School‐Based Health Services in Virginia and the COVID‐19 Pandemic

Abstract

BACKGROUND Schools have a long history of delivering health services, but it is unclear how the COVID‐19 pandemic may have disrupted this. This study examined changes in school‐based health services and student needs before and during the pandemic and the factors important for delivering school‐based health services. METHODS A web‐based survey regarding the impact of the pandemic on school‐based health services was distributed via email to all 1178 Virginia public elementary schools during May 2021. RESULTS Responding schools (N = 767, response rate = 65%) reported providing fewer school‐based health services during the 2020‐2021 school year than before the pandemic, with the largest declines reported for dental screenings (51% vs 15%) and dental services (40% vs 12%). Reports show that mental health was a top concern for students increased from 15% before the pandemic to 27% (P < .001). Support from families and school staff were identified by most respondents (86% and 83%, respectively) as very important for the delivery of school‐based health services. CONCLUSIONS Schools reported delivering fewer health services to students during the 2020‐2021 school year and heightened concern about students' mental health. Understanding what schools need to deliver health services can assist state and local education and health officials and promote child health.

Unmet dental needs in children following suspension of school-based oral health services due to COVID-19

“…In CariedAway, follow-up observation with study subjects after pandemic restrictions were lifted showed that over 12% had fistula, swelling, or pulpal involvement that were not treated while the project was suspended. This supplements other findings: post-pandemic, children were more likely to have poor oral health and a lower utilization of dental visits, specifically preventive ones [23], and a survey of primary schools in Virginia concluded that the largest decline in school health services due to the pandemic were reported for dental screenings and dental services [24]. In contrast, SBHCs that remained open for clinical care during the pandemic increased annual preventive health exams and were a critical source of primary care to vulnerable populations [25].…”

Unmet Dental Needs in Children Following Suspension of School‐Based Oral Health Services Due to COVID‐19

“…Research suggests that children were more likely to have poor oral health and a lower utilization of dental visits during the COVID-19 period, specifically preventive ones, 24 and the largest decline in school health services due to the pandemic were reported for dental screenings and dental services. 25 In contrast, those school health services that remained open for clinical care throughout COVID-19 saw increased annual preventive health exams and were a critical source of primary care for vulnerable populations. 16 Actual versus perceived availability of affordable dental health options may further exacerbate oral disease inequities in urban school children.…”

“…Similarly, approximately 12% of subjects returning to the program after the pandemic had fistula, swelling, or pulpal involvement that were not treated while the project was suspended. Research suggests that children were more likely to have poor oral health and a lower utilization of dental visits during the COVID‐19 period, specifically preventive ones, 24 and the largest decline in school health services due to the pandemic were reported for dental screenings and dental services 25 . In contrast, those school health services that remained open for clinical care throughout COVID‐19 saw increased annual preventive health exams and were a critical source of primary care for vulnerable populations 16 …”

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

“…2 Regarding vaccination provision, a study of Virginia elementary schools noted a significant decrease in delivery of routine childhood immunizations during COVID-19. 5 Mixed data exists regarding vision and hearing screenings during COVID-19. Within Virginia elementary schools, screening services appeared to continue at high rates during COVID-19, with no change in vision screening operations and only a 2.5% decline in hearing screenings by spring of 2021.…”

“…School closures frequently impacted operations of school health programs, with over three-quarters of SBHCs experiencing temporary shut-downs during the spring of 2020. 2 A growing number of reports have documented variations in school-based health service provision [3][4][5][6] and changes in the health and wellness needs of school-age children. [7][8][9] A subset of studies has examined COVID-19's impact on school health services from the perspective of school health professionals.…”