The impact of school-based health centers on the health outcomes of middle school and high school students.

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. Data were obtained from 744 students in both year 1 and year 2 of the study. We used 2-level hierarchical linear models to estimate the effects of the presence of SBHCs at the school level and of SBHC use at the student level.

Results: At year 2, users of SBHCs experienced greater satisfaction with their health, more physical activity, and greater consumption of healthy food than did nonusers of SBHCs.

Conclusions: Students who used SBHCs were more satisfied with their health and engaged in a greater number of health-promoting behaviors than did students who did not use SBHCs. These findings indicate that SBHCs are achieving their goal of promoting children's health.