title: The impact of school-based health centers on the health outcomes of middle school and high school students.
abstract: OBJECTIVE
  We studied the direct and indirect effects of school-based health centers (SBHCs) on the health and health behaviors of middle and high school students.
  
  
  METHODS
  We used a prospective cohort design to measure health outcomes annually over 2 consecutive years by student self-report. Cohorts of middle school and high school students were recruited from matched schools with and without SBHCs. Data were obtained from 744 students in both year 1 and year 2 of the study. We used 2-level hierarchical linear models to estimate the effects of the presence of SBHCs at the school level and of SBHC use at the student level.
  
  
  RESULTS
  At year 2, users of SBHCs experienced greater satisfaction with their health, more physical activity, and greater consumption of healthy food than did nonusers of SBHCs.
  
  
  CONCLUSIONS
  Students who used SBHCs were more satisfied with their health and engaged in a greater number of health-promoting behaviors than did students who did not use SBHCs. These findings indicate that SBHCs are achieving their goal of promoting children's health.
authors.affiliation: Community Education and Research Collaborative, University Outreach and Engagement, Michigan State University, Kellogg Center-Garden Level, East Lansing, MI 48824-1022, USA. mcnall@msu.edu
authors.forename: Miles A
authors.initials: MA
authors.lastname: McNall
authors.forename: Lauren F
authors.initials: LF
authors.lastname: Lichty
authors.forename: Brian
authors.initials: B
authors.lastname: Mavis
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D004032:Diet; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016014:Linear Models; D008297:Male; D008824:Michigan; D009043:Motor Activity; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012572:School Health Services / Q000458:organization & administration*; D011795:Surveys and Questionnaires