This study consisted of a descriptive survey undertaken to determine the status of school health services (SHS) as perceived by school nurses/school nurse practitioners, school superintendents, and parents of children in the public elementary and secondary schools of Alabama.

Data were collected by use of three separate questionnaires, each designed for a specific population.

There were three methods of providing SHS--budget, non-budget, or provided by other personnel/agencies. According to superintendents, 75% of the school districts which budget SHS provide one of three types of SHS--detection of communicable diseases, screening for health problems, and first-aid. All three types of SHS are provided by 26%. The school nurse alone is the most frequent provider of services.

Other personnel/agencies were the second most frequent method of providing SHS. The most frequently cited SHS was detection and referral of communicable diseases. The public health department cited by 50% of the superintendents was the most frequent provider.

The provision of SHS by "soft money" or volunteers was the least frequent method used. Screening children for health problems, i.e., vision, etc., was the most frequently mentioned non-budgeted SHS. The most frequent provider cited was the school nurse alone (8%) or the school nurse together with other allied health staffing (7%).

Educational preparation of school nurses varied--i.e., from diploma to Master of Science in Nursing.

Three pediatric nurse practitioners with BSN degrees were identified, but no school nurse practitioners (SNPs). School nurses opined that health services included among the SNP functions are seldom realized in actual practice.

According to the school nurses, only 22% felt school-age children are receiving optimal SHS, and there is a need for a SNP program to prepare SNPs to be more effective providers of child health services.

Parents who had received SHS were not significantly more prone to identify the schools as appropriate settings for delivery of SHS.

The two groups of parents did not differ significantly in their opinions as to who should provide services--nurses were preferred over doctors by a ratio of 2:1.