Graduate Thesis Or Dissertation
 

Use and Disclosure of Complementary Health Approaches Among Children with Developmental Disabilities

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https://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/js956k35d

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  • Children with developmental disabilities (DD), particularly autism spectrum disorder (ASD), may use complementary health approaches (CHA), including some modalities that can be unsafe, inefficacious, and/or costly. Still, the prevalence of CHA use among US children with DD is not known and their reasons for use are not well understood. By disclosing CHA used for children with DD, family-provider communication and shared treatment decision making can occur. Yet, little is known about disclosure among children with DD. This dissertation was, therefore, intended to provide new knowledge on the use and disclosure of CHA among children with DD, with a focus on children with ASD. To achieve this purpose, the dissertation had two main components. The first component involved the analysis of 2012 National Health Interview Survey data to estimate the prevalence and correlates of CHA use and nondisclosure among US children with DD aged 4-17. Results showed that 23% of US children with DD used CHA, and among them, 42% did not disclose. Factors significantly associated with CHA use included female gender, higher household income, not living in the South, difficulty accessing conventional care, or comorbidity. Factors significantly associated with nondisclosure included female gender, older age, no functional limitations, less conventional care use, or use of fewer CHA. The second component was a mixed methods study. Secondary parent-reported survey data on a probability sample of young children with ASD and primary data from in-depth interviews conducted with a purposive sample of parents who reported using CHA for ASD in the survey were analyzed. Survey results showed child age, the belief ASD has major consequences, location, and medication use were each significantly associated with use of CHA. Nine themes from the qualitative data helped explain these results: CHA use is viewed as no longer necessary when ASD symptoms change with age, parents believe there is a critical period to act by using CHA when children are younger, CHA are viewed as safe for young children, parents believe they can reduce ASD impact by using CHA, conventional healthcare is viewed as ineffective for ASD, CHA are viewed as effective for ASD, CHA are widely accepted in the family’s community, CHA are readily accessible, and ASD may necessitate different approaches including medication and CHA. Six themes regarding disclosure were also identified: disclosure is important to help optimize the child’s health, self-efficacy facilitates disclosure, beliefs about CHA effectiveness can help or hinder disclosure, parent-provider relationship quality affects disclosure, provider attitudes and knowledge regarding CHA and ASD influence disclosure, and visit length and other characteristics impact disclosure. Dissertation findings suggest use and nondisclosure of CHA may be common and multifactorial for children with DD. Application and future research related to these findings is needed to increase disclosure and promote health among children with DD.
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  • 2017-08-16 to 2018-05-30

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