Maternal and child health journal
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Matern Child Health J · Dec 2012
Dietary intakes of preschool-aged children in relation to caregivers' race/ethnicity, acculturation, and demographic characteristics: results from the 2007 California Health Interview Survey.
Few studies have examined the influence of acculturation on dietary behaviors of young children while controlling for other demographic variables. The purpose of this study was to assess reported dietary intakes of preschool-aged children (3-5 years) and subsequent associations with caregivers' race/ethnicity, acculturation and demographic characteristics, using data from the 2007 California Health Interview Survey (CHIS). Analysis was restricted to Hispanic and non-Hispanic white caregivers and their preschool-aged children (n = 1,105). ⋯ Caregivers' acculturation was associated with caregiver-reported consumption of sweets by children (β = 0.09, 95%CI = 0.01-0.18). Demographic characteristics that were associated with reported dietary intakes of children included caregivers' age, education, and geographic region of residence. In contrast to past studies of acculturation and diet in older children and adults, this study suggests that for 3-5 year olds, caregivers' level of acculturation does not play as strong a role in the dietary intakes of the younger children under their care.
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Matern Child Health J · Dec 2012
Factors associated with a medical home among children with Attention-Deficit Hyperactivity Disorder.
Providing a medical home to children with Attention-Deficit Hyperactivity Disorder (ADHD) is challenging. Little is known about the factors associated with having a medical home for these children, or how comorbidities affect having a medical home. Our study aims are: (1) identify factors associated with having a medical home and five sub-components of a medical home and (2) determine the effect of medical home on several outcomes for children with ADHD. ⋯ Our results suggest that there are differences in parent's perceptions of receiving care among children with ADHD. Pediatric medical home projects and policies should acknowledge that children with ADHD often have comorbidities making their care more complex. These complexities should be addressed during practice transformation and setting reimbursement policies.
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Matern Child Health J · Dec 2012
Emergency department visits and hospitalizations for injuries among infants and children following statewide implementation of a home visitation model.
To compare hospital-based utilization for early childhood injuries between program recipients and local-area comparison families following statewide implementation of an evidence-based home visitation program, and to describe site-level program variation. Propensity score matching on baseline characteristics was used to create a retrospective cohort of Nurse-Family Partnership (NFP) clients and local area matched comparison women. The main outcome, a count of injury visit episodes, was enumerated from Medicaid claims for injuries examined in an emergency department or hospital setting during the first 2 years of life of children born to included subjects. ⋯ The proportion of children with at least one injury visit varied from 14.5 to 42.5% among individual sites. Contrary to prior randomized trial data, no reductions in utilization for serious early childhood injuries were demonstrated following statewide implementation of an evidence-based home visitation program. Significant program variation on outcomes underscores the challenges to successful implementation.
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Matern Child Health J · Dec 2012
Timely access to quality health care among Georgia children ages 4 to 17 years.
We examined factors associated with children's access to quality health care, a major concern in Georgia, identified through the 2010 Title V Needs Assessment. Data from the 2007 National Survey of Children's Health were merged with the 2008 Area Resource File and Health Resources and Services Administration medically underserved area variable, and restricted to Georgia children ages 4-17 years (N = 1,397). The study outcome, access to quality health care was derived from access to care (timely utilization of preventive medical care in the previous 12 months) and quality of care (compassionate/culturally effective/family-centered care). ⋯ Factors positively associated with having access to higher/moderate versus lower quality care include having a usual source of care (USC) (adjusted odds ratio, AOR:3.27; 95 % confidence interval, 95 % CI 1.15-9.26), and special health care needs (AOR:2.68; 95 % CI 1.42-5.05). Lower odds of access to higher/moderate versus lower quality care were observed for non-Hispanic Black (AOR:0.31; 95 % CI 0.18-0.53) and Hispanic (AOR:0.20; 95 % CI 0.08-0.50) children compared with non-Hispanic White children and for children with all other forms of insurance coverage compared with children with continuous-adequate-private insurance. Ensuring that children have continuous, adequate insurance coverage and a USC may positively affect their access to quality health care in Georgia.