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Adolescent Preventive Services: Disparities and Outcomes

青少年预防服务：差异和结果

基本信息

批准号：
7128193
负责人：
SALLY Henderson ADAMS
金额：
$ 7.4万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-09-30 至 2008-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7128193
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

项目摘要

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）：理由和目的：青少年在卫生保健利用方面存在显著的种族/民族差异。即使青少年能够利用该系统，预防服务的提供也低于建议水平。然而，人们对预防服务提供方面的种族/族裔差异知之甚少。少数民族青少年在几个可预防的关键领域有更高的危险健康行为和相关结果。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）在初级保健中增加预防服务的提供的干预措施是否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/民族背景的青少年具有类似的影响。研究设计：人口：将使用2个样本：1）UCSF样本：3369名青少年参与了大型管理式护理组织的青少年预防服务评价; 2）CHIS样本：2001年2898名加州青少年参与了加州健康访谈调查（CHIS）。措施：加州大学旧金山分校的青少年参与者在临床良好护理访问后立即完成调查，询问提供者是否在访问期间在3个目标领域对他们进行筛选和咨询：物质使用，安全和性行为。UCSF子样本还参加了健康行为的纵向研究，在油井访问之前完成健康结果和自我效能调查，一年后在第二次年度油井访问时完成。CHIS参与者完成了电话调查，其中包括他们参加油井访问以及他们的供应商是否在目标地区筛选他们。研究方法：将对这些已建立的数据集进行二级数据分析，以检验青少年预防服务和结果中是否存在种族/民族差异。我们会进行多元回归及逻辑回归分析，以研究建议的目的。目标1和2的成果是在油井访问期间进行供应商筛选和咨询。目标3的结果是在接受预防服务的青少年纵向子样本中的行为改变和自我效能。我们将控制包括青少年特征（如年龄和性别）和家庭特征（如社会经济地位）在内的变量的协变。公共卫生相关性：在预防性服务提供方面查明种族/民族差异可以提高认识，并迅速改善所有青少年的保健。确定差异的健康行为和自我效能的结果，预防服务可能会导致更多的关注，以满足不同种族/民族背景的青少年的需求。