From leadership research to district action: Implementing Universal Whole‐Person Screening in High Schools: Lessons From a School–Health System Partnership

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

ABSTRACT Background Most school districts lack infrastructure to systematically identify whole‐person needs and connect students to coordinated services. We developed and implemented a whole‐person screening tool within a county–school partnership model. Methods Between 2020 and 2024, Riverside University Health System—Behavioral Health partnered with a Southern California unified school district to implement the Whole Person Health Score‐Adolescent Version (WPHS‐AV) for 11,786 high school students. The partnership included universal screening, governance structures, tiered triage workflows, and school‐embedded behavioral health teams. Results The WPHS‐AV demonstrated acceptable internal consistency (Cronbach's α = 0.64–0.65). Screening identified substantial moderate‐need students (86.3% had ≥ 1 Yellow flag) likely invisible under traditional crisis‐triggered referral systems, while high‐need classifications remained relatively uncommon (19.6% had ≥ 1 Red flag). Implications for School Health Policy, Practice, and Equity Universal whole‐person screening identified 86% of high school students with moderate needs likely missed by crisis‐triggered systems. This district‐health system partnership demonstrates that systematic screening requires formal governance structures, tiered triage workflows, and school‐embedded clinical teams to connect identified students to appropriate supports. Conclusions Universal whole‐person screening at scale requires partnership infrastructure, including formal governance structures, clearly defined workflows linking assessment to intervention, and iterative problem‐solving for consent barriers and referral bottlenecks.

Study methods

We conducted an implementation evaluation of a district–health system partnership that operationalized universal whole‐person screening to a tiered response pathway delivered jointly by school and county behavioral health staff. The program was implemented in a large, unified school district in Southern California serving approximately 17,500 high school students annually, with a predominantly Hispanic/Latino population (65%) and significant socioeconomic diversity.

Limitations

Several limitations warrant attention. First, screening reach was incomplete (67.7%) and varied across schools and waves, affecting the generalizability of prevalence estimates. Future studies should link screening rosters to district enrollment data to compare participants and nonparticipants, evaluate whether screening reach differs by school, grade, language, socioeconomic status, housing instability, disability status, or other student characteristics, and identify modifiable barriers to participation. Second, the evaluation focuses on screening classifications and triage pathways, not the full referral cascade, eligibility determination, service initiation, or clinical outcomes. Third, the WPHS‐AV lacks full psychometric validation, including construct, criterion, and test–retest reliability. Fourth, the evaluation was conducted in a single district during COVID‐19, limiting generalizability to other settings, time periods, or districts without comparable infrastructure. Fifth, although we adapted implementation in response to observed barriers, we did not formally evaluate Care Flow Plan fidelity or collect systematic student, family, or staff measures of feasibility and acceptability. Sixth, parental consent was obtained via a checkbox embedded within a multi‐program electronic registration module rather than a standalone consent process, which may have reduced visibility and contributed to incomplete screening uptake, particularly among families with limited English proficiency.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one school improvement question with teachers. Protect a short shared planning cycle, agree an instructional change and use a common rubric for examining student work. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Review implementation fidelity, teacher time and independently scored student work against a recorded baseline. Examine access differences and competing explanations before attributing changes to leadership. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Dhruv Khurana; Geoffrey Leung; Bijan Sasaninia; Janine Moore; Tracy Piper; Anthony Firek. Implementing Universal Whole‐Person Screening in High Schools: Lessons From a School–Health System Partnership. The Journal of School Health (2026-11-01). https://doi.org/10.1111/josh.70260

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.