Medical Home Outcomes for School-Aged Children With Chronic Health Care Needs: A Mokken Analysis.

BACKGROUND AND OBJECTIVES: We examined the structure of the medical home construct as well as the association of having a medical home with school outcomes among children with chronic health conditions. METHODS: The current study utilized a combination of structural equation modeling, item response theory, and Mokken scaling techniques to determine how components of a medical home may be prioritized. The components of an operationally defined medical home were the main measures along with number of missed school days and the degree of interference with a child's school. RESULTS: Results of the current study provide a clear structure for the components of a medical home using Mokken scaling analyses. These components of a medical home are important as they were associated with fewer missed school days and a lower likelihood of a child's condition interfering with school as reported by parents. CONCLUSION: With the results of the current study, providers working with schools can quickly discriminate (1) whether a child has a medical home and (2) understand how to guide parents toward a comprehensive medical home by understanding the hierarchy of medical home components.

Sleep disparities in the first month of college: implications for academic achievement.

Study Objective: We investigated sleep disparities and academic achievement in college. Methods: Participants were 6,002 first-year college students attending a midsize private university in the southern United States [62.0% female, 18.8% first-generation, 37.4% Black, Indigenous, or People of Color (BIPOC) students]. During the first 3-5 weeks of college, students reported their typical weekday sleep duration, which we classified as short sleep (<7 hours), normal sleep (7-9 hours), or long sleep (>9 hours). Results: The odds for short sleep were significantly greater in BIPOC students (95% CI: 1.34-1.66) and female students (95% CI: 1.09-1.35), and the odds for long sleep were greater in BIPOC students (95% CI: 1.38-3.08) and first-generation students (95% CI: 1.04-2.53). In adjusted models, financial burden, employment, stress, STEM academic major, student athlete status, and younger age explained unique variance in sleep duration, fully mediating disparities for females and first-generation students (but only partially mediating disparities for BIPOC students). Short and long sleep predicted worse GPA across students' first year in college, even after controlling for high school academic index, demographics, and psychosocial variables. Conclusions: Higher education should address sleep health early in college to help remove barriers to success and reduce disparities.