I.U. Bowen Research Center Indiana University Bowen Research Center Bowen Research Center Terrell W....

I.U. Bowen Research Center

Indiana UniversityIndiana University Bowen Research CenterBowen Research Center

Terrell W. Zollinger, Dr.P.H.Terrell W. Zollinger, Dr.P.H.Robert M. Saywell, Jr., Ph.D., M.P.H.Robert M. Saywell, Jr., Ph.D., M.P.H.

Komal Kochhar, M.B.B.S., M.H.A.Komal Kochhar, M.B.B.S., M.H.A.Christina A. Mandzuk, B.S.EChristina A. Mandzuk, B.S.E..

Learning Well EvaluationLearning Well EvaluationYear 5 ReportYear 5 Report

Academic Year 2005-2006Academic Year 2005-2006

Learning Well EvaluationLearning Well EvaluationYear 5 ReportYear 5 Report

Academic Year 2005-2006Academic Year 2005-2006


Evaluation Team• Terrell W. Zollinger, Dr.P.H.

– Epidemiologist & Biostatistician

• Robert M. Saywell, Jr., Ph.D., M.P.H.– Health Economist

• Komal Kochhar, M.B.B.S., M.H.A.– Clinician & Health Administrator

• Christina A. Mandzuk, B.S.E.– Senior Research Assistant


Data Sources• Clinic Services (Welligent) Student Surveys

122,319 (5,351 in 2001) 284 (104 in 2001)

• Parent Surveys Clinic Staff Surveys 68 (34 in 2001) 45 (6 in 2001)

• School Faculty/Staff Surveys Clinic Activity Logs 309 (134 in 2001) 313 (107 in 2001)


Overview

• Learning Well Description and Trends

• Clinical Services Provided in 2005-2006

• Achievement of Learning Well Objectives


Learning Well Description


Clinics 2005-2006

14 Nurse Practitioner Model Clinics (10 in 2001-2002)

39 Basic Health Services Model Clinics(0 in 2001-2002)

20 Feeder School Outreach Clinics


Learning Well Schools: 73 2005-2006

• 18 High Schools (4 in 2001)

• 21 Middle Schools (6 in 2001)

• 34 Elementary Schools (0 in 2001)


Learning Well, Inc. Penetration Rates

• 37.7% of IPS Students have access to a Learning Well clinic (14,330/38,036)

• 17.9% of all Marion County Children (ages 5-17) have access to a Learning Well clinic (28,717/160,396)


Learning Well, Inc. Utilization Rates

• 56.7% of the students at schools served by Learning Well clinics have visited the clinics (16,282/28,717)


Clinical Services Provided in 2005-2006


2005-2006 Clinic Services: 122,319

122,319 in 2005-200674,910 in 2004-200553,862 in 2003-200418,951 in 2002-20035,351 in 2001-2002

Over a twenty fold increase 2001-2006


Grade of Clinic Users2005-2006

Grade of clinic users

40.0%

26.0%

34.0%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

Elementary School Middle School High School

Pe

rce

nta

ge


Gender of Clinic Users2005-2006

Gender of clinic users

Female48.9%Male

51.1%


Race/Ethnicity of Clinic Users

2005-2006

Race/Ethnicity of clinic users

White48.1%

Hispanic8.1%

Other5.0%

Black38.8%


Complexity of Clinic Visit

2005-2006

Complexity of Clinic Visit

Minor 42.1%

Low32.0%

High/Extensive2.7%

Moderate23.2%


Top Ten Reasons for Visit

• Headache• Physical examination• Counseling • Vaccines• Rhinitis/Bronchitis• Menstrual disorders• Skin disorders• Esophagus/Stomach disorders• Pharyngitis/Tonsilitis/Sinusitis• Pain- abdomen


Regular Source of Primary Care

• 86.3% of students had a primary care provider

• Utilization– 33.1% had been admitted to a

hospital in the past year– 39.6% were treated in an Emergency

Room or Urgent Care Center in the past year


Achievement of Learning Well Objectives


Learning Well Goals• Goal I: Address Student Barriers to

Health Care Access• Goal II: Provide Students/Parents with

increased Health Care Knowledge• Goal III: Address Student/Parent

Perception Barriers to Clinic Utilization• Goal IV: Address Clinic Provider

Perception of the Ability of Clinics to Meet Student Health Care Needs


Goal I: Address Barriers to Health Care

Access

• Address economic barriers– 75.8% of parents indicated they

would NOT be able to pay for their child’s medical services if the clinic were not here


Goal I, continued

• Convenient location for health care services– 100.0% of parents and 97.7% of

students agreed

• Convenient hours for health care services– 98.4% of parents and 95.3% of

students agreed


Goal I, continued• If the clinic were not here, where would

parents take their child if he/she had a minor illness before leaving for school:

Treat and send to school70.6%

Doctors office or

clinic1.5%

Keep child at home26.5%

Urgent Care Center

1.5%


Goal I, continued• If the clinic were not here, where would

parents take their child if he/she had a minor illness while in school:

Stay at School35.8%

Urgent Care Center

1.5%

Take them Home62.7%


Goal II: Provide Health Care Knowledge

• Provide awareness of the value of preventive medicine– Parents: 88.2% schedule a regular check up for

their child each year– Students: 42.9% visit the clinic to get health

information even when not sick – Teachers: 59.4% VERY appropriate and 34.8%

SOMEWHAT appropriate for children to miss class to visit the clinic for preventive care


Goal II, continued

• Provide knowledge of self-care and preventive care– Do the parents and students know how to keep

healthy?

95.6

58.6

39.2

2.24.4

0

20

40

60

80

100

Definitely Somewhat Not really

Parents

Students


Goal II, continued

• Increase awareness of clinic services– Do the parents and students know what

services are available at the clinic?

89.6

3.0

42.8 42.8

14.47.4

0

20

40

60

80

100


Parents

Students


Goal II, continued

• Increase awareness of community health resources– Do the parents and students know where to

get health services, other than the clinic?

97.0

1.5

52.7

37.3

10.01.5

0

20

40

60

80

100


Parents

Students


Goal III: Address Attitudinal Barriers

• Provide a comfortable setting for health care– Parents: 97.0% indicated they were

comfortable with their children receiving health care at the clinic

– Students: 97.8% indicated they were comfortable receiving health care at the clinic


Goal III, continued

• Address the value of health care– How often is a regular medical check up

scheduled, when child is sick/not sick?

76.5

63.061.2

74.8

0

20

40

60

80

100

Sick Not Sick

Parents

Students


Goal III, continued

• Address the perception of the need for care– Parents: 91.2% were VERY

comfortable and 8.8% were SOMEWHAT comfortable deciding when to seek medical care for their child


Goal IV: Address Clinic Provider Issues, continued

• Are your child’s physical health needs being met at the clinic?

Child has no

Physical Health needs3.1%

Very Well met

42.4%

Not met3.0%

Well met51.5%


Goal IV, continued

• Are your child’s mental health needs being met at the clinic?

Not met1.5%

Well met23.5%

Child has no Mental

Health needs54.4%

Very Well met

20.6%


Health and School Performance

• 87.8% believed their health…… • 88.6% believed their school

performance…• 84.9% believed their grades……

….had either improved or were the same compared to one year ago (student survey)


Conclusions


Part I

• Learning Well increased the number of school-based health clinics and the number of students who were provided services

• Significant numbers of High risk children (30% hospitalized, 40% have ER visits) were identified

• Parents and children highly satisfied with Health Services provided by Learning Well


Part II • Students more likely to go to school

and stay in school for minor illnesses• Parents and children only somewhat

knowledgeable about preventive health care

• Parents feel their children’s physical health needs are generally being met, but not their mental health needs

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