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(Aut-SDAR) The Intersection of Public Health Insurance and Community Connectedness for Kids with ASD/IDD and their Family Caregivers: A Nationally Representative Study

Abstract

The Indiana Institute on Disability and Community (IIDC) at Indiana University requests support for an Autism Secondary Data Analysis Research project with a focus on children with autism and other intellectual/developmental disabilities and their family caregivers. Research has shown that public health policy and programmatic interventions, such as Medicaid and State Child Health Insurance Program coverage, are critical to children with disabilities. Yet, little attention is given to: 1) how these interventions affect the child and family unit and, 2) how intervention experiences for children and families differ for those families with stronger versus weaker community ties. Informed by the International Classification of Functioning, social determinants of health, and the Double ABCX model, this study seeks to build new knowledge regarding key contextual variables that can enhance public health policy and programmatic interventions. The proposed research will answer five overarching research questions to better understand the experiences of children and family caregivers that use public health insurance programs, and how these experiences differ for those with different levels of connectedness to their communities. Specific outcomes of interest include behavioral health and school participation of children, overall health of children and family caregivers, and economic engagement of family caregivers. The study will use 2014-2017 pooled National Health Interview Survey and link child, parent, and family data. The nationally representative, pooled sample includes 45,623 subjects; of this group 820 (1.7%) have autism (with or without co-occurring IDD) and 1,465 (3.2%) have ID and/or other DD (no autism). Analyses will account for complex survey design in constructing point estimates and multivariate models. Linear and logistic regression models will test for main effects and interaction effects, while controlling for key demographics, socioeconomics, family structure, and disability. During the funding year and by leveraging robust infrastructure, research, and production support, the multidisciplinary research team is prepared to deliver three peer reviewed publications, two national and/or international juried presentations, three research translation briefs, at least one press release, and a national social media and newsletter presence. The team also expects to publish an additional two articles post-funding. A national dissemination strategy that includes the IIDC and a partnership with the Association of University Centers on Disability, ensures that research outputs will be delivered widely to diverse audiences. The research team regularly conducts technical assistance to state, national, and international constituents; and it is prepared to engage in technical assistance, as requests are made. Finally, substantial formative and evaluation will occur to ensure the project is completed in a timely fashion and on budget.

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