, two different opportunities of free exam over the weekend and spectacle donation) were offered. For 87.1% of the absenteeism cases, the difficulties could have been overcome via improved structuring of the first call. A recall is not recommended when financial resources are low