Primary school classmate characteristics and school nursing predicting graduation from high school.

Abstract

To examine how primary school context variables, such as total students in the school, students with disability, and aspects of school nurse workload, predict later educational outcomes of high school attendance, being on-track to graduate, and graduation. This secondary analysis of 3,782 student records from 2008 to 2018 was conducted using United States public-school district data. Classmate attendance in fifth-grade predicted being on-track to graduate (adjusted odds ratio [AOR]=1.42 [95% confidence interval [CI]=1.27, 1.60]) and graduation (AOR=1.14 [95% CI=1.03, 1.26]). School nurse workload aspects affected being on-track to graduate: (low-income students per school nurse [AOR=0.77 [95% CI=0.70, 0.85]; total students per school nurse [AOR=1.3 [1.18, 1.44]) and graduation (low-income students per school nurse [AOR=0.82 [95% CI=0.75, 0.90]; total students per school nurse [AOR=1.4 [1.26, 1.57]). Characteristics of the school population such as classmate attendance and students with limited resources per school nurse are areas for future interventions as they affect student educational outcomes and lifelong health.