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Despite extensive literature on school-based health center (SBHC) characteristics and outcomes, their quality of care has not been examined nationally. Standardized quality metrics can inform health care delivery and improvement.SBHC national performance measures (NPMs) were developed by reviewing measures from national child health quality initiatives and engaging stakeholders in a consensus-building process. NPMs were pilot-tested with 73 SBHCs and SBHCs nationally subsequently reported data.Five NPMs were selected including the percentage of clients annually who received at least one: (1) well-child visit, whether administered in the SBHC or elsewhere; (2) risk assessment; (3) body mass index screen with nutrition and physical activity counseling; and, if age-appropriate, (4) depression screening with follow-up treatment plan; and (5) chlamydia screening among sexually active clients. SBHCs experienced challenges with reporting during pilot-testing, particularly related to extracting data from electronic health records, and identified strategies to address challenges. Approximately 20% of SBHCs nationally voluntarily reported data during the initial year.Standardized performance measures can help SBHCs monitor and improve care delivery and demonstrate effectiveness compared to other child health delivery systems.Ongoing data collection will help examine whether measure adoption drives quality improvement for SBHCs nationwide.

There is scant research on how Asian American adolescents’ resiliency relates to mental well-being in adulthood. The objective of this study was to determine the prospective associations between resiliency factors (individual, family, and school community) in adolescence and mental health outcomes in adulthood, among a national sample of Asian Americans. We analyzed data from 1020 Asian American adolescents who were followed for 14 years in the National Longitudinal Study of Adolescent to Adult Health. Of the resiliency factors, individual self-esteem (Adjusted Odds Ratio [AOR] 0.54, 95% Confidence Interval [CI] 0.37–0.79) and family connectedness (AOR 0.78, 95% CI 0.65–0.93) in adolescence were found to be protective against adult mental health outcomes in logistic regression models adjusting for sociodemographic factors and baseline mental health. Our study identified individual and family resiliency factors which can be leveraged to help Asian American adolescents and families in cultivating better mental health.

IntroductionSchool-based health centers (SBHCs) provide health services to more than six million youth annually. When schools throughout the United States closed in spring 2020, many SBHCs were also forced to close physical operations..MethodThis study uses qualitative data collected from SBHC representatives nationwide to examine supports and challenges affecting mental health services provision during the COVID-19 pandemic, changes in the provision of these services, and priorities for assessing and supporting student mental health needs in the 2021-2022 school year.ResultsPartnerships, community and stakeholder buy-in, and student access were key supports to continuous care throughout the pandemic, whereas lack of available staff and lack of in-person access to students were key challenges. Patients demonstrated increased acuity of presenting mental health problems, more immediate and complex mental health challenges, and greater co-morbidities.DiscussionSBHCs pivoted, even with limited resources, to meet students' increasing needs for mental health care.

The U.S. has a higher adolescent pregnancy rate than other industrialized countries. School-based health centers can improve access to contraceptives among youth, which can prevent unplanned pregnancies. This cross-sectional study examines the characteristics and predictors of contraceptive provision at school-based health centers in 2016-2017 and changes in and barriers to provision between 2001 and 2017.In 2020-2021, the authors conducted analyses of the National School-Based Health Care Census data collected from 2001 to 2017. The primary outcome of interest was whether adolescent-serving school-based health centers dispense contraceptives, and a secondary outcome of interest was the policies that prohibit school-based health centers from dispensing contraceptives. A multivariate regression analysis examined the associations between contraceptive provision and various covariates, including geographic region, years of operation, and provider team composition.Less than half of adolescent-serving school-based health centers reported providing contraceptives on site. Those that provided contraceptives were more likely located in the Western and Northeastern regions of the U.S., older in terms of years of operation, and staffed by a wide variety of health provider types. Among school-based health centers that experienced policy barriers to providing access to contraceptive methods, most attributed the source to the school or school district where the school-based health center was located.School-based health centers are an evidence-based model for providing contraceptives to adolescents but not enough are providing direct access. Understanding the predictors, characteristics, and barriers influencing the provision of contraceptives at school-based health centers may help to expand the number doing so.

Background: Emergency food aid is the most essential response of the international community to natural disasters and complex emergencies. The humanitarian aid organizations sometimes have been encountered with different challenges during the feeding process to target groups.Objective: The aim of this article is to review the food aid challenges in receiving countries of humanitarian food assistance during disasters and emergencies.Methods: This systematic review was conducted in August 2019, and the search was limited to published evidence before July 1, 2019. Through this systematic review, the international electronic databases such as PubMed, Web of Science, Scopus, ProQuest, and Google Scholar were investigated for the studies published in English. The articles were assessed based on title, abstract, and full text by Joanna Briggs Institute critical appraisal tools. Then, descriptive and thematic analyses were done to extract the most relevant food challenges in recipient countries of humanitarian food assistance.Results: A total of 179 studies were found. Of which, 34 and 118 were excluded because of duplication and quality appraisal, respectively. Finally, 27 eligible articles and reports were included in this study, and 30 main challenges were determined during the international humanitarian food assistance in receiving countries. The challenges were categorized in seven main category of availability (two subcategories), access (six subcategories), utilization (three subcategories), coordination and collaboration (eight subcategories), political and legal issues (three subcategories), monitoring and assessment (six subcategories), and human rights (two subcategories). Conclusion: The most repeated challenges were related to access and monitoring. Most of the extracted food aid challenges allocated to time after occurring the disasters. Regarding to the result of this study, further research should be conducted to suggest the practical approaches for solving the mentioned challenges and increase the effectiveness of such aids.

Retraction is a mechanism for eliminating and correcting serious problems in the scientific literature and increasing awareness among members of the scientific community about unreliable literature. The objectives of this study were to identify the characteristics and reasons for retraction, analyze citations, and describe the scientific, altmetrics, and technological impacts of hematology retracted papers. Retracted papers were searched using the hematology category of the Web of Science database. The search yielded 101 retracted papers in WoS. Statistics methods such as frequency, mean, interquartile range (IQR), and Pearson's Correlation were used for data analysis. The findings showed the retracted papers were published in 28 different hematology journals. The majority of retracted documents were in Article type (n = 81). The mean time interval of the retracted papers from the first publication to retraction was 50.83 months. The largest number of retracted papers belonged to the United States (n = 46). The most frequently reported reason for retraction was misconduct (n = 55). The findings of this study provide a landscape into the characteristics and citations of retracted papers before and after retraction in addition to the scientific, technological, and altmetrics impacts of hematology retracted papers in the scientific community.

We conducted this scoping review of common errors identified by editors and reviewers of biomedical manuscripts. Errors includes items that a reviewer or editor might identify as needing correction. The errors were categorized by section of the manuscript: Introduction, Methods, Results, Discussion, and References. After screening 87 published studies, 16 papers were selected for data extraction. Of these 16 studies, the most frequently represented disciplines were Medicine (n = 5), Radiology (n = 2), and Psychiatry (n = 2). The most reported common errors included inappropriate study design, inadequate sample size, poor statistical analysis, and unclear and inadequate description of methods. Abstracts not reflecting the content of the paper were the most frequent general common error in biomedical manuscripts. The findings of this study offer one perspective on common errors in biomedical manuscripts and might be a useful guide for novice authors.

The coronavirus disease 2019 (COVID-19) pandemic forced schools to close in spring 2020, affecting the ability of school-based health centers (SBHCs) to serve youth and families who relied on their services. This preliminary study aimed to understand the implications of school closures on SBHC operations. Survey data were collected from a convenience sample of representatives from 427 SBHCs, representing approximately one sixth of SBHCs nationwide. When schools closed in spring 2020, 77% of SBHCs closed temporarily, 5% closed permanently, and 12% remained physically open. Telehealth was a crucial strategy used to continue delivering essential services. The percentage reporting any telehealth service offering before and after school closures increased by over 200%. Yet they also reported challenges, including financial and policy restraints. Many SBHCs that closed temporarily did so because their host schools closed, suggesting that making arrangements to remain open if a similar situation to the COVID-19 pandemic should arise might be beneficial. SBHCs are a proven cost-effective model to deliver health care in resource-limited communities. These preliminary study results indicate that SBHCs maintained service delivery following school closures, though many faced challenges. Further research is needed to fully understand the pandemic’s impacts on SBHC service provision and health access and outcomes.

Background: Universal health coverage (UHC) is a very important and effective policy in the health system of countries worldwide. Using the experiences and learning from the best practices of successful countries in the UHC can be very helpful. Therefore, the aim of the present study is to provide a scoping review of successful global interventions and practices in achieving UHC.Methods: The present study is a scoping review study has conducted using the Arkesy and O'Malley framework. To gather information the databases of Embase, PubMed, The Cochrane Library, Scopus, SID and MagIran have searched using the keywords of Universal health coverage, Universal healthcare coverage, Universal health care coverage, Strength*, Transfer*, interventions, improve*, program*, innovations, initiative, Financing, "Service delivery", Stewardship, "Resource generation", from 2000 to 2019. Content-Analysis was also used to analyze the data.Results: Out of 4257 articles, 57 evidence finally included in the study. The results showed that of the 40 countries that had successful interventions, most were Asian. The interventions were financial protection (40 interventions that categorized to 14 items), service coverage (31 interventions that categorized to 7 items), population coverage (36 interventions that categorized to 9 items) and quality (18 interventions that categorized to 7 items) respectively. Also, the successful result were conducted financial protection (14 items), service coverage (7 items), population coverage (9 items) and quality (7 items)) respectively.Conclusion: This study provides a comprehensive and clear view of successful interventions in achieving to UHC. Therefore, with consideration to lessons learned from successful interventions, policymakers can be designing appropriate interventions to their country.

Background and PurposeThere are very limited brief, validated, open access screening tools for trauma symptoms in adolescent populations. This study aimed to test two brief tools used with adults in primary care settings for use with adolescents.MethodsYouth (n = 77) completed the Posttraumatic Stress Disorder (PTSD) Checklist (PCLC-2), the Primary Care PTSD Screen for Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-IV; PC-PTSD), and the PTSD Reaction Index for DSM-5 (reference tool). Sensitivities and specificities were analyzed.ResultsThe PCLC-2 and PC-PTSD demonstrated high sensitivity and specificity with adolescents when using lower cutoff scores than those recommended for adults.ConclusionsThe PC-PTSD and PCLC-2 have the potential to be used as brief screens with adolescents. Additional research is needed to further examine their validity with larger, diverse youth samples in primary care and school-based settings.

Background:The rising incidence of breast cancer places a financial burden on national health services and economies. The cost of breast cancer studies is constantly increasing; however, this cost is calculated based on the currency of the country in which the study takes place, therefore limiting national and international comparisons. On the other hand, there is no common method used to conduct such studies. The objective of this review is to contribute to this knowledge pool by examining the indirect costs of breast cancer in order to provide comparable estimates.Methods and analysis:This review will consider all relevant cost of illness studies dated from the year 2000 until the year 2018. Relevant papers will be identified through a systematic search in all major medical research databases. Two independent researchers will screen selected articles. Methodological quality of the studies will be assessed using a checklist designed by Stunhldreher et al. Discussion:The results will be presented in line with the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis) checklist. While the costs of breast cancer studies are helpful in planning health interventions in terms of the severity of the problem and budget priorities, the results could also be of great help to policymakers and decision makers in health systems.Study registration number: PROSPERO CRD42018108392

PURPOSE: To examine the association between the introduction of a school-based health center (SBHC) and high school graduation rates. METHODS: We use school-level longitudinal data from Colorado that combines data on the opening of SBHCs in high schools with 4-year high school graduation rates overall and by gender between 2000 and 2018. The analytic sample consists of high schools without a SBHC in 2000 (n=132). We compare high schools that opened SBHCs over the period to those that did not and run school-level panel fixed effects models to assess the relationship between opening a SBHC and change in high school graduation rates. RESULTS: Schools that subsequently opened SBHCs had larger minority populations and lower average graduation rates in 2000. Opening a SBHC was associated with a 4.1 percentage point increase in the overall graduation rate (p=0.077). The gender-stratified analyses indicate young men’s graduation rates were most sensitive to the presence of a SBHC, increasing 4.8 percentage points (p=0.051), compared to young women’s graduation rates increasing 3.0 percentage points (p=0.163). CONCLUSIONS: Our findings suggest that the benefits of SBHC access may extend beyond health- specific outcomes to graduation rates.

Youth in underserved communities lack access to consistent sources of high-quality health care. School-based health centers (SBHCs) address this challenge through the provision of primary care, mental health care, and other health services in schools. This article describes the current status of SBHCs nationally, including changes over the past twenty years. Data were collected through the School-Based Health Alliance's National School-Based Health Care Census. The number of SBHCs doubled from 1,135 in 1998-99 to 2,584 in 2016-17. During this time they adapted to the changing health care landscape and community needs. Sponsorship shifted predominantly to federally qualified health centers, and SBHCs provided access to primary care and, often, to mental, oral, and other health services to 10,629 schools and over 6.3 million students. SBHCs have grown steadily since 1998, and recent expansion through federally qualified health centers and telehealth technology forecasts even greater growth, innovation, and access for underserved communities.

Training adolescents as student researchers is a strategy that can improve the delivery of care at school-based health centers (SBHCs) and significantly shift school health policies impacting students. From 2003 to 2006, the University of California, San Francisco, in partnership with Youth In Focus, implemented a participatory student research project to enhance the existing evaluation of the Alameda County SBHC Coalition and its participating clinic members, and to help develop and implement school health policies. Providing opportunities and training that enabled youth to identify and research the health needs of their peers, as well as advocate for improvements in SBHCs based on their research findings, represents an exciting youth development strategy. This article describes the role the youth played, how their adult partners supported their work, and the impact that their efforts had on the SBHCs and school health programming and policies in the areas of condom accessibility and mental health services.

© 2015, American School Health Association. Bullying and victimization are ongoing concerns in schools. School health centers (SHCs) are well situated to support affected students because they provide crisis intervention, mental health care, and broader interventions to improve school climate. This study examined the association between urban adolescents' experiences of school-based bullying and victimization and their use of SHCs. METHODS: Data was analyzed from 2063 high school students in 5 Northern California school districts using the 2009-2010 California Healthy Kids Survey. Chi-square tests and multivariate logistic regression were used to measure associations. RESULTS: Students who were bullied or victimized at school had significantly higher odds of using the SHCs compared with students who were not, and were also significantly more likely to report confidentiality concerns. The magnitude of associations was largest for Asian/Pacific Islander students, though this was likely due to greater statistical power. African American students reported victimization experiences at approximately the same rate as their peers, but were significantly less likely to indicate they experienced bullying. CONCLUSIONS: Findings suggest that SHCs may be an important place to address bullying and victimization at school, but confidentiality concerns are barriers that may be more common among bullied and victimized youth.

SUMMARY Youth participation in social action can contribute to healthier, more just communities and more effective youth serving institutions. Reflecting on youth-led research projects conducted in seven school-based health centers, this article presents specific youth engagement strategies, the benefits of youth participation in health research, and the lessons learned for improving adolescent health and other outcomes.

School-based health centers (SBHCs) provide a variety of health care services to youth in a convenient and accessible environment. Over the past 40 years, the growth of SBHCs evolved from various public health needs to the development of a specific collaborative model of care that is sensitive to the unique needs of children and youth, as well as to vulnerable populations facing significant barriers to access. The SBHC model of health care comprises of on-school site health care delivery by an interdisciplinary team of health professionals, which can include primary care and mental health clinicians. Research has demonstrated the SBHCs' impacts on delivering preventive care, such as immunizations; managing chronic illnesses, such as asthma, obesity, and mental health conditions; providing reproductive health services for adolescents; and even improving youths' academic performance. Although evaluation of the SBHC model of care has been complicated, results have thus far demonstrated increased access to care, improved health and education outcomes, and high levels of satisfaction. Despite their proven success, SBHCs have consistently faced challenges in securing adequate funding for operations and developing effective financial systems for billing and reimbursement. Implementation of health care reform (The Patient Protection and Affordable Care Act [P.L. 111-148]) will profoundly affect the health care access and outcomes of children and youth, particularly vulnerable populations. The inclusion of funding for SBHCs in this legislation is momentous, as there continues to be increased demand and limited funding for affordable services. To better understand how this model of care has and could further help promote the health of our nation's youth, a review is presented of the history and growth of SBHCs and the literature demonstrating their impacts. It may not be feasible for SBHCs to be established in every school campus in the country. However, the lessons learned from the synergy of the health and school settings have major implications for the delivery of care for all providers concerned with improving the health and well-being of children and adolescents. © 2012 Mosby, Inc.