Strategy. School-Based Health Centers
Approach. Support partnerships between primary care clinics and local school-based health centers
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Overview. Thoughtful and intentional implementation of an expanded medical home partnership between primary care physicians and school-based health centers increases the number of shared high-risk adolescent patients. Shared patients have improved compliance with quality measures, which may lead to long-term improved health outcomes.[1]
Evidence. Emerging Evidence.
Strategies with this rating typically trend positive and have good potential to work. They often have a growing body of recent, but limited research that documents effects. However, further study is needed to confirm effects, determine which types of health behaviors and conditions these interventions address, and gauge effectiveness across different population groups. (Clarifying Note: The WWFH database calls this "mixed evidence").
Access the peer-reviewed evidence
through the MCH Digital Library or related evidence source.
(Read more about understanding evidence ratings).
Source. Peer-Reviewed Literature
Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):
- Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
- Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
- Health Outcomes. This strategy helps contribute to reducing avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability, or mortality.
Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.
Intervention Type. Collaboration (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).
Intervention Level. Community-Focused
Examples from the Field.
Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).
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Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")
- Number of shared care protocols, referral pathways, and communication systems implemented to facilitate coordination and continuity of care for adolescent patients between primary care clinics and SBHCs. (Measures the infrastructure and process put in place to support the partnership)
- Number of primary care providers and SBHC staff trained on the principles and practices of the expanded medical home model, including population health management, care coordination, and quality improvement. (Measures the capacity building efforts to ensure effective implementation of the partnership)
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Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")
- Percent of primary care clinics and SBHCs that have formally adopted and implemented the expanded medical home model, with clearly defined roles, responsibilities, and accountability measures. (Measures the institutionalization and standardization of the partnership approach)
- Percent of primary care-SBHC partnership meetings and quality improvement initiatives that involve active participation and leadership from adolescent patients and their families. (Measures the level of patient and family engagement in the governance and continuous improvement of the expanded medical home model)
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Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")
- Number of community and school-based outreach and engagement events conducted by the primary care-SBHC partnership to build awareness, trust, and participation among adolescent populations facing higher health risks and their families. (Measures the efforts to proactively reach and involve the focus population)
- Number of quality improvement projects and population health initiatives jointly undertaken by primary care clinics and SBHCs to address identified gaps in adolescent health outcomes. (Measures the collaborative use of data and evidence to drive system-level improvements)
- Number of adolescent patients with chronic conditions for mental health needs who achieve measurable improvements in their health status and quality of life through the comprehensive care and support provided by the primary care-SBHC partnership. (Measures the impact on patient-level health outcomes and well-being)
- Number of shared adolescent patients who successfully transition to adult primary care and specialty services, with support from the primary care-SBHC partnership in developing self-care skills and navigating the healthcare system. (Measures the long-term impact on preparing adolescents for lifelong health management)
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Quadrant 4:
Measuring Quality of Effect ("How are they better off?")
- Percent of primary care clinics and SBHCs that have implemented evidence-based and trauma-informed practices and policies to create welcoming environments for all adolescent patients and their families. (Measures the partnership's commitment to health outcomes)
- Percent of primary care-SBHC partnership resources and funding allocated to address root causes of health outcomes and non-medical barriers to care for adolescent patients facing higher health risks, such as transportation, nutrition, and housing support. (Measures the partnership's investment in upstream factors influencing adolescent health outcomes)
- Percent of shared adolescent patients from communities that traditionally have additional needs who report increased trust, engagement, and empowerment in their healthcare as a result of the patient-centered care provided through the primary care-SBHC partnership. (Measures the impact on reducing barriers and building trust with populations that have additional needs)
- Percent of overall adolescent healthcare spending in the jurisdiction that is shifted from costly emergency and specialty care to preventive, primary, and school-based care through the expanded medical home model, demonstrating improved efficiency and value. (Measures the long-term financial and system-level impact of the primary care-SBHC partnership approach)
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Note. When looking at your ESMs, SPMs, or other strategies:
- Move from measuring quantity to quality.
- Move from measuring effort to effect.
- Quadrant 1 strategies should be used sparingly, when no other data exists.
- The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.
Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.
References
1 Riley M, Laurie AR, Plegue MA, Richarson CR. The adolescent "expanded medical home": schoolbased health centers partner with a primary care clinic to improve population health and mitigate social determinants of health. J Am Board Fam Med. 2016;29(3):339-347.
