Everybody Wins: Meeting the Needs of K-12 Students through Rural Community Engagement in Medical Education

Proposal: Healthier Lives at School & Beyond is an innovative school-based telehealth program serving three rural eastern NC school districts delivering medical, nutritional, and behavioral health services to children facing socioeconomic and geographical barriers to care.

In the fall of 2020, operations shifted from a traditional telehealth approach to responding to our partners’ new primary need – school health assessments. At a time when healthcare systems were overwhelmed by COVID-19 and despite the school systems delivering education virtually to students at home, the NCDPI still required health assessments by a medical provider for students enrolling in NC public schools for the first time. The consequence for not filing assessments by the state-imposed deadline was suspension from school until barriers to care were overcome.

The solution -- an interprofessional team of healthcare providers travelled by retrofitted university-owned motorcoach to deliver medical services face-to-face. The first year, we made 11 trips to Duplin County schools, enabling 153 students to remain in school. Since that time, demand for health assessments each fall has not diminished, and we have continued to provide in-person visits to each district. Most recently, we completed 47 child assessments on the day before they would have been suspended. This important community outreach facilitates provision of necessary care services to patients who are already facing health disparities; by assisting these children in obtaining healthcare, we are able to support them remaining in school, reducing further gaps in education and their educational progress.

Capacity to serve more children each trip has increased by expanding community service-learning opportunities to include pediatric resident physicians and medical students during a time when such social mission experiences are scarce. They provide hands-on medical learning to further develop clinical skills and critical exposures to public health and advocacy. Rural interprofessional team-centered experiences are rarely found in the traditional classroom or clinic and provide real-time exposure highlighting social determinants of health and healthcare disparities existing within rural NC. This community outreach is overseen by the program’s PI/Medical Director/Professor of Pediatrics and Public Health who has twenty+ years’ experience in rural primary care and public health leadership.

Healthier Lives remains committed to serving children regionally, both virtually and in-person, and future aspirations include medical students to help us continue delivering wrap-around services to medically vulnerable, underserved populations. Learners unanimously express gratitude for the opportunity to imagine their future selves more readily as physicians providing care outside of clinic walls.