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Health Literacy-Disparities and transition in teens with special healthcare needs

健康素养——有特殊医疗保健需求的青少年的差异和转变

基本信息

批准号：
8334492
负责人：
Deena Chisolm
金额：
$ 29.31万
依托单位：
RESEARCH INST NATIONWIDE CHILDREN'S HOSP
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-19 至 2016-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8334492
关键词：
Address Adolescence Adolescent Adult African American Age Asthma Behavior Build-it Caring Child Child health care Childhood County Data Diabetes Mellitus Disease Disease Management Education Enrollment Family Funding Goals Grant Health Health Personnel Health Professional Health Resources Health Services Healthcare Healthcare Systems Home environment Intervention Language Managed Care Measures Mediating Mediator of activation protein Medicaid Medical National Institute of Child Health and Human Development Nature Ohio Outcome Parents Patients Pattern Pediatric Hospitals Phase Physician-Hospital Organizations Play Policy Maker Population Population Heterogeneity Preparation Process Provider Public Health Readiness Recruitment Activity Research Role Rural Self Care Self Efficacy Self Management Services Technology Teenagers Testing Youth base cost demographics design functional health literacy health care service utilization health disparity health literacy health related quality of life improved innovation literacy medical specialties residence skills social therapy design tool willingness

项目摘要

Nearly 20 percent of U.S. adolescents have special health care needs that require health or health-related services beyond that required by children generally. During adolescence, these youths begin the transition from parental management to self-management of their health and healthcare and from pediatric to adult care providers. Health literacy is an important tool in this transition but little is known about patterns of health literacy in adolescents with special healthcare needs and its importance in self care. Our long-term goal is to improve the quality of pediatric healthcare and to reduce health disparities through innovative approaches to adolescent care. The objective of this study is to conduct a large-scale study of health literacy and health outcomes in teens with special health care needs. Specifically, this study aims to: 1) Identify mediators and moderators of racial disparity in health literacy in adolescents with special health care needs. Relationships tested will include primary language spoken at home, rural/urban residence, and parental education; 2) Assess the relationship between adolescent health literacy, parent health literacy and effective planning for the healthcare transition from adolescence to adulthood; and 3) Assess the relationship between adolescent health literacy, parent health literacy, and adolescent health indicators including health-related quality of life and healthcare utilization. To accomplish these aims we will recruit 600 dyads of a teen, age 15-17, with special health care needs and a custodial parent from enrollees in a large, diverse Medicaid managed care plan serving central and southwestern Ohio. Participating teens and parents will independently complete assessments of demographics, child health-related quality of life, functional health literacy, medical home status, and healthcare transition planning. Health care utilization information in the year following the initial assessment will be measured using administrative encounter data. Analyses will test the hypotheses that racial disparities exist in health literacy and that disparities are mediated by parental education and other variables. We will also test the hypothesis that disparities in health literacy are associated with disparities in transition planning and inappropriate health services use. Results from this project will be used to design interventions that improve the healthcare transition process and health services use by expressly addressing issues of health literacy and to inform health care providers, payors, public health professionals, and policy-makers of the extent and predictors of health literacy limitations and of the health and social costs associated with limited health literacy in this population.

近 20% 的美国青少年有特殊的医疗保健需求，需要健康或与健康相关的服务超出儿童一般需求的服务。在青春期，这些年轻人开始转变从家长管理到健康和保健的自我管理，从儿科到成人护理提供商。健康素养是这一转变的重要工具，但人们对健康素养的模式知之甚少有特殊医疗保健需求的青少年及其在自我护理中的重要性。我们的长期目标是改善儿科医疗保健的质量并通过针对青少年的创新方法减少健康差距关心。本研究的目的是对健康素养和健康结果进行大规模研究有特殊医疗保健需求的青少年。具体来说，本研究的目的是： 1）确定中介者和调节者有特殊医疗保健需求的青少年健康素养方面存在种族差异。测试的关系将包括家庭、农村/城市居住地和父母教育的主要语言； 2）评估关系青少年健康素养、家长健康素养和医疗保健转型的有效规划之间的关系从青春期到成年； 3) 评估青少年健康素养、家长健康素养和青少年健康指标，包括与健康相关的生活质量和医疗保健利用率。为了实现这些目标，我们将招募 600 名 15 至 17 岁的青少年，并提供特殊医疗保健服务于中央的大型、多样化的医疗补助管理护理计划的参与者的需求和监护父母和俄亥俄州西南部。参与的青少年和家长将独立完成评估人口统计、儿童健康相关的生活质量、功能性健康素养、医疗之家状况以及医疗保健过渡规划。初步评估后一年的医疗保健利用信息将使用行政遭遇数据来衡量。分析将检验种族差异存在的假设健康素养方面的差异，并且差异是由父母教育和其他变量调节的。我们也会测试假设健康素养的差异与过渡计划和过渡计划的差异有关医疗服务使用不当。该项目的结果将用于设计干预措施，以改善通过明确解决健康素养问题和卫生保健转型过程和卫生服务的使用向卫生保健提供者、付款人、公共卫生专业人员和政策制定者通报其范围和情况健康素养限制以及与健康素养有限相关的健康和社会成本的预测因素在这个人群中。