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

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 一般来说，这是孩子们所需要的。在青春期，这些年轻人开始 从父母管理到自我管理他们的健康和医疗保健，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，但对健康素养的模式知之甚少 有特殊保健需要的青少年及其自我保健的重要性。我们的长期目标是改善 通过对青少年的创新方法， 在乎本研究的目的是进行大规模的健康素养和健康结果的研究， 有特殊医疗需求的青少年具体而言，本研究旨在：1）确定中介和主持人的 有特殊保健需要的青少年健康知识普及方面的种族差异。测试的关系将包括 家庭、农村/城市居住地和父母教育中使用的主要语言; 2）评估关系 青少年健康素养、父母健康素养和有效规划医疗保健转型之间的关系 从青少年到成年; 3）评估青少年健康素养，父母 健康知识普及和青少年健康指标，包括与健康有关的生活质量和保健 利用率为了实现这些目标，我们将招募600名年龄在15-17岁之间的青少年， 需要和监护父母从登记者在一个大型的，多样化的医疗补助管理式医疗计划，服务于中央 和西南部的俄亥俄州。参与的青少年和家长将独立完成以下评估： 人口统计学、儿童健康相关生活质量、功能性健康素养、医疗家庭状况，以及 医疗转型规划。初步评估后一年的卫生保健利用信息将 使用行政遭遇数据进行衡量。分析将检验种族差异存在的假设 在健康知识普及方面，父母教育和其他变量会调节这种差异。我们还将测试 假设健康素养的差异与过渡规划的差异有关， 不适当的卫生服务使用。该项目的成果将用于设计干预措施， 通过明确解决卫生知识普及问题， 告知卫生保健提供者、付款人、公共卫生专业人员和政策制定者， 健康素养限制的预测因素以及与有限健康素养相关的健康和社会成本 在这个人群中。

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.