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  • Evaluating the Sustainability of School-Based Health Centers
  • Stephanie Navarro, BA , Dorothy L. Zirkle, PhD, PHN, RN , and Donald A. Barr, MD, PhD

What Is the Purpose of this Study?

  • • To determine critical factors necessary for the sustainability of school-based health centers (SBHCs).

  • • To examine usefulness of expert SBHC sustainability models in practice in a community setting, including how these models may be especially helpful to planning for SBHC sustainability and how they may be lacking.

What Is the Problem?

  • • Funding and policies are being directed toward the establishment of SBHCs as community-based medical homes; however, little work has examined how to make SBHCs lasting, sustainability service providers in the community setting.

  • • Expert models of SBHC exist to inform SBHC administration and planning efforts; yet these models have yet to be substantiated through empirical research or demonstrated across the many community and clinic settings that SBHCs exist in.

What Are the Findings?

  • • Critical factors of SBHC sustainability were found to include care coordination, community buy-in, and community awareness.

  • • Cooperation between and across community partners in building, operating, and maintaining was a crucial element of ensuring that the three critical factors of SBHC sustainability are able to be accomplished.

  • • These findings support certain common themes from expert models of SBHC sustainability and illuminate ways in which factors from expert models may interact and support each other.

Who Should Care Most?

  • • Community clinics, schools and school districts, public and community health officials interested in or involved with SBHCs, and community organizations funding community health projects and SBHCs.

Recommendations for Action

  • • Although this work was only looking at a case study of three SBHCs, there is support from both these findings, as well as expert models of SBHC sustainability, for the importance of community partnerships that cohesively work to operate and maintain SBHCs and for thorough community involvement and high quality care that ensures patient traffic is maintained in the SBHC.

  • • Those looking to open new SBHCs or build sustainable practices into current SBHCs should work to incorporate these measures into the operations of their SBHC. [End Page 223]

Stephanie Navarro
Program in Human Biology, Stanford University
Dorothy L. Zirkle
School of Nursing, San Diego State University
Donald A. Barr
Program in Human Biology, Stanford University
Submitted 11 May 2016, revised 10 September 2016, accepted 17 September 2016.
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