School and Community Involvement of Adolescents With Chronic Health Conditions

Purpose: To investigate associations between chronic health conditions and participation in school and community activities at age 15 years. Methods: Secondary analysis of data from an urban U.S. birth cohort study was conducted to investigate associations between chronic health conditions and participation in specific types of school and community activities. Logistic regression was used to adjust for potentially confounding factors. Results: Over one third of the teens had a chronic health condition. Having a chronic developmental or behavioral health condition (vs. no chronic developmental or behavioral health condition) was associated with lower odds of participation in sports (odds ratio [OR], .714; 95% confidence interval [CI], .577–.883), volunteer activities (OR, .751; 95% CI, 0.611–.924), and any activities (OR, .690; 95% CI, .516–.921), after adjusting for potential confounders. The associations for having a chronic physical health condition were less consistent. Conclusions: Chronic developmental or behavioral conditions of teens are negatively associated with school and community participation, particularly sports and volunteering, both of which can substantially enhance their development. Schools can play a role in promoting participation by offering activities designed for students with disabilities that may also include typical students or by referring families to such activities in the community. Clinicians can play a role by educating families about the benefits of extracurricular activities, providing information about laws and regulations requiring schools and other organizations to provide accommodations, and linking families to activities and programs in their community.