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Implementation Outcomes and Impact of a School Health and Wellness Network Specialist Intervention in Chicago Public

Jamie F Chriqui¹, Julien Leider, Elizabeth Jarpe-Ratner

¹Author Affiliations:Division of Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, Illinois (Drs Chriqui and Jarpe-Ratner, Ms Offstein); Institute for Health Research and Policy, School of Public Health, University of Illinois Chicago, Chicago, Illinois (Dr Chriqui and Mr Leider); Moffitt Cancer Center (Dr Lin); Chicago Public Schools Office of Student Health and Wellness (Mr Simon, Mr. Zolfo, Ms DeClemente); American Institute for Research (Ms Tully).

Journal of Public Health Management and Practice : JPHMP

|May 12, 2026

Abstract

Objectives:

To evaluate implementation, impact, and cost-effectiveness of a Network Specialist intervention focused on health and wellness policy implementation in Chicago Public Schools. Education sector (Multi-Tiered System of Supports) and implementation science (Implementation Outcomes Framework, SISTER) frameworks informed the intervention.

Design:

Quasi-experimental case-comparison efficacy study conducted between 2020-2021 and 2022-2023. Annual survey data and key informant interviews were used to evaluate implementation outcomes (acceptability, appropriateness, and feasibility); survey and administrative data were used to assess impact and cost effectiveness using difference-in-difference (DID) analyses and an incremental cost-effectiveness ratio (ICER).

Setting:

One elementary school Network located on Chicago's Westside (intervention) and 1 socio-demographically matched comparison Network (DID only).

Participants:

Network Specialists, school-level stakeholders, and school-level administrative data.

Intervention:

The Network Specialist provided a multi-tiered system of support to schools for health and wellness policy implementation.

Main Outcome Measure:

Healthy CPS score (out of 100) and ICER.

Results:

The Specialist served 20 schools/year and an average of 302 students/school. At least 85% of school stakeholders perceived high levels of acceptability, appropriateness, and feasibility of working with the Specialist to support policy implementation. Schools in the intervention Network increased their Healthy CPS scores by 8 percentage points (70.95% pre vs. 78.95% post; P = .03), whereas scores stayed the same in the comparison network (74.03% pre vs. 73.03% post; P = .68), for an estimated 9-percentage point DID-estimated impact ( P = .04). The cost-effectiveness analysis indicated that it cost each school $414, on average, to increase their Healthy CPS score by 1 percentage-point.

Conclusions:

Having a designated district-level Specialist to provide multi-tiered supports to schools to help with health and wellness policy implementation is cost-effective and is valued and appreciated by schools. The Specialist connects schools to key resources and services which enables them to improve their school-level implementation of federal, state and local health and wellness policy requirements.

Keywords:

cost effectiveness implementation outcomes school health and wellness

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