Comprehensive School‐Based Services for Pregnant and Parenting Adolescents in West Dallas, Texas

Abstract

A cohort of 339 Black (n = 210), Hispanic (n = 118), and other (n = 11) adolescent mothers in Dallas, Texas, were followed from the start of their pregnancy through the school year of the delivery to assess differences in numbers of prenatal care visits, postpartum care, repeat deliveries, and school continuation rates. Approximately one-half the teens received reproductive services at a comprehensive, school-based clinic and one-half at a categorical (Title XX) family planning and prenatal care clinic. Adolescents attending the school-based clinic were more likely to be in school at conception and averaged more prenatal visits than those served by the categorical provider. However, during the pregnancy and following the delivery, school dropout rates for the two sets of teens converged. School continuation rates were higher among a subset of adolescents attending the Dallas Independent School District school for pregnant teens than among other teens. Hispanic teens were two times more likely than their Black counterparts to drop out of school. No differences were found in repeat birth rates, by ethnicity, clinic site, or school attended.

School-Based Health Centers to Advance Health Equity

“…Seventeen studies in 18 papers 46–49,56,65–69,74,78,85,88,89,91,92,94 assessed SBHC user–only effects by comparing users with non-users within SBHC schools (eight studies 46,68,69,78,88,91,92,94 ) or SBHC users with users of healthcare sources in non-SBHC settings (nine studies in ten papers 47–49,56,65–67,74,85,89 ). Four studies 59,76,78,90 assessed both whole-school and SBHC user–only effects.…”

“…Results of this review are largely applicable to the urban context, as only ten studies in 11 papers 51,52,58,70,72,75,76,79,90,92,96 were conducted in mixed rural and urban or suburban areas, and none in predominantly rural areas. Applicability to younger grade levels is limited, as most studies (26 studies in 28 papers 46–49,52,54,55,59,62,65,66,68–74,81,82,85,87,89,91,92,94,96,97 ) evaluated high school SBHCs, whereas one study 83 assessed middle school SBHCs, seven studies 57,58,67,77,83,93,95 evaluated pre-Kindergarten or elementary school SBHCs, and the remaining 12 studies 51,56,60,61,75,76,78,79,84,86,88,90 assessed combinations of grade levels.…”

Health care access, sexually transmitted diseases, and adolescents: Identifying barriers and creating solutions

“…Improved outcomes for infants are also associated with participation in school-based clinics. 83,85,87,108 Every effort must be made to provide comprehensive, on-site services. Clinics offering only limited medical care for students should endeavor to broaden their menu of services to include reproductive health and sexuality issues such as contraceptive counseling and provision, screening and treatment for STDs, pregnancy-related care, anticipatory guidance, mental health assessment and therapy, and substance abuse counseling.…”

Career Aspirations and Pregnancy Intentions in Pregnant Teens

“…3e8 Programs such as schoolbased health clinics exist, in part, for the benefit of teen mothers who are in school; however, these programs generally end with the completion of high school. 9,10 Although educational achievement is lower for teen mothers, their aspirations do not necessarily differ from those of teens who do not become pregnant during adolescence. Consistent with statistics reported for the general population of adolescents, 11 nearly all adolescent mothers express the desire to complete high school and 50e80% aspire to pursue post-secondary education.…”