The Role of Parental Engagement in the Intergenerational Transmission of Smoking Behavior and Identity

Public health education using social learning theory: a systematic scoping review

BACKGROUND

Public health education (PHE) in social environments plays a crucial role in mitigating the impact of public health events, especially with the recent surge in global incidents. Social learning theory (SLT) provides a strong theoretical foundation for implementing PHE. The objective of this study is to conduct a systematic scoping review of PHE using SLT, synthesizing the target populations, types of research, main findings, and future directions.

METHODS

The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR) guidelines. We conducted a comprehensive search of five electronic databases (Web of Science, Scopus, PubMed, ProQuest, and APA PsycInfo) for English articles related to PHE using SLT. Two reviewers independently screened the titles and abstracts. Descriptive statistics were utilized to analyze the characteristics of the articles included in the study, followed by a comprehensive narrative analysis of the results.

RESULTS

Research on PHE using SLT mainly focuses on adolescents, students, special patients, and vulnerable populations. The study sample includes seven research types and nine commonly used experimental methods. Four modes of PHE using SLT are identified, along with four types of summarized research results.

CONCLUSION

PHE research based on SLT can be prioritized for preventing widespread infectious diseases, spreading fundamental public health information, and assisting patients with particular illnesses. To enhance the implementation of PHE, researchers and policymakers should integrate online and offline health education resources, ensure the accessibility of up-to-date information, and leverage digital technologies in PHE. More highly interactive and participatory health education courses will be established in social learning environments to encourage public participation in PHE.

Vaccination in the childhood and awareness of basic public health services program among internal migrants: a nationwide cross-sectional study

BACKGROUND

Vaccination is proved to be one of the most effective and efficient way to prevent illness and reduce health inequality. Studies about association between vaccination inequalities in the childhood and awareness of basic public health services program among internal migrants in China are lacking. In this study, we aimed to explore the association between migrants' vaccination status between 0 and 6 years old and their awareness of the National Basic Public Health Services (BPHSs) project in China.

METHODS

We included 10,013 respondents aged 15 years old or above of eight provinces from 2017 Migrant Population Dynamic Monitoring Survey in China, a nationwide cross-sectional study. Univariate and multivariable logistic regressions were used to assess vaccination inequalities and the awareness of public health information.

RESULTS

Only 64.8% migrants were vaccinated in their childhood, which is far below the goal of national requirement of 100% vaccination. This also indicated the vaccination inequalities among migrants. Female, the middle-aged, married or having a relationship, the highly educated and the healthy population had higher awareness of this project than others. Both univariate and multivariate logistic regressions showed greatly significant association between vaccination status and some vaccines. Specifically, after adding convariates, the results showed that there were significant associations between the vaccination rates of eight recommended vaccines in the childhood and their awareness of BPHSs project (all p values < 0.001), including HepB vaccine (OR: 1.28; 95%CI: 1.19, 1.37), HepA vaccine (OR: 1.27; 95%CI: 1.15, 1.41), FIn vaccine (OR: 1.28; 95%CI: 1.16, 1.45), JE vaccine (OR: 1.14; 95%CI: 1.04, 1.27), TIG vaccine (OR: 1.27; 95%CI: 1.05, 1.47), DTaP vaccine (OR: 1.30; 95%CI: 1.11-1.53), MPSV vaccine (OR: 1.26; 95%CI: 1.07-1.49), HF vaccine (OR: 1.32; 95%CI: 1.11, 1.53), except for RaB vaccine (OR: 1.07; 95%CI: 0.89, 1.53).

CONCLUSIONS

The vaccination inequalities exist among migrants. There is a strong relationship between the vaccination status in the childhood and the awareness rate of BPHSs project among migrants. From our findings we could know that the promotion of vaccination rates of the disadvantaged population such as the internal migrants or other minority population can help them increase the awareness of free public health services, which was proved to be beneficial for health equity and effectiveness and could promote public health in the future.

Intergenerational transmission of parental risky health behaviors in Chinese children: Are there socioeconomic status differences?

Background

Risky health behaviors in childhood, including smoking, alcohol consumption, and having a poor diet, are the major sources of non-communicable diseases in adulthood. This study aimed to examine how parents affect children's risky health behaviors and whether intergenerational transmission differs based on socioeconomic status (SES).

Methods

Data were extracted from the 1991-2015 China Health and Nutrition Survey (CHNS). Smoking (n = 5,946), alcohol consumption (n = 7,821), and sugar-sweetened beverages (SSBs) consumption (n = 3,537) were used as proxies for risky health behaviors in children. A binary choice model for panel data with a random-effect specification was employed to examine whether risky health behaviors can be transmitted from parents to their children. Subsequently, we conducted a seemingly unrelated estimation test (SUEST) to explore the differences in parental transmission between the different SES groups.

Results

We found strong intergenerational persistence of smoking, alcohol drinking, and SSBs drinking behaviors, except for the mothers' smoking behavior. Mothers had a greater influence on children's alcohol drinking and SSBs drinking behaviors than fathers both in urban and rural areas and in different SES groups. The intergenerational transmission of SSBs drinking behavior exhibited a decreasing trend with increasing SES for both urban and rural families. In urban areas, mothers' alcohol drinking behavior has a decreasing trend with increasing education level, occupation, and income; however, in rural areas, the influence of mothers' alcohol drinking behavior occurred in the same direction with increasing education level and occupation type. In rural areas, the influence of fathers' drinking and smoking behaviors on children appears to mostly increase with increasing SES. Meanwhile, the influence of such behaviors among urban fathers would decrease with increasing SES.

Conclusion

Parents' behaviors and SES can influence the initiation of risky health behaviors in their offspring. Thus, to promote healthy behaviors, policymakers can introduce health education programs for parents, particularly for those living in rural areas and with a low SES.

Association between adolescent smoking and subsequent college completion by parent education - A national longitudinal study

BACKGROUND

Educational attainment is a social determinant of health associated with better quality of life and health outcomes. Current understanding of the association between adolescent smoking and college completion is limited. This study examined the association between adolescent smoking and subsequent college completion and how it varied by parent education in a longitudinal study of U.S. adolescents followed into young adulthood.

METHODS

Data were collected annually from a nationally representative cohort of 10th graders who participated in the NEXT Generation Health Study (2009 -2017; N = 1407). Participants reported if they smoked during 10th-12th grades (2009-2013). Self-report college completion was assessed in 2017. Parent reported their educational attainment at baseline. Weighted logistic regression models were used to assess the association between adolescent smoking during 10th-12th grades and subsequent college completion in the entire sample and stratified by parent educational attainment, adjusting for demographics, depressive symptoms, alcohol use, and parental monitoring.

RESULTS

Overall, adolescents who smoked during 10th-12th grade had lower odds of subsequently completing college compared to those who did not smoke (AOR=0.33, 95%CI=0.20-0.57). This association was stronger among those whose parents had ≤high school education (AOR=0.08, 95% CI=0.02-0.31) and some college education (AOR=0.18, 95%CI=0.08-0.39).

DISCUSSION

Adolescents from lower educational attainment households showed disproportionately stronger association between adolescent smoking and subsequent college completion. Future research needs to determine whether and how strategies to reduce adolescent smoking may promote educational attainment especially among adolescents whose parents have less than a college education.

The Role of Parental Involvement in Cigarette Smoking among Adolescents in Nepal

Limited studies have examined the role of a parent's involvement in their child's daily life as it relates to cigarette smoking among adolescents in low- and middle-income countries (LMICs). We examined the role of parental involvement with current smoking among 6,105 adolescents using a nationally representative sample from the 2015- 2016 Global School-based Students Health Survey in Nepal. Using the adolescents' perceptions of daily parental involvement, a composite variable was created to include parents (a) checking to see if the child's homework was done, (b) understanding the child's problems and worries, and (c) knowing what the child was doing with their free time. Our analysis utilized a multiple logistic regression to calculate adjusted odds ratios (aOR) accounting for significant covariates. Overall, an increase in parental involvement was associated with a 15% less (aOR = 0.86) likelihood of their child smoking. Additionally, being 15 years or older (aOR =1.55), being bullied (aOR =1.72), drinking alcohol (aOR =20.63), and having missed school without permission (aOR =2.29) were all associated with cigarette smoking. Further, girls were almost 70% less (aOR = 0.33) likely to be cigarette smokers than boys. Future longitudinal studies should examine parental involvement as a protective factor against cigarette smoking.

Stakeholders' Perceptions of a School-Based Eye Care Programme in Baltimore, MD

PURPOSE

To explore stakeholders' perceptions of a school-based vision programme (SBVP).

METHODS

We conducted 20 focus groups with 105 parents and teachers at schools in Baltimore, MD, that participated in a SBVP. Facilitators used a semi-structured interview guide to discuss participants' perceptions of the SBVP. Focus groups were audio-recorded, transcribed, and coded using inductive thematic analysis.

RESULTS

Participant perceptions fell into three categories: benefits of school-based eye care, limitations of school-based eye care, and observation of impact. The majority of participants had positive comments about the programme; benefits included convenience (location, time, and cost), the comprehensive nature of the programme, the quality of the eyeglasses and ability to receive replacements, and a positive screening/exam experience. Limitations of programme impact were related to communication and organisation, the time to receive the glasses, missed instructional time, and uncertainty about screenings. Observations of impact included academic and classroom improvements, as well as visual and other health improvements.

CONCLUSION

Parents and teachers reported mostly positive perceptions regarding the SBVP. Their appreciation for the convenience underscores that location, cost, time, and comprehensive services are crucial aspects for implementing a successful programme. To maximize impact, programs must also implement robust communication campaigns that integrate into the schools' workflow to help parents and teachers stay engaged in the process from start to finish.

I am what I am: A meta-analysis of the association between substance user identities and substance use-related outcomes

OBJECTIVE

Research indicates that a substance user identity (i.e., drinking, smoking, and marijuana identity) is positively correlated with substance use-related outcomes (e.g., frequency, quantity, consequences, and disorder symptoms). The current study aimed to meta-analytically derive single, weighted effect size estimates of the identity-outcome association as well as to examine moderators (e.g., substance use type, explicit/implicit assessment, demographic characteristics, and research design) of this association.

METHOD

Random effects meta-analysis was conducted on 70 unique samples that assessed substance user identity and at least one substance use-related outcome (frequency, quantity, consequences, and/or disorder symptoms), and provided the necessary information for effect size calculations.

RESULTS

Substance user identity was found to be a statistically significant moderate-to-large correlate of all substance use-related outcomes examined in the current study (r _w = .365, p < .001, r_w² = .133). The strongest associations were observed between identity and disorder symptoms (alcohol) and frequency of substance use (tobacco or marijuana). In terms of moderators of the identity-outcome association, the link between explicit drinking identity and alcohol use-related outcomes appeared to be stronger in magnitude than the relationship between implicit drinking identity and alcohol use-related outcomes; however, this difference appears to be largely due to the finding that implicit measures have lower reliability. The strongest identity-outcome association was observed among younger individuals.

CONCLUSIONS

Substance user identity is clearly an important correlate of substance use-related outcomes and this association is stronger among younger individuals. Additional theoretical, empirical, and intervention research is needed to utilize knowledge gleaned from the current study on the identity-outcome association. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Engagement in Tobacco Use Prompting During Childhood or Adolescence and Its Association with Tobacco Use in Adulthood among Colombian Women

Although most tobacco users initiate this behavior before the age of 18, little is known about engaging in tobacco use prompting behaviors (TPBs) during childhood/adolescence and tobacco use in adulthood, particularly among women in low- and middle-income countries (LMICs). The purpose of this study was to examine engagement in TPBs during childhood or adolescence and tobacco use in adulthood among Colombian women and whether or not current/past tobacco users who were engaged in TPBs during their childhood or adolescence had more odds of engaging other children or adolescents in these behaviors as adults. There were 4262 adult women who were recruited and completed an interviewer-administered survey through a door-to-door approach across the 9 regions of Antioquia, Colombia using a multi-stage probabilistic sampling. TPBs were defined as someone being asked to: (1) empty an ashtray, (2) buy cigarettes, (3) put the cigarette in their mouth and light it, (4) light a cigarette without putting it in their mouth, or (5) smoke with the adult during childhood or adolescence. We conducted bivariate regression logistic models where variables with a P < .25 were included in a parsimonious model. Approximately 40% of participants (41%) reported engaging in TPBs in childhood or adolescence. Buying cigarettes, lighting cigarettes with their mouth, and smoking with an adult were significantly associated with tobacco use in adulthood. Current/past tobacco users who reported being engaged in TPBs during childhood or adolescence (except for smoking with an adult) had higher odds of prompting these behaviors as adults. TPBs during childhood or adolescence are relevant contributors to tobacco use in adulthood among Colombian women.

The Influence of Exposure to Smoking in Movies on Cigarette Cravings among Adolescents: A Contextual Quasi-Experimental Model

This study explored the socio-contextual characteristics of adolescents that led them to have increased cigarette cravings when exposed to smoking scenes in films. We analyzed online survey data collected from a representative sample of 955 Korean adolescents. Our dependent variable was change in cigarette cravings after watching a smoking scene; independent variables included sex, age, school type, allowance, smoking experience, and parental smoking. We used paired t-tests to identify the differences in cigarette cravings modified by individual characteristics, and we performed logistic regression to explore the influences on these changes in cravings. The high school students investigated herein had significantly stronger cigarette cravings after they watched smoking scenes than they did prior to watching these scenes (t = -5.039, p < 0.001). The cravings were significantly higher after watching the clips among non-smokers (t = -4.264, p < 0.001) and participants who had at least one parent who smoked (t = -2.114, p < 0.05); non-smoking adolescents were also more likely to crave cigarettes after they watched smoking scenes than were smokers (odds ratio = 6.90, p < 0.001). Korean adolescents who did not smoke and those who had at least one parent who smoked showed the strongest cigarette cravings after being exposed to smoking in films. Consequently, more effective prevention strategies should be developed that recognize this tendency when regulating smoking scenes in movies or implementing related campaigns among adolescents.

Simplifying the implementation of modern scale scoring methods with an automated R package: Automated moderated nonlinear factor analysis (aMNLFA)

When generating scores to represent latent constructs, analysts have a choice between applying psychometric approaches that are principled but that can be complicated and time-intensive versus applying simple and fast, but less precise approaches, such as sum or mean scoring. We explain the reasons for preferring modern psychometric approaches: namely, use of unequal item weights and severity parameters, the ability to account for local dependence and differential item functioning, and the use of covariate information to more efficiently estimate factor scores. We describe moderated nonlinear factor analysis (MNLFA), a relatively new, highly flexible approach that allows analysts to develop precise factor score estimates that address limitations of sum score, mean score, and traditional factor analytic approaches to scoring. We then outline the steps involved in using the MNLFA scoring approach and discuss the circumstances in which this approach is preferred. To overcome the difficulty of implementing MNLFA models in practice, we developed an R package, aMNLFA, that automates much of the rule-based scoring process. We illustrate the use of aMNLFA with an empirical example of scoring alcohol involvement in a longitudinal study of 6998 adolescents and compare performance of MNLFA scores with traditional factor analysis and sum scores based on the same set of 12 items. MNLFA scores retain more meaningful variation than other approaches. We conclude with practical guidelines for scoring.

Profiling families in conflict: Multigenerational continuity in conflict predicts deleterious adolescent and adult outcomes

The present study investigated the associations between multigenerational continuity in family conflict and current psychopathology symptoms and social impairment experienced by parents and adolescents. We sampled 246 families from a multigenerational, high-risk, longitudinal study of parents (G1s) and their children (G2s), followed from adolescence (Mage = 14.3 years, 57% female, 71% Caucasian, 26% Hispanic or Latino) to adulthood as well as the children of G2 targets (G3s; Mage = 12.1 years, 47% female, 51% Caucasian, 33% Hispanic or Latino). Family conflict was measured by composite latent variables incorporating mother, father, and adolescent reports in G1-G2 families and incorporating G2 target, G2 target's spouse, and G3 adolescent report in G2-G3 families. Indicators of G2 and G3 impairment including psychopathology symptoms (e.g., internalizing, externalizing, and substance use symptoms) and social role impairment (e.g., marital satisfaction, parenting behavior) were predicted from G1-G2 family conflict, G2-G3 family conflict, and the interaction between G1-G2 and G2-G3 family conflict. Results indicate that G1-G2 family conflict uniquely predicted indicators of G2 and G3 psychopathology, as well as G2 social impairment, even after controlling for more temporally proximal G2-G3 family conflict. Results further indicate that for G2 externalizing, internalizing, and marital functioning outcomes, high G2-G3 family conflict was associated with highest G2 impairment when G1-G2 family conflict was also high. It appears that for many G2 outcomes the interactive effects of multigenerational conflict are associated with greater risk for impairment. (PsycINFO Database Record