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Impact of School-Based Health Centers on Improving Health and Promoting Equity

校本健康中心对改善健康和促进公平的影响

基本信息

批准号：
10656891
负责人：
Ashley Kranz
金额：
$ 69.6万
依托单位：
RAND CORPORATION
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：
2023-09-18 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10656891
关键词：
Adolescent Award Black race COVID-19 COVID-19 pandemic California Caring Characteristics Child Child Care Child Development Child Health Childhood Communities Comprehensive Health Care Congresses Counseling Data Data Set Delaware Diet Dimensions Disparate Disparity population Education Enrollment Equity Ethnic Origin Funding Future Growth Health Health Care Costs Health Insurance Health Services Accessibility Health Surveys Healthcare Healthcare promotion High School Student Hispanic Household Immunization Income Insurance Link Location Low income Medicaid Mental Health Services Methods Modeling National Institute of Child Health and Human Development Oregon Outcome Patients Population Population Heterogeneity Positioning Attribute Primary Care Race Recommendation Reduce health disparities Reporting Reproductive Health Services Research Sample Size Sampling School-Age Population Schools Selection Bias Services Site Strategic Planning Students Surveys Time Transportation United States Health Resources and Services Administration Vaccination Variant Well Child Visits adolescent health barrier to care cost design disparity reduction elementary school experience health care disparity health care service utilization health disparity health disparity populations health equity promotion improved insurance claims member operation pandemic disease protective effect rural area rurality school based health center screening service delivery

项目摘要

Project Summary Disparities in health outcomes and access to care for children and adolescents are large and persistent, with worse outcomes observed among children and adolescents who are Black and Hispanic, enrolled in Medicaid, live in low-income households, and live in rural areas. School-based health centers (SBHCs) may help to promote health equity by making care more accessible and affordable to school-aged children, meaning SBHCs are well-positioned to reduce disparities in health care use and health outcomes. Prior research generally suggests benefits from SBHCs. However, most studies only examine a few SBHCs and report correlational associations rather than causal evidence. This proposed study of SBHCs in California and Oregon will overcome the limitations of prior studies by using a large sample and rigorous causal inference methods. Because both states have experienced recent growth in SBHCs, we will exploit variation in availability of SBHCs over time and across schools to compare the impact of SBHCs on students before and after the opening of SBHCs in treatment schools (with SBHCs) and control schools (without SBHCs). Using multiple years of health insurance claims data, survey data, and education data, we will: (1) characterize SBHCs, including the services they provide, the patients receiving care at SBHCs, and changes since the start of the COVD-19 pandemic; (2) estimate the impact of SBHC access on health care utilization, cost, health outcomes, and education outcomes overall and for members of health disparity populations (defined by race/ethnicity, household income, and rurality); and (3) examine the dimensions on which SBHC characteristics vary, including location, services offered, size, and the pandemic to inform the operation of current SBHCS and design of future SBHCs. The proposed research is timely and important due to longstanding and new barriers to health care and the increasing recognition of the importance of schools in promoting the healthy development of children and adolescents.

项目总结