Adolescent school-based health care: a description of two sites in their 20th year of service.
OBJECTIVE
While there are currently nearly 1,400 school-based health centers (SBHC) nationwide, only 20% have been in operation for more than 10 years. The Mount Sinai Adolescent SBHC Program is now in its 20th year of service. The purpose of this study is to: (a) present the demographic data for 2003 high school SBHC medical visits, including age, sex and insurance status; (b) describe the current prevalence of medical and psychosocial risk factors of the students seen for examination; and (c) present general distributions for psychosocial risk factors found in 1988 archival information and note differences from current risk factors.


METHODS
A retrospective chart review was conducted in high school A, whose SBHC serves students mainly interested in going to college, and in high school B, whose SBHC has a heterogeneous population with a large proportion of recent immigrants. Data collected included demographic variables as well as reports of risk factors such as: considering oneself to be overweight, history of sexual activity, history of sexually transmitted diseases, same-sex attraction, use of alcohol, cigarette smoking, use of marijuana, suicidal ideation and exposure to violence.


RESULTS
For those participating from high school A (n=231): 78% female, mean age 15.75; asthma (17%); think oneself overweight (30%); family member with HIV (11%); sexually active (35%); same-sex attraction (3%); cigarette use (14%); marijuana use (13%); alcohol use (38%); suicide ideation (14%); witnessed violence (37%); and overweight and obese (33%). For those participating from high school B (n=241): 64% female; mean age 16; asthma (16%); think oneself overweight (32%); family member with HIV (9%); sexually active (43%); same-sex attraction (7%); cigarette use (38%); marijuana use (24%); alcohol use (53%); suicide ideation (23%); witnessed violence (33%); and overweight and obese (31%). In 1988, students at these schools reported: sexually active status (41%); marijuana use (13%); cocaine use (12%); alcohol use (20%); and sadness/depression (43%).


CONCLUSIONS
While a snapshot of the risk factors in 2003 might indicate that sexual activity has decreased somewhat, substance use, as well as eating-related and AIDS-related issues have come to the forefront. SBHCs continue to serve students with intense medical and psychological needs. It remains crucial that SBHCs provide comprehensive medical and mental health services.
Pastore
Doris R
DR
Mount Sinai Adolescent Health Care Center, Division of Adolescent Medicine, New York, NY, USA.
Techow
Beth
B
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D003710:Demography; D001068:Feeding and Eating Disorders / Q000453:epidemiology; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration / Q000706:statistics & numerical data; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D015397:Program Evaluation; D012189:Retrospective Studies; D012307:Risk Factors; D012572:School Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000453:epidemiology