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School-based health centers as an approach to address health disparities among rural youth: A study protocol for a multilevel research framework

Author

Listed:
  • Xue Zhang
  • Mildred E Warner
  • Sharon Tennyson
  • Wendy Brunner
  • Elaine Wethington
  • John W Sipple

Abstract

School-Based Health Centers (SBHCs) are important healthcare providers for children in medically underserved communities. While most existing research on SBHCs has focused on urban environments, this study protocol proposes a mixed-methods, multi-level research framework to evaluate the role of SBHCs in addressing health disparities among underserved children and adolescents in rural communities. The study area includes four high-poverty rural counties in New York State served by Bassett Healthcare Network that permits a comparison of school districts with SBHCs to those without SBHCs, all served by providers within the Bassett Healthcare Network. We employ a human ecological framework that integrates the micro layer of individuals and families, the meso layer of school districts and community institutions, and the macro layer of local and state policies. Our research framework first identifies the socioecological health risk factors, and then proposes innovative strategies to investigate how SBHCs impact them. We propose evaluating the impact of SBHCs on the individual (micro) level of child healthcare utilization using patient records data. At the meso level, we propose to investigate how School-SBHCs partnership may facilitate greater cross-agency collaboration and broader structural and social determinist of health to address health disparities. At the macro level, we propose to assess the impact of SBHCs and cross-agency collaboration on outcomes associated with a culture of community health. This study protocol will enable researchers to assess how SBHCs reduce rural health disparities, and provide evidence for organizational and public policy change.

Suggested Citation

  • Xue Zhang & Mildred E Warner & Sharon Tennyson & Wendy Brunner & Elaine Wethington & John W Sipple, 2024. "School-based health centers as an approach to address health disparities among rural youth: A study protocol for a multilevel research framework," PLOS ONE, Public Library of Science, vol. 19(5), pages 1-14, May.
    • Handle: RePEc:plo:pone00:0303660
    DOI: 10.1371/journal.pone.0303660
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    References listed on IDEAS

    as
    1. Hartley, D., 2004. "Rural health disparities, population health, and rural culture," American Journal of Public Health, American Public Health Association, vol. 94(10), pages 1675-1678.
    2. Xue Zhang & Mildred E. Warner & Elaine Wethington, 2020. "Can Age-Friendly Planning Promote Equity in Community Health Across the Rural-Urban Divide in the US?," IJERPH, MDPI, vol. 17(4), pages 1-16, February.
    3. Mildred E. Warner & Xue Zhang, 2020. "Healthy Places for Children: The Critical Role of Engagement, Common Vision, and Collaboration," IJERPH, MDPI, vol. 17(24), pages 1-14, December.
    4. Xue Zhang & Mildred E. Warner & Stephanie Firestone, 2019. "Overcoming Barriers to Livability for All Ages: Inclusivity Is the Key," Urban Planning, Cogitatio Press, vol. 4(2), pages 31-42.
    5. Xue Zhang & Mildred E. Warner & Stephanie Firestone, 2019. "Overcoming Barriers to Livability for All Ages: Inclusivity Is the Key," Urban Planning, Cogitatio Press, vol. 4(2), pages 31-42.
    6. Villalonga-Olives, E. & Wind, T.R. & Kawachi, I., 2018. "Social capital interventions in public health: A systematic review," Social Science & Medicine, Elsevier, vol. 212(C), pages 203-218.
    7. Yang Wang & Mildred E. Warner & John W. Sipple, 2023. "Sharing spaces: Joint use service delivery in New York state school districts," Community Development, Taylor & Francis Journals, vol. 54(4), pages 567-587, July.
    8. Mildred E. Warner & Xue Zhang, 2021. "Serving an ageing population: collaboration is key," Local Government Studies, Taylor & Francis Journals, vol. 47(3), pages 498-517, May.
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