Grow With Grit: A School Nurse-Led SBIRT Pilot for Early Anxiety Detection

Inclusion criteria

• GFPS students aged 8-12 years and enrolled at one of the following schools:
• Mountain View Elementary West Elementary Longfellow Elementary Sunnyside Elementary School
• Participants will be identified through a weekly review of school nurse electronic health records (Frontline EHR) and attendance logs, and will include students who have either:
• Three or more nurse visits for somatic complaints within the past 6 weeks. For this study, somatic complaints are defined as the following physical symptoms that are not otherwise linked to exclusionary illness or chronic medical processes: stomach aches, headaches, fatigue, \& generalized muscle aches.
• Absenteeism greater than or equal to 10% of total school days due to the previously defined somatic complaints, within the past 6 weeks.
• English-speaking without an interpreter (both student and guardian).

Exclusion criteria

• Currently receiving ongoing behavioral health services, including psychotherapy, psychiatric medication management, or active behavioral health case management.
• Brief, one-time crisis counseling is not considered ongoing services.
• Questions about eligibility should be directed to the Principal Investigator.
• Presence of a chronic medical diagnosis that fully accounts for the student's repeated somatic visits (e.g., asthma with frequent exacerbations, epilepsy, diabetes, sickle cell disease, or active cancer treatment).
• a. Students with partially explained symptoms who are also suspected to have co-occurring anxiety may be reviewed on a case-by-case basis by the PI/designee.
• Documented cognitive or communication impairments that preclude meaningful completion of the SCARED screening tool or informed assent.
• Examples include moderate to severe intellectual disability or severe receptive/expressive language disorder without feasible accommodations.
• Students with an IEP or 504 plan that includes communication supports may be included if they can complete the tool with reasonable accommodations.
• Students who are wards of the state or in foster care.
• Non-English speaking students or guardians.
• Acute safety concerns at the time of screening (e.g., active suicidal ideation with plan/intent, recent suicide attempt, or other crisis requiring immediate intervention).
• Such students will be triaged to crisis protocols and excluded from study participation at that time.