1. HEADACHES AND HISTORY CLASS UNDER ONE ROOF: PATCH (PRE-ADOLESCENT TO TEEN CENTER FOR HEALTH) Sue Hemingway Tobi Chassie Bobby Kelly John Freeman Aimee Valeras

2. Objectives: Identify compelling factors that support school systems to collaborate with local health centers Understand opportunities and challenges in meeting students’ behavioral health and medical health care concerns and needs in the school-setting Highlight a successfully implemented collaborative partnership between a health center and local school district

3. Adolescent healthcare in schools Population that is difficult to engage in healthcare Spend the majority of their days in school Increasing adolescents’ health knowledge can potentially reduce risk-taking behavior and increase likelihood of academic success

4. Pittsfield Middle High School NH Dartmouth Family Medicine Residency

5. PATCH (Pre-Adolescent to Teen Center for Health)

6. How PATCH broadened the residents’ awareness about adolescent issues Nice to see firsthand how the care team at school works to help keep troubled youth safe and engaged in the system. Great to interact with teenagers in their own environment. They seemed to feel more comfortable being open and honest in a setting they were used to, which is often not the case in the office.

7. How PATCH will influence residents’ future practice I will consider integrated care with maintaining a presence in high risk teen school care teams. I feel more comfortable having the drugs/ETOH/safe sex talk after practicing it many times at the PATCH clinic. It will encourage me to communicate with school RNs on my patients in the future. I realize the office is an insular, sheltered place and we need to see situations in context.

8. What teens are saying about PATCH I don’t have time to go to my doctor’s office. They can help me with my problems. (I like) that it is here at school. They are nice and quick. (I learned) how to pace myself and what might be happening.

9. Community Collaboration and Support (CCS) Regular meetings with team members: Student and family, community mental health, child protective services, juvenile justice system, school personnel and resident physicians Facilitated to meet students’ needs in complex psychological, social, and/or medical situations.

10. In summary… This fruitful collaboration has resulted in Easier access to behavioral health and medical healthcare and referrals for adolescents Family medicine residents learning about and gaining comfort with adolescent population Schools and medical providers building relationships to work more collaboratively Can you consider adapting this model to fit identified needs at your home institution?

11. Our Contact Information Tobi Gray Chassie, M.Ed. – tchassie@pittsfieldnhschools.org tchassie@pittsfieldnhschools.org Bobby Kelly, MD – bobbykellymd@gmail.com bobbykellymd@gmail.com Susan Hemingway, MA, LCMHC – shemingw@crhc.org shemingw@crhc.org

12. References Kisker EE, Brown RS. Do school-based health centers improve adolescents’ access to health care, health status and risk-taking behavior? Journal of Adolescent Health. 1996;18(5): 335-343. Horton JM, Lima-Negron J. School-based health care: Advancing Educational success and public health. Washington DC: American Public Health Association; 2012. Parasuraman SR, Shi L. Disparities in access to care among students using school-based health centers. Journal of Adolescent Health. 2014;54(2):S68-S69. Audardottir-Goulay H, Mullen B, Greiner A, Hobson K, Satterwhite CL. Health care seeking and risk behaviors among high school students in the context of a school-based health center. Kansas Journal of Medicine. 2013;6(4). Lear JG, Gleicher HB, St. Germaine A, Porter PJ. Reorganizing health care for adolescents: The experience of the School Based Adolescent Health Care Program. Journal of Adolescent Health. 1991;12(6):450-458.