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The Relationship between School-based Health Center Utilization, School Connectedness, and Academic Outcomes


School-based health centers (SBHCs) have gained popularity as an approach to provide adolescents with access to health and mental health services in a convenient, youth friendly environment. Although evidence exists regarding SBHC’s impact on access and health domains, clarification of the relationship between SBHC utilization and academic outcomes is needed. Yet, understanding the relationship between utilization of SBHCs and educational outcomes is fraught with many challenges. Although various studies attempt to singularly address these challenges, this study fully integrates these important prior insights into a single study. First, this study capitalizes upon a unique opportunity link three secondary data sources (administrative service utilization, education outcome data, and student survey data), which allows for analysis of the type of services used (medical services, general counseling, and behavioral health counseling) and dosage of each service used. Second, this study limits the impact school contextual differences by limiting the study population to one school, further enabling clarification of the general approach of the intervention. Third, this study employs propensity scoring methods to carefully control for differences between SBHC users and non-users. Specifically, this study aims to (1) clarify student level SBHC utilization patterns; (2) replicate prior research on school connection pathways (i.e. student perceptions of teacher support (school support) and student perceptions of their belonging to school (school connectedness), adding new analysis on specific types and dosages of SBHC use; and (3) replicate prior research linking SBHC utilization to academic outcomes, adding new analysis on specific types and dosages of SBHC use. Results indicate that students who use SBHC services have heterogeneous demographic characteristics and health and mental health needs compared to students who do not use SBHCs. This study did not find a relationship between SBHC service use and connection to school or education outcomes at the end of one school year. This study may serve as model for how we might approach future SBHC research.

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