Gersch Victoria, Garofalo Luciano, Rigel Sara, Johnson Kris, Yeun Samantha T, MacDougall Erin, van Draanen Jenna
University of Washington Department of Health Systems and Population Health, 3980 15th Ave NE, Forth Floor, Box 351621, Seattle, WA 98195, USA.
University of Washington School of Nursing Department of Child, Family, and Population Health Nursing, 1959 NE Pacific Street, Box 357262, Seattle, WA 98195, USA.
Prev Med Rep. 2024 Mar 5;41:102675. doi: 10.1016/j.pmedr.2024.102675. eCollection 2024 May.
School-Based Health Centers (SBHCs) can reduce barriers to accessing care for school-aged children and adolescents. However, current practices related to screening for and responding to social determinants of health (SDOH) in SBHCs are unknown. Our study sought to understand SBHC staff's knowledge related to SDOH, and their screening and referral practices for addressing SDOH.
This study was conducted with all SBHCs in King County, Washington (n = 30 clinics operated by n = 8 agencies) between January-March 2022. Data were collected using a web-based questionnaire, distributed to all provider and clinical care staff (n = 222) in these SHBCs.
While respondents had strong generalized knowledge regarding SDOH and how they impact health, they were less confident about the specific SDOH impacting the students they serve. Many health limiting and promoting factors are screened for by respondents; however, there was no standardization related to screening and referral practices across SBHCs or agencies. Respondents had suggestions on how to improve screening methodology and ensure that existing practices adequately assess the SDOH impacting student's lives. There was no clearly identified mechanism for making and following up on referrals. Respondents felt that there were either not or only sometimes enough resources available to meet student's needs.
SBHCs advance health and educational outcomes for students, yet SDOH are inconsistently assessed and addressed within SBHCs in King County. Standardizing processes for SDOH assessment and referral can help SBHCs develop practices that are in the best service of equity for their student populations.
校内健康中心（SBHCs）可以减少学龄儿童和青少年获得医疗服务的障碍。然而，目前SBHCs中与健康的社会决定因素（SDOH）筛查及应对相关的做法尚不清楚。我们的研究旨在了解SBHC工作人员关于SDOH的知识，以及他们针对SDOH的筛查和转诊做法。
2022年1月至3月期间，对华盛顿州金县的所有SBHCs（由8个机构运营的30家诊所）进行了这项研究。通过基于网络的问卷收集数据，问卷分发给这些校内健康中心的所有医疗服务提供者和临床护理人员（共222人）。
虽然受访者对SDOH及其如何影响健康有很强的一般知识，但他们对影响其所服务学生的具体SDOH不太有信心。受访者对许多限制健康和促进健康的因素进行了筛查；然而，SBHCs或各机构之间在筛查和转诊做法上没有标准化。受访者就如何改进筛查方法以及确保现有做法充分评估影响学生生活的SDOH提出了建议。没有明确确定的转诊跟进机制。受访者认为，要么没有足够的资源，要么只有有时有足够的资源来满足学生的需求。
SBHCs促进了学生的健康和教育成果，但金县的SBHCs对SDOH的评估和处理并不一致。标准化SDOH评估和转诊流程有助于SBHCs制定最有利于其学生群体公平性的做法。
