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APHA Scientific Session and Event Listing

Recorded presentation

Leslie A. Mandel, MS, MA, PhDc, Heller School for Social Policy and Management, Brandeis University, 70 Kodiak Way, #2621, Waltham, MA 02451, 7812091736, Lednam@Brandeis.edu

Research has demonstrated a strong link between children's health and learning. In response, health and school systems have formed interagency partnerships to deliver school-based health services. These School-Based Health Centers (SBHCs) have proliferated rapidly, demonstrated success in health outcomes and access for socioeconomically disadvantaged youth, and gained recognition as part of the US healthcare landscape.

Despite the need for and benefits of SBHCs, organizational dissimilarities in professional orientation and institutional mandates exist among health and school systems potentially leading to partnership barriers. Still, some partnerships flourish, while others fail to thrive? Why? One answer may lie in how key SBHC stakeholders perceive the status of the partnership. Is each system considered a co-equal or is there is a guest/host perception?

Utilizing case study methods, I conducted in-depth interviews and observations of 55 key stakeholders involved in program operations from four Massachusetts SBHCs to determine how partnering agencies promote cooperation across institutional boundaries. All of the research sites have similar general characteristics, yet two have strong interagency partnerships and two are experiencing difficulties.

Overall, health and school systems from the four cases express mutual respect for one another. However, stakeholders from more successful sites often stress the importance of dependence on one another as the primary means to achieve goals. In the less successful sites, SBHCs are treated more like guests than full partners. School representatives state that as guests, SBHCs must adhere to school rules. Similarly, health representatives assume that as guests they can be asked to leave at any time. This tenuous partnership notion may be counterproductive to SBHC growth and sustainability.

Providing school-based health enables greater access to youth and opportunities for prevention, early intervention and health promotion. Further, given current levels of public interest in education, SBHCs may afford enhanced attention to youth health. Additional financial and training resources are needed to build the common purpose that will further long-term sustainability of school-health partnerships.

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