Date of Paper/Work


Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice



First Advisor

Nanette Hoerr


Doctor of Nursing Practice


Access to affordable health care is essential to community health outcomes. Health care is not easily accessible to all, especially children who are uninsured and underinsured. Children affected by social determinants are more likely to be uninsured and underinsured, resulting in access barriers. Using Penchansky and Thomas's access theory, this project designed and implemented a school-based health center (SBHC) to develop meso-level change and improve health care access for uninsured and underinsured children. The SBHC was implemented in a Midwest public school-district. Health care services were no-cost and included primary care, mental health services, chronic illness management, and health education. Parents or guardians of children clinic users were surveyed to help determine if the clinic was accessible. The project evaluation concluded that the SBHC was accessible to clinic users. However, further initiatives such as the use of mobile clinics are needed to broaden outreach to the targeted population. Relatively inexpensive to operate, SBHCs offer high-quality care and improve health outcomes. School-based health centers contribute to socioeconomic development by bypassing larger social structural conditions that present barriers to care. Finally, this SBHC project model utilized post-secondary health students to deliver care; the up-close connection offers a unique opportunity for adolescent SBHC users to explore health careers. Policymakers should consider SBHCs a permanent solution to the U.S. health care system's failure to aid uninsured and underinsured children.