Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
J Sch Health. 2024 Nov;94(11):1009-1018. doi: 10.1111/josh.13503. Epub 2024 Sep 4.
Disparities in school attendance exist for children with medical complexity (CMC) due to COVID-19. Longitudinal changes in family-reported school safety perceptions and predictors of full-time, in-person school attendance are unknown.
This was a prospective, longitudinal cohort study with 3 survey waves (June 2021-June 2022) among English- and Spanish-speaking families of CMC aged 5 to 17 years and pre-pandemic school attendance. Changes in Health Belief Model perceptions and full-time in-person school attendance were estimated using multivariate generalized linear modeling with repeated measures.
Among 1601 respondents (52.9% of 3073 invited), 86.8% participated in all 3 surveys. School safety perceptions improved with time; however, perceived susceptibility to COVID-19 increased. Full-time in-person school attendance rose from 48.4% to 90.0% from wave 1 to 3 (p < .0001), and was associated with motivation, benefits, and cues. For example, families with low compared to high motivation for in-person attendance had 76% versus 98% predicted probability for child's school attendance, respectively at wave 3 (p < .0001).
IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Probability of full-time in-person school attendance was associated with several health belief model perceptions. School health policy and programs may benefit from promoting family motivation, benefits, and cues during future respiratory illness epidemics including COVID-19.
In-person school attendance improved for CMC over time. Opportunities exist to continue optimizing in-person attendance and family-perceived safety for CMC at school.
由于 COVID-19，患有复杂疾病的儿童（CMC）在上学方面存在差异。家庭报告的学校安全感知的纵向变化以及全日制面授学校出勤率的预测因素尚不清楚。
这是一项前瞻性、纵向队列研究，共有 3 个调查波次（2021 年 6 月至 2022 年 6 月），对象为年龄在 5 至 17 岁之间、患有复杂疾病且在疫情前上学的讲英语和西班牙语的儿童及其家庭。使用具有重复测量的多变量广义线性模型来估计健康信念模型感知的变化和全日制面授学校的出勤率。
在 1601 名应答者（受邀的 3073 人中的 52.9%）中，86.8%的应答者参加了所有 3 次调查。随着时间的推移，学校安全感知有所改善；然而，对 COVID-19 的易感性增加了。从第 1 波到第 3 波，全日制面授学校的出勤率从 48.4%上升到 90.0%（p<0.0001），并且与动机、收益和线索有关。例如，与高动机相比，低动机的家庭在第 3 波时，孩子上学的预测概率分别为 76%和 98%（p<0.0001）。
对学校健康政策、实践和公平的启示：全日制面授学校的出勤率与几个健康信念模型的感知有关。在未来的呼吸道疾病（包括 COVID-19）流行期间，学校健康政策和项目可能受益于促进家庭的动机、收益和线索。
随着时间的推移，CMC 的面授出勤率有所提高。为 CMC 继续优化面授出勤率和家庭对学校的安全感知提供了机会。
