title: Reproductive health impact of a school health center.
abstract: OBJECTIVE
  Although school health centers (SHCs) may improve access to reproductive health care services and contraception, published data on SHC service use and reproductive health impact are limited.
  
  
  METHODS
  Reproductive health indicators among students at four urban high schools in a single building with an SHC in 2009 were compared with students in a school without an SHC, using a quasi-experimental research design (N = 2,076 students, 1,365 from SHC and 711 from comparison school). The SHC provided comprehensive reproductive health education and services, including on-site provision of hormonal contraception.
  
  
  RESULTS
  Students in the SHC were more likely to report receipt of health care provider counseling and classroom education about reproductive health and a willingness to use an SHC for reproductive health services. Use of hormonal contraception measured at various time points (first sex, last sex, and ever used) was greater among students in the SHC. Most 10th-12th graders using contraception in the SHC reported receiving contraception through the SHC. Comparing students in the nonintervention school to SHC nonusers to SHC users, we found stepwise increases in receipt of education and provider counseling, willingness to use the SHC, and contraceptive use.
  
  
  CONCLUSIONS
  Students with access to comprehensive reproductive health services via an SHC reported greater exposure to reproductive health education and counseling and greater use of hormonal contraception. SHCs can be an important access point to reproductive health care and a key strategy for preventing teen pregnancy.
authors.affiliation: 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; Center for Community Health and Education, New York Presbyterian Hospital, New York, New York.
authors.forename: Mara
authors.initials: M
authors.lastname: Minguez
authors.affiliation: 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; Center for Community Health and Education, New York Presbyterian Hospital, New York, New York. Electronic address: js2637@columbia.edu.
authors.forename: John S
authors.initials: JS
authors.lastname: Santelli
authors.affiliation: 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; Center for Community Health and Education, New York Presbyterian Hospital, New York, New York.
authors.forename: Erica
authors.initials: E
authors.lastname: Gibson
authors.affiliation: Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York.
authors.forename: Mark
authors.initials: M
authors.lastname: Orr
authors.affiliation: San Diego Antiviral Research Center, University of California, San Diego, California.
authors.forename: Shama
authors.initials: S
authors.lastname: Samant
mesh_terms: D000293:Adolescent; D002140:California; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*; D043762:Reproductive Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D060728:Reproductive Health; D034121:Reproductive Health Services / Q000706:statistics & numerical data; D012572:School Health Services / Q000706:statistics & numerical data*; D012736:Sex Education / Q000458:organization & administration; D012725:Sexual Behavior / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Access to health care; Adolescent; Contraception; School health center; School health services