Sexually active students' willingness to use school-based health centers for reproductive health care services in North Carolina.
OBJECTIVE
School-based health centers (SBHCs) in North Carolina offer limited reproductive health care services. We investigate sexually active students' willingness to seek these services at SBHCs if available and predictors of willingness to seek services.


METHODS
Cross-sectional survey of 949 sexually experienced students in 2 middle and 5 high schools in North Carolina in 1994. Bivariate and multivariate analyses tested the influence of sociodemographic characteristics, risk of pregnancy/sexually transmitted infections (STIs), and past health care utilization on willingness to use SBHCs for sexuality-related services.


RESULTS
Participants were 52% female, 52% black, and median age at first coitus was 13.0 years. Many (49%) had sex at least once a month. Most (52%) reported inconsistent contraception use. One-fifth (18%) of females had been pregnant; 10% of males reported getting a partner pregnant. Seventy-five percent had used SBHCs. Most reported they would use SBHCs for information to protect against pregnancy and STIs (58%), pregnancy testing (51%), and birth control (48%) if available. Females were more likely than males to report they would use these services (adjusted odds ratio = 3.4, 95% confidence interval = 1.9-6.7), especially those receiving free lunch (adjusted odds ratio = 2.9, 95% confidence interval = 1.2-6.8]) and those with inconsistent use of contraception. We found no association between past health care and willingness to use SBHC services.


CONCLUSIONS
Most sexually experienced students report they would use their SBHC for reproductive/STI services if they were available. Absence of these services in SBHCs represents a missed opportunity to provide health care to adolescents who are at substantial risk of pregnancy and STIs.
Coyne-Beasley
Tamera
T
University of North Carolina School of Medicine, Chapel Hill, NC 27599-7220, USA. coybea@med.unc.edu
Ford
Carol A
CA
Waller
Martha W
MW
Adimora
Adaora A
AA
Resnick
Michael D
MD
D000293:Adolescent; D000294:Adolescent Behavior; D000704:Analysis of Variance; D003151:Community Health Centers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005193:Family Planning Services; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D008297:Male; D009657:North Carolina; D010298:Parity; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011247:Pregnancy; D011258:Pregnancy Tests; D011253:Pregnancy in Adolescence; D000297:Psychology, Adolescent; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D012307:Risk Factors; D012309:Risk-Taking; D012572:School Health Services / Q000706:statistics & numerical data*; D019529:Sexuality / Q000523:psychology*; D012749:Sexually Transmitted Diseases / Q000209:etiology; D012959:Socioeconomic Factors; D013334:Students / Q000523:psychology*