Medical Home Access Among Overweight and Healthy Weight Youth in the District of Columbia
Open AccessMedical Home Access among Overweight and Healthy Weight Youth in theDistrict of ColumbiaAbstract of DissertationObesity continues to be a significant public health issue. It is the most common nutritional disorder among children. Childhood obesity needs to be examined to inform the development of preventive interventions. To that end, the extent to which access to a Medical Home is associated with obesity or overweight status may be important to explore.The purpose of this study was threefold: to determine, after controlling for factors typically associated with obesity status, (1) whether having a Medical Home was associated with reduced risks for overweight/obese weight status among youth; (2) which of the five sub-components of having a Medical Home (i.e., having a personal doctor or nurse, a usual source of care, receipt of family-centered care, effective care coordination and having no problems getting a referral if needed) were most strongly associated with healthy weight versus overweight/obese status among youth; and (3) whether the number of sub-components of a Medical Home that are present was associated with reduced risks for overweight/obese weight status among youth.This study utilized a large and nationally representative database, the 2007 National Survey of Children's Health (NSCH), to examine Medical Home access among obese, overweight and healthy weight youth aged 10-17 in the District of Columbia. The primary independent variables were as follows: (1) Medical Home - defined as having all 5 Medical Home sub-components; (2) the 5 separate Medical Home sub-components; and (3) a more continuous measure of "Medical Homeness". Independent variables and other potential confounds were initially examined in bivariate analyses, and then in multivariate logistic regression analyses to determine whether associations with the dependent variable of weight status existed.Healthy weight youth were more likely than OW/OB youth to have a Medical Home after controlling for other potentially influential factors. Family-centered care was the most predictive of the five Medical Home sub-components in initial logistic regression analyses with healthy weight youth being significantly more likely than OW/OB youth to receive family-centered care. Healthy weight youth also had, on average, more Medical Home sub-components than OW/OB youth. This study identified associations between adolescent obesity and having access to a Medical Home.
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