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Titolo:
Impact of a school-based intervention on access to healthcare for underserved youth
Autore:
Britto, MT; Klostermann, BK; Bonny, AE; Altum, SA; Hornung, RW;
Indirizzi:
Univ Cincinnati, Childrens Hosp, Ctr Med, Div Adolescent Med, Cincinnati, OH 45229 USA Univ Cincinnati Cincinnati OH USA 45229 ent Med, Cincinnati, OH 45229 USA Univ Cincinnati, Inst Hlth Policy, Cincinnati, OH USA Univ Cincinnati Cincinnati OH USA , Inst Hlth Policy, Cincinnati, OH USA Univ Cincinnati, Hlth Serv Res, Cincinnati, OH USA Univ Cincinnati Cincinnati OH USA ati, Hlth Serv Res, Cincinnati, OH USA
Titolo Testata:
JOURNAL OF ADOLESCENT HEALTH
fascicolo: 2, volume: 29, anno: 2001,
pagine: 116 - 124
SICI:
1054-139X(200108)29:2<116:IOASIO>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
MEDICAL OUTCOMES; CARE; ADOLESCENTS; SERVICES; CONFIDENTIALITY; PERCEPTIONS;
Keywords:
adolescent; school-based intervention; evaluation; access to care; health status;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
23
Recensione:
Indirizzi per estratti:
Indirizzo: Britto, MT Univ Cincinnati, Childrens Hosp, Ctr Med, Div Adolescent Med, 3333 Burnet Ave, Cincinnati, OH 45229 USA Univ Cincinnati 3333 Burnet Ave Cincinnati OH USA 45229 229 USA
Citazione:
M.T. Britto et al., "Impact of a school-based intervention on access to healthcare for underserved youth", J ADOLES H, 29(2), 2001, pp. 116-124

Abstract

Purpose: To determine whether a multidimensional school-based intervention, which included physical and mental health services, increased adolescents' use of needed medical care and preventive care and decreased emergency room use. Methods: A total of 2832 seventh- through twelfth-grade students in six public urban intervention schools and 2036 students in six demographically matched comparison schools completed a previously validated survey regarding health status and healthcare utilization in spring 1998 and 1999. Bivariateanalyses examined the association between intervention status and Year 1/Year 2 outcomes. The multifaceted intervention included programs such as anger management groups, substance abuse prevention, tutoring, home visits, and enhanced school health services. Stepwise multivariate logistic models tested differences between the intervention and comparison groups across years, controlling for potential confounding variables [gender, age, race/ethnicity, maternal education, grade in school, school district (city or county), health status, and chronic health problems]. The interaction term for Group X Year was used to test the effect of the intervention. Multivariable modeling was also used to determine student factors independently associated with healthcare utilization. Results: Respondents had a median age of 15 years, 56% were female, 51% were white, 42% were black, and 34% reported chronic health problems. In bothyears, over 45% of students in both groups reported not seeking medical care they believed they needed. The proportion with missed care in the intervention schools did not change, whereas the proportion with missed care in the comparison schools increased. Emergency room use decreased slightly in the intervention schools and increased slightly in the comparison schools between Year 1 and Year 2. There were no major changes in healthcare deliveryin this area during the year, demonstrating the volatility of adolescents'perceived access to care. Among the student factors, health status, havinga chronic condition, and being in a higher grade were independently associated with students' report of not seeking care they believed they needed. Conclusion: These results confirm that many adolescents have unmet healthcare needs. Those with poor health status are most likely to report underutilization and unmet needs. These findings underscore the need for comparisongroups when evaluating interventions and suggest the need for better understanding of community level changes in perceived healthcare access and use. (C) Society for Adolescent Medicine, 2001.

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Documento generato il 01/04/20 alle ore 01:47:39