194 - Chronic School Absenteeism: Associations with Universal School Prevention Programs and Social Drivers of Health

Publication Number: 2187.194

Landon B. Krantz, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Laurel K. Leslie, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Mona E. Mansour, Cincinnati Children's Hospital Medical Center, Newport, KY, United States; Pierce Kuhnell, Cincinnati Children's Hospital Medical Center, Blue Ash, OH, United States; Alonzo Folger, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Background: Chronic school absenteeism (CSA), defined as missing 10% or more of instruction time, is closely tied to negative academic and health outcomes. National rates of absenteeism soared following the COVID-19 pandemic from 15% in 2019 to 28% in 2022. Prior reviews identify socioeconomic challenges, poor mental health, and bullying as some of the many factors associated with high rates of absenteeism, factors that are often addressed by universal school wellness programs. There is a need to better understand how such programs impact CSA.

Objective: 1) Investigate whether the presence of universal school prevention programs in areas of mental health, emotional health, and/or safety is associated with changes in CSA.

2) Examine the impact of social drivers of health (SDOH) on CSA and how SDOH interact with universal prevention programs.

Design/Methods: We synthesized publicly available data from 503 schools in Southwest Ohio. Schools self-report prevention programming to the Ohio Department of Education (ODE). We categorized each program through a combination of expert review, program-stated goals, ODE designation, and literature review (Table 1). Social deprivation index (SDI) was used as a proxy for SDOH. We used Wilcoxon rank-sum tests to measure associations between the presence of each program category, SDI, and CSA. Multivariable regression modeling was used to examine the effect of having a program category on absenteeism rate while adjusting for SDI. This research was approved by our IRB.

Results: ODE reported 104 unique prevention programs (Table 1). Median CSA was 22% (IQR 14%-35%). The presence of a suicide prevention program (p < 0.01), substance abuse prevention program (p=0.02), and social inclusion program (p < 0.01) were significantly associated with lower rates of CSA (Figure 1). When adjusting for SDI, all three program types remained significantly associated with decreased CSA. Social-Emotional Learning programs (p=0.05), bullying/violence prevention programs (p < 0.01), and high SDI (p < 0.01) were significantly associated with higher rates of CSA (Figure 1).

Conclusion(s): DOH is a significant predictor of CSA. Substance use prevention, suicide prevention, and social inclusion programs were associated with lower CSA rates, even when factoring in SDOH. A prospective study is needed to evaluate temporal relationships as programs may be implemented in response to high absenteeism rates, safety concerns, or emotional health problems. Another important next step is understanding what components of prevention programs contribute to lower CSA rates.

School Prevention Program Categories and Definitions
1: Category is based on the program's core principles or intended goals. We recognize that programs may have indirect impacts on other outcomes.
2: Mandated by Ohio Department of Education
3: Schools were excluded if they do not include students in 6th grade or older.


Associations between social deprivation index and universal school prevention programs with chronic absenteeism rates.
Program categories are in order from strongest to weakest association with decreased chronic school absenteeism.
1: Variable is significantly associated with decreased chronic absenteeism (Wilcoxon rank-sum p<0.05)
2: Variable is significantly associated with increased chronic absenteeism (Wilcoxon rank-sum p<0.05)