Development of school-based referral system for sexual health services

Abstract

Background/significance: Adolescents are particularly vulnerable to negative sexual health outcomes. Despite this, many adolescents avoid seeking sexual and reproductive health services for various reasons, including concerns about confidentiality, limited access, and lack of awareness. Purpose/Aim: This project aimed to create a referral list that can serve as the primary tool for school nurses at Hawaiʻi Keiki to guide the selection of an appropriate service provider to facilitate making a referral in the community. Timely access to sexual health services is crucial in enhancing adolescents’ sexual health outcomes. Methods: A referral guide was developed using the implementation framework developed by Project Connect. An in-service meeting was held to familiarize school nurses with using this toolkit effectively. After the referral guide was disseminated, school nurses completed both the pre-survey and the post-survey to examine whether the intervention helped to improve their confidence and knowledge in linking students to youth-friendly providers in the community for sexual and reproductive health services. Results: This quality improvement looked at constructs that influence an individual’s behavior derived from the Theory of Planned Behavior. Overall, an upward trend was observed across all domains when comparing the mean scores at the pre- and post-intervention levels. Conclusion: School nurses are in an ideal position to establish a trusting relationship with students, often becoming their trusted figures and advocates. Given the sensitive nature of sexual and reproductive health, school nurses can serve as a trusted point of contact for students who might otherwise feel uncomfortable to seek help.