713 - Implementation of a Novel School Absenteeism Screening Tool

Publication Number: 713.5433

Jacqueline S. Antoun, Children's Hospital Los Angeles, Los Angeles, CA, United States; Victoria Goldman, Children’s Hospital Los Angeles, Los Angeles, CA, United States; Panteha Hayati Rezvan, Children's Hospital Los Angeles, Los Angeles, CA, United States; Kevin Fang, Children's Hospital Los Angeles, Los Angeles, CA, United States

Background: Chronic school absenteeism nearly doubled during the COVID-19 pandemic, reaching almost 30% in 2021-2022 in California. It is defined as missing >15 school days per year (2 days per month). The link between school absenteeism and health is bidirectional. Absenteeism rates are higher among children with chronic disease such as asthma, and chronic absenteeism is linked to increased overall mortality. Therefore, healthcare providers play a role in addressing this crisis. Limited information exists, however, on the implementation of school attendance screening in healthcare settings.

Objective: To examine implementation of a chronic absenteeism screening tool at a Federally Qualified Health Center (FQHC).

Design/Methods: In July 2021, a screening tool for school attendance was integrated into the well-child check template at an FQHC tied to an urban freestanding children’s hospital in California. We analyzed all well-child checks for patients aged 5-17 from October 2022 onward. Data collected included provider type (attending vs. resident), patient demographics, and responses to the screening tool, which identified >=2 absences in the last month as an indicator of school absenteeism. Bivariate analyses were performed to assess differences in patient characteristics by school absenteeism.

Results: Among the 699 records analyzed, no significant differences were found between screened (n=489, 70.0%) and unscreened patients in age, sex, race/ethnicity, insurance type, language, medical diagnosis or provider type. Of those screened, 93.8% had public insurance, 82.4% identified as Hispanic/Latino, and 52.7% had a parent/guardian with limited English proficiency. Fifteen percent (n=72) screened positive for chronic absenteeism, with 62.5% due to an acute medical issue, 11.1% a chronic medical issue, and 4.2% related to mental health issue/substance use. Those who screened positive were more likely to be seen by a resident physician (p=0.022) or have an asthma diagnosis (p=0.023).

Conclusion(s): To our knowledge, these data are the first to document school absenteeism screening in a clinical setting. The risk of chronic absenteeism among our population is comparable to pre-pandemic rates in the state (16%), but lower than the 2022-2023 rates (25%). This difference may reflect factors such as recall bias, stigma, or the timing of data collection. Higher rates of chronic absenteeism among patients with asthma aligns with existing literature. Next steps include analyzing data over additional months and years, conducting focus groups to identify screening barriers, and partnering with schools to address school absenteeism.