On Making a Difference
Categories: Adolescent health care, Advocacy, Public Health, Wellness Centers
When students were asked, “Do you know where the Wellness Center clinic is at on your campus?”
More than 95% responded “yes”
When students were asked, “Have you visited the Wellness Center at your campus before?”
Approximately 70% said they had been to their Wellness Center
When students were asked, “Have you received services at the Wellness Center before?”
Around 40% of students shared being recipients of services.
When students were asked, “How likely is it that you will go to the Wellness Center for health or counseling services this year?”
Around 6% of students strongly affirmed future utilization while 35% of students strongly denied future utilization.
So what story is being told by these numbers? As a part of my work as a student engagement intern, I assess students’ utilization of the Wellness Centers and identify obstacles that impede students from achieving wellness. The L.A. Trust and our collaborators have made great strides in integrating Wellness Centers within school campuses, but now a major challenge is to bridge our students to these Wellness Centers. We cannot expect our students to immediately flock to the Wellness Centers just simply because they exist, especially when these students come from communities that have historically suffered under an unfavorable healthcare system- where many only knew the emergency room as their venue for health. The notions of low-cost healthcare and preventive services that we are attempting to normalize are unheard of in many of the communities we serve. That is not to say our continuous efforts to change this prevailing attitude is in vain; almost all students would be able to tell you where to find their Wellness Center and many have had some kind of interaction with the Wellness Center before. Yet, why is it that such a small percentage of students seek to access this incredible resource? In my investigation of perceptions and beliefs students have surrounding Wellness Centers, I identified two main trends:
1. Students are not practicing preventive care
Our current culture of health is focused on seeking care after we have become ill. Students have adopted this culture as well: 1 in 5 students reported not wanting to utilize Wellness Centers because there was no need to. The word “need” suggests that there would be no utilization of Wellness Center services unless they were absolutely required to. However, this begs the question, just because one does not need to do something, does that mean the action should not be done otherwise? People do not need to brush their teeth, but most people do to decrease the risk for worst possible outcomes . Likewise, the idea of taking preventative measures needs to be incorporated with students’ understanding of their overall health. Health is not something that we recognize in reaction to an adverse event, but must constantly be taking care of.
Another 10%-20% of students reported having a primary care provider as a reason to not receive services at the Wellness Center. One of the main roles of primary care providers is to treat illness within individuals. Other services primary care providers offer such as conducting screenings, assessments, and providing immunizations are also provided at Wellness Centers. While having a primary care provider is pivotal for student health, access may not be convenient due to distance, insurance difficulties, or scheduling. Wellness Centers can help alleviate these inconveniences as students are easily able to receive services regardless of distance or scheduling because Wellness Centers are on campus and allow students to seek services during class times. Wellness Centers not only provide health services, but also seek to promote health holistically through education, advocacy, and empowerment geared towards the communities they serve, which is not entirely emphasized by primary care providers.
2. Students are mostly concerned with their immediate health needs
The continuum of healthcare needs changes with age. Infants have different health needs compared to the elderly. Students too, especially those of adolescent age, have a unique set of needs. These needs become apparent in the services high school students were most cognizant of being offered by the Wellness Center, of which, two of the most common answers were sexual transmitted infection testing and birth control. Understandably, initiation of sexual activity is common during adolescence and we should be proud that students know where to access sexual health services. Furthermore, our Wellness Centers recognize the importance of sexual health to our students and so they ease accessibility by enacting protocols that circumvent the social stigma of requesting sexual health services. When we visited Garfield Wellness Center there was a “brown bag” policy, which allowed for students to receive contraceptives with minimal embarrassment. At Elizabeth Learning Center students were shown a sheet with images (see image on the right) and asked to point at the services they require, so no one could hear what service was taking place. It simply is not enough to provide the services and expect individuals to utilize them. We must take into consideration the modes of delivery for health care services while respecting the cultural context as well.
Now not to undermine the accomplishment, but much more still needs to be done in regards to service utilization at the Wellness Centers. Wellness Centers offer a plethora of services beyond those addressing sexual health, but many students demonstrated being misinformed about these services. Approximately 84% of students correctly stated there were confidential services offered, but upon closer examination less than half of these students knew which services were truly confidential. And while students did demonstrate some knowledge of other existing services, approximately 37% of students with intentions to utilize services were interested in those beyond sexual health or for physicals/check-ups.
The two major trends observed imply that we need to better promote Wellness Center services through education, outreach, and marketing. Our extraordinary executive director, Maryjane Puffer, once expressed her dream to us of one day seeing the ownership of the Wellness Centers belonging to the students- acting as an agency of empowerment for them and their communities . I along, with many others here at The L.A. Trust, would like to see this dream fulfilled. But in order for this dream to come to fruition, we need students to embrace and value what the Wellness Centers can do for their communities and that requires much more effort on our part and at times, may seem like an uphill battle. Yet, we must continue to tell ourselves, “I hope. I believe. I know. I am making a difference.”
Source: CFHC 2016 Surveys
*Data was collected from a total of High School in 2016.
Kevin Ngov graduated this spring from Cal State L.A. with a public health degree. He is a fellow with CDC’s Maternal Child Health Health Careers/Research Initiatives for Student Enhancement (MCHC/RISE-UP) program. He is interning with The L.A. Trust this summer supporting student engagement programs and will start an MPH program in Epidemiology at UC Irvine this fall.