School-Based Health Centers as Medical Homes: Parents' and Adolescents' Perspectives.
Preventive health services are underutilized by US adolescents, especially those from low-income populations. School-based health centers (SBHCs) have been endorsed as primary medical homes for adolescents. This study was undertaken to determine how adolescent SBHC users and their parents perceive SBHCs, particularly whether SBHCs fulfill each of the elements of a medical home as defined by the American Academy of Pediatrics.



Middle and high school adolescents who had been enrolled in a SBHC in a major metropolitan school district for a minimum of 1 year were interviewed about their perceptions of and experiences with SBHCs. English- and Spanish-speaking parents of SBHC-enrolled adolescents also participated in focus groups on this topic.



Four focus groups with parents (n = 30) and 62 interviews with adolescents were completed. Both adolescents and parents indicated satisfaction with the quality and utilization of SBHC services, reporting that SBHCs were highly accessible and family centered. Many students preferred to access care at their SBHC instead of their primary care practice because of the convenience, perceived trustworthiness, compassion, and high quality of care at the SBHC. A few parents reported unmet medical needs from their adolescent's SBHC, and some differences emerged between English- and Spanish-speaking parents.



Adolescents' and parents' perceptions of care received at these SBHCs are consistent with features of the medical home model. These findings suggest that SBHCs can provide coordinated, compassionate care to students in a large, urban school system and may be perceived as more accessible than traditional primary care settings.
Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo; Department of Community & Behavioral Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, Colo. Electronic address: karen.albright@ucdenver.edu.
Karen
K
Albright
Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo.
Juliana
J
Barnard
Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo; Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colo.
Sean
S
O'Leary
Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colo; Denver Health and Hospital Authority, Denver, Colo.
Steve
S
Federico
Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo.
Alison
A
Saville
Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo.
Steven
S
Lockhart
Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo.
Michelle
M
Lee
Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo.
Darren
D
Eblovi
Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo; Department of Family Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colo.
Miriam
M
Dickinson
Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo.
Deidre
D
Kile
Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora, Colo; Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colo.
Allison
A
Kempe
D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D000328:Adult; D001294:Attitude to Health; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D010290:Parents; D018802:Patient-Centered Care / Q000458:organization & administration*; D011314:Preventive Health Services / Q000458:organization & administration*; D036301:Qualitative Research; D012572:School Health Services / Q000458:organization & administration*; D014481:United States
patient-centered medical homes; qualitative research; school-based health centers