Center for Leadership in Disability, School of Public Health, Georgia State University, United States; Population Health Sciences, School of Public Health, Georgia State University, United States.
Department of Occupational Therapy, Augusta State University, United States.
Disabil Health J. 2022 Jan;15(1):101179. doi: 10.1016/j.dhjo.2021.101179. Epub 2021 Aug 13.
Non-White children with developmental disabilities are frequently identified later than White children and therefore miss out on opportunities for early intervention (EI). Recent research indicates that conjoint monitoring and screening is more strongly associated with EI receipt than monitoring or screening alone.
To determine if there are racial/ethnic inequities in the conjoint receipt of monitoring and screening.
A series of survey weighted and stratified logistic regression analyses were conducted on National Surveys of Children's Health (2016-2018) data with conjoint monitoring and screening, screening alone, monitoring alone, and non-receipt as outcomes for children aged 9-23 months of age. The primary predictor was child race/ethnicity (Black, Hispanic, Other, and White). Additional co-variates included child (e.g., Age), caretaker/family (e.g., poverty level), healthcare (e.g., usual source of healthcare), state EI policies, and city metropolitan status.
Bivariate analyses indicated significant variation in conjoint monitoring and screening across racial/ethnic groups and covariates. Bivariate analyses showed that Black and Hispanic children had significantly lower odds of conjoint monitoring and screening receipt than White children. Multivariate analyses showed that this relationship was better accounted by co-variates. The health service variable, usual source of healthcare, had the strongest relationship with receipt of conjoint monitoring and screening.
Black and Hispanic children are less likely to receive conjoint monitoring and screening than White children. Analyses investigating the role of usual source of healthcare seem particularly promising for understanding the sources of inequities in monitoring and screening receipt.
发育障碍的非裔和西班牙裔儿童通常比白人儿童晚被确诊，因此错失了早期干预（EI）的机会。最近的研究表明，联合监测和筛查与接受 EI 的相关性比单独监测或筛查更强。
确定联合监测和筛查的接受情况是否存在种族/民族差异。
对国家儿童健康调查（2016-2018 年）数据进行了一系列调查加权和分层逻辑回归分析，将联合监测和筛查、单独筛查、单独监测和未接受作为 9-23 个月儿童的结果。主要预测因素是儿童的种族/民族（黑人、西班牙裔、其他和白人）。其他协变量包括儿童（如年龄）、照顾者/家庭（如贫困水平）、医疗保健（如常规医疗来源）、州 EI 政策和城市大都市地位。
单变量分析表明，联合监测和筛查在种族/民族群体和协变量方面存在显著差异。单变量分析显示，黑人儿童和西班牙裔儿童联合监测和筛查接受的可能性显著低于白人儿童。多变量分析表明，这种关系可以通过协变量更好地解释。健康服务变量，即常规医疗来源，与联合监测和筛查的接受度之间存在最强的关系。
黑人儿童和西班牙裔儿童接受联合监测和筛查的可能性低于白人儿童。对常规医疗来源的分析似乎特别有希望，有助于理解监测和筛查接受方面的不平等的来源。
