When a school is more than just a school: Improving school-based health in the wake of COVID-19

Maryland School Health partners' Perspectives on the Impact of COVID-19 on School Health Services for Grades K-12

BACKGROUND

The COVID-19 pandemic disrupted routine school operations, including school health programs. This study aims to describe the pandemic's impact on school health service delivery from the perspective of Maryland school health partners.

METHODS

We conducted semi-structured interviews with health service representatives from public schools (K-12) between July and December 2021. Interviews were recorded, transcribed, and coded through an iterative process to develop analytic themes.

RESULTS

Twenty school health partners from 15 Maryland school districts participated. Participants identified key impacts of COVID-19 on school health: (1) COVID-19 disrupted delivery of services such as dental, mental health, and preventative care, (2) COVID-19 necessitated changes in service delivery platforms, (3) COVID-19 affected school health staff through increased responsibilities and staffing shortages, and (4) COVID-19 prompted schools to become hubs for community outreach and health education.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Consideration of school health service disruptions and the increased demands on service providers may inform future priorities for school administrators, health departments, and policymakers.

CONCLUSIONS

COVID-19 impacted the timing and method of service delivery as well as the roles of school health staff and schools themselves in public health and education.

US public opinion about reproductive health care in school-based health centers

OBJECTIVES

This study aimed to examine public support for the provision of seven reproductive health services in school-based health centers, including pregnancy testing, over-the-counter contraceptives, prescription (Rx) contraceptives, sexually transmitted disease testing, sexually transmitted disease treatment, gynecological examinations, sexual violence counseling, and an index measure combining all services.

STUDY DESIGN

We administered a large national online survey (N = 4196, response rate 31%) of US adults using Lucid, a large, internet-based, opt-in panel to assess public attitudes about offering sexual and reproductive health services in school-based health centers. We then used t tests and weighted linear regression models to carry out our study objectives.

RESULTS

Unadjusted analysis revealed that 60% of respondents supported the provision of all reproductive health services (combined) at school-based health centers. Regression analysis based on the index measure suggested that individuals identifying as Trump voters (p-value = 0.00) or conservatives (p-value = 0.00) reported the lowest support, while those identifying as liberal (p-value = 0.00) reported the highest support, controlling for demographic and health characteristics.

CONCLUSIONS

Respondents overwhelmingly support the provision of reproductive health services at school-based health centers, including pregnancy testing, over-the-counter contraceptives, prescription contraceptives, testing and treatment for sexually transmitted infections, and sexual violence counseling.

IMPLICATIONS

Adolescence is an important stage for sexual maturation, and access to appropriate sexual and reproductive health services can support healthy development into adulthood. Findings suggest that most respondents support the provision of reproductive health services at school-based health centers while there are important factors that influence public support.

Ten health policy challenges for the next 10 years

Health policies and associated research initiatives are constantly evolving and changing. In recent years, there has been a dizzying increase in research on emerging topics such as the implications of changing public and private health payment models, the global impact of pandemics, novel initiatives to tackle the persistence of health inequities, broad efforts to reduce the impact of climate change, the emergence of novel technologies such as whole-genome sequencing and artificial intelligence, and the increase in consumer-directed care. This evolution demands future-thinking research to meet the needs of policymakers in translating science into policy. In this paper, the Health Affairs Scholar editorial team describes "ten health policy challenges for the next 10 years." Each of the ten assertions describes the challenges and steps that can be taken to address those challenges. We focus on issues that are traditionally studied by health services researchers such as cost, access, and quality, but then examine emerging and intersectional topics: equity, income, and justice; technology, pharmaceuticals, markets, and innovation; population health; and global health.