Title:
Children’s health care utilization and parenting stress as predictors of behavior problems
Author:
Cierra A. Stanton
Thesis Advisor:
Mary Jo Coiro
Committee Member:
Frank D. Golom
Committee Member:
Beth A. Kotchick
Committee Member:
Stephen E. Fowl
Committee Member:
Sharon Green-Hennessy
Degree Granting Institution:
Loyola University Maryland--College of Arts and Sciences
Place:
Baltimore (Md.)
Publisher:
Loyola University Maryland
Date Created:
2020
Type of Resource:
text
Genre:
thesis
Language:
eng
Format:
application/pdf
Physical Form:
electronic
Digital Source:
born digital
Abstract:
Previous research has found an association between children’s utilization of health care services and mental health outcomes, specifically child behavior problems. One reason for this relation is that pediatricians have a unique role in the early identification of children’s mental health problems and in connecting families with needed mental health services. Consequently, children who do not utilize routine health care could be at a higher risk for behavior problems that may be left untreated, become more severe, or lead to greater functional impairment. Low-income and minority children are particularly at risk for not utilizing health care services as well as reporting more behavior problems. Although parenting stress has been found to be associated with utilization of care and child behavior problems, prior studies have not examined whether parenting stress may account for or mediate this association. The current research aims to fill this gap in the literature using parent/guardian report data from the 2007 National Survey of Children’s Health (NSCH). Data were obtained from 62,988 children ages 6-17 from all 50 states and the District of Columbia. Parents of children who did not utilize health care (defined as no preventive health care visits in the prior year and having unmet health care needs) reported higher levels of parenting stress and reported their children as exhibiting more behavior problems, compared to children who utilized health care services. Parenting stress did mediate the association between children’s utilization of health care and child behavior problems. The mediating role of parenting stress was found to be stronger for minority families than for White families, but family income did not moderate the prior mediation. Limitations for this study are discussed such as the survey used was based on parent/guardian reported data not objective psychological tests, and the NSCH used in the current study was administered in 2007. Moreover, the number of children who utilize services could be higher now compared to 2007 because of legislation such as the Affordable Care Act (ACA) of 2010 and the Mental Health Parity and Addition Equality Act (MHPAEA) of 2008 being put into effect. Suggestions for future research and practice are offered, including the development of integrated health care systems in which psychologists work closely with primary care physicians to provide interventions for families.
Degree:
Master of Sciece
Level:
Master
Discipline:
Clinical Psychology
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Identifier:
StantonC-20
