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School-Based Health Care for Urban Minority Junior High School Students

Heather J. Walter, MD, MPH; Roger D. Vaughan, MS; Bruce Armstrong, DSW; Roberta Y. Krakoff, ACSW; Lorraine Tiezzi, MS; James F. McCarthy, PhD
Arch Pediatr Adolesc Med. 1995;149(11):1221-1225. doi:10.1001/archpedi.1995.02170240039006.
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Objective:  To describe the use of school-based health clinics by urban minority junior high school students.

Design:  Review of demographic and utilization data collected by service providers during clinic visits.

Settings and Participants:  Health clinics in four junior high schools that enrolled predominantly Hispanic students who were residing in an economically disadvantaged, medically underserved New York (NY) school district.

Results:  Of5757 students who were enrolled in the schools, 5296 (92%) obtained parental consent to use the clinics, and 3723 (65%) used the clinics during the 1991-1992 academic year. Clinic users were 11 to 15 years old, 50% male and 50% female, 81% Hispanic and 14% black, and 29% sixth graders, 33% seventh graders, and 38% eighth graders. Clinic users made 16 340 clinic visits during the 1991-1992 academic year. Presenting complaints were mental health problems (32%), illness (14%), injury (12%), physical examination (5%), immunization (3%), follow-up (21%), and other (13%). Referral sources were clinic outreach (48%), self (44%), and school personnel (8%). Disposition of visits was on-site treatment (92%), referral to an affiliated hospital (5%), and referral elsewhere (3%). Compared with a nationwide group of high school–based clinics that served predominantly black adolescents, these clinics provided more mental health care (31% vs 21%), similar illness/injury care (32% vs 30%), and less preventive (10% vs 24%) and reproductive/contraceptive (7% vs 12%) care.

Conclusions:  Junior high school–based clinics can provide a wide range of primary and preventive health care services for large numbers of medically underserved youths. The provision of mental health services may fill a critical need among inner-city adolescents. Clinic outreach may be necessary to maximize utilization, especially among high-risk students.(Arch Pediatr Adolesc Med. 1995;149:1221-1225)


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