{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T15:00:49Z","timestamp":1785942049550,"version":"3.56.0"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study compared barriers to accessing craniofacial cleft care perceived by parents of children with orofacial clefts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Study Type: A cross-sectional multisite survey study was conducted from March 2024 to April 2025. Setting: The craniofacial clinics at Nicklaus Children's Hospital (NCH) and Children's Hospital of Pittsburgh (CHP) Patients\/Participants: 172 parents\/guardians of children with orofacial clefts (NCH\u2009=\u200999, CHP\u2009=\u200973).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Participants completed a 23-item paper-based survey designed to assess financial, social, geographic, and language barriers to cleft care in their region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Primary outcomes included differences in reported barriers related to insurance coverage, access to specialized services, language support, travel burden, and appointment scheduling difficulties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      NCH participants were more diverse and had a higher proportion of Hispanic families (81.6% vs 1.4%, P\u2009&lt;\u2009.0001,\n                      <jats:italic toggle=\"yes\">X<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ) and non-English speakers (31% vs 1.4%, P\u2009&lt;\u2009.0001,\n                      <jats:italic toggle=\"yes\">X<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ). CHP families reported higher rates of dual insurance coverage (37% vs 1%, P\u2009&lt;\u2009.0001,\n                      <jats:italic toggle=\"yes\">X<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ) and greater full insurance coverage (86.3% vs 58.2%, P\u2009=\u2009.0002,\n                      <jats:italic toggle=\"yes\">X<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ) compared to NCH. Access barriers were present at both sites with difficulty finding a specialist nearby being the most frequently cited (73.3% NCH and 78.1%CHP). On multivariate logistic regression, the variables more significantly affecting the perception of access barriers were language (Spanish-only Speakers, AOR 3.487, 95%CI 1.118-10.870, P\u2009=\u2009.031) and participant-patient relationship (Fathers, AOR 4.409, 95%CI 1.375-14.140, P\u2009=\u2009.013).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Significant regional differences exist in perceived barriers to cleft care, which suggest that addressing disparities in insurance coverage, language barriers, and specialty service availability would lead to equitable care delivery for children with orofacial clefts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261473956","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:23:25Z","timestamp":1785763405000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing Access Barriers to Orofacial Cleft Care: A Multicenter Study Across Two U.S. Children's Hospitals"],"prefix":"10.1177","author":[{"given":"George","family":"Yacoub","sequence":"first","affiliation":[{"name":"Nicklaus Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Miranda","sequence":"additional","affiliation":[{"name":"Nicklaus Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Arevalo","sequence":"additional","affiliation":[{"name":"Nicklaus Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1293-6167","authenticated-orcid":false,"given":"David L.","family":"Kornmehl","sequence":"additional","affiliation":[{"name":"UPMC Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center"},{"name":"Department of Plastic Surgery, UPMC Children\u2019s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4603-6177","authenticated-orcid":false,"given":"Lindsay A.","family":"Schuster","sequence":"additional","affiliation":[{"name":"UPMC Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center"},{"name":"Department of Plastic Surgery, UPMC Children\u2019s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6066-5843","authenticated-orcid":false,"given":"Carolina","family":"Duarte","sequence":"additional","affiliation":[{"name":"Nicklaus Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665617739564"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrg2933"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004987"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12171"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/003335490912400315"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-0825.2009.01588.x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/22925503231203216"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20522"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.31532\/OralHealthDentStud.2.1.002"},{"key":"e_1_3_2_11_2","unstructured":"Association ACP. . 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