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Guan K, Herold F, Owen N, Cheval B, Liu Z, Gerber M, Kramer AF, Taylor A, Paoli AD, Zou L. Prevalence and correlates of meeting 24-hour movement behavior guidelines among 8523 youth prescribed eyeglasses/contact lenses. Complement Ther Clin Pract 2024; 57:101893. [PMID: 39121807 DOI: 10.1016/j.ctcp.2024.101893] [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: 06/05/2024] [Revised: 08/03/2024] [Accepted: 08/04/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Contemporary 24-h movement behavior (24-HMB) guidelines provide recommendations on time spent on physical activity (PA), screen time (ST), and sleep (SL). There is evidence of physiological and psychological health benefits associated with meeting such guidelines. However, the prevalence of meeting 24-HMB guidelines among youth prescribed eyeglasses/contact lenses is less clear. The primary purpose of this cross-sectional analysis was to examine the prevalence of partially or fully meeting 24-HMB guidelines in U.S. youth prescribed eyeglasses/contact lenses, and variations in meeting the guidelines by demographic, health status, and environmental attributes. METHODS Data from the 2021 National Survey of Children's Health (NSCH) yielded a target subpopulation of 8523 youth aged 6-17 years (54.22 % girls) prescribed eyeglasses/contact lenses. The representative sample of US children and adolescents was used to estimate the prevalence of meeting 24-HMB guidelines, and a multinomial logistic regression analysis was conducted to examine the odds of meeting 24-HMB guidelines by demographic, health status, and environmental variables. RESULTS Overall, only 6.57 % met all three 24-HMB guidelines, 23.74 % did not meet any of the three 24-HMB guidelines, and 3.57 %, 10.88 %, and 29.98 % met single guidelines for physical activity, screen time, or sleep duration, respectively, while 25.27 % met any of two 24-HMB guidelines. Female participants were less likely to meet PA + SL guidelines (OR = 0.57, 95 % CI [0.38, 0.56]) but more likely to meet ST + SL guidelines (OR = 1.52, 95 % CI [1.20, 1.91]). Hispanic participants were less likely to meet PA + ST (OR = 0.28, 95 % CI [0.14, 0.52]) guidelines and all three guidelines (OR = 0.41, 95 % CI [0.23, 0.71]) while participants identified as black (OR = 0.33, 95 % CI [0.21, 0.51]) were significantly less likely to meet ST + SL guidelines. With respect to health status, overweight status, repeated/chronic physical pain, and born premature, were detrimentally associated with meeting two or more 24-HMB guidelines. Living in neighborhoods with parks or playgrounds and neighborhood safety were positively linked to meeting the guidelines while living in neighborhoods with sidewalks or walking paths was negatively linked to meeting PA + ST guidelines. CONCLUSION In U.S. youth prescribed eyeglasses/contact lenses the prevalence of meeting all three 24-HMB guidelines was low, especially the low prevalence observed in female participants, Hispanic and black participants, participants with overweight status, repeated/chronic pain, born premature, living in neighborhoods with sidewalks. Policy makers should take initiative to promote integrated guidelines among this special age group for health benefits.
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Affiliation(s)
- Kaiqi Guan
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Neville Owen
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia; Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Boris Cheval
- Department of Sport Sciences and Physical Education, Ecole Normale Supérieure Rennes, Bruz, France; Laboratory VIPS2, University of Rennes, Rennes, France
| | - Zijun Liu
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Arthur F Kramer
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, IL, USA; Center for Cognitive and Brain Health, Northeastern University, Boston, MA, USA; Department of Psychology, Northeastern University, Boston, MA, 02115, USA
| | - Alyx Taylor
- Health and Rehabilitation Sciences, AECC University College, Bournemouth, BH5 2DF, UK
| | | | - Liye Zou
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China.
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Muller D, Signal TL, Shanthakumar M, Fleming T, Clark TC, Crengle S, Donkin L, Paine SJ. Inequities in adolescent sleep health in Aotearoa New Zealand: Cross-sectional survey findings. Sleep Health 2024; 10:385-392. [PMID: 38910037 DOI: 10.1016/j.sleh.2024.05.007] [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: 11/29/2023] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVES To investigate ethnic inequities in, and social determinants of, adolescent sleep health in Aotearoa New Zealand. METHODS Analysis of self-report data from a cross-sectional survey of secondary school students (12- to 18-year-olds). Analyses included weighted prevalence estimates of good and poor sleep health stratified by ethnicity, and multivariable logistic regression models concurrently adjusted for ethnicity, school year, gender, rurality, neighborhood deprivation, school decile, housing deprivation, sleeping elsewhere due to lack of adequate housing, unsafe environment, and racism. RESULTS Inequities in social determinants of health were evident for Māori (Indigenous peoples of Aotearoa New Zealand; n = 1528) and minoritized (Pacific n = 1204; Asian n = 1927; Middle Eastern, Latin American, and African [MELAA] n = 210; and 'Other' ethnicity n = 225) adolescents. A greater proportion of Māori, Pacific, Asian, MELAA, and 'Other' adolescents had short sleep, compared to European (n = 3070). Māori, Pacific, Asian, and MELAA adolescents were more likely to report late bedtimes (after midnight), and Māori, Pacific, and 'Other' adolescents were more likely to report early waketimes (5 AM-6 AM or earlier), on school days. Rurality, neighborhood deprivation, school-level deprivation, housing deprivation, sleeping elsewhere due to inadequate housing, unsafe environments, and racism partially, but not fully, explained associations between ethnicity and short sleep, late bedtimes, and early waketimes. CONCLUSIONS Ethnic inequities exist in adolescent sleep health in Aotearoa New Zealand. Socio-political actions are needed to address racism and colonialism as root causes of ethnic inequities in adolescent sleep, to ensure all young people are afforded the basic human right of good sleep health and associated mental and physical well-being.
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Affiliation(s)
- Diane Muller
- Sleep/Wake Research Centre, School of Health Sciences, College of Health, Massey University, Wellington, New Zealand.
| | - T Leigh Signal
- Sleep/Wake Research Centre, School of Health Sciences, College of Health, Massey University, Wellington, New Zealand
| | - Mathangi Shanthakumar
- Environmental Health Intelligence New Zealand (EHINZ), Research Centre for Hauora and Health, College of Health, Massey University, Wellington, New Zealand
| | - Terry Fleming
- School of Health, Faculty of Health, Te Herenga Waka/Victoria University of Wellington, Wellington, New Zealand
| | - Terryann C Clark
- School of Nursing, Faculty of Medical Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Liesje Donkin
- Department of Psychology and Neuroscience, School of Clinical Sciences, Auckland University of Technology (AUT), Auckland, New Zealand
| | - Sarah-Jane Paine
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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3
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Harriman NW, Chen JT, Lee S, Slopen N. Individual-Level Experiences of Structural Inequity and Their Association with Subjective and Objective Sleep Outcomes in the Adolescent Brain Cognitive Development Study. J Adolesc Health 2024:S1054-139X(24)00244-1. [PMID: 39001748 DOI: 10.1016/j.jadohealth.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/24/2024] [Accepted: 05/03/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE Research has documented that adolescent sleep is impacted by various stressors, including interpersonal experiences and structural disadvantage. This study extends existing knowledge by empirically examining interconnected individual experiences of structural inequity and assessing its association with subjective and objective sleep outcomes. METHODS We utilized data from the Adolescent Brain and Cognitive Development Study to identify seven conceptual domains of structural inequity: perceived discrimination, low school inclusivity, neighborhood safety, unmet medical needs, legal problems, material hardship, and housing insecurity. We operationalized experiences of structural inequity as latent classes, a cumulative exposure, and each domain separately. Sleep disturbances were measured using the Sleep Disturbance Scale, and sleep duration was assessed using Fitbits. Mixed effects linear regression estimated the association between our measures of structural inequity, longitudinal sleep disturbances, and cross-sectional sleep duration. RESULTS Latent class analysis revealed common exposure profiles (low risk, interpersonal, and systemic) of experiences of structural inequity across our sample. In longitudinal models, structural inequity was associated with higher Sleep Disturbance Scale scores, whether measured as latent classes, a cumulative exposure, or individual domains. Individuals with interpersonal exposures, those with at least one exposure, and those with legal problems, material hardship, and housing insecurity had lower mean sleep duration. DISCUSSION Results are consistent with literature that frames structural inequity as a lifelong determinant of sleep disturbance and duration. Adolescence represents a crucial time for interventions aimed at improving sleep and redressing inequities throughout the life course; our work can inform the development of policies and interventions toward this end.
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Affiliation(s)
- Nigel Walsh Harriman
- Social and Behavioral Sciences Department, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Jarvis T Chen
- Social and Behavioral Sciences Department, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Sunmin Lee
- Department of Medicine, University of California Irvine School of Medicine, Irvine, California
| | - Natalie Slopen
- Social and Behavioral Sciences Department, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Harvard University, Center on the Developing Child, Cambridge, Massachusetts
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4
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Gaston SA, Alhasan DM, Johnson DA, Hale L, Harmon QE, Baird DD, Jackson CL. Perceived childhood neighborhood safety and sleep health during childhood and adulthood among a cohort of African American women. Sleep Med 2024; 117:115-122. [PMID: 38531166 DOI: 10.1016/j.sleep.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/22/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To investigate associations between perceived childhood neighborhood safety and sleep over the life course. METHODS Among a cohort of 1693 Black/African American women aged 23-35 years at enrollment (2010-2012), participants recalled neighborhood safety (safe vs. unsafe) when they were 5, 10, and 15 years old. Participants' mothers/caregivers and participants reported sleep-related health behaviors at age 5. We used ordinal logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for sleep-related health behaviors (i.e., rarely/never or sometimes vs. mostly/always going to bed by 8:00 p.m., bed in a quiet room, bed in a dimly lit or unlit room), separately. Adulthood sleep duration and insomnia symptoms were reported at enrollment and over three follow-up periods. We applied generalized estimating equations to log binomial regression models to estimate relative risks (RR) for adulthood sleep characteristics. RESULTS AND CONCLUSIONS Four percent of participants reported an unsafe neighborhood at age 5 years, only, and 12% reported an unsafe neighborhood at all ages. Participants in perceived unsafe vs. safe neighborhoods at age 5 had higher odds of poor sleep-related health behaviors (e.g., rarely/never or sometimes going to bed in a quiet room: OR = 1.73 [1.27-2.35]). Participants in perceived unsafe vs. safe neighborhoods throughout childhood had higher risk of short sleep (RR = 1.10 [1.02-1.18]) and insomnia symptoms (RR = 1.07 [1.00-1.15]) during adulthood after adjustment for life course socioeconomic characteristics and adulthood health behaviors and characteristics. Perceived unsafe childhood neighborhood was associated with poorer sleep over the life course and may serve as an early intervention target.
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Affiliation(s)
- Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Dana M Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook Medicine, Stony Brook, NY, USA
| | - Quaker E Harmon
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA; Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
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5
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Saelee R, Haardörfer R, Johnson DA, Gazmararian JA, Suglia SF. Neighborhood and Household Environment as Contributors to Racial Disparities in Sleep Duration among U.S. Adolescents. SLEEP EPIDEMIOLOGY 2023; 3:100065. [PMID: 38188485 PMCID: PMC10769009 DOI: 10.1016/j.sleepe.2023.100065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Objective Racial disparities in adolescent sleep duration have been documented, but pathways driving these disparities are not well understood. This study examined whether neighborhood and household environments explained racial disparities in adolescent sleep duration. Methods Participants came from Waves I and II of Add Health (n=13,019). Self-reported short sleep duration was defined as less than the recommended amount for age (<9 hours for 6-12 years, <8 hours for 13-18 years, and <7 hours for 18-64 years). Neighborhood factors included neighborhood socioeconomic disadvantage, perceived safety and social cohesion. Household factors included living in a single parent household and household socioeconomic status (HSES). Structural equation modeling was used to assess mediation of the neighborhood and household environment in the association between race/ethnicity and short sleep duration. Results Only HSES mediated racial disparities, explaining non-Hispanic (NH) African American-NH White (11.6%), NH American Indian-NH White (9.9%), and Latinx-NH White (42.4%) differences. Unexpectedly, higher HSES was positively associated with short sleep duration. Conclusion Household SES may be an important pathway explaining racial disparities in adolescent sleep duration. Future studies should examine mechanisms linking household SES to sleep and identify buffers for racial/ethnic minority adolescents against the detrimental impacts that living in a higher household SES may have on sleep.
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Affiliation(s)
- Ryan Saelee
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University
| | - Dayna A. Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | | | - Shakira F. Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University
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6
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Zeringue MM, Saini EK, Fuller-Rowell TE, Hinnant JB, El-Sheikh M. Neighborhood environment and adolescent sleep: The role of family socioeconomic status. Sleep Med 2023; 109:40-49. [PMID: 37413781 PMCID: PMC10529799 DOI: 10.1016/j.sleep.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVES Socioeconomic status (SES) and neighborhood context are influential predictors of adolescent sleep, yet little is known about how they may interact to influence sleep. We examined multiple dimensions of family SES as moderators of associations between neighborhood risk and multiple sleep parameters. METHODS Participants were 323 adolescents (Mage = 17.4 years, SD = 0.86; 48% male; 60% White/European American, 40% Black/African American). Sleep was assessed using 7 nights of actigraphy from which sleep duration (minutes from onset to wake time), efficiency, long wake episodes, and variability in minutes over the week were derived. Youth reported on their sleep/wake problems and sleepiness, as well as their perceptions of safety and violence in their neighborhoods. Parents reported on SES indices, including income-to-needs ratio and perceived financial stability. RESULTS Lower SES (income-to-needs, perceived financial stability) was associated with lower sleep efficiency and more frequent long wake episodes. Lower neighborhood safety and greater community violence concerns were related to greater subjective sleep problems. Moderation effects illustrated two general patterns. For actigraphy-derived sleep variables, lower neighborhood safety was associated with poor sleep only among youth from lower-income families. For subjective sleep/wake problems and daytime sleepiness, associations between neighborhood risk and sleep difficulties were pronounced for higher SES youth, while lower SES youth had greater sleep problems regardless of neighborhood factors. CONCLUSIONS Findings suggest that several dimensions of SES and neighborhood risk may be consequential for adolescents' sleep. Moderation effects highlight the significance of considering multiple contextual influences towards a better understanding of adolescents' sleep.
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7
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Zhang L, Cui Z, Huffman LG, Oshri A. Sleep mediates the effect of stressful environments on youth development of impulsivity: The moderating role of within default mode network resting-state functional connectivity. Sleep Health 2023; 9:503-511. [PMID: 37270396 PMCID: PMC10524131 DOI: 10.1016/j.sleh.2023.03.005] [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: 09/19/2022] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Youth raised in stressful environments are at increased risk for developing impulsive traits, which are a robust precursor of problem behaviors. Sleep may mediate the link between stress and problem behaviors as it is both sensitive to stress and essential for neurocognitive development underlying behavioral control during adolescence. The default mode network (DMN) is a brain network implicated in stress regulation and sleep. Yet, it is poorly understood how individual differences in resting-state DMN moderate the effect of stressful environments on impulsivity via sleep problems. METHODS Three waves of data spanning 2 years were obtained from the Adolescent Brain and Cognitive Development Study, a national longitudinal sample of 11,878 children (Mage at baseline = 10.1; 47.8% female). Structural equation modeling was used to test (a) the mediating role of sleep at T3 in the link between stressful environments at baseline and impulsivity at T5 and (b) the moderation of this indirect association by baseline levels of within-DMN resting-state functional connectivity. RESULTS Sleep problems, shorter sleep duration, and longer sleep latency significantly mediated the link between stressful environments and youth impulsivity. Youth with elevated within-DMN resting-state functional connectivity showed intensified associations between stressful environments and impulsivity via shorter sleep duration. CONCLUSION Our findings suggest that sleep health can be a target for preventive intervention and thereby mitigate the link between stressful environments and increased levels of youth impulsivity.
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Affiliation(s)
- Linhao Zhang
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, United States; Youth Development Institute, University of Georgia, Athens, Georgia, United States.
| | - Zehua Cui
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, United States; Youth Development Institute, University of Georgia, Athens, Georgia, United States
| | - Landry Goodgame Huffman
- Youth Development Institute, University of Georgia, Athens, Georgia, United States; Integrated Life Sciences, Behavioral and Cognitive Neuroscience, University of Georgia, Athens, Georgia, United States
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, United States; Youth Development Institute, University of Georgia, Athens, Georgia, United States; Integrated Life Sciences, Behavioral and Cognitive Neuroscience, University of Georgia, Athens, Georgia, United States
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8
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Mayne SL, DiFiore G, Hannan C, Nwokeji U, Tam V, Filograna C, Martin T, South E, Mitchell JA, Glanz K, Fiks AG. Feasibility and acceptability of mobile methods to assess home and neighborhood environments related to adolescent sleep. Sleep Health 2023; 9:331-338. [PMID: 36781356 PMCID: PMC10293018 DOI: 10.1016/j.sleh.2023.01.014] [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: 08/22/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 02/13/2023]
Abstract
OBJECTIVE A growing evidence base suggests home and neighborhood environmental exposures may influence adolescent sleep, but few studies have assessed these relationships using methods that account for time-varying, location-specific exposures, or multiple neighborhood contexts. This study aimed to assess the feasibility and acceptability of using smartphone global positioning system (GPS) tracking and ecological momentary assessment (EMA) to assess time-varying home and neighborhood environmental exposures hypothesized to be associated with adolescent sleep. METHODS Adolescents aged 15-17 years in Philadelphia completed 7 days of continuous smartphone GPS tracking, which was used to identify daily levels of exposure to geocoded neighborhood factors (eg, crime, green space). Four daily EMA surveys assessed home sleep environment (eg, noise, light), stress, health behaviors, and neighborhood perceptions. Feasibility and acceptability of GPS tracking and EMA were assessed, and distributions of daily environmental exposures were examined. RESULTS Among 25 teens (mean age 16, 56% male), there was a high level of GPS location data captured (median daily follow-up: 24 hours). Seventy-eight percent of EMA surveys were completed overall. Most participants (96%) reported no privacy concerns related to GPS tracking and minimal burden from EMA surveys. Exposures differed between participants' home neighborhoods and locations visited outside the home neighborhood (eg, higher crime away from home). Sleep environment disruptions were present on 29% of nights (most common: uncomfortable temperature) and were reported by 52% of adolescents. CONCLUSIONS Results demonstrate the feasibility and acceptability of mobile methods for assessing time-varying home and neighborhood exposures relevant to adolescent sleep for up to 1 week.
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Affiliation(s)
- Stephanie L Mayne
- Center for Pediatric Effectiveness, PolicyLab, and the Possibilities Project, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Leonard Davis Institute for Healthcare Economics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - Gabrielle DiFiore
- Center for Pediatric Effectiveness, PolicyLab, and the Possibilities Project, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Chloe Hannan
- Center for Pediatric Effectiveness, PolicyLab, and the Possibilities Project, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Uchenna Nwokeji
- Center for Pediatric Effectiveness, PolicyLab, and the Possibilities Project, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Vicky Tam
- Data Science and Biostatistical Unit, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Corinne Filograna
- Center for Pediatric Effectiveness, PolicyLab, and the Possibilities Project, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Tyler Martin
- Center for Healthcare Innovation, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Eugenia South
- Leonard Davis Institute for Healthcare Economics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Urban Health Lab, Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jonathan A Mitchell
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Karen Glanz
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alexander G Fiks
- Center for Pediatric Effectiveness, PolicyLab, and the Possibilities Project, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Leonard Davis Institute for Healthcare Economics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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9
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Conley MI, Hernandez J, Salvati JM, Gee DG, Baskin-Sommers A. The role of perceived threats on mental health, social, and neurocognitive youth outcomes: A multicontextual, person-centered approach. Dev Psychopathol 2023; 35:689-710. [PMID: 35232507 PMCID: PMC9437149 DOI: 10.1017/s095457942100184x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Perceived threat in youth's environments can elevate risk for mental health, social, and neurocognitive difficulties throughout the lifespan. However, few studies examine variability in youth's perceptions of threat across multiple contexts or evaluate outcomes across multiple domains, ultimately limiting our understanding of specific risks associated with perceived threats in different contexts. This study examined associations between perceived threat in youth's neighborhood, school, and family contexts at ages 9-10 and mental health, social, and neurocognitive outcomes at ages 11-12 within a large US cohort (N = 5525) enrolled in the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®). Latent profile analysis revealed four distinct profiles: Low Threat in all contexts, Elevated Family Threat, Elevated Neighborhood Threat, and Elevated Threat in all contexts. Mixed-effect models and post hoc pairwise comparisons showed that youth in Elevated Threat profile had poorer mental health and social outcomes 2 years later. Youth in the Elevated Family Threat profile uniquely showed increased disruptive behavior symptoms, whereas youth in the Elevated Neighborhood Threat profile predominantly displayed increased sleep problems and worse neurocognitive outcomes 2 years later. Together, findings highlight the importance of considering perceptions of threat across multiple contexts to achieve a more nuanced developmental picture.
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Affiliation(s)
- May I. Conley
- Department of Psychology, Yale University, New Haven, CT,
USA
| | | | - Joeann M. Salvati
- Department of Psychiatry and Behavioral Sciences, Feinberg
School of Medicine, Northwestern University, Chicago, IL, USA
| | - Dylan G. Gee
- Department of Psychology, Yale University, New Haven, CT,
USA
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10
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Schroeder K, Sinko L, Ibrahim J, Sarwer DB. Supporting student learning and development through trauma-informed campuses. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 36977341 PMCID: PMC10533736 DOI: 10.1080/07448481.2023.2187647] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 01/29/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Many students come to higher education with a history of trauma. College life may also expose students to traumatizing events. While the past decade has witnessed greater discussion of trauma-informed frameworks, it has not regularly been applied to the college environment. We advance the concept of a trauma-informed campus, where administrators, faculty, staff, and students from diverse disciplines create an environment that recognizes the widespread nature of trauma, integrates knowledge about trauma into practices and procedures, and minimizes further re-traumatization for all community members. A trauma-informed campus is prepared for students' past or future traumatic experiences, while also recognizing and responding to structural and historical harms. In addition, it recognizes the role of the surrounding community challenges, particularly how violence, substance use, hunger, poverty, and housing insecurity may contribute to further trauma or negatively impact healing. We use an ecological model to frame and shape the construct of trauma-informed campuses.
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Affiliation(s)
- Krista Schroeder
- Department of Nursing, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Laura Sinko
- Department of Nursing, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Jennifer Ibrahim
- Department of Academic Affairs and Department of Health Services Administration and Policy, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - David B Sarwer
- Temple University Center for Obesity Research and Education and Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
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11
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Semenza DC, Meldrum RC, Testa A, Jackson DB. Sleep duration, depressive symptoms, and digital self-harm among adolescents. Child Adolesc Ment Health 2022; 27:103-110. [PMID: 33763977 DOI: 10.1111/camh.12457] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study examines the relationship between sleep duration, depression, and engagement in a novel cyber behavior, digital self-harm, among adolescents. METHOD Logistic regression analyses were conducted using cross-sectional data from the 2019 Florida Youth Substance Abuse Survey (N = 9,819; 48% male; avg. grade level = 9th grade [SD = 1.9]) to analyze the association between sleep duration and digital self-harm. A Karlson-Holm-Breen (KHB) analysis was used to assess whether depressive symptoms attenuate this association. RESULTS Bivariate results indicated that longer sleep duration was associated with lower incidence of digital self-harm. Multivariate results showed that sleep duration was inversely associated with engaging in digital self-harm, net of all covariates. Depressive symptoms attenuated the influence of sleep duration on digital self-harm by 50.72%. CONCLUSIONS Both insufficient sleep and depressive symptoms were associated with engagement in digital self-harm among adolescents. Prospective research is needed, however, to confirm this pathway. Practitioners and clinicians should consider discussing digital self-harm with adolescents and parents, especially if adolescents are experiencing poor sleep and depressive symptoms.
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Affiliation(s)
- Daniel C Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, NJ, USA
| | - Ryan C Meldrum
- Department of Criminology and Criminal Justice, Florida International University, Miami, FL, USA
| | - Alexander Testa
- Department of Criminology and Criminal Justice, University of Texas at San Antonio, San Antonio, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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12
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Ursache A, Barajas-Gonzalez RG, Adhikari S, Kamboukos D, Brotman LM, Dawson-McClure S. A quasi-experimental study of parent and child well-being in families of color in the context of COVID-19 related school closure. SSM Popul Health 2022; 17:101053. [PMID: 35284616 PMCID: PMC8914215 DOI: 10.1016/j.ssmph.2022.101053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/17/2021] [Accepted: 02/18/2022] [Indexed: 01/09/2023] Open
Abstract
Families of color living in historically disinvested neighborhoods face a multitude of health disparities which have been exacerbated by COVID-19 and the resulting strategies to mitigate its transmission. School closure, which occurred with little warning and few, if any, resources for preparation, disrupted multiple aspects of families' lives; these disruptions are anticipated to adversely impact mental health and well-being. The current study aims to advance understanding of the experiences of families of young children of color during the pandemic by utilizing a natural experiment design to test impact on child and parent mental health and sleep in the context of COVID-19 related school closure among families in historically disinvested neighborhoods. Data from this study come from an ongoing study of 281 families of color enrolled in 41 pre-kindergarten (pre-K) programs in neighborhoods across New York City (NYC). In NYC, school closure occurred on March 16, 2020, during a data collection period involving phone surveys with parents; the quasi-experimental design allows for comparison of the 198 families who had completed the survey prior to March 16, and the 83 families who completed the survey after March 16, using identical protocols and procedures. Results demonstrate poorer mental health among parents surveyed after school closure as compared to before school closure. No differences were found for parent sleep, child mental health, or child sleep. Implications of this work highlight the need for structural and systemic supports for families faced with compounding stressors as a result of the COVID-19 pandemic and related school closure.
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Affiliation(s)
- Alexandra Ursache
- Department of Population Health, NYU Grossman School of Medicine, USA
| | | | | | - Dimitra Kamboukos
- Department of Population Health, NYU Grossman School of Medicine, USA
| | - Laurie M. Brotman
- Department of Population Health, NYU Grossman School of Medicine, USA
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13
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Neighborhood Disadvantage Is Associated with Lower Quality Sleep and More Variability in Sleep Duration among Urban Adolescents. J Urban Health 2022; 99:102-115. [PMID: 34988778 PMCID: PMC8866582 DOI: 10.1007/s11524-021-00570-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2021] [Indexed: 02/03/2023]
Abstract
Differential social and contextual environments may contribute to adolescent sleep disparities, yet most prior studies are limited to self-reported sleep data and have not been conducted at a national level, limiting the variation in neighborhood contexts. This study examined the association between neighborhood disadvantage and objective measures of adolescent sleep. A racially and geographically diverse sample of American adolescents (N = 682) wore wrist-worn accelerometers, "actigraphs," for ≥ 5 nights. Neighborhood disadvantage was calculated using a standardized index of neighborhood characteristics (proportion of female-headed households, public assistance recipients, households in poverty, adults without high school degrees, and unemployed). Adolescents in more disadvantaged neighborhoods spent more time awake after falling asleep (4.0 min/night, p < .05), a greater percentage of nighttime sleep intervals awake (1%, p < .01), and had less consistent sleep duration (11.6% higher standard deviation, p < .05). Sleep duration and timing did not differ across neighborhood groups. These findings demonstrate that adolescents who live in more disadvantaged neighborhoods have lower quality, less consistent sleep.
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14
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Ursache A, Robbins R, Chung A, Dawson-McClure S, Kamboukos D, Calzada E, Jean-Louis G, Brotman LM. Sleep, Classroom Behavior, and Achievement Among Children of Color in Historically Disinvested Neighborhoods. Child Dev 2021; 92:1932-1950. [PMID: 34041742 PMCID: PMC9074088 DOI: 10.1111/cdev.13590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Children of color are more likely to have poor sleep health than White children, placing them at risk for behavioral problems in the classroom and lower academic performance. Few studies, however, have utilized standardized measures of both classroom behavior and achievement. This study examined whether children's sleep (parent and teacher report) in first grade concurrently related to independent observations of classroom behavior and longitudinally predicted achievement test scores in second grade in a sample of primarily Black (86%) children (n = 572; age = 6.8) living in historically disinvested neighborhoods. Higher teacher-reported child sleepiness was associated with lower adaptive behaviors and higher problem behaviors in the classroom, and predicted lower achievement. Parent-reported bedtime resistance and disordered breathing also predicted lower achievement.
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Affiliation(s)
- Alexandra Ursache
- Department of Population Health, NYU Grossman School of Medicine, 227 East 30th Street, New York, NY 10016
| | - Rebecca Robbins
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115
- Department of Sleep and Circadian Disorders, Brigham and Women’s Hospital, 75 Francis St., Boston, MA 02115
| | - Alicia Chung
- Department of Population Health, NYU Grossman School of Medicine, 227 East 30th Street, New York, NY 10016
| | - Spring Dawson-McClure
- Department of Population Health, NYU Grossman School of Medicine, 227 East 30th Street, New York, NY 10016
| | - Dimitra Kamboukos
- Department of Population Health, NYU Grossman School of Medicine, 227 East 30th Street, New York, NY 10016
| | - Esther Calzada
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712
| | - Girardin Jean-Louis
- Department of Population Health, NYU Grossman School of Medicine, 227 East 30th Street, New York, NY 10016
| | - Laurie Miller Brotman
- Department of Population Health, NYU Grossman School of Medicine, 227 East 30th Street, New York, NY 10016
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15
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Berg KA, Francis MW, Ross K, Spilsbury JC. Opportunities to improve sleep of children exposed to interpersonal violence: A social-ecological perspective. CHILDREN AND YOUTH SERVICES REVIEW 2021; 127:106082. [PMID: 36090582 PMCID: PMC9455662 DOI: 10.1016/j.childyouth.2021.106082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Over 25% of U.S. children are witness to traumatic intrafamilial or community violence each year, and sleep medicine and developmental research jointly suggest that trauma-exposed youth experience more sleep disturbance than their non-exposed counterparts. Sleep medicine literature emphasizes physical and social environmental factors affecting sleep, and trauma literature underscores children's seeking out physically and emotionally safe and predictable environments during trauma recovery. This study employed a hermeneutic phenomenological framing to explore the lived experiences of 65 violence-exposed children and families, and to examine how youths' social and physical sleep environments facilitated or impeded sleep in the aftermath of trauma. Children's sleep experiences following violence exposure shared two primary essences of experience: a) navigating external threats that agitated sleep after trauma; and b) exercising agency over sleep and related environments to restabilize emotional security. Clinicians and social services coordinators working with children and families are uniquely positioned to indicate sleep assessments as part of treatment following trauma, and to also facilitate identification of tangible, sleep-supportive and changeable factors in sleep environments.
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Affiliation(s)
- Kristen A. Berg
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, United States
| | - Meredith W. Francis
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, United States
| | - Kristie Ross
- School of Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, United States
| | - James C. Spilsbury
- School of Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, United States
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16
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Mayne SL, Mitchell JA, Virudachalam S, Fiks AG, Williamson AA. Neighborhood environments and sleep among children and adolescents: A systematic review. Sleep Med Rev 2021; 57:101465. [PMID: 33827031 PMCID: PMC8164975 DOI: 10.1016/j.smrv.2021.101465] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 01/04/2021] [Accepted: 02/26/2021] [Indexed: 01/31/2023]
Abstract
Understanding salient environmental determinants of pediatric sleep is essential for informing interventions and public health initiatives. Emerging evidence suggests that the neighborhood environment can impact pediatric sleep, but this evidence has not yet been systematically reviewed. We conducted a systematic review of the scientific literature on associations between neighborhood environments and sleep in young children (0-5 y), school-aged children (6-12 y) and adolescents (13-18 y). We reviewed 85 articles published between 2003 and 2020. The most commonly examined neighborhood exposure was low socioeconomic status (40 studies), which was associated with sleep outcomes in 58% of studies (primarily shorter sleep duration, later sleep timing, or obstructive sleep apnea). Evidence was stronger for neighborhood safety/crime/violence (21 studies), with 86% of studies reporting associations with sleep outcomes (primarily self- or caregiver-reported sleep problems). Fewer studies examined associations of neighborhood physical environment exposures, including noise (15 studies), the built environment (seven studies), and air pollution (six studies). Limitations of the current body of evidence include 1) limited examination of neighborhood exposures other than socioeconomic status or safety, 2) use of primarily cross-sectional observational study designs, 3) lack of objective sleep outcome assessment, and 4) limits of current exposure assessment methods.
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Affiliation(s)
- Stephanie L Mayne
- The Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, USA; The Possibilities Project, Children's Hospital of Philadelphia, Philadelphia, USA; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA.
| | - Jonathan A Mitchell
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA; Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Senbagam Virudachalam
- The Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, USA; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA
| | - Alexander G Fiks
- The Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, USA; The Possibilities Project, Children's Hospital of Philadelphia, Philadelphia, USA; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA
| | - Ariel A Williamson
- The Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, USA; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA; Sleep Center, Children's Hospital of Philadelphia, Philadelphia, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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17
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Mori Y, Tiiri E, Khanal P, Khakurel J, Mishina K, Sourander A. Feeling Unsafe at School and Associated Mental Health Difficulties among Children and Adolescents: A Systematic Review. CHILDREN-BASEL 2021; 8:children8030232. [PMID: 33802967 PMCID: PMC8002666 DOI: 10.3390/children8030232] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 11/16/2022]
Abstract
This study systematically reviewed the literature on perceived school safety. We investigated the prevalence, factors and associated mental health difficulties, as well as cross-cultural findings. Five databases were searched up to 9 February 2021 for peer-reviewed papers published in English. We included quantitative studies that explored the perception of school safety among children and adolescents. The reference lists of the selected papers were also searched. We conducted a narrative synthesis of the included studies. The review included 43 papers. The mean prevalence of the students who felt unsafe at school was 19.4% and ranged from 6.1% to 69.1%. Their perceived safety was associated with a wide range of personal, school, and social factors. Not feeling safe at school was related to being victimized and mental health difficulties, including depressive symptoms and suicidal behavior. Higher perceived school safety was associated with measures such as the presence of a security officer and fair school rule enforcement. The results showed the lack of cross-cultural studies on perceived school safety. Empirical studies are needed that examine the mechanisms of school safety, using valid measures. A clear definition of school safety should be considered a key aspect of future studies.
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Affiliation(s)
- Yuko Mori
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Correspondence:
| | - Elina Tiiri
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Department of Child Psychiatry, University of Turku and Turku University Hospital, 20521 Turku, Finland
| | - Prakash Khanal
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
| | - Jayden Khakurel
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
| | - Kaisa Mishina
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Department of Nursing Science, University of Turku, 20014 Turun Yliopisto, Finland
| | - Andre Sourander
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Department of Child Psychiatry, University of Turku and Turku University Hospital, 20521 Turku, Finland
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18
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The association between excessive screen-time behaviors and insufficient sleep among adolescents: Findings from the 2017 youth risk behavior surveillance system. Psychiatry Res 2019; 281:112586. [PMID: 31629305 DOI: 10.1016/j.psychres.2019.112586] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 12/21/2022]
Abstract
Although studies have examined the association between television viewing and poor sleep quality, few studies have considered the association between excessive screen-time behaviors and insufficient sleep among adolescents drawing on a large nationally representative sample. The objective of this study was to examine the association between excessive screen-time behaviors and insufficient sleep among adolescents. Data for this study came from the 2017 Youth Risk Behavior Survey. A sample of 14,603 adolescents aged 14-18 years (51.5% female) was analyzed using logistic regression with insufficient sleep as the outcome variable and excessive screen-time behaviors as the main explanatory variable. Of the 14,603 adolescents, almost three out of four (74.8%) had less than 8 h of sleep on an average school night, and about 43% engaged in excessive screen-time behaviors on an average school day. Controlling for all other predictors, odds were 1.34 times higher for adolescents who engaged in excessive screen-time behaviors to have insufficient sleep when compared to adolescents who did not engage in excessive screen-time behaviors (AOR = 1.34, p < .001, 95% CI = 1.22-1.48). School-based behavior interventions that focus on reduction in excessive screen-time and sedentary behaviors might be beneficial in reducing excessive screen-time behaviors and consequently improve sleep quality among adolescents.
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