Introduction 

School absenteeism has been a major concern for parents, caregivers, teachers, administrators, and health care providers. This is a greater issue now more than ever before due to the many repercussions of the COVID-19 pandemic. Many of our students and patients did not have the opportunity to process their experience with virtual learning and social isolation during quarantine, and were expected to reacclimate to their school environment and jump right back into their academic responsibilities once schools opened back up. Many times, parents and caregivers are brought in to discuss their child’s absenteeism with school counselors, social workers, and teachers to create a plan of action to address any barriers to school attendance. Here at the Collaborative for Attendance Resources in Education & Health (CARE-H) Program at CHAI, we established a collaborative effort between the District of Columbia Public Schools (DCPS), Children’s National Goldberg Center providers, Whole Bear Care, social workers, CRISP data health informstion exchange managers, outreach coordinators, and parents/caregivers to assist in bridging gaps to school attendance, positive health and social outcomes, and academic success.  

But what about the high schoolers themselves? Over time, we are seeing that our high schoolers have higher absenteeism rates, more specific needs, and greater independence from their parents compared to our elementary and middle school students. As such, we believe it is essential to intervene and allow students to have agency and a space to share their needs, thoughts, and feelings on school absenteeism. This is why we built on the program’s strong foundation and efforts and created the CARE-H Coaching Program. 

Background Information 

CARE-H aims to support parents/caregivers in attempt to address medical and/or social barriers to their child’s school attendance. Seed funding was provided by the Bloomberg American Health Initiative for a pilot, and then expansion funding was provided by the United Health Foundation to continue the program through June 2025. In partnership with DCPS, attendance data of students enrolled in CARE-H from 14 public schools are collected and sent via the health information exchange, CRISP, on a monthly basis to pediatric practices. Prior to expanding to 14 schools, however, CARE-H partnered with 6 schools—4 elementary schools and 2 middle/high schools (MS/HS).  

Attendance data from these 6 schools were collected throughout the 2021 – 2022 school year and analyzed at the end of the year by the CARE-H team. We saw that MS/HS students had substantially higher absences throughout the year than those in elementary school. To be specific, the students who attended the two CARE-H middle/high schools were absent a total of 231 times within the 2021-2022 school year, compared to the 192 times elementary school students across the four CARE-H elementary schools were absent within the same school year. Additionally, 31% of the high school students had greater than 10 absences, which flags them as chronically absent for the 2021 – 2022 school year.  

This data encouraged us to figure out a way to connect with high school students in the 2022 – 2023 school year to directly identify their barriers and/or concerns related to attending school.  

Project with High Schoolers  

The Coaching Program focuses on high school students who participate in the CARE-H program at Children’s National Hospital and have 10+ cumulative absences in the 2021 – 2022 school year as of January 2023. We found 18 students who fall within the criteria for chronic absenteeism.  

We began by conducting our initial outreach to parents/caregivers, gauging family and students’ interest, and getting parents’ consent. We then invited our students to participate in a single, individual, hour-long coaching session with the goal to find and bridge gaps to school attendance, coordinate healthcare and social services, and establish a supportive relationship to encourage their school attendance and academic success. These sessions are conveniently conducted through telehealth on Zoom after school hours, and students receive a gift card for participating.  

Coaching Session 

The coaching session was designed to be an open, safe, and relaxed space between the student and coach to introduce one another, share fun facts, discuss what the CARE-H program can do to support their school attendance and general wellbeing, and talk about how things are currently going both inside and outside of school. We also had the opportunity to discuss their many school transitions such as going from virtual learning to in person learning, from middle school to high school, and their plans after high school and the future. We established personal and academic goals together and were able to visualize them and the steps required to attain these goals by creating fun vision boards together. Here, you can see one student’s vision board towards one day becoming an engineer.  

This student shared their excitement about becoming an engineer and walked through essential steps and motivating factors towards this goal. They stated that in order to apply to engineering programs, their first steps are to successfully complete their school’s academy of engineering, graduate high school, and secure a high school diploma. In addition, through solution-focused conversations and activities, we were both able to agree that consistent school attendance and successful completion of classwork are huge stepping stones towards graduating high school. Other motivating factors for this student included wanting to make their family proud and save up to buy a big, White pickup truck! We love to see all the goals and dreams our students have, and know that they are working incredibly hard, despite the many challenges they experience, and we are here to support in any way that we can. 

Conclusion 

Once our sessions are over, we provide students the opportunity to share some feedback about their experience with CARE-H Coaching through Kahoot!, a fun game-based online platform – see some images below. 

We found many interesting points. For example, so far students themselves had little knowledge of the CARE-H program, despite us working with their schools and caregivers for a few years. However, once hearing more about what we do, most students find that the CARE-H program is a helpful tool. In addition, we found that students value social relationships with their peers and teachers, interest in courses, and availability and quality of extracurricular activities. These have a major influence on their school attendance. Lastly, many also shared that they would be interested in being part of CARE-H’s outreach efforts regarding their attendance and resource coordination. This feedback reinforces our continued effort in working with our student participants and supporting their academic and wellness journeys.