The relationship between use of school-based health centers and student-reported school assets.

PURPOSE To examine the relationship between student-reported, school-based health center utilization and two outcomes: (1) caring relationships with program staff; and (2) school assets (presence of caring adults, high behavioral expectations, and opportunities for meaningful participation) using a school district-wide student survey. These relationships were also explored across schools. METHODS Using student-reported data from a customized version of the California Healthy Kids Survey from the San Francisco Unified School District (n = 7,314 students in 15 schools), propensity scoring methods were used to adjust for potential bias in the observed relationship between student utilization of services and outcomes of interest. RESULTS Estimates generally pointed to positive relationships between service utilization and outcome domains, particularly among students using services ≥10 times. Exploratory analyses indicate that these relationships differ across schools. CONCLUSIONS Use of school-based health centers appears to positively relate to student-reported caring relationships with health center staff and school assets. Future research is needed to confirm the robustness of these observed relationships.