The Sustainable School Health Initiative

Abstract

Introduction Decreasing chronic absenteeism is one of the Hawaiʻi State Department of Education (HIDOE) Strategic Plan’s primary target goals as attendance is a prominent indicator of academic success. Some of HIDOE’s schools have over a 30% chronic absenteeism rate. School-based health initiatives can help address this critical issue. National guidelines recommend one school nurse per 750 children in the public school system. Hawaiʻi DOE schools serve over 180,000 students for which there are only eight nurses on campuses throughout the state. The evidence is clear that school based health services are effective, but there is a lack of research on which models are best in improving academic outcomes and fiscal solvency. Business planning is an essential element to success. The purpose of this project was to design a business model to inform sustainable development of a school based health services program for the Waianae Nanakuli Complex Area located at Nānāikapono Elementary School in order to decrease health related absenteeism and early dismissal rates, and over time lead to improved student academic outcomes. The logic model was used as the conceptual framework. Methods The three main activities of this project included a needs assessment, business planning, and evaluation of the resulting business plan. Once completed, the business plan was evaluated utilizing quantitative and qualitative methods by community healthcare experts selected by the core project team. Target goal was an evaluation score of >80%. Results The business plan contains ten sections, including a comprehensive financial analysis. Evaluation of the business plan draft resulted in an aggregate score of 86%. Results were compiled, reviewed and applicable changes made. The final draft of the plan, which met our criteria for success, is included in the results section. Discussion The School Based Health Services Program model designed can be expanded to reach an entire HIDOE complex area, serving 70% more children and adolescents than a standalone clinic, while increasing fiscal sustainability. The business plan will be used to guide expansion to the remaining HIDOE complex areas contributing to the effort to keep Hawaiʻi’s keiki healthy and ready to learn.