School Clinics Affects on Students

School Clinics Affects on Students

School-Based Health Clinics

Do School-based Health Clinics Improve the Academics and Health Outcomes of School Children? What's the Evidence?

Do School-based Health Clinics Improve the Academics and Health Outcomes of School Children? What's the Evidence?

Who would have guessed school-based health clinics (SBHC) date back to 1837? A royal ordinance from the French government required schools to be responsible for students' health and for the maintenance of sanitary regulation. In 1892, Americans finally decided to try public health nursing in New York's East Side, which evolved into the Henry Street Settlement and the beginning of medical care in the school setting. According to the National Assembly on School-Based Health Care (NASBHC) 2007-2008 census, one hundred percent of SBHCs have some form of a primary care provider, either a physician, nurse practitioner, or physician assistant. Typically, these clinics are staffed by a nurse practitioner with medical supervision by a physician (Strozer, Juszczak, & Ammerman, 2010, School Nurse News, 1999).

SBHCs have withstood the test of time. Is it because SBHCs work with students and schools to achieve better attendance rates, decrease tardiness and increase grade point averages? Or is it the indirect impact they have on teaching and promoting healthier lifestyles? For students to thrive at school, they must be at their physical and mental best to function in a learning environment (Strolin-Goltzman, 2010).

Background and Significance

As reported in the latest NASBHC national census, SBHCs have experienced a growth to almost 2,000 centers in 2008 to accommodate the growing need for child and adolescent health care. School-based health centers and clinics were designed to provide accessible, affordable, and high quality health care to students located in or near the school campus. These clinics provide services such as physical check-ups and screenings, mental health care, substance abuse counseling, preventive dental care, health education and promotion, and disease prevention from a multidisciplinary team of providers.

School clinics vary from state to state producing a complex and diverse demographic and financial need. The majority of SBHC are capable of billing health care services to students directly or through their public and private insurance. Despite this reimbursement, there is a large need for additional funding, which is solicited from federal and state grants, local community health organizations, including hospitals, local health department, community health centers, academic medical centers and non-profit organization. Advocating for SBHC include Centers for Disease Control and Prevention, Department of Health and Human Services, Department of Public Health, Department of Education and various medical and health organizations.

Method

The target population for this integrative review was research articles, state reports, and literature reviews exploring the influences SBHC have on students' academics and overall health. An extensive search of CINAHL, COCHRANE, EBSCOhost, Pub Med, and Medline databases were utilized from 2000 to 2012. However, salient articles from previous years were also included as a comparison to updated research. An investigation was necessary beyond the health components since this topic involved the academic issues found in educational literature. Terms, phrases, and a combination of both were included in this research. Some of those were as follows: school-based health clinics, school-based health centers, SBHC, academic performances and outcome, students health and academics, students, adolescents, and children.

The use of the Garrard Matrix Method was used to identify relevant literature, to systematically organize and critically evaluate the available evidence, and to synthesize this data while identifying gaps in the knowledge on this subject. More research is needed in the area of defining and verifying the specific medical interventions accessible from SBCH for student's health and their impacts on student's scholarly outcomes.

Literature Review

Academic performance is more dependent on the students' health and well-being. When students are healthy and active, academics, educational grades and scores as well as the social life of the students is healthy. Still there are a low percentage of the students who attend schools with certain ailments that affect the academic performance of the students. In these cases, there are a number of roles that can be played by the schools in improving health of the students as well as their academic performance. The health of the students is one of the most important factor that has a direct impact on the learning and academic achievements of the children. There are a number of factors that have been reported in the children that impact the rates of academic achievements and learning in the children (Hoagwood, Olin, Kerker, Kratochwill, Crowe, & Saka, 2007, p. 67).

One of the main factors includes medical conditions. Many studies haves shown that some of the main medical conditions based on which absence of the children from schools is increasing includes asthma, tooth decay, obesity and diabetes. More than 20 to 30% of the children have been reported to have negative effects in the case of learning and academic achievements. Some of these medical conditions that have been reported in the studies include the following;

1. One of the main medical conditions based on which greatest numbers of children are marked absent includes asthma. The studies have reported that the children absent because of asthma are thrice times higher than the children absent based on other medical reasons. The studies have shown that there are more than 18% of children in California suffering from asthma. More than 2 million days of school that is missed by the children annually (Basch, 2011, p. 6).

2. The second important disease that has caused an increase in the children absentees from the schools includes tooth decay. Among the childhood diseases, this is one of the most important diseases having the highest rates. More than 6 out of 10 children have tooth decay. There are a number of American states in which tooth decay is one of those medical conditions that have not been considered by the healthcare centers in a proper manner.

3. Children who have poor oral as well as general health are the ones who have 3% higher chance of being absent from schools (Geierstanger, Amaral, Mansour, and Walters, 2004, p. 348).

Stress and depression among children is also increasing. There is a great percentage of children who are stressed and depressed because of the fact that they are not producing the academic results that are required. Not being able to be successful in accordance to the requirements of the family and the parents based on which stress is increasing the children. This kind of stress is defined as one of the factors that interfere with the normal healthy activities of children.

On the other hand, it has been reported that there are a number of students in the middle schools as well as high schools, who have reported a great reduction in a connection between them, family members and the parents. When these students are observed from their 7th grades, the connectedness decreases to as much as 33%. There are a number of studies that have shown that one of the main factors that control the rates of school connectedness, school absenteeism is the school connectedness. The rates of substance abuse and alcohol abuse are inversely proportional to the rates of school connectedness (Gall, Pagano, Desmond, Perrin, and Murphy, 2000, p. 292).

Based on these facts, it has been seen that there is much difference that can be made by the schools. Ensuring health of the students is one of the main aims of the schools. There are a number of policies that can be designed by the schools that can help in improving health of the students. There are a certain steps that need to be taken by the schools which do not even cost any monetary resources. The only resources that are required in order to improve the health of the students include strategies, policies, physical, emotional and social support.

There is much that can be done by the policymakers in an improvement of the health of the students. As health of the students are improved, it is ensured that the academic achievements of the students are improved thereby rates of learning within the students are higher. Policies that focus on an improvement in the health will not only make sure that the academic achievements of the students increase but increased revenues and profits can be generated by the schools with lesser cash with an increase in the attendance of the students (Wade, 2010, p. 1612). Thereby some of the most important steps that can be taken by the policymakers include the following;

1. It is important that the policies help increase collaboration between educators, community members, as well as health organizations. The collaborations between private and public sectors can help in gaining more funding for public schools as well as the schools that are running on smaller levels.

2. In order to make the policies, it is important that data is collected from the general population. When the policies are designed based on the data which is collected from the greater portion of the population, the policies would be better. Utilization of the data and collection of the data should be one of the main aims of the policy makers. The data can be used by the policymakers in order to develop the policies and implement these in order to make sure that improvement can be ensured (Basch, 2011, p. 9).

3. One of the main roles that can be played by the policy makers includes reviewing the policies that have already been designed for the schools. How these previous policies have played roles in an improvement of academics of the children, their environments and their health are important parts of the review by the policymakers. It is important that funding is collected for the issues that affect health and academics of children.

4. The policymakers should make sure that the importance of school-based health clinics that can play roles in looking after the needs of the students.

Great levels of differences can be made by the schools in improving heath of the students. There is a great variety of educational supports that can be provided by the schools. Some of these services include healthcare programs, mental health services and breakfast programs. The importance of school-based programs lies in the fact that a large part of daily lives of the students spend in the schools. Thereby, the changes that will be implemented by the schools will remain for long (Kropski, Keckley, and Jensen, 2008, p. 1010). Ensuring students health is one of the main aims of the schools.it is seen that schools require that proper physical examinations are carried out on the students in order to make sure that they are healthy. Certain set of immunizations are required to be carried out on the students to make sure that any contagious disease are not transmitted within the students. School-based health care has played the most important role in maintain health and academic achievements of the students.

School-based clinics and healthcare systems have played important roles in greatly reducing dropout rates and failure on courses. Studies have shown that there are certain public schools in Dallas that have been serving for the healthcare of the students. The mental healthcare services and clinical services offered in these schools have shown that there is 32% reduction in school absentees, 31% reduction in the rates of course failures, and more than 95% reduction in the disciplinary issues (Bruzzese, Sheares, Vincent, Du, Sadeghi, Levison, Mellins, and Evans, 2011, p. 999).

On the other hand, it has been reported that asthma care centers that have been developed inside the schools have also played roles in maintaining healthcare of the students. Improvement of grades has been seen in the students who were looked after by the nurses hired by the schools to look after the health of children suffering from asthma.

School breakfast programs have played important roles in improving the academic and health-based life of the students. There are a number of private and public schools in U.S. that offer breakfast programs. It has been seen that these programs within the schools have greatly improved basic test skills, along with a great reduction in absenteeism, lowering anxiety and tardiness in the students, hyperactivity, depression, and psychological dysfunction. Studies were conducted on many schools in Philadelphia, and Baltimore, USA. There are many studies that have shown positive effects of breakfast. Average math grades of 2.8 were seen in the case of students who had their regular breakfast in the schools as compared to the score of 1.9 in relation to the children who rarely had breakfast. The breakfast programs have shown that average absenteeism also reduced in the students giving regular breakfasts in the schools. Children having regular breakfasts only reported 1.5% of absents during the academic term as compared to the 2.8% for students not having breakfast in a regular manner (Zenzen, & Kridli, 2009, p. 243).

On the other hand, it has been seen that there are a set of mental healthcare services provided by the schools for the children. These mental healthcare services paly important roles in increasing connectedness within the children in the schools. As the connectedness in increased, there is a great increase in the connectedness in the children with the teachers and peers. With an increase in the connectedness, there is a great reduction in alcohol abuse, and substance abuse. There is a great increase in the academic achievement, low health risk behaviors, and increase in attendance. Studies have been carried out on various teenagers and school going children in regards to the effects of various kinds of protective factors. These factors include school connectedness; expectations of the parents for increased an academic achievement, connectedness between parents and the students, as well as the involvement of the teenagers in the religious movements. These factors have been seen to have positive effects on the health and well-being of the students and these have a positive effect on the academic achievements of the students (Basch, 2011, p. 10).

Of all the positive factors, one of the strongest factors that have played roles in an increase in positivity in the students includes school connectedness. This factor protects against alcohol abuse, sexual abuse, alcohol and substance abuse, violence, sexual initiation, as well as injury.

It has been seen that more importance has been given by the schools to the family connectedness as compared to school connectedness. The family connectedness has been related to a great decrease in damaging behaviors in the children.

Various studies have shown that there are various school based activities that have included school-based student counseling as well as behavior modification. These are the school-based programs that have also focused on an improvement of education curricula. The studies have shown that these school-based programs have greatly improved student behaviors causing a great improvement in student academic achievements (Zenzen, & Kridli, 2009, p. 250).

Not only are the students helped in the case of better school-based programs, but there are great advantages that are gained by the schools themselves. In the presence of better school-based health clinics, there will be a great reduction in school absentees, an overall increase in attendance within the school, as these are some of the factors that can help in collection of school funding (Guo, Wade, Pan, and Keller, 2010, p. 1618).