Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Rehabilitation and Therapy Services, Children's Hospital Colorado, Aurora, CO, USA.
Pediatr Surg Int. 2024 Jul 15;40(1):188. doi: 10.1007/s00383-024-05768-z.
To evaluate individual and community sociodemographic factors that predict bowel regimen adherence in youth and young adults with Spina Bifida (SB) following participation in a bowel management program (BMP).
Participants were drawn from clinical cases seen through an International Center for Colorectal and Urogenital Care. Area deprivation index (ADI) scores were extracted from participant addresses and bowel regimen adherence data were collected from the electronic medical record (EMR).
Participants' mean age was 8.06 years old, 51.7% were male, 72.4% white, 37.9% Hispanic, 56.9% government insurance, 89.7% myelomeningocele, 15.5% non-adherent. Average neighborhood disadvantage was 5.19 (SD:2.83, range:1-10). After controlling for variables correlated with adherence (p < .20), every one decile higher neighborhood disadvantage score was associated with a 48% decrease in the odds of being adherent (OR = 0.52, p = .005, 95% CI: - 101.90, - 0.21).
Our results suggest that neighborhood disadvantage is a strong predictor of medical adherence following a BMP, more so than other sociodemographic and health-related variables. These results may assist with identifying which individuals may be at higher risk for poor health outcomes due to neighborhood socioeconomic disadvantage and help health care systems intervene proactively.
评估个体和社区社会人口因素，预测参与肠道管理计划（BMP）后，患有脊髓脊膜膨出（SB）的青年和年轻成年人的肠道方案依从性。
参与者来自国际结直肠和泌尿生殖护理中心的临床病例。从参与者的地址中提取区域贫困指数（ADI）评分，并从电子病历（EMR）中收集肠道方案依从性数据。
参与者的平均年龄为 8.06 岁，51.7%为男性，72.4%为白人，37.9%为西班牙裔，56.9%为政府保险，89.7%为脊髓脊膜膨出，15.5%为不依从者。平均邻里劣势为 5.19（SD：2.83，范围：1-10）。在控制与依从性相关的变量（p < .20）后，邻里劣势每增加一个十分位数，其依从的可能性就会降低 48%（OR = 0.52，p = .005，95%CI：-101.90，-0.21）。
我们的研究结果表明，与其他社会人口和健康相关变量相比，邻里劣势是 BMP 后医疗依从性的一个强有力的预测因素。这些结果可能有助于确定哪些个体由于邻里的社会经济劣势而面临更高的健康结果不佳的风险，并帮助医疗保健系统主动进行干预。
