The Healthy Learner Model for Student Chronic Condition Management—Part I

BACKGROUND Educational and healthcare systems operate in silos. Few studies explore educators' perspectives of collaboration with pediatricians or cross‐system solutions for school‐identified concerns. We sought to investigate educators' viewpoints of collaboration with pediatricians. METHODS We conducted semistructured, qualitative interviews with full‐time teachers, vice‐principals, and principals, who worked with low‐income first‐ or second‐grade students. Interviews explored which students were concerning to educators, educators' experiences with collaboration, and barriers and facilitators of collaboration. Interview transcripts were analyzed with modified grounded theory. RESULTS We interviewed 12 teachers and 3 principals/vice‐principals. Students' socioemotional problems were a foremost concern. Effective collaboration with pediatricians was not typical. Participants described not knowing they could communicate with pediatricians or that collaboration was often limited or unidirectional. Respecting boundaries of parental privacy and maintaining parental trust emerged as potential barriers. Some participants described negative experiences with pediatricians and reflected on societal perceptions of doctors and teachers, which could affect the development of relationships. Participants recognized potential benefits to collaboration, including gaining a holistic understanding of a child's health and home life. CONCLUSIONS Educators perceived collaboration with pediatricians as inadequate. More developed and tested programs that foster collaboration between schools and pediatricians are needed to support low‐income youth.

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confidence: 99%

Educators' Perspectives of Collaboration With Pediatricians to Support Low‐Income Children

Lemkin

Walls

Kistin

et al. 2019

“…This high level of care coordination by the school nurse requires expertise in diabetes management as well as a foundational understanding of diabetes pathophysiology. 7 However, there is no standardized training for school nurses to ensure diabetes competency in these areas. Therefore, many nurses and other health staff take on their roles with limited expertise in pediatric diabetes and minimal training.…”

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confidence: 99%

“…Children with diabetes spend most of their day at school and require assistance with diabetes management to ensure health, safety and academic success. Thus, public schools must be able to support the medical needs of children with diabetes to ensure safety and equitable access to education . This is a difficult task to achieve considering there is no standardized diabetes training for school health personnel, and access to continuing education resources for schools is limited .…”

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confidence: 99%

“…As a result, most school nurses delegate medical responsibilities and tasks to teachers, other administrative staff, and unlicensed paraprofessionals, commonly referred to as health aides, when allowable by local nurse practice laws. This high level of care coordination by the school nurse requires expertise in diabetes management as well as a foundational understanding of diabetes pathophysiology . However, there is no standardized training for school nurses to ensure diabetes competency in these areas.…”

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confidence: 99%

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Equipping School Health Personnel for Diabetes Care with a Competency Framework and Pilot Education Program

Berget

Nii

Wyckoff

et al. 2019

BACKGROUND Schools struggle to support health needs of students with diabetes due to limited funding/resources. A competency framework can help individual schools clarify the knowledge and skills required for school‐based diabetes care within their unique context, and inform the development of standardized diabetes education for health staff. METHODS A consensus‐building technique, known as the Delphi method, was used to create a competency framework for diabetes care at school with a panel of 37 stakeholders. A continuing education program based on the resultant framework was developed and pilot‐tested with school nurses. Pretest and post‐test scores on knowledge, perceived competence, and self‐efficacy were compared to evaluate the effectiveness of the program. RESULTS Consensus was obtained for a total of 70 competencies: 22 competencies for health aids, 36 additional competencies for school nurses, and 12 additional competencies for diabetes resource nurses. Thirty school nurses completed the continuing education program and demonstrated significant improvement in diabetes knowledge, self‐efficacy, and competence in pathophysiology and diabetes care tasks (p < .01 for all). CONCLUSIONS Developing a consensus framework is an excellent starting place for stakeholders to identify the skills and knowledge required for various school personnel and to ensure that all school health staff members receive adequate diabetes education.

Health Services: Results From the School Health Policies and Programs Study 2006

Brener¹,

Wheeler²,

Wolfe³

et al. 2007

SHPPS 2006 suggests that the breadth of school health services can and should be improved, but school districts need policy, legislative, and fiscal support to make this happen. Increasing the percentage of schools with sufficient school nurses is a critical step toward enabling schools to provide more services, but schools also need to enhance collaboration and linkages with community resources if schools are to be able to meet both the health and academic needs of students.