Advancing Equity in School Health Services by School Nurses - NASN is uniquely qualified to address Priority 1 – School Health Services because of its history navigating the complexities of the “hidden healthcare system” in schools, and delivering programs, policies, and practices that impact student health equity. NASN proposes to use its reach to over 55,000 school health stakeholders, a network of 50 affiliate school nurse organizations, 17,000 NASN members, and an extensive network of collaborating organizations to achieve the outcomes for Priority 1. The COVID-19 pandemic unveiled how unmet social needs and community social determinants of health exacerbate physical, mental, and behavioral health needs of students and school staff. Schools and school nurses are increasingly being recognized as a community-based asset for achieving health equity for students and staff. School nurses are members of the interdisciplinary team of specialized instructional support personnel in schools; they are public health sentinels, essential to expanding access to health care for students. NASN’s proposed project will improve the health and well-being of students and school staff by supporting CDC-funded State Education Agencies, districts, schools, and school nurses across the country in with evidence-based policies, practices, and programs that expand access to physical, mental, and behavioral health services, and improve the delivery of school health services to students in underserved communities, using school nurses as the fulcrum. The following outcomes will help reach the long-term outcome of increased physical, mental, and emotional well-being among students and school staff in under-resourced communities: Increased use of evidence-based tools and resources that promote health equity; increased adoption and implementation of evidence-based school health policies, practices, and programs to address physical, mental, and behavioral health; and demonstrated expansion of school-based physical, mental and behavioral school health services in a minimum of five districts with pronounced inequities in student health. NASN will use four strategies, building on the efforts, partnerships, and resources developed in the previous CDC cooperative agreement (DP16-1601): (1) Professional development and technical assistance targeting school nurses to address physical, mental, and behavioral health using a health equity lens to reach underserved school communities. (2) Broad dissemination of evidence-based tools and resources for school nurses to advance equity in school health services using a Multi-Tiered System of Support approach, which aligns with the three levels of prevention integral to school nursing practice. (3) Sustaining and building new partnerships to expand access to health services. An emphasis Year 1 will be collaborating with partners with expertise addressing social needs and community social determinants of health. (4) Implementation of technical assistance to assess and strengthen school health services in five targeted school districts that have pronounced inequities in student health. Lessons learned will be made available beyond the target districts to further reach underserved communities. Our approach will address all three levels of prevention: primary (promoting/role modeling healthy behaviors to build protective factors), secondary (case finding, screening, community referrals, ongoing surveillance, insurance access), and tertiary (case management). Target audiences for this work will be CDC-funded SEAs, districts, schools, OST programs, and NASN’s constituents. SEAs in MN, NM, and WA have consented to provide districts with pronounced inequities in student health in Year 1 to provide intensive support to implement school health policies, practices, and programs within a WSCC framework. These three states were chosen to build on relationships forged with the previous DP16-1601 work and to provide continued support for the management of chronic health conditions in schools.
