Disability and Health Journal最新文献

{"title":"Understanding disability benefits decision-making among adults with self-reported work disabilities: A qualitative study","authors":"Lila Rabinovich M.Phil (Social Science Researcher),&nbsp;Doerte Junghaenel Ph.D. (Associate Professor),&nbsp;Tabasa Ozawa M.P.H. (Project Specialist)","doi":"10.1016/j.dhjo.2024.101681","DOIUrl":"10.1016/j.dhjo.2024.101681","url":null,"abstract":"<div><h3>Background</h3><div>Take-up gaps in safety net programs, long documented in the US, are an important policy problem as non-take up compromises the equity objectives and efficacy of programs. The Social Security Disability program is an example of this: more than 20 million adults report a work disability, but only around 11 million currently receive disability benefits through the Social Security Disability Insurance or Supplemental Security Income programs.</div></div><div><h3>Objectives</h3><div>We examine decision-making around benefits application among adults with self-reported work disability who have never applied for disability benefits.</div></div><div><h3>Methods</h3><div>We conducted 39 interviews with work-disabled adults who have never applied for disability benefits. Thematic analysis identified key barriers and inhibitors to disability application.</div></div><div><h3>Results</h3><div>High transaction costs involved in disability applications coupled with the widespread perception of low approval rates was mentioned as a critical deterrent. Uncertain and lengthy medical processes after disability onset were also frequently reported as a key deterrent. Stigma about receiving disability benefits did not emerge as a factor in application behavior, although a change in self-concept involving an adjustment to benefit-receiving, work-disabled status was cited as a barrier to claiming.</div></div><div><h3>Conclusion</h3><div>Our results broadly align with those of other research that examined the information, transaction, and social costs of applying for benefits. Nevertheless, the qualitative data afford a more in-depth, grounded understanding of the primary factors affecting application decisions, and how those interact. These insights are important to inform targets for interventions to reduce barriers to take-up of benefits among potentially eligible adults with disabilities.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 1","pages":"Article 101681"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal mental health and risk of severe maternal morbidity in women with physical disabilities, Massachusetts 2003-2015.","authors":"Anne Valentine, Ilhom Akobirshoev, Jiangying Zhang, Tiffany A Moore Simas, Monika Mitra","doi":"10.1016/j.dhjo.2024.101772","DOIUrl":"https://doi.org/10.1016/j.dhjo.2024.101772","url":null,"abstract":"<p><strong>Background: </strong>Perinatal mental health and substance use disorders contribute to adverse maternal outcomes. Women with disabilities experience increased risk for severe maternal morbidity (SMM). No studies have examined the association between perinatal mental health and SMM risk in women with physical disabilities.</p><p><strong>Objective: </strong>To examine the association between perinatal mental health and substance use disorders and SMM risk in women with physical disabilities.</p><p><strong>Methods: </strong>We analyzed delivery hospitalizations from 2003 to 2015 from the Massachusetts Pregnancy to Early Life Longitudinal (PELL) data system. We identified physical disability using International Classification of Diseases, Ninth Revision codes. Perinatal mental health status was based on the presence of at least one emergency department visit, observational, or in-patient stay attributed to a mental health or substance use disorder anytime from gestation to delivery. We used modified Poisson regressions to obtain risk ratios (RR) for SMM in women with either a physical disability or no disability by perinatal mental health status. Non-disabled women with no perinatal mental health or substance use disorder visit served as the referent group.</p><p><strong>Results: </strong>Deliveries in women with no physical disability and a perinatal mental health visit were not associated with risk of SMM. Compared to the referent group, women with a physical disability and a perinatal mental health or substance use disorder visit had greater risk of both SMM (RR = 1.84, 95 % CI:1.32-2.56), and nontransfusion SMM (RR = 2.35 1.52, 3.64), after adjusting for demographic and socioeconomic characteristics.</p><p><strong>Conclusions: </strong>Increased attention should be paid to perinatal mental health status in women with physical disabilities.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101772"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse childhood experiences in adults with chronic traumatic brain injury: Support for a life course approach to brain injury rehabilitation","authors":"Umesh M. Venkatesan PhD ,&nbsp;Shannon B. Juengst PhD","doi":"10.1016/j.dhjo.2024.101714","DOIUrl":"10.1016/j.dhjo.2024.101714","url":null,"abstract":"<div><h3>Background</h3><div>Adverse childhood experiences (ACEs) confer greater risk for adult traumatic brain injury (TBI), but little is known about their effects on post-injury outcomes.</div></div><div><h3>Objective</h3><div>To determine the prevalence and correlates of conventionally defined ACEs (occurring within household/in private; e.g., physical abuse) and community-level ACEs (e.g., bullying) after TBI.</div></div><div><h3>Methods</h3><div>Participants were 85 Philadelphia-area TBI Model System participants with chronic (&gt;1 year post-injury) TBI. We examined cross-sectional associations between total conventional and community ACEs reported (out of 21) before age 18, mental health symptoms, and health-related quality of life (HRQoL), as well as relationships between ACEs and neighborhood deprivation (census-derived neighborhood socioeconomic status).</div></div><div><h3>Results</h3><div>The median number of total ACEs was 3 (range: 0–17). Emotional abuse, physical abuse, and alcohol abuse in the household were the most common conventional ACEs (each at 36.5 %). Witnessing violence (45 %) was the most common community ACE. Black individuals (n = 32) reported more community ACEs (<em>p</em> &lt; .001) than White individuals (n = 45). Community ACEs were significantly associated with greater neighborhood deprivation, though this relationship was confounded by race. Total ACEs was significantly related to more severe mental health symptoms (<em>p</em> &lt; .001) and poorer HRQoL (<em>p</em> = .005), even after covariate adjustment. A fully-adjusted path model supported mental health as a mediator between total ACEs and HRQoL.</div></div><div><h3>Conclusions</h3><div>Results of this preliminary study reveal an appreciable prevalence and potential far-reaching consequences of conventional and community ACEs among those with chronic TBI. The results underscore the value of trauma-informed and life course approaches to research and clinical care in TBI.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 1","pages":"Article 101714"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The language of inclusion: A randomized trial of how DEI statements influence hiring practices for people with visible and invisible disabilities","authors":"Mason Ameri Ph.D.,&nbsp;Terri R. Kurtzberg Ph.D.","doi":"10.1016/j.dhjo.2024.101717","DOIUrl":"10.1016/j.dhjo.2024.101717","url":null,"abstract":"<div><h3>Background</h3><div>Companies are increasingly motivated to ensure that they are effective at hiring people with disabilities, but bias in the process remains a challenge. While Diversity, Equity, and Inclusion (DEI) statements are generally crafted as external-facing signaling devices, little is known about their potential effect on the employees themselves with regard to internal decisions, such as hiring.</div></div><div><h3>Objective</h3><div>This study aims to explore whether various DEI statements may encourage more positive hiring decisions for job candidates with both visible and invisible disabilities.</div></div><div><h3>Methods</h3><div>An experiment with a 2 × 4 × 2 design was used (<em>DEI Language</em>: legal/traditional or heartfelt; <em>Disability Type</em>: none, visible, and two types of invisible disabilities; <em>Candidate's Tone</em>: warm or overconfident). Quantitative and qualitative items measured general reactions to the candidate as well as perceptions about his employability, degree of risk as a new hire, skills at negotiating for his salary, and integrity. Statistical tests include analyses of variance and z-tests for proportions.</div></div><div><h3>Results</h3><div>Heartfelt statements improved ratings of candidates with disabilities in general, and more so for those with invisible disabilities. In addition, the two types of invisible disability were distinct from each other, with the mental health disability more stigmatized than the neurological one.</div></div><div><h3>Conclusions</h3><div>These results suggest that the DEI language that a company uses is an important signaling device not just for external constituents but also for internal employees. In addition, it is among the first to demonstrate differences in types of invisible disabilities, indicating that more nuance is needed to understand bias in this context.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 1","pages":"Article 101717"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-reported hearing loss and health during a pandemic: Findings from a cross-sectional analysis using a 2021 household survey","authors":"Eunice Y. Park PhD ,&nbsp;Erin R. Nelson-Bakkum AuD ,&nbsp;Amy A. Schultz PhD ,&nbsp;Lauren K. Dillard AuD, PhD","doi":"10.1016/j.dhjo.2024.101706","DOIUrl":"10.1016/j.dhjo.2024.101706","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic differentially impacted individuals with hearing loss, likely in part due to increased communication difficulties from masking, a commonly implemented protective measure.</div></div><div><h3>Objective</h3><div>This study examines the association between self-reported hearing loss and health during the pandemic.</div></div><div><h3>Methods</h3><div>This study uses data from the COVID-19 Survey collected by the Survey of the Health of Wisconsin from February to March 2021. Hearing loss was defined as self-reported fair or poor hearing. The outcomes were self-reported symptoms of anxiety and depression, separately, and self-reported general health. Multivariable models adjusted for age, gender, and race/ethnicity were used to examine the associations between hearing loss with each outcome. Results are presented as prevalence ratios (PR) with corresponding 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>There were 1857 participants (60.3 % female, 12.9 % non-white) with a mean age of 57.1 years in this cross-sectional study. In multivariable models, individuals with hearing loss (versus none) had higher prevalence of depression (PR: 1.22, 95 % CI: 1.06, 1.39), anxiety (PR: 1.13, 95 % CI: 1.02, 1.27), and self-reported fair or poor health (PR: 2.61, 95 % CI: 1.89, 3.61).</div></div><div><h3>Conclusion</h3><div>Hearing loss was associated with poorer self-reported health during winter 2021 of the COVID-19 pandemic, when mask use in public was newly mandated and vaccines were not widely available to the general public. Further research on the impact of public health policies on vulnerable populations, including those with hearing loss, is warranted. Such research could inform policy decisions that accommodate these populations.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 1","pages":"Article 101706"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health disparities and injection drug use behaviors among adults with and without disabilities in the National Survey on drug use and health, 2015–2019","authors":"Roberto Abadie Ph.D. ,&nbsp;Manuel Cano Ph.D.","doi":"10.1016/j.dhjo.2024.101715","DOIUrl":"10.1016/j.dhjo.2024.101715","url":null,"abstract":"<div><h3>Background</h3><div>Little is known about the prevalence of injection drug use in people with disabilities (PWD) when compared by disability type and to other adults without disabilities.</div></div><div><h3>Objective or hypothesis</h3><div>The prevalence of past-year injection drug use will be higher in adults with a reported disability than adults without any reported disability.</div></div><div><h3>Methods</h3><div>This study consisted of secondary analyses of data from the 2015–2019 National Survey of Drug Use and Health. The analytic sample comprised 214,505 US adults. Self-reported past-year injection drug use represented the outcome of interest. Disability status and socioeconomic characteristics were conceptualized as predictors, and sex and age were used as controls.</div></div><div><h3>Results</h3><div>Past-year prevalence of self-reported injection drug use was 0.24 % (95 % CI, 0.22–0.27) in adults without a disability but 0.66 % (95 % CI, 0.59–0.73) in adults with a disability. All disability types examined were associated with increased odds of reporting past-year injection drug use, but the strongest association was observed for disability related to difficulty concentrating (AOR, 4.90; 95 % CI, 3.92–6.14). Adjusted odds of past-year methamphetamine injection were more than three times as high in adults with a disability, compared to those without a disability (AOR, 3.21; 95 % CI, 2.37–4.33) and more than two times as high in adults with a disability for cocaine injection (AOR, 2.77; 95 % CI, 1.84–4.15).</div></div><div><h3>Conclusion</h3><div>Disability status is associated with injection of various types of drugs, and a variety of disability types are associated with higher odds of injection drug use.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 1","pages":"Article 101715"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of COVID-19 on livelihoods of people with and without disabilities: Results from a cross-sectional survey in 3 urban areas of Viet Nam","authors":"Lena Morgon Banks PhD ,&nbsp;Divya Goyal MSc ,&nbsp;Luong Anh Ngoc MSc ,&nbsp;Sara Rotenberg PhD ,&nbsp;Sarah Marks MSc ,&nbsp;Xanthe Hunt PhD ,&nbsp;Shaffa Hameed PhD ,&nbsp;Hoang Van Minh PhD ,&nbsp;Vu Quynh Mai MSc","doi":"10.1016/j.dhjo.2024.101674","DOIUrl":"10.1016/j.dhjo.2024.101674","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic has had widespread health, social and economic impacts worldwide. In many contexts, it has likely exacerbated existing inequalities.</div></div><div><h3>Objective</h3><div>This study compares the economic impacts of the COVID-19 pandemic amongst people with and without disabilities in Viet Nam.</div></div><div><h3>Methods</h3><div>A telephone survey was conducted in the three largest cities of Viet Nam (Da Nang, Ha Noi, and Ho Chi Minh City) between December 2021 and January 2022. Participants were recruited through convenience sampling (n = 898; 479 people with disabilities; 419 without). The survey collected data on livelihoods, employment, household economic security, and access to social protection and assistance.</div></div><div><h3>Results</h3><div>People with disabilities were three times more likely to have stopped working completely (PR: 2.8, 95 % CI: 2.0–4.0), 30 % more likely to report reduced earnings (PR: 1.3, 95 % CI: 1.2–1.5), twice as likely to report severe impacts on household finances (PR: 1.9, 95 % CI: 1.6–2.3) and three times more likely to report severe impacts on household food security (PR: 3.2, 95 % CI: 2.3–4.6) since the onset of the pandemic. Amongst people with disabilities, informal workers were particularly negatively affected. Households with members with disabilities were more likely to receive some types of COVID-19-related assistance (e.g. financial or food aid), but less likely to be enrolled in social insurance.</div></div><div><h3>Conclusions</h3><div>Urgent and inclusive responses are necessary during crises to address the unique challenges faced by people with disabilities. Implementing comprehensive social protection measures is crucial to narrowing disparities, and maintaining well-being and economic security during shocks such as COVID-19.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 1","pages":"Article 101674"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining outpatient occupational therapy utilization among children and youth with special health care needs in South Carolina: A structural equation model of individual- and community-level factors","authors":"Caitlin Koob PhD, MS, OTR/L ,&nbsp;Sarah F. Griffin PhD, MPH ,&nbsp;Kathleen Cartmell PhD, MPH ,&nbsp;Lior Rennert PhD ,&nbsp;Kerry Sease MD, MPH","doi":"10.1016/j.dhjo.2024.101687","DOIUrl":"10.1016/j.dhjo.2024.101687","url":null,"abstract":"<div><h3>Background</h3><div>Children and youth with special health care needs (CYSHCN) comprise 23 % of the pediatric population in South Carolina (SC), compared to state prevalences of 13.6 %–24 % nationwide. While occupational therapy (OT) is critical to maximizing CYSHCN's participation in daily activities, there are significant disparities in rehabilitation access in the Southeast region.</div></div><div><h3>Objective</h3><div>This study examines associations between patient-and community-level factors and outpatient OT utilization.</div></div><div><h3>Methods</h3><div>This study analyzes OT utilization data among CYSHCN (N = 1913) in a health system in SC from 07/01/2022-06/31/2023, merged with Child Opportunity Index 2.0 zip-code level social drivers of health (SDOH) data. SDOH are non-medical factors that affect individual's long-term health, with estimates ranging from “very low” to “very high” opportunity. Structural equation modeling was conducted to understand complex associations between observed and latent variables in a real-world context.</div></div><div><h3>Results</h3><div>CYSHCN were diagnosed with congenital (40.77 %), developmental (37.87 %), and neurological/neuromuscular conditions (21.36 %). CYSHCN who were non-Hispanic Black or Hispanic and were hospitalized were associated with living in lower opportunity areas. CYSHCN with private or military/other insurance/self-pay were associated with living in higher opportunity areas than Medicaid-insured CYSHCN. CYSHCN who were female and ≥12 years demonstrated lower OT utilization. CYSHCN who participated in speech and/or physical therapy demonstrated higher OT utilization. OT utilization increased with each increase in SDOH.</div></div><div><h3>Conclusion</h3><div>With these findings, healthcare providers may consider accessibility barriers, including transportation, when referring CYSHCN to OT services. Further research is needed to examine the impact of household-level SDOH on OT access across SC.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 1","pages":"Article 101687"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Athlete identity in para-sport: A comparative study of athletes with congenital and acquired disabilities","authors":"Kathryn M. Rougeau PhD ,&nbsp;Stephen R. Koziel MPH ,&nbsp;Angelina M. Gjorgjevski MPH ,&nbsp;Joshua L. Joines BA","doi":"10.1016/j.dhjo.2024.101685","DOIUrl":"10.1016/j.dhjo.2024.101685","url":null,"abstract":"<div><h3>Background</h3><div>Identity development explores how individuals perceive themselves based on their life experiences, including their current self and aspirations. Athlete Identity has been studied using a 4-factor framework across various sports and ability groups. However, there is limited research on how individuals with physical disabilities perceive themselves as athletes and how an acquired disability impacts identity compared to a congenital disability.</div></div><div><h3>Objective</h3><div>To test the validity of the 4-Factor Model of Athlete Identity and to determine if athletic identity differs between para-athletes who have congenital versus acquired disabilities.</div></div><div><h3>Methods</h3><div>Secondary analysis of cross-sectional data from the National Wheelchair Basketball Association. Participants consisted of 408 individuals (8 years and older) who play wheelchair basketball (n = 315 male; 29.13 ± 13.89 yrs; M ± SD) who responded to a brief online questionnaire including basic demographics and the 10-item Athlete Identity Measurement Scale (AIMS).</div></div><div><h3>Results</h3><div>No significant differences in total AIMS scores were found between participants with congenital disabilities and participants with acquired disabilities. Age was a significant covariate. Eigenvalue analysis of the AIMS scores shows that 2 factors describe this population of athletes.</div></div><div><h3>Conclusions</h3><div>Disability acquisition is not associated with total AIMS scores. Athletic identity is weaker in older participants suggesting a more inclusive self-schema as one ages. The 4-factor model of Athletic Identity is not applicable in this population. Continued research into the intersection of athlete and disability identity is warranted.</div></div><div><h3>Abstract presented</h3><div>North American Society for the Psychology of Sport and Physical Activity, 2019.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 1","pages":"Article 101685"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of special services among children and youth with special healthcare needs: A time-to-event analysis of the national survey of children's health data, 2016–2022","authors":"Suman Kanti Chowdhury MIH, CPH-Provisional ,&nbsp;Jennifer Marshall PhD, MPH, CPH ,&nbsp;Janice Zgibor RPh, PhD, CPH, FACE ,&nbsp;Russell S. Kirby PhD, MS, FACE","doi":"10.1016/j.dhjo.2024.101688","DOIUrl":"10.1016/j.dhjo.2024.101688","url":null,"abstract":"<div><h3>Background</h3><div>Special services including physical, occupational, speech, or behavioral therapies are associated with enhanced long-term functioning and well-being of children and youth with special healthcare needs (CYSHCN). Yet, there is a lack of recent evidence on the utilization of these services, and the age at which CYSHCN first receive them.</div></div><div><h3>Objective</h3><div>This study assessed the distribution, timing, and determinants of special services utilization across different types of special healthcare needs.</div></div><div><h3>Methods</h3><div>Data from 63,734 caregivers of CYSHCN aged 0–17 years from the 2016–2022 National Survey of Children's Health were analyzed using Rao-Scott Chi-Square, Log-rank, and Cox proportional hazard tests.</div></div><div><h3>Results</h3><div>Overall, 41.9 % of CYSHCN ever received special services, including 91.4 %, 90.3 %, 88.0, and 34.1 % of children and youth with Down syndrome, cerebral palsy, autism, and other special healthcare needs (OSHCN), respectively. Children with Down syndrome and cerebral palsy received special services earlier than those with autism or OSHCN. Utilization of special services was higher among male children and youth (aHR 1.41; 95 % CI: 1.33–1.49), aged 0–5 years (aHR: 4.70; 95 % CI: 4.32–5.11), second or later born children (aHR: 1.18; 95 % CI: 1.10–1.26), from families with low-income (aHR: 1.14; 95 % CI: 1.04–1.24), living with married parents (aHR: 1.11; 95 % CI: 1.04–1.19), consistently insured (aHR: 1.24; 95 % CI: 1.08–1.42), and with a more complex health condition (aHR: 3.40; 95 % CI: 3.13–3.70) compared to their counterparts.</div></div><div><h3>Conclusions</h3><div>These findings highlight the necessity of adopting tailored approaches for children with different special healthcare needs to optimize and sustain the utilization of special services.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 1","pages":"Article 101688"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}