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，需要健康或与健康有关一般儿童要求的服务超出了服务。在青春期，这些年轻人开始过渡从父母的管理到他们的健康和医疗保健的自我管理，从儿科到成人护理提供者。健康素养是这种过渡的重要工具，但对健康素养的模式知之甚少在有特殊医疗保健需求及其在自我护理中的重要性的青少年中。我们的长期目标是改善小儿医疗保健的质量和通过创新的青少年方法降低健康差异关心。这项研究的目的是对健康素养和健康成果进行大规模研究有特殊医疗保健需求的青少年。具体而言，本研究的目的是：1）确定调解人和主持人具有特殊卫生保健需求的青少年的健康素养中的种族差异。测试的关系将包括在家中使用的初级语言，农村/城市居住和父母教育； 2）评估关系在青少年健康素养，父母健康素养和有效计划之间的医疗保健过渡之间从青春期到成年； 3）评估青少年健康素养，父母之间的关系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，我们将通过特殊的医疗保健招募15-17岁的青少年的600个二元组需求和来自招待所的监护父母，在一个为中心服务的大型医疗补助托管计划中和西南俄亥俄州。参加的青少年和父母将独立完成对人口统计学，与儿童健康相关的生活质量，功能健康素养，医疗家庭状况和医疗保健过渡计划。初步评估后的一年，医疗保健利用信息将可以使用管理遭遇数据来测量。分析将检验存在种族差异的假设在健康素养和差异方面是由父母教育和其他变量介导的。我们还将测试关于健康素养差异与过渡计划的差异有关的假设和不适当的卫生服务使用。该项目的结果将用于设计改进的干预措施医疗保健过渡过程和健康服务使用明确解决健康素养问题和告知医疗保健提供者，付款人，公共卫生专业人员和政策制定者健康素养限制以及与健康素养有限相关的健康和社会成本的预测指标在这个人群中。