A systematic review of the role of school-based healthcare in adolescent sexual, reproductive, and mental health

Amanda J Mason-Jones, Carolyn Crisp, Mariette Momberg, Joy Koech, Petra De Koker, Cathy Mathews, Amanda J Mason-Jones, Carolyn Crisp, Mariette Momberg, Joy Koech, Petra De Koker, Cathy Mathews

Abstract

Background: Accessible sexual, reproductive, and mental healthcare services are crucial for adolescent health and wellbeing. It has been reported that school-based healthcare (SBHC) has the potential to improve the availability of services particularly for young people who are normally underserved. Locating health services in schools has the potential to reduce transport costs, increase accessibility and provide links between schools and communities.

Methods: A systematic review of the literature was undertaken. Pubmed, Psychinfo, Psychnet, Cochrane CENTRAL, and Web of Science were searched for English language papers published between January 1990 and March 2012

Results: Twenty-seven studies were found which fitted the criteria, of which, all but one were from North America. Only three measured adolescent sexual, reproductive, or mental health outcomes related to SBHC and none of the studies were randomized controlled trials. The remaining studies explored accessibility of services and clinic utilization or described pertinent contextual factors.

Conclusions: There is a paucity of high quality research which evaluates SBHC and its effects on adolescent sexual, reproductive, and mental health. However, there is evidence that SBHC is popular with young people, and provides important mental and reproductive health services. Services also appear to have cost benefits in terms of adolescent health and society as a whole by reducing health disparities and attendance at secondary care facilities. However, clearer definitions of what constitutes SBHC and more high quality research is urgently needed.

Figures

Figure 1
Figure 1
Study flow diagram.

References

    1. Ralph L, Brindis C. Access to reproductive healthcare for adolescents: establishing healthy behaviours at a critical juncture in the lifecourse. Curr Opin Obstet Gynecol. 2012;22:369–374.
    1. World Health Organization. In Caring for children and adolescents with mental disorders: Setting WHO directions. Geneva: WHO; 2003. Caring for children and adolescents with mental disorders: Setting WHO directions.
    1. UNAIDS. In Securing the future today: Synthesis of strategic information on HIV and Young People. Geneva: UNAIDS; 2011. Securing the future today: Synthesis of strategic information on HIV and Young People.
    1. World Health Organization. In Young people: health risks and solutions WHO Fact sheet N°345. Geneva: WHO; 2011. Young people: health risks and solutions WHO Fact sheet N°345.
    1. Merikangas KR, He J-p, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A) J Am Acad Child Adolesc Psychiatry. 2010;49:980–989. doi: 10.1016/j.jaac.2010.05.017.
    1. Kieling C, Baker-Henningham H, Belfer H, Conti G, Ertem I, Omigbodun O, Rohde L, Srinath S, Ulkuer N, Rahman A. Child and adolescent mental health worldwide: evidence for action. Lancet. 2011;378:1515–1525. doi: 10.1016/S0140-6736(11)60827-1.
    1. Lieu TA, Newacheck PW, McManus MA. Race, ethnicity, and access to ambulatory care among US adolescents. Am J Public Health. 1993;83:960–965. doi: 10.2105/AJPH.83.7.960.
    1. Dryfoos JG. Full service schools: revolution or Fad? J Res Adolesc. 1995;5:147–172. doi: 10.1207/s15327795jra0502_1.
    1. Richardson JW. Building bridges between school-based health clinics and schools. J Sch Health. 2007;77:337–343. doi: 10.1111/j.1746-1561.2007.00217.x.
    1. Dryfoos J. Full-service schools: A revolution in health and social services for children, youth and families. San Francisco, CA: Jossey-Bass; 1994.
    1. Bruininks R, Frenzel M, Kelly A. Integrating services: the case for better links to schools. J Sch Health. 1994;64:242–248. doi: 10.1111/j.1746-1561.1994.tb06195.x.
    1. Brindis CD, Klein J, Schlitt J, Santelli J, Juszczak L, Nystrom RJ. School-based health centers: accessibility and accountability. J Adolesc Health. 2003;32:98–107.
    1. Owen J, Carroll C, Cooke J, Formby E, Hayter M, Hirst J, Lloyd Jones M, Stapleton H, Stevenson M, Sutton A. School-linked sexual health services for young people (SSHYP): a survey and systematic review concerning current models, effectiveness, cost-effectiveness and research opportunities. Health Technol Assess. 2010;14:1–228.
    1. Motsoaledi A. In: In Health Budget Vote Policy Speech presented at the National Assembly by Minister of Health, Dr A Motsoaledi. Cape T, editor. Cape Town: Parliamentary Monitoring Group; 2011. Health Budget Vote Policy Speech presented at the National Assembly by Minister of Health, Dr A Motsoaledi.
    1. Balassone ML, Bell M, Peterfreund N. A comparison of users and nonusers of a school-based health and mental health clinic. J Adolesc Health. 1991;12:240–246. doi: 10.1016/0197-0070(91)90017-G.
    1. Anglin TM, Naylor KE, Kaplan DW. Comprehensive school-based health care: high school students' use of medical, mental health, and substance abuse services. Pediatrics. 1996;97:318–330.
    1. Amaral G, Geierstanger S, Soleimanpour S, Brindis C. Mental health characteristics and health-seeking behaviors of adolescent school-based health center users and nonusers*. J Sch Health. 2011;81:138–145. doi: 10.1111/j.1746-1561.2010.00572.x.
    1. Freudenberg N, Ruglis J. Reframing school dropout as a public health issue. Prev Chronic Dis. 2007;4:1–5.
    1. Kerns S, Pullmann M, Cusworth Walker S, Lyon A, Cosgrove T, Bruns E. Adolescent use of school-based health centers and high school dropout. Arch Pediatr Adolesc Med. 2011;165:617–623. doi: 10.1001/archpediatrics.2011.10.
    1. Van Cura M. The relationship between school-based health centers, rates of early dismissal from school, and loss of seat time. J Sch Health. 2010;80:371–377. doi: 10.1111/j.1746-1561.2010.00516.x.
    1. Clayton S, Chin T, Blackburn S, Echeverria C. Different setting, different care: integrating prevention and clinical care in school-based health centers. Am J Public Health. 2010;100:1592–1596. doi: 10.2105/AJPH.2009.186668.
    1. Kirby D, Waszak C, Ziegler J. Six school-based clinics: their reproductive health services and impact on sexual behavior. Fam Plann Perspect. 1991;23:6–16. doi: 10.2307/2135395.
    1. Ingram J, Salmon D. Young people's use and views of a school-based sexual health drop-in service in areas of high deprivation. Health Educ J. 2010;69:227–235. doi: 10.1177/0017896910364566.
    1. Fothergill K, Ballard E. The school-linked health center: A promising model of community-based care for adolescents. J Adolesc Health. 1998;23:29–38. doi: 10.1016/S1054-139X(98)00012-3.
    1. Wright T, Richardson JW, editor. School-based health care, advancing educational success and public health. Washington, DC: American Public Health Association; 2012.
    1. Peak GL, Hauser McKinney DL. Reproductive and sexual health at the school-based/school-linked health center: An analysis of services provided by 180 clinics. J Adolesc Health. 1996;19:276–281. doi: 10.1016/S1054-139X(96)00039-0.
    1. Ethier KA, Dittus PJ, DeRosa CJ, Chung EQ, Martinez E, Kerndt PR. School-based health center access, reproductive health care, and contraceptive use among sexually experienced high school students. J Adolesc Health. 2010;48:562–565.
    1. Kisker EE, Brown RS. Do school-based health centers improve adolescents' access to health care, health status, and risk-taking behavior? J Adolesc Health. 1996;18:335–343. doi: 10.1016/1054-139X(95)00236-L.
    1. Santelli J, Nystrom RJ, Brindis C, Juszczak L, Klein J, Bearss N, Kaplan D, Hudson M, Schlitt J. Reproductive health in school-based health centers: findings from the 1988–99 census of school-based health centres. J Adolesc Health. 2003;32:443–451. doi: 10.1016/S1054-139X(03)00063-6.
    1. Harold R, Harold N. School-based clinics: a response to the physical and mental health needs of adolescents. Health Soc Work. 1993;18:65–74.
    1. Adelman HS, Barker LA, Nelson P. A study of a school-based clinic: who uses it and who doesn't? J Clin Child Psychol. 1993;22:52–59. doi: 10.1207/s15374424jccp2201_5.
    1. Allison M, Crane L, Beaty B, Davidson A, Melinkovich P, Kempe A. School-based health centers: improving access and quality of care for low income adolescents. Pediatrics. 2007;120:e887–e894. doi: 10.1542/peds.2006-2314.
    1. Britto MT, Klostermann BK, Bonny AE, Altum SA, Hornung RW. Impact of a school-based intervention on access to healthcare for underserved youth. J Adolesc Health. 2001;29:116–124. doi: 10.1016/S1054-139X(01)00196-3.
    1. Coyne-Beasley T, Ford C, Waller M, Adimora A, Resnick M. Sexually active students' willingness to use school-based health centers for reproductive health care services in North Carolina. Ambul Pediatr. 2003;3:196–202. doi: 10.1367/1539-4409(2003)003<0196:SASWTU>;2.
    1. Guo J, Wade T, Keller K. Impact of school-based health centers on students with mental health problems. Public Health Rep. 2008;123:768–780.
    1. Jepson L, Juszczak L, Fisher M. Mental health care in a high school based health service. Adolescence. 1998;33:1–15.
    1. Juszczak L, Melinkovich P, Kaplan D. Use of health and mental health services by adolescents across multiple delivery sites. J Adolesc Health. 2003;32:108–118. doi: 10.1016/S1054-139X(03)00073-9.
    1. Kaplan D, Calonge N, Guernsey B, Hanrahan M. Managed care and school-based health centres. Arch Pediatr Adolesc Med. 1998;152:25–33.
    1. Langille D, Asbridge M, Kisely S, Leblanc M, Schaller E, Lynk A, Allen M. The relationship of sex and risk behaviours to students' use of school-based health centres in Cape Breton, Nova Scotia. Paediatr Child Health. 2008;13:605–609.
    1. Pastore D, Techow B. Adolescent school-based health care: A description of two sites in their 20th year of service. Mt Sinai J Med. 2004;71:191–196.
    1. Walter H, Vaughan R, Armstrong B, Krakoff R, Tiezzi L, MccCarthy J. Characteristics of users and nonusers of health clinics in inner-city junior high schools. J Adolesc Health. 1996;18:344–348. doi: 10.1016/1054-139X(95)00171-N.
    1. Weist M, Proescher E, Freedman A, Paskewitz D, Flaherty L. School-based health services for urban adolescents: psychosocial characteristics of clinic users vs nonusers. J Youth Adolesc. 1995;24:251–265. doi: 10.1007/BF01537152.
    1. Wolk LI, Rosenbaum R. The benefits of school-based condom availability: cross-sectional analysis of a comprehensive high school-based program. J Adolesc Health. 1995;17:184–188. doi: 10.1016/1054-139X(95)00031-M.
    1. Billy JOG, Grady WR, Wenzlow AT, Brener ND, Collins JL, Kann L. Contextual influences on school provision of health services. J Adolesc Health. 2000;27:12–24. doi: 10.1016/S1054-139X(99)00123-8.
    1. Bowlan N, Chevalier N, Gullo S, Lawrence L, Hinton Walker P. School-based care: clinical challenges and research opportunities. J Soc Pediatr Nurs. 1996;1:64–74. doi: 10.1111/j.1744-6155.1996.tb00003.x.
    1. Guo JJ, Wade TJ, Pan W, Keller KN. School-based health centers: cost-benefit analysis and impact on health care disparities. Am J Public Health. 2010;100:1617–1623. doi: 10.2105/AJPH.2009.185181.
    1. Szumilas M, Kutcher S, LeBlanc JC, Langille DB. Use of school-based health centres for mental health support in Cape Breton, Nova Scotia. Can J Psychiatry. 2010;55:319–328.
    1. Soleimanpour S, Geierstanger SP, Kaller S, McCarter V, Brindis CD. The role of school health centers in health care access and client outcomes. Am J Public Health. 2010;100:1597–1603. doi: 10.2105/AJPH.2009.186833.
    1. Alexander E. School-based clinics: questions to be answered in planning stages. High Sch J. 1989;73:133–138.

Source: PubMed

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