Impact of a school-based intervention on access to healthcare for underserved youth

被引:32
作者
Britto, MT
Klostermann, BK
Bonny, AE
Altum, SA
Hornung, RW
机构
[1] Univ Cincinnati, Childrens Hosp, Ctr Med, Div Adolescent Med, Cincinnati, OH 45229 USA
[2] Univ Cincinnati, Inst Hlth Policy, Cincinnati, OH USA
[3] Univ Cincinnati, Hlth Serv Res, Cincinnati, OH USA
关键词
adolescent; school-based intervention; evaluation; access to care; health status;
D O I
10.1016/S1054-139X(01)00196-3
中图分类号
B844 [发展心理学(人类心理学)];
学科分类号
040202 ;
摘要
Purpose: To determine whether a multidimensional school-based intervention, which included physical and mental health services, increased adolescents' use of needed medical care and preventive care and decreased emergency room use. Methods: A total of 2832 seventh- through twelfth-grade students in six public urban intervention schools and 2036 students in six demographically matched comparison schools completed a previously validated survey regarding health status and healthcare utilization in spring 1998 and 1999. Bivariate analyses examined the association between intervention status and Year 1/Year 2 outcomes. The multifaceted intervention included programs such as anger management groups, substance abuse prevention, tutoring, home visits, and enhanced school health services. Stepwise multivariate logistic models tested differences between the intervention and comparison groups across years, controlling for potential confounding variables [gender, age, race/ethnicity, maternal education, grade in school, school district (city or county), health status, and chronic health problems]. The interaction term for Group X Year was used to test the effect of the intervention. Multivariable modeling was also used to determine student factors independently associated with healthcare utilization. Results: Respondents had a median age of 15 years, 56% were female, 51% were white, 42% were black, and 34% reported chronic health problems. In both years, over 45% of students in both groups reported not seeking medical care they believed they needed. The proportion with missed care in the intervention schools did not change, whereas the proportion with missed care in the comparison schools increased. Emergency room use decreased slightly in the intervention schools and increased slightly in the comparison schools between Year 1 and Year 2. There were no major changes in healthcare delivery in this area during the year, demonstrating the volatility of adolescents' perceived access to care. Among the student factors, health status, having a chronic condition, and being in a higher grade were independently associated with students' report of not seeking care they believed they needed. Conclusion: These results confirm that many adolescents have unmet healthcare needs. Those with poor health status are most likely to report underutilization and unmet needs. These findings underscore the need for comparison groups when evaluating interventions and suggest the need for better understanding of community level changes in perceived healthcare access and use. (C) Society for Adolescent Medicine, 2001.
引用
收藏
页码:116 / 124
页数:9
相关论文
共 50 条
[21]   A motivational school-based intervention for adolescent sleep problems [J].
Cain, Neralie ;
Gradisar, Michael ;
Moseley, Lynette .
SLEEP MEDICINE, 2011, 12 (03) :246-251
[22]   Effectiveness of an intensive, school-based intervention for teen mothers [J].
Key, Janice D. ;
Gebregziabher, Mulugeta G. ;
Marsh, Linda D. ;
O'Rourke, Kathleen M. .
JOURNAL OF ADOLESCENT HEALTH, 2008, 42 (04) :394-400
[23]   A School-Based Intervention to Increase HPV Vaccination Rates [J].
Edwards, Tiffany ;
Hooper, Gwendolyn L. .
JOURNAL OF DOCTORAL NURSING PRACTICE, 2019, 12 (02) :196-201
[24]   The Dynamic Adaptation of the Journey of Hope: A School-Based Intervention to Support Pandemic and Disaster-Affected Children and Youth [J].
Powell, Tara ;
Wetzel, Greta ;
Cardoso, Jodi Berger .
CHILDREN & SCHOOLS, 2024, 46 (04) :233-243
[25]   Adolescent self-esteem and cognitive skills training: A school-based intervention [J].
Barrett P.M. ;
Webster H.M. ;
Wallis J.R. .
Journal of Child and Family Studies, 1999, 8 (2) :217-227
[26]   Promoting mental health literacy in female students: A school-based educational intervention [J].
Zare, Somayeh ;
Kaveh, Mohammad Hossein ;
Ghanizadeh, Ahmad ;
Asadollahi, Abdolrahim ;
Nazari, Mahin .
HEALTH EDUCATION JOURNAL, 2021, 80 (06) :734-745
[27]   The Impact of a High School-Based Positive Youth Development Program on Sexual Health Outcomes: Results from a Randomized Controlled Trial [J].
Walsh, Sarah ;
Jenner, Eric ;
Qaragholi, Noor ;
Henley, Catherine ;
Demby, Hilary ;
Leger, Rebekah ;
Burgess, Kelly .
JOURNAL OF SCHOOL HEALTH, 2022, 92 (12) :1155-1164
[28]   The Impact of Community Violence on School-Based Research [J].
Velsor-Friedrich, Barbara ;
Richards, Maryse ;
Militello, Lisa K. ;
Dean, Kyle C. ;
Scott, Darrick ;
Gross, Israel M. ;
Romeo, Edna .
JOURNAL OF SCHOOL NURSING, 2015, 31 (06) :397-401
[29]   School readiness to adopt a school-based adolescent nutrition intervention in urban Indonesia [J].
Octaria, Yessi ;
Apriningsih, Apriningsih ;
Dwiriani, Cesilia M. ;
Februhartanty, Judhiastuty .
PUBLIC HEALTH NUTRITION, 2021, 24 :s72-s83
[30]   Engaging Community Stakeholders for School-Based Physical Activity Intervention [J].
Salsberg, Jon ;
Macridis, Soultana ;
Bengoechea, Enrique Garcia ;
Macaulay, Ann C. ;
Moore, Spencer .
RETOS-NUEVAS TENDENCIAS EN EDUCACION FISICA DEPORTE Y RECREACION, 2015, (28) :225-231