School Based Health Care: A Model for Improving Educational Achievement for Children in Inner City Schools

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

147 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-01

Study Completion Date

2022-01-20

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Developmental problems have tremendous impact on children, affecting academic achievement and mental health later in life.The process of receiving a developmental assessment is long and arduous, and may require multiple physician visits taking over one year. Although a relatively new concept in Canada, School-Based Health Centres (SBHCs) have been successfully implemented in over 1900 schools in the United States.The first SBHC in Ontario, and Canada as a whole, was established through the Model Schools Pediatric Health Initiative (MSPHI) and is dedicated to reducing health inequities for inner city children by reducing barriers and providing accessible clinical care. To provide more conclusive evidence on the relative benefits of SBHCs as compared to traditional health care access, this study will use a prospective cohort quasi-experimental study design to compare differences in educational achievement for developmental assessments in the SBHC model relative to standard care. As per standard of care, students having difficulty in school are identified by the Toronto District School Board (TDSB) internal research staff and are presented to the monthly School Support team (SST) meetings. Historically physicians do not attend SST meetings, however, as a part of the SBHC program, pediatricians will participate in monthly SST meetings. Schools assigned to the intervention group will have SBHC physicians attend SST meetings, while schools assigned to the control group will not.

The overall objective of this study is to examine educational achievement, as defined by standardized test scores and report cards in students who use an inner city SBHCs for developmental concerns relative to those who do not. We hypothesize students attending schools in which SST meetings have a pediatrician present, that are referred to a SBHC, will score higher and show a greater increase in standardized test scores and report cards (from baseline to follow-up) than students attending schools in which SST meetings do not have a pediatrician present and access services through traditional means in the community (standard of care).The secondary objectives are: a) to examine socio-demographic data for these students and its relationship to educational achievement and b) to determine wait times to developmental assessment for students in the intervention group who attend the SBHCs using retrospective chart review.

Related Clinical Trials

Explore similar clinical trials based on study characteristics and research focus.

Feasibility Study on the Model School Pediatric Health Initiative Pilot Project

NCT01676532

School Board Health Centers

COMPLETED

Who Benefit From School Doctors' Health Checks?

NCT03178331

School Health Services

COMPLETED

Coordinated HEalthcare for Complex Kids

NCT04057521

Asthma Diabetes Mellitus Sickle Cell Disease +1 more

COMPLETED NA

Reducing Socioeconomic Disparities in Health at Pediatric Visits

NCT02451059

Asthma Obesity Health Care Utilization +5 more

COMPLETED NA

MNCH Programming in Southwest Uganda Maternal and Child Health In Bushenyi and Rubirizi Districts, UGANDA

NCT01571765

Child Mortality Maternal Mortality (All Cause)

COMPLETED NA

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Educational Achievement

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

This project will be a prospective cohort quasi-experimental study design to compare the benefits of using SBHCs as opposed to the traditional health care by evaluating educational achievements. The study period includes September 2017-June 2018 and September 2018-June 2019. Of 16 inner city schools not previously exposed to the SBHC in the TDSB, some schools (n=8) will be in the control arm following the standard of care while others (n=8) will have access to SBHC. Students presented to SST meetings whose outcomes include the need for a developmental/pediatric assessment at the 16 schools will be identified by TDSB internal research staff. To conduct our primary analysis, standardized test scores and numeric data from report cards will be analyzed using a linear mixed effect model where the schools are the random effects and the baseline test scores and report cards are adjusted for by including it as a covariate.

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

It is not feasible to blind students or their families or SST members as there are obvious differences in care procedures between the two groups.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Access to School Based Health Centre

Of the eight school in the intervention arm, four schools will be linked to a school based health center (SBHC) at Sprucecourt or Nelson Mandela Park Public Schools (established in partnership with the department of Pediatrics at St. Michael's hospital) and four schools will be linked to a SBHC at Parkdale Public School (established in partnership with St. Joseph's Health Centre). SBHC pediatricians will attend School Support Team (SST) meetings at all intervention schools and students with developmental concerns identified at the SST meetings will be referred to the SBHC.

Group Type EXPERIMENTAL

Access to School Based Health Centre

Intervention Type OTHER

The SBHC will be staffed by a family physician, two pediatricians and a developmental pediatrician, each with at least one half-day of clinic time per week from September through June. The SBHC is also staffed by a clinic coordinator who is responsible for booking appointments on a first-referral, first-serve basis.

Control Arm: Standard of care

Of the eight schools assigned to the control condition, four will be in the South East area of the city closer to Nelson Mandela Park PS and four will be in the South West area of the city closer to St. Josephs Health Center. The eight schools will be subject to standard of care which is: when a child is identified by the SST (no pediatrician present), students identified with developmental concerns are advised to access a pediatric/developmental assessment in the community.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Access to School Based Health Centre

The SBHC will be staffed by a family physician, two pediatricians and a developmental pediatrician, each with at least one half-day of clinic time per week from September through June. The SBHC is also staffed by a clinic coordinator who is responsible for booking appointments on a first-referral, first-serve basis.

Intervention Type OTHER