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Alternative
School Collaborates with Nursing School
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A collaborative project
was developed between an urban district's alternative schools and a university
college of nursing to address low immunization and physical examination
rates among students. At baseline, seven alternative school campuses had
72.6% (ranging from 59% to 80%) of the 1306 students (ages 13-16 years)
enrolled for academic risk also subject to suspension for noncompliance
with required immunizations and/or physical examinations. An estimated
95% of the students were uninsured. A formal partnership agreement for
a service learning project outlined duties and responsibilities of each
entity. A faith-based organization provided funding with the objective
of increasing access to care for uninsured youth. In the first efforts,
25 students from two schools had appointments to be transported to the
university department of pediatrics for services including assessments
by supervised nurse practitioner students. The nursing students had an
opportunity to practice skills in history taking and risk reduction education.
Half the school students were absent; most absentees indicated "fear
of hospitals and shots." In phase two, providers visited the schools
to deliver the exams on one day. The school nurse administered immunizations.
In addition to the physicals, students were informed about risk behaviors
and could speak with the provider. Within confidentiality guidelines,
parents were contacted about necessary referrals. Most students participated
(60 of 69) but lack of signed parental consent precluded the others. Phase
three added the use of community workers to make home visits to secure
parental consent. These workers assured undocumented parents that their
children could be served. All students scheduled were seen. The project
included student-selected incentives, i.e., raffle items and pizza lunch.
By the end of the first school year, the rate of non-completion dropped
to 13% (with a wide variation from two percent to over 36% among the schools).
Absences and lack of parent consent forms accounted for those not in compliance.
A total of 853 students (65% of total enrollment) had been seen. Arrangements
were made to include signed consent forms in the registration process
for the following school year.
(Glow K and Sperhac A. J Sch Health 2003;73(10):395-398 )
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