Academic, Psychosocial, and Demographic Correlates of School-Based Health Center Utilization: Patterns by Service Type

Abstract

Background Despite the promise of school-based health centers (SBHCs) as crucial source of mental health care for youth, accumulated literature describing how SBHCs are typically arranged, patterns of service utilization, and, ultimately, effects of services delivered through SBHCs is limited. Objective This study's aim was as disentangle the types of services provided into determine unique predictors of service use with the overall goals of making an incremental step towards understanding SBHC intervention effects and implementation challenges. Method This study used student-level administrative and survey data to examine academic, psychosocial, and demographic correlates of SBHC utilization by type of service (i.e., medical services, general counseling, and behavioral health counseling). The sample includes all students from one high school with a SBHC in a large urban district (n = 658). Logistic regression models were used to identify factors that uniquely contributed to service use. Results The strongest predictors of SBHC utilization overall were race, special education participation, and GPA. With regard to behavioral health services, demographic background (i.e. Black and Latino), special education participation, and violence victimization or perpetration predicted use. With regard to general counseling, being female was the strongest predictor of service use. For medical services, age and special education participation predicted use. Conclusion Heterogeneous student characteristics (e.g., demographic, academic, and psychosocial) are related to utilization of school-based health and mental health services. Future research must address the student characteristics that predict service use in order to minimize selection bias which may skew the results intended to document the impact of SBHCs on student outcomes.

Student and Teacher Perspectives of Service Utilization at Their School-based Health Center

“…Additionally, there is evidence that young African American men have specific health and health care needs. Previous research suggests that African American students-males in particular-are more likely to utilize SBHC services (Bains et al, 2014;Whitaker et al, 2019), and it would be inappropriate to generalize our findings to young women's or non-African American students' experiences with SBHCs. The small number of teachers who participated in focus groups presents another limitation.…”

Coming to College Hungry

“…The dummy variable adjustment method is a common method for dealing with missing data and is beneficial for retaining sample size (Allison, 2002(Allison, , 2010Puma et al, 2009). Furthermore, this technique can be widely found in published education and higher education-focused research (Adamecz-Völgyi et al, 2020;Crawford & Erve, 2015;Fitzpatrick, 2019;Marcenaro-Gutierrez et al, 2016;Whitaker et al, 2019).…”

Which Children Use School‐Based Health Services as a Primary Source of Care?*

“…SBHCs cover a wide range of services, including behavioral and reproductive health. 5 While SBHC use is more common among uninsured children, as well as Black, Hispanic, and Native American children, [6][7][8] prior studies have not considered the extent to which this use of SBHC services implies that school-based health care providers assume the role of the child's medical home. The medical home care model encompasses 5 subcomponents defining care that is (1) a usual source of sick care, (2) provides a personal doctor or nurse, (3) provides referral access, (4) offers care coordination, and (5) has a family-centered care approach.…”