Department of Community Paediatrics, School of Population Health, University of Auckland, New Zealand.
Am J Public Health. 2012 Oct;102(10):e14-20. doi: 10.2105/AJPH.2012.300775. Epub 2012 Aug 16.
We determined the association between availability and quality of school health services and reproductive health outcomes among sexually active students.
We used a 2-stage random sampling cluster design to collect nationally representative data from 9107 students from 96 New Zealand high schools. Students self-reported whether they were sexually active, how often they used condoms or contraception, and their involvement in pregnancy. School administrators completed questionnaires on their school-based health services, including doctor and nursing hours per week, team-based services, and health screening. We conducted analyses using multilevel models controlling for individual variables, with schools treated as random effects.
There was an inverse association between hours of nursing and doctor time and pregnancy involvement among sexually active students, with fewer pregnancies among students in schools with more than 10 hours of nursing and doctor time per 100 students. There was no association between doctor visits, team-based services, health screening, and reproductive health outcomes.
School health services are associated with fewer pregnancies among students, but only when the availability of doctor and nursing time exceeds 10 hours per 100 students per week.
我们旨在确定学校卫生服务的可及性和质量与性活跃学生生殖健康结果之间的关联。
我们采用两阶段随机抽样整群设计，从新西兰 96 所高中的 9107 名学生中收集具有全国代表性的数据。学生们自我报告其性活跃情况、使用避孕套或避孕药的频率以及其怀孕情况。学校管理人员则完成关于学校基础卫生服务的调查问卷，包括每周医生和护士的工作时间、团队服务以及健康筛查。我们采用多水平模型进行分析，控制个体变量，将学校视为随机效应。
在性活跃学生中，护士和医生的工作时间与怀孕参与之间呈负相关，每周每 100 名学生中护士和医生的工作时间超过 10 小时，怀孕的学生人数较少。医生就诊、团队服务、健康筛查与生殖健康结果之间没有关联。
学校卫生服务与学生怀孕人数减少有关，但只有当每周每 100 名学生中医生和护士的工作时间超过 10 小时时才会出现这种关联。
