title: The project connect health systems intervention: linking sexually experienced youth to sexual and reproductive health care.
abstract: OBJECTIVE
  To evaluate a health systems intervention to increase adolescents' receipt of high-quality sexual and reproductive health care services.
  
  
  METHODS
  Quasi experimental design. Twelve high schools in a large public school district were matched into pairs. Within each pair, schools were assigned to condition so that no control school shared a geographic border with an intervention school. Five yearly surveys (T1, T2, …, T5) were administered from 2005 to 2009 (N = 29,823) to students in randomly selected classes in grades 9-12. Community-based providers of high-quality sexual and reproductive health care services were listed on a referral guide for use by school nurses to connect adolescents to care.
  
  
  RESULTS
  Statistically significant effects were found for intervention school females on three outcomes, relative to controls. Relative to T1, receipt of birth control in the past year was greater at T4 (adjusted odds ratio [AOR] = 1.85; 95% confidence interval [CI], 1.09-3.15) and T5 (AOR = 2.22; 95% CI, 1.32-3.74). Increases in sexually transmitted disease testing and/or treatment in the past year were greater in T1-T3 (AOR = 1.78; 95% CI, 1.05-3.02), T1-T4 (AOR = 1.73; 95% CI, 1.01-2.97), T1-T5 (AOR = 1.97; 95% CI, 1.17-3.31), and T2-T5 (AOR = 1.76; 95% CI, 1.06-2.91). Increases in ever receiving an HIV test were greater in T1-T4 (AOR = 2.14; 95% CI, 1.08-4.26). Among males, no intervention effects were found.
  
  
  CONCLUSIONS
  A school-based structural intervention can improve female adolescents' receipt of services.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: pdittus@cdc.gov.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Dittus
authors.affiliation: Los Angeles County Department of Public Health, Division of HIV and STD Programs, Los Angeles, California; Institute for Health Promotion and Disease Prevention Research, University of Southern California, Los Angeles, California.
authors.forename: Christine J
authors.initials: CJ
authors.lastname: De Rosa
authors.affiliation: Los Angeles County Department of Public Health, Division of HIV and STD Programs, Los Angeles, California; Institute for Health Promotion and Disease Prevention Research, University of Southern California, Los Angeles, California.
authors.forename: Robin A
authors.initials: RA
authors.lastname: Jeffries
authors.affiliation: Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California.
authors.forename: Abdelmonem A
authors.initials: AA
authors.lastname: Afifi
authors.affiliation: Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California.
authors.forename: William G
authors.initials: WG
authors.lastname: Cumberland
authors.affiliation: Los Angeles County Department of Public Health, Division of HIV and STD Programs, Los Angeles, California.
authors.forename: Emily Q
authors.initials: EQ
authors.lastname: Chung
authors.affiliation: Los Angeles County Department of Public Health, Division of HIV and STD Programs, Los Angeles, California; Institute for Health Promotion and Disease Prevention Research, University of Southern California, Los Angeles, California.
authors.forename: Esteban
authors.initials: E
authors.lastname: Martinez
authors.affiliation: Los Angeles County Department of Public Health, Tuberculosis Control Program, Los Angeles, California.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Kerndt
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Ethier
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services; D005260:Female; D006801:Humans; D008297:Male; D015397:Program Evaluation; D034121:Reproductive Health Services; D012572:School Health Services; D012725:Sexual Behavior
keywords: Adolescent; Adolescent health services; HIV; Reproductive health; STD