Abstract
Background Black, Hispanic, and low income children bear a greater burden of chronic health conditions compared to wealthier white counterparts. Under federal law, schools provide services to children when their health conditions impair learning. These school services, called individualized education programs (IEPs) can reduce disparities in school outcomes. This paper examines the extent to which children with health conditions have an IEP plan, an important first step in understanding service utilization. Method Andersen’s Behavioral Model was used to examine IEP plan presence by using the 2012 National Survey of Children’s Health. School aged children (6–17), with at least one health condition (N = 16,496) were examined using multivariable logistic regression analysis to understand predisposing (age, sex, race/ethnicity), enabling (family and neighborhood), and need (health related) factors as predictors of having an IEP plan. Race/ethnicity interaction terms tested for moderating effects of race/ethnicity on the relationship between predisposing, enabling and need factors and having an IEP plan. Results Hispanic children were 93.4 % (OR = .066) less likely and Black children were 87.9 % (OR = .121) less likely to have an IEP plan compared to White children. Black, Hispanic, and Multiracial children were more likely to have an IEP plan if they had more family and neighborhood resources (OR range 1.37–1.62) and greater health needs and health care needs (OR range 1.29–2.57). Conclusion The Behavioral Model was useful in predicting the presence of IEP plans among racially/ethnically diverse children with health conditions as an important step in understanding disparities in healthcare access in schools.
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Acknowledgments
All data come from the 2011–2012 National Survey of Children’s Health under license from the Child and Adolescent Health Measurement Initiative (CAHMI) to Melanie Sberna Hinojosa. The research project was supported by a grant from the University of Central Florida Office of Research and Commercialization (105873; 2014–2015). We would like to acknowledge the members of the University of Central Florida Child Health Research Group in alphabetical order; Mandi Barringer, Sabrina Deaton, Enmanuel Espinales, Kaye-Alese Green, Matthew Hiesterman, Nya Ittai, Marisa Lucca, Rameika Newman, Boniface Noyongoyo, Emily Strohacker, Trisha Whitmire, and Lauren Wright.
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Hinojosa, M.S., Hinojosa, R., Nguyen, J. et al. Individualized Education Program Development Among Racially/Ethnically Diverse Children and Adolescents with Health Conditions. Matern Child Health J 21, 583–592 (2017). https://doi.org/10.1007/s10995-016-2142-6
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DOI: https://doi.org/10.1007/s10995-016-2142-6