Urban Versus Rural Differences in Insurance Coverage and Impact on Employment Among Families Caring for a Child With Cerebral Palsy

Background: The purpose of this study was to examine urban vs. rural differences on the relationship between family contextual variables and adequacy of insurance coverage and impact on employment for among families with a child with Cerebral Palsy from a nationally representative sample. Methods: A retrospective, observational study was carried out using data from the National Survey of Children with Special Healthcare Needs. Results: A total of 744 participants reported as having a child with a diagnosis of Cerebral Palsy and were included in the sample. Logistic regression analyses, adjusting for urban and rural setting revealed different predictors of adequacy of insurance coverage and impact on employment. Among urban respondents, three variables with odds ratios ranging from 1.33 to 1.58 served as protective factors, increasing the likelihood of adequate insurance coverage. Four variables with odds ratios ranging from 1.41 to 1.79 decreased the likelihood of negatively impacting employment. Among rural families, there was only one significant protective factor for adequacy of insurance coverage (odds ratio 1.80) and one for decreasing the chances of impact on employment (odds ratio 2.53). Conclusion: Families in rural areas caring for a child with CP have few protective factors for adequate insurance coverage and impact on familial employment

An Exploration of Spasticity in Young People with Cerebral Palsy

This article was published in Research Quarterly for Exercise and Sport

Adequacy of Insurance Coverage and Impact on Employment Among Families Caring for a Child With Cerebral Palsy

Background: Children with cerebral palsy (CP) require care from both healthcare providers and the family. The purpose of this study is to examine factors related to adequate insurance coverage and impact on family employment among families with a child with CP. Methods: Data from a survey with a nationally representative sample examining children with special healthcare needs was analyzed. A total of 744 of participants reported having a child with CP. Logistic regression modeled the probability of adequate insurance coverage and impact on family employment. Results: Families whose child missed fewer school days, had no unmet needs, no financial burden, or early screening were less likely to have employment negatively affected (adjusted OR [odds ration] = \u3e 1, 95% CI [confidence interval], p = \u3c 0.05). Whereas families who spent additional time caring for the child, and did not have a medical home were more likely to be negatively affected (OR \u3c 1, 95% CI, p \u3c 0.05). Families without unmet needs, fewer out-of-pocket expenses, or no financial burden, were more likely to have adequate coverage (adjusted OR = \u3e 1, 95% CI, p = \u3c 0.05). Families of children who missed fewer school days, did have not access to community-based services, did not engage in shared decision-making, and without a medical home were less likely to have adequate coverage (OR \u3c 1, 95% CI, p \u3c 0.05). Conclusion: Complex factors affect families caring for a child with CP and policy changes may improve their quality of life

Urban Versus Rural Differences in the Effects of Providing Care to Children With Cerebral Palsy on Family Member\u27s Employment

Background and Objective(s): Context (urban vs rural) can mediate the impact on the family among other childhood populations with special healthcare needs. To date, few studies have examined the role of context in caring for a child with CP; therefore, we analyzed data from the National Survey of Children with Special Health Care Needs (NS-CSHCN). Study Design: Cross-sectional. Study Participants & Setting: Participants were parents of children (\u3c 18y old) with CP. Children\u27s mean age of rural respondents was 10.17 (SD=4.69), while 73% were white, 13.5% Hispanic, 11% black, and 2.5% other (non-Hispanic). Among rural families, 33.05% were living in households with incomes below the Federal Poverty Level (FPL). For those respondents living in urban areas, children\u27s mean age was 9.74 (SD=4.50) and 63% were white, 13% Hispanic, 16% black, and 8% other (non-Hispanic). Overall 21.1% of urban families lived in households with incomes below the FPL. Materials/Methods: The NS-CSHCN was designed to examine state- and national-level estimates of CSHCN. A national random-digit-dial sample of US households were screened for children with special healthcare needs aged 0–17 years. Households reporting a CSHCN participated in an interview for one randomly selected child with a special healthcare need. Of 40 242 completed interviews from 2009 to 2011, 744 reported as having a child with a diagnosis of CP and were included in the sample. We performed logistic regression analyses, in the context of multiply imputed data to address missing data concerns, modeling the probability that family member\u27s employments were unaffected by the child\u27s health. Results: Our analysis indicated significant differences between families with children with CP living in an urban environment and those living in a rural setting concerning the impact that the child\u27s health had on family member\u27s work lives. There were six significant variables impacting the employment of family members for families living in an urban setting categories relating to missed school days, financial burden, and access to services (see Table 1). However, only a low financial burden and less time spent caring for the child were significant with regards to the impact on employment among rural families. Conclusions/Significance: Despite a higher percentage of families living in poverty, urban families had more protective factors to prevent the diagnosis of a child from impacting the employment of the family

Community-Based Upper Extremity Power Training for Youth with Cerebral Palsy: A Pilot Study

Aim: To examine the effects of an upper-extremity, community-based, and power-training intervention. Methods: Twelve participants with cerebral palsy (CP) [8 males, 4 females; mean age 14 years 6 months (SD 5 years 4 months), range 7–24] were randomly assigned to a rest-training (RT; n = 6) or training-rest (n = 6) group in this randomized, cross-over design. Training took place in participants’ home or school, three times per week for 6 weeks. We examined changes in upper extremity average power output (Pavg) in watts (W) and changes in function via the Pediatric Outcomes Data Collection Instrument (PODCI). Results: Each participant completed at least 15 of the 18 total training sessions (91.2% adherence). Pavg increased 92.2% on average among participants (p \u3c .05). There was a significant three-way interaction among treatment, sequence, and period with the data stratified by (Bimanual Fine Motor Function [BFMF]) level on the pain subscale of the PODCI (p = 0.0118). All participants decreased pain after training with the exception of individuals with lower functioning (BFMF II-V) in the RT group. Conclusion: A community-based upper extremity power-training intervention was feasible and effective at improving power among young people with CP and has the potential to improve pain

An Exploration of Metacognitive Strategies Efficacy in Upper Level Health and Kinesiology Students

This presentation was given during the Scholarship of Teaching and Learning Commons Annual Conference

Metacognitive Strategies and their Effectiveness in Kinesiology Classes

The purpose of this study was to explore the effect of different metacognitive strategies (exam wrappers, learning technique training and team learning) on metacognition, academic performance, perceived competence, and self-efficacy between early career and later career health and kinesiology students during fall 2016 semester. Three surveys were administered throughout the semester (week 1, mid-term and last week). Survey included demographic information, the Metacognition Awareness Inventory, Perceived Competence and Self-Efficacy questions. Final sample of participants included 386 undergraduate students. Roughly 56% of participants were enrolled in a lower division course, while 44.3% were enrolled in upper division courses. Mean levels of knowledge of cognition were high, while regulation of cognition were near the midline, but moderately high. Participants’ initial perceived competence was at a mean level of 4.52 (SD = .69), while self-efficacy was at 3.65 (SD = .52). Information management strategies (t (3, 360) = 2.69, p = .046), and evaluation (t (3, 360) = 5.83, p = .001) were significantly different between groups. Tukey post-hoc analysis revealed that the control group was significantly different than the video group for information management strategies and evaluation

Examining the Effects of Different Teaching Strategies on Metacognition and Academic Performance

The purpose of this study was to evaluate the effect of different metacognitive interventions on knowledge and regulation of cognition, as well as academic performance (i.e., exam and final grades) in three sections of an undergraduate human anatomy and physiology course. All targeted classes were randomly assigned to one of three groups (reflection practice, passive acquisition of knowledge, and collaborative learning), and the interventions were implemented after exam 1. A pre- and posttest survey was administered during the semester (during week 2 and after exam 2), and exam and final course grades were collected at the end of the semester. The final sample included 129 students. A significant interaction of group and time was observed for knowledge of cognition: it increased in the reflection practice group, did not change in the collaborative learning group, and it decreased in the passive acquisition of knowledge. The interventions did not produce any significant interactions or main effects on regulation of cognition, exam scores, or final grades. Along with more research on metacognition in physiology education contexts, it is recommended to further examine the ways in which such data can be collected, as self-report measures only tell part of the story