Medical home and pediatric primary care utilization among children with special health care needs.

INTRODUCTION: The medical home model seeks to improve health care delivery by enhancing primary care. This study examined the relationship between the presence of a medical home and pediatric primary care office visits by children with special health care needs (CSHCN) using the data from 2005-2006 National Survey of Children with Special Healthcare Needs. METHOD: Survey logistic regression was used to analyze the relationship. RESULTS: When CSHCN age, gender, ethnicity/race, functional status, insurance status, household education, residence, and income were included in the model, CSHCN with a medical home were 1.6 times more likely to have six or more annual pediatric primary care office visits than were children without a medical home [odds ratio = 1.60, 95% confidence interval = (1.47, 1.75)]. Female CSHCN, younger CSHCN, children with public health insurance, children with severe functional limitations, and CSHCN living in rural areas also were more likely to have a larger number of visits. DISCUSSION: By controlling for child sociodemographic characteristics, this study provides empirical evidence about how medical home availability affects primary care utilization by CSHCN.

The development and testing of an instrument to measure successful aging.

This article reports the development and testing of the Successful Aging Inventory (SAI). Two hundred participants completed two versions of the SAI, a Likert format and dichotomous format. To test the validity of the SAI, participants also completed the Life Satisfaction Inventory-A, Purpose in Life Test, Mastery Scale, and the Center for Epidemiologic Studies Depression Scale. Both versions of the SAI had acceptable psychometric properties. Principal components analysis resulted in five factors for the Likert version, accounting for 62.19% of the variance. The SAI shows promise as a measure of successful aging and also has the potential to be a useful method of tracking older adults' overall progress and improvements in response to health promotion strategies. The next step is to evaluate its sensitivity and appropriateness for use with ethnic and racial minority older adults, and those with more varied health status.

Perceptions of successful aging in Black older adults.

Successful aging is important; however, there is a lack of knowledge on how to promote successful aging in Black older adults. In this study, which examined Black older adults' perceptions of successful aging, a cross-sectional descriptive design was used to examine the psychometric properties of the Successful Aging Inventory and qualitative characteristics of successful aging in 100 Black older adults. The participants' responses to an open-ended question, "What does successful aging mean to you?" revealed relevant aspects of successful aging. Six broad categories emerged: Independence/Ability, Health, Mindset, Activity/Service, Family, and Spirituality. These categories suggest foci for potential interventions to promote successful aging in Black older adults.