I.U. Bowen Research Center Indiana University Bowen Research Center Bowen Research Center Terrell W. Zollinger, Dr.P.H. Robert M. Saywell, Jr., Ph.D., M.P.H. Komal Kochhar, M.B.B.S., M.H.A. Christina A. Mandzuk, B.S.E. Learning Well Evaluation Year 5 Report Academic Year

I.U. Bowen Research Center 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

I.U. Bowen Research Center Data Sources Clinic Services (Welligent)Student Surveys 122,319 (5,351 in 2001) 284 (104 in 2001) Parent Surveys Clinic Staff Surveys 68 (34 in 2001) 45 (6 in 2001) School Faculty/Staff Surveys Clinic Activity Logs 309 (134 in 2001) 313 (107 in 2001)

I.U. Bowen Research Center Overview Learning Well Description and Trends Clinical Services Provided in Achievement of Learning Well Objectives

I.U. Bowen Research Center Learning Well Description

I.U. Bowen Research Center Clinics Nurse Practitioner Model Clinics (10 in ) 39 Basic Health Services Model Clinics (0 in ) 20 Feeder School Outreach Clinics

I.U. Bowen Research Center Learning Well Schools: High Schools (4 in 2001) 21 Middle Schools (6 in 2001) 34 Elementary Schools (0 in 2001)

I.U. Bowen Research Center Learning Well, Inc. Penetration Rates 37.7% of IPS Students have access to a Learning Well clinic (14,330/38,036) 17.9% of all Marion County Children (ages 5-17) have access to a Learning Well clinic (28,717/160,396)

I.U. Bowen Research Center Learning Well, Inc. Utilization Rates 56.7% of the students at schools served by Learning Well clinics have visited the clinics (16,282/28,717)

I.U. Bowen Research Center Clinical Services Provided in

I.U. Bowen Research Center Clinic Services: 122, ,319 in ,910 in ,862 in ,951 in ,351 in Over a twenty fold increase

I.U. Bowen Research Center Grade of Clinic Users

I.U. Bowen Research Center Gender of Clinic Users

I.U. Bowen Research Center Race/Ethnicity of Clinic Users

I.U. Bowen Research Center Complexity of Clinic Visit

I.U. Bowen Research Center Top Ten Reasons for Visit Headache Physical examination Counseling Vaccines Rhinitis/Bronchitis Menstrual disorders Skin disorders Esophagus/Stomach disorders Pharyngitis/Tonsilitis/Sinusitis Pain- abdomen

I.U. Bowen Research Center Regular Source of Primary Care 86.3% of students had a primary care provider Utilization –33.1% had been admitted to a hospital in the past year –39.6% were treated in an Emergency Room or Urgent Care Center in the past year

I.U. Bowen Research Center Achievement of Learning Well Objectives

I.U. Bowen Research Center Learning Well Goals Goal I: Address Student Barriers to Health Care Access Goal II: Provide Students/Parents with increased Health Care Knowledge Goal III: Address Student/Parent Perception Barriers to Clinic Utilization Goal IV: Address Clinic Provider Perception of the Ability of Clinics to Meet Student Health Care Needs

I.U. Bowen Research Center Goal I: Address Barriers to Health Care Access Address economic barriers –75.8% of parents indicated they would NOT be able to pay for their child’s medical services if the clinic were not here

I.U. Bowen Research Center Goal I, continued Convenient location for health care services –100.0% of parents and 97.7% of students agreed Convenient hours for health care services –98.4% of parents and 95.3% of students agreed

I.U. Bowen Research Center 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:

I.U. Bowen Research Center 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:

I.U. Bowen Research Center Goal II: Provide Health Care Knowledge Provide awareness of the value of preventive medicine –Parents: 88.2% schedule a regular check up for their child each year –Students: 42.9% visit the clinic to get health information even when not sick –Teachers: 59.4% VERY appropriate and 34.8% SOMEWHAT appropriate for children to miss class to visit the clinic for preventive care

I.U. Bowen Research Center Goal II, continued Provide knowledge of self-care and preventive care –Do the parents and students know how to keep healthy?

I.U. Bowen Research Center Goal II, continued Increase awareness of clinic services –Do the parents and students know what services are available at the clinic?

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

I.U. Bowen Research Center Goal III: Address Attitudinal Barriers Provide a comfortable setting for health care –Parents: 97.0% indicated they were comfortable with their children receiving health care at the clinic –Students: 97.8% indicated they were comfortable receiving health care at the clinic

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

I.U. Bowen Research Center Goal III, continued Address the perception of the need for care –Parents: 91.2% were VERY comfortable and 8.8% were SOMEWHAT comfortable deciding when to seek medical care for their child

I.U. Bowen Research Center Goal IV: Address Clinic Provider Issues, continued Are your child’s physical health needs being met at the clinic?

I.U. Bowen Research Center Goal IV, continued Are your child’s mental health needs being met at the clinic?

I.U. Bowen Research Center Health and School Performance 87.8% believed their health…… 88.6% believed their school performance… 84.9% believed their grades…… ….had either improved or were the same compared to one year ago (student survey)

I.U. Bowen Research Center Conclusions

I.U. Bowen Research Center Part I Learning Well increased the number of school-based health clinics and the number of students who were provided services Significant numbers of High risk children (30% hospitalized, 40% have ER visits) were identified Parents and children highly satisfied with Health Services provided by Learning Well

I.U. Bowen Research Center 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 children’s physical health needs are generally being met, but not their mental health needs