Despite a rich and developing research literature on the relationships between transportation and healthcare outcomes, the impact of unmet transportation needs on children, particularly on their general psychosocial functioning, is less well understood. We hypothesized that caregiver's transportation needs may be a key point of intervention for child-level health outcomes, such that the resolution of caregiver transportation needs may have an important, downstream impact on other areas of the child's functioning. We tested this hypothesis in a sample of children (n=4341) served in a large, statewide public behavioral healthcare system. We conducted a retrospective longitudinal analysis of children served in the system between March 2019 and March 2020, using a specialized assessment tool that captures a comprehensive range of psychosocial functioning: the Child and Adolescent Needs and Strengths (CANS; Lyons, 2009) assessment. Linear mixed-effects analyses demonstrated that, if caregivers' transportation needs were resolved during the episode of care, those children demonstrated greater improvements on both need reduction and strength building across multiple domains than did their peers whose caregivers had unresolved transportation needs. By the end of the episode of care, children whose caregivers had resolved transportation needs were not significantly different than those children whose caregivers never had transportation needs. The resolution of transportation needs may be an important focus for providers working with children with a complex behavioral health, such that the resolution of these transportation needs seems to have a large, positive downstream impact on their overall functioning.

中文翻译：

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调查照顾者的运输需求对儿童对行为和心理健康治疗的反应的影响：纵向分析

尽管关于交通运输与医疗保健结果之间关系的研究文献日趋丰富，但人们对交通需求未得到满足对儿童尤其是对其总体社会心理功能的影响的了解还很少。我们假设照顾者的交通需求可能是干预儿童水平健康结果的关键点，因此照顾者的交通需求的解决可能会对孩子的其他功能方面产生重要的下游影响。我们在全州范围内大型公共行为保健系统中服务的儿童样本（n = 4341）中检验了该假设。我们对2019年3月至2020年3月在该系统中服务的儿童进行了回顾性纵向分析，使用一种专门的评估工具，该工具可以捕获广泛的社会心理功能：儿童和青少年的需求和优势（CANS；里昂，2009年）评估。线性混合效应分析表明，如果照料者在照料期间解决了运输需求，则与未解决照料者的同龄人相比，这些孩子在跨多个领域的需求减少和力量建设方面表现出更大的进步。到护理阶段结束时，照料者解决了交通需求的孩子与那些照料者从未遇到过运输需求的孩子没有显着差异。对于需要与行为健康状况复杂的儿童一起工作的提供者，交通需求的解决可能是一个重要的重点，