Birth Defects Monitoring and Research Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Division of Developmental Medicine, Seattle Children's Hospital, Seattle, Washington, USA.
Dev Med Child Neurol. 2023 Jun;65(6):821-830. doi: 10.1111/dmcn.15456. Epub 2022 Nov 16.
To describe the education and employment transition experience of young adults with spina bifida (YASB) and investigate factors associated with employment.
We queried education and employment data from the US National Spina Bifida Patient Registry from 2009 to 2019. We applied generalized estimating equations models to analyze sociodemographic and disease-related factors associated with employment.
A total of 1909 participants (850 males, 1059 females) aged 18 to 26 years contributed 4379 annual visits. Nearly 84% had myelomeningocele and, at last visit, the median age was 21 years (mean 21 years 5 months, SD 2 years 10 months). A total of 41.8% had at least some post-high school education, and 23.9% were employed. In a multivariable regression model, employment was significantly associated with education level, lower extremity functional level, bowel continence, insurance, and history of non-shunt surgery. This large, national sample of YASB demonstrated low rates of post-secondary education attainment and employment and several potentially modifiable factors associated with employment.
Specific sociodemographic, medical, and functional factors associated with employment are important for clinicians to consider when facilitating transition for YASB into adulthood. Additional research is needed to understand the impact of cognitive functioning and social determinants of health on transition success in YASB.
There were low education attainment and employment rates in a large sample of young adults with spina bifida. Specific sociodemographic, medical, and functional factors are associated with employment. Some employment-associated factors, such as continence and self-management skills, are modifiable.
描述脊柱裂青少年（YASB）的教育和就业过渡经历，并调查与就业相关的因素。
我们从 2009 年至 2019 年查询了美国国家脊柱裂患者登记处的教育和就业数据。我们应用广义估计方程模型分析与就业相关的社会人口学和疾病相关因素。
共有 1909 名 18 至 26 岁的参与者（850 名男性，1059 名女性）贡献了 4379 次年度就诊。近 84%的人患有脊髓脊膜膨出，最后一次就诊时，中位数年龄为 21 岁（平均 21 岁 5 个月，标准差 2 岁 10 个月）。共有 41.8%的人至少接受过高中后教育，23.9%的人就业。在多变量回归模型中，就业与教育程度、下肢功能水平、肠控便能力、保险和非分流手术史显著相关。这项针对 YASB 的大型全国性样本研究表明，这些青少年接受高等教育和就业的比例较低，存在一些可能与就业相关的可调节因素。
与就业相关的特定社会人口学、医学和功能因素对于临床医生在促进 YASB 成年过渡时考虑是重要的。需要进一步研究以了解认知功能和健康的社会决定因素对 YASB 过渡成功的影响。
在一个大型的脊柱裂青少年样本中，教育程度和就业率都较低。特定的社会人口学、医学和功能因素与就业相关。一些与就业相关的因素，如控便能力和自我管理技能，是可以调节的。
