title: Rethinking school-based health centers as complex adaptive systems: maximizing opportunities for the prevention of teen pregnancy and sexually transmitted infections.
abstract: This article examines school-based health centers (SBHCs) as complex adaptive systems, the current gaps that exist in contraceptive access, and the potential to maximize this community resource in teen pregnancy and sexually transmitted infection (STI) prevention efforts. Adolescent pregnancy is a major public health challenge for the United States. Existing community resources need to be considered for their potential to impact teen pregnancy and STI prevention efforts. SBHCs are one such community resource to be leveraged in these efforts. They offer adolescent-friendly primary care services and are responsive to the diverse needs of the adolescents utilizing them. However, current restrictions on contraceptive availability limit the ability of SBHCs to maximize opportunities for comprehensive reproductive care and create missed opportunities for pregnancy and STI prevention. A clinical case explores the current models of health care services related to contraceptive care provided in SBHCs and the ability to meet or miss the needs of an adolescent seeking reproductive care in a SBHC.
authors.affiliation: Yale University School of Nursing, Yale-New Haven Hospital Adolescent Clinic and Hill Regional Career High School, School-Based Health Center, New Haven, Connecticut, USA. alison.moriartydaley@yale.edu
authors.forename: Alison Moriarty
authors.initials: AM
authors.lastname: Daley
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*; D011320:Primary Health Care / Q000458:organization & administration; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D012572:School Health Services / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D014481:United States