Parent Knowledge and Opinions of School Health Services in an Urban Public School System. (Articles)

Article excerpt

School health services have existed for more than 100 years, beginning with attempts to control the spread of communicable disease. Increasingly, health services provided by schools have expanded to meet other acute, chronic, and preventive health care needs. The American Academy of Pediatrics (1) recommends that each comprehensive health assessment visit, beginning at age three, include attention to school health issues.

Public school districts in the United States provide varying levels of health services to their students. Level of service depends on several factors such as state and federal laws, local board of education perceptions about the importance of health services, and parental and community involvement. Basic school health services, usually provided by nurses, include screening for medical conditions, administration of prescribed medications, care of children with special health needs, assessment for acute and/or contagious conditions, administration of first aid, health education and promotion activities, assessment of student immunization status, and maintenance of school health records. (2) Some local boards of education also partner with universities and other institutions of higher learning, providing expanded services for younger students and opportunities for learning through providing service to communities (service-learning) to college students. (3, 4)

Many public school districts recognize the correlation between healthy students and academic performance, and they offer a wider array of health services. These services include well-child physical examinations, access to a school-based health center providing acute care to students at school, and active solicitation of community health resources to meet individual family needs. The American Academy of Pediatrics recently issued a policy statement regarding the integration of expanded school health services into community-based health care systems. This statement (5) elaborated on the actual and potential benefits of expanding health services offered in schools.

Several studies examined school health systems and parent follow-up to referrals made as part of school health screenings. Some evidence suggests that access to school-based health centers improves health care access and use for underserved minority elementary school children. (6) A survey of Nebraska parents showed that parents ranked school health activities such as providing first aid and emergency care, preventing or controlling infectious disease, caring for students who become sick at school, maintaining confidentiality of health records, and maintaining a safe environment as "extremely important." (7) Yet, school health personnel often become frustrated when a problem requiring further intervention has been identified, and parents do not follow through on referrals. Barriers to follow-up identified in some studies (8-10) include parents not having time to follow-up, not having financial resources, competing priorities, perception of poor communication between the schools and parents, lack of appropriate providers, and parental beliefs that the problem referred was not serious enough for follow-up.

The Dayton (Ohio) Public Schools system offers a comprehensive school health program to students. This article reports on a school survey of parents' knowledge and attitudes toward preventive health care and other services offered by the Dayton (Ohio) Public Schools, and identifies barriers to follow-up on referrals.

BACKGROUND

The Dayton (Ohio) Public School (DPS) district serves a student population of approximately 24,000. In Dayton, a medium-sized city in southwestern Ohio of 167,400, residents, the district consists of 32 elementary schools, five middle schools, and six high schools. Approximately 68% of the student population is African American. Most of the remaining students are Caucasian, with less than 2% coming from other ethnic groups. …