Performance Improvement 2001. Baltimore City Health Department: Ten Year Evaluation of Coverage and Effect on Student Childbearing and School Dropout


The Baltimore City Health Department (BCHD) established a Comprehensive School Health Services Program (CSHSP) in collaboration with the Baltimore City Public Schools. The goal was to create a single comprehensive health model for adolescents attending selected secondary schools. This evaluation describes CSHSP success in engaging students and in preventing student child bearing and dropouts. For students who did bear a child, the study describes CSHSP success in promoting adequate prenatal care and favorable birth outcomes. The research applies time series and cohort analyses to measure program coverage and impact in the CSHSP's first ten years, from 1985-86 through 1994-95. Study data were derived by matching existing computer files of school registration data, CSHSP registration and utilization data and birth certificates. The CSHSP was successful in engaging a majority of students in both middle and high schools. During the ten year study period, school birthrates rose then fell back to levels similar to those when the CSHSP was first initiated. The CSHSP was closely linked to prevention of school dropout. Within CSHSP schools, age-for-grade appropriate ninth graders who used the CSHSP were significantly more likely to stay in school. The study demonstrated the feasibility of evaluating the CSHSP through matching and secondary analysis of existing data sources. The CSHSP did not influence school-wide birthrates, but for students who did use the school-based clinics, birthrates during the high school years decreased by 5% and school dropout rates decreased by over a third.

AGENCY SPONSOR: National Institute of Child Health and Human Development

FEDERAL CONTACT: Susan Newcomer, 301-435-6981

PIC ID: 4467

PERFORMER: Johns Hopkins University School of Medicine, Baltimore, MD