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da Silva CCM, dos Santos AB, Leoci IC, Leite EG, Antunes EP, Torres W, Mesquita EDDL, Delfino LD, Beretta VS. The Association between Perceived Stress, Quality of Life, and Level of Physical Activity in Public School Teachers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:88. [PMID: 38248551 PMCID: PMC10815239 DOI: 10.3390/ijerph21010088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024]
Abstract
Chronic high stress levels related to work impact the quality of life (QoL). Although physical activity improves QoL, it is not clear whether this life study habit could attenuate possible relationships between QoL and stress in public school teachers. The sample for this study was made up of 231 teachers from public schools. QoL was assessed using the Short-Form Health Survey and physical activity via Baecke's questionnaire. A Likert scale assessed stress level perception. Poisson Regression analyzed the association between stress level and QoL domains adjusted for sex, age, and socioeconomic conditions (model 1). In model 2, physical activity level was inserted in addition to model 1. Seven out of eight domains of QoL, except the domain of pain, were associated with high levels of stress (all p < 0.05-model 1). However, in model 2, the associations of the high levels of stress with general health status (p = 0.052) and functional capacity (p = 0.081) domains of QoL were mitigated. Our results indicated that physical activity mitigated the relationship between higher levels of stress and lower perception of general health status and functional capacity domains in secondary public school teachers.
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Affiliation(s)
| | - Amanda Barbosa dos Santos
- Laboratory of InVestigation in Exercise—LIVE, Graduate Program in Movement Sciences, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente 19060-900, SP, Brazil; (A.B.d.S.); (I.C.L.); (E.G.L.); (E.P.A.); (W.T.); (E.D.d.L.M.); (L.D.D.)
| | - Isabella Cristina Leoci
- Laboratory of InVestigation in Exercise—LIVE, Graduate Program in Movement Sciences, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente 19060-900, SP, Brazil; (A.B.d.S.); (I.C.L.); (E.G.L.); (E.P.A.); (W.T.); (E.D.d.L.M.); (L.D.D.)
| | - Enrique Gervasoni Leite
- Laboratory of InVestigation in Exercise—LIVE, Graduate Program in Movement Sciences, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente 19060-900, SP, Brazil; (A.B.d.S.); (I.C.L.); (E.G.L.); (E.P.A.); (W.T.); (E.D.d.L.M.); (L.D.D.)
| | - Ewerton Pegorelli Antunes
- Laboratory of InVestigation in Exercise—LIVE, Graduate Program in Movement Sciences, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente 19060-900, SP, Brazil; (A.B.d.S.); (I.C.L.); (E.G.L.); (E.P.A.); (W.T.); (E.D.d.L.M.); (L.D.D.)
| | - Wesley Torres
- Laboratory of InVestigation in Exercise—LIVE, Graduate Program in Movement Sciences, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente 19060-900, SP, Brazil; (A.B.d.S.); (I.C.L.); (E.G.L.); (E.P.A.); (W.T.); (E.D.d.L.M.); (L.D.D.)
| | - Eduardo Duarte de Lima Mesquita
- Laboratory of InVestigation in Exercise—LIVE, Graduate Program in Movement Sciences, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente 19060-900, SP, Brazil; (A.B.d.S.); (I.C.L.); (E.G.L.); (E.P.A.); (W.T.); (E.D.d.L.M.); (L.D.D.)
| | - Leandro Dragueta Delfino
- Laboratory of InVestigation in Exercise—LIVE, Graduate Program in Movement Sciences, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente 19060-900, SP, Brazil; (A.B.d.S.); (I.C.L.); (E.G.L.); (E.P.A.); (W.T.); (E.D.d.L.M.); (L.D.D.)
| | - Victor Spiandor Beretta
- Laboratory of InVestigation in Exercise—LIVE, Graduate Program in Movement Sciences, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente 19060-900, SP, Brazil; (A.B.d.S.); (I.C.L.); (E.G.L.); (E.P.A.); (W.T.); (E.D.d.L.M.); (L.D.D.)
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Raghunandan R, Howard K, Smith S, Killedar A, Cvejic E, Howell M, Petrou S, Lancsar E, Wong G, Craig J, Hayes A. Psychometric Evaluation of the PedsQL GCS and CHU9D in Australian Children and Adolescents with Common Chronic Health Conditions. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:949-965. [PMID: 37789175 PMCID: PMC10627900 DOI: 10.1007/s40258-023-00836-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Generic instruments such as the Pediatric Quality of Life Inventory™ v4.0 Generic Core Scales (PedsQL GCS) and Child Health Utility 9D (CHU9D) are widely used to assess health-related quality of life (HRQOL) of the general childhood population, but there is a paucity of information about their psychometric properties in children with specific health conditions. This study assessed psychometric properties, including acceptability, reliability, validity, and responsiveness, of the PedsQL GCS and the CHU9D in children and adolescents with a range of common chronic health problems. METHODS We used data from the Longitudinal Study of Australian Children (LSAC), for children aged 10-17 years with at least one of the following six parent-reported health conditions: asthma, anxiety/depression, attention deficit hyperactivity disorder (ADHD), autism/Asperger's, epilepsy, and type 1 diabetes mellitus. The LSAC used parent proxy-reported PedsQL GCS and child self-reported CHU9D assessments. The performance of each instrument (PedsQL GCS and CHU9D) for each psychometric property (acceptability, reliability, validity, and responsiveness) was assessed against established criteria. RESULTS The study sample included 7201 children and adolescents (mean age = 14 years; range 10.1-17.9 years; 49% female) with 15,568 longitudinal observations available for analyses. Across the six health conditions, acceptability of the PedsQL GCS was high, while acceptability for the CHU9D was mixed. Both the PedsQL GCS and CHU9D showed strong internal consistency (Cronbach's alpha range: PedsQL GCS = 0.70-0.95, CHU9D = 0.76-0.84; item-total correlations range: PedsQL GCS = 0.35-0.84, CHU9D = 0.32-0.70). However, convergent validity for both the PedsQL GCS and CHU9D was generally weak (Spearman's correlations ≤ 0.3). Known group validity was strong for the PedsQL GCS (HRQOL differences were detected for children with and without asthma, anxiety/depression, ADHD, autism/Asperger's, and epilepsy). CHU9D was only able to discriminate between children with and without anxiety/depression, ADHD, and autism/Asperger's. The responsiveness of both the PedsQL GCS and CHU9D was variable across the six conditions, and most of the estimated effect sizes were relatively small (< 0.5). CONCLUSION This study expands the evidence base of psychometric performance of the PedsQL GCS and CHU9D and can aid in appropriate HRQOL instrument selection for the required context by researchers and clinicians.
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Affiliation(s)
- Rakhee Raghunandan
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia.
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Charles Perkins Centre D17, Sydney, NSW, 2006, Australia.
| | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Charles Perkins Centre D17, Sydney, NSW, 2006, Australia
| | - Sarah Smith
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, England, UK
| | - Anagha Killedar
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Charles Perkins Centre D17, Sydney, NSW, 2006, Australia
| | - Erin Cvejic
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Martin Howell
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Charles Perkins Centre D17, Sydney, NSW, 2006, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Emily Lancsar
- Department of Health Services Research and Policy, Australian National University, Canberra, Australia
| | - Germaine Wong
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Jonathan Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Alison Hayes
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
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O'Loughlin R, Hiscock H, Devlin N, Dalziel K. Distinct developmental trajectories of health-related quality of life for boys and girls throughout childhood and adolescence; a national level longitudinal study. Health Qual Life Outcomes 2023; 21:82. [PMID: 37528376 PMCID: PMC10394779 DOI: 10.1186/s12955-023-02171-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/24/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND To identify and describe distinct developmental trajectories of health-related quality of life (HRQoL) in a national level Australian population sample, overall and separately for boys and girls. METHODS Data were from the Longitudinal Study of Australian Children (LSAC). Participants were children aged 4-5 years recruited in 2004 and followed through to age 16-17 years in 2016, and their caregivers. Group-based trajectory modelling was used to identify groups of children that follow qualitatively distinct developmental trajectories of HRQoL. RESULTS Three distinct trajectories were identified for the total sample: (1) high-stable (52.2% of children); (2) middle-stable (38.0%); and (3) low-declining (9.8%). These trajectories differed for boys, who saw increasing HRQoL in the highest trajectory group; a middle-stable trajectory; and declining and rebounding HRQoL in the lowest trajectory group. In contrast, girls saw no increasing or rebounding trajectories; approximately half of girls had high-stable HRQoL and the remaining half had either steadily or rapidly declining HRQoL from age 4-5 to 16-17 years. CONCLUSIONS Our results highlight the importance of considering the distinct trajectories for girls and boys and not relying on population mean levels of HRQoL for decision-making. The presence of developmentally distinct trajectories of HRQoL, and differences in the trajectories faced by boys and girls, should be considered when assessing the effectiveness of treatments and interventions impacting upon HRQoL throughout childhood and adolescence. Failure to account for these pre-existing trajectories may over- or under-estimate treatment effects.
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Affiliation(s)
- Rachel O'Loughlin
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia.
| | - Harriet Hiscock
- Department of Paediatrics, Melbourne Medical School, University of Melbourne, Melbourne, VIC, 3010, Australia
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
- Health Services and Economics, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
| | - Nancy Devlin
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Kim Dalziel
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
- Health Services and Economics, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
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Martínez-Shaw ML, Del Río FJ, Sánchez-Sandoval Y. Spanish validation of the Pediatric Quality of Life Inventory (PedsQL™ 4.0) for parent report for toddlers (ages 2-4). Health Qual Life Outcomes 2023; 21:48. [PMID: 37202825 DOI: 10.1186/s12955-023-02128-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/06/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND/OBJECTIVE Health-related quality of life is a concept that includes aspects about physical, emotional and social well-being. The aim of the study was to validate the PedsQL for parent report for toddlers in Spain and provide reference data in a Spanish population. METHOD The sample included 478 parents (89.5% mothers) of children aged 18-36 months (M = 26.75 months). Sociodemographic data were gathered, and the PedsQL and Kiddy-KINDL-R were completed by the participants. RESULTS The fit of the original structure of the PedsQL was acceptable (CFI = 0.93; TLI = 0.92; RMSEA = 0.06), and the results showed good internal consistency (α = 0.85). The items about nursery school were excluded, since not all the toddlers attended this type of educational centre. Significant differences were found in physical health and activities and in the total mean in terms of parent education level, and in social activities regarding gender. For the normative interpretation of the PedsQL, the first, second and third quartiles corresponded to 77.78, 84.72 and 90.28, respectively. CONCLUSIONS This instrument is not only useful to individually evaluate the quality of life of a child with respect to his/her group, but also to measure the efficacy of a possible intervention.
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Affiliation(s)
| | | | - Yolanda Sánchez-Sandoval
- Biomedical Research and Innovation Institute of Cadiz, INIBICA, Cádiz, Spain.
- Department of Psychology, Faculty of Educational Sciences, University of Cádiz, Puerto Real, Avenida República Saharaui, s/n, 11519, Spain.
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Villadsen A, Asaria M, Skarda I, Ploubidis GB, Williams MM, Brunner EJ, Cookson R. Clustering of adverse health and educational outcomes in adolescence following early childhood disadvantage: population-based retrospective UK cohort study. Lancet Public Health 2023; 8:e286-e293. [PMID: 36965983 DOI: 10.1016/s2468-2667(23)00029-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 01/20/2023] [Accepted: 02/03/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND Disadvantage in early childhood (ages 0-5 years) is associated with worse health and educational outcomes in adolescence. Evidence on the clustering of these adverse outcomes by household income is scarce in the generation of adolescents born since the turn of the millennium. We aimed to describe the association between household income in early childhood and physical health, psychological distress, smoking behaviour, obesity, and educational outcomes at age 17 years, including the patterning and clustering of these five outcomes by income quintiles. METHODS In this population-based, retrospective cohort study, we used data from the Millennium Cohort Study in which individuals born in the UK between Sept 1, 2000, and Jan 1, 2002, were followed up. We collected data on five adverse health and social outcomes in adolescents aged 17 years known to limit life chances: psychological distress, self-assessed ill health, smoking, obesity, and poor educational achievement. We compared how single and multiple outcomes were distributed across early childhood quintile groups of income, as an indicator of disadvantage, and modelled the potential effect of three income-shifting scenarios in early childhood for reducing adverse outcomes in adolescence. FINDINGS We included 15 245 adolescents aged 17 years, 7788 (51·1%) of whom were male and 7457 (48·9%) of whom were female. Adolescents in the lowest income quintile group in childhood were 12·7 (95% CI 6·4-25·1) times more likely than those in the highest quintile group to have four or five adverse adolescent outcomes, with poor educational achievement (risk ratio [RR] 4·6, 95% CI 4·2-5·0) and smoking (3·6, 3·0-4·2), showing the largest single risk ratios. Shifting up to the second lowest, middle, and highest income groups would reduce multiple adolescent adversities by 4·9% (95% CI -23·8 to 33·6), 32·3% (-2·7 to 67·3), and 83·9% (47·2 to 120·7), respectively. Adjusting for parental education and single parent status moderately attenuated these estimates. INTERPRETATION Early childhood disadvantage is more strongly correlated with multiple adolescent adversities than any of the five single adverse outcomes. However, shifting children from the lowest income quintile group to the next lowest group is ineffective. Tackling multiple adolescent adversities requires managing early childhood disadvantage across the social gradient, with income redistribution as a central element of coordinated cross-sectoral action. FUNDING UK Prevention Research Partnership.
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Affiliation(s)
- Aase Villadsen
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK.
| | - Miqdad Asaria
- Department of Health Policy, London School of Economics, London, UK; REAL Centre, The Health Foundation, London, UK
| | - Ieva Skarda
- Centre for Health Economics, University of York, York, UK
| | - George B Ploubidis
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
| | | | - Eric John Brunner
- Department of Epidemiology and Public Health, University College London, London, UK
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Killedar A, Lung T, Taylor RW, Taylor BJ, Hayes A. Is the cost-effectiveness of an early-childhood sleep intervention to prevent obesity affected by socioeconomic position? Obesity (Silver Spring) 2023; 31:192-202. [PMID: 36471911 PMCID: PMC10947595 DOI: 10.1002/oby.23592] [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] [Received: 03/28/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study aimed to determine whether the cost-effectiveness of an infant sleep intervention from the Prevention of Overweight in Infancy (POI) trial was influenced by socioeconomic position (SEP). METHODS An SEP-specific economic evaluation of the sleep intervention was conducted. SEP-specific intervention costs and effects at age 5 years, derived from the trial data, were applied to a representative cohort of 4,898 4- to 5-year-old Australian children. Quality-adjusted life years and health care costs were simulated until age 17 years using a purpose-built SEP-specific model. Incremental cost-effectiveness ratios and acceptability curves were derived for each SEP group. RESULTS The incremental cost-effectiveness ratios, in Australian dollars per quality-adjusted life year gained, were smaller in the low- ($23,010) and mid-SEP ($18,206) groups compared with the high-SEP group ($31,981). The probability that the intervention was cost-effective was very high in the low- and mid-SEP groups (92%-100%) and moderately high in the high-SEP group (79%). CONCLUSIONS An infant sleep intervention is more cost-effective in low- and mid-SEP groups compared with high-SEP groups. Targeting this intervention to low-SEP groups would not require trade-offs between efficiency and equity.
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Affiliation(s)
- Anagha Killedar
- Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Thomas Lung
- School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- The George Institute for Global HealthUniversity of New South WalesKensingtonNew South WalesAustralia
| | | | - Barry J. Taylor
- Department of Women's and Children's HealthUniversity of OtagoDunedinNew Zealand
| | - Alison Hayes
- Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
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Scarabottolo CC, Tebar WR, Araújo Guerra PH, Martins CMDL, Ferrari G, Beretta VS, Christofaro DGD. Association between Different Domains of Sedentary Behavior and Health-Related Quality of Life in Adults: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16389. [PMID: 36554270 PMCID: PMC9778904 DOI: 10.3390/ijerph192416389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Extended periods of time on screen devices and sitting are the main activities that characterize sedentary behavior (SB), which negatively impacts the quality of life. This negative influence was demonstrated mainly by cross-sectional studies performed in high-income countries in which the effects of screen time on health-related quality of life (HRQoL) is not considered. Thus, we analyzed the association between the different domains of SB (i.e., subdomains of screen time-television, computer, cellphone) and the HRQoL in adults that live in Brazil during two years of follow-up. The sample included 331 adults. Subdomains of screen time (i.e., watching television, using computers, and cellphones) and of HRQoL (i.e., physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health, and current health perception) were assessed by a structured questionnaire and SF-36, respectively. Our results indicate a significant increase in screen time during the two years of follow-up. Linear regression models indicated that although domains of SB were differently associated with HRQoL, in general, screen time was negatively associated with social functioning and positively associated with physical functioning during locomotion and activities of daily living (ADL), role-physical (i.e., physical issues during work and ADLs), and role-emotional (i.e., emotional issues during work and ADLs) after the two-year follow-up. In conclusion, screen time may positively or negatively influence some domains of HRQoL in adults.
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Affiliation(s)
- Catarina Covolo Scarabottolo
- Graduate Program in Movement Sciences, Physical Education Department, School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente 19060-900, Brazil
| | - William Rodrigues Tebar
- Center of Clinical and Epidemiological Research, University Hospital, University of Sao Paulo, São Paulo 05403-000, Brazil
| | | | | | - Gerson Ferrari
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia 7500912, Chile
| | - Victor Spiandor Beretta
- Graduate Program in Movement Sciences, Physical Education Department, School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente 19060-900, Brazil
| | - Diego Giulliano Destro Christofaro
- Graduate Program in Movement Sciences, Physical Education Department, School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente 19060-900, Brazil
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Lucena JMSD, Loch MR, Silva ECDC, Farias Júnior JCD. Sedentary behavior and health-related quality of life in adolescents. CIENCIA & SAUDE COLETIVA 2022; 27:2143-2152. [PMID: 35649004 DOI: 10.1590/1413-81232022276.11842021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/06/2021] [Indexed: 11/22/2022] Open
Abstract
Health-related quality of life (HRQoL) represents the perception of each person about different aspects of their lives in the health context (physical, psychological, social environment and interpersonal relationships). Among adolescents, HRQoL can change considering habits adopted in this phase of life. This study analyzed the association between time used on different sedentary behaviors (SB) and HRQoL in adolescents. This is a cross-sectional epidemiological study with adolescents between 10 - 15 years of age. The SB was measured using a questionnaire (n = 1,455 adolescents) and accelerometer (n = 844 adolescents), and HRQoL using KIDSCREEN - 27. Time on videogames/cell phones/tablets was inversely associated with overall HRQoL (β = -0.021; 95%CI: -0.026; -0.006), psychological well-being (β = -0.030; 95%CI: -0.050; -0.010), peer social support (β = -0.041; 95%CI: -0.066; -0.016) and school environment (β = -0.033; 95%CI: -0.056; -0.010) scores. Screen time was inversely associated with the school environment score (β = -0.011; 95%CI: -0.020; -0.003). Computer time was positively associated with the psychological well-being (β = 0.025; 95%CI: 0.006; 0.043) and peer social support scores (β = 0.029; 95%CI: 0.004; 0.053). It concluded that adolescents with more screen time had lower HRQoL. However, theses associations varied with the type and method of SB measurement and the HRQoL dimension.
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Affiliation(s)
- Joana Marcela Sales de Lucena
- Grupo de pesquisa em epidemiologia da atividade física e doenças crônicas (GPEAFD), Universidade Federal de Tocantins. Tocantinópolis TO Brasil
| | - Mathias Roberto Loch
- Programa de Pós-Graduação em Saúde Coletiva. Universidade Estadual de Londrina. Londrina PR Brasil
| | - Eduarda Cristina da Costa Silva
- Grupo de Estudos e Pesquisas em Epidemiologia da Atividade Física, Universidade Federal da Paraíba. João Pessoa PB Brasil.,Programa Associado de Pós-Graduação em Educação Física UPE/UFPB, Universidade Federal da Paraíba. João Pessoa PB Brasil
| | - José Cazuza de Farias Júnior
- Grupo de Estudos e Pesquisas em Epidemiologia da Atividade Física, Universidade Federal da Paraíba. João Pessoa PB Brasil.,Programa Associado de Pós-Graduação em Educação Física UPE/UFPB, Universidade Federal da Paraíba. João Pessoa PB Brasil.,Departamento de Educação Física, Universidade Federal da Paraíba. Campus I, Cidade Universitária. 58059-900 João Pessoa PB Brasil.
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Bruner MW, McLaren C, Swann C, Schweickle MJ, Miller A, Benson A, Gardner LA, Sutcliffe J, Vella SA. Exploring the Relations Between Social Support and Social Identity in Adolescent Male Athletes. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2021; 92:566-572. [PMID: 32491971 DOI: 10.1080/02701367.2020.1737629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 02/26/2020] [Indexed: 06/11/2023]
Abstract
Purpose: Social identity (i.e., the strength with which individuals identify with a group) is a key mechanism through which youth sport participants derive developmental benefits. However, despite the importance of one's social identity in promoting these benefits, our understanding of the correlates of social identity within the sport context is limited by the absence of evidence. To address this gap, this study investigated the relations between perceived social support from coaches, family, and friends and social identification. Method: Male adolescent athletes (N = 344) completed measures of social support and social identity as part of a cross-sectional design. Latent profile analysis was used to identify distinct social support profiles. Results: Four latent profiles were identified: higher support, average support, diminished support, and lower support. ANCOVA results indicated that profile membership corresponded to significant differences in social identity perceptions, p < .001, partial η2 = .26. Participants in the higher social support profile perceived significantly higher social identity when compared with profiles of average, diminished, and lower support (ps < .05, Cohen's d ≥.67). Conclusion: Results highlight the association between support from different social agents and social identity in youth sport. Better understanding the correlates of social identity may be critical in enhancing the developmental benefits of participation in organized team sports given the relationship with social identity.
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Kallander EK, Weimand BM, Hanssen-Bauer K, Van Roy B, Ruud T. Factors associated with quality of life for children affected by parental illness or substance abuse. Scand J Caring Sci 2021; 35:405-419. [PMID: 32383213 DOI: 10.1111/scs.12868] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 04/05/2020] [Accepted: 04/13/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND There have been inconsistent findings from studies examining factors associated with quality of life (QoL) for children affected by parental illness. AIM The aim of this study was to explore factors associated with self-reported QoL in children affected by parental illness or parental substance abuse. DESIGN A cross-sectional multicentre study. METHODS The sample included 246 families with children 8-18 years recruited via ill parents who received treatment for severe physical illness, mental illness or substance abuse in specialised health services. We performed multiple linear regression analyses to examine factors associated with the children's self-reported QoL. MAIN OUTCOME MEASURE KIDSCREEN-27. RESULTS The children's self-reported QoL was positively associated with the ill parent's self-reported physical health, the children's self-reported social skills, the degree to which other adults took over the ill parent's responsibilities, provision of sibling care, provision of health care for the ill parent and positive outcome of caregiving. The children's QoL was negatively associated with the children's self-reported responsibilities due to parental illness, provision of emotional care for the ill parent, negative outcomes of caregiving and external locus of control. The model explained 63% of the variance (adjusted R2 ) in children's total QoL. STUDY LIMITATIONS Sampling bias may have occurred during recruitment. CONCLUSIONS The findings suggest factors of importance for the children's QoL. Clinicians should assess whether an ill parent's physical health may influence negatively on their ability to perform daily responsibilities at home and care for their children, and clinicians can use children's self-reported QoL to identify children who are most negatively affected.
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Affiliation(s)
- Ellen Katrine Kallander
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Fafo Research Foundation, Oslo, Norway
| | - Bente M Weimand
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Faculty of Health Sciences, Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Ketil Hanssen-Bauer
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Betty Van Roy
- Department of CAMHS, Clinic of Children and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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11
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van der Kemp J, Ketelaar M, Gorter JW. Environmental factors associated with participation and its related concepts among children and youth with cerebral palsy: a rapid review. Disabil Rehabil 2021; 44:1571-1582. [PMID: 34057002 DOI: 10.1080/09638288.2021.1923839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To provide an overview of environmental factors associated with participation and participation-related constructs in children and youth with cerebral palsy (CP). METHODS A rapid review following the principles from scoping methodology was performed with a literature search in September 2019. The CINAHL, Embase, Ovid MEDLINE and PsychINFO databases were searched to identify original articles which addressed participation in children and youth (aged 0-18) with CP. RESULTS In total, 9511 unique articles were identified, of which 34 met all inclusion criteria. Many different measures for environmental factors were used. Most common environmental factors associated with participation (i.e., attendance and involvement) were family ecology, type of school, and parental stress. Regarding participation-related constructs (activity competence, sense of self and preferences), most common factors were parental stress and the physical environment. CONCLUSIONS While environmental factors are found to be associated with participation attendance and activity competence in children with CP, there is a lack of research of environmental factors in relation to both participation involvement and other participation-related constructs. To increase impact in clinical practice, future research should involve structured assessments of the environment and focus more on modifiable factors, to help service providers develop treatment paradigms needed for meaningful participation outcomes.IMPLICATIONS FOR REHABILITATIONFamily ecology, type of school, and parental stress were the most common factors associated with participation.Future research should focus on modifiable factors associated with participation outcomes.Modifiable environmental factors associated with participation included parental stress, family activity and type of school.In clinical practice, environmental factors are to be assessed in a more systematic way in relation to current or future participation restrictions.
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Affiliation(s)
- Jet van der Kemp
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, Canada.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, Canada
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12
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Le HND, Mensah F, Eadie P, McKean C, Sciberras E, Bavin EL, Reilly S, Gold L. Health-related quality of life of children with low language from early childhood to adolescence: results from an Australian longitudinal population-based study. J Child Psychol Psychiatry 2021; 62:349-356. [PMID: 32488955 DOI: 10.1111/jcpp.13277] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Low language abilities are known to be associated with significant adverse long-term outcomes. However, associations between low language and health-related quality of life (HRQoL) are unclear. We aimed to (a) examine the association between low language and HRQoL from 4 to 13 years and (b) classify the children's trajectories of HRQoL and language and examine the association between language and HRQoL trajectories. METHODS Data were from an Australian community-based cohort of children. HRQoL was measured at ages 4-13 years using the parent-reported Pediatric Quality of Life Inventory 4.0. Language was assessed using the Clinical Evaluation of Language Fundamentals (CELF)-Preschool 2nd edition at 4 years and the CELF-4th edition at 5, 7 and 11 years. Multivariable linear regression and mixed effect modelling were used to estimate cross-sectional and longitudinal associations between low language and HRQoL from 4 to 13 years. A joint group-based trajectory model was used to characterize associations between HRQoL and language trajectories over childhood. RESULTS Children with low language had substantially lower HRQoL than children with typical language from 4 to 13 years. Higher language scores were associated with better HRQoL, particularly in social and school functioning. Three HRQoL trajectories were identified: stable-high (51% of children), reduced with slow decline (40%) and low with rapid decline (9%). Children with low language were less likely to follow a stable-high HRQoL trajectory (40%) while 26% and 34% followed the reduced with slow decline and low with rapid decline trajectories, respectively. CONCLUSIONS Children with low language experienced reduced HRQoL from 4 to 13 years. More than half had declining trajectories in HRQoL highlighting the need to monitor these children over time. Interventions should not only aim to improve children's language ability but also address the wider functional impacts of low language.
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Affiliation(s)
- Ha N D Le
- Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, Vic., Australia.,Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Pediatrics, Univey of Melbourne, Melbourne, Vic., Australia.,Royal Children's Hospital, Melbourne, Vic., Australia
| | - Patricia Eadie
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Vic., Australia
| | - Cristina McKean
- Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Speech and Language Sciences, School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
| | - Emma Sciberras
- Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Pediatrics, Univey of Melbourne, Melbourne, Vic., Australia.,School of Psychology, Deakin University, Geelong, Vic., Australia
| | - Edith L Bavin
- Murdoch Children's Research Institute, Melbourne, Vic., Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
| | - Sheena Reilly
- Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Pediatrics, Univey of Melbourne, Melbourne, Vic., Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
| | - Lisa Gold
- Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, Vic., Australia.,Murdoch Children's Research Institute, Melbourne, Vic., Australia
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13
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Veldman SLC, Chin A Paw MJM, Altenburg TM. Physical activity and prospective associations with indicators of health and development in children aged <5 years: a systematic review. Int J Behav Nutr Phys Act 2021; 18:6. [PMID: 33413484 PMCID: PMC7791660 DOI: 10.1186/s12966-020-01072-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/14/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Early childhood is a critical period for growth and development, yet the association with physical activity during this important period is unknown. The aim of this review is to critically summarize the evidence on the prospective associations between physical activity and health and development in children aged < 5 years. METHODS A systematic search in three electronic databases (Pubmed, PsycINFO, and Sportdiscus) was conducted to identify prospective studies examining the associations between physical activity (all types; specified by quantity) and health indicators (body composition, cardiometabolic health, bone health and risks/harm) or development (motor, cognitive and social-emotional development) in young children (mean age < 5 years at baseline). Two independent researchers assessed the methodological quality using the 'Quality Assessment Tool for Quantitative Studies' (EPHPP). This tool covers eight quality criteria: selection bias, study design, confounders, blinding, data collection methods, withdrawals and drop-outs, intervention integrity and data-analysis. RESULTS Thirty-nine studies, predominantly conducted in preschoolers (ages 3-5 years), were included of which nine were rated as high methodological quality. There was moderate evidence for a positive association between physical activity and motor (n = 11 studies) and cognitive development (n = 10 studies) based on consistent findings from studies having low-to-moderate methodological quality. There was insufficient evidence for an association between physical activity and body composition (n = 15 studies), cardiometabolic health indicators (n = 7 studies), social-emotional development (n = 2 studies) and bone health (n = 2 studies) based on inconsistent findings from studies having weak-to-high methodological quality. CONCLUSIONS There is a need for more high-quality research in order to determine the dose-response relationship between physical activity and health and development in early childhood. Special attention should be paid to studies in children below the age of 3 years.
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Affiliation(s)
- Sanne L C Veldman
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Mai J M Chin A Paw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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14
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Cohen J, Collins L, Gregerson L, Chandra J, Cohn RJ. Nutritional concerns of survivors of childhood cancer: A "First World" perspective. Pediatr Blood Cancer 2020; 67 Suppl 3:e28193. [PMID: 31994836 DOI: 10.1002/pbc.28193] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 12/12/2019] [Accepted: 12/24/2019] [Indexed: 12/14/2022]
Abstract
Childhood cancer survivor (CCS) numbers are increasing as a result of advances in both treatment and supportive care. This positive outcome is tempered by the recognition of a high burden of chronic health conditions. Here, we review the nutritional concerns of CCS, including dietary habits after treatment and the factors during treatment that may contribute to chronic health conditions. Dietary interventions that have been conducted in CCS will be summarized along with focused goals of these interventions. We will also address the need to leverage these interventions to reduce the risk of chronic disease in CCS.
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Affiliation(s)
- Jennifer Cohen
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Randwick, New South Wales, Australia
| | - Laura Collins
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Laura Gregerson
- Department of Nutrition, Exercises and Sport, University of Copenhagen, Copenhagen, Denmark
| | - Joya Chandra
- Departments of Pediatrics Research, Epigenetics and Molecular Carcinogenesis, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard J Cohn
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Randwick, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
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15
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Kuppens S, Moore SC, Gross V, Lowthian E, Siddaway AP. The Enduring Effects of Parental Alcohol, Tobacco, and Drug Use on Child Well-being: A Multilevel Meta-Analysis. Dev Psychopathol 2020; 32:765-778. [PMID: 31274064 PMCID: PMC7525110 DOI: 10.1017/s0954579419000749] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 02/04/2019] [Accepted: 03/21/2019] [Indexed: 11/07/2022]
Abstract
The effects of psychoactive substance abuse are not limited to the user, but extend to the entire family system, with children of substance abusers being particularly at risk. This meta-analysis attempted to quantify the longitudinal relationship between parental alcohol, tobacco, and drug use and child well-being, investigating variation across a range of substance and well-being indices and other potential moderators. We performed a literature search of peer-reviewed, English language, longitudinal observational studies that reported outcomes for children aged 0 to 18 years. In total, 56 studies, yielding 220 dependent effect sizes, met inclusion criteria. A multilevel random-effects model revealed a statistically significant, small detriment to child well-being for parental substance abuse over time (r = .15). Moderator analyses demonstrated that the effect was more pronounced for parental drug use (r = .25), compared with alcohol use (r = .13), tobacco use (r = .13), and alcohol use disorder (r = .14). Results highlight a need for future studies that better capture the effect of parental psychoactive substance abuse on the full breadth of childhood well-being outcomes and to integrate substance abuse into models that specify the precise conditions under which parental behavior determines child well-being.Registration: PROSPERO CRD42017076088.
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Affiliation(s)
- Sofie Kuppens
- Department of Public Health and Primary Care, KU Leuven, Centre for Environment and Health, Leuven, Belgium
- Karel de Grote University of Applied Sciences and Arts, Antwerp, Belgium
| | - Simon C. Moore
- School of Dentistry, Cardiff University, Cardiff, Wales, UK
- Crime and Security Research Institute Friary House, Cardiff, Wales, UK
| | - Vanessa Gross
- School of Dentistry, Cardiff University, Cardiff, Wales, UK
| | - Emily Lowthian
- DECIPHer, Cardiff School of Social Sciences, Cardiff University, Cardiff, Wales, UK
| | - Andy P. Siddaway
- Stirling Management School, University of Stirling, Stirling, Stirlingshire, Scotland, UK
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16
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Paz-Lourido B, Negre F, de la Iglesia B, Verger S. Influence of schooling on the health-related quality of life of children with rare diseases. Health Qual Life Outcomes 2020; 18:109. [PMID: 32345307 PMCID: PMC7189684 DOI: 10.1186/s12955-020-01351-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 04/02/2020] [Indexed: 12/18/2022] Open
Abstract
Background Although participation of children with rare diseases in school is considered beneficial, it poses new challenges for the educational system, but also for the affected children and their families. The aim of this study is to identify which aspects of the schooling experience may have an impact on the health-related quality of life of children with rare diseases. Method A qualitative study was conducted using the social-critical paradigm as theoretical perspective. Participants (n = 28) included children with rare diseases (n = 8), parents (n = 12) and school staff (n = 8). Data was obtained through in-depth interviews and focus groups and analysed through discourse analysis as methodological orientation. Results Participants’ discourses placed value on the social benefits of inclusion of children with rare diseases in schooling. Discourses also highlighted how the low numbers of children with rare diseases and the delay, or lack, of a clear diagnosis are among the difficulties experienced in the pursuit of the adaptations that children and teachers need to promote a healthy and normalized school experience. The issues identified in their health-related quality of life were summarized in seven categories: Attendance, Knowledge, Participation, Acceptance, Discrimination, Safety, Health-Related Support. Conclusion Children with rare diseases remain, in many cases, invisible at the educational level due to the low numbers of children affected, limiting the kind of resources available to the child and teaching staff. This situation requires inter-disciplinary and inter-sector measures between health services and educational environments to articulate a comprehensive approach focused on children’s clinical needs.
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Affiliation(s)
- Berta Paz-Lourido
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Edif. Beatriu de Pinós, Cra. de Valldemossa Km 7.5, 07122, Palma, Balearic Islands, Spain. .,Childhood, Technology, Education and Diversity Research Group, Institute of Research and Innovation in Education, Palma, Balearic Islands, Spain. .,Education, Communication and Quality in Health Research Group, University of the Balearic Islands, Carretera de Valldemossa, Km 7.5, 07122, Palma, Balearic Islands, Spain.
| | - Francisca Negre
- Childhood, Technology, Education and Diversity Research Group, Institute of Research and Innovation in Education, Palma, Balearic Islands, Spain.,Department of Applied Pedagogy and Psychology of Education, Palma, Balearic Islands, Spain
| | - Begoña de la Iglesia
- Childhood, Technology, Education and Diversity Research Group, Institute of Research and Innovation in Education, Palma, Balearic Islands, Spain.,Department of Applied Pedagogy and Psychology of Education, Palma, Balearic Islands, Spain
| | - Sebastià Verger
- Childhood, Technology, Education and Diversity Research Group, Institute of Research and Innovation in Education, Palma, Balearic Islands, Spain.,Education, Communication and Quality in Health Research Group, University of the Balearic Islands, Carretera de Valldemossa, Km 7.5, 07122, Palma, Balearic Islands, Spain.,Department of Applied Pedagogy and Psychology of Education, Palma, Balearic Islands, Spain
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17
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Killedar A, Lung T, Petrou S, Teixeira-Pinto A, Hayes A. Estimating Age- and Sex-Specific Utility Values from the CHU9D Associated with Child and Adolescent BMI z-Score. PHARMACOECONOMICS 2020; 38:375-384. [PMID: 31814078 DOI: 10.1007/s40273-019-00866-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Our objective was to identify age- and sex-specific utilities for children and adolescents by body mass index (BMI) z-score. METHODS We used data from 6822 participants and 12,094 observations from two cohorts and two waves of interviews from the Longitudinal Study of Australian Children. We fit linear models using generalised estimating equations to investigate associations between Child Health Utility 9D and BMI z-score in girls and boys aged 10-17 years. We initially fit models for each sex, fully adjusted for known predictors of health-related quality of life, including socioeconomic position, long-term medical condition and maternal smoking status and also included an interaction between age and BMI z-score to examine age-specific effects. Finally, we derived a minimal model for each sex by eliminating interaction terms with P > 0.01 and predictors with P > 0.05. RESULTS Our adjusted results show different utility patterns in girls and boys. In girls, utility decrements for each unit increase in BMI z-score changed with age (P < 0.01 for interaction between age and BMI z-score). At age 10 years, the mean utility decrement for each unit increase in BMI z-score was 0.002 (95% confidence interval [CI] 0.011 decrement to 0.006 increment), but, by age 17 years, this utility decrement was 0.023 (95% CI 0.013 to 0.032). In boys, small non-significant decrements were found in utility for each unit increase in BMI z-score, with no observable change with age. CONCLUSION Our analyses demonstrated that age and sex should be considered when attributing utility values and decrements to BMI z-scores.
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Affiliation(s)
- Anagha Killedar
- Faculty of Medicine and Health, School of Public Health, Edward Ford Building A27, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Thomas Lung
- Faculty of Medicine and Health, School of Public Health, Edward Ford Building A27, University of Sydney, Sydney, NSW, 2006, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Armando Teixeira-Pinto
- Faculty of Medicine and Health, School of Public Health, Edward Ford Building A27, University of Sydney, Sydney, NSW, 2006, Australia
| | - Alison Hayes
- Faculty of Medicine and Health, School of Public Health, Edward Ford Building A27, University of Sydney, Sydney, NSW, 2006, Australia
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18
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Killedar A, Lung T, Petrou S, Teixeira-Pinto A, Tan EJ, Hayes A. Weight status and health-related quality of life during childhood and adolescence: effects of age and socioeconomic position. Int J Obes (Lond) 2020; 44:637-645. [PMID: 31949296 DOI: 10.1038/s41366-020-0529-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 12/10/2019] [Accepted: 01/07/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Overweight and obesity in children is associated with poor health-related quality of life (HRQoL), but the nuances of this relationship across different age and socio-demographic groups are not well-established. The aim of this study is to examine how the association between weight status and HRQoL changes with age and socioeconomic position (SEP) throughout childhood and adolescence. METHODS We used data from the Longitudinal Study of Australian Children (LSAC), a cohort study in which children were interviewed biennially from ages 4 to 17 years over seven waves of data. Measurements of HRQoL (using PedsQLTM), body mass index (BMI), and socio-demographic characteristics were collected at each interview. Of the 4983 children recruited into the study, we included data from 4083 children (a total of 24,446 observations). We used generalised estimating equations to assess whether age and SEP modified the association between weight status and HRQoL, after controlling for sex, long-term medical condition, language spoken to child and maternal smoking status. RESULTS Age was a significant modifier of the association between weight status and HRQoL, with adjustment for known predictors of HRQoL (P < 0.001). At age 4, children with obesity had, on average, a 0.99 (95% CI 0.02-1.96) point lower PedsQL total score than children at healthy weight. This difference became clinically important by age 9 at 4.50 (95% CI 3.86-5.13) points and increased to 6.69 (95% CI 5.74-7.64) points by age 17. There was no evidence that SEP modified the relationship between weight status and HRQoL (P > 0.05). CONCLUSIONS Our results demonstrate that the relationship between overweight and obesity status and poor HRQoL is strengthened with increasing age through childhood and adolescence, but is not affected by SEP. Paediatricians, researchers and carers of children with obesity should acknowledge HRQoL outcomes, particularly for older children and adolescents.
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Affiliation(s)
- Anagha Killedar
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, 2006, Australia.
| | - Thomas Lung
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, 2006, Australia.,The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Stavros Petrou
- Warwick Medical School, University of Warwick, Coventry, UK.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Armando Teixeira-Pinto
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, 2006, Australia
| | - Eng Joo Tan
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, 2006, Australia
| | - Alison Hayes
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, 2006, Australia
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19
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Poppert Cordts KM, Steele RG. Trajectories of pediatric sleepiness and their associations with health-related quality of life. Bull Menninger Clin 2019; 83:175-197. [PMID: 31112409 DOI: 10.1521/bumc.2019.83.2.175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The need for sleep in children has sparked extensive research, with inconclusive support for an association between sleep duration and sleep quality and health-related quality of life (HR-QOL). Daytime sleepiness, which captures a child's subjective sleep experience, has seldom been explored. Latent class growth analysis (LCGA) was employed to identify longitudinal trajectories of children's sleepiness. Trajectories were utilized to assess their association with HRQOL. The present sample included 158 children and their self-reports of sleepiness and HRQOL collected at three time points across an academic year. Results provided support for three trajectories of sleepiness, with significant associations between trajectory and later HRQOL. Post hoc tests revealed significant differences in HRQOL between trajectories. Children with high and stable sleepiness-experienced impairments in HRQOL comparable to children with chronic health conditions. Implications include the establishment of daytime sleepiness as a pervasive state with both statistical and clinical significance.
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Affiliation(s)
| | - Ric G Steele
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas
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20
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Moeijes J, van Busschbach JT, Bosscher RJ, Twisk JWR. Sports participation and health-related quality of life: a longitudinal observational study in children. Qual Life Res 2019; 28:2453-2469. [PMID: 31161332 PMCID: PMC6698265 DOI: 10.1007/s11136-019-02219-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2019] [Indexed: 01/02/2023]
Abstract
PURPOSE In this study, longitudinal associations between sports participation and health-related quality of life (HRQoL) were explored. Sports participation was operationalized as membership of a sports club, frequency of sports participation, performing individual versus team sports and performing indoor versus outdoor sports. The concept of HRQoL referred to the self-perceived enjoyment and satisfaction with one's personal health situation. METHODS Data from 618 fourth-grade primary school children were included at baseline; 10-13 months later, 417 children (response rate 67.5%) were retained. At both time points, children reported on sports participation (Move and Sports Monitor Questionnaire-youth aged 8-12 years) and health-related quality of life (KIDSCREEN-52). Because of the clustering of children in schools, data were analysed using linear mixed models. Analyses were adjusted for sex, age, BMI, household composition, SES and frequency of sports participation. RESULTS The questionnaires were fully completed by 417 children. High sports-active children showed better scores on almost all dimensions of HRQoL than moderate [difference (B) = - 1.82 (p = 0.05) to - 1.51 (p = 0.05)] or low ports-active children [difference (B) = - 3.67 (p < 0.001) to - 1.95 (p = 0.03)] and non-sports club members [difference (B) = - 5.58 (p < 0.001) to - 2.65 (p = 0.02)]. Unlike frequency, the other examined characteristics of sports participation were only to a limited extent longitudinal associated with HRQoL. CONCLUSION As frequency is more relevant than the form of sports participation, children should be encouraged to perform any kind of sports activity on a very regular base.
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Affiliation(s)
- Janet Moeijes
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, The Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Jooske T. van Busschbach
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, The Netherlands
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands
| | - Ruud J. Bosscher
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, The Netherlands
| | - Jos W. R. Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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Abstract
Mental health is one of the most prominent global burdens of disease among young people, while organized youth sport is one of the most popular activities for children and adolescents worldwide. Organized sport can be an engaging vehicle for the promotion of mental health, but participation also brings several meaningful risks and detriments for young people’s mental health. This paper contains a review of the evidence underpinning the relationships between sport participation and mental health during childhood and adolescence and also outlines the key areas of risk for mental health problems. Relevant theoretical frameworks are discussed, as are the key concepts underpinning 2 exemplar sport-based interventions to promote mental health and reduce the risk of mental health problems. Recommendations for best practice in organized youth sport are not available. However, relevant frameworks are outlined, from which administrators, coaches, and athletes can base the design and delivery of sport programs to be consistent with relevant theoretical and philosophical approaches such as the athlete-centered approach to youth sports.
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Brown DMY, Mahlberg N, Pohl D, Timmons BW, Bray SR, Streiner DL, Ferro MA, Hamer S, Rosenbaum PL, Ronen GM. Can behavioral strategies increase physical activity and influence depressive symptoms and quality of life among children with epilepsy? Results of a randomized controlled trial. Epilepsy Behav 2019; 94:158-166. [PMID: 30939411 DOI: 10.1016/j.yebeh.2019.03.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 01/30/2019] [Accepted: 03/07/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE This study examined whether increasing physical activity (PA) through 6 months of behavioral counseling positively influenced depressive symptoms and quality of life (QoL) over 12 months among children with epilepsy (CWE). METHODS A longitudinal multisite randomized controlled trial (RCT) was conducted with 8-14-year-old children with active epilepsy. Participants wore a pedometer to track daily PA and completed 3 measures at 4 time points to examine depressive symptoms and QoL. Stratified by site and activity level, participants were randomized to an intervention or control group. The 6-month intervention included 11 behavioral counseling sessions targeting self-regulation of PA. To assess the associations among PA, depression scores, and QoL, primary analysis involved mixed-effects models. RESULTS We recruited 122 CWE, of whom 115 were randomized (Mage = 11 ± 2; 50% female) and included in the analysis. The intervention did not increase PA in the treatment compared with the control group. No differences were found between groups over time during the subsequent 6 months, where PA decreased among all participants. Results did not show differences between the groups and over time for measures of depressive symptoms and QoL. SIGNIFICANCE The intervention did not improve or sustain PA levels over 12 months. Both groups demonstrated declines in PA over one year, but there were no changes in depression scores or QoL. As most participants were already nearly reaching the Canadian average of step counts of children their age, with a baseline daily step count of over 9000, there may be a challenge for further increasing PA over a longer period.
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Affiliation(s)
- Denver M Y Brown
- Department of Kinesiology, McMaster University, 1280 Main Street W, Hamilton, ON L8S 4L8, Canada.
| | - Nadilein Mahlberg
- Department of Pediatrics, McMaster University, 1400 Main Street W, Institute for Applied Health Sciences, Room 408, Hamilton, ON L8S 1C7, Canada.
| | - Daniela Pohl
- Division of Neurology, Children's Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada.
| | - Brian W Timmons
- Department of Pediatrics, McMaster University, 1400 Main Street W, Institute for Applied Health Sciences, Room 408, Hamilton, ON L8S 1C7, Canada.
| | - Steven R Bray
- Department of Kinesiology, McMaster University, 1280 Main Street W, Hamilton, ON L8S 4L8, Canada.
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, ON L9C 3N6, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada.
| | - Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue W, Waterloo, ON N2L 3G1, Canada.
| | - Sabrina Hamer
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Research Institute Building 2, Room R2109, Ottawa, ON K1H 8L1, Canada.
| | - Peter L Rosenbaum
- Department of Pediatrics, McMaster University, 1400 Main Street W, Institute for Applied Health Sciences, Room 408, Hamilton, ON L8S 1C7, Canada.
| | - Gabriel M Ronen
- Department of Pediatrics, McMaster University, 1400 Main Street W, Institute for Applied Health Sciences, Room 408, Hamilton, ON L8S 1C7, Canada.
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23
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Vella SA, Gardner LA, Swann C, Allen MS. Trajectories and predictors of risk for mental health problems throughout childhood. Child Adolesc Ment Health 2019; 24:142-148. [PMID: 32677183 DOI: 10.1111/camh.12279] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children fluctuate in their risk for mental health-related problems. While children have demonstrated consistent trajectories for various types of mental health problems, the existence of developmental trajectories of overall risk of mental health problems has not been explored. This study aimed to identify distinct trajectories of overall mental health risk among children from ages 4-12 years. A secondary objective was to identify predictors of the mental health risk trajectories. METHOD Data from the first five waves of the Longitudinal Study of Australian Children (LSAC) were used to assess mental health risk and potential predictors. The primary parent (n = 3717) completed questionnaires, time-use diaries, and face-to-face interviews over the five waves. Growth mixture modeling was used to identify distinct latent trajectories of mental health risk. Multinomial logistic regression was used to identify predictors of the trajectories. RESULTS Six distinct trajectories of mental health risk were identified: Low Difficulty (72.9%), Improvers (9.7%), Decliners (7.9%), Early Decliners/Late Improvers (4.7%), Early Improvers/Late Decliners (2.7%), and High Difficulty (2.2%). Child sex, sociability, parental warmth, sports participation, and household income were identified as significant predictors of mental health trajectories. CONCLUSIONS There are distinct trajectories of overall risk for mental health problems during childhood. Research should focus on the High Difficulties group and the Early Improvers/Late Decliners group to address the predictors and improve access to early mental health services.
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Affiliation(s)
- Stewart A Vella
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia.,School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Lauren A Gardner
- School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Christian Swann
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Mark S Allen
- School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
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24
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Moeijes J, van Busschbach JT, Wieringa TH, Kone J, Bosscher RJ, Twisk JWR. Sports participation and health-related quality of life in children: results of a cross-sectional study. Health Qual Life Outcomes 2019; 17:64. [PMID: 30987637 PMCID: PMC6466683 DOI: 10.1186/s12955-019-1124-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 03/22/2019] [Indexed: 11/10/2022] Open
Abstract
Background In children physical activity has been shown to be associated with health-related quality of life (HRQoL). This study further explores this association for specific characteristics of sports participation, namely membership of a sports club, frequency of sports participation, performing individual versus team sports, performing indoor versus outdoor sports, while differentiating between specific dimensions in the physical, psychological and social domain of HRQoL. Methods Cross-sectional data were collected from Dutch primary school children aged 10 to 12 years. They completed the Movement and Sports Monitor Questionnaire Youth aged 8 to 12 years (MSMQ) and the KIDSCREEN-52, an HRQoL questionnaire for children and adolescents. The data were examined using linear multilevel analyses because of the clustering of children in schools. Results The questionnaires were completed by 1876 children (response rate 81.3%). Membership of a sports club, moderate or high frequency of sports participation, and performing outdoor sports were all significantly associated with better HRQoL. These associations were largely found in the physical domain of HRQoL, to a lesser degree in the social domain, and to a limited extent in the psychological domain. Conclusion The association between sports participation and HRQoL in children depends on both characteristics of sports participation and the domain of life that is concerned. These differences offer starting points for developing tailor-made sports programs for children. Electronic supplementary material The online version of this article (10.1186/s12955-019-1124-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Janet Moeijes
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands. .,Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers (AMC and VUMC), Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands.
| | - Jooske T van Busschbach
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands.,University of Groningen, University Medical Center Groningen, University Center for Psychiatry, P.O. Box 30001, 9700, RB, Groningen, The Netherlands
| | - Thomas H Wieringa
- Department of Medical Psychology, Amsterdam University Medical Centers (AMC and VUMC), Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
| | - Jordy Kone
- School of Health Care Studies, Hanze University of Applied Sciences Groningen, P.O. Box 30030, 9700, RM, Groningen, The Netherlands.,Department of Health and Welfare, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands
| | - Ruud J Bosscher
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers (AMC and VUMC), Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
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25
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Cliff DP, Howard SJ, Radesky JS, McNeill J, Vella SA. Early Childhood Media Exposure and Self-Regulation: Bidirectional Longitudinal Associations. Acad Pediatr 2018; 18:813-819. [PMID: 29704999 DOI: 10.1016/j.acap.2018.04.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate: 1) prospective associations between media exposure (television viewing, computers, and electronic games) at 2 years and self-regulation at 4 and 6 years, and 2) bidirectional associations between media exposure and self-regulation at 4 and 6 years. We hypothesized that media exposure and self-regulation would show a negative prospective association and subsequent bidirectional inverse associations. METHODS Data from the nationally-representative Longitudinal Study of Australian Children when children were aged 2 years (n = 2786) and 4/6 years (n = 3527) were used. Primary caregivers reported children's weekly electronic media exposure. A composite measure of self-regulation was computed from caregiver-, teacher-, and observer-report data. Associations were examined using linear regression and cross-lagged panel models, accounting for covariates. RESULTS Lower television viewing and total media exposure at 2 years were associated with higher self-regulation at 4 years (both β = -0.02; 95% confidence interval [CI], -0.03 to -0.01). Lower self-regulation at 4 years was also significantly associated with higher television viewing (β = -0.15; 95% CI, -0.21 to -0.08), electronic game use (β = -0.05; 95% CI, -0.09 to -0.01), and total media exposure (β = -0.19; 95% CI, -0.29 to -0.09) at 6 years. However, media exposure at 4 years was not associated with self-regulation at 6 years. CONCLUSIONS Although media exposure duration at 2 years was associated with later self-regulation, and self-regulation at 4 years was associated with later media exposure, associations were of small magnitude. More research is needed to examine content quality, social context, and mobile media use and child self-regulation.
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Affiliation(s)
- Dylan P Cliff
- Early Start, School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.
| | - Steven J Howard
- Early Start, School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Jenny S Radesky
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Mich
| | - Jade McNeill
- Early Start, School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Stewart A Vella
- Early Start, School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
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26
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Use-of-time and health-related quality of life in 10- to 13-year-old children: not all screen time or physical activity minutes are the same. Qual Life Res 2017; 26:3119-3129. [DOI: 10.1007/s11136-017-1639-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2017] [Indexed: 01/08/2023]
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27
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Goldfinger JZ, Preiss LR, Devereux RB, Roman MJ, Hendershot TP, Kroner BL, Eagle KA. Marfan Syndrome and Quality of Life in the GenTAC Registry. J Am Coll Cardiol 2017; 69:2821-2830. [PMID: 28595698 PMCID: PMC5519341 DOI: 10.1016/j.jacc.2017.04.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 03/30/2017] [Accepted: 04/04/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Previous small studies suggested reduced quality of life (QOL) for people with Marfan syndrome (MFS) compared with those without MFS. The national registry of GenTAC (Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions) is a longitudinal observational cohort study of patients with conditions that predispose to thoracic aortic aneurysms and dissections, including MFS. At the time of registry enrollment, GenTAC study participants are asked to complete questionnaires about demographics, medical history, health habits, and QOL. OBJECTIVES This study assessed QOL in GenTAC participants with MFS and identify associated factors using self-reported data. METHODS QOL was assessed using the 4 subscales of the Physical Component Summary (PCS) of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36): physical functioning; role limitations due to physical health; bodily pain; and general health. We studied the association of QOL with self-reported demographics, health behaviors, physical impairments, surgeries, comorbid medical conditions, medications, and MFS severity. RESULTS In the GenTAC registry, 389 adults with MFS completed the SF-36. Mean age was 41 years, 51% were men, 92% were white, and 65% were college graduates. The mean PCS composite score was 42.3. In bivariate analysis, predictors of better QOL included college education, marital status, higher household income, private health insurance, full-time employment, moderate alcohol use, fewer prior surgeries, fewer comorbid conditions, absence of depression, and less severe MFS manifestations. In a multivariable analysis, insurance status and employment remained significant predictors of QOL. CONCLUSIONS In a large cohort of patients with MFS in the GenTAC registry, health-related QOL was below the population norm. Better QOL was independently associated with socioeconomic factors, not factors related to general health or MFS severity.
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Affiliation(s)
- Judith Z Goldfinger
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Liliana R Preiss
- Biostatistics and Epidemiology Division, Research Triangle Institute International, Rockville, Maryland
| | - Richard B Devereux
- Division of Cardiology, Weill Cornell Medical College, New York, New York
| | - Mary J Roman
- Division of Cardiology, Weill Cornell Medical College, New York, New York
| | - Tabitha P Hendershot
- Biostatistics and Epidemiology Division, Research Triangle Institute International, Rockville, Maryland
| | - Barbara L Kroner
- Biostatistics and Epidemiology Division, Research Triangle Institute International, Rockville, Maryland
| | - Kim A Eagle
- Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan
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28
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Ferro MA, Avery L, Fayed N, Streiner DL, Cunningham CE, Boyle MH, Lach L, Glidden G, Rosenbaum PL, Ronen GM. Child- and parent-reported quality of life trajectories in children with epilepsy: A prospective cohort study. Epilepsia 2017; 58:1277-1286. [PMID: 28485850 DOI: 10.1111/epi.13774] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the developmental trajectories of quality of life (QoL) in a large cohort of children with epilepsy, and to assess the relative contribution of clinical, psychosocial, and sociodemographic variables on QoL trajectories. METHODS Five assessments during a 28-month prospective cohort study were used to model trajectories of QoL. Participants were recruited with their parents from six Canadian tertiary centers. A convenience sample of 506 children aged 8-14 years with epilepsy and without intellectual disability or autism spectrum disorder were enrolled. A total of 894 children were eligible and 330 refused participation. Participating children were, on average, 11.4 years of age, and 49% were female. Nearly one third (32%) had partial seizures. At baseline, 479 and 503 child- and parent-reported questionnaires were completed. In total, 354 children (74%) and 366 parents (73%) completed the 28-month follow-up. QoL was measured using the child- and parent-reported version of the Childhood Epilepsy QoL scale (CHEQOL-25). RESULTS Child-reported QoL was fitted best by a six-class model and parent-reported QoL by a five-class model. In both models, trajectories remained either stable or improved over 28 months. Of these children, 62% rated their QoL as high or moderately high, defined as at least one standard deviation above the average CHEQOL-25 score. Greater family, classmate, and peer social support, fewer symptoms of child and parent depression, and higher receptive vocabulary were identified as the most robust predictors of better QoL (all p < 0.001). SIGNIFICANCE Most children with epilepsy and their parents reported relatively good QoL in this first joint self- and proxy-reported trajectory study. Findings confirm the heterogeneous QoL outcomes for children with epilepsy and the primary importance of psychosocial factors rather than seizure and AED-specific factors in influencing QoL. These predictors that are potentially amenable to change should now be the focus of specific intervention studies.
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Affiliation(s)
- Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Lisa Avery
- Avery Information Services, Orillia, Ontario, Canada
| | - Nora Fayed
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Charles E Cunningham
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Michael H Boyle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Lucyna Lach
- School of Social Work, McGill University, Montreal, Ontario, Canada
| | - Gina Glidden
- School of Social Work, McGill University, Montreal, Ontario, Canada
| | - Peter L Rosenbaum
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Gabriel M Ronen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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29
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Harmsen WJ, Aarsen FJ, van der Cammen-van Zijp MHM, van Rosmalen JM, Wijnen RMH, Tibboel D, IJsselstijn H. Developmental problems in patients with oesophageal atresia: a longitudinal follow-up study. Arch Dis Child Fetal Neonatal Ed 2017; 102:F214-F219. [PMID: 27582496 DOI: 10.1136/archdischild-2015-309976] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 08/05/2016] [Accepted: 08/08/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To longitudinally evaluate motor development and predictive factors in school-age children with oesophageal atresia. DESIGN Cohort study with prospective longitudinal follow-up. SETTING Outpatient clinic of a tertiary university paediatric hospital. PATIENTS Children with oesophageal atresia born between January 1999 and May 2006 were assessed at 5 and 8 years of age. INTERVENTIONS None. MAIN OUTCOME Motor performance was evaluated at 5 and 8 years using the Movement Assessment Battery for Children (M-ABC). Additionally, we evaluated perinatal characteristics, duration of anaesthesia within the first 24 months, socioeconomic status, sports participation and school performance at time of follow-up and intelligence and sustained attention at the age of 8 years. RESULTS In 5-year-olds (n=54), the mean (SD) z-score M-ABC was slightly, but significantly lower than age-predicted normative values (-0.75 (0.83), p<0.001). In 8-year-olds (n=49), the z-score M-ABC was -0.53 (0.91) (p<0.001), intelligence was normal, but sustained attention was impaired: z-score speed (-1.50 (1.73)) and raw score attentional fluctuation (3.99 (1.90)) (both p<0.001). Motor problems mainly concerned gross motor performance. Duration of anaesthesia and sustained attention were negatively associated with motor development; sports participation was positively associated. CONCLUSIONS Longer duration of anaesthesia and sustained attention problems were associated with gross motor problems in school-age patients with oesophageal atresia. Parental awareness of risks for motor problems may provide the opportunity to offer timely intervention.
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Affiliation(s)
- Wouter J Harmsen
- Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Femke J Aarsen
- Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | | | - Rene M H Wijnen
- Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Dick Tibboel
- Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Hanneke IJsselstijn
- Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
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30
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Becker-Grünig T, Schneider S, Sonntag D, Jarczok MN, Philippi H, De Bock F. [Parental Social Status and other determinants of quality of life and behavioral problems: An analysis of German preterm births between 1987-2004]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 59:166-80. [PMID: 26637387 DOI: 10.1007/s00103-015-2276-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Knowledge of the factors affecting the development of preterm children in Germany is limited. We analysed the prevalence of preterm birth in Germany using the German Health Interview and Examination Survey for Children and Adolescents 2003-2006 and assessed factors associated with quality of life (QOL) and behavioural development in preterm children (< 37 weeks' gestational age). METHODS Data were weighted and preterm prevalence was calculated by socioeconomic status (SES) and year of birth for 1,106 preterm children. Using linear regression models, the relationship between sociodemographic, pre- and perinatal, lifestyle, and contextual determinants on the one hand, and the QOL (KINDL® parent questionnaire) and behavioural problems (the total problem behaviour scale, the Strengths and Difficulties Questionnaire [SDQ]) on the other was calculated. RESULTS Prevalence of preterm birth (mean 7.5 %) was higher in families with low compared with high SES (8.4 versus 7.0 %). In the final regression models, preterm children with high SES had higher QOL scores (+ 3.3 KINDL points, p = 0.024) compared with children with low SES, and adolescents (aged 14-17 years) had a higher QOL than children aged 7-13 years. All other variables (contextual, pre- and perinatal) were not related to QOL. In contrast, there were many determinants of behavioural development in preterms: the SDQ total score was lower in girls, children with older mothers, those from high SES and those with a high level of physical activity. However, both very low birth weight (< 1,500 g) and birth at > 34 weeks' gestation were associated with a higher SDQ total score. CONCLUSION Given its high prevalence, preterm birth is a relevant public health issue in Germany. While SES may be the most important determinant of QOL in preterms, determinants of behavioural problems are the same as those in term children and also encompass perinatal factors.
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Affiliation(s)
- Tabea Becker-Grünig
- Klinik für Kinder- und Jugendmedizin, Universitätsklinik Mannheim, Mannheim, Deutschland
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland
| | - Sven Schneider
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland
| | - Diana Sonntag
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland
| | - Marc N Jarczok
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland
| | - Heike Philippi
- Sozialpädiatrisches Zentrum Frankfurt Mitte, Frankfurt am Main, Deutschland
| | - Freia De Bock
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland.
- Sozialpädiatrisches Zentrum Frankfurt Mitte, Frankfurt am Main, Deutschland.
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31
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Early Adversity, Psychopathology, and Latent Class Profiles of Global Physical Health From Preschool Through Early Adolescence. Psychosom Med 2016; 78:1008-1018. [PMID: 27749744 PMCID: PMC5108573 DOI: 10.1097/psy.0000000000000398] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The purpose of the present report was to describe the longitudinal trajectories of physical health beginning during preschool and continuing into early adolescence; explore whether these trajectories were predicted by psychosocial adversity, family income-to-needs ratio, and psychiatric disorders occurring during the preschool period; and determine whether psychiatric disorders mediated these relations. METHODS Participants included 296 children participating in a longitudinal study of early-onset psychopathology spanning 10 years. Semistructured clinical interviews were conducted with caregivers to determine children's psychiatric diagnoses between ages 3 and 6 years. Caregivers also completed annual assessments of their child's physical health problems (ages 3-13) and reported on the family's income and indicators of psychosocial adversity. RESULTS Growth mixture modeling revealed 2 trajectories of physical health problems: a stable, low group (n = 199) and a high, increasing group (n = 57) indicating linear increases in physical health problems from ages 3 to 13. Preschool psychiatric diagnoses (Estimate [Est] = 0.05, p < .001), family income-to-needs ratio (Est = -0.01, p = .012), and psychosocial adversity (Est = 0.02, p = .015) predicted membership in the high, increasing trajectory of physical health problems. Early-onset psychopathology mediated relations between psychosocial adversity and physical health problems (αβ = 0.31, p = .050) and between income-to-needs ratio and physical health problems (αβ = -0.29, p < .021). CONCLUSIONS These findings indicate the importance of early indicators of risk: low income-to-needs ratios, high psychosocial adversity, and psychiatric disorders occurring during the preschool period for contributing to increasing physical health problems from preschool through early adolescence. Early-onset psychiatric disorders also mediated relations between psychosocial adversity, income-to-needs ratio, and physical health problems.
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