26 research outputs found
Nurturing children's development through healthy eating and active living : time for policies to support effective interventions in the context of responsive emotional support and early learning
Differences in caregiver-reported health problems and health care use in maltreated adolescents and a comparison group from the same urban environment.
Child welfare caregivers: An evaluation of access to pediatric health care
This study's purpose was to identify differences in pediatric health care barriers and utilization among children in child welfare by caregiver type (birth parents, kin, and unrelated foster). Surveys were administered to 237 caregivers in the waiting room of an outpatient pediatric clinic in Los Angeles, California. Least-square means of access-to-care barriers derived from general linear models were compared across three types of caregivers. Multiple logistic regression models were employed to compare odds of good health status, availability of regular physician, and up-to-date vaccination across caregiver types. In the multivariate analysis, birth parents with children in child welfare were more likely to rate transportation as an access barrier (p = 0.05) and unrelated caregivers were less likely to rate clinic hours inconvenient (p = 0.03) than other caregivers. Children with unrelated foster caregivers were less up-to-date on their vaccinations. All caregivers rated "difficulty understanding doctor's explanation", "wait too long to see a doctor", and "clinic hours inconvenient" as the most difficult access barriers. Children who remain at home with their birth parents and receive child welfare services have similar pediatric health access barriers as children in foster care and should be included in policy initiatives about improving health care for children in child welfare.
Improving health services for foster youth: Multidisciplinary and multistakeholder perspectives and recommendations
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Differences in Caregiver‐Reported Health Problems and Health Care Use in Maltreated Adolescents and a Comparison Group From the Same Urban Environment
Maltreated youth have a high prevalence of acute and chronic mental and physical health problems, but it is not clear whether these problems are related to maltreatment or to a disadvantaged environment. To compare health status and health care use of maltreated youth who had an open case with child protective services to comparison youth living in the same community, we conducted a secondary analysis of caregiver reports for 207 maltreated adolescents (mean age 11.9 years) and 142 comparison adolescents (mean age 12.3 years) living in urban Los Angeles, using questionnaire data from a larger longitudinal study framed in a socio-ecological model. Caregivers included biological parents, relatives, and unrelated caregivers. Analyses included t-test, MANOVA, chi-square, and multivariable logistic regression. Caregivers reported similar rates of physical health problems but more mental health problems and psychotropic medicine use in maltreated youth than in the comparison youth, suggesting that maltreated youths' higher rates of mental health problems could not be attributed to the disadvantaged environment. Although there were no differences in health insurance coverage, maltreated youth received preventive medical care more often than comparison youth. For all youth, having Medicaid improved their odds of receiving preventive health and dental care. Attention to mental health issues in maltreated adolescents remains important. Acceptance of Medicaid by neighborhood-based and/or school-based services in low-income communities may reduce barriers to preventive care