Abstract
Objectives
(1) Explore the relationship between various sociodemographic factors and caregiver health beliefs (CHBs), and (2) examine whether these relationships were associated with the use of pediatric therapy services.
Methods
We conducted a cross-sectional, secondary data analysis using the 2011 Survey of Pathways Diagnosis and Services dataset. 4,032 children ages 6–17 years had complete data on caregiver health beliefs and pediatric therapy use. Select CHBs reflected whether caregivers believe (1) problems related to their child’s condition can be prevented or decreased with treatment, (2) they have the power to change their child’s condition, and (3) their child’s condition is a mystery. Pediatric therapy included physical therapy, occupational therapy, and speech therapy. We performed multivariate logistic regression to test the associations between CHBs and select child and family characteristics (Aim 1) and use of pediatric therapy services (Aim 2).
Results
Caregivers with lower educational attainment were more likely to believe their child’s condition was a mystery and less likely to believe they had the power to change their child’s condition. Use of pediatric therapy services tended to be lower among children whose caregivers believed they had the power to change their child’s condition and higher among children whose caregivers believed their child’s condition was a mystery.
Conclusions for practice
Our findings add to existing research that suggests CHBs differ across groups of caregivers. This, combined with the recognition that CHBs also likely differ from providers, underscores the importance of eliciting caregiver beliefs, values, and priorities to help ensure the provision of truly family-centered care.
Significance
Pediatric therapy services support and optimize child development. Significant service use disparities exist, however, with children representing various marginalized groups being less likely to use pediatric therapy services. Little is known about the mechanisms underlying such disparities. We sought to explore the relationship between family sociodemographic factors, caregiver health beliefs, and pediatric therapy use. Our findings suggest that caregivers with fewer socioeconomic resources expressed beliefs that are consistent with limited knowledge and agency regarding their child’s condition. Thus, providers must work to engage families in conversations about their child’s development, elicit their knowledge and beliefs, and identify social or financial barriers to care.
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Data Availability
The data used to support these findings is publicly available at: https://action.cahmi.org/help/dataset.
Code Availability
custom code created in SAS 9.4.
References
Adams, R. C., & Tapia, C. (2013). Early intervention. IDEA Part C services, and the medical
home: collaboration for best practice and best outcomes.Pediatrics, 132(4),e1073-1088. doi:https://doi.org/10.1542/peds.2013-2305
Aday, L. A., & Andersen, R. (1974). A framework for the study of access to medical care. Health Services Research, 9(3), 208–220. Retrieved from. https://www.ncbi.nlm.nih.gov/pubmed/4436074
Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care. does it matter? Journal of Health and Social Behavior, 1–10
Berlin, L. J., Brooks-Gunn, J., McCarton, C., & McCormick, M. C. (1998). The effectiveness of early intervention: examining risk factors and pathways to enhanced development Preventive Medicine, 27(2),238–245
Child and Adolescent Health Measurement Initiative (2015). 2011 Pathways Outcome Measures, S. A. S., & Codebook, Version 1. In:Data Resource Center for Child and Adolescent, & Health.
Danseco, E. R. (1997). Parental beliefs on childhood disability: Insights on culture, child development and intervention. International Journal of Disability, Development and Education, 44(1),41–52
Eneriz-Wiemer, M., Sanders, L. M., Barr, D. A., & Mendoza, F. S. (2014). Parental limited English proficiency and health outcomes for children with special health care needs: a systematic review.Academic Pediatrics, 14(2),128–136. doi:https://doi.org/10.1016/j.acap.2013.10.003
Gottlieb, L. M., Hessler, D., Long, D., et al. (2016). Effects of Social Needs Screening and In-Person Service Navigation on Child Health: A Randomized Clinical Trial. JAMA Pediatrics, 170(11), e162521. doi:https://doi.org/10.1001/jamapediatrics.2016.2521
Groce, N. E., & Zola, I. K. (1993). Multiculturalism, chronic illness, and disability. PEDIATRICSSPRINGFIELD-, 91, 1048–1048
Gunderson, E. A., Ramirez, G., Levine, S. C., & Beilock, S. L. (2012). The Role of Parents and Teachers in the Development of Gender-Related Math Attitudes.Sex Roles, 66(3),153-166. doi:https://doi.org/10.1007/s11199-011-9996-2
Jimenez, M., Barg, F., Guevara, J., & Gerdes, M. Barriers to evaluation for early intervention services: parent and early intervention employee perspectives: Elsevier
Jolles, M. P., Lee, P. J., & Javier, J. R. (2018). Shared decision-making and parental experiences with health services to meet their child’s special health care needs: Racial and ethnic disparities. Patient Education and Counseling, 101(10), 1753–1760. doi:https://doi.org/10.1016/j.pec.2018.05.022
Kan, K., Choi, H., & Davis, M. (2016).Immigrant Families, Children With Special Health Care Needs, and the Medical Home.Pediatrics, 137(1). doi:https://doi.org/10.1542/peds.2015-3221
Litt, J. S., Glymour, M. M., Hauser-Cram, P., Hehir, T., & McCormick, M. C. (2017). Early Intervention Services Improve School-age Functional Outcome Among Neonatal Intensive Care Unit Graduates. Academic Pediatrics. doi:https://doi.org/10.1016/j.acap.2017.07.011
Magnusson, D., Palta, M., McManus, B., Benedict, R. E., & Durkin, M. S. (2016). Capturing Unmet Therapy Need Among YoungChildren With Developmental Delay Using National Survey Data. Academic Pediatrics, 16(2),145–153. doi:https://doi.org/10.1016/j.acap.2015.05.003
Magnusson, D. M., Minkovitz, C. S., Kuhlthau, K. A., Caballero, T. M., & Mistry (2017). K. B. Beliefs Regarding Development and Early Intervention Among Low-Income African American and Hispanic Mothers. Pediatrics, e20172059
Magnusson, D. M., & Mistry, K. B. (2017).Racial and ethnic disparities in unmet need for pediatric therapy services: The role of family-centered care.Academic Pediatrics, 17(1), 27–33.
Magnusson, D. M., Murphy, N., & Pena-Jackson, G. (2020). Community-Engaged Research to Translate Developmental Screening and Referral Processes into Locally-Relevant, Family-Centered Language. Maternal and Child Health Journal, 24(5), 651–659
McManus, B., Richardson, Z., Schenkman, M., & … Timing and Intensity of Early Intervention Service Use and OutcomesAmong a Safety-Net Population of Children JAMA network …. Retrieved from https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2722579
McManus, B. M., Carle, A. C., & Poehlmann, J. (2012).Effectiveness of part C early intervention physical, occupational, and speech therapy services for preterm or low birth weight infants in Wisconsin, United States. Academic Pediatrics, 12(2), 96–103. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586603/pdf/nihms348697.pdf
Mondschein, E. R., Adolph, K. E., & Tamis-LeMonda, C. S. (2000). Gender bias in mothers’ expectations about infant crawling.Journal of Experimental Child Psychology, 77(4), 304–316
National Center for Health Statistics (2011). Pathways to Diagnosis and Services. Retrieved from: https://www.cdc.gov/nchs/slaits/spds.htm
Pachter, L. M., & Dworkin, P. H. (1997). Maternal expectations about normal child development in 4 cultural groups. Archives of Pediatrics and Adolescent Medicine, 151(11),1144-1150. Retrieved from https://jamanetwork.com/journals/jamapediatrics/articleabstract/518581
Perez Jolles, M., & Thomas, K. C. (2018). Disparities in Self-reported Access to Patientcentered Medical Home Care for Children With Special Health Care Needs. MedicalCare, 56(10), 840–846. doi:10.1097/mlr.0000000000000978
Richardson, Z. S., Khetani, M. A., Scully, E., Dooling-Litfin, J., Murphy, N., & McManus,B. M. 2019. Social and Functional Characteristics of Receipt and Service Use Intensity of Core Early Intervention Services. Academic Pediatrics. doi:10.1016/j.acap.2019.02.004
Richardson, Z. S., Scully, E. A., Dooling-Litfin, J. K., Murphy, N. J., Rigau, B.,Khetani, M. A., & McManus, B. M. (2019). Early intervention service intensity and change in children’s functional capabilities. Archives of Physical Medicine and Rehabilitation.
Rosen-Reynoso, M., Porche, M. V., Kwan, N., Bethell, C., Thomas, V., Robertson, J.,… Palfrey, J. (2016). Disparities in Access to Easy-to-Use Services for Children with Special Health Care Needs. Matern Child Health J, 20(5), 1041–1053. doi:https://doi.org/10.1007/s10995-015-1890-z
Rosenberg, S. A., Robinson, C. C., Shaw, E. F., & Ellison, M. C. (2013). Part C early intervention for infants and toddlers: percentage eligible versus served. Pediatrics, 131(1), 38–46. doi: https://doi.org/10.1542/peds.2012-1662
SAS Institute Inc. (2013). SAS 9.4. Cary, NC: SAS Institute, Inc.
Son, E., Parish, S. L., & Igdalsky, L. (2017). Disparities in Health Care Quality among Asian Children with Special Health Care Needs. Health and Social Work, 42(2), 95–102. doi:https://doi.org/10.1093/hsw/hlx004
Zuckerman, K. E., Lindly, O. J., Sinche, B. K., & Nicolaidis, C. (2015). Parent health beliefs, social determinants of health, and child health services utilization among U.S. school age children with autism. Journal of Developmental and Behavioral Pediatrics, 36(3), 146–157. doi:https://doi.org/10.1097/DBP.0000000000000136
Acknowledgements
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors acknowledge the University Colorado Physical Therapy Program and Department of Physical Medicine and Rehabilitation for supporting this work.
Funding
The authors thank the Department of Physical Medicine and Rehabilitation at the University of Colorado Anschutz Medical Campus for funding support.
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DM conceived the idea for the presented analysis. NM carried out the analysis with supervision and support from DM. NM wrote this manuscript with support from DM and LO. All authors provided critical feedback and support and helped shape the interpretation of results and manuscript.
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Murphy, N.J., Magnusson, D. & Ollerenshaw, L. Caregiver Health Beliefs Associated with Use of Pediatric Therapy Services Among Children with Special Health Care Needs. Matern Child Health J 26, 2254–2262 (2022). https://doi.org/10.1007/s10995-022-03500-8
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DOI: https://doi.org/10.1007/s10995-022-03500-8