Perceived instrumental support and children's health across the early life course

A large, venerable literature demonstrates the importance of social relationships and social support for health, though much less research examines whether the benefits of social support to mothers extend to children. This paper examines the relationship between mothers' perceptions of instrumental support and children's health using longitudinal data from the U.S. Fragile Families and Child Wellbeing Study (N = 4342), a cohort of American children born in urban areas to mostly unmarried parents. Results suggest mothers' perceptions of instrumental support is positively associated with children's overall health, and this finding persists despite controlling for a host of individual-level characteristics of mothers and children (including a lagged indicator of children's health) and in fixed-effect models. Mothers' economic security and mothers' wellbeing attenuate some, but not all, of the association between perceived instrumental support and children's overall health. In addition, the link between perceived instrumental support and three specific indicators of health – asthma, overweight/obese, and number of emergency room visits – falls to statistical insignificance after accounting for individual-level characteristics, suggesting these associations result from social selection processes. Taken together, these findings suggest the beneficial health consequences of social support may extend to children across the early life course and demonstrate the need to better understand mothers' reports of children's overall health.     

Misclassification of Fourth-Grade Children's Participation in School-Provided Meals Based on Parental Responses Relative to Administrative Daily Records

Although many studies have relied on parental responses concerning children's school-meal participation, few studies have evaluated parental response accuracy. We investigated misclassification of fourth-grade children's participation in school-meal programs based on parental responses relative to administrative daily records using cross-sectional study data collected for 3 school years (2004-05, 2005-06, and 2006-07) for 1,100 fourth-grade children (87% black; 52% girls) from 18 schools total in one district. Parents reported children's usual school-meal participation on paper consent forms. The district provided administrative daily records of individual children's school-meal participation. Researchers measured children's weight and height. “Usual participation” in breakfast/lunch was defined as ≥50% of days. Parental responses misclassified 16.3%, 12.8%, 19.8%, and 4.7% of children for participation in breakfast, classroom breakfast, cafeteria breakfast, and lunch, respectively. Parental responses misclassified more children for participation in cafeteria than classroom breakfast (P=0.0008); usual-participant misclassification probabilities were less than nonusual-participant misclassification probabilities for classroom breakfast, cafeteria breakfast, and lunch (P<0.0001 for each) (two-proportion z tests). Parental responses concerning children's participation were more accurate for lunch than breakfast; parents overstated breakfast participation (both classroom and cafeteria) and lunch participation. Breakfast participation misclassification was not related to body mass index (P=0.41), sex (P=0.40), age (P=0.63), or socioeconomic status (P=0.21) (multicategory logistic regression controlling for school year, breakfast location, and school). Relying on parental responses concerning children's school-meal participation may hamper researchers' abilities to detect relationships that have policy implications for the child nutrition community. The use of administrative daily records of children's school-meal participation is recommended.     

Engaging Indigenous families in a community‐based Indigenous early childhood programme in British Columbia,Canada: A cultural safety perspective

This article is part of a larger study that explored how an Indigenous early intervention programme in British Columbia (BC), Canada, known as the ‘Aboriginal Infant Development Program’ (AIDP), influenced family and children's health and well‐being and was responsive to child health inequities. Postcolonial feminist and Indigenous feminist perspectives provided a critical analytical lens to this qualitative inquiry. The study was undertaken with AIDPs based in diverse community organisations located in off‐reserve urban municipalities throughout the province of BC. From September 2013 to March 2014, in‐depth, semi‐structured interviews were undertaken with: Indigenous primary caregivers (n = 10), Indigenous Elders (n = 4), AIDP workers (n = 18) and administrative leaders (n = 3). The purpose of this article is to examine and analyse the findings that focus on how AIDP workers supported family and children's health and well‐being by transforming their routine policies and practices in ways that fostered caregivers' active engagement in their programmes. Findings centre on three main themes: (i) overcoming mistrust; (ii) ‘being willing to move a step forward’ and (iii) resisting what's taken‐for‐granted. These inter‐related themes are examined and discussed in relation to the concept of cultural safety. The findings have international relevancy for social and healthcare community‐based programmes that are questioning how to engage with parents who may be hard to reach as a result of multi‐faceted social and structural factors.     

Chaos as a social determinant of child health: Reciprocal associations?

This study informs the social determinants of child health by exploring an understudied aspect of children's social contexts: chaos. Chaos has been conceptualized as crowded, noisy, disorganized, unpredictable settings for child development (Evans, Eckenrode, & Marcynyszyn, 2010). We measure chaos at two levels of children's ecological environment – the microsystem (household) and the mesosystem (work-family-child care nexus) – and at two points in early childhood (ages 3 and 5). Using data from the Fragile Families and Child Wellbeing Study (N = 3288), a study of predominantly low-income women and their partners in large US cities, we develop structural equation models that assess how maternal-rated child health (also assessed at ages 3 and 5) is associated with latent constructs of chaos, and whether there are important reciprocal effects. Autoregressive cross-lagged path analysis suggest that increasing chaos (at both the household and maternal work levels) is associated with worse child health, controlling for key confounders like household economic status, family structure, and maternal health status. Child health has little effect on chaos, providing further support for the hypothesis that chaos is an important social determinant of child health in this sample of relatively disadvantaged children. This suggests child health may be improved by supporting families in ways that reduce chaos in their home and work/family environments, and that as researchers move beyond SES, race, and family structure to explore other sources of health inequalities, chaos and its proximate determinants may be a promising avenue for future research.     

The indirect influence of child play on the association between parent perceptions of the neighborhood environment and sense of community

The neighborhood is a critical setting that broadly affects health, although specific mechanisms that link relationships between the neighborhood environment and indicators of health are still emerging. Children playing is a simple, but underexplored marker that may explain how the neighborhood built environment is related to a psychological sense of community. A telephone survey was conducted among parents with children in the Greater Phoenix Metropolitan area (n = 251) to gather information on perceptions of the built environment, parent attitudes and physical activity behaviors, children's play, and sense of community in the neighborhood. Results of a structural equation modeling analysis (SEM) indicated that children playing in the neighborhood partially explained the relationship between perceptions of the built environment and sense of community (β = 0.031, CI = 0.007–0.067). Parent perceptions of the built environment were positively associated with both children playing (β = 0.229, CI = 0.120–0.341) and sense of community (β = 0.360, CI = 0.220–0.505), and children playing (β = 0.135, CI = 0.027–0.243) and parent attitudes (β = 0.440, CI = 0.319–0.546) were positively related to sense of community. As planners and community advocates consider strategies to build a sense of community within neighborhoods, the importance of favorable environmental conditions that facilitate children's play should be considered.     

A survey of mothers' relationships with their preschoolers

A survey of mother-child relationships was conducted in a socially deprived, industrial area of Melbourne, Australia. The paper explores the relationships between child, temperament and behaviour, mother's causal attributions from mother-child interaction outcomes, their perceived stress and self-concept as educators of their child. The study included 103 subjects, recruited through community-based maternal and child health centres. Analysis revealed that mother's low self-concept as educators of the child was predictive of maternal stress. Also, mothers' ratings of child temperament as difficult or easy affected relationships between mothers' attributions of responsibility for mother-child interaction outcomes and perceived stress. The implications of these findings are relevant to occupational therapy's role in facilitating healthy relationships between mother and child.     

Climate change,women's workload in smallholder agriculture,and embodied political ecologies of undernutrition in northern Ghana

The burden of child undernutrition across Africa remains extraordinarily high. Among children under age five, chronic and acute undernutrition is responsible for more ill-health than any other cause. While climate change exacerbates the multiple burdens of undernutrition, we know very little about the embodied effects on women's workload in agriculture and implications for feeding practices, especially for infants whose nutrition depends on mothers' time. In this article, political ecologies of health, with its nested, place-based analysis, is used as a framework to address this knowledge gap. The study took place in Ghana's Upper West Region, a semi-arid and resource-poor setting with higher undernutrition rates. In-depth interviews were conducted with smallholder farmers (n = 33) whose infants have sub-optimal growth, and key informants (n = 7) with expertise in nutrition and health. Findings from the study demonstrate how climate change puts pressure on women's productive time, leading to poor child feeding practices and undernutrition. Ultimately, the article argues that there are hidden impacts of climate change on undernutrition. Global undernutrition interventions should therefore move beyond biomedical solutions to address these hidden impacts, some of which are social, gendered, and structural in nature.     

The impact of changes in different aspects of social capital and material conditions on self-rated health over time: A longitudinal cohort study

Individual aspects of social capital have been shown to have significant associations with health outcomes. However, research has seldom tested different elements of social capital simultaneously, whilst also adjusting for other well-known health determinants over time. This longitudinal individual-level study investigates how temporal changes in social capital, together with changes in material conditions and other health determinants affect associations with self-rated health over a six year period. We use data from the British Household Panel Survey, a randomly selected cohort which is considered representative of the United Kingdom's population, with the same individuals (N = 9303) providing responses to identical questions in 1999 and 2005. Four measures of social capital were used: interpersonal trust, social participation, civic participation and informal social networks. Material conditions were measured by total income (both individual and weighted household income), net of taxation. Other health determinants included age, gender, smoking, marital status and social class. After the baseline sample was stratified by health status, associations were examined between changes in health status and changes in all other considered variables. Simultaneous adjustment revealed that inability to trust demonstrated a significant association with deteriorating self-rated health, whereas increased levels of social participation were significantly associated with improved health status over time. Low levels of household and individual income also demonstrated significant associations with deteriorating self-rated health. In conclusion, it seems that interpersonal trust and social participation, considered valid indicators of social capital, appear to be independent predictors of self-rated health, even after adjusting for other well-known health determinants. Understandably, how trust and social participation influence health outcomes may help resolve the debate surrounding the role of social capital within the field of public health.     

National survey of the injury prevention activities of children's centres

Children's centres were established across England to provide a range of services including early education, social care and health to pre‐school children and their families. We surveyed children's centres to ascertain the activities they were undertaking to prevent unintentional injuries in the under fives. A postal questionnaire was sent to a sample of children's centre managers (n = 694). It included questions on current activities, knowledge and attitudes to injury prevention, health priorities and partnership working. Responses were received from 384 (56%) children's centres. Overall, 58% considered unintentional injury prevention to be one of the three main child health priorities for their centre. Over half the respondents (59%) did not know if there was an injury prevention group in their area, and 21% did not know if there was a home safety equipment scheme. Knowledge of how child injury deaths occur in the home was poor. Only 11% knew the major cause of injury deaths in children under five. Lack of both staff time and funding were seen as important barriers by children's centre staff to undertake injury prevention activities. Nearly all stated that training (97%) and assistance with planning injury prevention (94%) would be helpful to their centres. Children's centres need further support if they are to effectively tackle this important public health area.     

Leisure activities preference of Israeli Jewish children from secular versus Orthodox families

Abstract

Aims: To compare daily activity preferences of Israeli Jewish Orthodox and secular children in order to better understand the relationship between children's religious background and their participation patterns. Methods: Participants were 45 Orthodox and 45 secular Israeli Jewish children, aged 6–10.6 years. Major findings: In most PAC scales, the secular children showed a significantly lower preference than the Orthodox children to participate in activities. In both groups, activity preferences were impacted by age and gender. Among the secular group, mother's education level was correlated with a lower preference to participate in active physical activities. Principal conclusions: Family religiosity may impact on children's daily activity preferences. Occupational therapists should consider these socio-environmental factors in order to better integrate a child's religious and cultural identity into therapeutic interventions and assist the child in finding a meaningful occupational experience.     

Neighborhood context and racial/ethnic differences in young children's obesity: Structural barriers to interventions

Numerous studies in the last ten years have investigated racial/ethnic disparities in obesity for young children. Increasing attention is paid to the influence of neighborhood environments – social and physical—on a variety of young children's health outcomes. This work identifies resource-based and community-based mechanisms that impede on the maintenance of healthy weights for young children in socioeconomically depressed areas, and shows consistently higher rates of obesity in more deprived areas. None of this work, however, has explored whether area deprivation or the race/nativity composition of neighborhoods contributes to racial/ethnic disparities in young children's obesity. Utilizing restricted geo-coded data from the Early Childhood Longitudinal Study (Kindergarten) (N = 17,540), we utilize multilevel logistic regression models to show that neighborhood level measures do little to explain racial and ethnic differences in childhood obesity. However, living in neighborhoods with higher levels of poverty, lower levels of education, and a higher proportion of black residents is associated with increased child obesity risk after considering a host of relevant individual level factors. In addition, living in neighborhoods with a higher proportion of foreign-born residents is associated with reduced child obesity risk. Although well-intentioned childhood obesity intervention programs aimed at changing individual-level behaviors are important, our results highlight the importance of considering neighborhood structural factors for child obesity prevention.     

Participation of children on the autism spectrum in home,school, and community

Background

Children on the autism spectrum participate less frequently, and in a narrower range of activities, than their nonautistic peers, but little is known about exact participation patterns across contexts or how this is perceived by caregivers. This study aimed to document patterns of participation and caregiver views with regard to frequency and intensity of activities.

Method

Caregivers of children on the spectrum aged 5 (n = 90) and 9–10 years (n = 128) completed the Participation and Environment Measure for Children and Youth for home, school, and community. Caregivers reported on frequency of child's participation, level of involvement, and caregivers' desire for change in participation patterns.

Results

Item‐level analyses revealed similar patterns of participation across home, school, and community for both cohorts with some small age‐appropriate differences. Caregivers generally desired increased diversity, frequency, and involvement in activities but a decreased use of electronics (computers, games, TV, and DVDs).

Conclusion

The possibility of autism‐specific participation patterns could inform future interventions aimed at enhancing social inclusion. This warrants further investigation through multiinformant designs that seek the perspectives of the child and caregivers.     

A Contrast between Mothers' Assessments of Child Malnutrition and Physical Anthropometry in Rural Mexico: A Mixed Methods Community Study

ObjectiveTo compare mothers' assessments of nutritional status with anthropometric measures and gain further insights into mothers' reasons for their judgment.DesignEach mother was asked to assess the nutritional status of her child and 2 other children and to compare all 3. Rates for “hits” and “misses” between mothers' assessment and physical anthropometry were analyzed using the binomial test. The rationale for the mothers' assessments was explored through open-ended questions.SettingA rural clinic in an indigenous area of Mexico.Participants31 mothers of children 1-5 years of age.Main Outcome MeasuresPhysical anthropometry and mothers' assessments.ResultsA significant proportion (P ≤ .01) of mothers matched the anthropometry on weight for age and weight for height but not on height for age; only when assessing their own child, and when comparing weight for age of their own child with the first child used for comparison. Mothers based their assessment on the child's physical appearance, energy, eating behavior, and on their own performance as caregivers.Conclusions and ImplicationsMothers' assessments were better than mere guesses. Their understanding of children's nutritional status in particular and health in general should be used to design more effective and sustainable communication messages, properly combining mothers' and health providers' constructs. It is also important to find ways to make mothers recognize stunting as a nutrition-related problem.     

Effects of child health on parents' social capital

This paper adds to the literature on social capital and health by testing whether an exogenous shock in the health of a family member (a new baby) affects the family's investment in social capital. It also contributes to a small but growing literature on the effects of children's health on family resources and provides information about associations between health and social capital in a socioeconomically disadvantaged population. We use data from the Fragile Families and Child Wellbeing study, a longitudinal survey of about 5000 births to mostly unwed parents in 20 U.S. cities during the years 1998–2000. Both parents were interviewed at the time of the birth and then again one and three years later. The infants' medical records from the birth hospitalization were reviewed, and poor infant health was characterized to reflect serious and random health problems that were present at birth. Social interactions, reported at three years, include the parents' participation in church groups, service clubs, political organizations, community groups, and organizations working with children; regular religious attendance; and visiting relatives with the child. Education, employment, wages, and sociodemographic characteristics are included in the analyses. The results suggest that infant health shocks do not affect the parents' social interactions.     

Sociodemographic and Lesbian-Specific Factors Associated with Physical Activity Among Adult Lesbians

BackgroundAlthough participation in moderate and vigorous physical activity (MVPA) results in health benefits, the majority of adult lesbians are not sufficiently active. The purpose of this study was to examine the relationships between sociodemographic factors (age, education level, body mass index [BMI], race, partner status, employment status, annual household income, general health status, diagnosis of chronic conditions, children under 18 years living at home) and lesbian-specific factors (connection with the lesbian community, public identification as a lesbian) to participation in MVPA.MethodsParticipants included 847 self-identified lesbians 18 to 74 years old (M_age = 40.5; SD = 11.6) who completed a 20-minute, web-based survey.FindingsThe binary logistic regression model that included the 10 demographic factors was significantly associated with MVPA, χ² (15, N = 847) = 105.62, p < .001. However, when the two lesbian-specific factors were added, the model did not improve significantly, χ² (2, N = 847) = 5.20, p = .07. BMI and general health status were significantly associated with MVPA (Wald χ² (2) = 19.5, p < .001) and (Wald χ² (4) = 41.2, p < .001). Obese participants had 54.5% lower odds than healthy weight participants to engage in sufficient amounts of MVPA. Participants who reported general health status as excellent compared with those who reported poor had 12.7 times greater odds of engaging in sufficient amounts of MVPA.ConclusionsFuture research should extend on this study by utilizing sampling methods that target the recruitment of lesbian women not actively involved in lesbian-related activities.     

Agreement between children and parents demonstrated that illness-related absenteeism was validly reported by children

ObjectivesTo examine the agreement between children's and parents' reporting of illness-related absenteeism from school and to examine predictors for disagreement between children and parents.Study Design and SettingA total of 8,438 schoolchildren aged from 5 to 15 years (grade 0–8) and one parent of each child were invited to participate in the Hi Five baseline study. The response rate for children answering a questionnaire was 89% (n = 7,525), and 36% of the parents (n = 3,008) participated in a weekly illness registration study using text messages (short message service) over a period of 22 weeks. Text messages and questionnaire data were linked at the individual level, leaving 2,269 child–parent pairs in the analysis, corresponding to 27% of the eligible sample.ResultsThe agreement between children's and parents' reports of illness-related absenteeism was good, with high absolute agreement and slight to moderate Ƙ values. Agreement was lowest for 6- to 8-year-olds and highest for 11- to 12-year-olds. Children's reports of illness symptoms and parents' reports of their children's illnesses in the preceding week were strong predictors for children reporting illness-related absenteeism when parents did not.ConclusionIllness-related absenteeism can be reported by children, and children report higher prevalence of illness-related absenteeism than parents.     

A mothers' perspective on fish and her child's fish consumption in Surakarta,Indonesia

BACKGROUD/OBJECTIVESUnderstanding the factors associated with fish consumption is necessary to determine strategies to improve the fish consumption particularly those high in omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA). The aim of this study was to analyse the correlation between a mother''s perspective on fish and actual fish consumption in their children.SUBJECTS/METHODSTwo hundred thirty-one elementary school children grade 3–6 and their mothers in Surakarta were recruited using multi stage random sampling for this study. Data was collected in July and August 2017. A validated questionnaire consisted of 3 topics including knowledge related to the health benefits and organoleptic properties of fish and cooking technique-related attitudes on fish were used to measure the mother''s response to the fish properties. A validated food frequency questionnaire and a food picture book of fish specifically designed for the survey were developed and used to assess fish consumption of the children. A χ² test was used to analyse the correlation between the mothers'' perspective on fish and their children''s fish consumption.RESULTSThe median fish consumption in children was 65 g/d with fried non-oily or lean fish, e.g., milkfish (locally called Bandeng) and catfish (locally called Lele) were consumed more than oily fish as well as processed fish products. Of all children, 31% met the fish consumption recommended by the Environmental Protection Agency-Food and Drug Administration 2017. There was no relationship between a mother''s knowledge related to health benefits, organoleptic properties and cooking technique-related attitude toward fish and her child''s fish consumption.CONCLUSIONSThe fish consumption of children is not influenced by their mother''s perspective on fish. Nutrition education strategies are warranted to improve fish consumption and maintain the optimal benefits by consuming fish, including fish high in n-3 LCPUFA.     

Maternal Emotional Resources and Socio‐Emotional Well‐being of Children With and Without Learning Disabilities

This study investigated cumulative vulnerability/protection models of individual‐level factors (child's attachment relationship and sense of coherence –SOC) and family‐level factors (mothers' emotional resources), as explaining differences in socio‐emotional and behavioral adjustment among children with learning disabilities (LD) or typical development, age 8–12. Participants included 205 mother‐child dyads (107 LD, 98 typical). Preliminary analyses indicated significant group differences on all but one child measure. SEM analysis revealed high fit between the theoretical model and empirical findings. Model components interrelated differently for the two populations. Outcomes accentuated the potentially meaningful role of mothers' affect and attachment for children's adjustment and children's mediating variables. Findings also highlighted children's attachment and SOC as mediating associations between maternal emotional resources and children's well‐adjusted functioning.     

Factors related to preference for participation and degree of commitment in community activities among older adults in Japanese depopulated areas

To address the rapid increase in the ageing population, Japan implemented the Long‐Term Care Insurance System (LTCS) in 2000. Additionally, a community‐based integrated community care system was released in 2012. The purpose of these policies was to help older people who need care or support to continue to live their preferred lifestyles in their own communities. According to this paradigm, older residents are themselves considered members of the community caregiving team and expected to participate in volunteer activities to help the neighbourhood. One such activity is social participation including community activities. Many factors influencing social participation have been found in previous literature. However, knowledge of specific factors about community activities is limited, even though these kinds of activities have attracted policy attention. Our study examined factors related to thoughts about community activities among people aged >40 years. We conducted random sampling in two depopulated areas in Japan and used an anonymous mail survey method. Our survey consisted of three parts: social demographics, health and life, and medical/long‐term care. A total of 2,466 individuals participated in the study (response rate 52.2%), whose average age was 64.2 (SD = 10.3) and 46.5% (n = 1,146) were female. Items including talking with neighbours frequently (social demographics), higher self‐rated health (health and life), the need for health consultations and the desire to take care of family members when they need help (medical/long‐term care) were significantly related to both preference for participation and degree of commitment in community activities. To encourage participation in community activities among older citizens, we recommend interventions related to health literacy and family ties.