The School Telemedicine in Arkansas (STAR) program is collecting data that supports the feasibility and success of offering access to real-time telehealth services in rural School-Based Health Centers (SBHCs).
STAR, the first effort of its kind in the state, is funded by a four-year, $1.2 million HRSA grant in partnership with the Center for Distance Health at the University of Arkansas for Medical Sciences, the University of Central Arkansas, and the Arkansas Department of Education. SBHCs chosen for the initial grant program include Magazine, Lamar, Jasper, and Malvern.
“STAR was originally developed based on the distinct needs of our existing SBHCs in rural Arkansas. The targeted programs – behavioral health, obesity reduction and prevention, and oral health – were designed to enhance the clinical and educational services offered by using telehealth to provide on-the-spot care as well as distance education.” ~ Tina Pilgreen, Health Educator/Outreach
The STAR Team identified stakeholders in the SBHCs and implemented an assessment to determine specific student needs. Results of the assessment were used to develop three components that comprise the STAR Program Model.
Programs began rolling out in 2016-17 school year in accordance with the following plan:
- Year 1 – Behavioral Health
- Year 2 – Obesity Reduction and Prevention – HealthyNOW
- Year 3 – Oral Health
Year 1: Behavioral Health
While Arkansas Medicaid and other insurance plans reimburse for behavioral health services, access to mental health care providers is a challenge. According to the Henry J. Kaiser Family Foundation, Arkansas is designated as a Health Professional Shortage Area (HPSA) for mental health care providers.
STAR Behavioral Health, which rolled out to all four school districts during the 2016-17 school year, uses telehealth technology to provide clinical telemedicine services and medication management. Telehealth allows students to meet with a behavioral health provider during the school day, which reduces time away from the classroom and drive time to and from a provider’s office. Students can also access online learning modules that discuss topics such as bullying and healthy relationships.
“Even though we hit several roadblocks initially, we have been able to conduct around 200 consults for kids while at school, which has saved over 450 hours of seat time and 20,000 miles of drive time. I’m very proud of the successes we’ve seen with the behavioral health component of the STAR grant.”
~ Alan Faulkner, Project Director
Year 2: Obesity Reduction and Prevention – HealthyNOW
The World Health Organization reports, “Childhood obesity is associated with a higher chance of premature death and disability in adulthood. Overweight and obese children are more likely to stay obese into adulthood and develop noncommunicable diseases (NCDs) like diabetes and cardiovascular diseases at a younger age.” The Trust for America’s Health currently ranks Arkansas 6th in the nation for childhood obesity.
During the 2017-18 school year, STAR rolled out the obesity reduction and prevention component, HealthyNOW, in the Magazine school district. HealthyNow used telehealth to provide clinical telemedicine services for exercise science and dietetics; online physical education course modules; weekly activity and nutrition challenges; and scheduled wellness fairs and field days.
HealthyNow opportunities were presented in tiers that included (1) a weekly activity challenge and reward; (2) one-on-one exercise and nutrition counseling with exercise science and dietetic professionals at the University of Central Arkansas.
Data collected from October to April shows that 51% of children enrolled in the program, categorized with a BMI of greater than 85%, lowered their BMI.
HealthyNOW will roll out in the Lamar, Jasper and Malvern school districts in the 2018-19 school year.
Year 3: Oral Health
Good oral health is key to overall health. The Arkansas Department of Health reports that poor oral hygiene can cause problems such as, “speech difficulties, discomfort when eating, and disability.” In recent years, links have been made between oral health and chronic diseases such as diabetes and heart disease. As with other health care providers, the shortage of dental health professionals is also evident in Arkansas. The HRSA Data Warehouse identifies Arkansas as a Health Professional Shortage Area (HPSA) for dental health professionals.
During the 2018-19 school year, STAR will roll out a teledentistry component in all four school districts. The program will allow students to receive teledental services on their school campuses, including a remote oral health exam and services such as dental sealants to prevent decay.
“STAR is a wonderful example of how telemedicine can enable schools in Arkansas to improve the lives of their students. It does this by providing much-needed services not currently available to these children by delivering mental health and dental care directly into the school-based health centers while reducing absenteeism.”
~ Gordon Low, Principal Investigator
Join the STAR Team for the Quarterly Thought Conference
The South Central Telehealth Resource Center invites you to join us for the Quarterly Thought Conference on July 25 at 3 PM CST. The STAR Team, Gordon Low, Alan Faulkner, and Tina Pilgreen, will provide more details about their school-based telemedicine program including barriers and lessons learned. A 15-minute Q&A session will follow the presentation.
To register for the webinar, click here.
To submit a question for the STAR Team prior to the webinar, click here.