MAXIMIZING STUDENT SUCCESS BY STRENGTHENING PROGRAM LEADERSHIP
Background: The Centers for Disease Control and Prevention recommends that school districts employ SHAs to conduct health program planning, coordination, and evaluation, and to manage school-community health partnerships. Though most SHAs come from a nursing background, there are no training programs specific to SHAs offered by schools of nursing or school nurse credential programs. There are limited funds for school health programs, and not all districts can afford to employ a SHA. Regardless, schools have become a de facto health provider for students with increasing levels of acuity and chronic disease. SHAs provide critical leadership for ensuring the health and safety of 50 million schoolchildren in the U.S.
Methods: Key informants were asked to share their perspectives on what leadership skills were needed for SHAs to be successful, and what strategies SHAs should employ to secure more support and funding for their programs. Utilizing a grounded theory approach, eight semi-structured interviews were conducted with participants recruited using purposive and snowball sampling. Participants included state and county school health and education administrators, a school administration professor, a school reform expert, a school health grantmaker, and a school health lobbyist. The interviews were recorded for subsequent analysis. Participant responses were de-identified to protect their anonymity.
Results: Interviewees called for SHAs to be knowledgeable about both community health and educational systems, and to align school health program goals with those of district administrators. Participants felt that SHAs could best secure support by employing “soft” skills, such as collaboration and teamwork. Further, SHAs must demonstrate political savvy, acting as “empowered, but not confrontational,” advocates for student health, and marketing their health programs to school principals. Key informants also suggested that the new Local Control Funding Formula for California schools – which provides more funding for low-income, high-need students – offers an opportunity for SHAs to advocate for increased funding for school health programs that explicitly focus on improving student attendance and behavior in school.
Implications: SHAs are uniquely positioned to ensure school health programs address the needs of both students and schools. Inadequate funding for school health programs in California may require SHAs to finesse internal relationships to secure funding. Their work not only demands technical competency in health, education, staff supervision, and fiscal management, but also the ability to speak to multiple stakeholders’ diverse interests. Bridging health and education goals might be best expressed by aligning school health programs with efforts to improve attendance. Research on community health nursing and nurse leadership should include investigation into the important roles played by SHAs in ensuring the health and success of schoolchildren.