Gorette Amaral, MHS¹, Sara Peterson, MPH¹, Samira Soleimanpour, MPH¹, and Claire Brindis, DrPH². (1) Institute for Health Policy Studies, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94143, 415-476-8621, samira@itsa.ucsf.edu, (2) Center for Reproductive Health Research and Policy, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94143

In order to understand the health-seeking behaviors of school-based health center (SBHC) users versus non-users, this study analyzed survey data from 1999-2002 on 4,483 students from seven California high schools with SBHCs. Twenty-eight percent of respondents had used their school's SBHC. Only 7% of users identified SBHCs as their main source of care. More commonly, SBHCs were a secondary source of care, indicated by 26% of users. Forty-one percent of students identified Kaiser and 33% identified a private practice as their main source of care, with no significant differences between users and non-users. Multivariate logistic regression analysis revealed that insurance status was unrelated to the likelihood of seeking general SBHC services. However, compared to privately insured students, being uninsured (Odds ratio=1.64;95% CI:1.20-2.23) or on public assistance (Odds ratio=1.63;95% CI:1.24-2.14) significantly increased the odds of using SBHCs specifically for mental health services. SBHC users were more likely to have received preventive services in the past year, including a checkup (36% of users, 31% of non-users, p<0.01), sports physical (22%, 16%, p<0.01), contraceptive visit (7%, 2%, p<0.01), or counseling (6%, 3%, p<0.01). Users did not differ from non-users in their seeking of care for injuries (11%, 10%, p=0.32) or minor illnesses (8%, 8%, p=0.80). This study suggests that while few SBHC clients identified SBHCs as their primary source of healthcare, SBHCs complement other healthcare settings by encouraging utilization of important preventive services. The provision of mental health services in particular may fill a need among adolescents with public or no insurance.

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