School Health Services: Topics and Follow-up After 8th-grade Consultations

Most adolescents are generally in good health. However, many report lower quality of life and increasing symptoms of mental health problems moving through adolescence. Early identification of follow-up needs may prevent more serious problems. The school health service plays a key role in this work. The National Guideline for the School Health Services recommends individual health consultations in 8th grade, covering a range of topics and identifying student needs for follow-up. Current practice for these health consultations varies considerably, and school nurses report a need for structured support tools. The GuideMe study therefore co-developed SchoolHealth, a tool designed for this purpose. SchoolHealth includes the elements: 1) Web-dialog, a digital student health questionnaire providing school nurses with an individual student profile prior to the consultation; 2) Dialog support, ongoing group-based guidance for school nurses focusing on health-promoting conversations with adolescents; 3) Collaboration materials to strengthen system-level collaboration between schools and the school health service.
The aim of this presentation is to share knowledge about the topics addressed in 8th grade consultations and any subsequent follow-up. We will also present results on whether SchoolHealth elements, individually or in combination, contribute to ensuring that the topics described in the national guideline are addressed.

Quantitative data were obtained from the GuideMe study (ISRCTN reg.nr. 24173836), a randomized factorial experiment conducted in 25 municipalities and 49 schools. The SchoolHealth components constituted the experimental factors, with the design allowing testing of both individual and combined effects. Schools were randomized to different element combinations. A total of 57 school nurses conducted the consultations. Students and school nurses completed questionnaires at several time points during the school year.

In total, 1,425 students (69%) participated, and approximately 25% received follow-up after the health consultation. The presentation will describe which topics were discussed during the health consultations, as well as reasons for following up students. Individual and combined effects of the different SchoolHealth elements on adherence to guideline-recommended consultation topics will also be presented.

Our findings provide insight into whether the recommendation for 8th-grade health consultations is carried out as intended and whether the SchoolHealth elements influence this practice. This knowledge may contribute to the development of more equitable and targeted health consultations within school health services. The results may have implications for prioritization and future development of practice in health services.