Health

HE A LTH • Winter 2020 9 working to balance school work and a day-to-day life without friends and classmates they may still be getting used to. Seeing students in person isn't possible in school, and because of virus concerns isn't always advisable elsewhere either, leading to fewer visits to the health centers' main clinics and even fewer home visits. If students have to make their way to a clinic, such as for a physical or vaccine, they often have to rely on transportation from a parent or guardian, something that's not always a sure thing. Health providers often screen for substance abuse or behavioral health challenges, too. One question providers often ask is whether a student is safe at home – a question health centers' operations: Kennedy has six, including five in Worcester and one in Framingham, and Family Health Center has eight, including seven in Worcester and a dental program in Webster. "We all have concerns that trusted adults who were in kids' lives, either teachers or nurse practitioners, are not in those kids' lives anymore," said Abigail Mathews, Kennedy's assistant medical director who oversees its school programs. "There's no remote stand-in for that." Technological and other hurdles Going remote for health care is easier in some specialties than others. Across health care – not only in pediatrics or school-based centers – medical professionals have said talk therapy, for example, lends itself well to telehealth, because a therapist can still see someone's facial expressions or hear their emotion without needing to be in the same room. Specialists who would need to check vital signs or draw blood for a test have had more difficulty. The challenges are more complex for school-based health centers, whose staff complement existing school nurses and can sometimes serve as a student's de facto primary care provider. Schools provide the health centers with names and contact information for children, but Worcester Public Schools has had challenges ensuring enough students have computers and reliable internet access at home – the same hurdles health providers can sometimes struggle with. A phone call can be an easy way to get in touch, but sometimes cell phones are shared between people, or numbers are changed often. Students at home aren't always the easiest to reach, especially if they're already Courtney Pelley, the vice president for strategic part- nerships at Kennedy Health Center n Edward M. Kennedy Community Health Center • Roosevelt Elementary School*, Worcester • Norrback Avenue School*, Worcester • Worcester Technical High School, Worcester • Burncoat High School, Worcester • North High School, Worcester • Framingham High School, Framingham n Family Health Center of Worcester • Doherty High School, Worcester • Sullivan Middle School, Worcester • Elm Park Community School, Worcester • University Park Campus School, Worcester • South High School, Worcester • Claremont Academy/Woodland Academy, Worcester • Worcester East Middle School, Worcester • Webster Public Schools* Family Health Center of Worcester staff members hold hearts with the names of all seven Worcester public schools where they have medical offices. School-based health centers The Edward M. Kennedy Community Health Center and the Family Health Center of Worcester both rely on school- based locations to provide services to students, primarily in Worcester. With classes held remotely because of the coronavirus pandemic, however, they've had to adjust. Where both centers have school locations: *Dental services only. Webster is by appointment only. Sources: Edward M. Kennedy Community Health Center, Family Health Center of Worcester more delicate if asked when the student is at home, and one now made in the context of a student who is likely spending far more time at home than normal. "I'll ask if they can talk privately," Mathews said. "I haven't had a lot of pushback with that. I think everyone's family is juggling space. So it can be a matter of having a private space to have a conversation." That extra time at home can lead to potential depression and anxiety for students who would normally look forward to seeing friends in school or having after-school activities. The school-based centers have traditionally been more often used by new immigrants, who might not have had a chance to establish a relationship with a primary care doctor yet, leaving already at-risk groups even more vulnerable. "We've often been the first stop for kids who are new to come into this country," Mathews said. Continued on page 10 PHOTOS/COURTESY OF EDWARD M. KENNEDY COMMUNITY HEALTH CENTER Abigail Mathews, the family nurse practitioner and assistant medical director at the Edward M. Kennedy Community Health Center

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