School-based supports for child health and well-being

Strategy overview

  • Addressing student health and wellbeing needs at school: School-based supports for child health and wellbeing help position students to be physically and emotionally ready to learn. Supports can include a wide range of medical services (including physicals, vaccinations, STI tests, and more); dental and vision care; therapy and other mental health services; and school-wide programming, including sexual health education, social-emotional instruction, and trauma-informed school reform.
  • Delivering support services in a school setting: A core tenant of many evidence-based supports is that they are delivered by external partners at school, either in permanent offices (like a school-based health clinic) or temporarily (i.e. a mobile dentist’s office). Locating support services in schools addresses several major barriers. First, physical proximity to such services minimizes transportation and time costs. Second, many services are delivered for free, eliminating a financial barrier. Third, by integrating support services into school operations, student awareness is significantly increased, further raising the chances they will participate.
  • Bringing the community into school: In many jurisdictions, community groups and residents play a major role in supporting student needs. This can include partnerships with schools for clothing drives, providing free holiday meals, and hosting recreational events. Meanwhile, some school-based services, like dentistry or vision care, may also be made available to the broader community. In some cases, a full-time community liaison is hired to identify and connect students and their families to key services that are available both in school and in the community and to manage partnerships with service providers.
  • Taking a whole-school approach: While many supports are delivered directly and privately to students, some comprehensive approaches include school-wide reform and/or programming. For instance, community schools include setting school-wide goals and working with families and other partners to achieve them, like increased attendance; the trauma-informed school model, meanwhile, provides training to staff to better support students who have experienced trauma, and also is used to shape discipline policies and curricula. Some individual care models also include school-wide workshops or courses on a range of health and wellbeing issues, such as reproductive health, mental health, and social-emotional skills.
Target Population
All school-aged children
Key Stakeholders
District or School Leadership, School Support Staff, Nonprofit Partners, Public Health Department, Children and Family Services Department, Program Evaluation Team

What evidence supports this strategy?

Proven

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.

How do school-based supports for child health and well-being impact economic mobility?

  • Delivering health services to students: School-based supports for child health and wellbeing reduce barriers to accessing a wide range of health services, including medical, mental, and dental care. Good health for children, research shows, is linked to lifelong upward mobility, including higher rates of educational attainment and more stable employment.
  • Positioning students to succeed: When students' physical and emotional needs are met, they are likelier to attend school, less likely to participate in risky or dangerous behavior, and are better prepared to learn. Combined, these outcomes contribute to higher graduation rates — a key lever for upward mobility.

Best practices in implementation

  • 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.

Evidence-based examples

Individual-, group-, and community-level programming promoting healthy sexual behavior
Stable and healthy families
Proven
Holistic approach leveraging community partnerships to support student well-being
Elementary and middle school success High school graduation
Strong
Community- or school-based programming on protection against sexually transmitted infections (STIs)
Stable and healthy families
Proven
Clinic- or school-based short-term intervention program for youth who have been referred by juvenile justice, mental health, school, or child welfare systems
Stable and healthy families
Proven
Helping children and adults build behavioral skills and social support systems to encourage physical activity
Stable and healthy families
Proven
Healthy living and nutrition education classes, increased physical activity opportunities, and school-wide promotion of healthy food options
Elementary and middle school success High school graduation Stable and healthy families
Proven
Fully-subsidized and nutritious breakfast at school, often involving culturally relevant practices and food options
Kindergarten readiness Elementary and middle school success High school graduation Stable and healthy families
Proven
On-site clinics or partnerships that provide dental care to students
Kindergarten readiness Elementary and middle school success High school graduation
Proven
School-based gardens that host programming including nutrition education, food preparation lessons, and tasting opportunities
Elementary and middle school success High school graduation Stable and healthy families
Proven
Health care services provided on school premises
Kindergarten readiness Elementary and middle school success High school graduation
Proven
Curriculum and activities that focus on students' social-emotional development
Elementary and middle school success High school graduation
Proven
Teaching self-awareness, improving emotional self-control, building self-esteem, and more
High school graduation Elementary and middle school success Stable and healthy families Supportive neighborhoods
Proven
High school curriculum to develop social skills, positive character traits, and nonviolent and drug-free norms among high school students
High school graduation Supportive neighborhoods
Proven
School culture and climate reforms to ensure safe learning environments
High school graduation Elementary and middle school success
Strong