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Heather J. Walter, MD, MPH; Roger D. Vaughan, MS; Bruce Armstrong, DSW; Roberta Y. Krakoff, ACSW; Lorraine Tiezzi, MS; James F. McCarthy, PhD

Arch Pediatr Adolesc Med. 1995;149(11):1221-1225.

Abstract
Objective
To describe the use of school-based health clinics by urban minority junior high school students.

Design
Review of demographic and utilization data collected by service providers during clinic visits.

Settings and Participants
Health clinics in four junior high schools that enrolled predominantly Hispanic students who were residing in an economically disadvantaged, medically underserved New York (NY) school district.

Results
Of5757 students who were enrolled in the schools, 5296 (92%) obtained parental consent to use the clinics, and 3723 (65%) used the clinics during the 1991-1992 academic year. Clinic users were 11 to 15 years old, 50% male and 50% female, 81% Hispanic and 14% black, and 29% sixth graders, 33% seventh graders, and 38% eighth graders. Clinic users made 16 340 clinic visits during the 1991-1992 academic year. Presenting complaints were mental health problems (32%), illness (14%), injury (12%), physical examination (5%), immunization (3%), follow-up (21%), and other (13%). Referral sources were clinic outreach (48%), self (44%), and school personnel (8%). Disposition of visits was on-site treatment (92%), referral to an affiliated hospital (5%), and referral elsewhere (3%). Compared with a nationwide group of high school–based clinics that served predominantly black adolescents, these clinics provided more mental health care (31% vs 21%), similar illness/injury care (32% vs 30%), and less preventive (10% vs 24%) and reproductive/contraceptive (7% vs 12%) care.

Conclusions
Junior high school–based clinics can provide a wide range of primary and preventive health care services for large numbers of medically underserved youths. The provision of mental health services may fill a critical need among inner-city adolescents. Clinic outreach may be necessary to maximize utilization, especially among high-risk students.

(Arch Pediatr Adolesc Med. 1995;149:1221-1225)

Author Affiliations
From the Center for Population and Family Health, Columbia University School of Public Health, New York, NY. Dr Walter is now with the Department of Child and Adolescent Psychiatry, Children's Memorial Hospital, Chicago, Ill.

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