Date of Award

Spring 5-20-2019

Degree Type

Dissertation

Degree Name

EdD Education Leadership, Management and Policy

Department

Education Leadership, Management and Policy

Advisor

Luke Stedrak, Ed.D.

Committee Member

David Reid, Ph.D.

Committee Member

Rocco Tomazic, Ed.D.

Keywords

School Based Health Centers, SBHC, NJ School Health Centers, Implementation of School Health Centers

Abstract

There is a construct of causation between common health issues affecting children and the corollary effects on a student’s ability and motivation to learn, including impaired sensory perceptions, cognition, connectedness and engagement with school, absenteeism, and dropping out (Basch, 2011b). What is more, causal connections have been found between a students’ health, their socio-economic status (SES), and the achievement gap that exists in education between students with a low-SES and others (Basch, 2011a). To address deficiencies in health care, some school districts have begun providing medical and mental healthcare in school buildings by opening school-based health centers (SBHC; Bains & Diallo, 2015; Guo et al., 2010; Koenig et al., 2016; Larson et al., 2017; School-Based Health Alliance, 2013).

This study sought to examine the implementation and operation of SBHCs specifically in New Jersey (NJ) public schools as data showed that though NJ had a large number of lower SES students there was a paucity of healthcare resources for them (Hing, Decker, & Jamoon, 2015). In fact, based on the last SBHC Census, NJ only had thirty-five centers whereas surrounding states had triple and quadruple that number (School-Based Health Alliance, 2013). There were three methods of center implementation found, which included school operated centers, collaboration centers, and Federally Qualified Health Centers (FQHC). Purposeful sampling was used to generate a sample of each method of implementation to study one of each. A qualitative bounded case study was utilized to collect, organize, and report information from the centers on their operations staffing, financial, policy, and monitoring.

The results of the study showed emerging themes important for school administrators to become cognizant of the method of center implementation that a school district chooses, including collaboration with the local medical community, use of mid-level practitioners, personnel costs as a major expenditure of the center, school nurses as a main referral source of students to the center, the understanding that the SBHC is not a replacement for the school nurse’s office, and emphasis on referrals and connections to outside providers. Within the literature, the researcher noted that SBHCs were monitored for efficacy based on a number of measures, including school connectedness, student achievement, student attendance, and educational attainment. The centers that were part of this study, while they were concerned with their impact on achievement and attainment, by and large viewed the SBHC as serving a public health benefit (Barnett & Allison, 2012) and enhancing a student’s connection with the school (Stone et al., 2013; Strolin-Goltzman, 2010, 2014).

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