Outside of their homes, children spend more hours a day at school than any other place. School environments have great potential to shape child and adolescent health outcomes by influencing youth academic achievement, their interactions with adults and peers, and their sense of who they are and where they are going in life.
While the relationship between education and health is well documented, there is limited knowledge about how to harness that relationship to support optimal health and school function. School-based health services have the potential to reach the highly vulnerable youth to improve both their academic and health outcomes.
Current projects include:
Principal Investigator: Rebecca Dudovitz, MD, MSHS, PI
The L.A. Trust DataXchange is a unique database that provides insights and measurable connections between health and academic achievement for students served by LAUSD. Using student health and academic data gathered from clinical encounters occurring across 15 Wellness Centers and a host of other school-based health providers operating in the district, as well as students’ school records. Data is continuously uploaded to provide ongoing information to the district and its partners regarding:
As consultants to the LA Trust, we provide guidance on data integration, analysis, reporting and dissemination to school, health, and community stakeholders. Recent work has focused on building reports for asthma management, integrating oral health services into the DataXchange, and determining which specific health services are most closely associated with academic outcomes.
Evaluation of the Los Angeles Unified School District’s Oral Health Initiative
Funder: Los Angeles Trust for Children’s Health
Principal Investigator: Rebecca Dudovitz, MD, MSHS, PI
Dental decay is the most common chronic disease in childhood and is associated with poor academic and health outcomes. This is a community-partnered evaluation of a Dentaquest Foundation funded program to improve the oral health knowledge, attitudes, resources and behaviors across whole schools and communities in Los Angeles.
In addition to promoting preventative oral health behaviors, the program includes universal school-based oral health screening, fluoride varnishing, referral to a dental home, and case management. LAUSD is second largest school district in the nation and is testing their Oral Health Initiative with the goal of refining a model for school-based oral health that can be disseminated to the 10 largest school districts in the nation. Program evaluation focuses on:
We are tracking program implementation and participation, longitudinal oral health behaviors and outcomes, program costs and reimbursement models, and the impact on potential avoided school absences and restorative care.
Evaluating the effects of Bring Change 2 Mind High School Youth Leadership Club on Stigma
Funder: LA Biomed through CTSI / UCLA NRSA Fellowship grant
Principal Investigator: Eric Fein, MD, MPP
Mentors: Bowen Chung, MD, MSHS; Paul Chung, MD, MS; Rebecca Dudovitz, MD, MSHS; Moira Inkelas, PhD, MPH; Sheryl Kataoka, MD, MSHS
Mental illness stigma is one reason why people may wait years before seeing a mental health provider for emotional distress. Bring Change 2 Mind is a promising national high school youth leadership club with chapters across the United States that aims to promote mental health awareness and reduce the stigma of mental illness in high school students. In partnership with 3 LAUSD charter high schools that are newly implementing Bring Change 2 Mind, we aim to evaluate:
Our findings will help inform club participants and stigma researchers about how best to reduce mental illness stigma in high schools across the country.
The UniHealth-funded UCLA Upstream Obesity Solutions project, in collaboration with the LAUSD Medical Services, and Venice Family Clinic aims to build the capacity needed to fill the current gap of services for obese children. Upstream Obesity Solutions project links best practices and obesity management programs with LAUSD community clinic-based physicians and nurse practitioners to build capacity. This is accomplished through a variety of methods including: in person training sessions, scheduled coaching, development of new or identification of relevant existing protocols, discussion and implementation of clinical quality improvement activities such as consistent approaches to management and follow up of the obese pediatric patients, telemedicine and access to physician-to-physician consultation in order to increase capacity to prevent and manage pediatric overweight conditions in Los Angeles. These activities are conducted both in-person (large group, small group and one-on-one) and via electronic media (telephone, teleconference, and internet). The Upstream Obesity Solutions project allows underserved population of obese children within LAUSD to receive a higher level of expertise and medical sub-specialty care related to their co-morbid conditions than previously has been available to them.
UCLA AVID Study: Leveraging School Environments to Shape Social Networks and Prevent Substance Use
Funder: NIH-NIDA and RWJF
Principal Investigator: Rebecca Dudovitz, MD, MSHS
Despite decades of prevention work, recent data suggest that, by the end of high school, over 27% of teens regularly use marijuana and nearly 47% regularly use alcohol. Although social networks are thought to have a strong influence on adolescent substance use, few interventions target social networks to improve health behaviors. Specifically, it remains unknown whether schools might intentionally re-wire adolescent social networks to prevent or reduce substance use. Advancement via Individual Determination (AVID) is a widely disseminated college preparatory program targeting students in the academic middle (largely B and C-average students) for additional academic and emotion support. AVID removes middle-tier students from typical classrooms and groups them together with high performing students, exposing them to a peer network in which academic performance and positive social norms are valued. In addition, by strengthening the student/teacher relationship, AVID expands students’ network of supportive adults. Although evaluations of AVID suggest it improves educational outcomes, particularly for boys, there are no studies investigating whether it improves health behaviors like substance use.
Using a randomized controlled study design, this pilot will test whether AVID re-wires social networks and reduces substance use among high school youth, the specific aims of which are:
Information to be gained from this study can elucidate potential causal pathways linking school environments, social networks, and substance use, forming the basis for large-scale evaluations of AVID and the development of future social network interventions.