A Community-Based Intervention Designed to Increase Preventive Health Care Seeking Among Adolescents: The Gonorrhea Community Action Project

Objectives. We evaluated the effectiveness of an intervention designed to increase preventive health care seeking among adolescents. Methods. Adolescents and young adults aged 12 to 21 years, recruited from community-based organizations in 2 different communities, were randomized into either a 3-session intervention or a control condition. We estimated outcomes from 3-month follow-up data using logistic and ordinary least squares regression. Results. Female intervention participants were significantly more likely than female control participants to have scheduled a health care appointment (odds ratio [OR]=3.04), undergone a checkup (OR=2.87), and discussed with friends or family members the importance of undergoing a checkup (OR=4.5). There were no differences between male intervention and male control participants in terms of outcomes. Conclusions. This theory-driven, community-based group intervention significantly increased preventive health care seeking among female adolescents. Further research is needed, however, to identify interventions that will produce successful outcomes among male adolescents

Health Status and Health Service Access and Use Among Children in U.S. Immigrant Families

Objectives. We examined the health status and patterns of health care use of children in US immigrant families. Methods. Data from the 1999 National Survey of America’s Families were used to create 3 subgroups of immigrant children: US-born children with noncitizen parents, foreign-born children who were naturalized US citizens, and foreign-born children with noncitizen parents. Chi-square and logistic regression analyses were used to examine relationships between immigrant status and health access variables. Subgroup analyses were conducted with low-income families. Results. Foreign-born noncitizen children were 4 times more likely than children from native families to lack health insurance coverage and to have not visited a mental health specialist in the preceding year. They were 40% and 80% more likely to have not visited a doctor or dentist in the previous year and twice as likely to lack a usual source of care. US-born children with noncitizen parents were also at a disadvantage in many of these aspects of care. Conclusions. We found that, overall, children from immigrant families were in worse physical health than children from non-immigrant families and used health care services at a significantly lower frequency

An Assessment of the Impact of Medicaid Managed Care on WIC Program Coordination With Primary Care Services

Coordination between the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Medicaid has been an important component to ensuring access to primary care services for WIC clients. This study examines how increased use of managed care in the Medicaid program has affected WIC program coordination efforts. According to the study sample, 72 percent of State Medicaid agencies report that Managed Care Organizations (MCOs) are required to inform their members about WIC. About 43 percent of State WIC agencies sampled in the study have a formal agreement with a State Medicaid agency, generally revolving around data sharing, referrals, and provision of special metabolic infant formulas. The agreements often lack specific details on how services should be coordinated, however. Some local WIC agencies and MCOs have implemented innovative approaches to coordination. These approaches include Medicaid staff atWIC clinics to help clients with enrollment, sharing information to promote targeted outreach efforts, helping clients identify providers and resources, and MCOs paying transportation costs of WIC clients to attend WIC appointments

Condom Availability Programs in Massachusetts High Schools: Relationships With Condom Use and Sexual Behavior

Objectives. This study assessed relationships between condom availability programs accompanied by community discussion and involvement and adolescent sexual practices. Methods. Sexual practice and condom use differences were assessed in a representative sample of 4166 adolescents enrolled in high schools with and without condom availability programs. Results. Adolescents in schools where condoms were available were more likely to receive condom use instruction and less likely to report lifetime or recent sexual intercourse. Sexually active adolescents in those schools were twice as likely to use condoms, but less likely to use other contraceptive methods, during their most recent sexual encounter. Conclusions. The strategy of making condoms available, an indication of socioenvironmental support for condom use, may improve HIV prevention practices

A Community-Based Intervention Designed to Increase Preventive Health Care Seeking Among Adolescents: The Gonorrhea Community Action Project

Objectives. We evaluated the effectiveness of an intervention designed to increase preventive health care seeking among adolescents. Methods. Adolescents and young adults aged 12 to 21 years, recruited from community-based organizations in 2 different communities, were randomized into either a 3-session intervention or a control condition. We estimated outcomes from 3-month follow-up data using logistic and ordinary least squares regression. Results. Female intervention participants were significantly more likely than female control participants to have scheduled a health care appointment (odds ratio [OR]=3.04), undergone a checkup (OR=2.87), and discussed with friends or family members the importance of undergoing a checkup (OR=4.5). There were no differences between male intervention and male control participants in terms of outcomes. Conclusions. This theory-driven, community-based group intervention significantly increased preventive health care seeking among female adolescents. Further research is needed, however, to identify interventions that will produce successful outcomes among male adolescents