ABSTRACT
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. The model simulations provided insight into what processes may lead to suboptimal numbers of people being recruited and positively influenced by these programs.
Subject(s)
Community Networks , HIV Infections/prevention & control , Health Promotion , Models, Organizational , Patient Dropouts , Patient Selection , Computer Simulation , Humans , Public Health PracticeABSTRACT
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.
