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Health services and policy oral session 1—Innovation technology
O5-S1.01 Employing school nurses as a healthcare point of contact for male high school students: a school-based intervention to prevent STD, HIV, and teen pregnancy
  1. P Dittus1,
  2. C De Rosa2,
  3. R Jeffries3,
  4. A Afifi3,
  5. W Cumberland3,
  6. K Ethier1,
  7. E Chung2,
  8. E Martinez4,
  9. R Loya5,
  10. P Kerndt4
  1. 1Centers for Disease Control and Prevention Atlanta, USA
  2. 2Los Angeles County Department of Public Health, USA
  3. 3UCLA, USA
  4. 4Health Research Association, USA
  5. 5Los Angeles Unified School District, USA


Background Adolescent males tend to have lower levels of knowledge about sexual and reproductive health (SRH), and access health care less frequently than adolescent females. Innovative strategies are needed to reach males with accurate information and resources regarding their SRH needs. Such strategies may improve adolescent males' access to SRH services, including STD screening, treatment, and contraception.

Methods A multi-level intervention was delivered and evaluated across 5 years in a large public school district in Los Angeles, California. One intervention component sought to improve students' awareness and utilisation of condom availability programs (CAPs) in schools by working with key school personnel, particularly nurses, to more effectively implement district CAP policies. Six intervention and six control high schools participated in the study . Analyses included survey data from 13 733 high school males across 5 years (T1–T5). A mixed model logistic regression analysis was used to test for an intervention effect on males' reports of services sought from the school nurse. Random effects on the student level were included to control for repeated measures on the same student.

Results The sample was 80% Latino and 9% African American; the mean age was 16.3. In the intervention as compared to the control condition, statistically significant increases were observed across 5 years of intervention in respondents' reports of going to the school nurse for information about birth control, STDs, pregnancy, or sex (see Abstract O5-S1.01 figure 1), as well as reports of going to the school nurse for condoms. For example, 5.4% of intervention school males reported going to the nurse for condoms at T1; reports increased to 9.6% at T5 for this group, whereas an opposite trend was observed for control school males.

Abstract O5-S1.01 Figure 1

Adjusted ORs* for the change between time points in males going to the school nurse.

Conclusions School district policy combined with promotion of a CAP increased the number of adolescent males who sought out SRH information and condoms from the school nurse. With few points of access to the healthcare system available to males, school nurses may be especially important in connecting males to the healthcare system for services such as STD screening and contraception. As budget shortfalls affect all areas of school administration, school nurses should be recognised and retained as key players in promoting access to SRH services.

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