title: School-based health centers as patient-centered medical homes.
abstract: OBJECTIVE
  School-based health centers (SBHCs) have been suggested as possible patient-centered medical homes. Our objectives were to determine, in a low-income, urban population, adolescents' reasons for visiting SBHCs and the value parents place on SBHC services, and adolescents' and parents' assessment of how well SBHCs fulfill criteria for a medical home as defined by the American Academy of Pediatrics.
  
  
  METHODS
  A cross-sectional, mailed survey of a random sample of 495 adolescent SBHC users and 497 parents of SBHC users from 10 SBHCs in Denver, CO from May to October 2012. Eligible adolescents were registered in an SBHC with ≥ 1 visit during the 2011 to 2012 school year.
  
  
  RESULTS
  Response rates were 40% (198/495) among adolescents and 36% (181/497) among parents. The top 3 reasons for visits were for illness (78%), vaccines (69%), and sexual health education (63%). Factors reported as very important by >75% of parents in the decision to enroll their adolescent in an SBHC included clinic offering sick or injury visits, sports physicals, and vaccinations. More than 70% of adolescents gave favorable responses (always or usually, excellent or good) to questions about American Academy of Pediatrics medical home criteria (accessibility, continuity, comprehensiveness, family-centeredness, coordination, and compassion). Most parents (83%) reported that they could always or usually trust the SBHC provider to take good care of their child; 82% were satisfied with provider-to-provider communication.
  
  
  CONCLUSIONS
  In a low-income urban population, SBHCs met criteria of a medical home from adolescents' and parents' perspectives. Policymakers and communities should recognize that SBHCs play an important role in the medical community, especially for underserved adolescents.
authors.affiliation: Department of Pediatrics, and Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado; sean.oleary@ucdenver.edu.
authors.forename: Sean T
authors.initials: ST
authors.lastname: O'Leary
authors.affiliation: Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado;
authors.forename: Michelle
authors.initials: M
authors.lastname: Lee
authors.affiliation: Division of Pediatrics, Denver Health, Denver, Colorado;
authors.forename: Steve
authors.initials: S
authors.lastname: Federico
authors.affiliation: Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado; Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora, Colorado;
authors.forename: Juliana
authors.initials: J
authors.lastname: Barnard
authors.affiliation: Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado;
authors.forename: Steven
authors.initials: S
authors.lastname: Lockhart
authors.affiliation: Department of Pediatrics, and Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora, Colorado; Colorado School of Public Health, Aurora, Colorado.
authors.forename: Karen
authors.initials: K
authors.lastname: Albright
authors.affiliation: Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado; Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora, Colorado;
authors.forename: Doron
authors.initials: D
authors.lastname: Shmueli
authors.affiliation: Department of Pediatrics, and Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado;
authors.forename: Mandy A
authors.initials: MA
authors.lastname: Allison
authors.affiliation: Department of Pediatrics, and Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado; Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora, Colorado;
authors.forename: Allison
authors.initials: A
authors.lastname: Kempe
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D018802:Patient-Centered Care / Q000379:methods / Q000706:statistics & numerical data*; D012572:School Health Services / Q000706:statistics & numerical data*
keywords: medical home; school health