School Health Services for Children with Chronic Health Conditions in California Public Secondary Schools: Findings from the 2018 School Health Profiles Survey

Abstract

Background: More than 20% of school districts in the United States do not have policies on identification and case management for students with chronic health conditions (CHCs), suggesting that these students’ health needs may not be met during the school day. Prior research reports a gap in policy implementation and the actual provision or operationalization of the policy into action. Significance: While there is limited research on school health policies, little is known about the actual provision of the services that such policies indicate should be provided. Notably, the actual provision of health services in U.S. schools, particularly regarding CHC management and its association with school nurse employment, is underreported. Methodology: Using data from the 2018 School Health Profiles (SHP) Survey, health services including administering daily medication, providing stock rescue medication, providing case management, facilitating community partnering, and providing disease-specific education were examined in California public secondary schools together with school nurse employment. Complex sampling analysis and chi-square statistics were used to examine the statistical associations. Results: A significantly greater proportion of schools with a full- or part-time nurse compared with schools with no nurse provided: (1) daily medication administration (82.1% vs. 68.1%; p = .014); (2) case management services (75.8% vs. 62.0%; p = .031); (3) disease-specific education for parents and families (44.9% vs. 25.7%; p = .016); and (4) parent and student connection to health services in the community (83.7% vs. 72.2%; p = .035). Conclusion: Findings suggest that nationally representative data, such as SHP, contain important information for states to review regarding school health policies and provision of services. Further research needs to expand these findings to better understand school health policy and practice and its alignment with state and federal laws to support all children, especially those with CHCs.

Chronic Health Condition Management and School-Based Health Centers in New York: Findings From the 2020 School Health Profiles Survey

“…Therefore, this research endeavored to study the delivery of those health services in one select state of the United States, New York. We chose NY because there are variations in the provision of health services within states and across the United States (McCabe et al, 2021(McCabe et al, , 2022a(McCabe et al, , 2022b, differences exist in the amount of dedicated state funds to SBHCs, NY ranks in the top three states regarding number of SBHCs (Love et al, 2019), the proximity of practice to the research team, and sharing a model for other states to replicate. Data were accumulated from NY public secondary schools (specifically schools with grades 6 through 12) in the 2020 School Health Profiles data set.…”

“…McCabe et al (2022b) identified that over 20% of school districts in the United States do not have policies on CHCs, such as identification, instruction/education, tracking, and case management. In a subsequent paper, McCabe et al (2022a) examined the implementation of school health policies on CHCs in public secondary schools in California. Study results demonstrated that providing health services for children with CHCs was statistically significantly associated with having a full- or part-time school nurse employed in the school.…”

“…A chronic health condition (CHC) is described as an illness or disease that requires medical or nursing care and may reduce the ability to actively participate or perform activities of daily living (Centers for Disease Control and Prevention [CDC], 2019; McCabe et al, 2022a; Noonan et al, 2020; Shoesmith et al, 2021). In the United States (US), it is estimated that individuals with chronic disease account for 90% of the 4.1 trillion dollars in annual healthcare expenditure (Buttorff et al, 2017; Center for Medicare & Medicaid Services, 2021).…”

Advancing School Health: Building a Partnership Between School Nurses and the Centers for Disease Control and Prevention

“…The most suitable respondents for these specific questions are licensed school health professionals, namely school nurses, who directly provide these services. Some nurse researchers employing the YRBSS and Profiles surveys acknowledge the inherent limitations in data attributed to the survey's sources or phrasing of questions, asserting these constraints may contribute to a lack of understanding concerning the essential role of school nurses in implementation and influence over health and education outcomes (McCabe et al, 2022, 2024; Pontes et al, 2021). This hampers the formulation of policies, allocation of funding, and provision of resources toward enhancing school nursing services.…”