Wayne County Public Schools in North Carolina was named the National Civic Star Award winner for 2005 for a school-based program to improve adolescent health care.

Since it was established in 1997, the Wayne Initiative for School Health (WISH) has improved health-care accessibility in the rural, economically depressed county by setting up medical centers in four county middle schools.

With grants from such organizations as the Duke Endowment and the Robert Wood Johnson Foundation, local and federal funding and local in-kind contributions, WISH school-based health centers are devoting attention daily to well-child care, acute and chronic health problems and psychological issues.

The idea for WISH began taking shape in 1996 when the local hospital chief executive officer and a local pediatrician, with a vision for school-based health care, established a planning team consisting of community group leaders. State statistics had shown that Wayne County ranked ninth out of 100 counties in North Carolina with the largest number of uninsured children. While children from birth to age 6 received necessary medical care on a regular basis, according to state data, the early adolescent group received little to no health-care services.

With that information in hand, the planning team aimed to improve the physical and mental well-being of middle school students by increasing access to comprehensive health care in certain communities. Areas to be targeted would be those with high levels of ethnic minorities, poverty and uninsured children and where access to health care was hindered. The four schools selected to house centers were strategically located within the county.

Parental surveys helped determine adolescent health priorities. The top three needs were deemed to be basic health care, teen pregnancy prevention and mental health issues.

Eighty-two percent of respondents said it was difficult to obtain health care for their families because of the high cost of medical services and insurance, other financial issues, lengthy waiting periods to receive services and the inability to leave work to get health care for their children. Many said they had no regular office for obtaining medical services.

Organizations represented on the planning team included Wayne County Public Schools, the Wayne County Health Department, Goldsboro Pediatrics, Wayne Memorial Hospital, Communities In Schools, Wayne Community College, Wayne County Department of Social Services and Wayne County Mental Health. They established WISH as a nonprofit 501c3 nonprofit organization.

Leaders of Wayne County Public Schools were among the strongest advocates of school-based health centers. The centers were designed and built by the school superintendent and a dedicated staff. Each center is about 1,000 square feet and consists of two exam rooms, a laboratory, reception area, medical office space, a restroom and a group counseling room. Maintenance, custodial services, electricity and water are provided by the school district.

A school board member is on the WISH board of directors, and an additional central office staff member also meets with the board.

The community partner organizations provide most of the staffing for the centers, including a registered nurse who is the clinical director, health educators, nutritionists and mental health counselors. The county government has provided significant annual financial support for the program.

Successes documented at the centers include:

* A 75 percent decrease in teen pregnancies.

* Improved performance on required standardized tests.

* A 4 percent improvement in school attendance.

* A dramatic decrease in emergency room visits by adolescents.

* Enrollment in the WISH centers of 85 percent of the student body at each school.