Adolescent Preventive Services: Disparities and Outcomes

青少年预防服务：差异和结果

• 批准号: 7037713
• 负责人: SALLY Henderson ADAMS
• 金额: $ 7.58万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-30 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7037713
• 关键词: adolescence (12-20); behavioral /social science research tag; clinical research; disease /disorder prevention /control; health behavior; health care service evaluation; health care service utilization; health disparity; health services research tag; human data; managed care; racial /ethnic difference; sex behavior; statistics /biometry; substance abuse related disorder; transportation /recreation safety

DESCRIPTION (provided by applicant): Rationale and Objectives: Significant racial/ethnic disparities in health care utilization exist among adolescents. When adolescents do access the system, the preventive services delivery is below the recommended levels. However, little is known about racial/ethnic disparities in preventive services delivery. Minority adolescents have higher rates of risky health behaviors and associated outcomes in several key areas that are preventable. The long-term research objective is to decrease racial/ethnic disparities in adolescent health behaviors and outcomes. Specific aims are to determine if: 1) There are racial/ethnic disparities in the delivery of adolescent preventive services; 2) An intervention to increase the delivery of preventive services in primary care reduces racial/ethnic disparities in the receipt of preventive services; 3) Receipt of preventive services has a similar effect on adolescents of different racial/ethnic backgrounds. Research Design: Population: 2 samples will be utilized: 1) UCSF Sample: 3369 adolescents participated in an evaluation of adolescent preventive services in a large managed care organization; and 2) CHIS sample: 2898 California adolescents participated in The California Health Interview Survey (CHIS) in 2001. Measures: UCSF adolescent participants completed surveys immediately following clinical well care visits that queried whether providers screened and counseled them during the visit in 3 target areas: substance use, safety, and sexual behavior. A UCSF subsample also participated in a longitudinal study of health behaviors, completing health outcome and self-efficacy surveys prior to well visits and one year later at a 2nd annual well visit. CHIS participants completed phone surveys that included their attendance of well visits and whether their providers screened them in target areas. Methods: Secondary data analyses of these established data sets will be conducted to test for the presence of racial/ethnic disparities in adolescent preventive services and outcomes. We will conduct multiple regression and logistic regression analyses to examine the proposed aims. Outcomes for aims 1 and 2 are provider screening and counseling during well visits. Outcomes for aim 3 are behavior change and self- efficacy in the longitudinal subsample of adolescents who received preventive services. We will control for covariation from variables including adolescent characteristics, such as age and gender, and family characteristics, such as socio-economic status. Public Health Relevance: The identification of racial/ethnic disparities in preventive services delivery could increase awareness and prompt improvements in healthcare for all adolescents. The identification of disparities in health behavior and self-efficacy outcomes as the result of preventive services could lead to increased focus on meeting the needs of adolescents of differing racial/ethnic backgrounds.

描述（由申请人提供）：理由和目标：青少年在医疗保健利用方面存在显著的种族/民族差异。当青少年进入该系统时，提供的预防服务低于建议水平。然而，人们对提供预防服务方面的种族/族裔差异知之甚少。在几个可预防的关键领域，少数民族青少年的危险健康行为率和相关后果较高。长期研究目标是减少青少年健康行为和结果的种族/民族差异。具体目标是确定：1)在提供青少年预防服务方面是否存在种族/民族差异；2)增加初级保健预防服务提供的干预措施减少了在接受预防服务方面的种族/民族差异；3)接受预防服务对不同种族/民族背景的青少年有类似的效果。研究设计：总体：将使用2个样本：1)UCSF样本：3369名青少年参加了一个大型管理式护理组织的青少年预防服务评估；2) CHIS样本：2898名加州青少年参加了2001年加州健康访谈调查（CHIS）。措施：UCSF青少年参与者在临床健康护理访问后立即完成调查，询问提供者是否在访问期间对他们进行了3个目标领域的筛查和咨询：物质使用，安全性和性行为。一个加州大学旧金山分校的子样本也参与了健康行为的纵向研究，在访井前和一年后第二次年度访井时完成了健康结果和自我效能的调查。CHIS参与者完成了电话调查，包括他们的出勤率以及他们的供应商是否在目标区域筛选了他们。方法：将对这些已建立的数据集进行二次数据分析，以检验在青少年预防服务和结果中是否存在种族/民族差异。我们将进行多元回归和逻辑回归分析，以检验建议的目标。目标1和目标2的结果是在访井期间进行提供者筛选和咨询。目的3的结果是接受预防服务的青少年纵向子样本的行为改变和自我效能。我们将控制变量的共变，包括青少年特征（如年龄和性别）和家庭特征（如社会经济地位）。公共卫生相关性：确定在提供预防服务方面的种族/族裔差异，可以提高对所有青少年的认识，并促使他们改善保健服务。确认保健行为和自我效能方面的差异是预防服务的结果，可导致更加注重满足不同种族/族裔背景的青少年的需要。