Abstract
Drawing on a social determinants of health framework, we evaluated associations between perceived family-centered care (FCC) and positive developmental outcomes for youth with special health care needs across six different family structures (married biological families, cohabiting biological families, married stepfamilies, cohabiting stepfamilies, divorced/separated single-mother families, and never-married single-mother families). Using data from the 2011-2012 National Survey of Children's Health, we found that married biological families perceive greater FCC than do other family structures. Perceived FCC was positively associated with all three positive youth outcomes evaluated (children's health, participation in extracurricular activities, and flourishing) in married biological families, and two of the three outcomes (children's health and flourishing) in married stepfamilies and divorced/separated single-mother families. Implications for health care provision and future research with structurally diverse families are discussed.
Highlights
In 1960, 73% of children under age 18 lived in families headed by their married biological parents
We drew on a social determinants of health framework (Viner et al, 2012) to better understand how family structure may affect parents’ perceptions of Family-centered care (FCC) and its associations with positive developmental outcomes for youth with Special Health Care Need (SHCN)
The present study addressed a significant gap in the current health literature by conducting a secondary analysis of data provided by parents of youth with SHCNs who participated in the 2011-2012 National Survey of Children’s Health (NSCH)
Summary
In 1960, 73% of children under age 18 lived in families headed by their married biological parents. By 2015 that number had decreased to 46%, with a plurality of children instead living in single-parent, divorced, cohabiting, or remarried households (Pew Research Center, 2015). This shift in prevalence of diverse family structures can present a challenge for doctors’ and nurses’ efforts to promote children’s health and well-being (Chen & Escarce, 2008; Rusell, Coleman, Ganong, & Gayer, 2016) if children have a Special Health Care Need (SHCN). Though a handful of qualitative investigations have suggested that family structural diversity may present challenges for health care delivery and provision to youth with SHCNs (e.g., Kelly & Ganong, 2011; Russell et al, 2016) empirical evidence of differences in experiences and impacts of FCC across diverse family structures does not currently exist.
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