School of Public Health

Permanent URI for this communityhttp://hdl.handle.net/1903/1633

The collections in this community comprise faculty research works, as well as graduate theses and dissertations.

Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.

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    FAMILY-CENTERED PEDIATRIC CARE: PREDICTORS OF ACCESS AND ASSOCIATIONS WITH CHILD WELL-BEING
    (2019) Fife, Julie Marie; Lewin, Amy B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Despite widespread recognition that family-centered care (FCC) is a critical component of quality pediatric health care, not all children receive FCC. This study builds on previous work by: (1) examining the extent to which socioeconomic resources are associated with the receipt of FCC after implementation of the Affordable Care Act, (2) exploring whether healthcare workforce shortages interfere with the delivery of FCC, and (3) extending previous research on the role of FCC in child well-being by measuring well-being across multiple domains and including children without special health care needs. Using data from the 2016 National Survey of Children’s Health (n=50,212), this study found a graded relationship between the odds of receiving FCC and multiple indicators of family-level socioeconomic resources, indicating that socioeconomic resources, beyond health insurance, are important factors in accessing quality pediatric health care. Healthcare workforce shortages may also play a role in the availability of FCC. Results from this study found consistent and significant associations between FCC and positive child well-being among healthy and typically developing children, and these associations were found across all domains of development. Findings indicated that FCC is particularly beneficial for young children (0-5 years), and children in households with low to moderate socioeconomic resources, making it a potentially meaningful tool to help reduce health disparities for children from households with more limited socioeconomic resources. Future research, and policies and practices aimed at increasing the delivery of FCC should include and emphasize the experiences of Hispanic families and families with limited socioecnomic resources.
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    RACIAL/ETHNIC VARIABILITY IN THE EFFECT OF RADIATION ON SECOND PRIMARY THYROID CANCER IN CHILDREN: ANALYSIS USING SURVEILLANCE EPIDEMIOLOGY AND END RESULTS DATA
    (2015) McClarin, Lavisha J.; Carter-Pokras, Olivia; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Increases in pediatric thyroid cancer incidence could be partly due to previous clinical intervention. This retrospective cohort study used 1973-2012 data from the Surveillance Epidemiology and End Results program to assess the association between previous radiation therapy exposure in development of second primary thyroid cancer (SPTC) among 0-19-year-old children. Statistical analysis included the calculation of summary statistics and univariable and multivariable logistic regression analysis. Relative to no previous radiation therapy exposure, cases exposed to radiation had 2.46 times the odds of developing SPTC (95% CI: 1.39-4.34). After adjustment for sex and age at diagnosis, Hispanic children who received radiation therapy for a first primary malignancy had 3.51 times the odds of developing SPTC compared to Hispanic children who had not received radiation therapy, [AOR=3.51, 99% CI: 0.69-17.70, p=0.04]. These findings support the development of age-specific guidelines for the use of radiation based interventions among children with and without cancer.