Modeling Parental Influence on Food Consumption among Chinese Adolescents through Self-Efficacy: A Path Analysis

This study aimed to investigate the associations between perceived parental control, perceived parental modeling and parent–teen co-decision making, and fruit and vegetable (F&V) and sugar-sweetened beverage and junk food (S&J) consumption among Chinese adolescents, and examine whether self-efficacy mediates the associations. Data were collected in a cross-sectional survey of Chinese adolescents carried out in the fall of 2019. The questionnaires were adapted from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study. Ordinary least-squares regressions and a path analysis were performed to evaluate the hypothesized associations. The final sample included 3595 Chinese adolescents (mean (SD) age, 14.67 (1.73) years; 52.82% (n = 1899) males). Perceived parental control was positively associated with adolescents’ F&V consumption, and was negatively associated with adolescents’ S&J consumption. Perceived parental modeling and parent–teen co-decision making were both positively associated with adolescents’ F&V consumption and negatively associated with their S&J consumption. Adolescents’ self-efficacy was positively associated with F&V consumption and negatively associated with S&J consumption. These results suggest that serving as a positive role model, having adolescents participate in the decision-making process, and increasing adolescents’ self-efficacy can be feasible and efficacious strategies to improve the nutritional quality of Chinese adolescents’ diets.     

Parenting the Mobile Internet in Italian Households: Parents' and Children's Discourses

Drawing on the rich literature on parental mediation of children's use of digital and mobile media, this paper discusses the findings of an explorative study conducted in Italy, aimed at understanding how families appropriate smartphones in relation to the household's moral economy, their domestication of ICTs and the parenting style adhered to by parents. The aim of the paper is threefold: understand (1) how are social legitimations for or against children's use of smartphones constructed; (2) how do parents make sense of their mediation of children's mobile internet use drawing on different interpretative repertoires; and (3) how children negotiate, resist or evade parental justifications by producing alternative narratives.     

Parental and Peer Influences on the Risk of Adolescent Drug Use

Using a probability sample of 4,230 adolescents from grades 7–12, we used negative binomial regression to estimate the effects of peer and six family variables on the risk of adolescent drug use. Peer drug use had relatively strong effects of adolescent drug use. Parental drug attitudes, sibling drug use, and adult drug use had significant direct effects net of peer influences. In addition, they had significant indirect effects that were mediated by peer drug use. The influences of parental monitoring, attachment to mother, and attachment to father were statistically significant but relatively small. The findings applied to alcohol, binge drinking, cigarettes, marijuana, and other illicit drugs. Editors' Strategic Implications: The authors interpret their findings as being more consistent with social learning than social control theory. This research, although cross-sectional and limited to adolescents' self-reports, contributes to a growing literature on the direct and indirect influences of parents on their teens' substance use rates. It speaks to the need for school- and community-based prevention efforts to focus on families as well as peers.     

Alcohol Use Among Adolescent Mothers: Heterogeneity in Growth Curves,Predictors, and Outcomes of Alcohol Use Over Time

This paper examines patterns of alcohol use over a 10-year period in a sample of adolescent mothers and includes both predictors and outcomes of young mothers' alcohol use patterns over time. This study used mixture modeling to identify latent trajectory classes based on alcohol consumption over 10 years. Results indicate that there is significant heterogeneity in alcohol use trajectories of adolescent mothers during the transition from adolescence to adulthood as well as significant predictors and outcomes that vary by latent class trajectory. Specifically, measures of the consumption of alcohol by both quantity and frequency yielded multiple latent trajectory classes. Alcohol quantity measures yielded a two-class model with higher and lower quantity users. Age at first drink significantly differentiated between the two classes indicating that the younger the respondent was, the more likely she belonged to the higher quantity user class. In addition, members of the higher quantity class had significantly more negative outcomes in adulthood. The second measure of alcohol consumption, alcohol frequency, yielded a four-class solution consisting of low-level users, early decliners, late decliners, and increasers. As with alcohol quantity, age at first drink significantly differentiated between classes, as did age at first birth, in the expected direction. Similarly, two classes with the greatest growth and patterns of use over time, late decliners and increasers, had significantly worse outcomes in adulthood. The results suggest that identifying underlying heterogeneity in alcohol use can be informative with regard to both predictors and outcomes for young women who were adolescent mothers. Results suggest that there are possible higher order factors that can account for the results of this study.     

The Effects of Parental Mediation of Sexual Content on the Sexual Knowledge,Attitudes, and Behaviors of Adolescents in the US

This study explored the effects of parental mediation of sexual television content on adolescents' sexual knowledge, attitudes, and behaviors. Undergraduate students enrolled in an introductory communication class (N = 180) recalled the mediation behaviors their parents used when they were in high school as well as reported their past and current sexual behaviors, attitudes, and knowledge. The results revealed that coviewing of sexual content serves as an endorsement of the material for adolescents, restrictive mediation is best in moderate amounts, and that active mediation is most effective when it is paired with an open, conversational delivery style. Overall this study highlights the importance of the role of context, style, and nuance when studying the effects of parental mediation on adolescents' outcomes. The implications of this work for encouraging positive parent–child relationships and comfortable, healthy exchanges about sex are discussed.     

Internet mediation and the family gap: explorative ethnographic interviews in new family forms in Belgium

While studies have examined how parents organize, manage, or mediate children’s internet use, perspectives of non-traditional, new forms of family remain largely neglected in the research. Presenting the initial findings of explorative ethnographic work within one multi-household stepfamily and one divorced one-parent household in Belgium, this article points to the challenges of internet mediation in new family forms as it involves complex interpersonal dynamics that are the result of major changes in family life, and the fact that parenting is distributed between parents in different households with their own media use norms. Specifically, this study found that children in multi-household families experience different mediation regimes and navigate relatively easily between them, but also that post-divorce family life can generate dynamics that mitigate the outcomes of parental mediation, as well as intensify the role of peer-siblings in internet mediation. Methodological implications and suggestions for future family media research are discussed.     

Adolescent Childbearing,Poverty, and Siblings: Taking New Direction From the New Literature*

This article critically appraises the sibling‐comparison method by pointing to the following limitations: (1) it assumes within‐family homogeneity; (2) it neglects naturally occurring heterogeneity across siblings; (3) it overlooks the unique effects of a teen's childbearing for her family and siblings; (4) it underappreciates the selectivity of sisters of teenage mothers who delay childbearing; and, (5) it ignores differences in outcomes by sisters' birth order and age spacing. Directions for future research stemming from this new literature are discussed.     

Parental Mediation of Television Viewing in the Context of Changing Parent-Child Relationships in Belgium: A latent growth curve analysis in early and middle adolescence

The present study analyzed long-term trends in parental mediation of adolescent television viewing and how this mediation related to changes in teenagers' attachment to their parents. A Belgian panel of early adolescents (n = 883) and of middle adolescents (n = 651) rated three times in three consecutive years how often their parents used restrictive mediation, instructive mediation, and social co-viewing to control their television viewing. The results showed that parental mediation is common during adolescence, even for twelfth graders. However, the latent growth curve analyses indicated that the use of each parental mediation strategy tends to decline throughout adolescence. In addition, parallel process latent growth curve models showed that the decreasing occurrence of instructive mediation and co-viewing is related to parental separation. In contrast, the declining incidence of restrictive mediation during adolescence is not related to parental separation.     

Financial Stress,Parental Depressive Symptoms,Parenting Practices,and Children's Externalizing Problem Behaviors: Underlying Processes

This study examined the relationships among financial stress encountered by families, parents' social support, parental depressive symptoms, parenting practices, and children's externalizing problem behaviors to advance our understanding of the processes by which family financial stress is associated with children's problem behaviors. We also tested moderated mediation to investigate if these relationships differed depending on children's characteristics. The data were drawn from 290 predominantly rural families with young children who were identified as at risk for the development of serious conduct problems. Using structural equation modeling, we found that the relationship between family income and children's externalizing problem behaviors was mediated by parents' social support, parental depressive symptoms, and parenting practices. The results also showed that the children's levels of aggression severity, academic functioning, and developmental strengths moderated the mediating relationships between family income and parental depressive symptoms and between family income and positive parenting.     

School Climate and Adolescent Drug Use: Mediating Effects of Violence Victimization in the Urban High School Context

This study tested the mediating effects of violence victimization in the relationship between school climate and adolescent drug use. The hypothesized path model fit data collected from a probability sample of urban high school students (N=586) participating in an evaluation of a violence prevention program funded by the Substance Abuse and Mental Health Services Administration. Findings indicated that the lack of enforcement of school rules and the presence of unsafe places in and around the school influenced adolescent drug use directly and indirectly through their effects on violence victimization. Editors’ Strategic Implications: This research confirms the importance of the environment as a contributor to violence victimization. Violence victimization is obviously of concern in its own right, but in addition, these data indicate that it also contributes to adolescent drug use. School administrators should be aware that unsafe places in schools and the failure to enforce school rules may affect such victimization and drug use. Portions of this paper were presented at the Eighth Annual Conference of the Society for Social Work and Research, New Orleans, LA, January 17, 2004 and the Society for Community Research and Action – 10th Biennial Conference, University of Illinois at Urbana-Champaign, June 9–12, 2005.     

Relationships Between Alcohol-related Informal Social Control, Parental Monitoring and Adolescent Problem Behaviors Among Racially Diverse Urban Youth

The purpose of the present study is to investigate the relationships between alcohol-related informal social control and parental monitoring on alcohol use, behavior and intentions; violent behavior; and delinquent behavior in a racially diverse population of young urban adolescents. Baseline surveys were administered to 6th grade male and female students in 61 urban Chicago schools as part of Project Northland Chicago, a group randomized trial for the prevention/reduction of substance use. A subset of their parents (n = 3,034) was also surveyed regarding alcohol use, violence, and delinquency and related issues. Structural equation modeling was used to assess relationships between alcohol-related informal social control (as measured by parental perceptions of neighborhood action regarding youth drinking) and parental monitoring (as reported by parents), and three adolescent outcomes (alcohol use, behaviors and intentions; violent behavior; and delinquent behavior; as reported by teens). Associations between alcohol-related informal social control and parental monitoring were positive and significant (P < .001). Direct paths from parental monitoring to all three adolescent outcomes were negative and statistically significant (alcohol use, behaviors and intentions, P < .001; violent behavior, P < .001; and delinquent behavior, P < .001). Alcohol-related informal social control was not significantly associated with adolescent outcomes. Efforts to engage parents to be more active in monitoring adolescents’ activities may be related to lower levels of underage drinking, violence and delinquency among both female and male urban youth. Neighborhood norms and action against teenage drinking may be too distal to adolescent outcomes to be directly associated.     

Mixed Signals in Child and Adolescent Mental Health and Well-Being Indicators in the United States: A Call for Improvements to Population Health Monitoring

Policy Points

• Social indicators of young peoples’ conditions and circumstances, such as high school graduation, food insecurity, and smoking, are improving even as subjective indicators of mental health and well-being have been worsening. This divergence suggests policies targeting the social indicators may not have improved overall mental health and well-being.
• There are several plausible reasons for this seeming contradiction. Available data suggest the culpability of one or several common exposures poorly captured by existing social indicators.
• Resolving this disconnect requires significant investments in population-level data systems to support a more holistic, child-centric, and up-to-date understanding of young people's lives.

     

Computer Modeling of Diabetes and Its Transparency: A Report on the Eighth Mount Hood Challenge

Objectives

The Eighth Mount Hood Challenge (held in St. Gallen, Switzerland, in September 2016) evaluated the transparency of model input documentation from two published health economics studies and developed guidelines for improving transparency in the reporting of input data underlying model-based economic analyses in diabetes.

Pubertal Timing and Substance Use: The Effects of Gender, Parental Monitoring and Deviant Peers

PURPOSE: Early pubertal timing is associated with early initiation of cigarettes and alcohol; we evaluated parental monitoring and affiliation with deviant peers in a moderated, mediational model of this relationship for both genders. METHODS: We tested a prospective model explaining the process through which pubertal timing is related to early use of cigarettes and alcohol for 360 fourth and fifth graders, following them for 4 years. RESULTS: We found a relation between early pubertal maturation and trying cigarettes and alcohol without parents' knowledge for both boys and girls. In addition, for both genders, parental monitoring moderated the association between pubertal timing and trying alcohol, but not trying cigarettes. Affiliation with deviant peers mediated the effect of pubertal timing on both alcohol and cigarette initiation for girls only. CONCLUSIONS: Although pathways to substance use differ by gender, both early maturing girls and boys should be regarded as high-risk populations for initiation of substances, and intervention programs may be more effective if they are targeted accordingly.     

A Multilevel Analysis of State and Regional Disparities in Childhood and Adolescent Obesity in the United States

This study examines state- and regional disparities in obesity prevalence among 46,707 US children and adolescents aged 10–17 years before and after adjusting for individual socioeconomic and behavioral characteristics and area deprivation measures. The 2003 National Survey of Children’s Health was used to calculate obesity prevalence in nine geographic regions and in the 50 states and the District of Columbia (DC). Logistic regression was used to estimate odds of obesity and adjusted prevalence. OLS regression was used to determine the amount of variance explained by income inequality, poverty, and violent crime rates. The prevalence of childhood obesity varied substantially across geographic areas, with the Southcentral regions of the US having the highest prevalence (≥18%) and the Mountain region the lowest prevalence (11.4%). Children in West Virginia, Kentucky, Texas, Tennessee, and North Carolina (adjusted prevalence >18.3%) had over twice the odds of being obese than their Utah counterparts (adjusted prevalence = 10.4%). Geographic disparities in obesity were similar for male and female children. Individual characteristics such as race/ethnicity, household socioeconomic status, neighborhood social capital, television viewing, recreational computer use, and physical activity accounted for 55% of the state and 25% of the regional disparities in obesity. Area poverty rates accounted for an additional 18% of the state variance in adjusted obesity prevalence. Although individual and area level socioeconomic factors are important predictors, substantial geographic disparities in childhood and adolescent obesity remain. Prevention efforts targeting individual risk factors as well as contextual social and environmental factors may reduce geographic disparities in childhood and adolescent obesity.     

Measuring Problematic Internet Use,Internet Gaming Disorder,and Social Media Addiction in Young Adults: Cross-sectional Survey Study

BackgroundDigital technology use is nearly ubiquitous among young adults; this use provides both benefits and risks. The risks of technology use include maladaptive technology use or technology addiction. Several conceptualizations of these addictions have emerged, each with its own assessment tools. These conditions include problematic internet use (PIU), internet gaming disorder (IGD), and social media addiction (SMA). These conditions have been associated with health outcomes such as problematic alcohol use, sleep disorders, and mental illness. These maladaptive technology conditions have been most commonly studied in isolation from each other.ObjectiveThe aim of this study is to examine PIU, IGD, and SMA together to better inform future research approaches and provider screening practices for young adults.MethodsThis cross-sectional survey study was conducted using Qualtrics panel-based recruitment and survey hosting. We recruited US young adults aged 18-25 years. The survey assessed PIU, IGD, and SMA. Survey measures also included assessments of problematic alcohol use, sleep, depression, and anxiety. We evaluated the frequency of and overlap in positive screening scores among PIU, IGD, and SMA and modeled each condition using multivariate logistic regression. Finally, we calculated sensitivity and specificity, as well as the positive predictive value and negative predictive value of the screening tools using the most prevalent maladaptive technology type.ResultsOur 6000 participants had an average age of 21.7 (SD 2.5) years. Of these 6000 participants, 3062 (51.03%) were female, 3431 (57.18%) were Caucasian, 1686 (28.1%) were in a 4-year college program, and 2319 (38.65%) worked full time. The mean PIU score was 3.5 (SD 3.1), and 53.58% (3215/6000) of participants met the criteria for PIU. The mean IGD score was 2.7 (SD 2.6), and 24.33% (1460/6000) of participants met the criteria for IGD. The mean SMA score was 7.5 (SD 5.7), and 3.42% (205/6000) met the criteria for SMA. Across all 3 maladaptive technology use diagnoses, there were varied associations with demographic variables and similar overlap with health outcomes. The sensitivity of PIU screening to detect IGD was 82% and to detect SMA was 93%, whereas the specificity and positive predictive value were much lower (37%-54% specificity; 6%-37% positive predictive value).ConclusionsThis cross-sectional survey screened a large national sample of adolescents and young adults for PIU, IGD, and SMA to determine prevalence and overlap, demographic associations with each, and associations between these technology-related conditions and health outcomes. There was overlap across PIU, IGD, and SMA in some associated demographic variables and health outcomes. However, the patterns in the associated variables demonstrated unique qualities of each of these conditions.     

Explaining the origins and distribution of health and disease: an analysis of epidemiologic theory in core Master of Public Health coursework in the United States

This article examines the epidemiologic theories taught most frequently in core social and behavioral science coursework in Master of Public Health (MPH) programs in the United States, identifies lacunae, discusses their implications, and recommends specific pedagogical changes. Course syllabi were identified through online search and instructor outreach between June and December 2016. Content analysis was conducted to identify most commonly taught theories. Analysis continued until theoretical saturation. Behavioral health theories predominate within our sample of core social and behavioral science course syllabi. Behavioral health theory represents 93% of the most commonly taught epidemiologic theories within our sample. Individual health behavior theory was the most commonly encountered, the most prevalent of which were the health belief model and the theory of planned behavior, both appearing in 83% of syllabi (n = 25). Theories of interpersonal health behavior were the second-most commonly observed, including social cognitive theory (77%, n = 23) and social network theory (67%, n = 20). Behavioral-ecological theory was present in 87% (n = 26) of syllabi. The fundamental cause theory (23%, n = 7) was the only commonly taught non-behavioral epidemiologic theory. The social determinants of health were referenced in 60% of syllabi (n = 18). Based on this sample, behavioral health theories drawn from psychological, behavioral science, health education, and medical literatures predominate in US-based core MPH pedagogy concerned with explaining the etiology and distribution of health, morbidity, and mortality. We recommend the inclusion of non-behavioral epidemiologic theory from disciplines more engaged with structural aspects of health.