Exploring and Addressing the Underutilization of a School-Based Health Center: A Community-Based, Participatory Action Research Study
MetadataShow full item record
The purpose of this community-based, participatory action research study was to address the underutilization of a school-based health center (SBHC) at a public elementary school in the Pacific Northwest. The stakeholders in this study defined underutilization as the lack of sufficient patient encounters to generate a stable revenue stream that would, at minimum, cover the SBHC’s operational costs and contribute to its sustainability. The study employed community-based, participatory action research (CBPAR) methodology as outlined by Minkler and Wallerstein (2008). In this study, two separate CBPAR teams went through two consecutive action research cycles that involved iterations of identification, reflection, and intervention. Action research cycle one took place between October 2012 and July 2013 and action research cycle two took place between August 2013 and June 2014. In addressing the issue of the SBHC’s financial sustainability the CBPAR teams achieved the following outcomes: (a) the SBHC’s hours were revised to better meet the population’s needs; (b) an operational protocols binder was created to document operational protocols and policies; (c) an informational video was created to answer the most common questions from educators and parents; (d) a marketing and communication policy was established; (e) the planning protocol was revised to include in-depth discussions to establish the SBHC’s purpose and mission prior to it is launched; and, (f) the medical sponsorship organization self-financed the SBHC for one school-year after grant funding was depleted. The conclusions of the study are: (a) a major stumbling block to the on-going sustainability of SBHCs is the persistent divergence in understanding the goals, purposes, and mission of the center among stakeholders; (b) CBPAR is an effective tool for maintaining effective collaborative relationships among SBHC stakeholders; and (c) the conceptual model guiding this study should be enhanced to help SBHCs prioritize potential funding streams in their sustainability model including the possibility of mainly relying on patient revenue.