Using a retrospective chart review, this evaluation exam- ined the number of teen clinic visits during the 2011-2012 academic year (September 2011 - June 2012) and the number of teen clinic visits during the 2010-2011 academic year (September 2010 - June 2011), for all SBTC and RTC. The data sources used in the evaluation included client charts, SHT's Fox database, and the clinics' calendar. SHT nursing staff abstracted the following data items by clinic date for each visit and locations: visit date, age, sex, school, and reason for visit. Clinic visits were excluded from the study if (i) clients attending the teen sexual health clinics who were not between the ages of 13 and 19 and (ii) clients did not attend one of the LDSB secondary schools listed in Table 1.
The outcome measure was the number of clinic visits pre- campaign implementation (2010/2011 academic year) and post-campaign implementation (2011/2012 academic year).
Client characteristics were compared pre- and post- campaign implementation using the chi-squared test for categorical variables and the t-test for continuous variables to determine if there was a difference pre- and post- intervention (Table 2). The outcome variable, the number of clinic visits, was in the form of count data with a positive skew, a high number of zero-counts and without the possi- bility of a negative count. A negative binomial regression analysis was used to compare the clinic attendance inci- dent rate ratio (IRR); that is the impact of the predictor vari- ables in terms of a percentage change in the number of clinic visits. The primary predictor variables were academic year (2010/2011, 2011/2012) and clinic location (RTC, SBTC). A negative binomial model was preferred over a Poisson model because the data violated the assumption that the variance was equal to the mean. That is, the data was over-dispersed. Additional predictors consisted of client characteristics including gender, clinic type (regular teen clinic, school based-clinic), new client (no, yes), student's home school and primary reason for clinic visit (Table 3). A significant interaction (p < 0.05) indicated that an association existed. Age was not included in the model because it was not significantly different between the two academic years and because age was restricted to 13-19 years. In the 2011/12 academic year, a school based clinic was initiated at Sydenham High School (SHS). Data from SHS clinic visits were removed from the current analy sis in order to prevent over-estimation of clinic visits in the post-campaign implementation period. All statistical analyses were performed using Stata/SE 11.1 for Windows.
According to KFL&A Public Health's Scientific and Ethical Review policy (IV-316), this project did not require ethical review. This project involved the analysis of data normally accessible for the provision of services. Data was anonymized on abstraction.
|
Pre-intervention group (n=276) |
Post-intervention group (n=299) |
P | ||
|
N |
% |
N |
% |
|
Female |
276 |
96.7 |
296 |
94.9 |
.06 |
New client |
0 |
0.0 |
51 |
17.1 |
<.001* |
Clinic type attended |
|
|
|
|
|
Regular teen clinic |
25 |
9.1 |
38 |
12.7 |
.160 |
School based clinic |
251 |
90.9 |
261 |
87.3 |
|
Counselling visit |
112 |
40.9% |
109 |
36.6% |
.004* |
Mean age (SD) |
16.3 |
(1.3) |
16.4 |
(1.3) |
.23 |
*statistically significant at p<.05