Learning Well Evaluation Year 6 Report

Evaluation Team Terrell W. Zollinger, Dr.P.H. –Epidemiologist & Biostatistician Robert M. Saywell, Jr., Ph.D., M.P.H. –Health Economist Komal Kochhar, M.B.B.S., M.H.A. –Clinician & Health Administrator Christina A. Mandzuk, B.S.E. –Senior Research Assistant

Data Sources Clinic Services (Welligent) Student Surveys 205,384 (5,351 in 2001) 483 (104 in 2001) Parent Surveys Clinic Staff Surveys 118 (34 in 2001) 35 (6 in 2001) School Faculty/Staff Surveys Clinic Activity Logs 307 (134 in 2001) 342 (107 in 2001) Students Provided with Clinic Services 20,967

Overview Learning Well Description and Trends Clinical Services Provided in Achievement of Learning Well Objectives

Clinics Supported by Learning Well 14 Nurse Practitioner Model Clinics (10 in ) 42 Basic Health Services Model Clinics (0 in ) 19 Outreach Clinics (Feeder Schools)

Learning Well Schools: 75 High Schools (4 in 2001) 15 (9-12) 1 (K-12)* 2 (6-12)* Middle Schools (6 in 2001) 25 (6-8) 1 (K-12)* 2 (6-12)* 4 (K-8)* Elementary Schools (0 in 2001) 24 (K-5) 1 (K-12)* 4 (K-8)* * Seven schools have a combination of elementary (4), middle (2), or high (1), hence have been counted in each category

Penetration Rates Over one-third (37.1%) of IPS students had access to a Learning Well school-based clinic (vs. 37.7% in ) One-fifth (19.7%) of all Marion County children (5- 17 years) had access to a Learning Well school-based clinic (vs. 17.9% in ) Over one-half (55.2%) of the students in Learning Well schools visited the school-based clinics (vs. 56.7% in )

Clinical Services Provided:

Clinic Events 205,384 in ,319 in ,910 in ,862 in ,951 in ,351 in Over 200,000 increase from

Grade of Clinic Users

Gender of Clinic Users

Race/Ethnicity of Clinic Users

Complexity of Clinic Visit

Top 10 reasons for visit Headache Vaccines Counseling Pain Skin Disorders Medical Exams Behavioral Health Problems Pharyngitis/Tonsilitis/Sinusitis Screenings Menstrual Disorders

Top 3 Health Promotions Procedures & Counselings Health Promotions Procedures 1.Temperature 2.Cold Pack 3.Wound Cleaning/Bandaging Health Promotions Counseling 1.Health 2.Hygiene 3.Nutrition

Top 3 Immunizations, Referrals & Laboratory Services Immunizations Referrals Hepatitis BPrimary Care FluEye IPVOther Laboratory Services 1.Urinalysis (UA) Dip 2.Strep – Rapid 3.Pregnancy Test- Urine

Regular Source of Primary Care 78.0% of students had a primary care provider Utilization –32.2% had been admitted to a hospital in the past year –33.6% were treated in an Emergency Room or Urgent Care Center in the past year

Achievement of Learning Well Objectives

Learning Well Goals Goal I: Address Barriers to Health Care Access Goal II: Provide Health Care Knowledge Goal III: Address Attitudinal Barriers Goal IV: Address Clinic Provider Issues

Goal I: Address Barriers to Health Care Access Address economic barriers –19.8% of parents indicated they would NOT be able to pay for their childs medical services if the clinic were not here

Goal I, continued Convenient location for health care services –100.0% of parents and 95.4% of students agreed Convenient hours for health care services –100% of parents and 93.3% of students agreed

Goal I, continued If the clinic were not here, where would parents take their child if he/she had a minor illness before leaving for school:

Goal I, continued If the clinic were not here, where would parents take their child if he/she had a minor illness while in school:

Goal II: Provide Health Care Knowledge Provide awareness of the value of preventive medicine –Parents: 82.9% schedule a regular check up for their child each year –Students: 36.3% visit the clinic to get health information even when not sick –Teachers: 57.9% VERY appropriate and 38.2% SOMEWHAT appropriate for children to miss class to visit the clinic for preventive care

Goal II, continued Provide knowledge of self-care and preventive care –Do the parents and students know how to keep healthy?

Goal II, continued Increase awareness of clinic services –Do the parents and students know what services are available at the clinic?

Goal II, continued Increase awareness of community health resources –Do the parents and students know where to get health services, other than the clinic?

Goal III: Address Attitudinal Barriers Provide a comfortable setting for health care –Parents: 97.4% indicated they were comfortable with their children receiving health care at the clinic –Students: 96.9% indicated they were comfortable receiving health care at the clinic

Goal III, continued Address the value of health care –How often is a regular medical check up scheduled, when child is sick/not sick?

Goal III, continued Address the perception of the need for care –Parents: 96.6% were VERY comfortable and 3.4% were SOMEWHAT comfortable deciding when to seek medical care for their child

Goal IV: Address Clinic Provider Issues, continued Are your childs physical health needs being met at the clinic?

Goal IV, continued Are your childs mental health needs being met at the clinic?

Health and School Performance 89.1% students believed their school performance 87.3% students believed their health 84.7% students believed their grades ….had either improved or were the same compared to one year ago

Conclusions

Part I Increased number of schools and students served High risk children – –32% hospitalized –34% have ER visits Parents and children highly satisfied

Part II Students more likely to go to school and stay in school for minor illnesses Parents and children only somewhat knowledgeable about preventive health care Parents feel their childrens physical health needs are generally being met, but not their mental health needs