Comparison of Health Risks among Adolescents from School-based Health Centers and Community-based Primary Care Settings

Objective: School-based health centers (SBHCs) provide adolescents similar services to community-based primary care; however differences across settings require clarification. We aimed to examine whether adolescents presenting to SBHCs and community-based primary care in the same geographical region differ in demographics, psychosocial factors and health risk behaviors. Methods: Adolescents (N = 596, grades 9-12), completed a self-report app-based assessment of health behaviors prior to appointments. Results: Compared with youth in community-based primary care, participants in SBHCs were older, more racially diverse, and reported higher frequencies of substance use, depression, suicidal ideation, unsafe sex, poor road safety, disordered eating, and poor sleep. Adolescents at SBHCs reported poorer family relationship quality, poorer grades, and more school days absent. Conclusions: SBHCs potentially service diverse adolescents with higher rates of risk than community-based primary care. SBHCs offer an important venue for targeting health risks and should provide screening and intervention for multiple health-risk behaviors as part of comprehensive care.