STUDENT ATTITUDES TOWARD SCHOOL-BASED HEALTH CENTERS

Purpose: Little is known about student attitudes toward school-based h ealth centers (SBHCs) or about factors that influence SBHC enrollment. Methods: Students in 9 Baltimore schools with SBHCs and 4 schools wit hout health centers were surveyed in May 1991, using an anonymous clas sroom questionnaire. SBHC enrollees, nonenrollees from health center s chools, and students in schools without health centers were compared u sing bi-variate analyses. Logistic regression analyses identified pred ictors of enrollment. Results: A total of 91% of enrollees supported h aving a SBHC compared with 89% of nonenrollees and 77% of students fro m non-health center schools (p < .001). Support for a variety of sen i ces (including contraceptive services) was significantly higher among enrollees and nonenrollees compared with students in non-SBHC schools. A total of 86% of enrollees rated the quality of care ''satisfactory' ' to ''excellent'' and 79% rated privacy in the school health center a s ''satisfactory'' to ''excellent.'' The most common reason given for not enrolling was satisfaction with current provider. Independent pred ictors of student confidence in the privacy of SBHCs included prior SB HC use and enrollment of close peers. Predictors of enrollment include d: one or more self-reported health problems; having medical assistanc e; attending one or more special education classes; enrollment of clos e peers; membership in a school club, sports team, or church organizat ion; and being African-American. Conclusions: Students overwhelmingly supported school-based health centers. Personal experience and peer in fluences were important in shaping student attitudes. We found evidenc e of a ''learning curve'' gradient in student attitudes such that stud ents with the greatest exposure to SBHCs (as measured by attending a S BHC school, enrolling in the SBHC, and using the health center) had th e most favorable attitudes.