TY - JOUR
T1 - Adolescents’ Patterns of Well-Care Use Over Time
T2 - Who Stays Connected
AU - Van Eck, Kathryn
AU - Thakkar, Madhuli
AU - Matson, Pamela A.
AU - Hao, Lingxin
AU - Marcell, Arik V.
N1 - Funding Information:
The study sponsor did not have any role in the study design; collection, analysis, and interpretation of data; writing of the report; or the decision to submit the manuscript for publication. The findings and conclusions in this paper are those of the authors and do not necessarily present official positions of the NIH or the affiliated institutions. This work was supported by Hopkins Population Center pilot funds (Principal Investigator [PI]: AVM, from R24HD042854 and PI: LH) and by National Institute on Drug Abuse funds (PI: PAM, K01DA03538). KVE wrote the first draft of the manuscript and no honorarium, grant, or other forms of payment were given to anyone else to produce the manuscript. No financial disclosures were reported by the authors of this paper.
Funding Information:
This work was supported by Hopkins Population Center pilot funds (Principal Investigator [PI]: AVM, from R24HD042854 and PI: LH) and by National Institute on Drug Abuse funds (PI: PAM, K01DA03538).
Funding Information:
Data were analyzed in 2019 using the publicly available NLSY79 sponsored by the Bureau of Labor Statistics and funded by the National Institute of Child Health and Human Development. 21 Through the biennial survey Child/Young Adult component, a household-based child sample born to women from the original nationally representative NLSY79 sample were followed. Children eligible for this analysis (N=6,872; n=3,379 female, n=3,493 male) were born in 1980–1997 to women from the original NLSY79 and completed at-home surveys through trained interviewers and self-administered survey for sensitive information. Study procedures are described elsewhere. 22 The Johns Hopkins University IRB approved this secondary analysis as exempt. Participants were included in the analyses if they had WCU data at least once between ages 5 years (1986–2003) and 17 (1998–2015) years to explore WCU trajectories starting at school entry and to maximize the available NLSY79 sample size.
Publisher Copyright:
© 2021 American Journal of Preventive Medicine
PY - 2021/5
Y1 - 2021/5
N2 - Introduction: Well-care use can positively impact adolescents’ current and future health. Understanding adolescents’ longitudinal well-care use is critical to determine to whom and when to target engagement strategies to improve healthcare access. This study describes prospective well-care use patterns from childhood through adolescence stratified by sex. Methods: The sample (N=6,872) was drawn from the Child/Young Adult component of the household-based 1979 National Longitudinal Survey of Youth consisting of biological children born to female respondents (1980–1997). Well-care use (routine checkup with a doctor within last year) data were assessed from age 5 years (1986–2003) until age 17 years (1998–2015). Conducted in 2019, latent class analyses stratified by sex identified well-care use patterns reported over 7 biennial time points adjusted for cohort, race/ethnicity, urbanicity, maternal education, and insurance. Results: A total of 4 well-care use classes emerged for female adolescents: the majority belonged to Engaged (37%) and Moderately Engaged (39%) classes and the remainder belonged to Gradually Re-engaged (14%) and Disengaged-with-Rebound (10%) classes. A total of 3 classes emerged for male adolescents: the majority belonged to the Persistently Disengaged (48%) class and the remainder belonged to Engaged (34%) and Gradually Re-engaged (18%) classes. For both sexes, comparing each cohort with the first, Engaged class membership increased for subsequent cohorts. Less engaged well-care use classes had more non-Hispanic White adolescents living in rural areas with lower insurance coverage. Maternal education differentiated well-care use classes for male but not for female adolescents, being higher for male adolescents in the Engaged class than in other classes. Conclusions: These findings highlight that well-care use patterns for both sexes changed during the transition from childhood to adolescence and that class membership differed by covariates. These results suggest that sex-specific strategies may be needed to enhance adolescents’ well-care use engagement over time.
AB - Introduction: Well-care use can positively impact adolescents’ current and future health. Understanding adolescents’ longitudinal well-care use is critical to determine to whom and when to target engagement strategies to improve healthcare access. This study describes prospective well-care use patterns from childhood through adolescence stratified by sex. Methods: The sample (N=6,872) was drawn from the Child/Young Adult component of the household-based 1979 National Longitudinal Survey of Youth consisting of biological children born to female respondents (1980–1997). Well-care use (routine checkup with a doctor within last year) data were assessed from age 5 years (1986–2003) until age 17 years (1998–2015). Conducted in 2019, latent class analyses stratified by sex identified well-care use patterns reported over 7 biennial time points adjusted for cohort, race/ethnicity, urbanicity, maternal education, and insurance. Results: A total of 4 well-care use classes emerged for female adolescents: the majority belonged to Engaged (37%) and Moderately Engaged (39%) classes and the remainder belonged to Gradually Re-engaged (14%) and Disengaged-with-Rebound (10%) classes. A total of 3 classes emerged for male adolescents: the majority belonged to the Persistently Disengaged (48%) class and the remainder belonged to Engaged (34%) and Gradually Re-engaged (18%) classes. For both sexes, comparing each cohort with the first, Engaged class membership increased for subsequent cohorts. Less engaged well-care use classes had more non-Hispanic White adolescents living in rural areas with lower insurance coverage. Maternal education differentiated well-care use classes for male but not for female adolescents, being higher for male adolescents in the Engaged class than in other classes. Conclusions: These findings highlight that well-care use patterns for both sexes changed during the transition from childhood to adolescence and that class membership differed by covariates. These results suggest that sex-specific strategies may be needed to enhance adolescents’ well-care use engagement over time.
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U2 - 10.1016/j.amepre.2020.12.008
DO - 10.1016/j.amepre.2020.12.008
M3 - Article
C2 - 33648787
AN - SCOPUS:85101667846
VL - 60
SP - e221-e229
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
SN - 0749-3797
IS - 5
ER -