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Zou S, Zou X, Zhang R, Xue K, Xiao AY, Zhou M, Fu Z, Zhou H. Maternal depression and early childhood development among children aged 24-59 months: the mediating effect of responsive caregiving. Ann Gen Psychiatry 2024; 23:30. [PMID: 39164699 PMCID: PMC11334398 DOI: 10.1186/s12991-024-00515-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 08/05/2024] [Indexed: 08/22/2024] Open
Abstract
This study examined whether maternal depression is related to Early Childhood Developmental (ECD) delay among children by quantifying the mediating contribution of responsive caregiving. We used data from 1235 children (Children's mean age = 50.4 months; 582 girls, 653 boys, 93.9% were Han), selected through convenience sampling, in 2021. 4.7% of children had ECD delay, 34.3% of mothers had depression. Children with depressed mothers were less likely to receive responsive caregiving (OR 4.35, 95% CI 2.60-7.27), and those who did not receive responsive caregiving were more likely to experience ECD delay (OR 3.89, 95% CI 1.89-8.02). Responsive caregiving partly mediated the relationship between maternal depression and ECD. Early intervention for children with depressed mothers is worthy of further investigation.
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Affiliation(s)
- Siyu Zou
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xinye Zou
- Department of Education, University of Cambridge, Cambridge, UK
| | - Ruolin Zhang
- Duke Kunshan University, No.8 Duke Ave., Kunshan, 215316, Jiangsu, China
| | - Kefan Xue
- Oxford School of Global and Area Studies, University of Oxford, Oxford, OX2 6LH, UK
| | - Angela Y Xiao
- Department of International Studies, Macalester College, 1600 Grand Avenue, St. Paul, Minnesota, 55105, USA
| | - Mo Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Ziyuan Fu
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Hong Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
- Peking University Health Science Center - Weifang Joint Research Center for Maternal and Child Health, Beijing, 100191, China.
- National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, 100191, China.
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Chang R, Li C, Wei M, Jiang Y, Zhang J. Roles of caregiver-child interaction on the association of socioeconomic status with early childhood development: a population-based study in rural China. BMC Public Health 2024; 24:1604. [PMID: 38880881 PMCID: PMC11181537 DOI: 10.1186/s12889-024-18803-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/08/2024] [Indexed: 06/18/2024] Open
Abstract
OBJECTIVE Socioeconomic status (SES) has been previously associated with children's early development, health, and nutrition; however, evidence about the potential role of caregiver-child interaction in such associations was limited. This study aimed to explore the effect of caregiver-child interaction on the associations of SES with child developmental outcomes, including early neurodevelopment and social-emotional behavior. METHODS A cross-sectional survey was conducted among 2078 children aged 0-6 in a rural county that just lifted out of poverty in 2020 in Central China. The Ages & Stages Questionnaires-Chinese version (ASQ-C) and the Social-Emotional (ASQ: SE) questionnaire were used to assess children's early neurodevelopment and social-emotional behavior, respectively. Caregiver-child interaction was evaluated with the Brigance Parent-Child Interactions Scale. Regression-based statistical mediation and moderation effect were conducted with the PROCESS macro of SPSS. RESULTS Children with low SES had an increased risk of suspected neurodevelopmental delay [OR = 1.92, 95% CI: 1.50, 2.44] and social-emotional developmental delay [OR = 1.31, 95% CI: 1.04, 1.66]. The caregiver-child interaction partially mediated the associations of SES with child developmental outcomes; the proportion of the indirect effect was 14.9% for ASQ-C total score and 32.1% for ASQ: SE score. Moreover, the caregiver-child interaction had a significant moderation effect on the association of SES with ASQ-C total score (P < 0.05). A weaker association was observed in children with high-level caregiver-child interaction than in medium and low ones. Similar moderating effects were found among boys but not girls. CONCLUSION Caregiver-child interaction plays a vital role in the relationship between SES and child development. Children with low SES households will benefit more in terms of their early development from intervention programs strengthening caregiver-child interaction.
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Affiliation(s)
- Rui Chang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunan Li
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengna Wei
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanfen Jiang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Wang H, Zhao J, Yu Z, Pan H, Wu S, Zhu Q, Dong Y, Liu H, Zhang Y, Jiang F. Types of On-Screen Content and Mental Health in Kindergarten Children. JAMA Pediatr 2024; 178:125-132. [PMID: 38048076 PMCID: PMC10696513 DOI: 10.1001/jamapediatrics.2023.5220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/24/2023] [Indexed: 12/05/2023]
Abstract
Importance Excessive screen time has been associated with a higher risk for mental health problems, but whether the associations differ by screen content types is unclear. Objective To examine the allocation of and longitudinal changes in screen exposure across different content types and to explore their associations with mental health in children aged 3 to 6 years. Design, Setting, and Participants This cohort study used 3-wave, lagged generalized estimating equation models to analyze data from the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P) study in Shanghai, China. The cohort was a representative sample of kindergarten children. Data were collected between November 2016 and May 2019 when children were aged 3 to 4 years (wave 1), 4 to 5 years (wave 2), and 5 to 6 years (wave 3). Data analysis was performed between June 2022 and May 2023. Exposure Screen exposure (total daily time and time with each type of content, including educational programs, entertainment programs, non-child-directed programs, electronic games, and social media) was collected when children were aged 3, 5, and 6 years. Main Outcomes and Measures Mental health of children at age 3, 5, and 6 years was reported by parents using the Strengths and Difficulties Questionnaire. Results Of the 15 965 children included in the representative sample, 8270 were males (51.7%) and the mean (SD) age at wave 1 was 3.73 (0.30) years. As children developed from ages 3 to 6 years, the proportion of screen exposure to educational programs (≤1 hour per day: 45.0% [95% CI, 43.5%-46.5%] to 26.8% [95% CI, 25.3%-28.3%]) and entertainment programs (≤1 hour per day: 44.4% [95% CI, 42.8%-45.9%] to 32.1% [95% CI, 30.4%-33.9%]) decreased, whereas exposure to social media increased (≤1 hour per day: 1.5% [95% CI, 1.2%-1.9%] to 27.1% [95% CI, 25.5%-28.7%]). The associations between on-screen content and mental health varied. For a given total screen time, a higher proportion of screen exposure to educational programs was associated with a lower risk for mental health problems (adjusted odds ratio [AOR], 0.73; 95% CI, 0.60-0.90), whereas non-child-directed programs were associated with a higher risk for such problems (AOR, 2.82; 95% CI, 1.91-4.18). Regardless of the content, total screen time was consistently associated with mental health problems. Conclusions and relevance Results of this study indicated that both total screen time and different types of content were associated with mental health problems in children aged 3 to 6 years. Limiting children's screen time, prioritizing educational programs, and avoiding non-child-directed programs are recommended.
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Affiliation(s)
- Haiwa Wang
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jin Zhao
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhangsheng Yu
- Clinical Research Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hao Pan
- Child Health Advocacy Institute, National Children’s Medical Center, Shanghai Children’s Medical Center, Shanghai, China
| | - Saishuang Wu
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuanyuan Dong
- Child Health Advocacy Institute, National Children’s Medical Center, Shanghai Children’s Medical Center, Shanghai, China
| | - Huilin Liu
- Child Health Advocacy Institute, National Children’s Medical Center, Shanghai Children’s Medical Center, Shanghai, China
| | - Yunting Zhang
- Child Health Advocacy Institute, National Children’s Medical Center, Shanghai Children’s Medical Center, Shanghai, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Xu J, Cui Y, Huang C, Dong Y, Zhang Y, Fan L, Li G, Jiang F. Prevalence and factors associated with pentavalent vaccination: a cross-sectional study in Southern China. Infect Dis Poverty 2023; 12:84. [PMID: 37715293 PMCID: PMC10502987 DOI: 10.1186/s40249-023-01134-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/31/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Immunization is one of the most far-reaching and cost-effective strategies for promoting good health and saving lives. A complex immunization schedule, however, may be burdensome to parents and lead to reduced vaccine compliance and completion. Thus, it is critical to develop combination vaccines to reduce the number of injections and simplify the immunization schedule. This study aimed to investigate the current status of the pentavalent diphtheria-tetanus-acellular pertussis inactivated poliomyelitis and Haemophilus influenzae type B conjugate (DTaP-IPV/Hib) vaccination in Southern China as well as explore the factors in the general population associated with uptake and the differences between urban and rural populations. METHODS A cross-sectional study was conducted with recently enrolled kindergarten students in Hainan Province between December 2022 and January 2023. The study employed a stratified multistage cluster random sampling method. Information regarding the demographic characteristics and factors that influence decisions were collected from the caregivers of children via an online questionnaire. Multivariate logistic regression was used to determine the factors associated with the status of DTap-IPV/Hib vaccinations. RESULTS Of the 4818 valid responses, 95.3% of children were aged 3-4 years, and 2856 (59.3%) held rural hukou. Coverage rates of the DTaP-IPV/Hib vaccine, from 1 to 4 doses, were 24.4%, 20.7%, 18.5%, and 16.0%, respectively. Caregivers who are concerned about vaccine efficacy [adjusted odds ratio (aOR) = 1.53, 95% confidence interval (CI): 1.30-1.79], the manufacturer (aOR = 2.05, 95% CI: 1.69-2.49), and a simple immunization schedule (aOR = 1.26, 95% CI: 1.04-1.54) are factors associated with a higher likelihood of vaccinating children against DTaP-IPV/Hib. In addition, caregivers in urban areas showed more concern about the vaccine price (P = 0.010) and immunization schedule (P = 0.022) in regard to vaccinating children. CONCLUSIONS The DTaP-IPV/Hib vaccine coverage rate in Hainan Province remains low. Factors such as lower socioeconomic status, cultural beliefs, concerns about vaccine safety, and cost may hinder caregivers from vaccinating their children. Further measures, such as health education campaigns to raise knowledge and awareness, and encouragement of domestic vaccine innovation, which would reduce out-of-pocket costs, could be implemented to improve the coverage of DTap-IPV/Hib vaccination.
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Affiliation(s)
- Jianing Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chong Qing Road, Shanghai, 200025, China
- China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Yujie Cui
- China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Chuican Huang
- Department of Child Health Care, Hainan Women and Children's Medical Center, Haikou, China
| | - Yuanyuan Dong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chong Qing Road, Shanghai, 200025, China
- Child Health Advocacy Institute, National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yunting Zhang
- Child Health Advocacy Institute, National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lichun Fan
- Department of Child Health Care, Hainan Women and Children's Medical Center, Haikou, China
| | - Guohong Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chong Qing Road, Shanghai, 200025, China.
- China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China.
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 227 South Chong Qing Road, Shanghai, 200025, China.
- Pediatric Translational Medicine Institute, National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
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Acharya K, Rahman MS, Islam MR, Gilmour S, Dhungel B, Parajuli RP, Nishimura T, Senju A, Tsuchiya KJ. Socioeconomic and education-based inequality in suspected developmental delays among Nepalese children: a subnational level assessment. Sci Rep 2023; 13:4750. [PMID: 36959346 PMCID: PMC10036624 DOI: 10.1038/s41598-023-31629-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 03/15/2023] [Indexed: 03/25/2023] Open
Abstract
Failure to meet early childhood developmental milestones leads to difficulty in schooling and social functioning. Evidence on the inequality in the burden of developmental delays across population groups, and identification of potential risk factors for suspected developmental delays (SDD) among younger children, are essential for designing appropriate policies and programs. This study explored the level of socioeconomic and maternal education-based inequality in the prevalence of SDD among Nepalese children at subnational level and identified potential risk factors. Individual-level data from the 2019 Nepal Multiple Indicator Cluster Survey was used to estimate the prevalence of SDD among children aged 3-4 years. Regression-based slope index of inequality (SII) and relative index of inequality were used to measure the magnitude of inequality, in terms of household socioeconomic status (SES) and mother's education, in the prevalence of SDD. In addition, a multilevel logistic regression model was used to identify potential risk factors for SDD. The national prevalence of SDD was found to be 34.8%, with relatively higher prevalence among children from rural areas (40.0%) and those from Karnali Province (45.0%) followed by Madhesh province (44.2%), and Sudhurpashchim Province (40.1%). The prevalence of SDD was 32 percentage points higher (SII: -0.32) among children from the poorest households compared to their rich counterparts at the national level. At the subnational level, such inequality was found to be highest in Lumbini Province (SII = -0.47) followed by Karnali Province (SII = -0.37), and Bagmati Province (SII = -0.37). The prevalence of SDD was 36 percentage points higher (SII: -0.36) among children whose mother had no formal education compared to children of higher educated mothers. The magnitude of education-based absolute inequality in SDD was highest in Lumbini Province (SII = -0.44). Multilevel logistic regression model identified lower levels of mother's education, disadvantaged SES and childhood stunting as significant risk factors for SDD. One in each three children in Nepal may experience SDD, with relatively higher prevalence among children from rural areas. Subnational level variation in prevalence, and socioeconomic and education-based inequality in SDD highlight the urgent need for province-specific tailored interventions to promote early childhood development in Nepal.
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Affiliation(s)
| | - Md Shafiur Rahman
- Research Centre for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan.
| | - Md Rashedul Islam
- Department of Global Health Policy, The University of Tokyo, Tokyo, Japan
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Bibha Dhungel
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
- Department of Health Policy, National Centre for Child Health and Development, Tokyo, Japan
| | - Rajendra P Parajuli
- Central Department of Zoology, Central Campus, Institute of Science and Technology (IOST), Tribhuvan University, Kritipur‑1, Kathmandu, Nepal
| | - Tomoko Nishimura
- Research Centre for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan
| | - Atsushi Senju
- Research Centre for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan
| | - Kenji J Tsuchiya
- Research Centre for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan
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Association of perinatal factors with suspected developmental delay in urban children aged 1-36 months - a large-scale cross-sectional study in China. BMC Pediatr 2023; 23:11. [PMID: 36604702 PMCID: PMC9817418 DOI: 10.1186/s12887-022-03819-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/23/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Studies on perinatal risk factors and the developmental delay of children have been inconclusive and few studies have assessed the association between infants and toddlers' body mass index (BMI) and developmental outcomes. METHODS We conducted a cross-sectional study of children aged 1-36 months who had a routine physical examination in the child health departments of hospitals from March 2018 to November 2021 in 16 provinces, 4 autonomous regions and 2 municipalities directly under the central government by using the Infant Toddler Growth Development Screening Test (ITGDST). Normal children were defined as those with scores ≥ mean - 2 standard deviations (SD), while children with developmental delay were those with scores < mean-2SD in terms of overall development, gross motor, fine motor and language development. Binary logistic regression was used to analyze the risk factors of gross motor, fine motor, language and overall neurodevelopment. RESULTS After removing some provinces with a small sample size and children with incomplete data, 178,235 children with 12 complete variables were included in the final analysis. The rate of overall developmental delay was 4.5%, while 12.5% of children had at least one developmental delay aspect. Boys, parity, advanced maternal age, multiple birth, cesarean section, neonatal injury, family heredity history, microcephaly, abnormal BMI at birth and at physical examination after controlling the confounding of other factors had a significant effect on development delay (overall neurodevelopment, gross motor, fine motor or language development). Per capita gross domestic product was a protective factor for the children's neuropsychological development. CONCLUSIONS This study reveals significant associations of perinatal factors and BMI with developmental delay in the Chinese children aged 1-36 months, which may be crucial for early intervention.
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Chen Y, Sylvia S, Dill SE, Rozelle S. Structural Determinants of Child Health in Rural China: The Challenge of Creating Health Equity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13845. [PMID: 36360724 PMCID: PMC9654689 DOI: 10.3390/ijerph192113845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
Over the past two decades, the literature has shown a clear gradient between child health and wealth. The same health-wealth gradient is also observed among children in China, with a large gap in health between rural and urban children. However, there are still unanswered questions about the main causes of China's rural-urban child health inequality. This paper aims to review the major factors that have led to the relatively poor levels of health among China's rural children. In addition to the direct income effect on children's health, children in rural areas face disadvantages compared with their urban counterparts from the beginning of life: Prenatal care and infant health outcomes are worse in rural areas; rural caregivers have poor health outcomes and lack knowledge and support to provide adequate nurturing care to young children; there are large disparities in access to quality health care between rural and urban areas; and rural families are more likely to lack access to clean water and sanitation. In order to inform policies that improve health outcomes for the poor, there is a critical need for research that identifies the causal drivers of health outcomes among children. Strengthening the pediatric training and workforce in rural areas is essential to delivering quality health care for rural children. Other potential interventions include addressing the health needs of mothers and grandparent caregivers, improving parenting knowledge and nurturing care, improving access to clean water and sanitation for remote families, and most importantly, targeting poverty itself.
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Affiliation(s)
- Yunwei Chen
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Sean Sylvia
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Sarah-Eve Dill
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305, USA
| | - Scott Rozelle
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305, USA
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Intensive Health Care plus Vitamin D Administration Benefits the Growth and Development of Young Children and Reduces the Incidence of Nutritional Disorders. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8097035. [PMID: 35707482 PMCID: PMC9192294 DOI: 10.1155/2022/8097035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022]
Abstract
This study was intended to assess the effect of intensive health care plus vitamin D administration on the growth, development, and nutritional status of young children. Totally, 131 young children who were admitted to Shiyan Maternal and Child Health Care Hospital from January 2020 to January 2021 were included and assigned via the random number table method at a ratio of 1 : 1 : 1 to receive either vitamin D administration (vitamin D group, n = 42), intensive health care (IHC) (IHC group, n = 44), or vitamin D administration plus intensive health care (combination group, n = 45). All children received a normal diet and routine care. After the intervention, all children showed robust improvement in their height, weight, neuropsychological development, and nutritional status, in which the combination therapy was associated with better outcomes in terms of physical development, neuropsychological development, and nutritional status, and a higher serum 25-hydroxyvitamin D3 (25-(OH)D3) level of the children versus monotherapy. Children receiving combined therapy had a significantly lower incidence of nutritional disorders than those receiving single therapy. Intensive health care plus vitamin D benefits the growth and development of young children and reduces the incidence of nutritional disorders in children.
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Wu S, Zhang D, Li X, Zhao J, Sun X, Shi L, Mao Y, Zhang Y, Jiang F. Siblings and Early Childhood Development: Evidence from a Population-Based Cohort in Preschoolers from Shanghai. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5739. [PMID: 35565134 PMCID: PMC9099463 DOI: 10.3390/ijerph19095739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 11/16/2022]
Abstract
(1) Background: The current study aims to investigate the association between the presence of a sibling and early childhood development (ECD). (2) Methods: Data were obtained from a large-scale population-based cohort in Shanghai. Children were followed from three to six years old. Based on birth order, the sample was divided into four groups: single child, younger child, elder child, and single-elder transfer (transfer from single-child to elder-child). Psychosocial well-being and school readiness were assessed with the total difficulties score from the Strengths and Difficulties Questionnaire (SDQ) and the overall development score from the early Human Capability Index (eHCI), respectively. A multilevel model was conducted to evaluate the main effect of each sibling group and the group × age interaction effect on psychosocial well-being and school readiness. (3) Results: Across all measures, children in the younger child group presented with lower psychosocial problems (β = −0.96, 95% CI: −1.44, −0.48, p < 0.001) and higher school readiness scores (β = 1.56, 95% CI: 0.61, 2.51, p = 0.001). No significant difference, or marginally significant difference, was found between the elder group and the single-child group. Compared to the single-child group, the single-elder transfer group presented with slower development on both psychosocial well-being (Age × Group: β = 0.37, 95% CI: 0.18, 0.56, p < 0.001) and school readiness (Age × Group: β = −0.75, 95% CI: −1.10, −0.40, p < 0.001). The sibling-ECD effects did not differ between children from families of low versus high socioeconomic status. (4) Conclusion: The current study suggested the presence of a sibling was not associated with worse development outcomes in general. Rather, children with an elder sibling are more likely to present with better ECD.
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Affiliation(s)
- Saishuang Wu
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; (S.W.); (J.Z.); (X.S.)
| | - Donglan Zhang
- Division of Health Services Research, Department of Foundations of Medicine, New York University Long Island School of Medicine, New York, NY 11501, USA;
| | - Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong 999077, China;
| | - Jin Zhao
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; (S.W.); (J.Z.); (X.S.)
| | - Xiaoning Sun
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; (S.W.); (J.Z.); (X.S.)
- Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai 201602, China
| | - Lu Shi
- Department of Public Health Science, College of Behavioral, Social and Health Science, Clemson University, Clemson, SC 29634, USA;
| | - Yuping Mao
- Department of Communication Studies, California State University Long Beach, Long Beach, CA 90840, USA;
| | - Yunting Zhang
- Child Health Advocacy Institute, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; (S.W.); (J.Z.); (X.S.)
- Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai 201602, China
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Ji F, Sun Y, Xu Y, Tang J, Hu J. How Well Are Socioeconomic Factors Associated With Improved Outcomes for Infants Diagnosed With Early Childhood Developmental Delay? An Observational Study. Front Pediatr 2022; 10:890719. [PMID: 35903167 PMCID: PMC9315099 DOI: 10.3389/fped.2022.890719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/02/2022] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Early childhood developmental delay remains problematic worldwide in terms of weight and the five domains of child development, including gross motor, fine motor, cognition, language, and social domains. Based on the World Health Organization (WHO) guideline and the theoretical domain framework, this study identified five key socioeconomic factors, such as parenting time during hospitalization, parental educational level, medical spending, distance to hospital, and medical insurance coverage, to describe how these five factors are associated with improved outcomes of developmental quotient (DQ) values and the weight of infants in a tertiary hospital. METHODS In this prospective observational study, clinical and socioeconomic data were collected. Clinical data included the weight and DQ values of infants and other data relevant to the birth of infants. A National Developmental Scale was used to observe infants in five domains and calculate the DQ values of infants. These five domains include gross motor, fine motor, cognition, language, and social domains. Parenting time during hospitalizations was observed by a research nurse. Other socioeconomic factors were reported by parents and verified with system information. RESULTS A total of 75 infants' parents were approached, of which 60 were recruited. The age of infants ranged from 75 to 274 days at the first admission. Increments of their weight and DQ values improved from -0.5 to 2.5 kg and from -13 to 63, respectively. More than half of the parents (54.1%) were at the level of minimum secondary education although the results were not statistically significant. However, there was a positive correlation between weight improvement and parenting time during hospitalization (r(58) = 0.258, p < 0.05), medical spending (r(58) = 0.327, p < 0.05), distance to hospital (r(58) = 0.340, p < 0.01), but there was a negative association with medical insurance coverage (r(58) =-0.256, p < 0.05). There was also a significant relationship between the improved DQ value and distance to hospital (r(58)= 0.424, p < 0.01). CONCLUSION Parenting time during hospitalization, medical spending, distance to hospital, and medical insurance coverage are important factors for early childhood developmental delay in relation to possible hospital intervention and improved accessibility to health services for families in rural areas. Therefore, changes in the current medical scheme are needed because a universal medical subsidy among regions will reduce the financial burden of families and provide families with more access to the necessary health services that their children need.
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Affiliation(s)
- Fang Ji
- Department of Rehabilitation Medicine, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yao Sun
- Department of Rehabilitation Medicine, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yi Xu
- Department of Rehabilitation Medicine, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jian Tang
- Department of Rehabilitation Medicine, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Hu
- Department of Rehabilitation Medicine, Children's Hospital of Nanjing Medical University, Nanjing, China.,Member of Professional Committee of Rehabilitation Nursing of Nanjing Rehabilitation Medical Association, Nanjing, China
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