For many school-based mobile health programs, success connects to challenges and successful partnerships. Mobile healthcare staff shared with SBHA that while success is most often the students served, services provided, removal of barriers, reduction of stigma, and community engagement, these marks of success are only possible with strong partnerships. Many programs note that a successful partnership starts with a champion at the school to act as a liaison between the program and the school to create buy-in and facilitate initial communication. Many programs described advocating for this type of role, often asking for someone in administration with decision-making power and the ability to call for students. One informant shared that this is their most significant source of buy-in and success:

“If they buy in, we typically have a success. Once we have a breakdown somewhere in that chain, those are the schools we’re struggling at, we’re not typically getting that many kids or there’s always a hassle to get to what you need. But the principals that are really buying in, they assign somebody who can help us with our day-to-day stuff…So that’s typically a successful school for us is when we have everything from top down, everybody buying in.”
– Sponsor Representative, Florida

A consistent, stable presence is vital for community buy-in, engagement, quality health care, and trust. However, sometimes communities are hard to reach, and a champion can provide a connection. Champions are trusted pillars in their school communities, such as principals, teachers, librarians, and school nurses who continually support mobile clinics by advocating, organizing, and coordinating events to encourage students and families to seek services if needed. For example, one school-based mobile healthcare program staff noted that school nurses justify the need for mobile units for their schools, students, families, and communities:

“I mean honestly, it’s gotten to the point now where the nurses at the schools justify it to us that they want the mobile unit there.”
– Sponsor Representative, Arkansas

For school-based mobile healthcare programs’ success, the people within the education system —from top to bottom—must be enthusiastic participants. This can be a challenge as there are many competing yet complementary school priorities, such as testing, attendance rates, and discipline issues.
When the school-based mobile healthcare professionals demonstrate their commitment to the school’s priorities through their actions, the school support likely follows.

It is critical to engage school partners for the following reasons:

• • • Conducting outreach to school leaders increases school-based mobile healthcare program visibility and promotes involvement.
    • Engaging with school staff reiterates the importance, benefits, and impacts of student health and wellness. It also builds trust and support for the school-based mobile healthcare team and increases referrals.

Create coordinated systems of care between the school-based mobile healthcare program and the school, such as joint protocols for obtaining consent, enrolling students, and sharing information.

Demonstrating that you are integral to the school’s health and wellness will lead to an increase in the visibility of your school-based mobile healthcare program. Some ideas include:

• • • Lead school-wide events and age-appropriate classroom health education lessons. Be sure to obtain permission from school leadership and teachers first.
    • Attend interdisciplinary meetings (e.g., student support teams, individualized education plan (IEP) teams, curriculum development teams) and school-wide events (i.e., staff meetings, PTA meetings, back-to-school nights, attendance meetings, discipline meetings, and student support/services coordination meetings).
    • Present at teacher orientations and offer professional development or in-service days on wellness.

Some key informants shared that many of their school partners are increasing their understanding of the value of their school-based mobile healthcare programming:

“You’re going to have all these other barriers to getting them to pay attention, and if their goal is to get these kids educated and to a certain level, they will have to be healthy, and that’s where we’re there to support them. So, when we have a principal who receives the message, it trickles down all the way to the front-line staff.”
– Sponsor Representative, Florida

As primary beneficiaries of school-based mobile healthcare, young people are critical partners. Their voices need to be heard and active across the design, implementation, delivery, and evaluation of your efforts. When youth champion healthcare in their schools, they can both advocate for the needs and create demand for access to better healthcare. School-based mobile healthcare programs that incorporate youth perspectives exhibit a model healthcare system, one that values collective input and the holistic success of children and adolescents.

• • • Foster student leaders and give them more equity (and ownership) in decisions about their health and wellness.
    • Create a Youth Advisory Council (YAC) if no such group exists. YACs empower student leaders through creative problem-solving. They are crucial for identifying student concerns in the school environment, designing youth-led strategies to address them, and representing the student body.
    • Collaborate with student leaders to design health promotion messages and share them with their peers. Promote activities through youth-friendly communication channels such as school social media, newsletters, and P.A. system announcements.
    • Empower youth to build their practical skills, make healthier decisions, share their experiences and opinions on health and wellness, and take leadership roles in their schools and communities.
    • Receive feedback on the services, programs, and policies youth want, need, and expect.
    • Conduct school-wide needs assessments, student surveys, and focus groups so students can identify their top concerns and priorities within their environment. Engaging youth in this way can uncover health inequities across diverse genders, races, and sexual identities and identify culturally competent approaches for each affinity group.
    • Ask youth to collect the data, too. They can explain to their peers the data collection process, its importance, and how it will be used. They can also administer the assessments.
    • Gain insight into the social determinants of health or root causes of health disparities or poor health outcomes youth face.
    • Identify meaningful actions to get the conditions to achieve positive health and education outcomes for students.
    • Where possible, offer incentives to foster student participation in your program. Incentives should be appealing to youth–offer community service hours, gift cards, or other giveaways, and host awards ceremonies to recognize student participants and leaders.

As the prime educators for their children, parents and guardians play an important role in shaping opportunities and outcomes for children and youth. And because of their powerful influence in schools, neighborhoods, and communities, parents and guardians can be catalysts towards student health. School-based mobile healthcare professionals must make a positive connection with parents and guardians to increase their support for their programs and services.

Parents and guardians can collaborate with school-based mobile healthcare programs in various ways: serving on advisory teams, providing consent for their children to receive services, promoting awareness of healthcare services, and advocating to the school and district leaders and local legislators for funding and support.

Make parents and guardians feel like welcome and valued partners.

• • • Invite parents, guardians, and parent groups to participate as partners in advisory committees so that they may provide input and feedback throughout the school-based mobile healthcare planning and implementation process.
    • Institute a process to obtain parental/guardian consent for children and youth to be able to utilize the school-based mobile healthcare services. At the beginning of the year, distribute packets with the school-based mobile healthcare program information and consent forms.

Here are some sample consent forms from the school-based mobile healthcare field.

• Sample Consent form One
• Sample Consent form Two
• Sample Consent form Three

The success of school-based mobile healthcare programs is linked to collaborating with the entire school community. You can engage the school community by attending school activities – such as field days, health fairs, parents’ nights, and open houses, collaborating with partners, and maintaining relationships with communities, families, students, and the school’s staff. These activities allow the school-based mobile healthcare programs to be visible to the community and ease any apprehension about the mobile units, the services being offered, and the staff.

 “The brick-and-mortar sites are integrated into the schools in a very different way than the mobile units because they are physically embedded into the school structure…. And then sometimes there may be a little bit of reservation having services provided in a mobile space. It’s still a little of a newer phenomenon for some folks. I’ll have parents’ call. They’re like “well, I’ll just have my child go to their regular Doctor’s office. I don’t want them to be seen on a bus” but then, when they visit, they’re like, “oh, wait, this is like a real doctor’s office” like yeah, we just have four wheels, [and] we move from site to site.”
– Sponsor Representative, California

While visibility and transparency increase trust, many programs also stress the need for stability and advocacy. Many students have experienced traumatic events and tremendous losses that require trauma-enforced and culturally sensitive care:

 “So, a big part of the youth right now is just consistent presence. And so, I think that consistency is a really important piece. And so, if that means just like really advocating for your organization, or whoever you’re working with, to have that consistency of time and day that is – speaks so loudly to the partners that you’re working with, and, most importantly, the students and the families.”
– Sponsor Representative, Arizona

Another key informant provided an example of a historically difficult district to collaborate with because they could not maintain consistency in the school due to turnover. However, they finally connected with the community and achieved buy-in due to a champion:

 “We’ve had another [district] that we always had trouble breaking in[to] and really understanding. They knew that they needed us. They begged us, “Please bring your mobile units out, and we really need your help.” But then we’d park and nobody would come. But they’d still beg us, “I know it was really bad. But come back again.” We’d come back, and nobody showed. It came down to again to a – It was a librarian at this school that knew the community, knew what we had to offer. And really advocated for us to be there. And now, one of the smallest school districts that we have, we have the highest use out of. They come in droves now, when opposed to we’d be lucky if we got one family to come in.”
– Sponsor Representative, California

Many programs wish that schools knew that school-based mobile healthcare programs are an asset for schools, as they all have the same goal: to facilitate learning for healthy kids.

 “I mean, we are definitely keeping those kids healthy and making sure that they stay in school. But I don’t know that they always realize that.”
– Sponsor Representative, Florida

School-based mobile healthcare programs see the impact health has on the ability of a student to learn. School-based mobile healthcare program staff  shared success in registering and enrolling students in school, providing sports physicals, offering preventative services, dental care, and much more, all of which can change a ‘student’s life trajectory and sense of agency: “I wish that schools would remember what it felt like to be a young person and remembering the resources that they needed, or [wish] they had available to them.” School-Based Mobile Healthcare programs and partnerships open doors to students who may typically not otherwise have access to quality healthcare and the opportunity to increase self-esteem, job opportunities, and address other social determinants of health.

School-based mobile healthcare key informants recommend that schools and mobile healthcare programs establish MOUs. This is an opportunity to integrate programs into school policies and procedures and sit down to discuss barriers, preventative measures, and other collaborative efforts with partners.

A successful partnership is one that has frequent opportunities for open communication about the needs, recommendations, and questions of its partners.

Sample MOUs.

• MOU Sample One
• MOU Sample Two
• MOU Sample Three
• MOU Sample Four