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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
I.U. Bowen Research Center
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
I.U. Bowen Research Center
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)
I.U. Bowen Research Center
Overview
• Learning Well Description and Trends
• Clinical Services Provided in 2005-2006
• Achievement of Learning Well Objectives
I.U. Bowen Research Center
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
I.U. Bowen Research Center
Learning Well Schools: 73 2005-2006
• 18 High Schools (4 in 2001)
• 21 Middle Schools (6 in 2001)
• 34 Elementary Schools (0 in 2001)
I.U. Bowen Research Center
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)
I.U. Bowen Research Center
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)
I.U. Bowen Research Center
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
I.U. Bowen Research Center
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
I.U. Bowen Research Center
Gender of Clinic Users2005-2006
Gender of clinic users
Female48.9%Male
51.1%
I.U. Bowen Research Center
Race/Ethnicity of Clinic Users
2005-2006
Race/Ethnicity of clinic users
White48.1%
Hispanic8.1%
Other5.0%
Black38.8%
I.U. Bowen Research Center
Complexity of Clinic Visit
2005-2006
Complexity of Clinic Visit
Minor 42.1%
Low32.0%
High/Extensive2.7%
Moderate23.2%
I.U. Bowen Research Center
Top Ten Reasons for Visit
• Headache• Physical examination• Counseling • Vaccines• Rhinitis/Bronchitis• Menstrual disorders• Skin disorders• Esophagus/Stomach disorders• Pharyngitis/Tonsilitis/Sinusitis• Pain- abdomen
I.U. Bowen Research Center
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
I.U. Bowen Research Center
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
I.U. Bowen Research Center
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
I.U. Bowen Research Center
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
I.U. Bowen Research Center
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%
I.U. Bowen Research Center
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%
I.U. Bowen Research Center
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
I.U. Bowen Research Center
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
I.U. Bowen Research Center
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
Definitely Somewhat Not really
Parents
Students
I.U. Bowen Research Center
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
Definitely Somewhat Not really
Parents
Students
I.U. Bowen Research Center
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
I.U. Bowen Research Center
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
I.U. Bowen Research Center
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
I.U. Bowen Research Center
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%
I.U. Bowen Research Center
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%
I.U. Bowen Research Center
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)
I.U. Bowen Research Center
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
I.U. Bowen Research Center
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