USE OF HEALTH-SERVICES BY URBAN YOUTH - A SCHOOL-BASED SURVEY TO ASSESS DIFFERENCES BY GRADE LEVEL, GENDER, AND RISK BEHAVIOR

Purpose: The purpose of this study was: (a) to describe reported acces s to health care among urban youth, and (b) to compare intention to se ek care and risk behaviors for youth who did and did not seek care. Me thods: A cross-sectional survey measuring knowledge, attitudes, self-e fficacy, and behavioral intentions related to sexuality and use of and access to health care was administered to 3,677 urban middle and high school students in health education classes. Results: A total of 13% of students reported no established health care, whereas 25% reported no care within the past 6 months. A physical examination was the most common reason for seeking care. Younger teenagers, males, and those no t under care were less aware of teen clinics, thought it more difficul t to access care, and had less intention to seek care within the next year (P<.001). Older students had greater knowledge and self-efficacy concerning sexual matters, were less positive about abstinence, and ha d higher life and sex risk scores (P<.001). Females reported greater s elf-efficacy regarding sexual matters, were more positive about abstin ence, and had lower life risk scores (P<.001). Adolescents receiving c are had higher knowledge and self-efficacy scores, were more positive about condoms, had greater intention to seek care, but had higher life and sex risk scores. Conclusions: Awareness and use of health care re main low for a sizable number of at risk urban youth, especially young er and male teenagers. The school is a setting in which adolescents no t under care can be reached for provision of information about health care.