School Based Health Centers - An approach to address health disparities among rural youth.

学校健康中心 - 解决农村青年健康差距的一种方法。

基本信息

批准号：
10801764
负责人：
Wendy Brunner
金额：
$ 67.05万
依托单位：
CORNELL UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-24 至 2028-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10801764
关键词：
Acute Address Area Asthma Caring Child Child Health Chronic Collaborations Communities Community Health Community Healthcare Community Networks Community Services Comprehensive Health Care Consolidated Framework for Implementation Research Continuity of Patient Care County Data Data Set Dental Economics Effectiveness Emergency Situation Enrollment Epidemiologist Evaluation Evidence based intervention Face Family Family health status Focus Groups Frequencies Health Health Care Visit Health Personnel Health Policy Health Services Health Services Accessibility Health care facility Healthcare Human Individual Institution Interdisciplinary Study Interview Local Government Location Low income Measures Mental Health Mental Health Services Methods New York Outcome Outcome Measure Patient Selection Patients Performance Personal Satisfaction Play Policies Poverty Preventive care Preventive dental care Primary Care Physician Psyche structure Public Health Qualitative Research Quasi-experiment Records Research Research Design Research Personnel Research Project Grants Resources Role Running Rural Rural Community Rural Health Schools Service provision Services Shapes Site Social Work Structure Students Surveys Time Transportation Universities Vaccination Variant Visit Youth acute care age group analytical method built environment community based participatory research cost family structure health care availability health care service utilization health disparity health equity improved individual patient innovation medically underserved migration morphogens multidisciplinary pediatric patients pediatrician response rural area rural counties rural underserved school based health center school district social determinants social health determinants sociologist underserved community urban setting urgent care

项目摘要

Project summary abstract Low-income rural youth face negative social determinants of health and challenges in accessing health care. School-Based Health Centers (SBHCs) are an innovative response to increase access, but their impact in rural communities is not well documented. This project proposes a multilevel mixed-methods evaluation of an SBHC network operating in 4 low-income rural counties in New York state. Run by the Bassett Healthcare Network, these SBHCs are permanent, on-site, year-round and attend to the full range of healthcare needs (physical, dental, mental, chronic and acute) at no out-of-pocket cost to patients. The setting permits a quasi-experimental design to assess SBHC impact by comparing 16 school districts with SBHCs and 22 school districts without. The project involves a multi-disciplinary team of Cornell University and Bassett researchers and community partners. The project will use both qualitative data (from semi-structured interviews and focus groups) and quantitative data (administrative data, survey, and patient healthcare visit data) and multilevel analytical methods to address three aims: Aim 1. Assess the impact of SBHCs on healthcare utilization. We will assemble a panel dataset of all patient visits to Bassett healthcare facilities over 12 years (2011-2022) to measure healthcare utilization (frequency, location, services) for preventive care (e.g., well-care, vaccinations) and care for acute and chronic conditions (e.g., asthma, mental health) among children in school districts with and without SBHCs. Aim 2. Assess the impact of SBHCs on cross-agency collaboration. We will assess provision of social services in the 4-county study area through document research, focus groups, interviews with school and community leaders, and a survey of agency leaders. We will identify and measure factors that differentiate the level of cross- agency collaboration among healthcare providers, community agencies, and local governments for each school district. Aim 3. Assess the impact of SBHCs and cross-agency collaboration on school performance and on community healthcare utilization. Combining data from multiple levels (patient, school district, and county) will enable us to assess the different roles SBHCs play in addressing social determinants of health. Community outcome measures include school attendance and broader community healthcare utilization. Study results will enhance understanding of how SBHCs may shape health outcomes and contribute to individual and community wellbeing to inform rural health policy.

项目摘要摘要低收入农村青年面临着负面的社会决定因素，并在获得医疗保健方面面临挑战。基于学校的卫生中心（SBHC）是提高访问权限的创新反应，但它们对农村的影响社区没有充分记录。该项目提出了SBHC的多级混合方法评估网络在纽约州的4个低收入农村县运营。由Bassett Healthcare网络运行，这些SBHC全年是永久的，现场，全年都可以满足整个医疗保健需求（物理，物理，牙齿，精神，慢性和急性）没有自付费用。该设置允许准实验通过将16个学区与SBHC和22个没有的学区进行比较，以评估SBHC影响的设计。这项目涉及康奈尔大学和巴塞特研究人员和社区合作伙伴的多学科团队。该项目将使用定性数据（来自半结构化访谈和焦点小组）和定量数据（行政数据，调查和患者医疗保健访问数据）和多级分析方法三个目标：目标1。评估SBHC对医疗保健利用的影响。我们将组装一个面板数据集在12年（2011 - 2022年）对Bassett Healthcare设施的所有患者访问中，以衡量医疗保健利用（频率，位置，服务）用于预防性护理（例如，护理，疫苗接种）和急性和慢性的护理有或没有SBHC的学区儿童中的病历（例如哮喘，心理健康）。目标2。评估SBHC对跨机构协作的影响。我们将评估社会服务的提供通过文档研究，焦点小组，对学校和社区的访谈的四县学习领域领导者和代理领导者的调查。我们将确定和衡量区分跨度水平的因素每所学校的医疗保健提供者，社区机构和地方政府之间的代理机构合作区。目标3。评估SBHC和跨机构合作对学校绩效的影响关于社区医疗保健利用。结合来自多个级别的数据（患者，学区和县）将使我们能够评估SBHC在解决健康的社会决定因素方面所扮演的不同角色。社区结果措施包括上学和更广泛的社区医疗保健利用。研究结果将增强对SBHC如何塑造健康结果并为个人和社区做出贡献的理解福祉以告知农村卫生政策。