The Impact of School-Based Health Centers on the Health Outcomes of Middle School and High School Students

Objectives. We studied the direct and indirect effects of school-based health centers (SBHCs) on the health and health behaviors of middle and high school students. Methods. We used a prospective cohort design to measure health outcomes annually over 2 consecutive years by student self-report. Cohorts of middle school and high school students were recruited from matched schools with and without SBHCs. Data were obtained from 744 students in both year 1 and year 2 of the study. We used 2-level hierarchical linear models to estimate the effects of the presence of SBHCs at the school level and of SBHC use at the student level. Results. At year 2, users of SBHCs experienced greater satisfaction with their health, more physical activity, and greater consumption of healthy food than did nonusers of SBHCs. Conclusions. Students who used SBHCs were more satisfied with their health and engaged in a greater number of health-promoting behaviors than did students who did not use SBHCs. These findings indicate that SBHCs are achieving their goal of promoting children's health. (Am J Public Health. 2010; 100:1604-1610. doi:10.2105/AJPH.2009.183590)