Brief Report: Medicaid Expansion and Growth in the Workforce for Autism Spectrum Disorder / Ryan K. MCBAIN in Journal of Autism and Developmental Disorders, 52-4 (April 2022)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 52-4 (April 2022) . - p.1881-1889 Titre : Brief Report: Medicaid Expansion and Growth in the Workforce for Autism Spectrum Disorder Type de document : texte imprimé Auteurs : Ryan K. MCBAIN, Auteur ; Jonathan H. CANTOR, Auteur ; Aaron KOFNER, Auteur ; Bradley D. STEIN, Auteur ; Hao YU, Auteur Article en page(s) : p.1881-1889 Langues : Anglais (eng) Mots-clés : Autism Spectrum Disorder/therapy  Child  Humans  Insurance Coverage  Medicaid  Pediatricians  United States  Workforce  Autism  Autism spectrum disorder  Child psychiatrists  Medicaid expansion Index. décimale : PER Périodiques Résumé : Over 700,000 children throughout the U.S. have received insurance coverage through welcome mat effects of Medicaid expansion, including children with autism spectrum disorder (ASD). Utilizing health workforce data from the Health Resources and Services Administration, we examined workforce growth (2008-2017) among three types of health providers for children with ASD as a result of Medicaid expansion: child psychiatrists, board-certified behavioral analysts (BCBAs) and pediatricians. We found that state Medicaid expansion was associated with a 9% increase in BCBAs per 100,000 children one year after enactment, a 5% increase in child psychiatrists, and was not associated with growth in pediatricians. Results indicate the importance of new policies that directly address a shortage of providers for children with ASD. En ligne : http://dx.doi.org/10.1007/s10803-021-05044-2 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=476 [article] Brief Report: Medicaid Expansion and Growth in the Workforce for Autism Spectrum Disorder [texte imprimé] / Ryan K. MCBAIN, Auteur ; Jonathan H. CANTOR, Auteur ; Aaron KOFNER, Auteur ; Bradley D. STEIN, Auteur ; Hao YU, Auteur . - p.1881-1889. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 52-4 (April 2022) . - p.1881-1889 Mots-clés : Autism Spectrum Disorder/therapy  Child  Humans  Insurance Coverage  Medicaid  Pediatricians  United States  Workforce  Autism  Autism spectrum disorder  Child psychiatrists  Medicaid expansion Index. décimale : PER Périodiques Résumé : Over 700,000 children throughout the U.S. have received insurance coverage through welcome mat effects of Medicaid expansion, including children with autism spectrum disorder (ASD). Utilizing health workforce data from the Health Resources and Services Administration, we examined workforce growth (2008-2017) among three types of health providers for children with ASD as a result of Medicaid expansion: child psychiatrists, board-certified behavioral analysts (BCBAs) and pediatricians. We found that state Medicaid expansion was associated with a 9% increase in BCBAs per 100,000 children one year after enactment, a 5% increase in child psychiatrists, and was not associated with growth in pediatricians. Results indicate the importance of new policies that directly address a shortage of providers for children with ASD. En ligne : http://dx.doi.org/10.1007/s10803-021-05044-2 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=476

Context matters: community characteristics and mental health among war-affected youth in Sierra Leone / Theresa S. BETANCOURT in Journal of Child Psychology and Psychiatry, 55-3 (March 2014)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 55-3 (March 2014) . - p.217-226 Titre : Context matters: community characteristics and mental health among war-affected youth in Sierra Leone Type de document : texte imprimé Auteurs : Theresa S. BETANCOURT, Auteur ; Ryan K. MCBAIN, Auteur ; Elizabeth A. NEWNHAM, Auteur ; Robert T. BRENNAN, Auteur Article en page(s) : p.217-226 Langues : Anglais (eng) Mots-clés : Social ecology  mental health  child soldiers  post-conflict  war  externalizing  internalizing Index. décimale : PER Périodiques Résumé : Background Worldwide, over one billion children and adolescents live in war-affected settings. At present, only limited research has investigated linkages between disrupted social ecology and adverse mental health outcomes among war-affected youth. In this study, we examine three community-level characteristics – social disorder and collective efficacy within the community, as reported by caregivers, and perceived stigma as reported by youth – in relation to externalizing behaviors and internalizing symptoms among male and female former child soldiers in postconflict Sierra Leone. Methods A total of 243 former child soldiers (30% female, mean age at baseline: 16.6 years) and their primary caregivers participated in interviews in 2004 and 2008, as part of a larger prospective cohort study of war-affected youth in Sierra Leone. Two-point growth models were estimated to examine the relationship between community-level characteristics and externalizing and internalizing outcomes across the time points. Results Both social disorder within the community, reported by caregivers, and perceived stigma, reported by youth, positively covaried with youths' externalizing and internalizing scores – indicating that higher levels of each at baseline and follow-up were associated with higher levels of mental health problems at both time points (p .05). The relationship between collective efficacy and mental health outcomes was nonsignificant (p .05). Conclusions This study offers a rare glimpse into the role that the postconflict social context plays in shaping the mental health among former child soldiers. Results indicate that both social disorder and perceived stigma within the community demonstrate an important relationship to externalizing and internalizing problems among adolescent ex-combatants. Moreover, these relationships persisted over a 4-year period of follow-up. These results underscore the importance of the postconflict social environment and the need to develop postconflict interventions that address community-level processes in addition to the needs of families and individuals. En ligne : http://dx.doi.org/10.1111/jcpp.12131 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=226 [article] Context matters: community characteristics and mental health among war-affected youth in Sierra Leone [texte imprimé] / Theresa S. BETANCOURT, Auteur ; Ryan K. MCBAIN, Auteur ; Elizabeth A. NEWNHAM, Auteur ; Robert T. BRENNAN, Auteur . - p.217-226. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 55-3 (March 2014) . - p.217-226 Mots-clés : Social ecology  mental health  child soldiers  post-conflict  war  externalizing  internalizing Index. décimale : PER Périodiques Résumé : Background Worldwide, over one billion children and adolescents live in war-affected settings. At present, only limited research has investigated linkages between disrupted social ecology and adverse mental health outcomes among war-affected youth. In this study, we examine three community-level characteristics – social disorder and collective efficacy within the community, as reported by caregivers, and perceived stigma as reported by youth – in relation to externalizing behaviors and internalizing symptoms among male and female former child soldiers in postconflict Sierra Leone. Methods A total of 243 former child soldiers (30% female, mean age at baseline: 16.6 years) and their primary caregivers participated in interviews in 2004 and 2008, as part of a larger prospective cohort study of war-affected youth in Sierra Leone. Two-point growth models were estimated to examine the relationship between community-level characteristics and externalizing and internalizing outcomes across the time points. Results Both social disorder within the community, reported by caregivers, and perceived stigma, reported by youth, positively covaried with youths' externalizing and internalizing scores – indicating that higher levels of each at baseline and follow-up were associated with higher levels of mental health problems at both time points (p .05). The relationship between collective efficacy and mental health outcomes was nonsignificant (p .05). Conclusions This study offers a rare glimpse into the role that the postconflict social context plays in shaping the mental health among former child soldiers. Results indicate that both social disorder and perceived stigma within the community demonstrate an important relationship to externalizing and internalizing problems among adolescent ex-combatants. Moreover, these relationships persisted over a 4-year period of follow-up. These results underscore the importance of the postconflict social environment and the need to develop postconflict interventions that address community-level processes in addition to the needs of families and individuals. En ligne : http://dx.doi.org/10.1111/jcpp.12131 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=226

Generosity of state insurance mandates and growth in the workforce for autism spectrum disorder / Ryan K. MCBAIN in Autism, 25-4 (May 2021)  

Public ISBD [article]  inAutism > 25-4 (May 2021) . - p.921-931 Titre : Generosity of state insurance mandates and growth in the workforce for autism spectrum disorder Type de document : texte imprimé Auteurs : Ryan K. MCBAIN, Auteur ; Jonathan H. CANTOR, Auteur ; Aaron KOFNER, Auteur ; Timothy CALLAGHAN, Auteur ; Bradley D. STEIN, Auteur ; Hao YU, Auteur Article en page(s) : p.921-931 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  health services  policy  vocational/labor force participation Index. décimale : PER Périodiques Résumé : To improve access to health services for children with autism spectrum disorder, US states have passed laws requiring health insurers to cover autism-related care, commonly known as state insurance mandates. However, the features of mandates differ across states, with some state laws containing very generous provisions and others containing very restrictive provisions such as whether the mandates include children aged above 12 years, whether there is a limit on spending, and whether there are restrictions on the types of services covered. This study examined the relationship between generosity of mandates and growth in the health workforce between 2003 and 2017, a period during which 44 states passed mandates. We found that states that enacted more generous mandates experienced significantly more growth in board-certified behavioral analysts who provide behavioral therapy as well as more growth in child psychiatrists. We did not find differences in the growth of pediatricians, which is a less specialized segment of the workforce. Our findings were consistent across eight different mandate features and suggest that the content of legislation may be as important as whether or not legislation has been passed in terms of encouraging growth in the supply of services for children with autism spectrum disorder. En ligne : http://dx.doi.org/10.1177/1362361320976744 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=444 [article] Generosity of state insurance mandates and growth in the workforce for autism spectrum disorder [texte imprimé] / Ryan K. MCBAIN, Auteur ; Jonathan H. CANTOR, Auteur ; Aaron KOFNER, Auteur ; Timothy CALLAGHAN, Auteur ; Bradley D. STEIN, Auteur ; Hao YU, Auteur . - p.921-931. Langues : Anglais (eng) in Autism > 25-4 (May 2021) . - p.921-931 Mots-clés : autism spectrum disorders  health services  policy  vocational/labor force participation Index. décimale : PER Périodiques Résumé : To improve access to health services for children with autism spectrum disorder, US states have passed laws requiring health insurers to cover autism-related care, commonly known as state insurance mandates. However, the features of mandates differ across states, with some state laws containing very generous provisions and others containing very restrictive provisions such as whether the mandates include children aged above 12 years, whether there is a limit on spending, and whether there are restrictions on the types of services covered. This study examined the relationship between generosity of mandates and growth in the health workforce between 2003 and 2017, a period during which 44 states passed mandates. We found that states that enacted more generous mandates experienced significantly more growth in board-certified behavioral analysts who provide behavioral therapy as well as more growth in child psychiatrists. We did not find differences in the growth of pediatricians, which is a less specialized segment of the workforce. Our findings were consistent across eight different mandate features and suggest that the content of legislation may be as important as whether or not legislation has been passed in terms of encouraging growth in the supply of services for children with autism spectrum disorder. En ligne : http://dx.doi.org/10.1177/1362361320976744 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=444

The intergenerational impact of war: longitudinal relationships between caregiver and child mental health in postconflict Sierra Leone / Theresa S. BETANCOURT in Journal of Child Psychology and Psychiatry, 56-10 (October 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-10 (October 2015) . - p.1101-1107 Titre : The intergenerational impact of war: longitudinal relationships between caregiver and child mental health in postconflict Sierra Leone Type de document : texte imprimé Auteurs : Theresa S. BETANCOURT, Auteur ; Ryan K. MCBAIN, Auteur ; Elizabeth A. NEWNHAM, Auteur ; Robert T. BRENNAN, Auteur Article en page(s) : p.1101-1107 Langues : Anglais (eng) Mots-clés : War  depression  anxiety  intergenerational  dyadic analysis Index. décimale : PER Périodiques Résumé : Background Trauma from witnessing events such as bombings and killings as well as direct victimization or participation in violence has been associated with psychosocial distress and poor mental health among war-exposed children and adolescents. This study examines the relationship between caregiver mental health and child internalizing (anxiety and depression) symptoms over a 4-year period in postconflict Sierra Leone. Methods The sample included 118 adolescent Sierra Leonean youth (73% male; mean age = 16.5 years at Time 1) and their caregivers (40% male; mean age = 39.0 at Time 1). To measure depression and anxiety symptoms, the Hopkins Symptom Checklist–25 was used with adults and the Oxford Measure of Psychosocial Adjustment – previously validated for use with children and adolescents in the region – was used to assess youth. A multivariate hierarchical linear model (HLM) for studying change within dyads was implemented to study covariation in internalizing symptoms among caregivers and youth over time; these models also included covariates at the individual, family and community levels. The relationship of caregiver mental health to child's internalizing was tested in a latent variable extension of the HLM. Results The latent variable extension estimated that a one standard deviation (SD) change in caregiver anxiety/depression was associated with a .43 SD change in youth internalizing (p < .01) over the 4-year period. Family acceptance was negatively related to youth internalizing (p < .001), while community stigma was positively associated (p < .001). Conclusions The findings highlight an important interplay between caregiver and child mental health within the postconflict setting and the need for psychosocial interventions to extend beyond the individual to account for family dynamics. En ligne : http://dx.doi.org/10.1111/jcpp.12389 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=269 [article] The intergenerational impact of war: longitudinal relationships between caregiver and child mental health in postconflict Sierra Leone [texte imprimé] / Theresa S. BETANCOURT, Auteur ; Ryan K. MCBAIN, Auteur ; Elizabeth A. NEWNHAM, Auteur ; Robert T. BRENNAN, Auteur . - p.1101-1107. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-10 (October 2015) . - p.1101-1107 Mots-clés : War  depression  anxiety  intergenerational  dyadic analysis Index. décimale : PER Périodiques Résumé : Background Trauma from witnessing events such as bombings and killings as well as direct victimization or participation in violence has been associated with psychosocial distress and poor mental health among war-exposed children and adolescents. This study examines the relationship between caregiver mental health and child internalizing (anxiety and depression) symptoms over a 4-year period in postconflict Sierra Leone. Methods The sample included 118 adolescent Sierra Leonean youth (73% male; mean age = 16.5 years at Time 1) and their caregivers (40% male; mean age = 39.0 at Time 1). To measure depression and anxiety symptoms, the Hopkins Symptom Checklist–25 was used with adults and the Oxford Measure of Psychosocial Adjustment – previously validated for use with children and adolescents in the region – was used to assess youth. A multivariate hierarchical linear model (HLM) for studying change within dyads was implemented to study covariation in internalizing symptoms among caregivers and youth over time; these models also included covariates at the individual, family and community levels. The relationship of caregiver mental health to child's internalizing was tested in a latent variable extension of the HLM. Results The latent variable extension estimated that a one standard deviation (SD) change in caregiver anxiety/depression was associated with a .43 SD change in youth internalizing (p < .01) over the 4-year period. Family acceptance was negatively related to youth internalizing (p < .001), while community stigma was positively associated (p < .001). Conclusions The findings highlight an important interplay between caregiver and child mental health within the postconflict setting and the need for psychosocial interventions to extend beyond the individual to account for family dynamics. En ligne : http://dx.doi.org/10.1111/jcpp.12389 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=269

Where are US outpatient mental health facilities that serve children with autism spectrum disorder? A national snapshot of geographic disparities / Jonathan CANTOR in Autism, 26-1 (January 2022)  

Public ISBD [article]  inAutism > 26-1 (January 2022) . - p.169-177 Titre : Where are US outpatient mental health facilities that serve children with autism spectrum disorder? A national snapshot of geographic disparities Type de document : texte imprimé Auteurs : Jonathan CANTOR, Auteur ; Ryan K. MCBAIN, Auteur ; Aaron KOFNER, Auteur ; Bradley D. STEIN, Auteur ; Hao YU, Auteur Article en page(s) : p.169-177 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  health services Index. décimale : PER Périodiques Résumé : There has been a rise in the observed prevalence of autism spectrum disorder among children. Existing studies show the share of counties with a treatment facility that offers care for children with autism spectrum disorder. However, no estimates exist of the share of US outpatient mental health treatment facilities that provide services for children with autism spectrum disorder. We identified key facility-level characteristics in offering mental health care for children with autism spectrum disorder. We used a telephone survey to contact almost all outpatient mental health treatment facilities in the contiguous United States. We asked the facilities if they provided mental health care for children with autism spectrum disorder. We took the results of this survey and estimated multivariable regressions to examine county- and facility-level predictors of offering services. We found that over half (50.3%) of the 6156 outpatient facilities reported offering care for children with autism spectrum disorder. Non-metro counties, counties with a lower percentage of non-White residents, counties with a higher percentage of uninsured residents, and counties with a higher poverty rate had fewer outpatient mental health treatment facilities providing care for children with autism spectrum disorder. Facilities accepting Medicaid as a form of payment, offering telehealth, and private for-profit facilities were more likely to provide services for children with autism spectrum disorder. Because only half of outpatient mental health treatment facilities offer care for children with autism spectrum disorder, public health officials and policymakers should do more to ensure that this vulnerable population has access to mental health services. En ligne : http://dx.doi.org/10.1177/13623613211024046 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=451 [article] Where are US outpatient mental health facilities that serve children with autism spectrum disorder? A national snapshot of geographic disparities [texte imprimé] / Jonathan CANTOR, Auteur ; Ryan K. MCBAIN, Auteur ; Aaron KOFNER, Auteur ; Bradley D. STEIN, Auteur ; Hao YU, Auteur . - p.169-177. Langues : Anglais (eng) in Autism > 26-1 (January 2022) . - p.169-177 Mots-clés : autism spectrum disorders  health services Index. décimale : PER Périodiques Résumé : There has been a rise in the observed prevalence of autism spectrum disorder among children. Existing studies show the share of counties with a treatment facility that offers care for children with autism spectrum disorder. However, no estimates exist of the share of US outpatient mental health treatment facilities that provide services for children with autism spectrum disorder. We identified key facility-level characteristics in offering mental health care for children with autism spectrum disorder. We used a telephone survey to contact almost all outpatient mental health treatment facilities in the contiguous United States. We asked the facilities if they provided mental health care for children with autism spectrum disorder. We took the results of this survey and estimated multivariable regressions to examine county- and facility-level predictors of offering services. We found that over half (50.3%) of the 6156 outpatient facilities reported offering care for children with autism spectrum disorder. Non-metro counties, counties with a lower percentage of non-White residents, counties with a higher percentage of uninsured residents, and counties with a higher poverty rate had fewer outpatient mental health treatment facilities providing care for children with autism spectrum disorder. Facilities accepting Medicaid as a form of payment, offering telehealth, and private for-profit facilities were more likely to provide services for children with autism spectrum disorder. Because only half of outpatient mental health treatment facilities offer care for children with autism spectrum disorder, public health officials and policymakers should do more to ensure that this vulnerable population has access to mental health services. En ligne : http://dx.doi.org/10.1177/13623613211024046 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=451

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