The effects of School Based Health Centers on the learning Environment

Background and purpose: School based health centers (SBHC) are designed to decrease health disparities by increasing health care access for all youth regardless of age, race, income or insurance status. They are full health centers located within a public school setting. The services provided by the centers include prevention, early intervention and risk reduction. The majority of the SBHCs have social work and other mental health professionals employed to work with students who present with high risk clinical symptoms that may not be adequately served by school social workers. There is clear evidence supporting the effects of SBHCs on improving access to healthcare and improving health for all students (Santelli, 1996; Kaplan, 2003; Monsour, 2004). However, due to increasing school accountability standards and the decrease of local, state and federal resources, SBHC are being pressured by school administrators to also demonstrate their impact on academic performance and the learning environment. Few studies have investigated the effects school based health centers on the learning environment. This paper will present the results from a study that investigates the relationship between SBHCs and the learning environment in one large northeastern metropolis.

Design: Using a retrospective quasi-experimental design, this study investigated the impact of the presence of school based health center on the learning environment. Researchers used secondary data from the Board of Education 2007 Learning Environment Survey to compare schools with SBHCs to schools without SBHCs. The learning environment was measured by asking a series of questions about (a) school engagement, (b) safety and respect, (c) academic expectations and (d) communication. The total size of the sample was 400. Two hundred individuals responded to the survey from SBHC and thus 200 individuals from non SBHC schools were matched on demographic variables using propensity score and school type. T-tests and multiple regression were used in the analysis.

Findings: Mean scores were significantly higher on school engagement for respondents in the SBHC schools as compared to respondents in schools without school based health centers (t = 2.49, p<.013). Although the raw scores for the SBHC schools were higher for safety and respect, academic expectations and communication, they did not reach statistical significance. As hypothesized, multivariate analysis showed a positive effect of SBHC on school engagement even when controlling for race, poverty, percent English as a second language and percent students in special education.

Conclusions and Implications for practice: Many studies have show n a relationship between school engagement and academic performance. Therefore the findings from this study showing a direct link between SBHCs and school engagement have implications for the improvement of academic performance. Social workers and other liaisons between the SBHC and the school community should continue to provide services to the entire student body that enhance a sense of school engagement such as youth led health fairs or other universal prevention programs.