{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:57:01Z","timestamp":1792119421675,"version":"4.4.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary children's hospital in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Five hundred thirty-five children with cleft-related diagnoses scheduled for speech evaluations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure<\/jats:title>\n                    <jats:p>Adherence to initial and follow-up speech evaluations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Those with more severe cleft phenotypes were more likely to attend both initial (ORs 4.11-4.35,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and follow-up visits (ORs 6.29-7.49,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Children with velopharyngeal dysfunction and compensatory errors were also more likely to remain engaged in care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SVI did not improve prediction of adherence. Insurance type, cleft phenotype, and speech function are the dominant factors influencing adherence to recommended speech evaluations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261436717","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T10:49:31Z","timestamp":1775213371000},"page":"3963-3968","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Can the Social Vulnerability Index Enhance Models Predicting Adherence to Craniofacial Speech Evaluations?"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2355-305X","authenticated-orcid":false,"given":"Bo Hyun","family":"Kong","sequence":"first","affiliation":[{"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0515-8413","authenticated-orcid":false,"given":"Katherine","family":"Dillon","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2410-4344","authenticated-orcid":false,"given":"Colin M.","family":"Brady","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6529-1377","authenticated-orcid":false,"given":"Stefanie E.","family":"Hush","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9829-4856","authenticated-orcid":false,"given":"Alexis","family":"Tashima","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Soldanska","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph K.","family":"Williams","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6839-9116","authenticated-orcid":false,"given":"Kazlin N.","family":"Mason","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta"},{"name":"University of Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2003_040_0453_tiocto_2.0.co_2"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1597\/11-202"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1597\/16-119"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2021.02.043"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.4103\/2231-0746.101342"},{"key":"e_1_3_2_7_2","unstructured":"Association ACP-C. Parameters of care for evaluation and treatment of individuals with cleft lip\/palate and\/or other craniofacial conditions. 2024. Accessed January 30 2026. https:\/\/acpacares.org\/parameters-of-care\/"},{"key":"e_1_3_2_8_2","first-page":"411","volume-title":"Evaluation and management of cleft lip and palate\u202f: a developmental perspective","author":"Zajac DJ","year":"2026","unstructured":"Zajac DJ, Vallino-Napoli LD. The adult. In: Zajac DJ, , and Vallino-Napoli LD, eds. Evaluation and management of cleft lip and palate\u202f: a developmental perspective. 2nd ed. Plural Publishing, Inc.; 2026:pp.411-429.","edition":"2"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656241310203"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665618764739"},{"key":"e_1_3_2_11_2","unstructured":"Registry. CfDCaPAfTSaD. Social Vulnerability Index (SVI): interactive map and database. 2022. 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