A group of three interdependent strategies impact students using the SBHC one or more times during the school year: strong school partnerships, strong student and family engagement, and high awareness of SBHC services. The SBHC and school staff each play a critical role in maximizing utilization.
Example from the SBHC Field
Case Example: Leveraging a Student Council to Increase Awareness of SBHC Program
The student council for the Minneapolis School-Based Health Clinics, sponsored by the Minneapolis Health Department, plays an active role in increasing awareness of their SBHC program(s). Some of their efforts include peer-to-peer outreach (students talking up the health center with other students), one-on-one marketing at school-sponsored events, and presentations to fellow students, teachers, parents, school leaders, and community groups.
Watch this video of a student explaining one of the student council’s lunchroom outreach efforts.
Frequently Asked Questions
Create buy-in, support, and promotion of your SBHC from school board members, district staff, school administration, and staff. Proven strategies for accomplishing this include:
- Give members of the school administration, staff, and students a voice in SBHC operational decisions by asking them to join the SBHC advisory group.
- Share your health expertise with school personnel, perhaps during teacher in-service days, by organizing in-services on employee wellness, stress management, mental health first aid, asthma triggers.
- Offer employee wellness services and activities to school staff (e., the opportunity to receive an annual well care visit, immunizations, and fitness activities) as incentives to get them involved with your SBHC program.
- Reach out routinely to school administrators, teachers, and other staff to inform them about the SBHC services, share how SBHC services support the academic goals of their students, specify what the SBHC can offer to students who may be struggling in the classroom, and encourage them to refer students to you.
- Interact frequently with school staff – formally and informally – to build their confidence and comfort with the SBHC.
- Conduct a satisfaction survey annually with school personnel. Use their feedback to make changes to improve services, and share them with school staff.
- Integrate your SBHC staff and services into the daily life and operations of the school(s) it serves.
- Increase your visibility by participating actively on school wide committees that address student health, wellness, and safety issues.
- Collaborate with student assistance team to identify students experiencing attendance, discipline, and/or academic problems to ensure they complete annual well care visits, annual risk assessments, annual depression screenings, and early interventions as needed.
Create buy-in, support, and promotion of your SBHC from families and students by employing similar strategies to those recommended for creating strong school partnerships.
- Invite student(s) and/or family member(s) to join the SBHC advisory group to give them a voice in operational decisions and marketing.
- Conduct annual needs surveys and/or focus groups with students and families to clarify needs and co-design an optimal SBHC experience for them.
- Administer a client care survey, also referred to as satisfaction survey, annually with students and families. Be proactive and use the information to improve services and communicate improvements to students and families.
- Convene educational groups for students and families on wellness topics such as healthy cooking, community gardening, exercise, mindfulness, and peaceful conflict resolution.
- Encourage students to come into the SBHC for important seminal visits like annual risk assessments and well-care visits by using incentives like drawing for a gift certificate or gym membership.
- Engage with your school’s Parent-Teacher Association (PTA) to give families a voice in what they want for the health and safety of their children. Parents and guardians can be powerful champions for SBHC when opportunities arise to expand or enhance services.
- Create a Youth Advisory Committee (YAC) to give students an equitable role in the operational decisions that affect their use of health care and ensure reflection of students’ opinions in SBHC activities and outreach efforts. Forming a YAC is also a great strategy for nurturing student ambassadors who will advocate to their peers for your SBHC program.
- Capitalize on school enrollment season and initial school year events (e., open houses, school fairs, etc.) to educate students and families about the services your SBHC program provides and have the families sign SBHC consent forms and registration materials. At other times of the year, market your SBHC program students and families at school-sponsored events (e.g., freshman orientation, back-to-school nights, report card pick-up, clubs, sports events, plays, dances, craft fairs, PTA, student government, etc.).
- Place SBHC program posters and brochures strategically around the school and in the community.
- Design incentives to boost enrollment (g., a party for the classroom with most returned consent forms, homework pass, etc.).
- Make periodic announcements about your SBHC services (g., the benefit of consent and enrollment, well child visits, sports physicals, immunizations, flu shots, cooking classes, etc.) via morning announcements, school website, robo-calls, and social media outlets.
- Think outside of the box! Do community outreach in atypical venues such as churches and other trusted community institutions.
Strong School Partnerships:
- Meet frequently in person or via video conferencing with education partners
- Provide program overview to key stakeholders, including how telehealth works
- Plan, make information accessible, and work jointly on SBHC outreach efforts. Be sure to include connections with school nurses and counselors.
- Consider how SBHC staff can stay connected to students. Connection and relationships are essential drivers of SBHC service utilization. Some SBHCs increase connections by working with the school to deliver food to families and participating in outreach activities led by teachers and support staff (i.e., video messages to students, parades, writing a column in the school’s newsletter)
Strong Student and Family Engagement
- Use an online platform to offer “daily surprises” to students. To keep students engaged, one SBHC behavioral health clinician uses Google classroom to post a daily quote, coping skill, silly video, meditation, etc.
- Offer virtual “office hours” as a time when students and parents/guardians can connect with their providers.
- Use a variety of methods to reach students and families: phone calls, letters, social media, email, press conferences, and ambassadors.
- Reach out to students and families proactively and prioritize students due for a visit to invite them to a telehealth appointment
- Hold brief phone check-ins with students/guardians to assess urgent needs and arrange follow-ups as indicated.
- Be flexible about timing. If you work with high school students, consider offering appointment times later than the SBHC’s typical hours to better align with teens’ sleep schedules.
- Use email and texting to remind students about appointments
- One SBHC reported morning calls to schedule same-day appointments
- Telehealth may present additional opportunities for family engagement in care because children and caregivers may be home together.
High Awareness of SBHC Services:
- Develop and implement a marketing plan
- The SBHC Youth Advisory Council can advertise telehealth services via word-of-mouth and social media.
- To generate telehealth traffic, post information about telehealth services on the school district website, send an email or text blast to students and caregivers, advertise services through school lunch programs, include information about telehealth services in school registration packets.
- SBHC staff can create videos for students, sending the message that they miss their students and that they are available via telehealth.
- Offer students quick calls regularly to keep in touch and maintain the relationship.
- In one example, SBHC staff scanned enrollment forms for students with documented health issues, such as asthma or eating disorders, and then conducted courtesy calls to these students explaining how to schedule telehealth visits.
- Include consents in the beginning of the school year packet
- Integrate consent into the student registration process
- Offer electronic consents
- Determine whether the state laws allow waiving written consent. If obtaining written consent for telehealth is a barrier for patients, consider obtaining and documenting verbal consent.
- Develop a verbal script for obtaining consent. Embed it within the visit template in the EHR (explain risks such as possible loss of confidentiality, break-in HIPAA, and risk of the visit with no physical exam or vital signs; document that risks have been explained).
- Develop an electronic method of obtaining consent (within EHR, DocuSign).
- Send consent and ask for a picture back of signed consent
- One SBHC that offers online consent forms extended wireless internet access into the parking lots of its clinics. Families who do not have internet access can complete the enrollment/ consent paperwork in the parking lot.
- Some SBHCs proactively reach out to students due for services to schedule telehealth appointments. In one example, a participant explained that before the COVID outbreak, only 5% of students had an activated EHR portal, which is a necessary first step for the SBHC to provide telehealth. Within a week of the SBHC closing, all staff received remote access to this portal and then called students’ families to help them activate their portals. This process increased the activation rate to 37%.
- One SBHC staff member reached out to families that are having trouble completing the online consent to walk them through it.