Kirby D, Waszak C, Ziegler J
Center for Population Options.
Fam Plann Perspect. 1991 Jan-Feb;23(1):6-16.
An evaluation of the reproductive health programs of six diverse school-based clinics measured the impact of the clinics on sexual behavior and contraceptive use. All six clinics served low-income populations; at five of them, the great majority of the students served were black. An analysis of student visits by type of care given found that these clinics were not primarily family planning facilities; rather, they provided reproductive health care as one component of a comprehensive health program. Student survey data collected in the clinic schools and nearby comparison schools (four sites) or collected both before the clinic opened and two years later (two sites) indicated that the clinics neither hastened the onset of sexual activity nor increased its frequency. The clinics had varying effects on contraceptive use. Providing contraceptives on site was not enough to significantly increase their use; in only one of the three sites that did so were students in the clinic school significantly more likely than students in the comparison school to have used birth control during last intercourse. However, condom use rose sharply at one clinic school that had a strong AIDS education program and was located in a community where AIDS was a salient issue. At another clinic school, where pregnancy prevention was a high priority and staff issued vouchers for contraceptives, the use of condoms and pills was significantly higher than in the comparison school. A third clinic school--which focused on high-risk youth, emphasized pregnancy prevention and dispensed birth control pills--recorded a significantly higher use of pills than its comparison school. Although the data suggest that the clinics probably prevented small numbers of pregnancies at some schools, none of the clinics had a statistically significant effect on school-wide pregnancy rates.
一项对六家不同的校内诊所生殖健康项目的评估，测量了这些诊所对性行为和避孕措施使用情况的影响。所有这六家诊所都为低收入人群服务；其中五家诊所服务的学生绝大多数是黑人。根据所提供护理类型对学生就诊情况进行分析发现，这些诊所并非主要的计划生育机构；相反，它们将生殖健康护理作为综合健康项目的一个组成部分来提供。在诊所所在学校和附近对照学校（四个地点）收集的学生调查数据，或者在诊所开业前及两年后收集的学生调查数据（两个地点）表明，这些诊所既没有加速性活动的开始，也没有增加其频率。这些诊所在避孕措施使用方面有不同的影响。在现场提供避孕药具不足以显著增加其使用；在这样做的三个地点中，只有一个地点的诊所学校学生在最近一次性交时使用避孕措施的可能性明显高于对照学校的学生。然而，在一所开展了强有力的艾滋病教育项目且位于艾滋病是突出问题的社区的诊所学校，避孕套的使用大幅上升。在另一所将预防怀孕作为高度优先事项且工作人员发放避孕药具代金券的诊所学校，避孕套和避孕药的使用明显高于对照学校。第三所诊所学校——专注于高危青少年，强调预防怀孕并发放避孕药丸——记录的避孕药丸使用量明显高于其对照学校。尽管数据表明这些诊所可能在一些学校预防了少量怀孕，但没有一家诊所对全校的怀孕率产生统计学上显著的影响。
