To determine whether the Centers for Disease Control and Prevention's Social Vulnerability Index (SVI) influences models of adherence to speech evaluations beyond individual demographic and clinical factors.
Design
Retrospective cohort analysis.
Setting
Tertiary children's hospital in the United States.
Participants
Five hundred thirty-five children with cleft-related diagnoses scheduled for speech evaluations.
Main Outcome Measure
Adherence to initial and follow-up speech evaluations.
Results
SVI was not predictive for adherence in logistic regression models. Children with private insurance had higher odds (OR) of attending initial evaluation (OR = 2.14, P < .001). Those with more severe cleft phenotypes were more likely to attend both initial (ORs 4.11-4.35, P < .001) and follow-up visits (ORs 6.29-7.49, P < .001). Children with velopharyngeal dysfunction and compensatory errors were also more likely to remain engaged in care.
Conclusion
SVI did not improve prediction of adherence. Insurance type, cleft phenotype, and speech function are the dominant factors influencing adherence to recommended speech evaluations.
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