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A school-based health clinic (SBHC) located in an isolated region of the county has been serving high school students from the school and surrounding community for more than 15 years through financial support from a federal grant, a philanthropic donor, and a regional healthcare system. The advanced practice registered nurse (APRN) working in the clinic has provided services to more than 5,000 clients over the past few years and has collaborated with a number of key stakeholders in the community and education and health professional organizations to promote the benefits of the SBHC. Because of the mandate to use distance-based learning during the COVID-19 pandemic, the donor stopped funding the SBHC. The healthcare system has requested that the APRN "relocate" to another clinical site and provide care via telehealth and has proposed closing the SBHC permanently. Knowing that the students and the local community have ongoing healthcare needs, the school administrative team and parent association president have requested a meeting to discuss the implications of the closure of the clinic. Please answer the following questions:
1. Who are the key stakeholders the APRN should engage to discuss strategies for program planning?
2. Which evaluation methods and data should the APRN consider sharing with the administrative team at the health system and with policymakers?
3. What ethical considerations and role conflicts might the APRN face?
4. Describe the possible unintended consequences (positive and negative) of the evaluation effort.
5. How could the APRNs leverage trustworthiness, influence in the community, and established partnerships to disseminate evaluation data to influence the state policymakers to reinstitute funding for school clinics?
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