The role of community health centers in providing preventive care to adolescents

V. A. Hedberg, R. S. Byrd, J. D. Klein, P. Auinger and M. Weitzman
Division of Adolescent Medicine, University of Rochester (NY) School of Medicine and Dentistry, USA.

OBJECTIVES: To (1) compare preventive health visits by poor and nonpoor adolescents, (2) describe adolescent users of community health centers (CHCs), (3) investigate adolescent preventive visits to CHCs, and (4) determine factors independently associated with timely preventive visits. DESIGN: Analysis of the nationally representative sample of 6635 adolescents aged 11 to 17 years in the Child Health Supplement to the 1988 National Health Interview Survey. RESULTS: Overall, 4% of US adolescents used CHCs for routine health care, and the percentage was higher for poor compared with nonpoor adolescents (11% vs 3%, P < .01). Although CHC users were more likely to be poor (41% vs 10%, P < .001), uninsured (23% vs 10%, P < .001), and to have behavior (16% vs 9%, P = .02) and school problems (56% vs 43%, P < .001), they were as likely to have had timely preventive visits (83% vs 81%, P = .61) as adolescents who used private practices. Using logistic regression, timely adolescent preventive visits were independently associated with having a source for routine care (odds ratio, 4.1; 95% confidence interval, 3.3-5.2), a chronic health condition (odds ratio, 1.2; 95% confidence interval, 1.0-1.5), and the use of seat belts all or most of the time (odds ratio, 1.4; 95% confidence interval, 1.2-1.6), but no independent association was observed between poverty status and timely preventive visits. CONCLUSIONS: Community health centers are an important source of preventive care for impoverished adolescents. Although those who use CHCs have greater psychosocial problems, they seek preventive care as regularly as those using private practices. Thus, periodic comprehensive visits may be an effective strategy for CHCs to provide preventive services to adolescents.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Achieving Quality Health Services for Adolescents
Committee on Adolescence
Pediatrics 2008;121:1263-1270.
ABSTRACT | FULL TEXT  

Effect of a Pediatric Practice-Based Smoking Prevention and Cessation Intervention for Adolescents: A Randomized, Controlled Trial
Pbert et al.
Pediatrics 2008;121:e738-e747.
ABSTRACT | FULL TEXT  

How Effectively Can Health Care Settings Beyond the Traditional Medical Home Provide Vaccines to Adolescents?
Schaffer et al.
Pediatrics 2008;121:S35-S45.
ABSTRACT | FULL TEXT  

A Longitudinal Study of the Prevalence, Development, and Persistence of HIV/Sexually Transmitted Infection Risk Behaviors in Delinquent Youth: Implications for Health Care in the Community
Romero et al.
Pediatrics 2007;119:e1126-e1141.
ABSTRACT | FULL TEXT  

Smoking Prevention and Cessation Intervention Delivery by Pediatric Providers, as Assessed With Patient Exit Interviews
Pbert et al.
Pediatrics 2006;118:e810-e824.
ABSTRACT | FULL TEXT  

Health Center Trends, 1994-2001: What Do They Portend For The Federal Growth Initiative?
O'Malley et al.
Health Aff (Millwood) 2005;24:465-472.
ABSTRACT | FULL TEXT  

The State of Office-Based Interventions for Youth Tobacco Use
Pbert et al.
Pediatrics 2003;111:e650-660.
ABSTRACT | FULL TEXT  

Direct Observation of Health-Habit Counseling of Adolescents
Goodwin et al.
Arch Pediatr Adolesc Med 1999;153:367-373.
ABSTRACT | FULL TEXT  

Adolescents' Access to Care: Teenagers' Self-reported Use of Services and Perceived Access to Confidential Care
Klein et al.
Arch Pediatr Adolesc Med 1998;152:676-682.
ABSTRACT | FULL TEXT