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School Perceptions and Attendance for Children With Medical Complexity During COVID-19 Over Time.

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Summary

Full-time, in-person school attendance for children with medical complexity (CMC) significantly improved from 2021 to 2022. Health belief perceptions, like motivation and perceived benefits, predicted higher attendance rates for these children.

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Area of Science:

  • Pediatric Health
  • Public Health
  • Epidemiology

Background:

  • Children with medical complexity (CMC) faced school attendance disparities during COVID-19.
  • Longitudinal data on school safety perceptions and attendance predictors for CMC remain limited.

Purpose of the Study:

  • To examine changes in family-perceived school safety and predictors of full-time, in-person school attendance for CMC.
  • To analyze the impact of Health Belief Model perceptions on school attendance.

Main Methods:

  • Prospective, longitudinal cohort study with 3 survey waves (June 2021-June 2022).
  • Included English- and Spanish-speaking families of CMC aged 5-17 years with pre-pandemic attendance.
  • Multivariate generalized linear modeling with repeated measures analyzed changes in perceptions and attendance.

Main Results:

  • School safety perceptions improved over time, but perceived susceptibility to COVID-19 increased.
  • Full-time, in-person school attendance rose from 48.4% to 90.0% (p < .0001).
  • Attendance was associated with motivation, benefits, and cues (e.g., 76% vs. 98% predicted probability for low vs. high motivation at wave 3).

Conclusions:

  • In-person school attendance for CMC improved significantly over the study period.
  • Health belief perceptions are key predictors of full-time, in-person school attendance.
  • School health policies should promote family motivation, benefits, and cues during epidemics.