title: Individualized Education Program Development Among Racially/Ethnically Diverse Children and Adolescents with Health Conditions.
abstract: Background Black, Hispanic, and low income children bear a greater burden of chronic health conditions compared to wealthier white counterparts. Under federal law, schools provide services to children when their health conditions impair learning. These school services, called individualized education programs (IEPs) can reduce disparities in school outcomes. This paper examines the extent to which children with health conditions have an IEP plan, an important first step in understanding service utilization. Method Andersen's Behavioral Model was used to examine IEP plan presence by using the 2012 National Survey of Children's Health. School aged children (6-17), with at least one health condition (N = 16,496) were examined using multivariable logistic regression analysis to understand predisposing (age, sex, race/ethnicity), enabling (family and neighborhood), and need (health related) factors as predictors of having an IEP plan. Race/ethnicity interaction terms tested for moderating effects of race/ethnicity on the relationship between predisposing, enabling and need factors and having an IEP plan. Results Hispanic children were 93.4 % (OR = .066) less likely and Black children were 87.9 % (OR = .121) less likely to have an IEP plan compared to White children. Black, Hispanic, and Multiracial children were more likely to have an IEP plan if they had more family and neighborhood resources (OR range 1.37-1.62) and greater health needs and health care needs (OR range 1.29-2.57). Conclusion The Behavioral Model was useful in predicting the presence of IEP plans among racially/ethnically diverse children with health conditions as an important step in understanding disparities in healthcare access in schools.
authors.affiliation: Department of Sociology, University of Central Florida, 4000 Central Florida Blvd., Orlando, FL, 32816, USA. melanie.hinojosa@ucf.edu.
authors.forename: Melanie Sberna
authors.identifier: 0000-0001-5188-3315
authors.initials: MS
authors.lastname: Hinojosa
authors.affiliation: Department of Sociology, University of Central Florida, 4000 Central Florida Blvd., Orlando, FL, 32816, USA.
authors.forename: Ramon
authors.initials: R
authors.lastname: Hinojosa
authors.affiliation: Department of Sociology, University of Central Florida, 4000 Central Florida Blvd., Orlando, FL, 32816, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Nguyen
authors.affiliation: Department of Health Outcomes and Policy, University of Florida, PO Box 100177, Gainesville, FL, 32610-0177, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Bright
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology; D019988:Children with Disabilities / Q000193:education*; D005006:Ethnicity / Q000193:education*; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D017145:Models, Educational; D016730:Program Development / Q000379:methods; D044469:Racial Groups / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Andersen Behavioral Model; Individualized education program; Race/ethnicity; School service use