An observational study of adolescent health outcomes associated with school-based health service utilization: A causal analysis.
Adolescent
Adolescent Health
Depression
/ epidemiology
Emotions
Female
Humans
Male
Mental Disorders
/ epidemiology
Mental Health Services
/ organization & administration
New Zealand
Patient Acceptance of Health Care
/ statistics & numerical data
School Health Services
/ organization & administration
Socioeconomic Factors
Substance-Related Disorders
/ epidemiology
Suicide
/ statistics & numerical data
Suicide Prevention
adolescent
delivery of health care
instrumental variable analyses
school health services
Journal
Health services research
ISSN: 1475-6773
Titre abrégé: Health Serv Res
Pays: United States
ID NLM: 0053006
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
pubmed:
19
3
2019
medline:
30
1
2020
entrez:
19
3
2019
Statut:
ppublish
Résumé
Our aim is to examine the unbiased association between use of school-based health services (SBHS) and student health outcomes. Data are from a nationally representative health and well-being survey of 8500 New Zealand high school students from 91 high schools. 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. 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. 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. These analyses suggest that team-based SBHS are associated with better mental health among students who attend them.
Identifiants
pubmed: 30883726
doi: 10.1111/1475-6773.13136
pmc: PMC6505405
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
678-688Subventions
Organisme : Ministries of Youth Development, Social Development, Health, Education and Justice
Pays : International
Organisme : Department of Labour; Families Commission
Pays : International
Organisme : Alcohol Advisory Council of New Zealand
Pays : International
Informations de copyright
© Health Research and Educational Trust.
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