Structural Intervention With School Nurses Increases Receipt of Sexual Health Care Among Male High School Students

Abstract

Purpose: Adolescent males are less likely to receive health care and have lower levels of sexual and reproductive health (SRH) knowledge than adolescent females. The purpose of this study was to determine if a school-based structural intervention focused on school nurses increases receipt of condoms and SRH information among male students.

Methods: Interventions to improve student access to sexual and reproductive health care were implemented in six urban high schools with a matched set of comparison schools. Interventions included working with school nurses to improve access to sexual and reproductive health care, including the provision of condoms and information about pregnancy and sexually transmitted disease prevention and services. Intervention effects were assessed through five cross-sectional yearly surveys, and analyses include data from 13,740 male students.

Results: Nurses in intervention schools changed their interactions with male students who visited them for services, such that, among those who reported they went to the school nurse for any reason in the previous year, those in intervention schools reported significant increases in receipt of sexual health services over the course of the study compared with students in comparison schools. Further, these results translated into population-level effects. Among all male students surveyed, those in intervention schools were more likely than those in comparison schools to report increases in receipt of sexual health services from school nurses.

Conclusions: With a minimal investment of resources, school nurses can become important sources of SRH information and condoms for male high school students.

Keywords: Access to condoms; Adolescent males; Sexual health information.

Figure 1.

Raw percentage of male students who went to the school nurse in the past year by intervention group and year of intervention (n = 13,423). An asterisk indicates a significant difference between intervention and control students for that intervention year (p<.01

Figure 2.

Bar charts for the raw percentage of students who went to the school nurse for either condoms or SRH information in the past year by intervention group and intervention year among (A) male high school students who reported going to the school nurse for any service, (B) all male high school students, and (C) male high school students who ever had sex. An asterisk indicates a significant difference between intervention and control students for that intervention year (p < .05).