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  1. 1. School-Based Health Centers: Lessons from Community Collaboration Virginia Bishop, MD, MPH Northwestern Feinberg School of Medicine Co-Director ARCC Coordinator Programs in Public Health Professional Experience
  2. 2. What are they?  First centers opened in MN and TX  Illinois in 1982 at Austin Community High School  School-based health centers, located on school grounds.  School-linked health centers, located off school grounds close to a school.
  3. 3. What are they?  Characteristics:  SBHC’s require parents to sign written consents for their children to enroll in the SBHC  Have an advisory board consisting of community representatives, parents and family organizations to provide planning and oversight  Provide clinical services through a qualified health provider such as a hospital, health department, or medical practice
  4. 4. Core Mission  Bringing services to students where they learn and grow  Addressing critical health issues  Serving kids in need  Supporting parents  Supporting schools
  5. 5. SBHC Common Services  School and Sports  Preventative & Physicals Health Education  Acute Care  Diagnosis and  Immunizations Treatment of Illness  Mental Health  Laboratory Services  Reproductive Health  Risk Assessments Services  Dental Care  Linkages to Support  Eye Exams Services  Nutrition Counseling  Benefits Enrollment  Referrals to Community Agencies
  6. 6. SBHC: Lessons Learned  A Model for Collaborative Initiatives  A Model for Health Care Education  A Model for Public Health  A Model for Community-Based Participatory Research  A Model for Practice Based Research
  7. 7. My SBHC Experience  1989 – 1992 Adolescent Medicine Fellowship/MPH  College Health: George Washington U, American U  1992 University of Illinois College of Nursing/ SBHC Jose De Diego Community Academy  Patience  Community Mental Health  1996 - 2001 Children’s Memorial Hospital/ SBHC Jose De Diego  1998 – 2000 Executive Board Illinois Coalition for School Health Centers
  8. 8. College Health in WDC  Infectious Diseases  Sexually Transmitted Infections/Pregnancies  Alcohol and Drug Use  Working with Physician Assistants, Nurse Practitioners, Internists, Health Educators, Peer Educators
  9. 9. Jose De Diego Community Academy: Elementary School  Community Mental Health  Always be open and aware of community events  Violence Prevention Project  Listen to the students/get their feedback  Model Parent Volunteer program  Initiation into Community Health  Primary Health Care
  10. 10. Jose De Diego Community Academy: Feedback  Cultural Sensitivity  Resident Education  Observe and then De-Brief  Assist then De-Brief  Conduct Exam/History with Observation, then De-Brief
  11. 11. Illinois Coalition for School Health Centers  Illinois Maternal and Child Health  Learned about advocacy  Learned about policy  Learned about consensus  Learned about different SBHC strategies  Learned about funding  Learned about Chicago SBHC politics
  12. 12. SBHCs: Lessons Learned  2000 worked on opening Roberto Clemente Community Academy’s SBHC  LSC (Local School Council)  CPS Board (Chicago Public School)  Community Assessments (focus groups)  Hospitals  Social service agencies  Youth Serving Agencies  Parents  Students
  13. 13. SBHCs: Lessons Learned  2001: Roberto Clemente Community Academy  Illinois Department of Human Services  Polk Brothers  Chicago Department of Health  Illinois Department of Health  Chicago Public Schools  St. Elizabeth Hospital  Youth Guidance  Illinois Coalition of School Health Centers  National Assembly for School Based Health Centers
  14. 14. RCWSHC Staffing  Primary Care Services  Director, Dr. Michael Friedman  Co-Founder, Dr. Virginia Bishop  Physician Assistant, Stacy Dobreff  Physician Assistant, Junirose Zaide  Medical Assistant – Jazlin Flecha  Administrative Assistant –  Mental Health Services  Licensed Clinical Professional Counselor (LCPC)  Catharine Rocha and Anthony DiVittorio  Preventive Health Education  Director of Health Education, Roxane Medina  Health Educator, Chelsea McKinney
  15. 15. Current Stats  Established in 2000  July 1, 2008 – June 30, 2009 Students Population 2008-2009 1 Total RCCA School Population 1774 2 Total number of students enrolled in RCWSHC 1419 3 Total number of new students registered with 814 RCWSHC 4 Total number of referrals (external/internal) 87 Estimate of: 80%
  16. 16. Health Services Provided  Current process for the delivery of patient services and education Primary Health Services Mental Health Preventive Education Services Services Administrative
  17. 17. Youth Empowering Strategies! Y.E.S.! A Peer Education Model
  18. 18. Peer Education  Peer education draws on the credibility that young people have with their peers  It leverages the power of role modeling  It provides flexibility in meeting the diverse needs of today’s youth  Supports young people in developing positive group norms and in making healthy decisions about sex
  19. 19. Peer Education  Programs with youth-adult partnerships are highly effective in building young people's skills and reducing their sexual risk-taking behaviors  Acknowledges contributions of all partnerships  If the messenger is similar to them and faces the same concerns:  youth gain experience and confidence  youth hear and personalize the messages  organizations gain a fresh perspective on youth culture  organizations develop more effective outreach  young gain more from an experience when they are actively involved
  20. 20. Y.E.S.! Program Teen Pregnancy Prevention  Safer Choices Curriculum  Two level program (9th & 10th grade)  Ten week program  Ten 40-45 minutes long sessions  Can be extended by providing add’l time  Sessions are offered once a week  Twice a week sessions are offered depending on schedule  Services are offered every quarter
  21. 21. SBHC: Research Collaboration  ARCC funding  NuFit  EatFit Curriculum  Culinary Arts  Audio-Visual  Cookbooks  Community inputs
  22. 22. NuFit Evaluation  Pre- post surveys  Feedback from teachers, observers  Qualitative (focus groups)  Randomized sample  Control- sophomores  Culinary art sophomore students  Peer Educators  Academic Achievement sophomores
  23. 23. SBHC’s: Challenges  Firefighter vs. Visionary  Awareness of community resources  Funding  Prioritization  Evaluation of programming  Periodic reviews  Keeping all stakeholders aware
  24. 24. SBHC’s: Lessons Learned  Challenges at RCWSHC  Physical exam & immunization compliance  Provision of Mental Health  Non-medical model  Length of time to get build out  Lack of specific adolescent trained or sensitive personnel  Engaging school faculty
  25. 25. SBHC’s: Future  Special Interest Group????  Shared expertise  Shared experiences  Potential for Collaboration  Potential for Educational Experiences

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