ABSTRACT
OBJECTIVES: To assess the feasibility and efficacy of a school-based health centre (SBHC) established at an inner-city elementary school to help alleviate barriers to accessing health care. METHODS: A retrospective chart review of the first year of the SBHC was conducted. Feasibility metrics included the number of children who enrolled at the SBHC. Efficacy metrics included the proportion of enrolled children who attended and received new diagnoses and treatment plans. RESULTS: A total of 379 children enrolled at the SBHC and 127 children attended. Of the SBHC users, 74.0% received a new diagnosis and 90.6% received a treatment plan; 79.6% were from families with an annual income <$30,000, and 91.6% were from families whose first language was not English. CONCLUSION: The SBHC represents a feasible and efficacious way to enhance the delivery of health care to inner-city children.
OBJECTIF: Évaluer la faisabilité et l'efficacité d'un centre de santé en milieu scolaire (CSMS) installé dans l'école primaire d'un quartier pauvre pour contribuer à réduire les obstacles liés à l'accès aux soins. MÉTHODOLOGIE: Les chercheurs ont mené une analyse rétrospective des dossiers de la première année du CSMS. Comme mesures de faisabilité, ils ont inclus le nombre d'enfants inscrits au CSMC, tandis que les mesures d'efficacité incluaient la proportion d'enfants inscrits qui ont utilisé le service et reçu de nouveaux diagnostics et plans thérapeutiques. RÉSULTATS: Au total, 379 enfants se sont inscrits au CSMS et 127 ont utilisé le service. Parmi les utilisateurs du CSMS, 74,0 % ont reçu un nouveau diagnostic et 90,6 %, un plan thérapeutique. De plus, 79,6 % provenaient d'une famille dont le revenu annuel était inférieur à 30 000 $, et la langue maternelle de 91,6 % d'entre eux n'était pas l'anglais. CONCLUSION: Le CSMS est un moyen faisable et efficace d'améliorer la prestation des soins aux enfants des quartiers pauvres.
ABSTRACT
OBJECTIVES: We assessed sexual orientation disparities in exposure to violence and other potentially traumatic events and onset of posttraumatic stress disorder (PTSD) in a representative US sample. METHODS: We used data from 34 653 noninstitutionalized adult US residents from the 2004 to 2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions. RESULTS: Lesbians and gay men, bisexuals, and heterosexuals who reported any same-sex sexual partners over their lifetime had greater risk of childhood maltreatment, interpersonal violence, trauma to a close friend or relative, and unexpected death of someone close than did heterosexuals with no same-sex attractions or partners. Risk of onset of PTSD was higher among lesbians and gays (adjusted odds ratio [AOR] = 2.03; 95% confidence interval [CI] = 1.34, 3.06), bisexuals (AOR = 2.13; 95% CI = 1.38, 3.29), and heterosexuals with any same-sex partners (AOR = 2.06; 95% CI = 1.54, 2.74) than it was among the heterosexual reference group. This higher risk was largely accounted for by sexual orientation minorities' greater exposure to violence, exposure to more potentially traumatic events, and earlier age of trauma exposure. CONCLUSIONS: Profound sexual orientation disparities exist in risk of PTSD and in violence exposure, beginning in childhood. Our findings suggest there is an urgent need for public health interventions aimed at preventing violence against individuals with minority sexual orientations and providing follow-up care to cope with the sequelae of violent victimization.
