Measuring the impact of school based health centers on student outcomes: An evaluation of school health connection in new orleans

Since 2009, the Louisiana Public Health Institute's (LPHI) School Health Connection (SHC) program has funded and provided technical support to School-Based Health Centers (SBHCs) in a subset of New Orleans public high schools. This paper assesses the role of part-time and full-time SBHCs in improving adolescent health outcomes and risk behaviors. Surveys of high school students in schools with and without SBHCs were conducted in 2009 and again in 2012. Multivariate regression analysis was used to estimate the adjusted effects on student health outcomes of being in a school with a full time SBHC relative to a school with a part time SBHC or no SBHC. Relative to students without an SBHC, students in schools with a full-time SBHC were less likely to report unmet need for health care than students without access to an SBHC (p=0.0357), and were more likely to have ever talked to a mental health counselor (p=0.0179); talked to a mental health counselor in the last 12 months (p=0.0019); used SBHC behavioral health in the last 12 months (p=0.0057); been tested for HIV (p=0.0209); and been tested for STDs (p=0.0357). Students in schools with only a part-time SBHC fared no better on nearly all outcomes relative to students in schools without an SBHC. The paucity of significant effects on student health outcomes from part-time SBHCs brings into question the value of such services, while the presence of a full-time SBHC shows promise in yielding considerable improvements in key adolescent outcomes and risk behaviors.