School-based supports for child health and well-being

Multiple rigorous systematic reviews and research syntheses of various school-based supports for child health and wellbeing found strong evidence that the strategy is associated with significant improvements in health and academic outcomes.

• A 2019 research synthesis of community schools, which integrate school-based supports for child health and wellbeing into school operations, can be associated with improved academic performance, increased attendance, and a reduction in risky behavior.

• A 2015 systematic review of rigorous evaluations of school-based health centers found that they are associated with improvements in a range of academic outcomes, including higher grade point average and high school graduation rates, and health outcomes, like increased use of contraception and preventative medicine, and reduced consumption of tobacco and alcohol.

• A 2019 systematic review of school-based cognitive behavioral therapy found robust evidence that the practice is associated with reductions in student anxiety and depression, especially when treatment is delivered by mental health professionals instead of school staff.

• A 2017 research synthesis found that school dental programs can reduce instances of cavities for all students, especially among low-income students and students in rural areas.

• Identify and match supports to student, family needs: During the initial planning phase, conduct a needs assessment in close consultation with school staff and families. Given the wide range of supports and their variance in intensity, a robust, community-informed planning process will help determine which interventions and models have the highest value given local conditions and contexts. This is especially important when implementing a school-wide reform model like trauma-informed or community schools, which can be used to shape curricula, school discipline models, approaches to family engagement, and more.
• Integrate service providers into school facilities and operations: Many support models require external service providers (like nurses or counselors) to work on-site on a regular basis. To help them reach more students, ensure that external staff are given frequent opportunities to engage with students and teachers (such as during recess or lunch). This can also extend to thoughtful assignment of office space, such as in a high-traffic area that can serve as a physical reminder to students. Lighter-touch efforts, like inviting service providers to speak at school-wide invites and listing them in school directories, can further facilitate a strong working partnership.
• Dedicate staff capacity to managing partnerships: Many services, like physical health or dental care, are not core competencies for a school or district. As a result, external partnerships take on a particularly important role. Especially for comprehensive approaches that include multiple partners, effective model delivery often requires a dedicated, school-based staff member with a mandate to engage deeply with students, families, service providers, and community members alike.
• Promote services to students and families: The impact of any given support is reliant on student uptake. To address this dynamic, school and district leaders should proactively promote and market supports throughout the school year, both during in-person events like student orientation or back-to-school nights, and in written communications. Promotion should also include messaging aiming to de-stigmatize student use of services; stigma remains a persistent barrier for student access to services including free meals, therapy, sexual health care, and more.