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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2016

Open Access 01-12-2016 | Research

Teen clinics: missing the mark? Comparing pregnancy and sexually transmitted infections rates among enrolled and non-enrolled adolescents

Authors: Souradet Y. Shaw, Colleen Metge, Carole Taylor, Mariette Chartier, Catherine Charette, Lisa Lix, Rob Santos, Joykrishna Sarkar, Nathan C. Nickel, Elaine Burland, Dan Chateau, Alan Katz, Marni Brownell, Patricia J. Martens, the PATHS Equity Team

Published in: International Journal for Equity in Health | Issue 1/2016

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Abstract

Background

In Manitoba, Canada, school-based clinics providing sexual and reproductive health services for adolescents have been implemented to address high rates of sexually transmitted infections (STIs) and pregnancies.

Methods

The objectives of this population-based study were to compare pregnancy and STI rates between adolescents enrolled in schools with school-based clinics, those in schools without clinics, and those not enrolled in school. Data were from the PATHS Data Resource held in the Population Health Research Data Repository housed at the Manitoba Centre for Health Policy. Adolescents aged 14 to 19 between 2003 and 2009 were included in the study. Annualized rates of pregnancies and positive STI tests were estimated and Poisson regression models were used to test for differences in rates amongst the three groups.

Results

As a proportion, pregnancies among non-enrolled female adolescents accounted for 55 % of all pregnancies in this age group during the study period. Pregnancy rates were 2–3 times as high among non-enrolled female adolescents. Compared to adolescents enrolled in schools without school-based clinics, age-adjusted STI rates were 3.5 times (p < .001) higher in non-enrolled males and 2.3 times (p < .001) higher in non-enrolled females.

Conclusions

The highest rates for pregnancies and STIs were observed among non-enrolled adolescents. Although provision of reproductive and health services to in-school adolescents should remain a priority, program planning and design should consider optimal strategies to engage out of school youth.
Appendix
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Literature
1.
Grunbaum JA, Kann L, Kinchen S, Ross J, Hawkins J, Lowry R, Harris WA, McManus T, Chyen D, Collins J. Youth risk behavior surveillance--United States, 2003. MMWR Surveill Summ. 2004;53:1–96.PubMed
2.
Eaton DK, Kann L, Kinchen S, Shanklin S, Ross J, Hawkins J, Harris WA, Lowry R, McManus T, Chyen D, et al. Youth risk behavior surveillance--United States, 2007. MMWR Surveill Summ. 2008;57:1–131.PubMed
3.
Santelli JS, Melnikas AJ. Teen fertility in transition: recent and historic trends in the United States. Annu Rev Public Health. 2010;31:371–83. 374 p following 383.CrossRefPubMed
4.
Gaudie J, Mitrou F, Lawrence D, Stanley FJ, Silburn SR, Zubrick SR. Antecedents of teenage pregnancy from a 14-year follow-up study using data linkage. BMC Public Health. 2010;10:63.CrossRefPubMedPubMedCentral
5.
Public Health Agency of Canada. Report on Sexually Transmitted Infections in Canada: 2008. Ottawa: Public Health Agency of Canada; 2008.
6.
Fothergill K, Ballard E. The school-linked health center: a promising model of community-based care for adolescents. J Adolesc Health. 1998;23:29–38.CrossRefPubMed
7.
Kirby D, Short L, Collins J, Rugg D, Kolbe L, Howard M, Miller B, Sonenstein F, Zabin LS. School-based programs to reduce sexual risk behaviors: a review of effectiveness. Public Health Rep. 1994;109:339–60.PubMedPubMedCentral
8.
Shepherd J, Kavanagh J, Picot J, Cooper K, Harden A, Barnett-Page E, Jones J, Clegg A, Hartwell D, Frampton GK, Price A. The effectiveness and cost-effectiveness of behavioural interventions for the prevention of sexually transmitted infections in young people aged 13-19: a systematic review and economic evaluation. Health Technol Assess. 2010;14:1–206. iii-iv.CrossRef
9.
Kirby D, Waszak C, Ziegler J. Six school-based clinics: their reproductive health services and impact on sexual behavior. Fam Plann Perspect. 1991;23:6–16.CrossRefPubMed
10.
Carroll C, Lloyd-Jones M, Cooke J, Owen J. Reasons for the use and non-use of school sexual health services: a systematic review of young people's views. J Public Health (Oxf). 2012;34:403–10.CrossRef
11.
Olsen JR, Cook PA, Forster S, Phillips-Howard PA. Accessibility of sexual health services in teenage sexual health service users: local area geospatial analysis. J Public Health (Oxf). 2012;34:438–46.CrossRef
12.
DeMatteo D, Major C, Block B, Coates R, Fearon M, Goldberg E, King SM, Millson M, O'Shaughnessy M, Read SE. Toronto street youth and HIV/AIDS: prevalence, demographics, and risks. J Adolesc Health. 1999;25:358–66.CrossRefPubMed
13.
Public Health Agency of Canada. Street Youth in Canada: Findings from Enhanced Surveillance of Canadian Street Youth 1999-2003. Ottawa: Public Health Agency of Canada; 2006.
14.
Manlove J. The influence of high school dropout and school disengagement on the risk of school-age pregnancy. J Res Adolesc. 1998;8:187–220.CrossRefPubMed
15.
Nickel NC, Chateau DG, Martens PJ, Brownell MD, Katz A, Burland EM, Walld R, Hu M, Taylor CR, Sarkar J, et al. Data resource profile: Pathways to Health and Social Equity for Children (PATHS Equity for Children). Int J Epidemiol. 2014;43:1438–49.CrossRefPubMedPubMedCentral
16.
Brownell MD, Roos NP, Roos LL. Monitoring health reform: a report card approach. Soc Sci Med. 2001;52:657–70.CrossRefPubMed
17.
Jutte DP, Roos LL, Brownell MD. Administrative record linkage as a tool for public health research. Annu Rev Public Health. 2011;32:91–108.CrossRefPubMed
18.
Roos LL, Nichol JP. A research registry: uses, development, and accuracy. J Clin Epidemiol. 1999;52:39–47.CrossRefPubMed
19.
Roos LL, Menec VH, Currie RJ. Policy analysis in an information-rich environment. Soc Sci Med. 2004;58:2231–41.CrossRefPubMed
20.
Roos LL, Gupta S, Soodeen RA, Jebamani L. Data quality in an information-rich environment: Canada as an example. Can J Aging. 2005;24 Suppl 1:153–70.CrossRefPubMed
21.
Robinson JR, Young TK, Roos LL, Gelskey DE. Estimating the burden of disease. Comparing administrative data and self-reports. Med Care. 1997;35:932–47.CrossRefPubMed
22.
Martens PJ, Chateau DG, Burland EM, Finlayson GS, Smith MJ, Taylor CR, Brownell MD, Nickel NC, Katz A, Bolton JM, Team PE. The effect of neighborhood socioeconomic status on education and health outcomes for children living in social housing. Am J Public Health. 2014;104:2103–13.CrossRefPubMed
23.
Nickel NC, Martens PJ, Chateau D, Brownell MD, Sarkar J, Goh CY, Burland E, Taylor C, Katz A. Have we left some behind? Trends in socio-economic inequalities in breastfeeding initiation: a population-based epidemiological surveillance study. Can J Public Health. 2014;105:e362-8.
24.
Brownell MD, Nickel NC, Chateau D, Martens PJ, Taylor C, Crockett L, Katz A, Sarkar J, Burland E, Goh CY. Long-term benefits of full-day kindergarten: a longitudinal population-based study. Early Child Dev Care. 2014;185:291-316.
25.
Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance - United States, 2009. MMWR Surveill Summ. 2010;59:1-142.
26.
Swartzendruber A, Zenilman JM, Niccolai LM, Kershaw TS, Brown JL, Diclemente RJ, Sales JM. It takes 2: partner attributes associated with sexually transmitted infections among adolescents. Sex Transm Dis. 2013;40:372–8.CrossRefPubMedPubMedCentral
27.
Ford K, Sohn W, Lepkowski J. American adolescents: sexual mixing patterns, bridge partners, and concurrency. Sex Transm Dis. 2002;29:13–9.CrossRefPubMed
28.
Martens PJ, Bartlett J, Burland E, Prior H, Burchill C, Huq S, Romphf L, Sanguins J, Carter S, Bailly A. Health Inequities in Manitoba: is the Socioeconomic Gap in Health Widening or Narrowing Over Time? Winnipeg: Manitoba Centre for Health Policy; 2010.
29.
Brownell M, Chartier M, Santos R, Ekuma O, Au W, Sarkar J, MacWilliam L, Burland E, Koseva I, Guenette W. How are Manitoba's Children Doing? Winnipeg: Manitoba Centre for Health Policy; 2012.
30.
Fransoo R, Martens P, The Need To Know Team, Prior H, Burchill C, Koseva I, Bailly A, Allegro E. The 2013 RHA Indicators Atlas. Winnipeg: Manitoba Centre for Health Policy; 2013.
31.
Roos LL, Hiebert B, Manivong P, Edgerton J, Walld R, MacWilliam L, de Rocquigny J. What is most important: social factors, health selection, and adolescent educational achievement. Social Indicators Res. 2013;110:385–414.CrossRef
32.
Martens P, Fransoo R, The Need To Know Team, Burland E, Prior H, Burchill C, Chateau D, Romphf L, Bailly A, Ouelette C. What Works? A First Look at Evaluating Manitoba's Regional Health Programs and Policies at the Population Level. Winnipeg: Manitoba Centre for Health Policy; 2008.
33.
Mustard CA, Derksen S, Berthelot JM, Wolfson M, Roos LL. Age-specific education and income gradients in morbidity and mortality in a Canadian province. Soc Sci Med. 1997;45:383–97.CrossRefPubMed
34.
Brownell M, Santos R, Kozyrskyj A, Roos N, Au W, Dik N, Chartier M, Girard D, Ekuma O, Sirski M, et al. Next Steps in the Provincial Evaluation of the BabyFirst Program: Measuring Early Impacts on Outcomes Associated with Child Maltreatment. Winnipeg: Manitoba Centre for Health Policy; 2007.
35.
Allen JP, Philliber S. Who benefits most from a broadly targeted prevention program? Differential efficacy across populations in the teen outreach program. J Community Psychol. 2001;29:637–55.CrossRefPubMedPubMedCentral
36.
Crosby RA, DiClemente RJ, Wingood GM, Salazar LF, Rose E, Sales JM. The protective value of school enrolment against sexually transmitted disease: a study of high-risk African American adolescent females. Sex Transm Infect. 2007;83:223–7.CrossRefPubMedPubMedCentral
37.
Walker SC, Kerns SE, Lyon AR, Bruns EJ, Cosgrove TJ. Impact of School-Based Health Center use on academic outcomes. J Adolesc Health. 2010;46:251–7.CrossRefPubMed
38.
Van Cura M. The relationship between school-based health centers, rates of early dismissal from school, and loss of seat time. J Sch Health. 2010;80:371–7.CrossRefPubMed
39.
Kerns SE, Pullmann MD, Walker SC, Lyon AR, Cosgrove TJ, Bruns EJ. Adolescent use of school-based health centers and high school dropout. Arch Pediatr Adolesc Med. 2011;165:617–23.CrossRefPubMed
40.
Barnet B, Arroyo C, Devoe M, Duggan AK. Reduced school dropout rates among adolescent mothers receiving school-based prenatal care. Arch Pediatr Adolesc Med. 2004;158:262–8.CrossRefPubMed
Metadata
Title
Teen clinics: missing the mark? Comparing pregnancy and sexually transmitted infections rates among enrolled and non-enrolled adolescents
Authors
Souradet Y. Shaw
Colleen Metge
Carole Taylor
Mariette Chartier
Catherine Charette
Lisa Lix
Rob Santos
Joykrishna Sarkar
Nathan C. Nickel
Elaine Burland
Dan Chateau
Alan Katz
Marni Brownell
Patricia J. Martens
the PATHS Equity Team
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2016
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-016-0386-9

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