Characteristics of users and nonusers of health clinics in inner-city junior high schools (original) (raw)
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Journal of Youth and Adolescence, 1995
Evaluated psychosocial differences between adolescent users and nonusers of an urban school-based health clinic, considering the influence of gender. As expected, a number of gender differences were found (e.g., girls reported more fear, were rated as more likeable by peers than boys). Examination of differences based purely on clinic use indicated that nonusers were rated as more socially withdrawn by their peers than clinic users; otherwise, these two groups did not differ on psychosocial measures. Gender by clinic-status interaction effects were found for academic measures (e.g., nonusing boys had more absences and lower grades than boys who used the clinic). A group of intensive clinic users (n=14) reported higher levels of emotional distress than other students, and surprisingly, most of these students were not receiving mental health services.
Problems and help seeking in high-risk adolescent patients of health clinics
Journal of adolescent health care : official publication of the Society for Adolescent Medicine, 1988
In this study, 2787 adolescents between the ages of 13 and 18 years living in inner-city communities were interviewed about their mental and physical health and their clinic use. The patients used consolidated mental and physical health clinics located in neighborhoods, hospitals, or schools; or traditional neighborhood or hospital health clinics. Analyses of selected patient problems reveal that less than one third of adolescent patients with suicide ideation, conduct disorder, and substance abuse or dependency sought or received care for those problems. Only half of the adolescents with major depression sought or received care for depression, and only two thirds of the sexually active females sought or received help with birth control. A special effort needs to be made to attract troubled youth to clinics and to identify and treat their problems, particularly when those problems involve mental health concerns.
School-Based Health Center Utilization
Archives of Pediatrics & Adolescent Medicine, 1998
Background: As school-based health centers (SBHCs) continue to grow, it remains important to study use of the centers. The extent to which mental health problems exist in the students with access to the centers, whether those students are using the available services, if they are satisfied with the services, and the reasons for nonuse by those students who do not enroll are all meaningful questions. Methods: The above issues were studied in an urban high school with a 2-year-old SBHC by administering questions during physical education classes on health center use and mental health concerns. The 630 respondents were 45% male, 55% female, 61% black, 29% Hispanic, 54% in grades 9 or 10, 46% in grades 11 or 12. Results: Sixty percent of the students were registered in the SBHC; 40% were not registered. Seventy-five percent of registered students reported average use (Յ3 visits); females were more likely than males (P = .017) to be frequent (Ͼ3 visits) users of SBHC services. Mental health problems among all participants included depression in 31%, use of alcohol 1 time or more per month in 21%, use of alcohol daily in 5%, suicidal ideation in 16%, history of a suicide attempt in 10%, knowing someone who had been murdered in 50%, and being in at least 1 fight at school in 26%. Frequent users, average users, and nonusers did not differ by age, grade, race, or any of the measured mental health problems. Among the 472 students who completed the survey section on SBHC perceptions, 305 described health center use: 92% were satisfied with health center services, 79% were comfortable being seen in the SBHC, 74% believed visits were kept confidential, 61% told their parents about each visit, and 51% considered the SBHC their regular health care source. The health center was used for mental health services by 34% and sexualityrelated care by 15%. The 167 students who described reasons for not using the SBHC most frequently reported that they already had a physician (60%), did not need it (50%), prefer continuing previous health care (45%), did not get around to it (30%), parents were opposed (20%), were not comfortable (19%), did not know about the service (19%), and did not want problems known (19%). Conclusions: We conclude that, in this urban high school, (1) average users, frequent users, and nonusers did not differ in the mental health problems measured in this study; (2) those who used the SBHC indicated strong satisfaction with the care received; and (3) those who did not use the SBHC chose to stay away for a variety of reasons, most commonly the availability of other care or the perception of lack of need.
School-Based Health Center Utilization: A Survey of Users and Nonusers
Journal of the American Academy of Child and Adolescent Psychiatry, 1999
Background: As school-based health centers (SBHCs) continue to grow, it remains important to study use of the centers. The extent to which mental health problems exist in the students with access to the centers, whether those students are using the available services, if they are satisfied with the services, and the reasons for nonuse by those students who do not enroll are all meaningful questions. Methods: The above issues were studied in an urban high school with a 2-year-old SBHC by administering questions during physical education classes on health center use and mental health concerns. The 630 respondents were 45% male, 55% female, 61% black, 29% Hispanic, 54% in grades 9 or 10, 46% in grades 11 or 12. Results: Sixty percent of the students were registered in the SBHC; 40% were not registered. Seventy-five percent of registered students reported average use (Յ3 visits); females were more likely than males (P = .017) to be frequent (Ͼ3 visits) users of SBHC services. Mental health problems among all participants included depression in 31%, use of alcohol 1 time or more per month in 21%, use of alcohol daily in 5%, suicidal ideation in 16%, history of a suicide attempt in 10%, knowing someone who had been murdered in 50%, and being in at least 1 fight at school in 26%. Frequent users, average users, and nonusers did not differ by age, grade, race, or any of the measured mental health problems. Among the 472 students who completed the survey section on SBHC perceptions, 305 described health center use: 92% were satisfied with health center services, 79% were comfortable being seen in the SBHC, 74% believed visits were kept confidential, 61% told their parents about each visit, and 51% considered the SBHC their regular health care source. The health center was used for mental health services by 34% and sexualityrelated care by 15%. The 167 students who described reasons for not using the SBHC most frequently reported that they already had a physician (60%), did not need it (50%), prefer continuing previous health care (45%), did not get around to it (30%), parents were opposed (20%), were not comfortable (19%), did not know about the service (19%), and did not want problems known (19%). Conclusions: We conclude that, in this urban high school, (1) average users, frequent users, and nonusers did not differ in the mental health problems measured in this study; (2) those who used the SBHC indicated strong satisfaction with the care received; and (3) those who did not use the SBHC chose to stay away for a variety of reasons, most commonly the availability of other care or the perception of lack of need.
School-Based Health Centers: Improving Access and Quality of Care for Low-Income Adolescents
PEDIATRICS, 2007
OBJECTIVES. We sought to compare visit rates, emergency care use, and markers of quality of care between adolescents who use school-based health centers and those who use other community centers within a safety-net health care system for low-income and uninsured patients. . The cohort included all 14-to 17-year-old Denver Public Schools high school enrollees who were active Denver Health patients and were either uninsured or insured by Medicaid or the State Children's Health Insurance Program. "School-based health center users" were those who had used a Denver Health school-based health center; "other users" were those who had used a Denver Health community clinic but not a school-based health center. Markers of quality included having a health maintenance visit and receipt of an influenza vaccine, tetanus booster, and hepatitis B vaccine if indicated. Multiple logistic regression analysis that controlled for gender, race/ethnicity, insurance status, chronic illness, and visit rate was used to compare school-based health center users to other users.
The Role of School Health Centers in Health Care Access and Client Outcomes
American Journal of Public Health, 2010
Objectives. We describe the impact of school health centers in Alameda County, California, on adolescents' access to care and their mental and physical health outcomes. Methods. We used a multimethod evaluation of 12 school health centers to track data on clients (n = 7410), services, and provider-reported outcomes; client pre–post surveys (n = 286); and student focus groups (n = 105 participants). Results. School health centers were the most commonly reported source of medical (30%), family planning (63%), and counseling (31%) services for clients. Mental health providers reported significant improvements (P < .05) from baseline to follow-up in clients' presenting concerns and resiliency factors. Medical providers and clients also reported general improvements in reproductive health, particularly in the use of birth control other than condoms. Student focus group participants noted that school health centers helped improve access to services students might not seek out o...
This study estimates the relationships between adolescents' health risks, race, and use of behavioral-health focused school-based health centers (SBHCs). Controlling for gender, family structure, English language preference, grade level, grade point average, student race, and the racial composition of the student body, youth reported higher odds of receiving SBHC services if they reported ever having sexual intercourse (OR 1.74, p<.001), depressive symptoms or suicidality in the past 12 months (OR 1.65, p<.001), or use of multiple substances in their lifetime (OR 1.29, p<.001). In this same model, Black (OR 2.23, p<.05) and Latino (OR 1.26, p<.05) youth had higher odds of using their SBHC compared to Asian students. These findings suggest that SBHCs may be reducing the behavioral health service-system gap observed for Black and Latino youth. Further research is needed to understand the mechanisms responsible for Asian students’ underrepresentation in SBHC services and identify effective outreach and engagement strategies with these youth.
Health Services Research, 2019
School-based health services (SBHS) are health services located in schools which ideally can provide youth-appropriate health care through their accessible, low-cost, youth-focused services and comprehensive care. 1,2 Most SBHS provide a range of services from acute and primary care to mental health, sexual health, substance use counseling, and health promotion. SBHS are among the few broadly available health services specifically for young people, and their numbers are increasing globally. 3 As such, SBHS have the
School-Based Health Clinics: Remaining Viable in a Changing Health Care Delivery System
Annual Review of Public Health, 1997
▪ Adolescents are often vulnerable to particular health risks and face multiple barriers to accessing health care. School-based clinics and school-linked services represent an alternative model of care that has responded to the unique health issues of adolescents by offering preventive, comprehensive services, including mental health and other sensitive services. The current restructuring of the American health care delivery system presents a serious challenge to the continued existence of these services, which must link successfully with managed care organizations and adapt to significant changes in federal and state funding streams to remain viable. The continued success of school-based health services in improving adolescent health will largely depend on how well they can capitalize on their strategic position to reach adolescents, respond to their health needs, and reduce barriers to care, and how effectively they can integrate themselves into a rapidly evolving US health care...