Methods: Secondary analysis of demographic data (2005) used in research psychometrically evaluating  the Caregiver Recognition of Symptom Severity Scale (CROSS) was performed using ANOVA  to evaluate group differences in scores on the scale related to age, school grade, ethnicity, type of residence, and child care experience (Nelson, 2005).  Participants determine how ill they think the child is (mild, moderate or severely ill) and the health care management needed (home care, office, emergency department). An ethnically and socio-economically diverse sample of 702 parenting and non-parenting male and female adolescents, 13 to 19 years of age participated

Results:  No differences among mean scores on factors of age, school grade and residence (who they reside with) in illness recognition or management were found.  Significant gender differences were present in accurate identification of severe illnesses but not in management. Childcare experience was a significant factor in moderate illness recognition and management of severe illnesses. Means for teens with childcare experience were predictive for appropriate management of all illness severities. Ethnicity was not a significant factor in illness recognition but was significant in management. .

Conclusions:  Providers can target high-risk groups for additional education and assistance in illness identification and management. This situation is especially important for teen parents. The CROSS scale can be easily used by clinicians  for health education  to evaluate the ability of adolescent parents and caregivers to recognize illness severity in small children and chose appropriate and cost-effective health care options before the need arises in their care giving roles.