Family-centered care for US children with special health care needs: Who gets it and why?

Tumaini R. Coker, Michael A. Rodriguez, Glenn Flores

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

OBJECTIVE: The goal was to examine racial/ethnic and language disparities in family-centered care (FCC) and in FCC components for children with special health care needs (CSHCN). METHODS: Bivariate and multivariate logistic regression analyses of data from the 2005-2006 National Survey of CSHCN were performed. RESULTS: A total of 66% of CSHCN with a health visit in the past year received FCC. In adjusted analyses, we found lower odds of FCC for Latino (odds ratio: 0.53 [95% confidence interval: 0.45-0.63]), African-American (odds ratio: 0.60 [95% confidence interval: 0.52-0.69]), and other (odds ratio: 0.58 [95% confidence interval: 0.43-0.78]) children, compared with white children, and for children in households with a non-English primary language (odds ratio: 0.48 [95% confidence interval: 0.36-0.64]), compared with those in households with English as the primary language. These disparities persisted after adjustment for child health (condition severity and emotional, behavioral, and developmental needs), socioeconomic (poverty level, parental education, household composition, and residing in a metropolitan statistical area), and access (insurance type, usual source of care, and having a personal physician) factors. Of these factors, only condition severity was significantly associated with the racial/ethnic disparities; none was significantly associated with the language disparities. Disparities were found for Latino and African-American children and children in households with a non-English primary language for the FCC components of time spent with the provider and sensitivity to the family's values and customs. CONCLUSIONS: Robust FCC racial/ethnic and language disparities exist for CSHCN; initial efforts to address these disparities should focus on increasing provider time and cultural sensitivity.

Original languageEnglish (US)
Pages (from-to)1159-1167
Number of pages9
JournalPediatrics
Volume125
Issue number6
DOIs
StatePublished - Jun 2010

Fingerprint

Child Care
Delivery of Health Care
Language
Odds Ratio
Confidence Intervals
Hispanic Americans
African Americans
Poverty
Insurance
Logistic Models
Regression Analysis
Physicians
Education
Health

Keywords

  • Children with special health care needs
  • Family-centered care
  • Medical home
  • Racial/ethnic disparities

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Family-centered care for US children with special health care needs : Who gets it and why? / Coker, Tumaini R.; Rodriguez, Michael A.; Flores, Glenn.

In: Pediatrics, Vol. 125, No. 6, 06.2010, p. 1159-1167.

Research output: Contribution to journalArticle

Coker, Tumaini R. ; Rodriguez, Michael A. ; Flores, Glenn. / Family-centered care for US children with special health care needs : Who gets it and why?. In: Pediatrics. 2010 ; Vol. 125, No. 6. pp. 1159-1167.
@article{09f96dafe7cc46748edd6453ac4cf087,
title = "Family-centered care for US children with special health care needs: Who gets it and why?",
abstract = "OBJECTIVE: The goal was to examine racial/ethnic and language disparities in family-centered care (FCC) and in FCC components for children with special health care needs (CSHCN). METHODS: Bivariate and multivariate logistic regression analyses of data from the 2005-2006 National Survey of CSHCN were performed. RESULTS: A total of 66{\%} of CSHCN with a health visit in the past year received FCC. In adjusted analyses, we found lower odds of FCC for Latino (odds ratio: 0.53 [95{\%} confidence interval: 0.45-0.63]), African-American (odds ratio: 0.60 [95{\%} confidence interval: 0.52-0.69]), and other (odds ratio: 0.58 [95{\%} confidence interval: 0.43-0.78]) children, compared with white children, and for children in households with a non-English primary language (odds ratio: 0.48 [95{\%} confidence interval: 0.36-0.64]), compared with those in households with English as the primary language. These disparities persisted after adjustment for child health (condition severity and emotional, behavioral, and developmental needs), socioeconomic (poverty level, parental education, household composition, and residing in a metropolitan statistical area), and access (insurance type, usual source of care, and having a personal physician) factors. Of these factors, only condition severity was significantly associated with the racial/ethnic disparities; none was significantly associated with the language disparities. Disparities were found for Latino and African-American children and children in households with a non-English primary language for the FCC components of time spent with the provider and sensitivity to the family's values and customs. CONCLUSIONS: Robust FCC racial/ethnic and language disparities exist for CSHCN; initial efforts to address these disparities should focus on increasing provider time and cultural sensitivity.",
keywords = "Children with special health care needs, Family-centered care, Medical home, Racial/ethnic disparities",
author = "Coker, {Tumaini R.} and Rodriguez, {Michael A.} and Glenn Flores",
year = "2010",
month = "6",
doi = "10.1542/peds.2009-1994",
language = "English (US)",
volume = "125",
pages = "1159--1167",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "6",

}

TY - JOUR

T1 - Family-centered care for US children with special health care needs

T2 - Who gets it and why?

AU - Coker, Tumaini R.

AU - Rodriguez, Michael A.

AU - Flores, Glenn

PY - 2010/6

Y1 - 2010/6

N2 - OBJECTIVE: The goal was to examine racial/ethnic and language disparities in family-centered care (FCC) and in FCC components for children with special health care needs (CSHCN). METHODS: Bivariate and multivariate logistic regression analyses of data from the 2005-2006 National Survey of CSHCN were performed. RESULTS: A total of 66% of CSHCN with a health visit in the past year received FCC. In adjusted analyses, we found lower odds of FCC for Latino (odds ratio: 0.53 [95% confidence interval: 0.45-0.63]), African-American (odds ratio: 0.60 [95% confidence interval: 0.52-0.69]), and other (odds ratio: 0.58 [95% confidence interval: 0.43-0.78]) children, compared with white children, and for children in households with a non-English primary language (odds ratio: 0.48 [95% confidence interval: 0.36-0.64]), compared with those in households with English as the primary language. These disparities persisted after adjustment for child health (condition severity and emotional, behavioral, and developmental needs), socioeconomic (poverty level, parental education, household composition, and residing in a metropolitan statistical area), and access (insurance type, usual source of care, and having a personal physician) factors. Of these factors, only condition severity was significantly associated with the racial/ethnic disparities; none was significantly associated with the language disparities. Disparities were found for Latino and African-American children and children in households with a non-English primary language for the FCC components of time spent with the provider and sensitivity to the family's values and customs. CONCLUSIONS: Robust FCC racial/ethnic and language disparities exist for CSHCN; initial efforts to address these disparities should focus on increasing provider time and cultural sensitivity.

AB - OBJECTIVE: The goal was to examine racial/ethnic and language disparities in family-centered care (FCC) and in FCC components for children with special health care needs (CSHCN). METHODS: Bivariate and multivariate logistic regression analyses of data from the 2005-2006 National Survey of CSHCN were performed. RESULTS: A total of 66% of CSHCN with a health visit in the past year received FCC. In adjusted analyses, we found lower odds of FCC for Latino (odds ratio: 0.53 [95% confidence interval: 0.45-0.63]), African-American (odds ratio: 0.60 [95% confidence interval: 0.52-0.69]), and other (odds ratio: 0.58 [95% confidence interval: 0.43-0.78]) children, compared with white children, and for children in households with a non-English primary language (odds ratio: 0.48 [95% confidence interval: 0.36-0.64]), compared with those in households with English as the primary language. These disparities persisted after adjustment for child health (condition severity and emotional, behavioral, and developmental needs), socioeconomic (poverty level, parental education, household composition, and residing in a metropolitan statistical area), and access (insurance type, usual source of care, and having a personal physician) factors. Of these factors, only condition severity was significantly associated with the racial/ethnic disparities; none was significantly associated with the language disparities. Disparities were found for Latino and African-American children and children in households with a non-English primary language for the FCC components of time spent with the provider and sensitivity to the family's values and customs. CONCLUSIONS: Robust FCC racial/ethnic and language disparities exist for CSHCN; initial efforts to address these disparities should focus on increasing provider time and cultural sensitivity.

KW - Children with special health care needs

KW - Family-centered care

KW - Medical home

KW - Racial/ethnic disparities

UR - http://www.scopus.com/inward/record.url?scp=77953075104&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953075104&partnerID=8YFLogxK

U2 - 10.1542/peds.2009-1994

DO - 10.1542/peds.2009-1994

M3 - Article

C2 - 20439596

AN - SCOPUS:77953075104

VL - 125

SP - 1159

EP - 1167

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 6

ER -