Learn More About Our Initiatives

For more than two decades, the School-Based Health Alliance has worked with our national, state, and local partner organizations to develop resources, learning labs, and initiatives. Such initiatives help build and improve school-based health providers’ capacity in responding to child and adolescent health needs.

The School Health Services National Quality Initiative

The School-Based Health Alliance and National Center for School Mental Health lead the School Health Services National Quality Initiative (NQI), supported by the Maternal and Child Health Bureau since 2014. This program aims to expand school-based health services, improve care quality, and strengthen sustainability. Driven by our National Performance Measures, the school-based health center (SBHC) work consists of two components:

1) Annual national reporting through NQI Quality Counts
The NQI  challenges 100% of SBHC providers and administrators to adopt and annually report standardized performance measures voluntarily. The standards ensure that every child who uses an SBHC receives the highest standard of preventative care, including:

  • An annual well-child visit
  • A risk assessment
  • Screening for body mass index (BMI) with nutrition and physical activity counseling

When age-appropriate, every child also receives screening and proper follow-up for:

  • Depression
  • Chlamydia

2) The School-Based Health Services Collaborative Improvement and Innovation Network (CoIIN).
This competitive application-based year-long learning laboratory allows participating state teams to advance the quality of their SBHC services by networking with other state teams, receiving expert technical assistance and coaching, sharing best practices and lessons learned, and tracking progress toward National Performance Measure benchmarks and goals. 

Discover what participating in the NQI makes possible for students!

Annual Data Submission & Report Downloads

Quality Improvement Resources

Collaborative Improvement & Innovation Network

This work is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services grant titled: Collaborative Improvement and Innovation Network on School-Based Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government [grant number U61MC31885]

The National School-Based Health Care Survey

The National School-Based Health Care Survey (formerly the Census) is a triennial survey of school-based health centers (SBHCs). The School-Based Health Alliance has conducted the survey for twenty years, capturing the growth and evolution of SBHCs across the country. Our 2016-17 Census—which had a 90% response rate—collected information on SBHC locations, staffing, services provided, populations served, telehealth services, and funding.

The 2016-17 Census identified 2,584 SBHCs in 48 of 50 states, the District of Columbia, and Puerto Rico. Over the past twenty years, the number of SBHCs in the country has more than doubled—growing from 1,135 SBHCs in 1998.

We have conducted this survey since 1998. Prior to SBHA, data collection efforts were led by the Center for Population Options (now Advocates for Youth) and the Center for Health and Health Care in Schools.

This online survey provides the school-based health field with accurate, up-to-date data about SBHC demographics, staffing, services, utilization, financing, prevention activities, and clinical policies.

Youth Safety Net Project

The Youth Safety Net Project (YSNP) supports community health centers that serve children and adolescents to address social and economic conditions that profoundly affect the health, well-being, and success of young people through school and community partnerships. Through support since 2008 from the Bureau of Primary Health Care (BPHC), the YSNP project provides training and technical assistance to safety net providers serving children and adolescents in the following focus areas: 

  • Adolescent Relationship Abuse screening, prevention, and intervention strategies that promote prosocial norms, reduce exposure to violence, and support healthy relationships 
  • Childhood Diabetes Prevention in partnership with schools to improve nutrition and physical activity counseling  
  • Social Determinants of Health (SDOH) screening, care coordination and referrals, and sustainable best practices to influence population-level health outcomes 
  • Youth Development principles and practices to advance youth agency within health centers and cultivate youth-led approaches to health care delivery

School-Based Oral Health Services

Tooth decay is the most prevalent and preventable chronic disease of children in the United States. SBHA partnered with the DentaQuest Foundation in 2015 to launch the Innovation in School-Based Oral Health Services initiative to address this.

Hallways to Health

The School-Based Health Alliance implemented Hallways to Health (H2H) from 2013-2018, with support from Kaiser Permanente’s Thriving Schools. H2H looks at delivering services and building partnerships beyond the physical walls of a school-based health center to include integrating health into classrooms, teachers’ lounges, and neighborhoods. This initiative aims to empower school-based health care leaders as agents of change within their schools and communities, creating policy and systems change in three focus areas: healthy eating/active living, social-emotional health, and school employee wellness. The culmination of the project, the Hallways to Health, Creating a School-Wide Culture of Wellness Toolkit, helps school-based health centers:

  • Build a wellness team
  • Engage community-based organizations and businesses, youth, parents/guardians, and school partners
  • Build buy-in and engage stakeholders and partners
  • Assess conditions for wellness
  • Create and implement an action plan
  • Tell your story
  • Sustain your efforts
  • An annual well-child visit
  • A risk assessment
  • Screening for body mass index (BMI) with nutrition and physical activity counseling

When age-appropriate, every child also receives screening and proper follow-up for:

  • Depression
  • Chlamydia

PlaySMART Videogame Project

The PlaySMART Videogame Project harnesses the power of play and videogame technology to prevent opioid misuse in youth.

SBHA is honored to partner with the play2PREVENT Lab at the Yale Center for Health & Learning Games to develop, evaluate and implement a new videogame intervention, PlaySmart, geared toward opioid misuse prevention.

PlaySMART is a serious videogame intervention focused on preventing opioid misuse in adolescents, aged 16-19. PlaySMART teaches players strategies to prevent the initiation of opioid misuse, and highlights how to find help for mental health challenges that can co-occur with substance misuse.

PlaySMART is funded by the National Institute on Drug Abuse’s Helping to End Addiction Long-Term (HEAL) Initiative, and is developed by the play2PREVENT Lab at the Yale Center for Health & Learning Games in partnership with the National School-Based Health Alliance and Schell Games.

Innovations in Family Planning Clinical Service Delivery for Hard to Reach School-Based Populations

With funding from the Office of Population Affairs, SBHA supports Child Trends in the Innovations in Family Planning Clinical Service Delivery for Hard to Reach School-Based Populations project. SBHA works with Child Trends to identify, evaluate, and disseminate successful strategies that are used to provide family planning services to underserved adolescents in school-based settings. Examples include establishing partnerships to provide or expand family planning services, using telehealth or mobile clinic services, using strong referral systems when contraceptives are not provided on-site, conducting outreach to increase SBHC awareness and access, and incorporating culturally relevant and youth-friendly approaches.

SBHA is engaged in:

  • conducting a scan of innovative SBHCs through provider interviews
  • supporting process evaluations of a selection of SBHCs to understand facilitators and barriers in developing and sustaining innovative practices
  • developing practitioner-friendly toolkits on innovative strategies that reach a large audience

This work will increase family planning providers’ knowledge of ways to work collaboratively with schools to better reach underserved adolescents and young adults.

Adolescent HIV Prevention ECHO

The goal of the Adolescent HIV Prevention ECHO (Extension for Community Healthcare Outcomes) is to reduce Human Immunodeficiency Virus (HIV) and Sexually Transmitted Disease (STD) acquisition risk for adolescents. The initiative focuses on those who identify as lesbian, gay, bisexual, transgender, and questioning (LGBTQ) or gender non-conforming (GNC). We aim to improve the knowledge, skills, and clinical competency of primary care providers in Southern states’ school-based health centers.

Substance Use Prevention​

This initiative pairs the evidence-based model of SBIRT (Screening, Brief Intervention, and Referral to Treatment) with the unique school-clinic environment of SBHCs. The SBIRT model delivers evidence-based adolescent substance use prevention while also addressing related issues such as lack of youth treatment options, co-occurring diagnoses, adolescent engagement in health care, and restorative justice.