title: Effectiveness of an Adaptation of the Project Connect Health Systems Intervention: Youth and Clinic-Level Findings.
abstract: The Project Connect Health Systems Intervention (Project Connect) uses a systematic process of collecting community and healthcare infrastructure information to craft a referral guide highlighting local healthcare providers who provide high quality sexual and reproductive healthcare. Previous self-report data on healthcare usage indicated Project Connect was successful with sexually experienced female youth, where it increased rates of human immunodeficiency virus (HIV) and sexually transmitted disease (STD) testing and receipt of contraception. This adaption of Project Connect examined its effectiveness in a new context and via collection of clinic encounter-level data.
  
  
  
  Project Connect was implemented in 3 high schools. (only 2 schools remained open throughout the entire project period). Participant recruitment and data collection occurred in 5 of 8 participating health clinics. Students completed Youth Surveys (N = 608) and a Clinic Survey (paired with medical data abstraction in 2 clinics [N = 305]).
  
  
  
  Students were more likely than nonstudents to report having reached a clinic via Project Connect. Nearly 40% of students attended a Project Connect school, with 32.7% using Project Connect to reach the clinic. Students were most likely to have been referred by a school nurse or coach.
  
  
  
  Project Connect is a low-cost, sustainable structural intervention with multiple applications within schools, either as a standalone intervention or in combination with ongoing efforts.
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E02, Atlanta, GA 30333. ploosier@cdc.gov.
authors.forename: Penny S
authors.initials: PS
authors.lastname: Loosier
authors.affiliation: HIV Care and Prevention Section, Michigan Department of Health and Human Services, Lansing, MI 48913. Dolls@michigan.gov.
authors.forename: Shelli
authors.initials: S
authors.lastname: Doll
authors.affiliation: Center for Data Management and Translational Research, Michigan Public Health Institute, Okemos, MI 48864. dlepar@mphi.org.
authors.forename: Danielle
authors.initials: D
authors.lastname: Lepar
authors.affiliation: Center for Data Management and Translational Research, Michigan Public Health Institute, Okemos, MI 48864. kward@mphi.org.
authors.forename: Kristin
authors.initials: K
authors.lastname: Ward
authors.affiliation: Center for Data Management and Translational Research, Michigan Public Health Institute, Okemos, MI 48864. ggamble@mphi.org.
authors.forename: Ginger
authors.initials: G
authors.lastname: Gamble
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E44, Atlanta, GA 30333. pdittus@cdc.gov.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Dittus
mesh_terms: D000293:Adolescent; D003267:Contraception / Q000379:methods; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D011258:Pregnancy Tests; D015397:Program Evaluation; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000458:organization & administration*; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D012572:School Health Services / Q000458:organization & administration*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: adolescent; healthcare seeking; linkage to healthcare; school health; structural intervention