Healthcare, educational, and vocational transitions in young adults with pediatric-onset disabilities: Associations with social determinants of health.

Autor:	Petranovich CL; Children's Hospital Colorado, Department of Rehabilitation Medicine; University of Colorado Anschutz School of Medicine, Department of Rehabilitation Medicine. Electronic address: christine.petranovich@childrenscolorado.org., Person-Jones K; University of Colorado Anschutz School of Medicine, Department of Rehabilitation Medicine., Koerber S; University of Colorado Anschutz School of Medicine, Department of Rehabilitation Medicine., Lantagne A; Children's Hospital Colorado, Department of Rehabilitation Medicine; University of Colorado Anschutz School of Medicine, Department of Rehabilitation Medicine., Graber S; Children's Hospital Colorado, Department of Rehabilitation Medicine., Sarmiento CA; Children's Hospital Colorado, Department of Rehabilitation Medicine; University of Colorado Anschutz School of Medicine, Department of Rehabilitation Medicine., Peterson RL; Children's Hospital Colorado, Department of Rehabilitation Medicine; University of Colorado Anschutz School of Medicine, Department of Rehabilitation Medicine., Simpson T; Children's Hospital Colorado, Department of Rehabilitation Medicine; University of Colorado Anschutz School of Medicine, Department of Rehabilitation Medicine., Wilson P; Children's Hospital Colorado, Department of Rehabilitation Medicine; University of Colorado Anschutz School of Medicine, Department of Rehabilitation Medicine., Miele A; Children's Hospital Colorado, Department of Neurology., Apkon S; Children's Hospital Colorado, Department of Rehabilitation Medicine; University of Colorado Anschutz School of Medicine, Department of Rehabilitation Medicine., Dichiaro M; Children's Hospital Colorado, Department of Rehabilitation Medicine; University of Colorado Anschutz School of Medicine, Department of Rehabilitation Medicine., Connery AK; Children's Hospital Colorado, Department of Rehabilitation Medicine; University of Colorado Anschutz School of Medicine, Department of Rehabilitation Medicine., Kirkwood MW; Children's Hospital Colorado, Department of Rehabilitation Medicine; University of Colorado Anschutz School of Medicine, Department of Rehabilitation Medicine.
Jazyk:	angličtina
Zdroj:	Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2024 Dec 20. Date of Electronic Publication: 2024 Dec 20.
DOI:	10.1016/j.apmr.2024.11.015
Abstrakt:	Objective: We aim to describe healthcare, vocational, and educational transitions in young adults with pediatric-onset disabilities and to examine the associations with social determinants of health and depressive symptoms. Design: This cross-sectional study used multinomial and binary logistic regression to examine the associations of sociodemographic factors and depressive symptoms with healthcare, educational, and vocational transitions. Setting: Participants were recruited from outpatient specialty clinics in a Rehabilitation Medicine department at a quaternary academic children's hospital. Participants: Transition age adults (TAA) with acquired brain injury (ABI = 17), spina bifida (SB = 10), and neuromuscular disorders (NMD = 28) participated in this study. Interventions: N/A MAIN OUTCOME MEASURE: Participants provided information about their current healthcare utilization and educational/ vocational status. Results: Twenty-five percent of participants were unsure of their primary resource for preventative healthcare; this uncertainty was associated with White race/ Hispanic ethnicity (p = 0.004) and public insurance (p = 0.02). When asked about their primary healthcare resource if they are sick or have an immediate health-related question, 18% identified the emergency department; this was significantly related to greater neighborhood disadvantage (p = 0.009). Considering current educational and vocational status, having a job while also going to school was associated with more self-reported depressive symptoms (p = 0.009) and younger age (p = 0.02). Conclusion: Outcomes during the transition to adulthood are related to multiple factors, including race and ethnicity, public insurance, neighborhood disadvantage, and depressive symptoms. Targeted interventions to support healthcare, vocational, and educational transitions in the context of social determinants of health and mental health status are needed. Competing Interests: Declaration of competing interest Dr. Miele is a consultant for Biogen and part of the advisory board for Catalyst Pharma. The other authors have nothing to disclose. (Copyright © 2024. Published by Elsevier Inc.)
Databáze:	MEDLINE
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