Additive Impact of Preterm Birth and Neighborhood Characteristics on Early Child Academic Achievement Öffentlichkeit
Patterson, Amirah (2012)
Abstract
Additive Impact of Preterm Birth and Neighborhood
Characteristics on
Early Child Academic Achievement
Objective: This study aimed to assess independent and possibly
supra-additive impact of
being born preterm and living in impoverished, predominately black,
and deprived
neighborhoods on academic achievement.
Methods: The effect of failing state-administered
standardized tests for first grade Georgia
public school students were calculated using the Georgia Linked
Birth Record and
Educational Data Set for the Atlanta MSA (n=138,289). Exposures
included preterm birth
status and neighborhood exposures (poverty, racial composition, and
deprivation). Using
binomial-identity (risk difference) modeling, models were obtained
that assessed the
interaction of preterm birth and neighborhood exposures.
Results: Binomial-identity modeling showed statistically
significant additive interactions of
preterm birth status and each of the three neighborhood exposures
in relation to failing
statewide standardized tests (p-value = <.0001). This
corresponds to an additional effect of
2.9-4.3% of failing when compared to the expected effect of preterm
birth and highest
quintiles of neighborhood exposures.
Conclusions: These results imply that those born both
preterm and into neighborhoods
classified with high concentrations of poverty, predominantly
non-Hispanic black racial
composition, and/or high deprivation are at increased risk of low
academic achievement in
early education. This provides further research about the impact
that both preterm births and
neighborhood environment has on a child's academic achievement.
Results provide a
targeted population for interventions aimed at limiting the risk of
low academic achievement.
Since children born both preterm and in certain neighborhoods have
higher risks of failing
standardized tests, interventions aimed at improving academic
achievement should be aimed
at these children and their families. This would enable children
most at-risk a chance to
mediate the possible effects of neighborhood and birth status in
succeeding academically,
positively impacting their future life course.
Table of Contents
Title/Author/Abstract.......................................................11
Introduction...................................................................12
Methods........................................................................13
Results..........................................................................17Discussion......................................................................20
References.....................................................................24
Table 1. Distribution of exposures, outcomes, and covariates...28
Table 2. Binomial risk difference model demonstrating additive interaction of preterm birth and neighborhood environment on risk of CRCT test failure in first grade....30
Figure 1. Additive interaction of preterm birth and neighborhood environment on risk for failing CRCT in first grade....31
A. Tables of exposures by covariates...................................34
B. Distribution of failing each CRCT by covariates...................42
C. Stratified analysis for interaction tests.............................44
D. Binomial-Identity Models (RD).........................................46
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