title: The role of school-based health centers in increasing universal and targeted delivery of primary and preventive care among adolescents.
abstract: BACKGROUND
  School-based health centers (SBHC) can provide equitable and comprehensive care for adolescents; yet, few studies have described how patterns of health service utilization differ among groups. The purpose of this study was to investigate differences in utilization and perceptions of SBHC care among adolescents.
  
  
  METHODS
  This study sample included 414 adolescent respondents to the Healthy Schools, Healthy Communities User Survey. Three outcome measures represented utilization of care, while 4 represented perceptions of care. Multivariate logistic regressions modeled the effects of user characteristics on outcome measures.
  
  
  RESULTS
  There were few notable and significant differences in either utilization or perceptions of care, based on sociodemographic or health status characteristics.
  
  
  CONCLUSIONS
  SBHCs can eliminate differences in utilization based on sociodemographic characteristics. However, null findings show that they fall short in delivering comprehensive care to high-risk adolescents, and may not be capitalizing on opportunities to offer targeted services. Results showing positive perceptions of care suggest that adolescents would be amenable to additional counseling or education services offered at SBHCs. To foster positive health outcomes among adolescents, SBHC administrators should regularly evaluate their scope of services and support quality improvement efforts.
authors.affiliation: Postdoctoral Research Fellow, (srane1@jhmi.edu), Division of General Pediatrics & Adolescent Medicine, Johns Hopkins University School of Medicine, 200 N Wolfe Street, Room 2088, Baltimore, MD 21287.
authors.forename: Sarika R
authors.initials: SR
authors.lastname: Parasuraman
authors.forename: Leiyu
authors.initials: L
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011315:Preventive Medicine; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012572:School Health Services; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: adolescents; quality of care; school health; utilization of care