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

项目总结摘要 低收入农村青年面临健康的负面社会决定因素和在获得保健方面的挑战。 校本卫生中心(SBHC)是一种创新的应对措施，旨在增加获得机会，但其在农村地区的影响 社区没有很好的记录。本项目提出了一种多层次混合方法的SBHC评估方法 在纽约州4个低收入农村县运营的网络。由巴西特医疗网络运营， 这些SBHC是永久性的、现场的、全年的，并满足各种医疗需求(物理、 牙科、精神疾病、慢性和急性疾病)，患者无需自付费用。该设置允许准实验 通过比较16个有SBHC的学区和22个没有SBHC的学区来评估SBHC的影响。这个 该项目由康奈尔大学、巴西特研究人员和社区合作伙伴组成的多学科团队参与。 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 要解决的数据(管理数据、调查和患者医疗访问数据)和多层次分析方法 三个目标：目标1.评估社区卫生服务中心对医疗保健利用的影响。我们将汇编一个面板数据集 在过去12年(2011-2022)，所有患者前往巴塞特医疗机构就诊以衡量医疗服务利用率 (频率、地点、服务)用于预防护理(例如，良好护理、接种疫苗)和急性和慢性护理 在有和没有儿童保健中心的学区，儿童的健康状况(如哮喘、精神健康)。目标2. 评估SBHC对跨机构协作的影响。我们会评估社会服务的提供情况。 通过文献研究、焦点小组、学校和社区访谈等方式，对4个县的研究区进行调研 领导人，以及对机构领导人的调查。我们将确定和衡量区分交叉水平的因素 每所学校的医疗保健提供者、社区机构和地方政府之间的机构合作 地区。目标3.评估SBHC和跨机构合作对学校表现和 关于社区卫生保健的利用。合并来自多个级别(患者、学区和县)的数据 将使我们能够评估SBHC在解决健康的社会决定因素方面所发挥的不同作用。社区 结果衡量标准包括就学人数和更广泛的社区医疗保健利用率。研究结果将 加强对社区卫生服务中心如何塑造健康结果并为个人和社区作出贡献的了解 为农村卫生政策提供信息的福祉。

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.