Differences Exist in Utilization of School Based Health Centers by School Semester and by Proportion of Low-Income Students

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Bibliographic Details
Title: Differences Exist in Utilization of School Based Health Centers by School Semester and by Proportion of Low-Income Students
Language: English
Authors: Jenna Van Draanen, Taylor C. Ryan (ORCID 0000-0001-7484-4749), Luciano Garofalo (ORCID 0000-0003-3211-9279), Brenda Y. Goh (ORCID 0009-0001-6079-4629), Sara Rigel, Samantha T. Yeun, Erin MacDougall, Michael Nash (ORCID 0000-0003-1950-5837)
Source: Journal of School Health. 2025 95(9):723-730.
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 8
Publication Date: 2025
Document Type: Journal Articles
Reports - Research
Education Level: Elementary Education
Junior High Schools
Middle Schools
Secondary Education
High Schools
Descriptors: School Health Services, Access to Health Care, Elementary Schools, Middle Schools, High Schools, Racial Differences, Income, Attendance, Correlation, Student Characteristics
Geographic Terms: Washington (Seattle)
DOI: 10.1111/josh.70045
ISSN: 0022-4391
1746-1561
Abstract: Background: School based health centers (SBHCs) are essential for providing health care to students. Literature demonstrates student characteristics such as race and income are associated with SBHC utilization; however, little data exists on temporal trends in utilization. This gap in knowledge is crucial for informing policies and resource allocation. Methods: This study examined utilization across 27 SBHCs at elementary, middle, and high schools in King County, Seattle from 2017 to 2021. Negative binomial models with random intercepts were constructed to evaluate semester-level variation in utilization, accounting for school-level differences in race, income, and attendance. Interaction models were constructed to test for effect modification of utilization by race, income, and attendance. Results: Findings indicate that higher rates of utilization occurred in the fall. There was a decrease in utilization during the study, potentially due to the pandemic. Lower school-level income was positively and significantly associated with higher utilization and none of the interaction models were significant. Implications: Our study holds important implications for planning and policy recommendations surrounding SBHC care delivery, such as the potential need for more staffing to meet the higher demand in the fall. Conclusion: SBHC utilization varies by semester and schools serving low-income communities may experience higher rates of utilization, requiring increased staffing needs.
Abstractor: As Provided
Notes: www.ashaweb.org
Entry Date: 2025
Accession Number: EJ1479153
Database: ERIC
Description
Abstract:Background: School based health centers (SBHCs) are essential for providing health care to students. Literature demonstrates student characteristics such as race and income are associated with SBHC utilization; however, little data exists on temporal trends in utilization. This gap in knowledge is crucial for informing policies and resource allocation. Methods: This study examined utilization across 27 SBHCs at elementary, middle, and high schools in King County, Seattle from 2017 to 2021. Negative binomial models with random intercepts were constructed to evaluate semester-level variation in utilization, accounting for school-level differences in race, income, and attendance. Interaction models were constructed to test for effect modification of utilization by race, income, and attendance. Results: Findings indicate that higher rates of utilization occurred in the fall. There was a decrease in utilization during the study, potentially due to the pandemic. Lower school-level income was positively and significantly associated with higher utilization and none of the interaction models were significant. Implications: Our study holds important implications for planning and policy recommendations surrounding SBHC care delivery, such as the potential need for more staffing to meet the higher demand in the fall. Conclusion: SBHC utilization varies by semester and schools serving low-income communities may experience higher rates of utilization, requiring increased staffing needs.
ISSN:0022-4391
1746-1561
DOI:10.1111/josh.70045