title: Measuring school health center impact on access to and quality of primary care.
abstract: OBJECTIVE
  School health centers (SHC) that provide comprehensive health care may improve access and quality of care for students; however, published impact data are limited.
  
  
  METHODS
  We evaluated access and quality of health services at an urban high school with a SHC compared with a school without a SHC, using a quasiexperimental research design. Data were collected at the beginning of the school year, using a paper and pencil classroom questionnaire (n = 2,076 students). We measured SHC impact in several ways including grade by school interaction terms.
  
  
  RESULTS
  Students at the SHC school were more likely to report having a regular healthcare provider, awareness of confidential services, support for health services in their school, and willingness to utilize those services. Students in the SHC school reported higher quality of care as measured by: respect for their health concerns, adequate time with the healthcare provider, understandable provider communications, and greater provider discussion at their last visit on topics such as sexual activity, birth control, emotions, future plans, diet, and exercise. Users of the SHC were also more likely to report higher quality of care, compared with either nonusers or students in the comparison school.
  
  
  CONCLUSIONS
  Access to comprehensive health services via a SHC led to improved access to health care and improved quality of care. Impact was measureable on a school-wide basis but was greater among SHC users.
authors: 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; New York Presbyterian Hospital, New York, New York.
authors: Erica J
authors: EJ
authors: Gibson
authors: John S
authors: JS
authors: Santelli
authors: Mara
authors: M
authors: Minguez
authors: Alyssa
authors: A
authors: Lord
authors: Ashley C
authors: AC
authors: Schuyler
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D009519:New York City; D011320:Primary Health Care; D011787:Quality of Health Care; D012572:School Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014504:Urban Health
keywords: Access to health care; Adolescent health services; Adolescents; Health education; Health promotion; Preventive health services; Primary health care; Quality of care; School health services