A mixed-methods systematic review identifying, describing, and examining the effects of school-based care coordination programs in the US on all reported outcomes

Assessing and addressing social determinants of health in school-based health centers in King County, Washington

Objective

School-Based Health Centers (SBHCs) can reduce barriers to accessing care for school-aged children and adolescents. However, current practices related to screening for and responding to social determinants of health (SDOH) in SBHCs are unknown. Our study sought to understand SBHC staff's knowledge related to SDOH, and their screening and referral practices for addressing SDOH.

Methods

This study was conducted with all SBHCs in King County, Washington (n = 30 clinics operated by n = 8 agencies) between January-March 2022. Data were collected using a web-based questionnaire, distributed to all provider and clinical care staff (n = 222) in these SHBCs.

Results

While respondents had strong generalized knowledge regarding SDOH and how they impact health, they were less confident about the specific SDOH impacting the students they serve. Many health limiting and promoting factors are screened for by respondents; however, there was no standardization related to screening and referral practices across SBHCs or agencies. Respondents had suggestions on how to improve screening methodology and ensure that existing practices adequately assess the SDOH impacting student's lives. There was no clearly identified mechanism for making and following up on referrals. Respondents felt that there were either not or only sometimes enough resources available to meet student's needs.

Conclusion

SBHCs advance health and educational outcomes for students, yet SDOH are inconsistently assessed and addressed within SBHCs in King County. Standardizing processes for SDOH assessment and referral can help SBHCs develop practices that are in the best service of equity for their student populations.

An Update on State Legislation Supporting Menstrual Hygiene Products in US Schools: A Legislative Review, Policy Report, and Recommendations for School Nurse Leadership

Access to menstrual products is important to support adolescent health. Advocacy to increase access to menstrual products in schools is growing; however, ideal access requires policies that will require schools to support the menstrual health of menstruating students. We conducted a legislative review on the existence and status of state legislation related to the provision of menstrual products in US schools and categorized by state's political control (political party affiliation of governors and state legislature). Of 50 states and 6 territories, 21 had legislation to support menstrual products in schools, 7 had bills pending, 10 had bills failed, and 18 states had no policies introduced in the state legislature. States with Democrat control have significantly more menstrual product state laws compared to states with Republican control [z  =  2.54, p  =  0.01]. There is a need, especially in Republican states, to accelerate efforts to pass laws that will support menstrual product access in schools.

Ngaramadhi Space: An Integrated, Multisector Model of Care for Students Experiencing Problematic Externalising Behaviour

Introduction

Behavioural and emotional disorders are a significant cause of morbidity for young people aged 10-19 years. School-based health care (SBHC) provides an innovative approach to addressing these issues within Australia.

Description

We describe an innovative and integrative SBHC model called Ngaramadhi Space (NS) based at a specialised behavioural school called Yudi Gunyi school (YGS) in metropolitan Sydney, Australia. NS was developed in partnership with the Aboriginal community to provide holistic, integrated, multidisciplinary child and family centred care to students experiencing problematic externalising behaviour. We contextualise the historical factors leading to the development of NS, highlighting the importance of effective partnerships between sectors, and providing the theoretical framework and key components underpinning the model of care.

Discussion

In Australia, schools are an under-utilised resource for the delivery of health and support alongside education. Collaboration between sectors can be challenging but allows a more coordinated approach to the management of complex social and health issues. By forming effective partnerships with schools and communities, the health sector has an opportunity to improve access to health and social care in a culturally safe and acceptable way. This is in line with national and international frameworks for improving health service delivery and addressing inequity.

Conclusion

The health sector can play a pivotal role in improving the wellbeing of children by forming effective partnerships with schools and communities. The NS model is a practice-based example of this.

Systems of communication in school-nurse led care coordination: A concept analysis

AIM

To analyze the concept of systems of communication in school nurse-led care coordination to develop an operational definition that will inform intervention development.

BACKGROUND

Communication has been identified as an essential attribute in care coordination. However, previous concept analyses of care coordination did not clearly define systems of communication or consider the context of school-based care coordination. Defining and conceptualizing systems of communication has important implications for improving school nurse-led care coordination.

METHODS

Concept analysis was conducted using Walker and Avant's eight-step concept analysis method. The literature was searched to identify supporting literature that was analyzed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.

RESULTS

Systems of communication in school nurse-led care coordination can be defined as systems wherein care team members, led by the school nurse, collaborate by communicating information and knowledge through an individualized healthcare plan that is student/family-centered and shared through information systems. Attributes require developing an individual health plan that incorporates care coordination needs, information sharing with student/family consent, and a clear delineation of team member roles. Consequences include student/family outcomes, team member knowledge, and efficiency and accuracy of information.

CONCLUSIONS

Concept clarification and a synthesized definition allow for more effective measurement development for effective communication in school nurse-led care coordination. Students with healthcare needs in the school environment require systems of communication that efficiently work toward school nurse-led care coordination that addresses the student's health and academic outcomes.