rates. The researchers found this relationship "particularly striking" among black males and attributed these successful outcomes to the trust and support provided by the clinic staff to help students function better in school.

Results from California's Healthy Start program showed that children who received intensive services in school-based programs made a significant improvement in grade point average, particularly among younger students and those who were performing least well before participating in the programs (Wagner et al., 1994). Teacher ratings of student behavior also improved significantly for those who received intensive services.

Evaluation of the Walbridge Caring Community program showed that students who received intensive services had a 27 percent increase in how their teacher rated their work habits, a 16 percent improvement in their social-emotional growth, and a 23 percent improvement in grade point average (Philliber Research Associates, 1994).

The Children's Aid Society reported "overwhelmingly positive results" after the first two years that IS 218 Community School had been opened: "student scores are up 15 points in both math and reading, attendance is the highest in the district; there has been no incidence of violence … [and] no destruction of property or even graffiti" (Children's Aid Society, 1994). At least 1,000 parents have been involved and the schools have become a central meeting place in the community.

The Partnership Center in Tama, Iowa, claims an increase in attendance and grade point averages as a result of its program, but the center cites no significant decreases in dropout rates (STC Partnership Center, 1994).

The study of school-based health programs in Florida showed a high percentage of students who were returned to class after being seen in the health room (Eimhovich and Herrington, 1993). Only 10 percent of elementary students and 18 percent of high school students were unable to return, much lower rates than those typically found in routine school nursing practices. In the Baltimore study, absenteeism because of illness was not significantly different between schools with SBHCs and other schools, where 51 percent of the sample of students reported having been absent in the past 30 days (Santelli et al., in press).

Although it is difficult to locate evaluations that specifically look at the effect of the provision of medical services on long-term outcomes, some success stories are emerging from an array of other kinds of school-based interventions. Several of the Success for All elementary schools in Baltimore that included Family Support Teams (social worker, school nurse, facilitator) and Integrated Human Services (on-site health clinic run by the health department or services from family counseling or men-



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