SCHOOL-BASED HEALTH CENTER VOICES

The NP, still very concerned, referred Emma to a dietitian. After some prodding, the dietitian was able to determine that the real issue was a lack of food at home. This was a “food-insecure household.” Emma had been using the income from her part-time job—about $70 a week—to buy “healthier foods.” The dietitian helped the SBHC team get Emma signed up for access to some local food banks. The school had a “Backpack Program,” where students could pick up a backpack filled with donated food for the weekend. Sadly, upper-level students were reluctant to participate due to the stigma. During this time, the SBHC team had participated in a New York State Department of Health learning collaborative promoted by the National School-Based Health Alliance. As a result of the program, our SBHC team decided to add food-insecurity screening to all our annual exams. Beyond just annual exams, our team expanded that screening to at least once every year for all students we see for any reason. We also adopted the screening for any student presenting with weight concerns. While identifying a serious problem is important, developing a solution is key. Our SBHC worked with the school social worker to identify options for supporting students identified as “food insecure.” The SBHC staff used the stipend they received for participating in the collaborative to help fund an in-school food pantry in the Middle/High School. The student who was initially identified and worked with had a positive outcome, with appropriate weight gain. And while there was already a backpack program in the school, it now supports the elementary school only. The food pantry in the Middle/High School allows students to self-select the foods that appeal to them from a discreet site. Referrals to this intervention can be made not only through the SBHC but also through the school’s guidance office and by word of mouth. For Emma, this in-school food pantry came at a critical time. She is back to a normal weight. Hopefully, other students will benefit now that this structure is in place. The moral of the story: School-Based Health Centers work because they operate where the students are—in the school.