Karen Johnson, PhD, RN FSAHM, FAAN, associate professor, received The University of Texas at Austin School of Nursing Dean’s Research Stimulus Pilot Award, in February 2025, to support her research in improving health outcomes for high school students.
The award supports innovative concepts and approaches in nursing science/research to improve the health of patients, families and communities. This award will provide the pilot data needed to plan for a larger-scale study to explore the impact of school policies and health services staffing on student health and academic outcomes.
Finding their potential
Johnson’s research focuses on examining how policies aimed at addressing health-risk behaviors, such as funding for school health services staff, can influence student well-being and physical and mental health.
“Adolescents deserve our full support to reach their full potential, but too often, there’s fear and uncertainty about teenagers,” Johnson said. “They are at a unique and pivotal stage of development that sets the stage for the rest of their lives. Just like during infancy—another rapid and critical stage of development—they need a lot of investment and attention. But unlike during infancy (which, make no mistake, needs more attention and resources as well), we don’t always see the same enthusiasm, attention or evidence-based resources poured into them.
Research has found that health-risk behaviors contribute to the leading causes of morbidity and mortality among adolescents, such as unintentional injuries, suicide and homicide. Johnson’s research over the past 15 years has focused on understanding students engaged in higher levels of health-risk behaviors and the resources schools have and need to support them.
“We have a great foundation of research showing how factors more proximal to the adolescent, such as connectedness to caring adults and prosocial peers, can protect young people from becoming involved in risky health behaviors such as substance use,” she said.
“We also need a robust evidence-base for how policy-level decisions in our schools and communities—such as having adequate school nurse and mental health counselor staffing and empowering them to practice to their full scope—serve either as facilitators or barriers to treating the underlying health-related roots of risky behaviors.”
For example, Johnson said substance use can serve as a coping mechanism for mental health challenges, often triggered by significant stressors in a teen’s school, home or community. To support healthier choices, students need encouraging adults, nurturing environments, and access to evidence-based programs, with policies playing a key role in shaping these protective spaces, she added.
Turning analysis into action
Johnson and her team are leveraging innovative tools including text mining and natural language processing to analyze policies and gain deeper insights into how schools and districts address student health behaviors.
These advanced computational methods enable a more comprehensive and efficient review of policy language, allowing researchers to identify key themes and trends across thousands of school district policies—far beyond what would be feasible through manual analysis alone.
Through this research, Johnson will provide data to support important conversations about how schools and districts can better identify, prevent and potentially address youth addiction, overdose and the related health issues tied to substance use.
She also aims for the findings to inform policies that address a wide range of health-risk behaviors during adolescence, ultimately helping students stay engaged in their education, graduate and transition into successful adult lives.
In addition, she aims for her research to highlight the stories of resilient youth, educators, administrators and health and social services staff, providing deeper insight into how to implement effective policies that promote teen health, support sound decision-making and ensure students graduate with the tools to build their futures.
Johnson is particularly interested in examining the role of school nurses and other health services staff in supporting adolescents.
The Future of Nursing Report published by the Academy of Medicine in 2021 emphasized the critical role of school nurses and the need for further research on their value within school settings.
While there was increased investment in school nurses during the COVID-19 pandemic, the expiration of funding policies and the tough budget decisions facing school districts call for research that helps school district leaders allocate resources wisely. Early evidence suggests school nurses are a valuable investment, and understanding the full scope of their impact remains crucial.
“Practically, understanding where there might be gaps in our policies for addressing youth substance use can help us to allocate resources towards preventing overdoses, addiction, school dropout, crime and other risky behaviors associated with substance use,” she added. “All of society benefits when youth are healthy, sober and engaged in school.”