Original articleImpact of a school-based intervention on access to healthcare for underserved youth
Section snippets
The Children First Plan
The Plan is a 3-year pilot intervention program designed to improve outcomes for children and families in high-risk schools and neighborhoods in Hamilton County, Ohio. The Plan was developed by the Family and Children First Council, a multidisciplinary organization of over 80 local agencies and institutions serving children and youth. Based on an extensive needs assessment, including community input, the Council identified four priorities for the Plan: reducing school absences and discipline
Population
The target population for the student survey consisted of all seventh- through 12th-grade students enrolled in regular classes in the intervention and comparison schools. Precise participation rates could not be calculated owing to lack of exact enrollment and attendance data for the days that the survey was administered. The response rate calculations that follow are based on best-guess estimates. The overall proportion of enrolled students who completed useable surveys was approximately 42%.
Results
Participant characteristics, stratified by intervention versus comparison group and by year, are summarized in Table 1. The groups were similar with respect to gender, health status, and the presence of one or more chronic health conditions over both years. Although the median age was 15 years in all groups and the median grade was ninth, the nonparametric testing demonstrated that the intervention students were older in Year 2 and that the grade level was higher for both the intervention and
Discussion
Students in these schools, especially those with fair or poor health status, report high levels of unaddressed healthcare needs. The proportion who reported not seeking medical care they believed they needed in the past year was almost double the lifetime rate of 27% found in the Commonwealth Fund’s recent national survey [11]. This disparity likely reflects the disadvantaged status of the poor and middle-class urban public school students in our population. There was a 6% absolute increase in
Acknowledgements
This project was supported by the Family and Children First Council of Hamilton County, Ohio and by Children’s Hospital Medical Center and the Institute for Health Policy and Health Services Research, University of Cincinnati, Cincinnati, Ohio. The authors thank the staff and students of the participating school districts for their participation, and Carol Muir for assistance with manuscript preparation.
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