142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Expanding Healthcare Service Delivery in South Bexar County, Texas: Development and Implementation of a School-Based Health Center

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 1:30 PM - 1:50 PM

Camerino I. Salazar, MS , Health Analytics, Research and Information Management, University Health System, San Antonio, TX
Trina Roman , Women's and Preventive Health Services, University Health System
Sadaf Rafique, MS , Department of Quality and Outcomes, Texas Diabetes Institute, San Antonio, TX
Matthew Lee Smith, PhD, MPH, CHES , Department of Health Promotion and Behavior, The University of Georgia, College of Public Health, Athens, GA
Theresa De La Haya, RN, MPH , Community Health and Clinical Preventive Programs, University Health System, San Antonio, TX
Kristen Plastino, M.D. , Obstetrics & Gynecology, The University of Texas Health Science Center at San Antonio, San Antonio, TX
Jennie Quinlan, MPH , Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio, San Antonio, TX
School-based health centers (SBHCs) are an important avenue for helping students receive timely clinical preventive care (screenings and immunizations). As part of an effort to redesign healthcare delivery to priority populations, University Health System, a major safety net hospital system located in South Central Texas, opened its first SBHC within Bexar County in August 2013. The Harlandale Independent School District (HISD) was the selected setting because of their large enrollment (14,000 students) and high percentage of economically disadvantaged students (88%).

Focus groups were conducted to better understand the health service needs of students. Participants included school district administrators, teachers, parents, and health service staff. Geospatial analyses of the proposed service catchment area were utilized to prioritize areas most in need of health services. Geospatial methods were also used to examine local population-level health indices, student characteristics (social and demographic), and quality of available health services.

Since the SBHC opened, it has received 1,222 care visits for immunizations (49%), acute care (37%), well-child exams (10%) and sports physicals (9%). For the first time, HISD achieved 100% completion of minimum state vaccination requirements for K-12 students.

This initiative highlights the innovative and synergistic strategy used to leverage school, community, and health services efforts to address regional disparities in child and adolescent health. Findings support the importance of complementing traditional strategic planning efforts with mix-method evaluation approaches to assess the implementation, reach, and sustainability of community-based collaborative models of care.

Learning Areas:

Administration, management, leadership
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe the theory, design, and implementation of a school-based health center partnership between an economically disadvantaged school district and major safety-net hospital tailored to address the health services needs of school-based priority populations. Evaluate reach and effectiveness in delivery of school-based health services through use of geospatial analysis. Discuss lessons learned, challenges and opportunities for sustainability and expansion of school-based health centers within the era healthcare transformation and payment reform.

Keyword(s): Children and Adolescents, School-Based Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: In my current capacity I am primarily responsible supporting the evaluation of health services interventions, strategic planning and quality improvement in delivery of health services within a large safety net hospital system. I hold a Masters of Science in Sociology from the University of Texas at San Antonio with research interests in integration of public health and health service delivery initiatives, health services and disparities research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.