Date of Conferral



Doctor of Public Health (DrPH)


Health Services


Claire Robb


Medically underserved communities face challenges accessing health care services, and millions of Americans have no access to primary care. In many areas of the United States, the supply of primary care providers cannot keep up with the demand for health services. Newer healthcare delivery models are needed to address the issue. Using telehealth can augment the physician workforce shortages. The purpose of this quantitative dissertation is to examine the associations of telehealth utilization using a pediatric school-based telehealth model in Health Professional Shortage Areas (HPSAs) in North Texas. Texas has many counties without a primary care provider, making them medically underserved. The study uses data from a program designed by Children’s Health, serving school-aged children (ages 0-18) in 148 school sites across 5 counties. Approximately 12,471 telehealth visits occurred during the study period. The results revealed that telehealth utilization was significantly higher in HPSA zip code schools, and significant differences were observed in utilization patterns by race, age group, and school type. Additionally, provider status and insurance status were significantly associated with telehealth utilization. The significance of the study underscores the importance of telehealth and its value in serving medically underserved areas. School-based telehealth programs can promote positive societal change by addressing provider shortages and increasing access for underserved populations. The socioecological framework offers insights into social and environmental mediating factors. Additional research is needed to examine school-based telehealth program interventions further.