Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




Objective: There is a lack of research on the impact of sociodemographic factors on youth with spina bifida (SB). This is concerning given the pervasive health disparities that exist in pediatric chronic illness groups. The aims of this study were to examine: (1) differences in health-related, neuropsychological, and psychosocial functioning among youth with SB based on sociodemographic risk; (2) cumulative risk as a predictor of youth outcomes, as moderated by age; (3) SB-related family stress as a mediator of the associations between sociodemographic/cumulative risk and youth outcomes, longitudinally. Methods: Participants (M age = 11.43, 53.6% female) were recruited as part of a larger, longitudinal study (Devine et al., 2012). The study included questionnaire (parent-, teacher-, and youth- report), neuropsychological testing, and medical chart data on sociodemographic factors (e.g., parent education, income, health insurance) health-related (body mass index, urinary tract infections, sleep disturbances, pain, medical adherence), neuropsychological (attention problems, executive function problems, academic achievement), and psychosocial functioning (internalizing symptoms, externalizing symptoms, social adjustment, health-related quality of life). Data were collected at three time points, spaced two years apart. Results: Certain sociodemographic factors and their cumulative risk were more predictive of outcomes than others. Youth characterized by sociodemographic risk had higher pain, lower academic achievement, but also fewer UTIs and fewer attention and executive function problems. Age did not moderate the association between cumulative risk and outcomes. Sociodemographic risk and cumulative risk predicted lower SB-related family stress, which, in turn, predicted several outcomes. Conclusions: Examining a range of sociodemographic indicators is warranted. Sociodemographic risk is linked to poorer outcomes in some ways, whereas, in other ways, youth with SB who are characterized by sociodemographic risk have similar or better outcomes compared to youth not characterized by risk. Results have implications for delivering evidence-based, diversity-sensitive clinical care to youth with SB.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.