Student Perceptions and Utilization of School-Based Health Centers in Los Angeles: Results of an STD Prevention Campaign

Background: Research has demonstrated that adolescents with access to a school-based health center (SBHC) are more likely to receive reproductive preventive care, including chlamydia screening. In the Los Angeles Unified School District (LAUSD) a network of 14 SBHCs known as Wellness Centers serve students and community members, managed by local Federally Qualified Health Centers. In 2015, we evaluated an STD prevention campaign to address low student awareness and utilization of SBHCs.

Methods:  In response to low student utilization of the Wellness Centers, annual student-led STD awareness events target peers with messages about STDs, minor rights to confidential services, and Wellness Center services. 45,573 outreach contacts were made during 2015 student-led STD awareness events at 14 school sites. Students at 3 LAUSD school sites were surveyed to evaluate the reach and impact of campaign messages. A total of 720 pre- and post-campaign surveys were collected and an inductive content analysis approach was used to identify major themes regarding student perceptions of the Wellness Centers.

Results: Data analysis demonstrated that survey respondent demographics were representative of LAUSD’s diverse, majority racial/ethnic minority student population. Following the STD awareness campaigns, survey respondents reported increases in knowledge of Wellness Center location (40%), knowledge of minor rights to confidential services (57%), and having visited a Wellness Center (139%). Additionally, expressed interest in accessing sexual & reproductive health services doubled (8% vs 15% of positive responses); however, respondents did not report increased intention to utilize a Wellness Center for sexual health services following campaign implementation.

Conclusions: Qualitative data indicates that future STD Prevention campaigns should address perceived stigma associated with seeking services at Wellness Centers as well as further technical assistance around adolescent-friendly service delivery for Wellness Center clinical staff.