Original article
Structural Intervention With School Nurses Increases Receipt of Sexual Health Care Among Male High School Students

https://doi.org/10.1016/j.jadohealth.2017.07.017Get rights and content

Abstract

Purpose

Adolescent males are less likely to receive health care and have lower levels of sexual and reproductive health (SRH) knowledge than adolescent females. The purpose of this study was to determine if a school-based structural intervention focused on school nurses increases receipt of condoms and SRH information among male students.

Methods

Interventions to improve student access to sexual and reproductive health care were implemented in six urban high schools with a matched set of comparison schools. Interventions included working with school nurses to improve access to sexual and reproductive health care, including the provision of condoms and information about pregnancy and sexually transmitted disease prevention and services. Intervention effects were assessed through five cross-sectional yearly surveys, and analyses include data from 13,740 male students.

Results

Nurses in intervention schools changed their interactions with male students who visited them for services, such that, among those who reported they went to the school nurse for any reason in the previous year, those in intervention schools reported significant increases in receipt of sexual health services over the course of the study compared with students in comparison schools. Further, these results translated into population-level effects. Among all male students surveyed, those in intervention schools were more likely than those in comparison schools to report increases in receipt of sexual health services from school nurses.

Conclusions

With a minimal investment of resources, school nurses can become important sources of SRH information and condoms for male high school students.

Section snippets

Participants and procedure

Twelve high schools in attendance areas1 with rates of chlamydia and births among 15- to 19-year-olds exceeding Healthy People 2010 [13] goals participated in Project Connect. Schools were selected and matched based on size and demographics, availability of a school-based health center, and geography. Schools from each pair were purposively assigned to either the intervention or the

Results

Male students in the sample were, on average, 16.3 years old (SD = 1.36), 80.4% were Latino, and 9.1% were identified as African-American. More than half (52.1%) reported having engaged in sexual intercourse. Two fifths (40.1%) of the sample reported having gone to the school nurse in the past year, with 12.1% reporting having gone to the school nurse for either condoms or SRH information. Table 1 contains demographic information for the sample at baseline, by intervention group. There were

Discussion

Research suggests, and previous analyses on Project Connect confirm, that efforts to increase receipt of reproductive health care often fail with males. The current analyses indicate that intervening with school nurses may be an effective strategy for increasing both visits to and receipt of services. The effects demonstrate that changing environments for youth takes time but that the impact can be significant and long-lasting. Although we did not see differences between males in comparison and

Funding Sources

This research was supported by the CDC (U30/CCU922283-01). This project was supported in part by an appointment to the Research Participation Program at the CDC administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and the CDC.

References (21)

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Conflicts of Interest: The authors have no conflicts of interest to disclose.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine.