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Weinstein SM, Lee HH, Dziak JJ, Berbaum ML, Zhang T, Avenetti D, Sandoval A, Martin MA. Examining Caregiver- and Family-Level Psychosocial Influences on Child Oral Health Behavioral Outcomes in Racially and Economically Minoritized Urban Families. CHILDREN (BASEL, SWITZERLAND) 2024; 11:882. [PMID: 39062331 PMCID: PMC11276087 DOI: 10.3390/children11070882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/10/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVES Understanding the pathways linking caregiver- and family-level psychosocial factors and child oral health behaviors is critical for addressing oral health disparities. The current study examined the associations between caregiver psychosocial functioning and family chaos and child toothbrushing behaviors in children at high risk for poor oral health outcomes. METHODS Data were drawn from the baseline wave of the CO-OP Chicago Cohort Study (U01DE030067), a longitudinal study on child/caregiver dyads exploring oral health behaviors and caries development in young children (N = 296 dyads; child mean age = 5.36, SD = 1.03; caregiver mean age = 33.8 years, SD = 6.70; caregiver race = 43% Black; caregiver ethnicity = 55% Latinx). The oral health behavioral outcomes included child toothbrushing frequency, child plaque levels, and caregiver assistance with child toothbrushing. The data included demographics; caregiver depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, social functioning, social support, and resilience; and family-level household chaos. RESULTS Multiple regression models indicated that greater household chaos was significantly related to lower caregiver assistance with child toothbrushing (p = 0.0075). Additionally, caregiver anxiety and PTSD symptoms as well as number of children in the home significantly predicted higher levels of household chaos (p < 0.01). Notably, 18% of caregivers reported clinically significant PTSD. The relationships between caregiver-level psychosocial factors and child oral health behaviors were not significant. CONCLUSIONS The results suggest household chaos may play an important role in child oral health behaviors and highlight the importance of investigating family-level factors for understanding and addressing child oral health risk.
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Affiliation(s)
- Sally M. Weinstein
- Department of Psychiatry, College of Medicine, University of Illinois Chicago, 1747 W. Roosevelt Road, Chicago, IL 60608, USA;
| | - Helen H. Lee
- Department of Anesthesiology, College of Medicine, University of Illinois Chicago, 1740 W. Taylor Street, Chicago, IL 60612, USA
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, Chicago, IL 60608, USA; (J.J.D.); (M.L.B.); (T.Z.); (D.A.); (A.S.); (M.A.M.)
| | - John J. Dziak
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, Chicago, IL 60608, USA; (J.J.D.); (M.L.B.); (T.Z.); (D.A.); (A.S.); (M.A.M.)
| | - Michael L. Berbaum
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, Chicago, IL 60608, USA; (J.J.D.); (M.L.B.); (T.Z.); (D.A.); (A.S.); (M.A.M.)
| | - Tong Zhang
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, Chicago, IL 60608, USA; (J.J.D.); (M.L.B.); (T.Z.); (D.A.); (A.S.); (M.A.M.)
| | - David Avenetti
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, Chicago, IL 60608, USA; (J.J.D.); (M.L.B.); (T.Z.); (D.A.); (A.S.); (M.A.M.)
- Department of Pediatric Dentistry, College of Dentistry, University of Illinois Chicago, 801 S. Paulina Street, Chicago, IL 60612, USA
| | - Anna Sandoval
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, Chicago, IL 60608, USA; (J.J.D.); (M.L.B.); (T.Z.); (D.A.); (A.S.); (M.A.M.)
| | - Molly A. Martin
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, Chicago, IL 60608, USA; (J.J.D.); (M.L.B.); (T.Z.); (D.A.); (A.S.); (M.A.M.)
- Department of Pediatrics, College of Medicine, University of Illinois Chicago, 840 S. Wood Street, Chicago, IL 60612, USA
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Adolescents' reports of chaos within the family home environment: Investigating associations with lifestyle behaviours and obesity. PLoS One 2023; 18:e0280737. [PMID: 36701326 PMCID: PMC9879426 DOI: 10.1371/journal.pone.0280737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Disorganised and chaotic home environments may hinder the adoption of healthy lifestyle behaviours and contribute to excessive weight gain among adolescents. We examined whether self-reported level of chaos within the family home environment is associated with lifestyle behaviours and obesity in adolescent girls and boys. METHODS Cross-sectional data from the 3rd wave of the Québec Adipose and Lifestyle Investigation in Youth (QUALITY) study were analyzed. The sample consisted of n = 377 White adolescents with a history of parental obesity. Home environment chaos was measured using the Confusion, Hubbub, and Order Scale (CHAOS) analyzed both continuously and dichotomized as high vs. low chaos. Body Mass Index z-scores (zBMI) were computed using WHO standards from measured weight and height. Physical activity (7-day accelerometry), vegetable and fruit intake (three 24-hour diet recalls), and leisure screen time and sleep duration (questionnaire) were assessed. Sex-specific linear regression models were used to estimate associations between level of family home environment chaos, lifestyle behaviours and zBMI. RESULTS The overall level of chaos was low in our study sample, with higher reported levels among girls compared to boys. Among girls, high (vs low) chaos was associated with shorter sleep duration (hours/day) (B = - 0.44, 95% CI: -0.75, -0.14). No associations were observed for other lifestyle behaviours or for zBMI. CONCLUSION In this sample of adolescents with a parental history of obesity, higher household chaos was not associated with obesity or lifestyle behaviours, except for sleep duration among girls. Replication of findings in more diverse samples is indicated.
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Morrow T, Bhatia SH, Parmar AM, Baker L, Abadula F, Williamson D, Choudhary A, Jaser SS. Sleep Habits of Early School-Aged Children with Type 1 Diabetes and Their Parents: Family Characteristics and Diabetes Management. Behav Sleep Med 2022; 20:649-658. [PMID: 34559603 PMCID: PMC8943443 DOI: 10.1080/15402002.2021.1977305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
STUDY OBJECTIVES School-aged children with type 1 diabetes (T1D) and their parents are at risk for sleep disturbances, yet few studies have used objective measures to assess sleep characteristics in young children with T1D. METHODS Forty children (ages 5-9) with T1D and their parents wore actigraph watches and completed sleep diaries for 7 nights. Parents also completed questionnaires about demographic information, diabetes distress, fear of hypoglycemia, and family routines. Children's clinical data (HbA1c and blood glucose data) were extracted from the medical record. RESULTS Most of the children and their parents obtained insufficient sleep. Based on actigraphy data, children slept an average of 7.9 hours/night and parents slept 6.7 hours/night, below the recommendations of 9-11 and 7-9 hours of sleep, respectively. Shorter child sleep latency was significantly associated with better glycemic levels, and parents' sleep duration and efficiency were related to child's glycemic levels. Parental fear of hypoglycemia and lack of family routines were associated with poorer sleep quality in parents and children, and with parental diabetes distress. CONCLUSIONS Sleep duration and quality is a modifiable target for potentially improving glycemic levels and parental distress in early school-aged children with T1D.
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Affiliation(s)
- Troy Morrow
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Shivani H Bhatia
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Angelee M Parmar
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Logan Baker
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Fayo Abadula
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Dylan Williamson
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Arjun Choudhary
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sarah S Jaser
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
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Urzeală C, Bota A, Teodorescu S, Vlăiculescu M, Baker JS. Quality of Life in Romanian Children with Type 1 Diabetes: A Cross-Sectional Survey Using an Interdisciplinary Healthcare Intervention. Healthcare (Basel) 2020; 8:healthcare8040382. [PMID: 33023137 PMCID: PMC7711784 DOI: 10.3390/healthcare8040382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 09/26/2020] [Indexed: 12/03/2022] Open
Abstract
Background: The purpose of this study was to assess the quality of life in Romanian type 1 diabetes mellitus (T1DM) children attending an early interdisciplinary healthcare intervention. Hypothesis: engaging T1DM children in leisure sports leads to a better quality of life. Methods: This research embeds a cross-sectional observational study, incorporating some clinical characteristics relevant for diabetes management. The Kidscreen 27 questionnaire was issued to 100 T1DM children aged between 7 and 17 years. Parents completed the questionnaire. All subjects received interdisciplinary healthcare in the previous year. Statistics were performed using SPSS, v20. The required sample size of 100 subjects was obtained with a confidence interval of 95% and a sampling error of 0.009. The tests were two-sided, with a type I error set at 0.05. Results: Subjects reached an increased level of physical well-being, psychological well-being, autonomy, parent relationships, peer and social support, and school inclusion. There was a significant difference (p < 0.05) between children who practice leisure activities and children who only participated in physical education (PE) classes, regarding their physical well-being (t = 2.123). ANOVA demonstrated significant differences between age groups regarding physical well-being. Conclusion: The interdisciplinary healthcare intervention increased the efficiency of T1DM management with positive effects on life quality.
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Affiliation(s)
- Constanta Urzeală
- Sports and Motor Performance Department, Faculty of Physical Education and Sports, National University of Physical Education and Sports from Bucharest, 060057 Bucharest, Romania
- Correspondence:
| | - Aura Bota
- Training of Teaching Staff Department, Faculty of Physical Education and Sports, National University of Physical Education and Sports from Bucharest, 060057 Bucharest, Romania;
| | - Silvia Teodorescu
- Doctoral School, National University of Physical Education and Sports from Bucharest, 060057 Bucharest, Romania;
| | - Mihaela Vlăiculescu
- Outpatient Diabetes Clinic “DiabNutriMed” Telemedicine Center, 020358 Bucharest, Romania;
- Support for Diabetes Association, 020358 Bucharest, Romania
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China;
| | - The Kidscreen Group Europe
- Research Division “Child Public Health”, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
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Marsh S, Dobson R, Maddison R. The relationship between household chaos and child, parent, and family outcomes: a systematic scoping review. BMC Public Health 2020; 20:513. [PMID: 32316937 PMCID: PMC7175577 DOI: 10.1186/s12889-020-08587-8] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 03/25/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Household chaos, represented by the level of disorganisation or environmental confusion in the home, has been associated with a range of adverse child and family outcomes. This review aims to (1) identify how household chaos is measured, (2) chart study details of household chaos literature, and (3) map the existing literature with respect to the relationship between household chaos and child, parent, and family outcomes. We expect that this review will highlight the need to consider the importance of household chaos in child well-being research, particularly in those families where children may be more vulnerable to the adverse effects of household chaos. METHODS We searched five electronic databases (last updated September 1st 2018) in addition to Google Scholar, and identified publications via a 3-stage screening process, which was conducted by two researchers. Published studies were included if they investigated the association between household chaos and child, parent, or family outcomes. Research that investigated household chaos as a mediator or moderator, or that investigated how the relationship between household chaos and the outcome of interest was mediated or moderated, were also included. RESULTS One hundred twelve studies in 111 publications were included. The majority were conducted in the United States (n = 71), and used either cross-sectional (n = 60) or longitudinal (n = 49) study designs. Outcomes of interest were categorised into seven categories: (1) cognitive and academic (n = 16), (2) socio-emotional and behavioural (n = 60), (3) communication (n = 6), (4) parenting, family, and household functioning (n = 21), (5) parent outcomes (n = 6), (6) hormone (n = 8), and (7) physical health and health behaviours (n = 19). There was consistent evidence for significant correlations between household chaos and adverse outcomes across all seven categories in diverse populations with respect to age, disease status, and socio-economic status (SES). CONCLUSION There is consistent evidence for associations between household chaos and a number of adverse child, parent, and family-level outcomes. Household chaos may also help describe variations in outcomes between low SES and child development.
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Affiliation(s)
- Samantha Marsh
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand.
| | - Rosie Dobson
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Ralph Maddison
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
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Crandall A, Novilla LKB, Hanson CL, Barnes MD, Novilla MLB. The Public Health Family Impact Checklist: A Tool to Help Practitioners Think Family. Front Public Health 2019; 7:331. [PMID: 31781531 PMCID: PMC6861214 DOI: 10.3389/fpubh.2019.00331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 10/25/2019] [Indexed: 11/16/2022] Open
Abstract
Families are an important cornerstone of individual and community health across the lifecourse. Not only do families play a role in the development of health, but the family's health is likewise influenced by individual health behaviors and outcomes. Therefore, to improve population health, public health programs must support families. Limited training in family science, as well as lack of instruments to help “think family,” often result in Public Health practitioners feeling ill-equipped to develop programming that supports, targets, and/or involves a diverse range of families. Tools to help public health practitioners think family are limited. The Family Impact Checklist is one tool that may help improve the degree to which policies support families. The purpose of this study was to adapt the Family Impact Checklist specifically for use in public health programming efforts. Through a two-round Delphi approach comprised of 17 public health professionals, the Public Health Family Impact Checklist was developed. The adapted Checklist includes 14 items across four think family principles: family engagement, family responsibility, family stability and family diversity. We propose that this tool will help practitioners develop high impact, family-friendly programs that ultimately lead to improved individual and community health.
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Affiliation(s)
- AliceAnn Crandall
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | | | - Carl L Hanson
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Michael D Barnes
- Department of Public Health, Brigham Young University, Provo, UT, United States
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Weinstein SM, Pugach O, Rosales G, Mosnaim GS, Walton SM, Martin MA. Family Chaos and Asthma Control. Pediatrics 2019; 144:peds.2018-2758. [PMID: 31289192 PMCID: PMC6855822 DOI: 10.1542/peds.2018-2758] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2019] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Asthma is a highly prevalent childhood chronic disease, with particularly high rates among poor and minority youth. Psychosocial factors have been linked to asthma severity but remain poorly understood. This study examined (1) relationships between parent and child depression and posttraumatic stress disorder (PTSD) symptoms, family functioning, and child asthma control in a sample of urban minority youth with uncontrolled asthma and (2) family functioning as a pathway linking parent depression and asthma outcomes. METHODS Data were drawn from the baseline cohort of a randomized trial testing community interventions for children aged 5 to 16 with uncontrolled asthma (N = 223; mean age = 9.37, SD = 3.02; 85.2% Hispanic). Asthma control was defined by using the Asthma Control Test and Childhood Asthma Control Test, activity limitation, and previous-12-month asthma severity. Psychosocial measures included parent and child depression and PTSD symptoms, family chaos, and parent social support. RESULTS Parent and child depression symptoms, but not PTSD, were associated with worse asthma control (β = -.20 [SE = 0.06] and β = -.12 [SE = -.03]; P < .001). Family chaos corresponded to worse asthma control, even when controlling for parent and child depression (β = -.33; [SE = 0.15]; P < .05), and was a mediator of the parent depression-asthma path. Emotional triggers of asthma also mediated the parent depression-asthma relationship. CONCLUSIONS Findings highlight family chaos as a mechanism underlying the relationship between parent depression and child asthma control. Addressing parent and child depression, family routines, and predictability may optimize asthma outcomes.
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Affiliation(s)
| | | | | | | | - Surrey M. Walton
- Pharmacy Systems Outcomes and Policy, University of Illinois at Chicago, Chicago, Illinois; and
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