Evidence map›Paper›PMID 34519425›Full record

ArticlePediatric blood & cancer2021

Disparities in pediatric psychosocial oncology utilization.

Daniel J Zheng, Puja J Umaretiya, Emily R Schwartz, Hasan Al-Sayegh, Jean L Raphael, Raphaële R L van Litsenburg, Clement Ma, Anna C Muriel, Kira Bona

Abstract read
In one paragraph

Article in Pediatric blood & cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Daniel J ZhengDepartment of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.
Puja J UmaretiyaDepartment of Pediatric Oncology and Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.ORCID 0000-0002-7587-4875
Emily R SchwartzDepartment of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.
Hasan Al-SayeghDepartment of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.
Jean L RaphaelDepartment of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.ORCID 0000-0002-8612-1705
Raphaële R L van LitsenburgPrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Clement MaDepartment of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.
Anna C MurielDepartment of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.ORCID 0000-0002-8283-6076
Kira BonaDepartment of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.ORCID 0000-0001-5602-7059

Funding

Material Hardship as a Targetable Measure of Poverty in Pediatric CancerK07CA211847 · NCI · DANA-FARBER CANCER INST · PI BONA, KIRA O. · 2016 to 2021
$731k
NCI NIH HHS K07 CA211847
6 · The paper itself

Abstract

backgroundIntegratedbehavioral health models have been proposed as care delivery approaches to mitigate mental health disparities in primary care settings. However, these models have not yet been widely adopted or evaluated in pediatric oncology medical homes.

methodsWe conducted a retrospective cohort study of 394 children with newly diagnosed cancer at Dana-Farber/Boston Children's Cancer and Blood Disorders Center (DF/BCH) from April 2013 to January 2017. Baseline sociodemographic characteristics and psychiatry utilization outcomes at 12 months following diagnosis were abstracted from the medical record. The severity of household material hardship (HMH), a concrete poverty exposure, at diagnosis and race/ethnicity were characterized by parent report using the Psychosocial Assessment Tool 2.0 (PAT). Associations between sociodemographic characteristics and receipt of psychiatry consultation were assessed with multivariable logistic regression models.

resultsAmong 394 children, 29% received a psychiatric consultation within 12 months postdiagnosis. Of these, 88% received a new psychiatric diagnosis, 76% received a psychopharmacologic recommendation, and 62% received a new behavioral intervention recommendation. In multivariable logistic regression adjusting for age, cancer diagnosis, and PAT total score, there was no statistically significant association between HMH severity or household income and psychiatry utilization. Children who identified as racial/ethnic minorities were significantly less likely to receive a psychiatry consultation (OR = 0.48, 95% CI = 0.27-0.84).

conclusionsIn a pediatric oncology medical home with an integrated behavioral health model, socioeconomic status was not associated with disparate psychiatry utilization. However, there remained a profound racial/ethnic disparity in psychiatry utilization, highlighting the need for additional research and care delivery intervention.

Indexed as

Ethnic and Racial MinoritiesHealthcare DisparitiesNeoplasmsPsycho-OncologyChildHumansPovertyRetrospective StudiesSocial Classhealth care disparitieshealth services researchmental healthminority healthpediatric oncologypsychiatry

Identifiers

PMID34519425
PMCPMC8463506

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