An observational study of adolescent health outcomes associated with school‐based health service utilization: A causal analysis

Autor:	Jennifer Utter, Sue Grant, Simon Denny, Terryann Clark, Ross Galbreath, Theresa Fleming
Rok vydání:	2019
Předmět:	Male Mental Health Services Suicide Prevention Adolescent Substance-Related Disorders media_common.quotation_subject Emotions education Adolescent Health Poison control Suicide prevention Occupational safety and health 03 medical and health sciences 0302 clinical medicine International Research Health care Humans 030212 general & internal medicine School Health Services media_common Selection bias Suicide attempt Depression business.industry Mental Disorders 030503 health policy & services Health Policy Patient Acceptance of Health Care Mental health Suicide Socioeconomic Factors Female 0305 other medical science business Psychology New Zealand Clinical psychology Adolescent health
Zdroj:	Health Serv Res
ISSN:	1475-6773 0017-9124
DOI:	10.1111/1475-6773.13136
Popis:	Objective Our aim is to examine the unbiased association between use of school-based health services (SBHS) and student health outcomes. Data sources Data are from a nationally representative health and well-being survey of 8500 New Zealand high school students from 91 high schools. Study design Student data were linked to the level of SBHS available to them: no SBHS, regular clinics from visiting health professionals, a health professional onsite, or a health team onsite. Data collection/extraction methods Causal analyses are used to compare utilization of SBHS and their association with student-reported health outcomes, including foregone health care, depressive symptoms, emotional and behavioral difficulties, suicide risk, substance use, and unsafe sexual behaviors. Principal findings Results from the multinomial propensity score-weighted regressions show that the use of SBHS was associated with poorer health outcomes, suggesting that selection bias was present due to unmeasured confounders. Instrumental variable analyses found that that students using team-based SBHS had a 4.7 percent (95% CI 0.5-8.9) probability of high levels of depressive symptoms compared to 14.2 percent (95% CI 11.5-16.8) among students not using team SBHS. For suicide attempt, students using team-based SBHS had a 2.0 percent (95% CI -0.3-4.2) probability of a suicide attempt in the previous 12 months compared to 5.6 percent (95% CI 2.6-8.5) among students not using team SBHS. Conclusions These analyses suggest that team-based SBHS are associated with better mental health among students who attend them.
Databáze:	OpenAIRE
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