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需求，需要健康或与健康相关的需求 超出儿童一般需求的服务。在青春期，这些年轻人开始转变 从父母管理到自我管理他们的健康和保健，从儿科护理到成人护理 供应商。健康素养是这一转变中的重要工具，但人们对健康素养的模式知之甚少 有特殊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进 提高儿科保健的质量，并通过对青少年采取创新办法减少健康差距 关心。这项研究的目的是在#年对健康素养和健康结果进行大规模研究。 有特殊卫生保健需求的青少年。具体地说，本研究的目的是：1)确定 有特殊保健需求的青少年在健康素养方面的种族差异。测试的关系包括 家庭、农村/城市居民的母语和父母的教育；2)评估关系 青少年健康素养、家长健康素养和医疗转型有效规划之间的关系 从青春期到成年期；3)评估青少年健康素养、父母 健康素养和青少年健康指标，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15-17岁的青少年，他们有特殊的健康护理 服务中心的大型多元化医疗补助管理保健计划的投保人的需求和监护父母 以及俄亥俄州西南部。参与的青少年和家长将独立完成对 人口统计学、与儿童健康相关的生活质量、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 使用管理遭遇数据进行测量。分析将检验种族差异存在的假设 儿童在健康素养方面存在差异，父母教育和其他变数起到了调节作用。我们还将测试 假设健康素养方面的差异与过渡规划和规划方面的差异有关 不适当的医疗服务使用。该项目的结果将用于设计干预措施，以改善 通过明确解决卫生知识普及和卫生服务使用问题，促进卫生保健过渡进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 健康素养有限的预测因素以及与有限的健康素养相关的健康和社会成本 在这群人中。

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.