{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:44:09Z","timestamp":1792140249832,"version":"4.4.0"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Promotion Practice"],"abstract":"<jats:p>Period poverty is increasingly recognized as a public health equity issue, yet limited research has examined the implementation of school-based menstrual health and hygiene programs in the United States. This study investigates Missouri school nurses\u2019 perceptions of state government funding for menstrual hygiene products, availability of products in schools, and students\u2019 needs related to period poverty. Using a cross-sectional, quantitative design, an electronic survey was emailed to lead school nurses in Missouri public and charter schools from February to March 2024. Those who serve students in fourth grade or higher were included in analyses. The survey assessed awareness of state funding, menstrual hygiene products in schools, and nurses\u2019 perceptions of students experiencing period product insecurity. Chi-square tests and logistic regression models examined associations between district-level characteristics and reported outcomes. Among 243 school nurses who responded and served fourth grade or higher, nearly all (92%) were aware of the state\u2019s grant program. 59% reported knowing students who struggle to afford menstrual products, and 12% said their school experienced product stockouts during the current academic year. Adjusting for district size and race\/ethnicity, as the district\u2019s percentage of students eligible for free or reduced lunch increases, nurses were significantly more likely to report students facing difficulties accessing period products. Findings highlight critical gaps in menstrual product availability and policy implementation from nurses\u2019 perspective. Strengthening communication, standardizing distribution practices, and ensuring sustainable funding are essential to advance menstrual equity in schools. Future research should evaluate the long-term outcomes of state-funded menstrual health and hygiene programs.<\/jats:p>","DOI":"10.1177\/15248399261494559","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:14:49Z","timestamp":1791969289000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["State Funding and Period Product Access in Missouri Schools: A Statewide Study of Lead School Nurses"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7350-0186","authenticated-orcid":false,"given":"Anne K.","family":"Sebert Kuhlmann","sequence":"first","affiliation":[{"name":"Saint Louis University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rubaiya Binte","family":"Razzak","sequence":"additional","affiliation":[{"name":"Saint Louis University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamirah","family":"Abdul-Haqq","sequence":"additional","affiliation":[{"name":"Saint Louis University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6831-8993","authenticated-orcid":false,"given":"Ifeoma M.","family":"Obionu","sequence":"additional","affiliation":[{"name":"Saint Louis University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8300-1281","authenticated-orcid":false,"given":"Mintesnot Tenkir","family":"Teni","sequence":"additional","affiliation":[{"name":"Saint Louis University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"Ament S. M. C. Gillissen F. Maessen J. Dirksen C. van der weijden T. Meyenfeldt M. (2012). Sustainability of healthcare innovations (SUSHI): Long term effects of two implemented surgical care programmes (protocol). BMC Health Services Research 12 423. https:\/\/doi.org\/10.1186\/1472-6963-12-423","DOI":"10.1186\/1472-6963-12-423"},{"key":"e_1_3_3_3_1","doi-asserted-by":"crossref","unstructured":"Belay S. Kuhlmann A. K. S. Wall L. L. (2020). Girls\u2019 attendance at school after a menstrual hygiene intervention in northern Ethiopia. International Journal of Gynecology & Obstetrics 149(3) 287\u2013291. https:\/\/doi.org\/10.1002\/ijgo.13127","DOI":"10.1002\/ijgo.13127"},{"key":"e_1_3_3_4_1","doi-asserted-by":"crossref","unstructured":"Chandra-Mouli V. Patel S. V. (2017). Mapping the knowledge and understanding of menarche menstrual hygiene and menstrual health among adolescent girls in low- and middle-income countries. 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Frontiers in Public Health 10 Article 913262. https:\/\/doi.org\/10.3389\/fpubh.2022.913262","DOI":"10.3389\/fpubh.2022.913262"},{"key":"e_1_3_3_7_1","doi-asserted-by":"crossref","unstructured":"Francis L. Meraj S. Konduru D. Perrin E. M. (2022). An update on state legislation supporting menstrual hygiene products in US schools: A legislative review policy report and recommendations for school nurse leadership. The Journal of School Nursing 39(6) 536\u2013541. https:\/\/doi.org\/10.1177\/10598405221131012","DOI":"10.1177\/10598405221131012"},{"key":"e_1_3_3_8_1","doi-asserted-by":"crossref","unstructured":"Godlove Aka B. (2025). Period poverty in the United States of America: A socio-economic policy analysis. 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