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All students have the right to education. Students with disabilities need support from health providers to achieve their potential at school. Barriers to health service provision exist including shortages of providers, waitlists for services, complexities of coordination between the health and education sectors, and more recently the COVID-19 pandemic. Given these barriers, some schools have been using telehealth to increase access to school-based health services; however, the literature is still emerging in this area. In this thesis, I used scoping review methods to explore the literature pertaining to telehealth use in schools. The first manuscript describes the characteristics of telehealth use in schools as depicted in 57 included articles. The findings elucidated who is providing services using telehealth and with whom, when they are using telehealth, how they are using telehealth, and why they are using telehealth in the schools. Based on the findings, I identified practice and research recommendations. The second manuscript delves into the factors that influence telehealth use in schools. We used diffusion of innovations theory to categorize statements in the 57 included articles to identify factors that influenced telehealth implementation in schools. These categories included the features of the telehealth itself (the innovation), the communication about telehealth, the process of deciding to use telehealth (time), and the social system. The findings pointed to at least four key factors that influence implementation of telehealth in schools. The final concluding chapter integrates the findings from the two studies with overarching ideas about technology complexity, access to services, and current knowledge. Additionally, implications for schools, health providers, and specifically occupational therapists are provided along with policy implications. / Thesis / Master of Science Rehabilitation Science (MSc) / School-based health providers experience barriers to servicing children and youth. These barriers reduce access to services. Telehealth is a way to provide services that may increase access to health services in schools. This thesis explored the current research about telehealth use in schools. The first study looked at the characteristics of use such as who is using telehealth, how are they using telehealth, and why are they using telehealth. The second study looked at what factors influence use of telehealth in the schools. The findings from these two studies describe what is currently known about telehealth use in schools. With this information, health providers can decide when, with whom, and how to provide telehealth in the schools. Researchers may use these studies to fill gaps in knowledge about how to best use telehealth in the school setting.

When the deadly EF-4 tornado devastated the Winston County in 2014, the local hospital and various doctors’ offices and clinics were destroyed. Win School District (WSD) had already realized the need to reestablish health care services within the school, and now county health professionals realized they were unable to meet the health care needs of the county. A partnership emerged with the Winston County Health Foundation and established a School-Based Health Clinic (SBHC) on the lower elementary school campus. The purpose of this research study was to investigate the lived experiences of school administrators, teachers, parents, and health professionals related to the SBHC in a rural school district. An exploratory qualitative research design was selected for the study to answer the central, overarching research question: How do teachers, parents, health professionals, and administrators describe their experiences related to an SBHC in a rural school district? Overall, as experienced by school administrators, teachers, parents, and health professionals, and evidenced by official school records, the SBCH met a tremendous health need in the community and had a positive impact on students’ academic achievement, students’ attendance, and teachers’ attendance. This study focused on the benefits and advantages, disadvantages and challenges, impact on student and teacher attendance, impact on student achievement, and suggested improvements. Lessons learned and insights are provided for educational leaders that can be used to promote and implement SBHC programs in Mississippi as well as throughout the country.

School-based health clinics are on the rise while telemedicine is increasingly used to provide communities access to health care. Incorporating the two together poses to create healthier school communities. Parker County Hospital District collaborated with Weatherford Independent School District (WISD) to implement the district's first telemedicine school-based health clinic. This project is in partnership with Parker County Hospital District to explore parent perceptions and desires of telemedicine and school-based health clinics to facilitate utilization among the WISD community.

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This capstone project was part of a team project completed by two school principals in Hillsborough County, Florida. The project began because of our passion for meeting the needs of our students in urban high poverty schools being supported by varying district turnaround initiatives. We looked at our district’s previous and current attempts to increase student success in high poverty schools. We questioned the ways in which supports and resources were provided, and we explored ways through which success in high poverty schools might be increased by redefining the supports and resources provided. Our appreciative exploration of the topic was guided by the question, what successful examples of services and supports have contributed to an increase in success for students in high poverty schools? More specifically, I was interested in school-based health centers (SBHC), their benefits, and their impact on student academic outcomes. I looked for literature using the following keywords: wrap around services, school based health centers, health and student achievement. School-Based Health Centers improve access to healthcare, which can help to identify and address health risk behaviors and contribute to more stable attendance at school. More instructional seat time can contribute to improved academic outcomes. The preventative role played by SBHCs can reduce barriers to learning, such as treating undiagnosed mental and physical illnesses. School-Based Health Centers provide wraparound services so that issues impacting students such as obesity or asthma can be addressed on a school’s campus where key mental health, medical and school professionals can collaborate to meet the needs of students.

Abstract The purpose of this study was to determine the differences in academic achievement, behavioral health outcomes and attendance in poor, rural children receiving physical and mental health services regularly as opposed to those children not receiving the intervention. The intervention was a school-based health and mental health clinic located on the school’s campus. This study was analyzed by providing descriptive information for several variables including the number of suspensions per year, number of times corporal punishment was used as a means of correction, educational outcomes, total number of clinic visits per year, attendance percentages per year, and number of teacher and parent referrals to the school clinic. Data for this study were presented in multiple charts and graphs and schools are compared using descriptive information. The results suggested that as the number of clinic visits increased across the three year period, the numbers of, and rates of, corporal punishment in the clinic school decreased. In contrast, the available data suggested that across the first two years the numbers of, and rates of, corporal punishment increased in the control school. Further, in the majority of subject areas, the percentage of students’ proficiency levels in the clinic school increased across time and the percentages exceeded these in the control school. These findings were consistent with the hypotheses that there will be improvements in the behavioral outcomes associated with the presence of the clinic in the school. Unfortunately there were not enough data to conduct a test of statistical significance of the differences between schools for the third year.

Background: Tobacco use either in the form of smoking or smokeless tobacco is typically initiated or established behaviorally for adult smokers before 18 years of age. Given that data from monitoring and surveillance systems drives every policy and program, accurate surveillance of tobacco consumption by adolescents is a major part of curbing tobacco addiction. Methodology: The consistency and reliability of youth smoking prevalence data was assessed by investigating discrepancies within versions of the Global Youth Tobacco (GYTS) as well as between GYTS and the Global School-based Health Survey (GSHS). Sources of errors and biases were examined in order to determine the cause for discrepancies in results. Results: Significant discrepancies were found within GYTS versions as well as between the survey results produced by GYTS and GSHS. Discrepancies within GYTS versions were determined to be due to quality control errors. Analyzed by gender, negligible variation was found between boys and girls. When comparing the total smoking prevalence estimates between GYTS and GSHS, four of the six WHO administrative regions (Africa, Americas, Eastern-Mediterranean, South-Eastern and Western- Pacific) were found to have significantly different estimates. The European region did not consist of any significantly different estimates. When comparing variance in total smoking prevalence estimates, GSHS results were found to be lower than GYTS estimates with the exception of the EMRO region. The EMRO region was further analyzed to explore gender variation within the region and boys were found to have 44.5% more significantly different estimates in comparison to girls. Conclusion: Up-to-date, reliable and consistent surveillance and monitoring efforts are part and parcel to solving this tobacco epidemic and fighting wealthy and powerful tobacco companies.

Bakgrund: Fysisk aktivitet har ett flertal goda hälsoeffekter samt positiv inverkan på, kognition, prestation i skolan och motorisk utveckling. I dagens Sverige rör sig barn och ungdomar allt mindre och få uppnår rekommendationerna för fysisk aktivitetsnivå. Fysioterapeuter har god kunskap om fysisk aktivitet och rörelse och nyttjas i andra länder inom skolans värld, i dagsläget är detta dock mycket ovanligt i Sverige. Syfte: Utforska hur fysioterapeuter verksamma inom skolans värld i Sverige upplever sin möjlighet och handlingsutrymme att påverka barns rörelsebeteende. Metod: Studien bygger på kvalitativ metod och tre semikonstruerade intervjuer genomfördes med fysioterapeuter verksamma inom elevhälsan. Intervjuerna spelades in och transkriberades. Materialet analyserades sedan enligt Graneheim och Lundmans kvalitativa innehållsanalys. Resultat: Fem huvudkategorier framkom: Vårdnadshavarnas avgörande roll för beteendeförändring, Att använda ett systematisk men samtidigt individanpassat arbetssätt, Elevernas medverkan och möjligheten att få lyckas: nyckel till framgång, Socialt stöd och gruppens betydelse för både elev och fysioterapeut, Fysioterapeuten är beroende av och utgår ifrån skolans egna resurser i sitt arbete. Dessa kategorier delades därefter in i 16 underkategorier. Slutats: Skolfysioterapeuterna i Sverige arbetar huvudsakligen för att aktivera och identifiera elever med motorisk svårighet som skolan själva inte når. I arbetet med dessa elever identifieras skolmiljön och dess resurser som viktiga för skolfysioterapeutens förmåga och handlingsutrymme att arbeta med elevers rörelsebeteende. / Introduction: Physical activity has been proven to be beneficial for cognition, academic results, overall health, and motor development. Physiotherapists have a profound knowledge in how to promote physical activity and movement. This knowledge is made use of in other countries, where school-based physiotherapists are common. In Sweden, on the other hand, school-based physiotherapists are scarce.  Purpose: To explore how school-based physiotherapists in Sweden experience their ability and room for manoeuvre when it comes to affecting children's movement behaviours.  Method: A qualitative study based on three semi-structured interviews with school-based physiotherapists in Sweden. The interviews were recorded, transcribed, and later analysed according to Graneheim and Lundman’s qualitative content analysis. Result: The results revealed five main categories and 16 subcategories. The main categories that were identified were: Guardians crucial role for behaviour change, Using a systematic but at the same time individualised approach, Students participation and the opportunity to succeed: the key to success, Social support and the group's importance for both student and physiotherapist and Physical therapists are dependent on the school's own resources.  Conclusion: The school-based physiotherapists in Sweden mainly work to activate and identify students with motor difficulties that the school itself does not have the ability to help. School-based physiotherapists identified the school environment and its resources as important for their ability and room for manoeuvre to work with students' movement behaviours.

The purpose of this study was to describe the impact that the school-based health center in Sneedville, Tennessee had on students who attended Hancock County High School. The study documented how the school-based health center affected students, families, and the community of Sneedville. Case study methodology was used to determine if the school-based health center impacted school attendance, mental and emotional health, sexual practices, and overall quality of life for students and their families. Data were collected through 25 interviews with health center stakeholders. The methodology included working with the staff at the school-based health center to identify the key players and key center users over the seven years of the center's existence. An interview protocol was designed for each of the seven groups that were interviewed. Data were collected from current and former students, parents of current and former students, school counselors, teachers, and the school nurse. Students who attended Hancock County High School as well as their parents were impacted by their direct access to primary comprehensive health care services. Benefits to parents included a reduction of time in missed work and lower medical care costs for students without health insurance. The center promoted and improved school attendance while distributing valuable health education information to students and parents. Because the city of Sneedville has only one medical center and no hospital, the school-based health center served the rural residents well. Beginning as one of only three such centers in the United States, the school-based health center endured and evolved into a full-service, comprehensive health care provider. The center is located in an isolated region of Northeast Tennessee; the location added to the center's impact on the residents. This study could provide a model for rural communities seeking ways to serve the health care needs of youth. In this time of economic instability and educational accountability, this school-based health center appeared to impact student care, thus allowing students to be more capable and ready to learn.