Using the Children with Special Health Care Needs Screener with Immigrant Families: An Analysis of the National Survey of Children's Health.
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ABSTRACT:
SUBMITTER: Warden C
PROVIDER: S-EPMC7085865 | biostudies-literature | 2019 Feb
REPOSITORIES: biostudies-literature
Publications
Using the Children with Special Health Care Needs Screener with Immigrant Families: An Analysis of the National Survey of Children's Health.
Warden Clara C Yun Katherine K Semere Wagahta W
Journal of immigrant and minority health 20190201 1
Children in immigrant families are less likely to screen positive with the Children with Special Health Care Needs Screener (CSHCN-S). This may indicate that children in immigrant families are healthier or require fewer health services than non-immigrant peers. Alternatively, the screener may under-identify special healthcare needs in this population. Using the 2011-2012 National Survey of Children's Health, we examined the prevalence of a positive CSHCN-S among children from first, second, and ...[more]
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Project description:ObjectiveTo report rates of need and unmet need for specialised health services (occupational and speech therapies, durable medical equipment, home healthcare, and mobility and communication aids) from the National Survey of Children with Special Health Care Needs (CSHCN) (2009/2010) and assess the role of care coordination in having needs met. We distinguish between CSHCN with and without emotional, behavioural and developmental disorders (EBDPs) in the USA.DesignA cross sectional cohort study of a nationally representative sample of CSHCN from the National Survey of CSHCN for 2009/2010 used logistic regression to assess the relationship between EBDPs and need and unmet need for specialised services. It also estimates the association of care coordination with unmet need for all services, for CSHCN with and without EBDPs.SettingA nationally representative sample of CSHCN in the USA.ParticipantsChildren ages 0-17 years of age.ResultsAcross all specialised health services, rates of unmet need were at or below 25%. Need and unmet need for most services was higher among CSHCN with EBDPs than those without. For CSHCN with and without EBDPs, adequate care coordination was associated with greater probability of having needs for therapy, home health and communication aids met.ConclusionCare coordination is essential to reducing barriers to a wide range of healthcare services for CSCHN. Policies requiring adequate insurance coverage for care coordination may play a critical role in ensuring access to specialised health services.
| S-EPMC9670924 | biostudies-literature
Project description:BackgroundFamilies with young children have faced serious challenges during the first lockdown as a result of the COVID-19 pandemic. In addition to remote working, parents have had to monitor their children's schoolwork and manage their daily lives. When one of the children also has neuro-developmental disorders, this results in an increased burden. We can therefore wonder how these families with one or more young children (under 6 years old) with special needs have experienced and dealt with this lockdown.Aim of the studyIn this context, the "COVJEUNENFANT" study focused more specifically on the subjective experience, as a parent, of those who cared for children with special needs (i.e., with developmental disorders, neurodevelopmental disorders, proven disabilities or chronic health conditions) compared to the general population. We wished to see if the consequences of the health crisis were significantly different from those perceived by respondents in the general population (n = 490) and if the sociodemographic structure of these families differed from those of other respondents.MethodsNinety three French families with at least one child under 6 years old and one with developmental difficulties or a chronic illness, from a cohort of 490 control families, participated in a web-based survey during the first lockdown, from the 28th April 2020 to 29th May 2020.ResultsAfter presenting the participants' sociodemographic characteristics, the results show that these French families (n = 93) are less wealthy than the control population "without special needs" (n = 397), have felt more pressures originating from their environment (families, friends, colleagues, media, social networks…), have suffered from more health issues (other than COVID-19), have taken more measures to protect themselves (social-distancing), and were less likely to feel happy. A significantly larger number of them lamented the lack of free time and voiced a larger need for information regarding children's education. However, their parental role was felt as being more satisfying and their family relations strengthened more than in the general population of participants.ConclusionIt is apparent that urgent prioritisation is needed in order to support and care for these families by continuing to provide care for their children in one way or another, and by ensuring that their need to adapt again does not exceed their own abilities and resources, especially as young children, who have high levels of requirements, are present in the home.
| S-EPMC9088877 | biostudies-literature
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| S-EPMC4369217 | biostudies-literature
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| S-EPMC9219960 | biostudies-literature
Project description:BackgroundA high percentage of dental caries (∼70%) was reported amongst 4- and 5-year-old Kuwaiti kindergarten children. Parents contact paediatricians several times during the child's early life. Paediatricians can play an important role in improving the oral health of their patients. The objective of the study is to evaluate the knowledge level and awareness of paediatricians and paediatric residents regarding children's oral health in Kuwait.MethodsA national cross-sectional survey was distributed to paediatricians and paediatric residents practicing in Kuwait. Data concerning demographic variables, knowledge on dental caries preventive measures, current anticipatory guidance, and experience with dental problems and oral care were collected using online and paper-based surveys.ResultsA total of 230 participants completed the survey, with a response rate of 50.1%. Most respondents (81%) had frequently noticed dental caries in children in their practice. Two-thirds of respondents felt confident in detecting dental caries. However, more than two-thirds were unfamiliar with preventive dental practices and the management of dental trauma. Only 16.5% of the respondents got a satisfactory knowledge score on the preventive measure questions, and nearly 51% had satisfactory knowledge on the recent anticipatory guidance questions. No significant correlations were found between gender or years of practice and knowledge scores. Respondents' confidence in detecting caries was significantly associated with the knowledge score of the anticipatory guidance (P = .003). Fewer than half of the respondents considered prescribing sugar-free syrup (47.4%) and counselled patients regarding the use of mouthguards during sports for schoolchildren (39%).ConclusionsThe majority of paediatricians have adequate knowledge of the current anticipatory guidance of oral health issues, but they have insufficient knowledge of oral preventative measures and dental trauma. Adequate education and training in oral health are highly recommended.
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| S-EPMC10495855 | biostudies-literature
Project description:BackgroundImmigrants typically arrive in good health. This health benefit can decline as immigrants adopt behaviours similar to native-born populations. Risk of injury is low in immigrants but it is not known whether this changes with increasing time since migration. We sought to examine the association between duration of residence in Canada and risk of unintentional injury.MethodsPopulation-based cross-sectional study of children and youth 0 to 24 years in Ontario, Canada (2011-2012), using linked health and administrative databases. The main exposure was duration of Canadian residence (recent: 0-5 years, intermediate: 6-10 years, long-term: >10 years). The main outcome measure was unintentional injuries. Cause-specific injury risk by duration of residence was also evaluated. Poisson regression models estimated rate ratios (RR) for injuries.Results999951 immigrants were included with 24.2% recent and 26.4% intermediate immigrants. The annual crude injury rates per 100000 immigrants were 6831 emergency department visits, 151 hospitalizations, and 4 deaths. In adjusted models, recent immigrants had the lowest risk of injury and risk increased over time (RR 0.79; 95% CI 0.77, 0.81 recent immigrants, RR 0.90; 95% CI 0.88, 0.92 intermediate immigrants, versus long-term immigrants). Factors associated with injury included young age (0-4 years, RR 1.30; 95% CI 1.26, 1.34), male sex (RR 1.52; 95% CI 1.49, 1.55), and high income (RR 0.93; 95% CI 0.89, 0.96 quintile 1 versus 5). Longer duration of residence was associated with a higher risk of unintentional injuries for most causes except hot object/scald burns, machinery-related injuries, non-motor vehicle bicycle and pedestrian injuries. The risk of these latter injuries did not change significantly with increasing duration of residence in Canada. Risk of drowning was highest in recent immigrants.ConclusionsRisk of all-cause and most cause-specific unintentional injuries in immigrants rises with increasing time since migration. This indicates the need to develop strategies for maintaining the immigrant health advantage over time while balancing the desire to support integration, active living, and healthy child development.
| S-EPMC5540344 | biostudies-literature
Project description:To describe the parent-reported prevalence of treatments for attention deficit/hyperactivity disorder (ADHD) among a national sample of children with special health care needs (CSHCN), and assess the alignment of ADHD treatment with current American Academy of Pediatrics guidelines.Parent-reported data from the 2009-2010 National Survey of Children with Special Health Care Needs allowed for weighted national and state-based prevalence estimates of medication, behavioral therapy, and dietary supplement use for ADHD treatment among CSHCN aged 4-17 years with current ADHD. National estimates were compared across demographic groups, ADHD severity, and comorbidities. Medication treatment by drug class was described.Of CSHCN with current ADHD, 74.0% had received medication treatment in the past week, 44.0% had received behavioral therapy in the past year, and 10.2% used dietary supplements for ADHD in the past year. Overall, 87.3% had received past week medication treatment or past year behavioral therapy (both, 30.7%; neither, 12.7%). Among preschool-aged CSHCN with ADHD, 25.4% received medication treatment alone, 31.9% received behavioral therapy alone, 21.2% received both treatments, and 21.4% received neither treatment. Central nervous system stimulants were the most common medication class (84.8%) among CSHCN with ADHD, followed by the selective norepinephrine reuptake inhibitor atomoxetine (8.4%).These estimates provide a benchmark of clinical practice for the period directly preceding issuance of the American Academy of Pediatrics' 2011 ADHD guidelines. Most children with ADHD received medication treatment or behavioral therapy; just under one-third received both. Multimodal treatment was most common for CSHCN with severe ADHD and those with comorbidities. Approximately one-half of preschoolers received behavioral therapy, the recommended first-line treatment for this age group.
| S-EPMC4469986 | biostudies-literature
Project description:ObjectiveTo identify subgroups of U.S. children with special health care needs (CSHCN) and characterize key outcomes.Data sourceSecondary analysis of 2009-2010 National Survey of CSHCN.Study designLatent class analysis grouped individuals into substantively meaningful classes empirically derived from measures of pediatric medical complexity. Outcomes were compared among latent classes with weighted logistic or negative binomial regression.Principal findingsLCA identified four unique CSHCN subgroups: broad functional impairment (physical, cognitive, and mental health) with extensive health care (Class 1), broad functional impairment alone (Class 2), predominant physical impairment requiring family-delivered care (Class 3), and physical impairment alone (Class 4). CSHCN from Class 1 had the highest ED visit rates (IRR 3.3, p < .001) and hospitalization odds (AOR: 12.0, p < .001) and lowest odds of a medical home (AOR: 0.17, p < .001). CSHCN in Class 3, despite experiencing more shared decision making and medical home attributes, had more ED visits and missed school than CSHCN in Class 2 (p < .001); the latter, however, experienced more cost-related difficulties, care delays, and parents having to stop work (p < .001).ConclusionsRecognizing distinct impacts of cognitive and mental health impairments and health care delivery needs on CSHCN outcomes may better direct future intervention efforts.
| S-EPMC4946040 | biostudies-literature