{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T03:20:16Z","timestamp":1794021616535,"version":"4.8.0"},"reference-count":73,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"<jats:sec id=\"ab-ooi240076-4\"><jats:title>Importance<\/jats:title><jats:p>Cochlear implants can restore sound and enable speech and language development for children with severe to profound sensorineural hearing loss. Long-term outcomes of pediatric cochlear implant recipients are variable. Although the association between social determinants of health (SDH) and pediatric cochlear implant outcomes has been explored, the strength of this association has not been quantitatively synthesized in the literature.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240076-5\"><jats:title>Objective<\/jats:title><jats:p>To determine the association of SDH with language and academic outcomes in pediatric cochlear implant recipients.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240076-6\"><jats:title>Data Sources<\/jats:title><jats:p>In August 2023, the following databases were searched: Embase.com, Ovid MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, Cumulated Index to Nursing and Allied Health Literature Plus, APA PsycINFO, and ClinicalTrials.gov. Following duplicate exclusion of 8687 results, 5326 records were finalized.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240076-7\"><jats:title>Study Selection<\/jats:title><jats:p>Abstract screening, full-text review, and risk of bias assessment was performed by 1 to 2 reviewers. Articles were included if an effect size for an SDH variable that was associated with measures of language, communication, reading, academics, and quality of life was reported.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240076-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>A random-effects meta-analysis was performed, with standardized regression coefficients measuring the relative direction and magnitude of a variable association with the outcome of interest.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240076-9\"><jats:title>Results<\/jats:title><jats:p>Of 5326 articles, 40 articles that included a total of 3809 children were included in the systematic review; 20 articles that included a total of 1905 children were included in the meta-analysis. Parental involvement, education level, and low socioeconomic status were moderately to strongly associated with language outcomes (\u03b2\u2009=\u20090.30; 95% CI, 0.13-0.48; \u03b2\u2009=\u20090.45; 95% CI, 0.29-0.62; \u03b2\u2009=\u2009\u22120.47; 95% CI, \u22120.83 to \u22120.10, respectively). Known determinants of language outcomes, such as the age of cochlear implantation and duration of cochlear implant use, demonstrated moderate to no associations with language outcomes (\u03b2\u2009=\u2009\u22120.30; 95% CI, \u22120.43 to \u22120.17; \u03b2\u2009=\u20090.19; 95% CI, \u22120.26 to 0.63, respectively).<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240076-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>The results of this systematic review and meta-analysis suggest that SDH are associated with childhood language development and academic achievement. In addition to efforts to expedite cochlear implant placement in eligible children, optimal outcomes may be achieved with interventions centered on the child\u2019s home, primary medical care, and school environment.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2024.3564","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T16:00:37Z","timestamp":1731600037000},"page":"29","source":"Crossref","is-referenced-by-count":23,"title":["Social Determinants of Health and Language and Academic Outcomes in Pediatric Cochlear Implantation"],"prefix":"10.1001","volume":"151","author":[{"given":"Lauren","family":"Mueller","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Washington University in St Louis, School of Medicine, St Louis, Missouri"},{"name":"School of Medicine, Tulane University, New Orleans, 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