Objectives: We studied the direct and indirect effects of school-based health centers (SBHCs) on the health and health behaviors of middle and high school students.
Methods: We used a prospective cohort design to measure health outcomes annually over 2 consecutive years by student self-report. Cohorts of middle school and high school students were recruited from matched schools with and without SBHCs.
The study used system dynamics modeling computer simulations to gain a better understanding of the process of delivering small-group, evidence-based HIV prevention programs in the community and to explore implications for public health practice. A model was developed to explain provider-reported challenges associated with recruiting, retaining, and graduating people from small-group workshop programs. The model simulations revealed the difficulty in sustaining high rates of recruitment and retention in small-group programs over time.
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