Health / 2013

Student Health = Student Success. Improving student health and readiness to learn in LA

Idea submitted in the My LA2050 Maker Challenge by The Los Angeles Trust for Children's Health

The LA Trust for Children’s Health envisions a LA2050 where all students are learning in an environment that not only supports their academic achievement, but one that fosters lifelong health and wellness through a comprehensive web of emotional and physical health promotion services and supports. This system of care enables students to miss fewer days of school, succeed in their academic careers, graduate on time and pursue successful futures. The LA Trust is the champion of a bold vision for the Los Angeles Unified School District (LAUSD) developing a network of 14 School Wellness Centers that will improve student health and academic achievement. The Wellness Centers will each serve the students and families throughout its network of surrounding schools and community brining needed access to health care and prevention for at least 40,000 individuals at each center. The LA Trust is working tirelessly with its many partners to open 12 of the 14 centers by June 2013. In 2008 the school district and county Department of Public Health joined forces with The LA Trust, and other supporters to find solutions for our children and teens who were experiencing violence, obesity, poverty and sexually transmitted diseases. These harsh realities and poor health outcomes were impacting student achievement leading to higher dropout rates and school failure. This group of innovators recognized that success in school requires that students are healthy enough to learn, but far too many students have little or no access to the health care they need. School-based health clinics in the district have provided more than 200,000 health care visits annually to elementary, middle, and high school students. But, it is not enough. The bold vision for Wellness Centers moves beyond the traditional health care visit. The Wellness Centers are a one-stop shop, providing near universal access to care and information about healthy diet and exercise, diabetes prevention, mental health promotion, and oral health care. Care doesn’t end at the door of the Wellness Center, but expands throughout the school network to promote wellness for all students. The Wellness Center is not a place a student goes, but an experience students and their families have of being connected with essential preventive health care, health education, support programs, and health insurance coverage that create a healthy life at school and at home. Wellness Networks engage students and offer opportunities for students to promote positive health behaviors for themselves, other students and their community, thereby increasing their leadership skills, self-empowerment, and interest in a future health career. Wellness Networks also facilitate access for students to training and placement to pursue a health career pathway. The LA Trust is leading the charge in moving this vision forward, bringing the numerous stakeholders, sponsors, and experts to the table through the Wellness Network Learning Collaborative. It is this collaborative planning approach that ensures the success of the process by bringing LAUSD, federally qualified health centers, Public Health Department, and other partners together to negotiate the operational and programmatic details. The Wellness Centers will bring together all student programs within the district including mental health, pupil services, medical services, health education and nursing to build linkages and coordination to create a student-centered approach to prevention and wellness promotion. An unprecedented investment by the school district of $34 million has helped build the infrastructure, the bricks and mortar, for the Wellness Network. Federal grant funds have also been awarded to support the effort. But, the school district cannot do this alone. To realize the promise of the Wellness Network in Los Angeles, there has to be buy-in and investment of public and private partners throughout the county. The LA Trust has brought in some initial foundations to invest in the vision. However, additional support is needed to: (1) Engage communities, students and families in the collaborative planning process, (2) Get creative and expand the horizon of services and supports that the Wellness Centers offer, and (3) Build awareness among students and communities of the Wellness Centers and the services available. A grant from the Goldhirsh Foundation would support our efforts to develop and launch this innovative network of Wellness Centers that would redesign health care and prevention for a generation of youth and their families in Los Angeles.

What are some of your organization’s most important achievements to date?

One of the most significant achievements to date for The LA Trust has been the engagement of a broad cross-section of stakeholders to develop a strategic plan, which outlines the vision for the Wellness Networks. This considerable undertaking has built the foundation and buy-in across the many collaborators and partners.

The LA Trust has supported the opening of four new Wellness Centers on high school campuses within the school district. An additional eight Wellness Centers are currently under development and will be open by June 2013.

Additional achievements to date include:

  • Convened more than 15 conferences, meetings and symposia with key stakeholders to build community buy-in and support of the Wellness Centers
  • Developed overall goals for Wellness Network operations, student and community engagement practices that have consensus among the schools and providers at 14 sites
  • Provided resources and support so that more than 30,000 students could receive needed immunizations
  • Supported student advisory groups on 14 campuses to increase awareness of and support for important health and mental health issues
  • Established plans to roll out a District wide oral health initiative for students in K-3rd grade
  • Raised funds for and created a District Oral Health Nurse position

Please identify any partners or collaborators who will work with you on this project.

The LA Trust plays a leadership role as the convener and strategic coordinator by facilitating the Wellness Network Learning Collaborative. This collaborative brings partners and stakeholders together to build and realize the vision on the ground. However, this would not be possible without the commitment of LAUSD. In addition, all of the Wellness Networks are sponsored and managed by a federally qualified health center and supported by dedicated school personnel. The LA Trust also works closely with the California School Health Centers Association, the Community Clinic Association of Los Angeles County, the LA School Health Coalition, LA Health Action, the Children’s Partnership, the LA County Education Foundation and many others.

Please explain how you will evaluate your project. How will you measure success?

The LA Trust and our partners in the Wellness Networks recognize that there is an important and necessary role for local community stakeholders, particularly students, families and caregivers when employing a place-based and population-based approach. As part of the evaluation approach, Wellness Networks utilize students and community members in the data collection at the beginning planning stages and throughout implementation. Community members can map community assets, help set baseline measures for evaluation of key outcomes, and monitor progress on what matters most to students, families and communities.

Wellness Networks build in evaluation plans that are based on a set of outcomes common across school complexes that relate to the foundational principles of the Network. Evaluation goals include determining what works, what’s likely to be replicable and what holds promise for scaling up to other school complexes or the district as a whole.

Wellness Networks conduct data gathering, analysis and evaluation of outcomes that help to demonstrate the efficacy of the Wellness Network concept, in comparison to traditional school-based health care. Consistent results and measures will demonstrate potential benefits to stakeholders in terms that students, families, providers and school staff will understand as tangible measures of their schools’ and students’ well-being.

Quantitative and qualitative data (such as case studies) are both important to tell the story of student wellness. Such evaluation will also support efforts to seek funding and contribute to national knowledge about school-based strategies for improving students’ wellness and readiness to learn.

Wellness Networks have written agreements with internal partners and providers and formal arrangements with external partners and providers. Agreements set out mutual expectations and benefits, including increased utilization of services, demonstrating success with underserved populations, demonstrating follow-up capacity and demonstrating outcomes to internal leadership and external funders. Agreements also cover quality assurance and improvement requirements.

How will your project benefit Los Angeles?

Every day more than 680,000 children attend school in the Los Angeles Unified School District. Many of our students have little or no access to essential preventive and primary health care. In some classrooms, one in three students are obese and are already on the path towards chronic health care conditions such as diabetes or heart disease. In some classrooms, one or two students will develop Type 2 diabetes before graduation and four teenage girls will contract a sexually transmitted infection. One in three young women in LA will have an unplanned pregnancy before their 20th birthday and many of them will drop out of school as a result.

We know, and the research confirms this, that kids that are healthy are better able to learn and achieve academic success. The Wellness Networks provide a launching pad for a range of public health interventions in the schools to address these serious issues and improve children’s health and community health outcomes. Wellness Networks use a community-based approach and strategies to address health concerns. Research has shown that school-based strategies are effective in improving health and student readiness to learn. Place-based approaches call for engaging the community where people live, work, learn and play to understand their resources, identify their needs and engage them in culturally appropriate ways.

Through the Wellness Networks and using evidence-based strategies, The LA Trust, in partnership with LAUSD and other key allies, is working to:

  • Increase access to preventive and primary health care services
  • Improve access to dental care for children by bringing in mobile dental clinics for preventive screenings, cleanings and treatment
  • Engage communities in healthy living

Improved access to health information, health promotion interventions, and health care services will have a positive impact on the students and the overall health of the community. The long-term goals The LA Trust seeks to achieve improve student academic outcomes and population health over the next five to seven years, achieving outcomes such as:

  • All students are career and college ready (in line with District goals)
  • Decrease chlamydia and teen pregnancy rates
  • Decrease overweight and obesity rates
  • Increase insurance enrollment
  • Improved asthma management

What would success look like in the year 2050 regarding your indicator?

Success in the year 2050 would see a generation of county residents that are healthier than their parents and grandparents because they were raised with universal access to prevention and wellness promotion supports and programs that set them on the path for lifelong health. In 2050 the disparities in chronic disease and poor health outcomes between the wealthy and the poor would be nearly erased with the equitable access to health care and coverage fostered by the LAUSD Wellness Networks.

LA County would be rated as one of the healthiest places to live in the U.S. based on its low rates of obesity, heart disease, diabetes, teen births and sexually transmitted disease. LAUSD’s Wellness Networks would be a national model for promoting health in schools and the community and as a coordinated system that leverages numerous community resources and assets to support the needs of our community.

In 2050 the deeply rooted connections between the schools, health care professionals, social services, students and their families create strong communities that are connected, thriving, and prosperous.