Parental modeling, education and children's sports and TV time: the ENERGY-project

Which aspects of education are health protective? a life course examination of early education and adulthood cardiometabolic health in the 30-year study of early child care and Youth Development (SECCYD)

BACKGROUND

Past research describes robust associations between education and health, yet findings have generally been limited to the examination of education as the number of years of education or educational attainment. Little is known about the specific features or processes underpinning education that are health protective. The objective of the current study was to address this gap by examining specific aspects of early education pertaining to student characteristics and experiences, as well as features of the classroom environment, in predicting cardiometabolic health in adulthood.

METHODS

Subjects were 1364 participants in the NICHD Study of Early Child Care and Youth Development (SECCYD, 1991-2009) and recent SECCYD 30-year follow-up, the Study of Health in Early and Adult Life (SHINE, 2018-2022). Models examined individual education indicators (student social skills, student-teacher relationship quality, and classroom emotional and instructional quality in the period of elementary school and student academic performance between ages 54 months and 15 years) in relation to a composite of cardiometabolic risk in adulthood (ages 26-31), reflecting central adiposity, blood pressure, insulin resistance, inflammation, and dyslipidemia. Models were adjusted for key explanatory factors including socio-demographics, infant characteristics, parental socioeconomic status (SES), and child health status. Follow-up analyses were performed to test potential mediators of early education effects on adult health, including adult SES (educational attainment, household income) and health behaviors (diet quality, activity level, sleep duration, smoking).

RESULTS

In adjusted models, results showed greater student social skills, indexed by a mean of annual teacher ratings between kindergarten and 6th grade, predicted lower cardiometabolic risk in adulthood (β=-0.009, p <.05). In follow-up analyses, results showed the protective effect of student social skills on cardiometabolic risk may be mediated by adult income (β=-0.0014, p <.05) and diet quality (β=-0.0031, p <.05). Effects of the other early education indicators were non-significant (ps > 0.05).

CONCLUSIONS

Findings point to the potential significance of early student social competence as a link to long-term health, possibly via the acquisition of resources needed for the maintenance of health, as well as through engagement in health behaviors supporting healthy eating. However, more research is needed to replicate these findings and to elaborate on the role of early student social competence and the pathways explaining its effects on cardiometabolic health in adulthood.

Reducing Screen-Based Sedentary Behavior Among Overweight and Obese Hispanic Adolescents Through a Family-Based Intervention

BACKGROUND

Sedentary behaviors, including screen-based activities, are associated with obesity, cardiovascular, and mental health risks. In the US, minority and socioeconomically disadvantaged youth engage in substantial sedentariness, requiring targeted interventions. Familias Unidas for Health and Wellness (FUHW) is a family intervention to reduce risks among Hispanic youth with overweight and obesity. Analyses examined (1) FUHW's impact on parent and adolescent screen-based sedentary behavior and (2) differential intervention effects by adolescent gender, internalizing symptoms, and body mass index.

METHODS

A total of 280 overweight/obese Hispanic middle schoolers and parents were randomized to FUHW or control and assessed at baseline, 6, 12, and 24 months between 2015 and 2019.

RESULTS

Linear growth models showed that exposure to FUHW was not associated with parent sedentary behavior over time (b = -0.11, P = .32) but was associated with decreases in adolescent sedentary behavior (b = -0.27, P = .03). Neither gender nor internalizing symptoms moderated intervention effects, but there were differential effects by body mass index. Compared to controls, FUHW showed significant decreases in sedentary behavior among overweight (b = -0.85, P < .01) and obese (b = -0.79, P < .01) youth but not severely obese youth.

CONCLUSIONS

FUHW reduced youth screen-based sedentary behavior. Youth with severe obesity require additional intervention.

Physical Activity in Adolescents Living in Rural and Urban New Caledonia: The Role of Socioenvironmental Factors and the Association With Weight Status

Physical activity (PA) is an important factor for the prevention of overweight and obesity, particularly during adolescence. This study focuses on the understudied adolescent population of New Caledonia with the aim to (1) determine the daily PA levels and estimate the sedentary time through out-of-school sitting time; (2) highlight the influence of sociodemographic and environmental factors, and (3) assess the associations of PA and sitting time with overweight and obesity. A sample of 508 school-going adolescents living in New Caledonia was surveyed about their PA habits using the International Physical Activity Questionnaire-Short Form, as well as about the context in which they usually engage in PA. The influences of the place of living and ethnic community were also investigated. Results indicated that about 66% of the adolescents performed an average of at least 60 min of PA daily. Both Melanesian adolescent boys and girls were more active than Caucasian adolescents but only when they lived in rural areas (females: 115 vs. 93 min/day, p = 0.018; males: 133 vs. 97 min/day, p = 0.018). Indeed, PA was reduced in an urban environment (females: 88 min/day; males: 95 min/day, p = 0.028; rural vs. urban in Melanesian adolescents). Melanesian adolescents also spent less time in out-of-school sitting than Caucasian adolescents independently of where they lived (females: 164 vs. 295 min/day, p < 0.001; males: 167 vs. 239 min/day, p = 0.001). Feeling safe was positively associated with PA levels (females: OR_adj = 2.85, p < 0.001; males: OR_adj = 4.45, p < 0.001). In the adolescent boys, accessibility to a suitable place was also an important factor (OR_adj = 2.94, p = 0.002). Finally, while PA and sitting time were negatively associated with overweight in male adolescents (OR_adj = 0.28, p = 0.044 and OR_adj = 0.39, p = 0.004), they were not in females. Living in a rural area allowed the Melanesian adolescents to maintain a more active lifestyle with more physical activities and less sitting time. Our results also indicated that safety was an important driver for engagement in PA. The urban environment in New Caledonia appears to be a contributor of a less active lifestyle in adolescents.

Maternal Education Level and Excessive Recreational Screen Time in Children: A Mediation Analysis

There is increasing recognition of the adverse health consequences of excessive recreational screen time (RST) in children and adolescents. Early interventions that aim to reduce RST are crucial, but there are some controversies about which individual and parental variables affect RST in children. The aim of this study was to determine the relationship of parental education level with RST in children and early adolescents and to identify mediators of these relationships. This cross-sectional study examined a sample of children (2–14 year-old) who attended routine childcare visits in primary health care centers in Spain (n = 402; 53.7% males; mean age: 7 ± 4 year-old). A self-reported questionnaire was given to the parents to assess sociodemographic data, parental education, the home media environment, and RST in children. Separate analysis was performed for two age groups (2–6 year-old and 6–14 year-old). Path analysis, an application of structural equation modeling, was used to analyze the data. Fitty three percent of the children had excessive RST (≥2 h/day). The maternal education level, eating lunch/dinner in front of a TV, presence of a background TV, and the amount of parental TV viewing had significant associations with excessive RST in both age groups. For the younger group, the maternal education level had direct and indirect effects on RST (total effect: β = −0.29, p < 0.01). For the older group, maternal education level only had a significant indirect effect on RST, and this was mediated by the presence of a background TV and the time of parental TV viewing (total indirect effect: β = −0.11, p < 0.01). A higher maternal education level appears to be associated with certain environmental factors or habits that prevent excessive RST.

Family characteristics and children's knowledge of cardiovascular risk factors

BACKGROUND

Cardiovascular disease has the highest mortality rate than any other disease globally. Some major risk factors seem to be established in the early stages of life, suggesting preventive strategies as a major means to reduce cardiovascular mortality. The aim of the present study was to investigate the role of socioeconomic status and family characteristics on children's knowledge and perceptions concerning cardiovascular disease risk factors.

METHODS

A cross-sectional survey was conducted among 1,728 children (46% male) aged 10-12 years, attending Greek primary schools in Athens; Heraklion (capital city of the island of Crete); Kalamata; Pyrgos; and Sparti (Peloponnese peninsula), Greece. Sampling was conducted on school premises, during the school years 2014-15 and 2015-16 (participation rate, 95-100%). Data were collected via self-administered, anonymous questionnaire. Children's knowledge of various issues related to cardiovascular risk, such as nutrition, physical activity and smoking was also examined. Data on family characteristics were collected through another questionnaire completed by parents.

RESULTS

Paternal education level and living with both parents instead of single-parent upbringing, were positively associated with children's knowledge of cardiovascular risk factors (b = 0.42; 95%CI: 0.01-0.83; P = 0.04; and b = 0.78; 95%CI: 0.013-1.43; P = 0.02 respectively). Moreover, children with more siblings seemed to have less sufficient knowledge compared with peers with fewer siblings (b per 1 sibling = -0.24; 95%CI: -0.47 to -0.014; P = 0.04).

CONCLUSIONS

The present findings enhance the link between the micro-environment and children's knowledge and perceptions concerning cardiovascular health, providing information to health-care professionals while counseling youths.

Socioeconomic Correlates of Sedentary Behavior in Adolescents: Systematic Review and Meta-Analysis

Background

The body of evidence on associations between socioeconomic status (SES) and sedentary behaviors in adolescents is growing.

Objectives

The overall aims of our study were to conduct a systematic review and meta-analysis of this evidence and to assess whether (1) the associations between SES and sedentary behavior are consistent in adolescents from low-middle-income and from high-income countries, (2) the associations vary by domain of sedentary behavior, and (3) the associations vary by SES measure.

Methods

We performed a systematic literature search to identify population-based studies that investigated the association between SES and sedentary behavior in adolescents (aged 10–19 years). Only studies that presented risk estimates were included. We conducted meta-analyses using random effects and univariate meta-regression and calculated pooled effect sizes (ES).

Results

Data from 39 studies were included; this provided 106 independent estimates for meta-analyses. Overall, there was an inverse association between SES and sedentary behavior (ES 0.89; 95 % confidence interval [CI] 0.81–0.98). However, the direction of the association varied: in high-income countries, SES was inversely associated with sedentary behavior (ES 0.67; 95 % CI 0.62–0.73), whereas in low-middle-income countries, there was a positive association between SES and sedentary behavior (ES 1.18; 95 % CI 1.04–1.34). In high-income countries, the associations were strongest for screen time (ES 0.68; 95 % CI 0.62–0.74) and television (TV) time (ES 0.58; 95 % CI 0.49–0.69), whereas in low-middle-income countries, the associations were strongest for ‘other’ screen time (i.e., computer, video, study time, but not including TV time) (ES 1.38; 95 % CI 1.07–1.79). All indicators of SES were negatively associated with sedentary behavior in high-income countries, but only resources (income and assets indexes) showed a significant positive association in low-middle-income countries.

Conclusion

The associations between SES and sedentary behavior are different in high- and low-middle-income countries, and vary by domain of sedentary behavior. These findings suggest that different approaches may be required when developing intervention strategies for reducing sedentary behavior in adolescents in different parts of the world.

Electronic supplementary material

The online version of this article (doi:10.1007/s40279-016-0555-4) contains supplementary material, which is available to authorized users.

Individual and family environmental correlates of television and computer time in 10- to 12-year-old European children: the ENERGY-project

Background

The aim was to investigate which individual and family environmental factors are related to television and computer time separately in 10- to-12-year-old children within and across five European countries (Belgium, Germany, Greece, Hungary, Norway).

Methods

Data were used from the ENERGY-project. Children and one of their parents completed a questionnaire, including questions on screen time behaviours and related individual and family environmental factors. Family environmental factors included social, political, economic and physical environmental factors. Complete data were obtained from 2022 child–parent dyads (53.8 % girls, mean child age 11.2 ± 0.8 years; mean parental age 40.5 ± 5.1 years). To examine the association between individual and family environmental factors (i.e. independent variables) and television/computer time (i.e. dependent variables) in each country, multilevel regression analyses were performed using MLwiN 2.22, adjusting for children’s sex and age.

Results and discussion

In all countries, children reported more television and/or computer time, if children and their parents thought that the maximum recommended level for watching television and/or using the computer was higher and if children had a higher preference for television watching and/or computer use and a lower self-efficacy to control television watching and/or computer use. Most physical and economic environmental variables were not significantly associated with television or computer time. Slightly more individual factors were related to children’s computer time and more parental social environmental factors to children’s television time. We also found different correlates across countries: parental co-participation in television watching was significantly positively associated with children’s television time in all countries, except for Greece. A higher level of parental television and computer time was only associated with a higher level of children’s television and computer time in Hungary. Having rules regarding children’s television time was related to less television time in all countries, except for Belgium and Norway.

Conclusions

Most evidence was found for an association between screen time and individual and parental social environmental factors, which means that future interventions aiming to reduce screen time should focus on children’s individual beliefs and habits as well parental social factors. As we identified some different correlates for television and computer time and across countries, cross-European interventions could make small adaptations per specific screen time activity and lay different emphases per country.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-2276-2) contains supplementary material, which is available to authorized users.