Brokering student well-being: Understanding the work of school health administrators

Abstract

<p>Background: Despite a well-documented need for school health programs (SHPs) among school children who have chronic conditions, require medically complex interventions at school, or experience socio-emotional health issues, there is little school health funding in California. There is limited research on the role of those who manage SHPs. Purpose and aims: This qualitative study investigated the work of a selected group of school health administrators (SHAs) in California. Study aims were to explore SHA job pathways and responsibilities, the contextual factors influencing their work, and how they get their work done given limited funding for SHPs. Methods: Thirty in-depth, semi-structured interviews were conducted with SHAs and their staff, supervisors, and deputy SHAs. Interviewees were initially recruited using purposive sampling to reach SHAs from a variety of backgrounds and districts of different sizes and locations throughout California. Snowball sampling was then employed to recruit additional SHAs, as well as staff and supervisors. Findings: Limited funding and devaluation of SHPs has led to a marginalization of SHAs. As a result of this disempowerment, SHAs&rsquo; work required double duty: in addition to their daily responsibilities developing and managing district-wide health programs and staff, SHAs had to engage in an array of strategies to broker political support. These brokering strategies included raising awareness of student health needs and the benefits of SHPs, building relationships with decision-makers, and adjusting to working conditions by waiting and devising lower-level workarounds. Conclusion: This study provides insight into the unique role of SHAs in promoting student health, and identifies some of the strategies SHAs employ in response to the challenges they face in their work. Study findings may inform the development of SHA-specific training programs and more appropriate SHA job descriptions and titles.</p>