Additive Impact of Preterm Birth and Neighborhood Characteristics on Early Child Academic Achievement 公开

Patterson, Amirah (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/8c97kq847?locale=zh
Published

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 = 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


Table of Contents



Chapter 1: Background/Literature Review......................................1


Chapter II: Manuscript.............................................................11

Title/Author/Abstract.......................................................11

Introduction...................................................................12

Methods........................................................................13

Results..........................................................................17

Discussion......................................................................20

References.....................................................................24


Tables...................................................................................28

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


Figures..................................................................................31

Figure 1. Additive interaction of preterm birth and neighborhood environment on risk for failing CRCT in first grade....31


Chapter III: Summary, Public Health Implications, Future Directions...32


Appendices.............................................................................34

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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