Patricia J Dittus1, Christine J De Rosa2, Robin A Jeffries2, Abdelmonem A Afifi3, William G Cumberland3, Emily Q Chung4, Esteban Martinez2, Peter R Kerndt5, Kathleen A Ethier6. 1. Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: pdittus@cdc.gov. 2. Los Angeles County Department of Public Health, Division of HIV and STD Programs, Los Angeles, California; Institute for Health Promotion and Disease Prevention Research, University of Southern California, Los Angeles, California. 3. Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California. 4. Los Angeles County Department of Public Health, Division of HIV and STD Programs, Los Angeles, California. 5. Los Angeles County Department of Public Health, Tuberculosis Control Program, Los Angeles, California. 6. Centers for Disease Control and Prevention, Atlanta, Georgia.
Abstract
PURPOSE: To evaluate a health systems intervention to increase adolescents' receipt of high-quality sexual and reproductive health care services. METHODS: Quasi experimental design. Twelve high schools in a large public school district were matched into pairs. Within each pair, schools were assigned to condition so that no control school shared a geographic border with an intervention school. Five yearly surveys (T1, T2, …, T5) were administered from 2005 to 2009 (N = 29,823) to students in randomly selected classes in grades 9-12. Community-based providers of high-quality sexual and reproductive health care services were listed on a referral guide for use by school nurses to connect adolescents to care. RESULTS: Statistically significant effects were found for intervention school females on three outcomes, relative to controls. Relative to T1, receipt of birth control in the past year was greater at T4 (adjusted odds ratio [AOR] = 1.85; 95% confidence interval [CI], 1.09-3.15) and T5 (AOR = 2.22; 95% CI, 1.32-3.74). Increases in sexually transmitted disease testing and/or treatment in the past year were greater in T1-T3 (AOR = 1.78; 95% CI, 1.05-3.02), T1-T4 (AOR = 1.73; 95% CI, 1.01-2.97), T1-T5 (AOR = 1.97; 95% CI, 1.17-3.31), and T2-T5 (AOR = 1.76; 95% CI, 1.06-2.91). Increases in ever receiving an HIV test were greater in T1-T4 (AOR = 2.14; 95% CI, 1.08-4.26). Among males, no intervention effects were found. CONCLUSIONS: A school-based structural intervention can improve female adolescents' receipt of services. Published by Elsevier Inc.
PURPOSE: To evaluate a health systems intervention to increase adolescents' receipt of high-quality sexual and reproductive health care services. METHODS: Quasi experimental design. Twelve high schools in a large public school district were matched into pairs. Within each pair, schools were assigned to condition so that no control school shared a geographic border with an intervention school. Five yearly surveys (T1, T2, …, T5) were administered from 2005 to 2009 (N = 29,823) to students in randomly selected classes in grades 9-12. Community-based providers of high-quality sexual and reproductive health care services were listed on a referral guide for use by school nurses to connect adolescents to care. RESULTS: Statistically significant effects were found for intervention school females on three outcomes, relative to controls. Relative to T1, receipt of birth control in the past year was greater at T4 (adjusted odds ratio [AOR] = 1.85; 95% confidence interval [CI], 1.09-3.15) and T5 (AOR = 2.22; 95% CI, 1.32-3.74). Increases in sexually transmitted disease testing and/or treatment in the past year were greater in T1-T3 (AOR = 1.78; 95% CI, 1.05-3.02), T1-T4 (AOR = 1.73; 95% CI, 1.01-2.97), T1-T5 (AOR = 1.97; 95% CI, 1.17-3.31), and T2-T5 (AOR = 1.76; 95% CI, 1.06-2.91). Increases in ever receiving an HIV test were greater in T1-T4 (AOR = 2.14; 95% CI, 1.08-4.26). Among males, no intervention effects were found. CONCLUSIONS: A school-based structural intervention can improve female adolescents' receipt of services. Published by Elsevier Inc.
Entities:
Keywords:
Adolescent; Adolescent health services; HIV; Reproductive health; STD
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