title: Missouri K-12 school collection and reporting of school-based syndromic surveillance data: a cross sectional study.
abstract: BACKGROUND
  School participation in collecting and reporting syndromic surveillance (SS) data to public health officials and school nurses' attitudes regarding SS have not been assessed.
  
  
  METHODS
  An online survey was sent to Missouri Association of School Nurses members during the 2013/2014 school year to assess whether K-12 schools were collecting and reporting SS data. Z-scores were used to assess collection versus reporting of SS indicators. Logistic regressions were used to describe factors predicting nurses' collection and reporting of SS indicators: all-cause absenteeism, influenza-like illness and gastrointestinal illness. Univariate predictors were assessed with Chi-Squares.
  
  
  RESULTS
  In total, 133 school nurses participated (33.6 % response rate). Almost all (90.2 %, n = 120) collect at least one SS indicator; half (49.6 %, n = 66) report at least one. Schools are collecting more SS data than they are reporting to the health department (p < .05 for all comparisons). Determinants of school nurses' collection of SS data included perceived administrative support, and knowledge of collecting and analyzing SS data. The strongest predictive factors for reporting SS data were the perception that the health department was interested in SS data and being approached by the health department to collect SS data.
  
  
  CONCLUSIONS
  Schools are collecting SS indicators at a relatively high rate, yet less than half of the data is reported to public health officials. Findings from this study indicate that public health officials can increase access to school-based SS data by approaching schools about collecting and reporting this important data.
authors.affiliation: Department of Environmental and Occupational Health, Institute for Biosecurity, Saint Louis University, College for Public Health & Social Justice, 3545 Lafayette Avenue Room 463, Saint Louis, MO, 63104, USA. rebmannt@slu.edu.
authors.forename: Terri
authors.initials: T
authors.lastname: Rebmann
authors.affiliation: Department of Environmental and Occupational Health, Institute for Biosecurity, Saint Louis University, College for Public Health & Social Justice, 3545 Lafayette Avenue Room 463, Saint Louis, MO, 63104, USA. akunerth@slu.edu.
authors.forename: Allison K
authors.initials: AK
authors.lastname: Kunerth
authors.affiliation: Department of Environmental and Occupational Health, Institute for Biosecurity, Saint Louis University, College for Public Health & Social Justice, 3545 Lafayette Avenue Room 463, Saint Louis, MO, 63104, USA. zelicoff@slu.edu.
authors.forename: Alan
authors.initials: A
authors.lastname: Zelicoff
authors.affiliation: Department of Biostatistics, Saint Louis University, College for Public Health & Social Justice, Saint Louis, MO, USA. elliotmb@slu.edu.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Elliott
authors.affiliation: Villa Duchesne High School, St. Louis, MO, USA. harperwieldt2017@gmail.com.
authors.forename: Harper F
authors.initials: HF
authors.lastname: Wieldt
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D009726:Nurses; D062486:Public Health Surveillance / Q000379:methods*; D012574:Schools / Q000706:statistics & numerical data*
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