Behavioral Symptoms, Community Health Workers, Educational Problems, Social Determinants of Health
Conditions
Brief summary
The goal of this community-engaged research is two-fold. The first goal is to gather stakeholder feedback to inform a school-based community health worker intervention with youth with poor school attendance and an enhanced usual care condition. The second goal is to evaluate the feasibility of implementing the school-based community health worker intervention and enhanced usual care approach within rural schools. The main question it aims to answer is whether it is feasibile to recruit children with poor school attendance and their families to the intervention, to complete the trauma-informed intervention, and to complete the associated study measures of meeting social determinants of health/mental health needs, school-based health center utilization, and behavioral helath symptoms. At least 38 rural students in grades 6-12 with poor school attendance and their parents/guardians will meet with the school-based community health worker for support around social determinants of health needs that may be barriers to attendance. Researchers will also assess the feasibility of recruiting at least 10 rural students and their parents/guardians to complete the study measures in an enhanced usual care condition in which the school-based health center without a school-based community health worker is reminded of the availability of an online social services directory.
Detailed description
The HERE pilot study will consist of two phases to strengthen and finalize the HERE school-based community health worker (SB-CHW) intervention. The 6-month Phase I will provide broad stakeholder feedback on the proposed model and rationale, the SB-CHW intervention, the associated domains and measures, and the evaluation. The following 18-month Phase II will align with the school year and provide a feasibility test of the training, intervention, data collection, and analyses.
Interventions
BEHAVIORALSchool-Based Community Health Worker (SB-CHW) intervention
The school-based community health worker will support students with chronic poor attendance and their parent/guardian for a minimum of two 30-minute encounters focused on addressing social determinants needs, understanding the range/student encounter varies greatly due to the intensity of the social need(s) (e.g., crisis/noncrisis) and the number of needs being jointly addressed. The SB-CHW will build relationships across encounters and apply trauma-informed best practices.
BEHAVIORALEnhanced Usual Care (EUC) Methods
The network of school-based health centers without school-based community health workers will receive reminders of the the existing online social services directory.
Sponsors
University of Kansas Medical Center
National Institute of Nursing Research (NINR)
National Institutes of Health (NIH)
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
This is a two phase feasibility pilot. Consistent with the community engaged approach, the first study phase is interviews with at least 30 stakeholders to enhance the school-based community health worker (SB-CHW) intervention and the enhanced usual care (EUC) arms. The second study phase is a feasibility trial to assess the feasibility of the SB-CHW condition across 38 students and 38 parent/guardians and the EUC condition across 10 students and their 10 parents/guardians.
Eligibility
Sex/Gender
ALL
Age
12 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Phase I Stakeholder Interviews (nonintervention): Inclusion Criteria: * A member of the program's Community Advisory Board, including community health workers; * Caregiver of a child ages 12-18 from the Southeast Kansas region; or * Student at least 12 years in age. Phase II Feasibility Pilot- SB-CHW Intervention and Enhanced Usual Care Conditions Inclusion Criteria: * Children ages 12-18 and their parents/guardians from the Southeast Kansas region * Student with or at risk for chronic poor attendance (missing 10% or more of the days that school has been in session at any point in the school year)
Exclusion criteria
* Parents/guardians or youth with profound intellectual/cognitive disability will be excluded.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| School Based Health Services Utilization | At study completion (an average of 10 months/1 school year) | The number of visits to School Based Health Centers (SBHC) |
| School Attendance | At study completion (an average of 10 months/1 school year) | The number of school days in attendance, collected by ½ day increments 1(b) determination whether the student continues to meet the definition of chronic poor attendance (Yes/No) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Parent & Child Self-Sufficiency and Needs | At enrollment, at study completion (an average of 10 months/1 school year) | Arizona Self-Sufficiency Matrix. An 18-item self-report measure assessing needs on a 5-point Likert scale, including Housing, Employment, Income, Food, Childcare, Children's Education, Adult Education, Health Care Coverage, Life Skills, Family/Social Relations, Mobility, Community Involvement, Parenting Skills, Legal, Mental Health, Substance Abuse, Safety, and Disabilities. |
| Child and Adolescent Needs and Strengths | At enrollment, at study completion (an average of 10 months/1 school year) | Child and Adolescent Needs and Strengths (CANS) is a validated semi-structured interview that assesses children's exposure to potentially traumatic experiences \& level of traumatic stress symptoms, as well as considering strengths (Kisiel \& Fehrenbach, 2015). |
| Family Engagement | At enrollment, at study completion (an average of 10 months/1 school year) | The Family Engagement Survey -- Version 2 (FES), a validated measure of family and school engagement consisting of 20 items rated on a Likert-type scale from 1 (Strongly Disagree) to 5 (Strongly Agree). |
| School-Based Community Health Worker Interactions | At study completion (an average of 10 months/1 school year) | Number of CHW interactions with the student, parent/guardian, and/or both |
| Process for Enhanced Usual Care | At enrollment, at study completion (an average of 10 months/1 school year) | Use of resources from the online social services directory (yes/no) |
Countries
United States
Contacts
CONTACTEve-Lynn Nelson, PhD
CONTACTKelsey Dean
PRINCIPAL_INVESTIGATOREve-Lynn Nelson, PhD
University of Kansas Medical Center
Outcome results
None listed