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This scoping review explores (a) barriers faced by immigrant families of children with intellectual and developmental disabilities (IDD) when accessing healthcare-related services in the United States, (b) where research stands based on the health disparity research framework, and (c) implications for future health disparities research with this population. Our scoping review found 26 empirical studies published between 2000 and 2020 that met our inclusion criteria. Data were extracted and synthesized based on the stages of research outlined in the health disparity research framework. Overall, immigrant families experienced barriers on multiple levels including patient, provider, and healthcare system levels. Studies focusing on detecting and reducing disparities are emerging. We conclude with recommendations for future research and practice with immigrant families of children with IDD. [ABSTRACT FROM AUTHOR]

This study examined maintenance of treatment effects in a culturally tailored parent education program for Latinx families of children with autism spectrum disorder using a behavior maintenance framework. In a two-site randomized waitlist-control study, we compared differences in parent and child outcomes across three timepoints using linear mixed models to determine whether outcomes observed at 4 months after baseline (Time 2) were maintained for an additional 4-month period (Time 3). Parent outcomes included family empowerment, self-reported confidence in, and frequency of using evidence-based strategies. Child outcomes included parent-reported challenging behaviors, social communication impairments, and the number of services received. Participants were 109 Latina mothers (intervention = 54, control = 55) of children with autism spectrum disorder. Results showed that at Time 3, mothers in the intervention groups reported significantly greater confidence in and frequency of using evidence-based strategies, and that their child received significantly more services. Site-specific treatment differences were found in outcomes such as parent-reported empowerment and child social communication impairments. Findings suggest that the intervention for Latinx parents of children with autism spectrum disorder was efficacious and could be maintained, and that site-specific policy and service differences may need to be examined in future research to inform dissemination and implementation. Background: We conducted a follow-up investigation of a two-site randomized controlled trial in the United States. We examined whether the treatment effects in a culturally tailored parent education program for Latinx families of children with autism spectrum disorder were maintained over time. Methods: Using linear mixed models, we compared differences in parent and child outcomes across three timepoints: baseline, 4 months after baseline (Time 2), and 8 months after baseline (T3). Parent outcomes included family empowerment, self-reported confidence in, and frequency of using evidence-based strategies. Child outcomes included parent-reported challenging behaviors, social communication impairments, and the number of services received. Participants were 109 Latina mothers (intervention = 54, control = 55) of children with autism spectrum disorder. Results: After intervention at both Time 2 and Time 3 in both sites, mothers in the intervention groups reported significantly greater confidence in and frequency of using evidence-based strategies, and that their child received significantly more services. We also found that there were treatment differences across the two study sites in several outcomes. Implications: The intervention for Latinx parents of children with autism spectrum disorder was efficacious and could be maintained, and that site-specific policy and service differences may need to be examined in future research to inform dissemination and implementation. [ABSTRACT FROM AUTHOR]

Wildfires burn more than 7 million acres in the United States annually, according to the US Forest Service. Little is known about which subpopulations are more vulnerable to health risks from wildfire smoke, including those associated with fine particulate matter. We estimated exposure to fine particles specifically from wildfires, as well as the associations between the presence of wildfire-specific fine particles and the amount of hospital admissions for respiratory causes among subpopulations older than 65 years of age in the western United States (2004-2009). Compared with other populations, higher fractions of persons who were black, lived in urban counties, and lived in California were exposed to more than 1 smoke wave (high-pollution episodes from wildfire smoke). The risks of respiratory admissions on smoke-wave days compared with non-smoke-wave days increased 10.4% (95% confidence interval: 1.9, 19.6) for women and 21.7% (95% confidence interval: 0.4, 47.3) for blacks. Our findings suggest that increased risks of respiratory admissions from wildfire smoke was significantly higher for women than for men (10.4% vs. 3.7%), blacks than whites (21.7% vs. 6.9%), and, although associations were not statistically different, people in lower-education counties than higher-educated counties (12.7% vs. 6.1%). Our study raised important environmental justice issues that can inform public health programs and wildfire management. As climate change increases the frequency and intensity of wildfires, evidence on vulnerable subpopulations can inform disaster preparedness and the understanding of climate change consequences. [ABSTRACT FROM AUTHOR]

Increasing wildfire activities in the mountainous western US may present a challenge for the region to attain a recently revised ozone air quality standard in summer. Using current Eulerian chemical transport models to examine the wildfire ozone influences is difficult due to uncertainties in fire emissions, inadequate model chemistry, and resolution. Here we quantify the wildfire influence on the ozone variability, trends, and number of high MDA8 (daily maximum 8 h average) ozone days over this region in summers (June, July, and August) 1989-2010 using a new approach. We define a fire index using retroplumes (plumes of back-trajectory particles) computed by a Lagrangian dispersion model (FLEXPART) and develop statistical models based on the fire index and meteorological parameters to interpret MDA8 ozone concentrations measured at 13 Intermountain West surface sites. We show that the statistical models are able to capture the ozone enhancements by wildfires and give results with some features different from the GEOS-Chem Eulerian chemical transport model. Wildfires enhance the Intermountain West regional summer mean MDA8 ozone by 0.3-1.5 ppbv (daily episodic enhancements reach 10-20 ppbv at individual sites) with large interannual variability, which are strongly correlated with the total MDA8 ozone. We find large fire impacts on the number of exceedance days; for the 13 CASTNet sites, 31 % of the summer days with MDA8 ozone exceeding 70 ppbv would not occur in the absence of wildfires. [ABSTRACT FROM AUTHOR]

Background: Since diet is a known modulator of inflammation, the Dietary Inflammatory Index (DII), which quantifies the inflammatory potential of an individual's diet, becomes a significant parameter to consider. Chronic diarrhea is commonly linked to inflammatory processes within the gut. Thus, this study aimed to explore the potential link between DII and chronic diarrhea., Methods: This research utilized data from the National Health and Nutrition Examination Survey (NHANES) 2005-2010. The DII was calculated according to the average intake of 28 nutrients using information gathered from two 24-hour recall interviews. The Bristol Stool Form Scale (BSFS) was adopted to describe chronic diarrhea, identifying stool Type 6 and Type 7. Multivariate logistic regression models examined the causal connection between DII and chronic diarrhea. Additionally, subgroup analyses and interaction tests were conducted., Results: The study encompassed 11,219 adults, among whom 7.45% reported chronic diarrhea. Initially, multivariate logistic regression analysis revealed a positive association between DII and chronic diarrhea. Nevertheless, this connection lost statistical significance (OR = 1.00; 95% CI, 0.96-1.05; P = 0.8501) after adjusting for all confounding variables. Stratified by sex, the analysis revealed a notable rise in the risk of chronic diarrhea with increasing DII among female participants (all P for trend < 0.05). This tendency remained constant even after full adjustment (P for trend = 0.0192), whereas no significant association was noted in males (all P for trend > 0.05). Furthermore, an L-shaped association emerged between DII and chronic diarrhea, with an inflection point of -1.34. In the population with DII scores below -1.34, each unit increase in DII correlated with a 27% reduction in the probability of chronic diarrhea (OR = 0.73; 95% CI, 0.57-0.93), whereas in the population with DII scores above -1.34, the risk increased by 4% (OR = 1.04; 95% CI, 0.98-1.10). Merely, the gender interaction was shown to be statistically significant based on subgroup analyses and interaction tests., Conclusions: A favorable association between DII and chronic diarrhea exists in adults in the United States. Nevertheless, additional long-term prospective studies are required to confirm and solidify those findings., Competing Interests: Declarations. Ethics approval and consent to participate: The Declaration of Helsinki was followed in conducting the study. The NCHS study Ethics Review Board authorized all study protocols, and survey participants provided signed informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Lay Abstract: Background: We conducted a follow-up investigation of a two-site randomized controlled trial in the United States. We examined whether the treatment effects in a culturally tailored parent education program for Latinx families of children with autism spectrum disorder were maintained over time. Methods: Using linear mixed models, we compared differences in parent and child outcomes across three timepoints: baseline, 4 months after baseline (Time 2), and 8 months after baseline (T3). Parent outcomes included family empowerment, self-reported confidence in, and frequency of using evidence-based strategies. Child outcomes included parent-reported challenging behaviors, social communication impairments, and the number of services received. Participants were 109 Latina mothers (intervention = 54, control = 55) of children with autism spectrum disorder. Results: After intervention at both Time 2 and Time 3 in both sites, mothers in the intervention groups reported significantly greater confidence in and frequency of using evidence-based strategies, and that their child received significantly more services. We also found that there were treatment differences across the two study sites in several outcomes. Implications: The intervention for Latinx parents of children with autism spectrum disorder was efficacious and could be maintained, and that site-specific policy and service differences may need to be examined in future research to inform dissemination and implementation.

Background: Therapy services can support developmental needs, improve social emotional outcomes, and reduce persistent health inequities for children with developmental disabilities (DD). Receipt of therapy services may be especially timely when children with DD are school-aged, once diagnosis has often occurred. Yet limited knowledge exists on geographic variability and determinants of therapy use among school-aged U.S. children with DD., Objectives: We aimed to (1) determine if therapy use varies significantly by state and (2) examine associations of health determinants with therapy use among U.S. school-aged children with DD., Methods: This was a secondary analysis of 2016 and 2017 National Survey of Children's Health data. The sample included 9984 children with DD ages 6-17 years. We obtained odds ratios and predicted margins with 95% confidence intervals from multilevel logistic regression models to examine therapy use variation and determinants., Results: Overall, 34.6% of children used therapy services. Therapy use varied significantly across states (σ 2  = 0.11, SE = 0.04). Younger age, public insurance, functional limitations, individualized education program, frustration accessing services, and care coordination need were associated with higher adjusted odds of therapy access. In states with Medicaid Home and Community-Based Services waivers, higher estimated annual waiver cost was associated with lower adjusted odds of therapy use., Conclusions: Results highlight geographic disparities in therapy use and multilevel targets to increase therapy use for school-aged children with DD., (Copyright © 2021 Elsevier Inc. All rights reserved.)