A school-based comprehensive health clinic for adolescents

School-based clinic use and school performance

School-based health clinics (SBCs) have been promoted as an innovative approach to providing adolescent health care. The present study examined the effect of a SBC on academic success. We studied the effect of clinic registration and use on students' absence, suspension, withdrawal, and graduation or promotion rates in an alternative high school for students who were not able to succeed in traditional educational programs. On average, these 322 high-risk students attended school only 56% of the time; 24% were suspended; and only 26% graduated or were promoted. The 189 (59%) students who were registered to use the clinic and the 159 (49%) who actually used the clinic were as likely to be absent or to be suspended as non-registered students. However, students who used the clinic were significantly more likely to stay in school, and to graduate or be promoted than students who were not registered for the clinic. This relationship was strongest for black males; those who used the clinic were nearly three times [odds ratio = 0.35; 95% confidence interval (CI) = (0.16-0.78)] more likely to stay in school than those who did not use the clinic. In multiple linear regression models predicting school performance, only clinic use and percent of enrolled days absent were significantly associated with graduation/promotion, and these two variables predicted 23% of the variance in promotion status.

[Description and evaluation of the counseling and consultation activities performed by public health nurses for apprentices and students in Vaud: the youth and health program]

Since 1983 apprentices and students 16-19 years of the Canton of Vaud (Switzerland) have been offered various activities in the frame of a school-based health promotion program called "Jeunesse et Santé" (screening, health education...). This paper focuses on the description and the evaluation of emergency care and counseling activities ran by nurses in each school. During one and a half year, 969 adolescents have presented themselves for medical reasons (40%), or for problems of psychosomatic (30%) or psycho-social (30%) nature. Most of the pupils have consulted either spontaneously (40%) or after a screening procedure (40%). 297 youngsters have been sent to another institution for further evaluation and treatment (personal physician, outpatient clinic, social services). Three months after the first consultation, the nurses have contacted both the adolescents an the institutions for an evaluation: A large part of the pupils is satisfied with the help they have received (greater than 90%). However the follow-up seems more difficult to organize and less effective for the adolescents that have presented themselves with psychosocial problems. The paper ends with the advantages and the limitations of ambulatory research performed in the frame of school health activities.