The Relationship Between the Use of Health Clinics in Rural Mississippi Schools and the CHIP-AE Adolescent Health Profile

Abstract

School health clinics are one way to meet the objectives in Healthy People 2010 for adolescent health. To determine the relationship between adolescent health status and use of the school health clinics in four Mississippi high schools, the Child Health and Illness Profile-Adolescent Edition (CHIP-AE) was used. The CHIP-AE identifies health status, giving scores on resilience, comfort, risks, and satisfaction, resulting in health profiles. One hundred seventy-one 9th-graders participated in this descriptive study. Students with the highest discomfort and risk scores had no use of the school health clinic. Students with fair health profiles were the highest users of the school health clinic when compared to all other profiles. Of those students with very poor health status, 60% reported the school health clinic was their only source of health care. In this study, the term school health clinic refers to the health office staffed by a nurse without an advanced degree.

Predictors of lifestyle behaviors, trust of health care provider, and utilization of health services among adolescents living in a rural area.

“…With this sample, self-rated health had a significant negative relationship with having a HCP diagnosed condition, which means that poorer health was associated with having at least one HCP-diagnosed condition. In other studies, fair or poor self-rated health has been associated with increased rates of chronic health conditions such as asthma, diabetes, overweight, and obesity (Fosse & Haas, 2009), as well as increased rates of health services utilization (Bradford, 2007). In this study, fair or poor self-rated health was also positively associated with diabetes, overweight, and obesity, in addition to depression and hypertension.…”

“…In this study, need included perceived need (self-rated health, selfperceived need, foregone care) and evaluated need (diagnosed conditions). Self-rated health and diagnosed conditions are strong predictors of utilization of health services among adolescents, while foregone care reports an unmet need for health services and accounts for subjective barriers to utilization of health services (Bradford & O'Sullivan, 2007).…”

“…Foregone care over the past three months was reported by 37% of participants (Bradford & O'Sullivan, 2006). Of those reporting foregone care, the following reasons were given with percentage of participants reporting the reason: (1) thought the problem would go away (63.9%), (2) did not want to miss school (37.1%), (3) afraid of what the doctor might say (19.7%), (4) afraid parents might find out (13.1%), (5) could not get an appointment (9.8%), (6) could not get out of class (9.8%), (7) had no transportation (6.6%), (8) could not pay/no insurance (6.6%), (9) parent or guardian would not go (4.9%), and (10) did not know where to go or whom to see (3.3%) (Bradford & O'Sullivan, 2007).…”

“…Self-rated health is an important indicator of overall wellness because the individual is able to indicate subjective health conditions that may not reveal themselves on narrow measurements of health. Among adolescents, fair or poor self-rated health is associated with chronic health conditions such as asthma, diabetes, overweight, and obesity (Fosse & Haas, 2009) as well as increased rates of health services utilization (Bradford, 2007).…”

Gender and Ethnic Differences in Health-Promoting Behaviors of Rural Adolescents

“…Importantly, the health behavior of adolescents living in rural communities is studied less often than those of youth in urban or suburban environments—particularly those from racial/ethnic minority backgrounds (Curtis, Waters, & Brindis, 2011). For example, a survey of health status and clinic use among ninth graders in rural Mississippi yielded a response rate of only 27.6% for a mostly White school and a 2.6% response rate for a school that was predominantly African American (Bradford & O’Sullivan, 2007). Compared to urban and suburban areas, rural areas rank low in most population health indicators including health behaviors and maternal and child health (Hartley, 2004).…”