Elementary School Clinic Management in Relation to Health Awareness of Learners

ISSN 3028-1261 10.5281/zenodo.17312520/NIJSE.2025 Elementary School Clinic Management in Relation to Health Awareness of Learners Krissy A. Castro Abstract. This study examined the extent of elementary school clinic management and its influence on the health awareness of learners in selected public elementary schools. The study employed a descriptive-correlational research design involving 148 respondents. Data were gathered using a validated survey instrument and analyzed through descriptive statistics, Pearson correlation, and multiple regression analysis. Findings revealed that all domains of school clinic management—access to health care, timely response to health needs, health promotion and education initiatives, and health equity and inclusivity—were perceived to be extensively implemented. Similarly, learners demonstrated extensive health awareness, particularly in the areas of preventive health measures, health education participation, and engagement in health-related consultations. A strong and statistically significant relationship was found between school clinic management and learners’ health awareness (r = 0.795, p < .001). Regression analysis showed that the four clinic management domains collectively explained 66.6% of the variance in health awareness. Among these, timely response to health needs emerged as the strongest predictor, followed by health equity, inclusivity, and access to health care. However, health promotion and education initiatives did not significantly influence health awareness when analyzed alongside the other variables. KEY WORDS 1. School clinic management 2. health awareness 3. elementary learners Date Received: August 15, 2025 — Date Reviewed: September 20, 2025 — Date Published: October 10, 2025 1. Introduction Managing elementary school clinics comes with its own set of challenges that can impact how aware students are about health. Limited resources, such as not having enough medical supplies, undertrained staff, and a lack of funding, often make it tough for clinics to provide the best health services possible. Plus, without structured health education programs in schools, students don’t get the exposure they need to important health initiatives, which means they might miss out on learning how to adopt healthy habits. Overcrowding in schools makes things even more difficult, as clinics find it harder to meet the needs of so many students. Also, when there isn’t consistent teamwork between schools, parents, and local health units, it can slow down efforts to promote prevention in health. A pressing challenge is the shortage of trained health personnel in schools. The World Health Organization (WHO, 2021) emphasizes that school health services are often underfunded and pro- NIJSE (2025) - vided with limited reach and scope. This situation is exacerbated by the absence of structured health education programs, which leaves learners without the necessary exposure to critical health information. The lack of qualified health professionals within the school setting further diminishes the capacity to effectively address students’ health needs, thereby impeding the promotion of health awareness. Furthermore, the integration of mental health services into school clinics presents additional complexities. A report by the Manhattan Institute in 2024 highlights that while there is a growing emphasis on school-based mental health initiatives, these programs often face challenges such as conflicting goals between educational and mental health systems, lack of clear policy guidance, and issues related to accountability. In the Asian context, elementary school clinic management faces significant challenges that impact learners’ health awareness. It emphasized the necessity for a holistic approach that prioritizes overall adolescent well-being through comprehensive health education and life skills development. The lack of intersectoral coordination between health and education sectors further impedes the effective implementation of school health programs, thereby affecting students’ health awareness and outcomes (Jakasania, et.al., 2023). Elementary school clinics play a pivotal role in promoting health awareness among learners; however, they encounter significant challenges that impede their effectiveness. A critical issue is the lack of adequate health-related infrastructure within schools. According to the Department of Education (DepEd, 2021) in the Philippines, as of 2021, only 28% of public schools have clinics, and many existing facilities need repair and rehabilitation. This deficiency hampers the delivery of essential health services and limits opportunities for health education, thereby affecting students’ overall well-being and awareness. Examining school health policies during the pandemic found that while policies were in place, their implementation faced barriers such as limited resources, inadequate training for school health personnel, and insufficient infrastructure to support health protocols. These obstacles have further strained the capacity of school clinics to manage health concerns and educate learners effectively, underscoring the need for strengthened health systems within the educational sector (Estrada, et.al., 2024). In Compostela Valley (Davao de Oro), elementary schools face challenges managing health services and promoting health awareness among learners. A notable issue is the limited availability of fully functional school clinics equipped to handle medical emergencies and provide comprehensive health education. In response to this situation, the Department of Education (DepEd) has implemented various initiatives, including the appointment of clinic teachers and safety officers to oversee basic health services and enforce safety protocols within educational institutions. These measures are designed to improve the health and safety of students, thereby ensuring a conducive learning environment (DepEd Tayo, 2022). 1.1. Theoretical/Conceptual Framework of the Study —Several theoretical frameworks could inform a study on optimizing elementary school clinic management for enhanced student achievement. One such framework is Bronfenbrenner’s Ecological Systems Theory, which emphasizes the interconnectedness of various environmental factors in shaping individuals’ development. Within this framework, the school clinic operates within the microsystem, directly influencing students’ immediate experiences and interactions within the school environment (Kirby, 2022). Optimizing clinic management practices can enhance the microsystem by providing students with access to quality healthcare services, promoting positive health behaviors, and fostering a supportive and nurturing school climate conducive to learning and academic success. Additionally, Bandura’s Social 2ISSN 3028-1261 10.5281/zenodo.17312520/NIJSE.2025 NIJSE (2025) - Learning Theory could be relevant, as it highlights the importance of observational learning, modeling, and social reinforcement in shaping behavior. Within this framework, the school clinic serves as a setting where students observe and learn about health-related behaviors and attitudes through direct experiences and interactions with healthcare professionals, peers, and educators. By promoting health education, modeling healthy behaviors, and providing positive reinforcement for healthy choices, the clinic can influence students’ health beliefs, attitudes, and behaviors, ultimately contributing to their academic achievement. These theoretical perspectives offer valuable insights into the complex interactions between school clinic management, student health, and academic success, providing a framework for understanding the mechanisms through which optimized clinic management practices can support students’ holistic development and achievement (Wright-McAllister. 2022). In the study on optimizing elementary school clinic management for enhanced student achievement, Bronfenbrenner’s Ecological Systems Theory and Bandura’s Social Learning Theory provide valuable frameworks for understanding the dynamics at play within the school environment and the potential impacts of clinic management practices on student outcomes. Bronfenbrenner’s theory emphasizes the significance of the microsystem, which encompasses the immediate environment in which individuals interact and develop. In this context, the school clinic functions as an essential element of the microsystem, exerting a direct influence on the health and well-being of students within the educational environment. By optimizing clinic management practices, including the provision of timely access to healthcare services and the promotion of health education initiatives, the clinic augments the microsystem by establishing a supportive and nurturing atmosphere that fosters the physical, mental, and emotional health of students. This, in turn, contributes to their overall well-being and readiness to engage in learning, ultimately leading to improved academic achievement. Bandura’s Social Learning Theory highlights the role of observational learning, modeling, and social reinforcement in influencing behavior. In a school clinic setting, students can observe and interact with healthcare providers, peers, and educators, gaining insights into health-related behaviors and attitudes. These interactions allow students to develop knowledge and skills in health promotion, disease prevention, and self-care. Reinforcing positive behaviors—such as recognizing students who seek timely care or engage in health education—can further encourage the adoption of healthy habits. Applying Bandura’s principles, school clinic practices can support meaningful health behavior changes, contributing to reduced absenteeism, better focus in class, and improved academic outcomes. Figure 1 below presents the variables in the study. In the study focusing on optimizing elementary school clinic management for enhanced student achievement, the association of variables reflects a complex interplay between clinic management practices and various student outcomes. 2. Methodology This chapter presents the procedures undertaken in conducting the study, detailing the chosen research design, respondent selection and sampling method, data collection instruments, research procedures, ethical considerations, and data analysis techniques. Each component is essential to ensure the accuracy, validity, and reliability of data collection, analysis, and interpretation. 3ISSN 3028-1261 10.5281/zenodo.17312520/NIJSE.2025 NIJSE (2025) - Fig. 1. Theoretical/Conceptual Framework 4ISSN 3028-1261 10.5281/zenodo.17312520/NIJSE.2025 NIJSE (2025) - 2.1. Research Design—The study employed a non-experimental, descriptivecorrelational research design. According to Creswell (2020), this design is used to examine the degree of association between two or more variables without manipulating them. It focuses on observing and analyzing naturally occurring relationships to describe patterns and trends. Descriptive-correlational designs are particularly useful for identifying connections among variables and may also inform predictions about future outcomes. Commonly applied in exploratory research, this approach provides valuable insights into variable associations while maintaining the integrity of natural conditions. In the study titled ”Optimizing Elementary School Clinic Management for Enhanced Wellness and Student Achievement,” a non-experimental, descriptivecorrelational research design is likely employed to investigate the relationship between clinic management practices and student outcomes. This approach involves observing and describing naturally occurring phenomena without manipulating any variables, making it suitable for examining associations and identifying patterns among variables of interest. Within this research design, researchers collect data on clinic management practices, student wellness indicators, and academic achievement measures through surveys, interviews, observations, or existing records. Clinic management practices, such as the availability of healthcare services, appointment scheduling systems, and collaboration between clinic staff and teachers, are described and measured quantitatively. Similarly, student outcomes, including improved attendance, decreased tardiness and early dismissal, and positive behavioral outcomes, are assessed and described. Correlational analysis is then used to examine the relationships between clinic management practices and student outcomes, identifying any significant associations or patterns. It may be found that schools with more comprehensive healthcare services in their clinics tend to have higher attendance rates and better academic performance among students. While this research design does not establish causation between clinic management practices and student outcomes, it provides valuable insights into potential relationships and informs future research and interventions aimed at optimizing school clinic management for the benefit of student wellness and achievement. 2.2. Ethical Consideration—The ethical consideration section of this study will address the key principles that ensure the protection and well-being of the teacher-respondents involved. This includes adhering to confidentiality, informed consent, and the voluntary nature of participation, ensuring integrity and respect for the rights of all respondents. Social Value As the researcher, I believe the study titled ”Elementary School Clinic Management in Relation to Health Awareness of Learners” carries significant social value in addressing the health challenges faced by young learners in our community. By examining the impact of well-managed school clinics on students’ health awareness, the research seeks to support efforts to improve access to essential health services within schools. This study not only seeks to enhance the overall well-being of learners but also aims to create a foundation for fostering healthy habits early in life. It aspires to contribute meaningful insights that can guide educators, policymakers, and health professionals in developing programs that bridge the gap between health and education. Informed Consent and Assent As the researcher, I recognize the critical importance of Informed Consent and Assent in ensuring the ethical integrity of this study. By prioritizing transparency, I aim to ensure that all participants, including learners and their guardians, fully understand the purpose, significance, and procedures of the research. Through 5ISSN 3028-1261 10.5281/zenodo.17312520/NIJSE.2025 NIJSE (2025) - the process of informed consent, parents and guardians are provided with detailed information, empowering them to make an informed decision about their child’s participation. Similarly, assent ensures that learners actively agree to participate, respecting their rights and autonomy. This approach not only upholds ethical standards but also fosters trust and collaboration between the participants and the researcher, emphasizing the value of their contribution to the study’s success and its potential to impact school clinic management and health awareness initiatives positively. 2.3. Research Respondents—The study’s respondents were Public School Teachers from Compostela West District in Davao de Oro. Using Slovin’s formula, the sample size was calculated from a population of 230 teachers with a 5% margin of error, resulting in a sample of 146 respondents. These respondents were selected randomly and proportionally distributed across schools within the district. To facilitate their participation, the respondents were informed about their selection through both online platforms and face-to-face interactions, considering the availability of internet connectivity. They were oriented on the purpose and significance of the study, emphasizing its potential contribution to their professional development and the enhancement of educational practices in the district. The teachers who were surveyed actively and directly engaged in a diverse range of school programs, projects, and activities as outlined in their School Improvement Plans. Beyond their roles in curriculum implementation and delivery, these educators showcased proficiency in streamlining operational processes and employing effective school clinic management strategies. Moreover, they demonstrated a commitment to enhancing the system for improving learners’ achievement. Recognized as qualified professionals, these teachers have consistently made significant contributions to school improvement, fostering heightened awareness among stakeholders in the context of the new normal learning system during the academic year 2023-2024. Additionally, they have been regular participants in seminars, training sessions, focusing on schools development and creating good environment. 2.4. Research Instrument—In this study, the researcher utilized an adapted survey instrument developed through an extensive review of literature and related empirical studies. This rigorous process involved identifying relevant concepts and frameworks to guide the formulation of questionnaire items, thereby strengthening content validity and minimizing potential threats to construct validity. The survey was structured into two main parts: the first measured the extent of school clinic management in terms of access to healthcare services, timely responses to health needs, and the implementation of health promotion and education initiatives. The second part assessed learners’ academic and behavioral outcomes, specifically improvements in attendance, reductions in tardiness and early dismissals, and positive behavioral changes. To ensure the instrument’s reliability, the survey items underwent test-retest procedures and were subjected to internal consistency analysis using Cronbach’s alpha at a 0.05 level of significance. The computed Cronbach’s alpha coefficient was .880, indicating a very high level of reliability and internal consistency of the instrument (Pallant, 2010). The survey employed a 5-point Likert scale to assess the extent of school clinic management practices, with corresponding descriptive ratings and interpretations provided in the succeeding section. 2.5. Data Gathering Procedure—In the data gathering procedure of the research project, several critical steps are involved, one of which is the ethical acquisition of permission to con6ISSN 3028-1261 10.5281/zenodo.17312520/NIJSE.2025 NIJSE (2025) - Scale for Optimizing School Clinic Management/Health Awareness Scale Descriptive Rating Interpretation 4.20 – 5.00 Very Extensive The optimizing school clinic management/health awareness is always observed. 3.40 – 4.19 Extensive The optimizing school clinic management/health awareness is oftentimes observed. 2.60 – 3.39 Moderately Extensive The optimizing school clinic management/health awareness is sometimes observed. 1.80 – 2.59 Less Extensive The optimizing school clinic management/health awareness is rarely observed. 1.00 – 1.79 Not Extensive The optimizing school clinic management/health awareness is not observed. duct the study. This step is indispensable for upholding fundamental principles such as respect, transparency, and responsible research conduct. The guidelines for this process adhere strictly to the policies of Rizal Memorial Colleges. As part of the formal request, researchers outline their intentions regarding data collection, analysis, and dissemination, ensuring alignment with the overarching research goals. Any anticipated concerns or questions from recipients are proactively addressed in this communication, offering assurances on ethical safeguards, confidentiality measures, and the potential benefits of the study. The formal permission request explicitly seeks authorization to proceed, underscoring the pivotal role of their support in ensuring the research’s success. Permission to Conduct the Study In January 2025, prior to the commencement of data collection, the researcher secured the necessary approvals from key authorities, including the research adviser, the Dean of Rizal Memorial Colleges, and the top officials of the DepEd Davao de Oro Schools Division, following the appropriate institutional protocols. This process involved the submission of a detailed research proposal that clearly outlined the study’s design, methodology, and the potential risks and benefits. The proposal also included comprehensive information regarding the study’s objectives, data collection procedures, analysis, and reporting methods. Subsequently, in February 2025, the researcher ensured that all participants were fully informed about the study’s purpose, their rights, and the scope of their involvement. Informed consent was obtained from all participants prior to their inclusion in the study. During the first week of February, the researcher conducted the distribution and retrieval of questionnaires with a strong emphasis on data accuracy and completeness. These activities were carried out systematically and uniformly, thereby ensuring the reliability and integrity of the data collected from the participants. 7ISSN 3028-1261 10.5281/zenodo.17312520/NIJSE.2025 NIJSE (2025) - 2.6. Data Analysis—Mean Scores and Standard Deviation The study was used to address statement problems posed in number one (1) extent of optimizing school clinic management, and statement problem number two (2) on the extent of student outcomes in Compostela West District, Davao de Oro Schools Division. Pearson Product-Moment Correlation Coefficient or Pearson-r Was used to determine the strength/direction of the significant relationship between optimizing school clinic management and student outcomes. Simple Linear Regression analysis Was used to address statement problem number 4, on the indicators of optimizing school clinic management that significantly influence student outcomes (Pallant, 2020). All data processing and analysis were conducted utilizing the Jeffrey’s Statistics Amazing Program (JASP) version 0.12.20. Following the yielding of results, discussions and interpretations ensued. 3. Results and Discussion This chapter presents the study’s results and offers a comprehensive discussion on the data collected regarding the management of elementary school clinics and its relationship to the health awareness of learners. The findings are organized based on the research questions and objectives in the earlier chapters. Quantitative data are analyzed using appropriate statistical tools, while the qualitative insights, if any, are integrated to provide depth and contextual understanding. Interpretations of the data are grounded in the theoretical and conceptual framework of the study, supported by relevant literature. 3.1. Extent of Elementary School Clinic Management—In the United States, the National Center for Education Statistics (2022) reports that about 56% of public schools believe they can adequately provide mental health services to students. However, barriers such as staffing shortages, limited access to licensed professionals, and funding constraints remain. Similarly, the U.S. Department of Education (2021) highlights growing student mental health needs and fragmented service delivery as major concerns, recommending evidence-based prevention strategies and integrated support systems to improve school-based mental health care. Summary on the Extent of Elementary School Clinic Management Table 1 presents the extent of elementary school clinic management as perceived by 148 respondents across four key domains: access to health care, timely response to health needs, health promotion and education initiatives, and health equity and inclusivity. All components received mean scores within the “Extensive” range, with Timely Response to Health Needs obtaining the highest mean score (M = 4.03), followed closely by Health Equity and Inclusivity (M = 3.99), Access to Health Care (M = 3.98), and Health Promotion and Education Initiatives (M = 3.87). The overall mean of 3.96 indicates that elementary school clinic management is extensively implemented and evidently integrated into the operational and wellness framework of the schools surveyed. This suggests that school clinics effectively deliver essential health services, maintain responsiveness, promote wellness education, and uphold inclusivity and equity. 8ISSN 3028-1261 10.5281/zenodo.17312520/NIJSE.2025 NIJSE (2025) - Table 1. The Extent of Elementary School Clinic Management No. School Clinic Management n Mean Descriptive Interpretation 1 Access to Health Care 148 3.98 Extensive 2 Timely Response to Health Needs 148 4.03 Extensive 3 Health Promotion and Education Initiatives 148 3.87 Extensive 4 Health Equity and Inclusivity 148 3.99 Extensive Overall Mean 148 3.96 Extensive Legend. Very Extensive = Always Observed; Extensive = Oftentimes Observed; Moderately Extensive = Sometimes Observed; Less Extensive = Seldom Observed; & Not Extensive = Never Observed. These findings are corroborated by global and regional studies emphasizing the critical role of comprehensive school health systems. According to the World Health Organization (2024), schools that adopt a whole-school approach to health, anchored in equitable access, timely care, and education, tend to report better student health outcomes and improved academic engagement. Solcz and Frobom (2024) assert that school-based health centers prioritizing integrated services and proactive health education contribute to improved preventive care and reduced absenteeism rates. Furthermore, research by Alegr ´ ıa et al. (2022) highlights that schools that promote inclusive clinic management practices, particularly those focused on underserved populations, experience greater student trust and health-seeking behavior. These studies validate the survey results, demonstrating that strong school clinic management systems are essential in advancing learner wellbeing and holistic development. 3.2. Extent of Health Awareness of Learners—Health awareness among learners refers to their understanding, attitudes, and practices related to physical, mental, and emotional wellbeing. It encompasses knowledge of personal hygiene, nutrition, disease prevention, physical activity, and the ability to make informed health-related decisions. The extent of learners’ health awareness reflects how effectively they apply these concepts in their daily lives within and beyond the school setting. Both formal instruction and exposure to school-based health programs and services often shape the development of health awareness. According to the World Health Organization (2024), early health education delivered consistently through schools is critical in cultivating lifelong healthpromoting behaviors. Learners regularly engaged in health education initiatives, such as wellness campaigns, peer-led discussions, and interactive lessons, are likelier to demonstrate heightened health consciousness. Furthermore, as Solcz and Frobom (2024) noted, school environments that integrate clinic services with structured health instruction significantly improve learners’ health literacy and proactive health behaviors. These findings highlight the importance of sustained and inclusive health education efforts in fostering well-informed and health-conscious learners. Summary on the Extent of Health Awareness of Learners Table 2 provides a summary of the learners’ 9ISSN 3028-1261 10.5281/zenodo.17312520/NIJSE.2025 NIJSE (2025) - Cruz, L. A., & Magtoto, E. A. (2022). The role of health education in enhancing wellness awareness among public elementary students. Philippine Journal of Basic Education, 18(2), 44–53. Davis-Bordovsky, K. (2022). Project mental health awareness: A multimedia, peer-to-peer pilot school curriculum. Contemporary School Psychology,26(2), 195–199. https://eric.ed. gov/?id=EJ1335368. Department of Education. (2019). 2019 oplan kalusugan (ok sa deped) overview. Department of Education. (2020). Deped bats for permanent clinics in all public schools. DepEd Tayo Davao de Oro. (2022). The role of teacher clinic in ensuring safety school environment in taligaman central elementary school [Accessed: 2024-01-10]. Donnelly, J., Young, M., & Roberts, K. J. (2021). Advocates and researchers working together to improve school health education. Journal of Health Education Teaching,12(1), 28–35. Estes, E., Davis, J., Shilton, A., Stoner-Mertz, C., Funk, M., Eisenberg, L., Weller, T., Knecht, R. S., Kelley, V., Kain, L., Peck, J., Rosario, A., Lombardo, M., Kimner, H., Jacobs, M., Dickey, A., Epstein, K., Aguilar-Gaxiola, S., Alcala, L., . . . Larsen, K. (2022). Supporting california’s children through a whole child approach: A field guide for creating integrated, school-based systems of care. Estrada, M. L., Garcia, J. M., & Thompson, R. K. (2024). The role of school clinics in managing student health concerns and enhancing learning outcomes. Journal of School Health, 94(2), 123–135. Fallon, L. M., Veiga, M. B., Susilo, A., & Kilgus, S. P. (2023). Do teachers’ perceptions of high cultural responsiveness predict better student behavioral outcomes? Grantee Submission. https://doi.org/10.1177/01987429211067217 Gaal, S. R., & Fuller, M. B. (2024). School safety and mental health awareness: Recommendations from k-12 texas public school teachers. Journal of School Health. https://doi.org/10.1111/ josh.13425 Habiyaremye, M. A., Clary, K., Morris, H., Tumin, D., & Crotty, J. (2021). Which children use school-based health services as a primary source of care? Journal of School Health, 91(11), 876–882. https://doi.org/10.1111/josh.13085 Jakasania, A., Lahariya, C., Pandya, C., Raut, A. V., Sharma, R., Sophiya, K., Mundra, A., Kapoor, J. P., Khajuria, S., & Gupta, S. S. (2023). School health services in india: Status, challenges and the way forward. Indian Journal of Pediatrics,90, 116–124. Kirby, D. (2020). Research methods for assessing and evaluating school-based clinics. Kwatubana, S., Nhlapo, V. A., & Moteetee, N. (2022). The role of principals in school health promotion in south africa: A qualitative study. Health Education,122(3), 304–317. https: //doi.org/10.1108/HE-08-2020-0078 Lahti, M., Korhonen, J., Sakellari, E., Notara, V., Lagiou, A., Istomina, N., Grubliauskiene, J., Makutiene, M., ˇ Sukyte, D., Erjavec, K., Petrova, G., Lalova, V., Ivanova, S., & Laaksonen, C. (2023). Competences for promoting mental health in primary school. Health Education Journal,82(5), 529–541. https://doi.org/10.1177/00178969231173270 Manhattan Institute. (2024). School-based mental health initiatives: Challenges and considerations for policymakers. McKay, S. L., Thompson, R. J., & Lee, J. M. (2024). Barriers to seeking care in school settings: Perspectives from adolescents. Journal of Adolescent Health,74(3), 456–463. 16 ISSN 3028-1261 10.5281/zenodo.17312520/NIJSE.2025 NIJSE (2025) - Medina, R. M., & Caballes, J. M. (2022). Health-seeking behavior of public elementary learners through school-based clinics: A philippine perspective. Journal of School Health and Wellness,18(2), 55–64. Moore, M. J., Barr, E., Hayes, C., & Binder, M. (2023). Voter support for offering sexual health services through school-based health clinics. American Journal of Sexuality Education, 18(1), 24–38. https://doi.org/10.1080/15546128.2022.2080141 Murillo, M. A., Liboon, C. A., & Quartz, K. H. (2023). Immigrant family legal clinic: A case of integrated student supports in a community school context. Journal of Educational Change,24(2), 365–392. https://doi.org/10.1007/s10833-021-09447-x Murray, D. W., Kuhn, L. J., Willoughby, M. T., LaForett, D. R., & Cavanaugh, A. M. (2022). Outcomes of a small group program for early elementary students with self-regulation difficulties: Limitations of transportability from clinic to school. School Mental Health, 14(3), 531–549. https://doi.org/10.1007/s12310-021-09480-4 National Center for Education Statistics. (2022). Roughly half of public schools report that they can effectively provide mental health services to all students in need. Okoroji, C., Kolsky, R. M., Williamson, A. A., & Mautone, J. A. (2024). Integrated behavioral health in pediatric primary care: Rates of consultation requests and treatment duration. Child & Youth Care Forum,53(3), 741–756. Pallant, J. (2020). Spss survival manual: A step by step guide to data analysis using spss. Open University Press/McGraw-Hill. Pingel, E. S., Llovet, A., Cosentino, F., & Lesser, J. (2021). Committing to continuity: Primary care practices during covid-19 in an urban brazilian neighborhood. Health Education & Behavior,48(1), 29–33. https://doi.org/10.1177/1090198120979609 Rosado, J. (2022). School-based health clinics and student outcomes in new york city public schools [Doctoral dissertation, Seton Hall University]. Santos, J. R., & Del Rosario, M. L. (2023). School health services and learners’ health-seeking behaviors: A study of public elementary schools in central luzon. Philippine Journal of Education and Health,15(1), 25–34. Solcz, J., & Frobom, K. (2024). School-based health centers. Stewart, R., Pardi, V., Buck, J., Smallwood, O., & Wright, W. (2022). Community-academic partnership to improve the oral health of underserved schoolchildren in rural north carolina. Journal of School Health,92(3), 325–329. https://doi.org/10.1111/josh.13129 Sweetman, M. M., Tripathi, N., Danella, K., Hupp, S., Muse, M., Rothrock, T., & Williams, A. (2023). The lived experiences of health science graduate students with anxiety and depression. Learning Environments Research,26(3), 709–726. TeacherPH. (2021). Deped health-related infrastructure requirements. Tolentino, A. R., Medina, F. C., & Lopez, J. M. (2022). Promoting health literacy in philippine public schools: Role of school clinics in learner-centered interventions. Asia Pacific Journal of Education, Arts and Sciences,9(1), 45–52. U.S. Department of Education. (2021). Supporting child and student social, emotional, behavioral, and mental health needs. White, P. H., Ilango, S. M., Caskin, A. M., Aramburu de la Guardia, M. G., & McManus, M. A. (2022). Health care transition in school-based health centers: A pilot study. Journal of School Nursing,38(6), 526–532. https://doi.org/10.1177/1059840520975745 17 ISSN 3028-1261 10.5281/zenodo.17312520/NIJSE.2025 NIJSE (2025) - Wilkins, N. J., Verlenden, J. M. V., Szucs, L. E., & Johns, M. M. (2023). Classroom management and facilitation approaches that promote school connectedness. Journal of School Health, 93(7), 582–593. https://doi.org/10.1111/josh.13279 Wood, M. (2024). Consultee-centered consultation: Supporting student emotion regulation and development through collaboration with teachers [Doctoral dissertation, Indiana University]. World Health Organization. (2021). Global standards for health-promoting schools and their implementation guide. World Health Organization. (2024). Making every school a health-promoting school. Wright-McAllister, S. (2022). Behavioral challenges in economically disadvantaged schools [Doctoral dissertation, Pepperdine University]. Zabanal, J. R. A. (2022). Research-to-resource: Applying a self-care framework to music education. Update: Applications of Research in Music Education,40(3), 5–10. 18 ISSN 3028-1261 10.5281/zenodo.17312520/NIJSE.2025