Learning Well

EvaluationYear 6 Report

2006-2007

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 2006-2007

• Achievement of Learning Well Objectives

Clinics Supported by Learning Well

14 Nurse Practitioner Model Clinics (10 in 2001-2002)

42 Basic Health Services Model Clinics(0 in 2001-2002)

19 Outreach Clinics (Feeder Schools)

Learning Well Schools: 75High 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 2005-2006)

• 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 2005-2006)

• Over one-half (55.2%) of the students in Learning Well schools visited the school-based clinics (vs. 56.7% in 2005-2006)

Clinical Services Provided:

2006-2007

Clinic Events

205,384 in 2006-2007122,319 in 2005-200674,910 in 2004-200553,862 in 2003-200418,951 in 2002-20035,351 in 2001-2002

Over 200,000 increase from 2001-2007

Grade of Clinic UsersGrade of clinic users

40.8%

25.4%

33.8%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

Elementary School Middle School High School

Pe

rce

nta

ge

Gender of Clinic Users

Gender of clinic users

Female48.9%Male

51.1%

Race/Ethnicity of Clinic Users

Race/Ethnicity of clinic users

White45.8%

Hispanic8.8%

Other1.4%

Black40.3%

Complexity of Clinic Visit

Complexity of Clinic Visit

Minor 63.4%

Low13.8%

High/Extensive2.1%

Moderate20.7%

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 & Counseling’s

Health Promotions Procedures1. Temperature2. Cold Pack

3. Wound Cleaning/Bandaging

Health Promotions Counseling1. Health2. Hygiene3. Nutrition

Top 3 Immunizations, Referrals

& Laboratory Services

Immunizations ReferralsHepatitis B Primary

CareFlu EyeIPV Other

Laboratory Services1. Urinalysis (UA) Dip2. Strep – Rapid3. 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

2006-2007

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 child’s 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:

Urgent Care Center0.9%

Keep child at home29.1%

Doctors off ice or

clinic2.6%

Treat and send to school67.4%

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:

Take them home 78.6%

Others 0.9%Doctor's Office

2.6%

Stay at School17.9%

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?

1.7

53.141.8

5.12.6

95.7

0

20

40

60

80

100

Definitely Somewhat Not really

Parents

Students

Goal II, continued

• Increase awareness of clinic services– Do the parents and students know what

services are available at the clinic?

77.4

7.0

43.038.0

18.915.7

0

20

40

60

80

100

Definitely Somewhat Not really

Parents

Students

Goal II, continued

• Increase awareness of community health resources– Do the parents and students know

where to get health services, other than the clinic?

86.3

5.1

52.3

37.1

10.58.5

0

20

40

60

80

100

Definitely Somewhat Not really

Parents

Students

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?

75.2

60.762.972.3

0

20

40

60

80

100

Sick Not Sick

Parents

Students

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 child’s physical health needs

being met at the clinic?

Well met56.2%

Very Well met

42.0%

Child has no

Physical Health needs1.8%

Goal IV, continued

• Are your child’s mental health needs being met at the clinic?

Well met16.8%

Child has no Mental

Health needs62.8%

Very Well met

20.4%

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 children’s physical health needs are generally being met, but not their mental health needs