School-Based Health Centers (SBHCs) and Reproductive Health Services: A Qualitative Analysis of SBHC Coordinators and Their Educator Partners

• In Event: Analyzing the Relationship Between School-Based Health Centers and Schools

Abstract

Objectives or Purposes. Oregon youth report gaps in school-based sexual and reproductive health services (Oregon Student Health Survey, 2020). Extant literature has found that the presence of school-based health centers (SBHCs) can begin to close that gap by increasing students’ access to contraceptives (Stein et al, 2020). However, it is apparent that barriers exist for students in accessing the sexual and reproductive healthcare that SBHCs can offer. The Oregon Healthy Teen Survey (2019) suggests a lack of awareness amongst adolescents about the existence of SBHCs on school campuses. Further, the attitudes and beliefs of students’ families, educators, and broader community can influence the accuracy of information they receive about SBHCs and the types of reproductive health services they provide (Kohn et al., 2011). As such, most SBHCs throughout the country cite school and district level policies as explicit barriers to providing contraceptives to students (Sullivan et al., 2022).The purpose of this study is to expand on existing literature by further exploring schools’ and school based health centers’ motivations behind offering sexual and reproductive services, as well as the barriers they face in these efforts and the perceived barriers students face in accessing these services from SBHCs.

Perspective(s) or Theoretical Framework.
Access to contraception methods helps reduce sexually transmitted infections (STIs) and unwanted pregnancies among adolescents. While Oregon has some of the most comprehensive sexuality education laws and policies in the U.S. Many SBHCs in the state face challenges to offering reproductive health services because of local policies, funding and broader community and family support.

Data Sources. This study uses data from semi-structured interviews with 17 SBHC Coordinators and 19 Educator Partners (principles, student services directors, etc.), representing 40 of Oregon’s 76 SBHCs. Interviews were conducted remotely over Zoom and lasted between 30 and 60 minutes. Interviews were recorded and transcribed in full using the Zoom recording and transcription functions. Using Dedoose data analysis software, interview transcripts were coded using a primarily deductive approach to identify themes related to our research questions; we also incorporated an inductive approach to allow for emergent themes.

Findings. Respondents describe supporting the whole child as a key motivation for offering reproductive health services, yet SBHCs face barriers, including stigma from parents, students, and the broader community; restrictive school policy; and a lack of resources to provide contraceptives on site.

Significance. SBHCs are unique and essential options for increasing youth access to reproductive health services. By providing safe, comfortable, and comprehensive sites for sexual health information and resources, SBHCs support the health of young people at a pivotal time in their development. This study has broad implications for public health researchers and policymakers who seek to support SBHCs and their educational partners in overcoming barriers to providing reproductive health services to students.

Authors

• Erika Carpenter, Portland State University
  Presenting Author

• Haley Simons, University of North Carolina - Chapel Hill
  Non-Presenting Author