学校健康中心对生殖健康的影响。

Reproductive health impact of a school health center.

作者信息

Minguez Mara, Santelli John S, Gibson Erica, Orr Mark, Samant Shama

机构信息

Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York; Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York; Center for Community Health and Education, New York Presbyterian Hospital, New York, New York.

出版信息

J Adolesc Health. 2015 Mar;56(3):338-44. doi: 10.1016/j.jadohealth.2014.10.269.

DOI:10.1016/j.jadohealth.2014.10.269

PMID:25703321

Abstract

PURPOSE

Although school health centers (SHCs) may improve access to reproductive health care services and contraception, published data on SHC service use and reproductive health impact are limited.

METHODS

Reproductive health indicators among students at four urban high schools in a single building with an SHC in 2009 were compared with students in a school without an SHC, using a quasi-experimental research design (N = 2,076 students, 1,365 from SHC and 711 from comparison school). The SHC provided comprehensive reproductive health education and services, including on-site provision of hormonal contraception.

RESULTS

Students in the SHC were more likely to report receipt of health care provider counseling and classroom education about reproductive health and a willingness to use an SHC for reproductive health services. Use of hormonal contraception measured at various time points (first sex, last sex, and ever used) was greater among students in the SHC. Most 10th-12th graders using contraception in the SHC reported receiving contraception through the SHC. Comparing students in the nonintervention school to SHC nonusers to SHC users, we found stepwise increases in receipt of education and provider counseling, willingness to use the SHC, and contraceptive use.

CONCLUSIONS

Students with access to comprehensive reproductive health services via an SHC reported greater exposure to reproductive health education and counseling and greater use of hormonal contraception. SHCs can be an important access point to reproductive health care and a key strategy for preventing teen pregnancy.

摘要

目的

尽管学校健康中心（SHCs）可能会改善获得生殖健康护理服务和避孕措施的机会，但关于SHC服务使用情况及生殖健康影响的已发表数据有限。

方法

采用准实验研究设计，将2009年在同一栋楼内设有SHC的四所城市高中的学生的生殖健康指标，与一所没有SHC的学校的学生进行比较（N = 2076名学生，1365名来自设有SHC的学校，711名来自对照学校）。该SHC提供全面的生殖健康教育和服务，包括现场提供激素避孕措施。

结果

设有SHC的学校的学生更有可能报告接受过医疗保健提供者关于生殖健康的咨询和课堂教育，并且愿意使用SHC提供的生殖健康服务。在设有SHC的学校的学生中，在不同时间点（首次性行为、末次性行为以及曾经使用过）测量的激素避孕措施的使用率更高。在设有SHC的学校中，大多数使用避孕措施的10至12年级学生报告是通过SHC获得避孕措施的。将非干预学校的学生与未使用SHC的学生以及使用SHC的学生进行比较，我们发现接受教育和提供者咨询的程度、使用SHC的意愿以及避孕措施的使用呈逐步上升趋势。