Characteristics of Youth Who Use School-Based Health Centers Only Once.

OBJECTIVE: School-based health centers (SBHCs) deliver healthcare on or near school campuses. Little is known about youth who use SBHCs infrequently. This study compared youth with a single SBHC visit to those with multiple visits over a 12-month observation period to understand differences in clients' demographic characteristics and healthcare needs. METHODS: Electronic health records of 3,742 adolescent clients who used eight California SBHCs (2021-2024) were analyzed using Chi-square tests and mixed-effects logistic regression to estimate effects of age, gender, race/ethnicity, and diagnoses on the odds of having a single visit during a 12-month observation period. RESULTS: One-third (36.1%) of participants had a single SBHC visit in the 12-month observation period. Younger clients (AOR: 2.63; CI: 2.19-3.16) and males (AOR: 1.98; CI: 1.67-2.35) were more likely to have a single visit. Clients were significantly more likely to have a single visit if they had diagnoses related to reproductive health (AOR: 1.93; CI: 1.58-2.37) or sports physicals (AOR: 1.51; CI: 1.01-2.27) during their initial (or only) visit. Clients were less likely to have a single visit if they received a diagnosis related to behavioral health (AOR: 0.36; CI: 0.29-0.46), social determinants of health (SDOH; AOR: 0.35; CI: 0.28-0.44), or injury/pain (AOR: 0.70; CI: 0.50-0.98). CONCLUSIONS: SBHCs appear to appropriately engage youth in follow-up care for behavioral health and SDOH concerns. Clients' single visits, particularly for sports physicals, may represent opportunities to further engage youth in ongoing preventive care. Further research should confirm whether single-visit clients receive the level of care they need.