Migraine can become an increasingly frequent and disabling disorder if not identified and appropriately treated soon after first developing.  However, a minority of youth with migraine see a specialist for evaluation.  Beginning with a collaboration with a large local school district and then extending to others, our team sought to determine the extent to which headache specialist mentoring of school nurse “champions” in headache evaluation and behavioral treatment is a viable model for expediting early effective migraine care and preventing long-term disability.  In our initial work, 25 school nurses from a large school district in the state of Kansas (USA) received coaching about headache evaluation and nonpharmacological intervention resources that they could implement in the school setting.  Results from mixed methods studies indicated high perceived value of the mentoring program from school nurse participants, prevalent use of the school nurse-facilitated intervention resources, and reliable improvements in headache frequency and disability (mean reduction of 1 headache day per month and 1.5 disability days/month) for a sample of students with migraine enrolling in a pilot study.  Successes and challenges based on our experiences with school-based approaches to system change in pediatric migraine will be discussed.