was the SNED, which school nurses use to document
student visits. The SNED contains information relating
to reason for visit, length of time of visit, student
disposition, assessment(s) conducted; service(s)
provided; consultation(s) made; and referral(s) made.
Data analyzed from SNED for this study were limited
to reason(s) for visits and frequency of visits by
individual students.
Demographic data were collected from the city in
which the school district is situated. The city stores
these data as part of a levy agreement with the school
district. The categorical variables that were analyzed
were poverty (free and reduced price lunch [FRPL]
was used as a proxy for poverty in this study), race,
and ethnicity. Ethnicity is distinguished from race in
this study. It is defined as membership in a group in
which cultural values and mores are shared. Alternatively,
race assumes an exclusive focus on phenotypic
characteristics. For example, while Asian students often
are grouped as a whole, this study analyzes Asian
groups in the aggregate as well as by subethnic Asian
groups such as Filipinos and Vietnamese to determine
whether ethnocultural differences exist in usage rate
patterns. Individual identification numbers assigned
to students were scrambled to ensure anonymity,
as well as to link visit numbers and types of visits to
student demographic variables.
Analytic strategy
Data from the SNED and from the city were placed
into Access 2000 for categorization and analyses.
Using Access 2000, 51,767 individual encounters,
reasons for visits, and student demographic variables
were compiled. Three sets of analyses were conducted.
The first was a broad cross-analysis of
frequency and types of student visits according to race
and poverty. Further analysis was conducted between
single aggregate ethnic groups (e.g., Hispanics) and
subethnic groups within that category (e.g., Black Hispanics,
White Hispanics, and Indian Hispanics) to
discern whether ethnocultural differences influenced
these students’ use of school nurse services. Similarly,
comparative analyses were conducted among Asians
in the aggregate and among the 9 subethnic Asian
groups recognized by the district under study.
Finally, comparative analyses were conducted on
both inter- and intragroup use of school nurse services.
This allowed inferences to be made concerning
reasons for visit patterns according to common group
membership as well as cross-group membership. For