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Wright AL, Butt ML, Valerio C, Ahmed O, Russell LM, Ferron EM. The experiences of gender and sexually diverse parents using support and services for their young children: An integrative review. J Clin Nurs 2024; 33:2476-2495. [PMID: 38284462 DOI: 10.1111/jocn.17036] [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: 06/02/2023] [Revised: 12/11/2023] [Accepted: 01/07/2024] [Indexed: 01/30/2024]
Abstract
AIM To address: What are the experiences of 2SLGBTQQIA+ parents using parenting supports and services to meet their children's early childhood development needs (<5 years of age)? DESIGN Whittemore and Knafl's (2005) integrative review methodology. METHODS Electronic databases were searched from 2000 to October 14, 2022 for empirical studies or reviews addressing the research question. The title and abstract of 12,158 articles were screened for inclusion in the review by two independent researchers; 175 of these articles underwent full-text review. Studies selected were critically appraised using a Joanna Briggs Institute Critical Appraisal tool. Relevant key findings were extracted from each study and entered into N-VIVO-12. Thematic content analysis was employed and PRISMA guidelines were adhered to. RESULTS A total of 18 articles (15 qualitative and three multi-method studies) met the inclusion criteria and were selected for the review. Seven themes were revealed from analysis of the studies: (1) 2SLGBTQQIA+ Status kept a secret; (2) Forced to come out; (3) Heteronormative messaging; (4) Feeling excluded; (5) Stigmatised; (6) Parents act as educators; and (7) Positive experiences. CONCLUSION This integrative review provides nurses with insight into the experiences of 2SLGBTQQIA+ parents using health care services for their young child. IMPLICATIONS FOR THE PROFESSION This article highlights what changes nurses need to make to their practice to ensure appropriate, inclusive care for clients of diverse sexual and gender identities and their families. IMPACT Health care providers, especially nurses, have an opportunity to improve the experiences of these families and positively impact their health and well-being. Additionally, there is a need for research with the 2SLGBTQQIA+ parent community and the use of rigorous methodological techniques, including clearly linking participants' gender and sexual identities with study findings, to improve our understanding of 2SLGBTQQIA+ parent experiences. PATIENT OR PUBLIC CONTRIBUTION Although there was no direct patient contribution to the work since it was an integrative review of the literature, indirectly patient contributions are incorporated from the original research results of studies incorporated into this review.
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Affiliation(s)
- Amy L Wright
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Michelle L Butt
- School of Nursing and Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Claudia Valerio
- College of Early Childhood Educators, Toronto, Ontario, Canada
| | - Ossaid Ahmed
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Lisa M Russell
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Era Mae Ferron
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Alijanzadeh M, RajabiMajd N, RezaeiNiaraki M, Griffiths MD, Alimoradi Z. Prevalence and socio-economic determinants of growth and developmental delays among Iranian children aged under five years: A cross sectional study. BMC Pediatr 2024; 24:412. [PMID: 38926691 PMCID: PMC11201323 DOI: 10.1186/s12887-024-04880-2] [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: 10/27/2023] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND The main cause of growth and development delays remains unknown, but it can occur as an interaction between genetic, environmental, and socio-economic factors. OBJECTIVE The aim of the study was to investigate the prevalence and social determinants of growth and developmental delays among children aged under five years in Qazvin, Iran. METHODS A cross-sectional study was conducted between January 2019 to December 2020 with participation of 1800 mothers with children aged 4-60 months who were referred to comprehensive health centers in Qazvin city, Iran. Structural and intermediate social determinants of health were assessed including: parents and children socio-demographic characteristics, families' living and economic status, parents' behavioral factors, household food security, mother's general health, and perceived social support. Children's growth was assessed based on their anthropometric assessment and their development was assessed using their age-specific Ages and Stages Questionnaire. Data were analyzed using univariable and multivariable logistic regression models using SPSS software version 24 and Stata version 14. RESULTS The prevalence of developmental problems in each domain were 4.28% for personal and social delay, 5.72% for gross motor delay, 6.5% for communication delay, 6.72% for fine motor delay, and 8% for problem-solving delay. The prevalence of weight growth delays was 13.56% and height growth delays was 4.66%. Communication, gross motor, and problem-solving delays were higher among children whose fathers' smoked cigarettes. Fine motor delays were lower among mothers with education status of high school diploma and university degree vs. the under diploma group. Personal and social delay was significantly higher among families with fair economic status and lower among children when their fathers were employed (vs. unemployed). Weight and height growth delays were higher among mothers who had experienced pregnancy complications and household food insecure families, respectively. CONCLUSION There are different predictors of growth and developmental delay problems among Iranian children aged under five years including fathers' smoking, families' economic status, and household food insecurity as well as history of mothers' pregnancy complications. The present study's findings can be used to screen for at-risk of growth and developmental delays among children and could help in designing and implementation of timely interventions.
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Affiliation(s)
- Mehran Alijanzadeh
- Social Determinants of Health Research Center, Research Institute for prevention of Non- Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Nilofar RajabiMajd
- Social Determinants of Health Research Center, Research Institute for prevention of Non- Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Masoumeh RezaeiNiaraki
- Social Determinants of Health Research Center, Research Institute for prevention of Non- Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for prevention of Non- Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
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Kurbatfinski S, Komanchuk J, Dosani A, Letourneau N. Validity, Reliability, Accessibility, and Applicability of Young Children's Developmental Screening and Assessment Tools across Different Demographics: A Realist Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:745. [PMID: 38929324 PMCID: PMC11201752 DOI: 10.3390/children11060745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/09/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024]
Abstract
Valid and reliable developmental screening and assessment tools allow professionals to identify disabilities/delays in children, enabling timely intervention to limit adverse lifelong impacts on health. However, differences in child development related to culture, genetics, and perinatal outcomes may impact tool applicability. This study evaluated the validity, reliability, and accessibility of multidomain developmental screening tools for young children, analyzed the applicability of tools across different contexts, and created a compendium of tools. Employing adapted realist review methods, we searched APA PsycInfo, MEDLINE, CINAHL, ERIC, and Google to identify relevant articles and information. We assessed accessibility, validity, reliability, and contextual applicability (N = 4110 evidence sources) to create tool ratings and make recommendations. Of 33 identified tools, 22 were screening and 11 were assessment tools. Fewer screening tools than assessment tools were rated highly overall. Evidence for use in different cultures was often lacking for both types of tools. The ASQ (screening) and BDI (assessment) tools were rated most favorably and are recommended for use, though other tools may be more applicable in different contexts (e.g., NEPSY among children with Asperger's Syndrome). Future research should focus on assessing the validity and reliability of tools across different demographics to increase accessibility and ensure all children are properly supported.
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Affiliation(s)
- Stefan Kurbatfinski
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Jelena Komanchuk
- Faculty of Health and Social Development, School of Nursing, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada;
| | - Aliyah Dosani
- Faculty of Health, Community and Education, School of Nursing and Midwifery, Mount Royal University, Calgary, AB T3E 6K6, Canada;
| | - Nicole Letourneau
- Faculties of Nursing & Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
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Plavnicka J, Chovan S, Filakovska Bobakova D. Understanding the Impact of Socioeconomic Factors on Early Childhood Development in Marginalised Roma Communities: The Role of Parental Education and Household Equipment. CHILDREN (BASEL, SWITZERLAND) 2024; 11:622. [PMID: 38929202 PMCID: PMC11201684 DOI: 10.3390/children11060622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/21/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024]
Abstract
This study aimed to explore the effect of socioeconomic disadvantage accumulated in marginalised Roma communities (MRCs) on early childhood development and to assess the role of selected socioeconomic indicators in the association between belonging to MRCs vs. the majority and early childhood development. We obtained cross-sectional data from 232 mother-child dyads from MRCs and the majority population. The differences in early childhood development and background variables between the two groups were tested using chi-square and Mann-Whitney U tests. The moderated mediation was tested using PROCESS Macro in SPSS Model 14 on 5000 bootstrap samples. Statistically significant differences between children from MRCs and the majority were found in terms of maternal age, parental education, household equipment, as well as early childhood development. Household equipment moderated the indirect effect of being from MRCs vs. the majority on early childhood development through parental education. The indirect effect through parental education was high at a low household equipment level, reduced at an average level and non-significant at a high level of household equipment. Our study uncovered disparities in early childhood development between children from MRCs and the majority population. Parental education significantly influenced developmental outcomes, while household equipment mitigated its impact.
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Affiliation(s)
- Jana Plavnicka
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, 041 11 Kosice, Slovakia; (S.C.); (D.F.B.)
| | - Shoshana Chovan
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, 041 11 Kosice, Slovakia; (S.C.); (D.F.B.)
| | - Daniela Filakovska Bobakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, 041 11 Kosice, Slovakia; (S.C.); (D.F.B.)
- Olomouc University Social Health Institute, Palacky University in Olomouc, 771 11 Olomouc, Czech Republic
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Taylor J, Majeed T, Remond M, Bagade T, Edwards L, Austin K, Smith E, Howard M, Sullivan E. A rapid review of the evidence on models of service delivery for correctional centre-based mothers and children's units: does our approach need to change? BMJ Glob Health 2024; 9:e012979. [PMID: 38770813 PMCID: PMC11085710 DOI: 10.1136/bmjgh-2023-012979] [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: 05/29/2023] [Accepted: 01/16/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Incarcerated mothers are a marginalised group who experience substantial health and social disadvantage and routinely face disruption of family relationships, including loss of custody of their children. To support the parenting role, mothers and children's units (M&Cs) operate in 97 jurisdictions internationally with approximately 19 000 children reported to be residing with their mothers in custody-based settings. AIM This rapid review aims to describe the existing evidence regarding the models of service delivery for, and key components of, custodial M&Cs. METHOD A systematic search was conducted of four electronic databases to identify peer-reviewed literature published from 2010 onwards that reported quantitative and qualitative primary studies focused on custody-based M&Cs. Extracted data included unit components, admission and eligibility criteria, evaluations and recommendations. RESULTS Of 3075 records identified, 35 met inclusion criteria. M&Cs accommodation was purpose-built, incorporated elements of domestic life and offered a family-like environment. Specific workforce training in caring for children and M&Cs evaluations were largely absent. Our systematic synthesis generated a list of key components for M&C design and service delivery. These components include timely and transparent access to information and knowledge for women, evaluation of the impact of the prison environment on M&C, and organisational opportunities and limitations. CONCLUSION The next generation of M&Cs requires evidence-based key components that are implemented systematically and is evaluated. To achieve this, the use of codesign is a proven method for developing tailored programmes. Such units must offer a net benefit to both mothers and their children.
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Affiliation(s)
- Jo Taylor
- The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Tazeen Majeed
- The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Marc Remond
- The University of Newcastle, Callaghan, New South Wales, Australia
| | - Tanmay Bagade
- The University of Newcastle, Callaghan, New South Wales, Australia
| | - Layla Edwards
- University of Technology, Sydney, New South Wales, Australia
| | - Kelly Austin
- Corrective Services New South Wales, Sydney, New South Wales, Australia
| | - Emma Smith
- Corrective Services New South Wales, Sydney, New South Wales, Australia
| | - Mark Howard
- Corrective Services New South Wales, Sydney, New South Wales, Australia
| | - Elizabeth Sullivan
- The University of Newcastle, Callaghan, New South Wales, Australia
- Justice Health and Forensic Mental Health Network, Matraville, New South Wales, Australia
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Abo Hamza E, Tindle R, Pawlak S, Bedewy D, Moustafa AA. The impact of poverty and socioeconomic status on brain, behaviour, and development: a unified framework. Rev Neurosci 2024; 0:revneuro-2023-0163. [PMID: 38607658 DOI: 10.1515/revneuro-2023-0163] [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: 12/31/2023] [Accepted: 03/17/2024] [Indexed: 04/13/2024]
Abstract
In this article, we, for the first time, provide a comprehensive overview and unified framework of the impact of poverty and low socioeconomic status (SES) on the brain and behaviour. While there are many studies on the impact of low SES on the brain (including cortex, hippocampus, amygdala, and even neurotransmitters) and behaviours (including educational attainment, language development, development of psychopathological disorders), prior studies did not integrate behavioural, educational, and neural findings in one framework. Here, we argue that the impact of poverty and low SES on the brain and behaviour are interrelated. Specifically, based on prior studies, due to a lack of resources, poverty and low SES are associated with poor nutrition, high levels of stress in caregivers and their children, and exposure to socio-environmental hazards. These psychological and physical injuries impact the normal development of several brain areas and neurotransmitters. Impaired functioning of the amygdala can lead to the development of psychopathological disorders, while impaired hippocampus and cortex functions are associated with a delay in learning and language development as well as poor academic performance. This in turn perpetuates poverty in children, leading to a vicious cycle of poverty and psychological/physical impairments. In addition to providing economic aid to economically disadvantaged families, interventions should aim to tackle neural abnormalities caused by poverty and low SES in early childhood. Importantly, acknowledging brain abnormalities due to poverty in early childhood can help increase economic equity. In the current study, we provide a comprehensive list of future studies to help understand the impact of poverty on the brain.
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Affiliation(s)
- Eid Abo Hamza
- College of Education, Humanities & Social Sciences, 289293 Al Ain University , 64141, Al Jimi, UAE
- Faculty of Education, Tanta University, Al-Geish St., 122011, Tanta, Egypt
| | - Richard Tindle
- JMS Allied Services, 1109 Coffs Harbour , NSW, 2452, Australia
| | - Simon Pawlak
- Department of Psychological Sciences, Swinburne University of Technology, John Street, Hawthorn, VIC 3122, Australia
| | - Dalia Bedewy
- Department of Psychology, College of Humanities and Sciences, 59104 Ajman University , University Street, Al jerf 1, Ajman, UAE
- Department of Psychology, Faculty of Education, Tanta University, Al-Geish St., 122011, Tanta, Egypt
- 59104 Humanities and Social Sciences Research Center (HSSRC), Ajman University , University Street, Al jerf 1, Ajman, UAE
| | - Ahmed A Moustafa
- Department of Human Anatomy and Physiology, The Faculty of Health Sciences, University of Johannesburg, Cnr Kingsway & University Roads, Auckland Park, Johannesburg, 2092, South Africa
- School of Psychology, Faculty of Society and Design, 448704 Bond University , 14 University Dr, Robina QLD 4226, Gold Coast, QLD, Australia
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Lind A, Mason SM, Brady SS. Investing in family-centered early childhood education: A conceptual model for preventing firearm homicide among Black male youth in the United States. Prev Med 2024; 181:107917. [PMID: 38408647 PMCID: PMC10947821 DOI: 10.1016/j.ypmed.2024.107917] [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: 10/25/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Firearms are now the number one killer of children and adolescents in the United States. Firearm homicides among Black male youth are the driver of this increase. Prevention requires a multi-faceted life course approach. Academic achievement has been identified as a protective factor. Early childhood education, which is linked to later achievement, is thus an intervention area of interest. Conceptualizing the potential links between early childhood education and reduced risk for youth firearm homicide is important for guiding policy advocacy and informing future research. METHODS This paper presents a conceptual model linking early childhood education to reduced risk for firearm homicide. Each link in the model is discussed, and a corresponding review of the literature is presented. The need for anti-racist policies to strengthen the impact of early childhood education is highlighted. RESULTS Early education and firearm homicide research are each well-established but largely disconnected. There are clear immediate benefits of early childhood education; however, these effects wane with time, particularly for youth of color. At the same time, juvenile delinquency-a major risk factor for firearm homicide-is influenced by educational inequities. CONCLUSIONS Effective interventions to reduce firearm homicides among Black male youth in the United States are needed. Early childhood education shows promise as an intervention. However, to have an impact, this education needs to be accessible and affordable for all, particularly families of color and low income. Societal structures and policies must also better support the positive gains seen through early childhood education to avoid dissipation.
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Affiliation(s)
- Allison Lind
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States.
| | - Susan M Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Sonya S Brady
- Department of Family Medicine and Community Health, School of Medicine, University of Minnesota, Minneapolis, MN, United States
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Bentley SE, Garg P, Gudes O, Hurwitz R, Vivekanandarajah S, So LYL. Access to child developmental assessment services in culturally and linguistically diverse metropolitan Sydney: a retrospective cohort analysis. BMC Health Serv Res 2024; 24:342. [PMID: 38486262 PMCID: PMC10941404 DOI: 10.1186/s12913-024-10800-y] [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: 04/18/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Despite the increasing prevalence of neurodevelopmental disorders (NDD), data regarding access to child development services have remained limited globally. Long wait times are a major barrier to developmental assessments, impacting on care and outcomes. The aim is to retrospectively analyse the demographic profile and prioritisation of patients seen at a child developmental assessment service (CDAS) in a vulnerable region of Sydney, and explore factors affecting wait times. METHODS Data was collated and analysed for 2354 patients from 2018 to 2022. Socio-Economic Indexes for Areas (SEIFA) were collated from the Australian Bureau of Statistics. Descriptive statistics were used for demographic data and various statistical methods were used to analyse the relationships and impact of factors likely to affect wait lists. RESULTS The median age was 51 months (IQR41-61) and males comprised 73.7% of the cohort. 64% of children were from culturally and linguistically diverse backgrounds (CALD) and 47% lived in the most disadvantaged suburbs. The median wait time was 302.5 days (IQR175-379) and 70% of children were seen within 12 months. CALD patients and children over 5-years had shorter wait times. Most children with Global Developmental Delay (GDD) were from the lowest four SEIFA deciles and waited longer for an appointment. 42.6% were seen within the priority allocated time or sooner. Children with ASD and/or severe GDD were prioritised to be seen earlier. Overall, the study could not demonstrate any difference in the wait times according to the prioritisation groups. CONCLUSION This study provides insights into the profile, prioritisation processes and wait lists of children seen by CDAS in South Western Sydney with high rates of social vulnerability and presents an argument to discuss benchmarking targets with service providers. It identifies the need to prioritise children living in suburbs with socioeconomic disadvantage and refine prioritisation and data collection processes to improve wait times.
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Affiliation(s)
- Sibella E Bentley
- The Children's Hospital at Westmead, Corner Hawkesbury Road and Hainsworth Street, Westmead, NSW, 2145, Australia.
- University of Notre Dame Australia School of Medicine, Sydney, Australia.
| | - Pankaj Garg
- Department of Community Paediatrics, South Western Sydney Local Health District Health Services Building Level 3, Liverpool, NSW, 2170, Australia
- Department of Medicine & Health, University of New South Wales, Sydney, Australia
| | - Ori Gudes
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Romy Hurwitz
- Department of Community Paediatrics, South Western Sydney Local Health District Health Services Building Level 3, Liverpool, NSW, 2170, Australia
| | - Sinthu Vivekanandarajah
- Department of Community Paediatrics, South Western Sydney Local Health District Health Services Building Level 3, Liverpool, NSW, 2170, Australia
| | - Lydia Y L So
- Department of Community Paediatrics, South Western Sydney Local Health District Health Services Building Level 3, Liverpool, NSW, 2170, Australia
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Taylor J, Majeed T, Remond M, Bagade T, Edwards L, Sullivan E. Are custodial-based mothers and children's units evaluated, effective and aligned with a human rights-based approach? - A systematic review of the evidence. EClinicalMedicine 2024; 69:102496. [PMID: 38384336 PMCID: PMC10878864 DOI: 10.1016/j.eclinm.2024.102496] [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: 12/11/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 02/23/2024] Open
Abstract
Background Special considerations are warranted for incarcerated mothers and their children, as both experience substantial health and social disadvantage. Children residing in custodial settings are at risk of not having access to the equivalence of education, healthcare and socialisation commensurate to that of children living in the community. This systematic review describes the existing evidence regarding underpinning theories, accessibility, and the effectiveness of custody-based Mothers and children's units (M&Cs) globally. Methods A systematic database search was conducted on May 1, 2023, of PsycINFO, Scopus, Sociology Ultimate and Web of Science (January 1, 2010, and May 1, 2023). Findings Our systematic synthesis reveals evidence gaps related to best practice guidelines that align with a human right-based approach, and evaluations of the impact of the prison environment on mothers and their children. Interpretation These findings support re-design of M&Cs using co-design to develop units that are evidence-based, robustly evaluated, and underpinned by the 'best interest of the child'. Funding This systematic review was conducted as part of a broader review into M&C programs commissioned and funded by Corrective Services NSW, Australia (CSNSW), a division of the Department of Communities and Justice, as part of the NSW Premier's Priority to Reduce Recidivism within the Women as Parents workstream. No funding was received for this review.
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Affiliation(s)
- Jo Taylor
- University of Newcastle, Newcastle, Australia
| | | | - Marc Remond
- University of Newcastle, Newcastle, Australia
| | | | - Layla Edwards
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Elizabeth Sullivan
- University of Newcastle, Newcastle, Australia
- Justice Health and Forensic Mental Health Network, Sydney, Australia
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Loomis AM, McLaughlin RX, Lyon M, Mitchell J. Infant and early childhood teleconsultation and training: Program description and feasibility outcomes from a statewide implementation. Infant Ment Health J 2024; 45:185-200. [PMID: 38230980 DOI: 10.1002/imhj.22101] [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: 09/20/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/18/2024]
Abstract
To address high rates of mental health and developmental concerns facing young children ages 0-6 in the United States and internationally, providers across professional sectors need Infant and early childhood mental health (IECMH) training and support. The training and teleconsultation program (TTP) is a state-funded program developed in one Mountain West state in the United States to provide free IECMH training and teleconsultation to any provider working with young children. The TTP included access to webinars and individual or group consultation with licensed mental health providers. Webinars focused on increasing awareness and knowledge related to attachment and child development, supporting parents and caregivers, trauma-informed practice, supporting emotional health of staff and providers, and culturally responsive practices with infants, young children, and caregivers. Teleconsultation included case consultation, reflective individual and group supervision, and collaboration supports/referrals. During the 18-month evaluation period, 1568 unique providers engaged in either training or teleconsultation services, an average of 9% growth in new providers each month, with representation from all professional sectors and all state counties. This program demonstrates the feasibility and need for statewide training and teleconsultation programs to help meet the needs of providers who interact with and support young children and caregivers.
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Affiliation(s)
- Alysse M Loomis
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
| | - Rose X McLaughlin
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
| | - McCall Lyon
- The Children's Center Utah, West Valley City, Utah, USA
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Roccati E, Bindoff AD, Collins JM, Eastgate J, Borchard J, Alty J, King AE, Vickers JC, Carboni M, Logan C. Modifiable dementia risk factors and AT(N) biomarkers: findings from the EPAD cohort. Front Aging Neurosci 2024; 16:1346214. [PMID: 38384935 PMCID: PMC10879413 DOI: 10.3389/fnagi.2024.1346214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/15/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction Modifiable risk factors account for a substantial proportion of Alzheimer's disease (AD) cases and we currently have a discrete AT(N) biomarker profile for AD biomarkers: amyloid (A), p-tau (T), and neurodegeneration (N). Here, we investigated how modifiable risk factors relate to the three hallmark AT(N) biomarkers of AD. Methods Participants from the European Prevention of Alzheimer's Dementia (EPAD) study underwent clinical assessments, brain magnetic resonance imaging, and cerebrospinal fluid collection and analysis. Generalized additive models (GAMs) with penalized regression splines were modeled in the AD Workbench on the NTKApp. Results A total of 1,434 participants were included (56% women, 39% APOE ε4+) with an average age of 65.5 (± 7.2) years. We found that modifiable risk factors of less education (t = 3.9, p < 0.001), less exercise (t = 2.1, p = 0.034), traumatic brain injury (t = -2.1, p = 0.036), and higher body mass index (t = -4.5, p < 0.001) were all significantly associated with higher AD biomarker burden. Discussion This cross-sectional study provides further support for modifiable risk factors displaying neuroprotective associations with the characteristic AT(N) biomarkers of AD.
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Affiliation(s)
- Eddy Roccati
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Aidan David Bindoff
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Jessica Marie Collins
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Joshua Eastgate
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Jay Borchard
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Jane Alty
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
- Royal Hobart Hospital, Hobart, TAS, Australia
| | - Anna Elizabeth King
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - James Clement Vickers
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | | | - Chad Logan
- Roche Diagnostics GmbH, Penzberg, Germany
| | - EPAD Consortium
- Department of Radiology and Nuclear Medicine, University of Amsterdam, De Boelelaan, Amsterdam, Netherlands
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Kirkegaard A, Irwin C, Byrne R, Sambell R, Vincze L. Barriers and enablers to a healthy food environment in Australian childcare services: Exploring directors' perspectives. Health Promot J Austr 2024; 35:122-133. [PMID: 36998156 DOI: 10.1002/hpja.722] [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: 09/27/2022] [Revised: 02/07/2023] [Accepted: 03/29/2023] [Indexed: 04/01/2023] Open
Abstract
ISSUE ADDRESSED Early childhood education and care (ECEC) settings are ideal environments to optimise nutrition and positively influence children's food behaviours. However, recent research has identified the need to improve nutrition policies, food provision, and mealtime environments in Australian ECEC settings. This study explored the perceptions of ECEC directors regarding barriers and enablers to a health-promoting food environment within ECEC services. METHODS Eleven directors from ECEC services in Nerang, Queensland, and surrounding areas, participated in qualitative interviews between March and May 2021. Transcripts were analysed using qualitative content analysis that followed a deductive-inductive approach employing nutrition-related domains from the Wellness Child Care Assessment Tool, these being: (i) nutrition policy; (ii) nutrition education; (iii) food provision; and (iv) mealtimes. Transcripts were coded independently by two researchers in NVivo and consensus for barriers and enablers was achieved through discussion. RESULTS Barriers and enablers were reported across four domains (nutrition policy, nutrition education, food provision, and mealtimes). Comprehensive nutrition-related policies were an enabler to a healthy nutrition environment but were sometimes described as lacking detail or customisation to the service. Nutrition education for children was described as competing with other activities for time and resources in an already-crowded curriculum. Financial and time pressures faced by families were a barrier to healthy food provision in services where families provided food for children. The ability of staff to sit with children and engage in conversation during mealtimes was an enabler; however, competing demands on time and the unavailability of food for staff were cited as barriers to health-promoting mealtimes. CONCLUSIONS Directors in ECEC services report both barriers and enablers to a healthy food environment. Nutrition policies were an enabler when comprehensive and relevant but a barrier when vague and not tailored to the service environment. ECEC services should be supported to develop and implement service-specific nutrition policies and practices by engaging with parents and staff. SO WHAT?: The barriers and enablers reported in this study should be considered when designing and implementing future evidence-based interventions to improve the nutrition environment in ECEC services.
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Affiliation(s)
- Amy Kirkegaard
- Centre for Community Health and Wellbeing, University of Queensland, Springfield, QLD, Australia
- Menzies Health Institute of Queensland, Griffith University, Southport, QLD, Australia
- Nutrition and Dietetics, School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Chris Irwin
- Menzies Health Institute of Queensland, Griffith University, Southport, QLD, Australia
- Nutrition and Dietetics, School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Ros Sambell
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Lisa Vincze
- Menzies Health Institute of Queensland, Griffith University, Southport, QLD, Australia
- Nutrition and Dietetics, School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
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Au LE, Arnold CD, Ritchie LD, Lin SK, Frongillo EA. Differences in Infant Diet Quality Index by Race and Ethnicity Predict Differences in Later Diet Quality. J Nutr 2023; 153:3498-3505. [PMID: 37858725 PMCID: PMC10843900 DOI: 10.1016/j.tjnut.2023.10.010] [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: 07/03/2023] [Revised: 08/15/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Racial and ethnic disparities in infant-feeding practices may negatively influence diet quality and health. OBJECTIVES This study investigated the racial, ethnic, and language (English or Spanish) differences in infant diet quality, later diet quality, and weight status at 2-5 y, and whether these differences were explained through infant diet quality among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). METHODS Using the WIC Infant and Toddler Feeding Practices Study-2 (unweighted n = 2663; weighted n = 362,712), relationships between the Infant Dietary Quality Index (IDQI; range 0-1) and Healthy Eating Index-2020 (HEI-2020; range 0-100) and BMI z-score (BMIz) at 2-5 y were analyzed by race, ethnicity, and language preference [Hispanic Spanish-speaking, Hispanic English-speaking, non-Hispanic (NH) White, and NH Black participants]. Statistical interaction between IDQI and each group was evaluated in multivariable models. The mediation of each group through the IDQI was assessed using causal mediation methods. RESULTS Differences in IDQI [mean (standard deviation)] were observed between Hispanic Spanish-speaking participants [0.41 (0.10)], Hispanic English-speaking participants [0.37 (0.10)], NH White participants [0.36 (0.10)], and NH Black participants [0.35 (0.09)], P < 0.001. Differences in HEI-2020 occurred at 2-5 y, with the Hispanic Spanish-speaking participants having consistently higher HEI-2020 scores. Differences in BMIz were observed at 5 y, with higher scores among Hispanic Spanish-speaking participants. Interaction between race, ethnicity, and IDQI was observed for all outcomes except for BMIz at 3 y. Through mediation, IDQI explained 13%-20% of the difference in HEI-2020 scores between Hispanic Spanish-speaking and NH White participants at 2-5 y. IDQI explained 22%-25% of the difference in HEI-2020 scores between the Hispanic Spanish-speaking and NH Black participants at 4 y and 5 y. CONCLUSIONS Higher infant diet quality scores observed in Hispanic Spanish-speaking participants explain some of the racial and ethnic differences observed in later diet quality, suggesting that improving infant diet quality may help reduce diet disparities during early childhood.
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Affiliation(s)
- Lauren E Au
- Meyer Hall, Department of Nutrition, University of California, Davis, CA, United States.
| | - Charles D Arnold
- Meyer Hall, Department of Nutrition, University of California, Davis, CA, United States
| | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA, United States
| | - Sarina K Lin
- Meyer Hall, Department of Nutrition, University of California, Davis, CA, United States
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, United States
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Latham N, Young J, Wilson J, Gray M. Measuring success: program fidelity of Queensland's child health home visiting services. A document analysis. Aust J Prim Health 2023; 29:575-586. [PMID: 37468222 DOI: 10.1071/py23002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 06/30/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND The Family CA.R.E. (Community-based Assistance Resourcing and Education) program was introduced in Queensland two decades ago. It aimed to redress health inequalities for infants from families experiencing specific social stressors. The program has been locally adapted over time and has not been evaluated against the original program. This study assessed the extent to which selected hospital and health services in Queensland, Australia have modified the original Family C.A.R.E. PROGRAM METHODS Altheide's model was used to facilitate a critical document analysis of policies and guidelines for adapted Family C.A.R.E. home visiting programs in use by hospital and health services (target n =7). RESULTS Five of seven eligible services provided service model documentation. There was low alignment with the original Family C.A.R.E. program across four of the five participating services. While the program delivered within Service 4 was highly aligned to the structure and intent of the original model, variation to the program was still evident. Importantly, four of the five participating programs were not collecting evaluation measures. CONCLUSIONS Health services have adapted the original Family C.A.R.E program format to 'fit' the local service environment but have largely failed to collect data to facilitate evaluation. Inability to evaluate the program leads to uncertainty about program success and benefits as well as any unintended consequences for families engaging in unevaluated home visiting programs. This study highlights the importance of monitoring program fidelity and evaluating success given the potential ramifications for this vulnerable cohort and for health service delivery.
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Affiliation(s)
- Nicole Latham
- Digital Health, Sunshine Coast Hospital and Health Service, Birtinya, Qld 4575, Australia; and School of Health, University of the Sunshine Coast, Sippy Downs, Qld 4556, Australia
| | - Jeanine Young
- School of Health, University of the Sunshine Coast, Petrie, Qld 4502, Australia; and Sunshine Coast Health Institute, Birtinya, Qld 4575, Australia
| | - Josephine Wilson
- School of Health, University of the Sunshine Coast, Petrie, Qld 4502, Australia
| | - Michelle Gray
- School of Health, University of the Sunshine Coast, Sippy Downs, Qld 4556, Australia; and Edith Cowan University, Joondalup, WA 6027, Australia
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15
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Berge V, Thyen U. [Effects of High Birth Weight on the Development of Preschoolers]. Z Geburtshilfe Neonatol 2023; 227:448-465. [PMID: 37758195 DOI: 10.1055/a-2160-0584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
BACKGROUND A high birth weight above 4,000 g may lead to risks in the development of affected children. The association is less studied than the effects of very low birth weight and is the subject of this study. METHODS The retrospective study design used data from school entry surveys in Schleswig-Holstein (Germany) collected in 2014-2017 and included 88,858 children aged 5-6 years. End points examined were language, motor skills, cognition, and behavior; use of support measures; and recommendation for special educational needs. Logistic regression models were used to estimate the association between birth weight and the outcome measures, adjusting for sociodemographic factors. RESULTS After accounting for sociodemographic factors, high birth weight is not associated with impaired child development, whereas low birth weight emerges as a significant predictor. Across all birth weights, sociodemographic factors explain most of the variance in multivariate models of the influence of birth weight on child development. CONCLUSIONS Very high birth weight does not justify a general recommendation for support measures. Therefore, individual developmental trajectories should be monitored. Growing up in disadvantaged circumstances may represent a significant risk and should be a reason for early intervention.
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Affiliation(s)
- Valerie Berge
- UKSH Campus Lübeck, Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
- Institut für Humangenetik, Universität zu Lübeck, Lübeck, Germany
| | - Ute Thyen
- UKSH Campus Lübeck, Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
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Sadrkhanlou M, Maher A, Alimohammadzadeh K, Jafari M, Bahadori M. Applying the Delphi Approach to Prioritize Social Factors Affecting the Development of Children Under Six Years. BMC Public Health 2023; 23:1659. [PMID: 37644469 PMCID: PMC10466685 DOI: 10.1186/s12889-023-16521-x] [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: 12/22/2022] [Accepted: 08/14/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Social determinants of health have a key role in the growth and development of children, particularly in early childhood which is mentioned from infancy to the age of six years old. These factors might cause disparities in living conditions and consequently bring about inequities regarding different aspects of development such as emotional, psychological, social, psychological, and intellectual. This research aimed to provide a model for prioritizing social factors affecting the development of children under six years. METHODS We used quantitative-qualitative (mixed) method to perform data analysis. The statistical population included 12 medical experts and professionals in the field of children's development and social determinants of health that were selected using the snowball method. In the quantitative section, a Delphi technique was applied to screen the extracted indicators. Then through applying a decision-making trial and evaluation laboratory (DEMATEL) method, the cause-and-effect interactions among main social determinants were identified. To analyze data, super decision software was used. RESULTS According to literature review and the results obtained from focus group discussions, five dimensions including individual factors, family factors, environmental factors, governance, and global factors were identified. Based on the study findings, the criterion of "family factors" was mentioned as the most important priority affecting childhood development. Furthermore, the sub-criterion of "International Programs and Policies" received the greatest priority among other sub-criteria with a profound impact on children's healthy growth and development. CONCLUSION Despite the current knowledge about social determinants of health, it is required to identify the most influential socioeconomic factors on childhood development. In such a manner, political strategies for improving the health condition of children can be implemented based on scientific evidence. Due to the crucial role of family factors, environmental factors and other socio-economic conditions, health policy makers and public health practitioners should be informed of the importance of these factors in shaping the health condition of children.
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Affiliation(s)
- Mitra Sadrkhanlou
- Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Ali Maher
- Department of Health Policy, Economics and Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Khalil Alimohammadzadeh
- Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
- Department of Health Services Management, North Tehran Branch, Islamic Azad University. Economics Policy Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mehrnoosh Jafari
- Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mohammadkarim Bahadori
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Areed WD, Price A, Arnett K, Thompson H, Malseed R, Mengersen K. Assessing the spatial structure of the association between attendance at preschool and children's developmental vulnerabilities in Queensland, Australia. PLoS One 2023; 18:e0285409. [PMID: 37556459 PMCID: PMC10411799 DOI: 10.1371/journal.pone.0285409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 04/22/2023] [Indexed: 08/11/2023] Open
Abstract
Demographic and educational factors are essential, influential factors of early childhood development. This study aimed to investigate spatial patterns in the association between attendance at preschool and children's developmental vulnerabilities in one or more domain(s) in their first year of full-time school at a small area level in Queensland, Australia. This was achieved by applying geographically weighted regression (GWR) followed by K-means clustering of the regression coefficients. Three distinct geographical clusters were found in Queensland using the GWR coefficients. The first cluster covered more than half of the state of Queensland, including the Greater Brisbane region, and displays a strong negative association between developmental vulnerabilities and attendance at preschool. That is, areas with high proportions of preschool attendance tended to have lower proportions of children with at least one developmental vulnerability in the first year of full-time school. Clusters two and three were characterized by stronger negative associations between developmental vulnerabilities, English as the mother language, and geographic remoteness, respectively. This research provides evidence of the need for collaboration between health and education sectors in specific regions of Queensland to update current service provision policies and to ensure holistic and appropriate care is available to support children with developmental vulnerabilities.
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Affiliation(s)
- Wala Draidi Areed
- School of Mathematical Science, Center for Data Science, Queensland University of Technology, Queensland, Australia
| | - Aiden Price
- School of Mathematical Science, Center for Data Science, Queensland University of Technology, Queensland, Australia
| | | | - Helen Thompson
- School of Mathematical Science, Center for Data Science, Queensland University of Technology, Queensland, Australia
| | - Reid Malseed
- Children’s Health Queensland, Queensland, Australia
| | - Kerrie Mengersen
- School of Mathematical Science, Center for Data Science, Queensland University of Technology, Queensland, Australia
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Rahman F, Tuli SN, Mondal P, Sultana S, Hossain A, Kundu S, Clara AA, Hossain A. Home environment factors associated with early childhood development in rural areas of Bangladesh: evidence from a national survey. Front Public Health 2023; 11:1209068. [PMID: 37448657 PMCID: PMC10338095 DOI: 10.3389/fpubh.2023.1209068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
Background Knowing the relationship between the factors related to home environment and early childhood development (ECD) in Bangladeshi children aged 3 to 4 years would help to find out appropriate interventions for the children with lower ECD outcomes. Therefore, we aimed to understand the relationship between the home environment factors and ECD in rural Bangladeshi children aged 3 to 4 years. Methods We used data from the Multiple Indicator Cluster Survey (MICS) 2019, and included 7,326 rural children aged 3 to 4 years. The ECD index (ECDI) included four domains: literacy-numeracy, learning, physical and socio-emotional development. If a child met at least three of these four domains, the child was indicated as developmentally "on track". Results The findings show that 27.4% of rural children missed to reach developmentally on-track while 72.2% of children did not attain the literacy-numeracy domain of ECD. The home environment factors including parental participation in children's activities, was found to be associated with ECD. For instance, reading books to child had 26% (aOR = 1.26, 95% CI = 1.08-1.48), and telling stories to child had 29% (aOR = 1.29, 95% CI = 1.09-1.53) more developmentally on-track in overall ECDI. Similar associations between home environment factors and specific ECD domains were also obtained. We also identified that children aged 4 years, girls, and children of mothers with higher socio-economic status (SES) were higher developmentally on-track than their counterparts. Conclusion Home environment factors like reading books and telling stories to children were found to be significantly associated with ECD in rural areas of Bangladesh. Our study's findings would assist in implementing the essential public health intervention to enhance the ECD program especially in the rural Bangladeshi context.
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Affiliation(s)
- Farzana Rahman
- Department of Public Health, North South University, Dhaka, Bangladesh
- Armed Forces Medical College, Dhaka, Bangladesh
| | - Samiha Nahar Tuli
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Prasenjit Mondal
- Department of Public Health, North South University, Dhaka, Bangladesh
- School of Medicine and Dentistry, Griffith University, QLD, Australia
| | - Shakina Sultana
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Asmita Hossain
- Department of Public Health, North South University, Dhaka, Bangladesh
- Z.H. Sikder Women’s Medical College and Hospital, Dhaka, Bangladesh
| | - Satyajit Kundu
- School of Public Health, Southeast University, Nanjing, China
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Afrin Ahmed Clara
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Ahmed Hossain
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Global Health Institute, North South University, Dhaka, Bangladesh
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Jamaluddine Z, Safadi G, Irani A, Salti N, Chaaban J, Abdulrahim S, Thomas A, Ghattas H. Inequalities in Wellbeing in Lebanese Children and Different Refugee Subpopulations: A Multidimensional Child Deprivation Analysis. CHILD INDICATORS RESEARCH 2023; 16:1-19. [PMID: 37363705 PMCID: PMC10241607 DOI: 10.1007/s12187-023-10040-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/28/2023]
Abstract
Background and Objectives This study constitutes the first attempt to describe the overlapping deprivations faced by Lebanese children (Lebanese) and that of the three sub-populations of refugees living in Lebanon: Palestinian refugees living in Lebanon, Palestinian refugees from Syria and Syrian refugees. Methods Using data from the United Nations International Children's Emergency Fund (UNICEF) Household Survey 2016 (n = 10,555 Lebanese; 7,106 Palestinian refugees living in Lebanon; 2,768 Palestinian refugees from Syria and 5,891 Syrian refugee children aged 2 to 17 years old), we report on single and overlapping deprivations (at least two concurrent deprivations) using indicators related to survival (nutrition, health, water, sanitation and overcrowding), development (education) and protection (labor, exposure to violence and early marriage). Maternal education and geographical correlates of deprivation were explored using multivariable logistic regression models clustering for children in the same households. Main Results In terms of co-occurrence of deprivations, Syrian refugees had the highest prevalence in all age groups (68.5%, 2-4y and 65.7%, 6-17y), followed by Palestinian refugees from Syria (46.2%, 2-4y and 45.5%, 6-17y), Palestinian refugees living in Lebanon (28.9%, 2-4y and 23.7%, 6-17y), with Lebanese children having the lowest prevalence (13.2%, 2-4y and 15.3, 6-17y). About half of Palestinian refugees from Syria and Syrian refugees (6-17y) were deprived in protection and housing. Education deprivation is of primary concern for Syrian children. Higher maternal education was consistently associated with lower odds of co-occurrence of deprivations among children aged 6-17y. Conclusion This study highlights the importance of including refugee populations in reporting frameworks. This analysis additionally generates geographical and socio-economic profiles of the deprived children and identifies key deprivation areas of the affected sub-groups to inform effective policy design especially in light of the prevailing economic crisis. Supplementary Information The online version contains supplementary material available at 10.1007/s12187-023-10040-2.
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Affiliation(s)
- Zeina Jamaluddine
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- London School of Hygiene and Tropical Medicine, London, UK
| | - Gloria Safadi
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Alexandra Irani
- Applied Economics and Development Research Group, American University of Beirut, Beirut, Lebanon
| | - Nisreen Salti
- Applied Economics and Development Research Group, American University of Beirut, Beirut, Lebanon
- Department of Economics, American University of Beirut, Beirut, Lebanon
| | - Jad Chaaban
- Applied Economics and Development Research Group, American University of Beirut, Beirut, Lebanon
| | - Sawsan Abdulrahim
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Alban Thomas
- Paris-Saclay Applied Economics, University of Paris-Saclay, INRAE, AgroParisTech, Palaiseau, France
- Observatory of Rural Development, INRAE, Toulouse, France
| | - Hala Ghattas
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Arnold School of Public Health, University of South Carolina, Columbia, SC USA
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Arun A, Prabhu MP. Social determinants of health in rural Indian women & effects on intervention participation. BMC Public Health 2023; 23:921. [PMID: 37208651 DOI: 10.1186/s12889-023-15743-3] [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: 09/16/2022] [Accepted: 04/24/2023] [Indexed: 05/21/2023] Open
Abstract
The social determinants of health have become an increasingly crucial public health topic in recent years and refer to the non-medical factors that affect an individual's health outcomes. Our study focuses on understanding the various social and personal determinants of health that most affect women's wellbeing. We surveyed 229 rural Indian women through the deployment of trained community healthcare workers to understand their reasons for not participating in a public health intervention aimed to improve their maternal outcomes. We found that the most frequent reasons cited by the women were: lack of husband support (53.2%), lack of family support (27.9%), not having enough time (17.0%), and having a migratory lifestyle (14.8%). We also found association between the determinants: women who had lower education levels, were primigravida, younger, or lived in joint families were more likely to cite a lack of husband or family support. We determined through these results that a lack of social (both spousal and familial) support, time, and stable housing were the most pressing determinants of health preventing the women from maximizing their health outcomes. Future research should focus on possible programs to equalize the negative effects of these social determinants to improve the healthcare access of rural women.
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Almahmoud OH, Abushaikha L. Prevalence and risk factors of developmental disabilities among preschool children in the Arab world: a narrative literature review. CHILD HEALTH NURSING RESEARCH 2023; 29:101-110. [PMID: 37170489 PMCID: PMC10183763 DOI: 10.4094/chnr.2023.29.2.101] [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: 09/27/2022] [Accepted: 11/22/2022] [Indexed: 05/13/2023] Open
Abstract
PURPOSE Developmental disabilities (DDs) are a global childhood problem whose prevalence is rising, with a disproportionate impact on individuals in low-and middle-income countries. However, data on the prevalence of DDs in the Arab world are limited. This review highlights what is currently known about the prevalence and risk factors of DDs in preschool children in the Arab world. METHODS PubMed, Cochrane Library, Scopus, CINAHL, Science Direct, and Google Scholar were searched for publications on DDs among preschool children in the Arab world. Only 14 studies were identified in the literature, from 12 Arab countries. RESULTS The overall estimated prevalence of DDs among preschool children in the Arab world is 27.5%. An analysis of risk factors for DDs showed that child-related, maternal, and family-related factors account for a significant cumulative risk of developing DDs in preschool children. Maternal factors, such as antenatal and perinatal complications, were the most common risk factors. CONCLUSION The prevalence of DDs among preschoolers is significantly high in the Arab world, which emphasizes the importance of the early detection and diagnosis of DD, as well as its associated risk factors.
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Affiliation(s)
- Omar H Almahmoud
- Doctoral Candidate, Faculty of Nursing, University of Jordan, Amman, Jordan ․ Nursing Department, Faculty of Pharmacy, Nursing and Health Profession College, Birzeit University, Birzeit, West Bank, Palestine
| | - Lubna Abushaikha
- Professor, Faculty of Nursing, University of Jordan, Amman, Jordan
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Smith J, Halliwell N, Laurent A, Tsotsoros J, Harris K, DeGrace B. Social Participation Experiences of Families Raising a Young Child With Autism Spectrum Disorder: Implications for Mental Health and Well-Being. Am J Occup Ther 2023; 77:24095. [PMID: 37083974 PMCID: PMC10137595 DOI: 10.5014/ajot.2023.050156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
IMPORTANCE Social participation (SP) is an important facilitator of positive mental health for children and families. Children are dependent on their families to mediate SP, yet families of children with autism spectrum disorder (C-ASD) seemingly limit SP because of behavioral and functional challenges in community environments. The resulting isolation can affect the child's and the family's mental health. OBJECTIVE To distill the essence of everyday SP experiences in the community of families raising C-ASD. DESIGN Data collected via in-depth, semistructured interviews with a purposive sample and analyzed in the phenomenological tradition. SETTING Community. PARTICIPANTS We recruited seven families with English-speaking parents (ages 18-64 yr) raising one C-ASD (age 2-8 yr). Families with more than one C-ASD or those whose C-ASD was diagnosed with complex medical condition or a neurological or genetic disorder were excluded. RESULTS The essence of experiences of SP emerged in the form of three themes depicting the mismatch between societal expectations for SP and families' experience: (1) "the struggle," (2) "it's hard to feel like you belong," and (3) what we "have to do." CONCLUSIONS AND RELEVANCE As a collective, families expressed desire for everyday community SP and could do so only in select environments with core groups. The findings, as interpreted through the lens of mental health promotion, reveal opportunities to reduce barriers and to promote meaningful family SP so as to facilitate positive mental health and well-being through the transactional intersecting characteristics of the child with ASD, the family, and the community. What This Article Adds: This study illuminates the experience of SP of families raising a young C-ASD, highlighting both supports and barriers. Practitioners can use this information to potentially prevent isolation and promote both child and family mental health and well-being.
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Affiliation(s)
- Julie Smith
- Julie Smith, DSc, OTR/L, is Early Intervention Lead, Oklahoma County, Family Health Services, Oklahoma State Department of Health, Oklahoma City, OK. At the time of the study, Smith was Doctoral Student, Rehabilitation Sciences Program, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Nicole Halliwell
- Nicole Halliwell, DSc. OTR/L, is Assistant Professor, Occupational Therapy Department, Marjorie K. Unterberg School of Nursing and Health Sciences, Monmouth University, West Long Branch, NJ. At the time of the study, Halliwell was Doctoral Student, Rehabilitation Sciences Program, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City;
| | - Amy Laurent
- Amy Laurent, PhD, OTR/L, is Codirector, Autism Level UP!, North Kingstown, RI. At the time of the study, Laurent was Adjunct Faculty, Department of Psychology, University of Rhode Island, Kingston
| | - Jessica Tsotsoros
- Jessica Tsotsoros, PhD, OTR/L, is Associate Professor and International Experience Coordinator, Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Tulsa
| | - Katelyn Harris
- Katelyn Harris, OTR/L, is Occupational Therapist, Intervention Center for Early Childhood, Irvine, CA
| | - Beth DeGrace
- Beth DeGrace, PhD, OTR/L, FAOTA, is Director of Kids Ministry, Crossings Community Church, Oklahoma City, OK. At the time of the study, DeGrace was Associate Professor, Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
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Spry EA, Olsson CA, Aarsman SR, Mohamad Husin H, Macdonald JA, Dashti SG, Moreno-Betancur M, Letcher P, Biden EJ, Thomson KC, McAnally H, Greenwood CJ, Middleton M, Hutchinson DM, Carlin JB, Patton GC. Parental personality and early life ecology: a prospective cohort study from preconception to postpartum. Sci Rep 2023; 13:3332. [PMID: 36849463 PMCID: PMC9971123 DOI: 10.1038/s41598-023-29139-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 01/31/2023] [Indexed: 03/01/2023] Open
Abstract
Personality reliably predicts life outcomes ranging from social and material resources to mental health and interpersonal capacities. However, little is known about the potential intergenerational impact of parent personality prior to offspring conception on family resources and child development across the first thousand days of life. We analysed data from the Victorian Intergenerational Health Cohort Study (665 parents, 1030 infants; est. 1992), a two-generation study with prospective assessment of preconception background factors in parental adolescence, preconception personality traits in young adulthood (agreeableness, conscientiousness, emotional stability, extraversion, and openness), and multiple parental resources and infant characteristics in pregnancy and after the birth of their child. After adjusting for pre-exposure confounders, both maternal and paternal preconception personality traits were associated with numerous parental resources and attributes in pregnancy and postpartum, as well as with infant biobehavioural characteristics. Effect sizes ranged from small to moderate when considering parent personality traits as continuous exposures, and from small to large when considering personality traits as binary exposures. Young adult personality, well before offspring conception, is associated with the perinatal household social and financial context, parental mental health, parenting style and self-efficacy, and temperamental characteristics of offspring. These are pivotal aspects of early life development that ultimately predict a child's long-term health and development.
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Affiliation(s)
- Elizabeth A. Spry
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia ,grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Craig A. Olsson
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Stephanie R. Aarsman
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Hanafi Mohamad Husin
- grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Jacqui A. Macdonald
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia
| | - S. Ghazaleh Dashti
- grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia ,grid.1058.c0000 0000 9442 535XClinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Margarita Moreno-Betancur
- grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia ,grid.1058.c0000 0000 9442 535XClinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Primrose Letcher
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Ebony J. Biden
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Kimberly C. Thomson
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.17091.3e0000 0001 2288 9830Human Early Learning Partnership, School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada ,grid.498772.7Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, Canada
| | - Helena McAnally
- grid.29980.3a0000 0004 1936 7830Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Christopher J. Greenwood
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Melissa Middleton
- grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia ,grid.1058.c0000 0000 9442 535XClinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Delyse M. Hutchinson
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia ,grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - John B. Carlin
- grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia ,grid.1058.c0000 0000 9442 535XClinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - George C. Patton
- grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia
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Islam MM, Khan MN. Early childhood development and its association with maternal parity. Child Care Health Dev 2023; 49:80-89. [PMID: 35384014 PMCID: PMC10084392 DOI: 10.1111/cch.13011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Maternal parity, which is usually measured as the number of children born to a mother, has a substantial impact on the social and environmental factors around children and their development. This paper estimates the Early Childhood Development Index (ECDI) of 3- and 4-year-old children in Bangladesh and examines the relationship between maternal parity and early childhood development. METHODS The study analysed nationally representative data from the Bangladesh Multiple Indicator Cluster Survey 2019. The dataset had 9453 children aged from 36 to 59 months. The ECDI was computed following the UNICEF's approach involving psychometric computation of four domains of development: physical, literacy-numeracy, learning and social-emotional. Since the dataset has a hierarchical structure, we used multilevel logistic regression. RESULTS A quarter (25%) of the children were not on track in their early childhood development. Seventy-one percent were not developmentally on track in the literacy-numeracy domain, 27% were not in the social-emotional and smaller percentages were not in learning (9%) and physical (1%) domains. There was a significant negative association between maternal parity and ECDI (adjusted odds ratio [AOR] 0.95; 95% CI: 0.91-0.99). Attendance at early childhood education programmes was significantly associated with early childhood development (AOR 1.73; 95% CI: 1.47-2.03). Also, female children, those who were not stunted, located in rural areas, received parental stimulation activities, lived in relatively wealthy households or had mothers who had received secondary or further education were more likely than others to be on track of early childhood development. CONCLUSIONS Early childhood development is negatively correlated with maternal parity. The literacy-numeracy domain constitutes the major developmental delay. Programmes for parental awareness should be widely expanded.
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Affiliation(s)
- M Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, Victoria
| | - Md Nuruzzaman Khan
- Department of Population Sciences, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
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Complex early childhood experiences: Characteristics of Northern Territory children across health, education and child protection data. PLoS One 2023; 18:e0280648. [PMID: 36656893 PMCID: PMC9851518 DOI: 10.1371/journal.pone.0280648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 01/04/2023] [Indexed: 01/20/2023] Open
Abstract
Early identification of vulnerable children to protect them from harm and support them in achieving their long-term potential is a community priority. This is particularly important in the Northern Territory (NT) of Australia, where Aboriginal children are about 40% of all children, and for whom the trauma and disadvantage experienced by Aboriginal Australians has ongoing intergenerational impacts. Given that shared social determinants influence child outcomes across the domains of health, education and welfare, there is growing interest in collaborative interventions that simultaneously respond to outcomes in all domains. There is increasing recognition that many children receive services from multiple NT government agencies, however there is limited understanding of the pattern and scale of overlap of these services. In this paper, NT health, education, child protection and perinatal datasets have been linked for the first time. The records of 8,267 children born in the NT in 2006-2009 were analysed using a person-centred analytic approach. Unsupervised machine learning techniques were used to discover clusters of NT children who experience different patterns of risk. Modelling revealed four or five distinct clusters including a cluster of children who are predominantly ill and experience some neglect, a cluster who predominantly experience abuse and a cluster who predominantly experience neglect. These three, high risk clusters all have low school attendance and together comprise 10-15% of the population. There is a large group of thriving children, with low health needs, high school attendance and low CPS contact. Finally, an unexpected cluster is a modestly sized group of non-attendees, mostly Aboriginal children, who have low school attendance but are otherwise thriving. The high risk groups experience vulnerability in all three domains of health, education and child protection, supporting the need for a flexible, rather than strictly differentiated response. Interagency cooperation would be valuable to provide a suitably collective and coordinated response for the most vulnerable children.
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Nurse home visiting to improve child and maternal outcomes: 5-year follow-up of an Australian randomised controlled trial. PLoS One 2022; 17:e0277773. [PMID: 36441705 PMCID: PMC9704648 DOI: 10.1371/journal.pone.0277773] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/19/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Nurse home visiting (NHV) is widely implemented to address inequities in child and maternal health. However, few studies have examined longer-term effectiveness or delivery within universal healthcare systems. We evaluated the benefits of an Australian NHV program ("right@home") in promoting children's language and learning, general and mental health, maternal mental health and wellbeing, parenting and family relationships, at child ages 4 and 5 years. SETTING AND PARTICIPANTS Randomised controlled trial of NHV delivered via universal, child and family health services (the comparator). Pregnant women experiencing adversity (≥2 of 10 risk factors) were recruited from 10 antenatal clinics across 2 states (Victoria, Tasmania) in Australia. INTERVENTION Mothers in the intervention arm were offered 25 nurse home visits (mean 23·2 home visits [SD 7·4, range 1-43] received) of 60-90 minutes, commencing antenatally and continuing until children's second birthdays. PRIMARY AND SECONDARY OUTCOMES MEASURED At 4 and 5 years, outcomes were assessed via parent interview and direct assessment of children's language and learning (receptive and expressive language, phonological awareness, attention, and executive function). Outcomes were compared between intervention and usual care arms (intention to treat) using adjusted regression with robust estimation to account for nurse/site. Missing data were addressed using multiple imputation and inverse probability weighting. RESULTS Of 722 women enrolled in the trial, 225 of 363 (62%) intervention and 201 of 359 (56%) usual care women provided data at 5 years. Estimated group differences showed an overall pattern favouring the intervention. Statistical evidence of benefits was found across child and maternal mental health and wellbeing, parenting and family relationships with effect sizes ranging 0·01-0·27. CONCLUSION An Australian NHV program promoted longer-term family functioning and wellbeing for women experiencing adversity. NHV can offer an important component of a proportionate universal system that delivers support and intervention relative to need. TRIAL REGISTRATION 2013-2016, registration ISRCTN89962120.
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Davidson SA, Ward R, Elliott C, Harris C, Bear N, Thornton A, Salt A, Valentine J. From guidelines to practice: A retrospective clinical cohort study investigating implementation of the early detection guidelines for cerebral palsy in a state-wide early intervention service. BMJ Open 2022; 12:e063296. [PMID: 36428013 PMCID: PMC9703326 DOI: 10.1136/bmjopen-2022-063296] [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] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To report on knowledge translation strategies and outcomes from the implementation of the early detection guidelines for cerebral palsy (CP) in a state-wide tertiary early intervention (EI) service and investigate the impact of social determinants on clinical services. DESIGN Retrospective longitudinal cohort study. SETTING The Western Australia tertiary paediatric EI service. PARTICIPANTS EI clinicians, consumers and children using the EI service. OUTCOME MEASURES Knowledge translation strategies including consumer perspectives, clinician training and Communities of Practice (CoP) guided implementation. We measured changes in referral number and age, delivery of early detection and intervention following the implementation of the guidelines. Exposure to adverse childhood experiences (ACEs), appointment non-attendance (DNA) rates, remoteness and socioeconomic quintiles were used to measure social determinants of health using negative binomial (Incidence Rate Ratios, IRR) and logistic regression (Odds Ratios, ORs). RESULTS Ten consumers participated in Focus Groups, 100 clinicians were trained and 22 clinicians established a monthly CoP. Referrals increased fourfold to 511 children. Corrected gestational age at referral decreased from a median of 16.1 to 5.1 months (p<0.001) and at first appointment from 18.8 to 6.8 months (p<0.001). Children living in social disadvantage had the highest DNA risk (quintile 1 vs 5: IRR 2.2, 95% CI 1.1 to 4.6, p=0.037). Children exposed to ACEs had higher odds of living in social disadvantage (quintile 1 vs 5, OR=3.8, 95% CI 1.4 to 10.0, p=0.007). No significant association was found between remoteness and DNA rate or ACE score. CONCLUSIONS Implementation strategies reduced referral age and improved the delivery of early detection assessments. Further investigation of the association between social disadvantage, DNA risk and ACE score is required in the development of a state-wide early detection network.
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Affiliation(s)
- Sue-Anne Davidson
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Kids Rehab WA, Perth Children's Hospital, Nedlands, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Roslyn Ward
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Catherine Elliott
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Courtenay Harris
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Natasha Bear
- Institute for Health Research, Notre Dame University, Perth, Western Australia, Australia
| | - Ashleigh Thornton
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Division of Paediatrics, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Alison Salt
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Kids Rehab WA, Perth Children's Hospital, Nedlands, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Jane Valentine
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Kids Rehab WA, Perth Children's Hospital, Nedlands, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
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28
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Waid J, Tomfohrde O, Kutzler C. Promoting health and social equity through family navigation to prevention and early intervention services: a proof of concept study. BMC Public Health 2022; 22:1972. [PMID: 36303175 PMCID: PMC9610316 DOI: 10.1186/s12889-022-14320-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 09/30/2022] [Accepted: 10/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health and social inequality are associated with multiple adverse childhood experiences including poverty, mental illness, and child maltreatment. While effective interventions currently exist for many health and social problems, large segments of the population experience barriers accessing needed services. In alignment with broader public health efforts to reduce health and social inequality in one state in the U.S.A., the current study describes the development and formative evaluation of a brief, low cost, portable model of prevention-oriented family service navigation called Navigate Your Way. METHODS Caregivers of children experiencing significant unmet health or social service needs were recruited to the study. Participants completed an initial and closing telephone interview which included measures of past and current family health and social service utilization, service barriers, parenting stress, and child internalizing/externalizing behaviors. Between interviews participants created a family service plan and received 10 weeks of telephone and web-mediated family navigation, at which time process and fidelity of implementation data were collected. Frequency and descriptive statistics are provided for participant demographic characteristics, service barriers, intervention engagement, and primary and secondary study outcomes. Paired samples t-tests examined changes in study outcomes between initial and closing telephone interviews. RESULTS Thirty two caregivers enrolled, twenty-nine completed the study. The age range was 20-59 (M = 39.5, SD = 10.0). The majority identified as female (96.9%, n = 31), racial/ethnic minority (56.2%, n = 18), and reported an average 10 barriers to care (M = 10.4, SD = 4.1). The most frequently reported service needs were mental health care, housing, food security, transportation, and health insurance. The mean duration of intervention delivery was 83 days. Most participants (82.8%, n = 24) were connected to one or more health or social services. Caregivers reported significant improvements to youth internalizing behaviors (d = 2.5, p = .05) and high levels of overall satisfaction with the navigation approach. CONCLUSION Telephone and web-mediated service navigation is a feasible and practical approach to supporting families in rapidly connecting to health and social care. Future research investigating the efficacy and implementation of Navigate Your Way in routine settings is indicated.
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Affiliation(s)
- Jeffrey Waid
- School of Social Work, University of Minnesota - Twin Cities, 1404 Gortner Ave, 105 Peters Hall, 55108, St. Paul, MN, USA.
| | - Olivia Tomfohrde
- Family Social Science, University of Minnesota - Twin Cities, 1985 Buford Ave, 55108, St. Paul, MN, USA
| | - Courtney Kutzler
- School of Social Work, University of Minnesota - Twin Cities, 1404 Gortner Ave, 105 Peters Hall, 55108, St. Paul, MN, USA.,School of Public Health, University of Minnesota - Twin Cities, 420 Delaware St SE, 55455, Minneapolis, MN, USA
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29
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Filakovska Bobakova D, Chovan S, Bosakova L, Koky R, de Kroon MLA, Dankulincova Veselska Z. Desirable but not feasible: Measures and interventions to promote early childhood health and development in marginalized Roma communities in Slovakia. Front Public Health 2022; 10:942550. [PMID: 36276342 PMCID: PMC9580395 DOI: 10.3389/fpubh.2022.942550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/07/2022] [Indexed: 01/21/2023] Open
Abstract
Roma are the largest and most disadvantaged ethnic minority in Europe often facing generational poverty, and limited access to education, employment, housing, and various types of services. Despite many international and national initiatives, children from marginalized Roma communities face multiple risks and are being disadvantaged as early as from conception onward. We, therefore, aimed to identify measures and/or interventions targeting equity in early childhood health and development in marginalized Roma communities which implementation is considered to be urgent but not feasible. We used a group concept mapping approach-a participatory mixed research method-and involved 40 experts and professionals from research, policy and practice. From 90 measures and interventions proposed to achieve early childhood equity for children from marginalized Roma communities, 23 measures were identified as urgent but not feasible. These concerned particularly measures and interventions targeting living conditions (including access to income, access to housing, and basic infrastructure for families) and public resources for instrumental support (covering mainly topics related to financial and institutional frameworks). Our results reflect the most pressing issues in the area of equality, inclusion and participation of Roma and expose barriers to implementation which are likely to arise from public and political discourses perpetrating a negative image of Roma, constructing them as less deserving. Measures to overcome persistent prejudices against Roma need to be implemented along with the measures targeting equity in early childhood health and development.
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Affiliation(s)
- Daniela Filakovska Bobakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia,Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czechia,*Correspondence: Daniela Filakovska Bobakova
| | - Shoshana Chovan
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | - Lucia Bosakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia,Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czechia
| | - Richard Koky
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | - Marlou L. A. de Kroon
- Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands,Department of Public Health and Primary Care, Centre for Environment and Health, Catholic University Leuven, Leuven, Belgium
| | - Zuzana Dankulincova Veselska
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
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30
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Germán M, Alonzo JK, Williams IM, Bushar J, Levine SM, Cuno KC, Umylny P, Briggs RD. Early Childhood Referrals by HealthySteps and Community Health Workers. Clin Pediatr (Phila) 2022; 62:321-328. [PMID: 36113109 DOI: 10.1177/00099228221120706] [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] [Indexed: 11/15/2022]
Abstract
This study explored how a community health worker (CHW) within a primary care team with a HealthySteps (HS) Specialist impacted referrals to social determinant of health resources for families with children aged birth to 5 years. Medical charts with documentation of HS comprehensive services between January and June 2018 were reviewed at 3 primary care clinics: 2 with an HS Specialist (HSS Only) and 1 with an HS Specialist and CHW (HSS + CHW). Eighty-six referrals were identified, 78 of which had documented outcomes. Outcomes were categorized as successful, unsuccessful, and not documented. The HSS + CHW group had a higher rate of successful referrals (96%) than the HSS Only group (74%). Statistical analysis (χ2 = 8.37, P = .004) revealed a significant association between the referral outcome and having a CHW on a primary care team with an HS Specialist. Therefore, primary care practices should consider adapting their HS model to include CHWs.
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Affiliation(s)
- Miguelina Germán
- Pediatric Behavioral Health Services, Montefiore Medical Group, Albert Einstein College of Medicine, Montefiore Medical Center, Yonkers, NY, USA
| | - Jayxa K Alonzo
- Pediatric Behavioral Health Services, Montefiore Medical Group, Albert Einstein College of Medicine, Montefiore Medical Center, Yonkers, NY, USA
| | - I Mihiri Williams
- Pediatric Behavioral Health Services, Montefiore Medical Group, Albert Einstein College of Medicine, Montefiore Medical Center, Yonkers, NY, USA
| | | | - Sydney M Levine
- Pediatric Behavioral Health Services, Montefiore Medical Group, Albert Einstein College of Medicine, Montefiore Medical Center, Yonkers, NY, USA
| | - Kate C Cuno
- Maimonides Children's Hospital, Brooklyn, NY, USA
| | - Polina Umylny
- Pediatric Behavioral Health Services, Montefiore Medical Group, Albert Einstein College of Medicine, Montefiore Medical Center, Yonkers, NY, USA
| | - Rahil D Briggs
- Pediatric Behavioral Health Services, Montefiore Medical Group, Albert Einstein College of Medicine, Montefiore Medical Center, Yonkers, NY, USA.,ZERO TO THREE, Washington, DC, USA
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31
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Invisibility of nurses and midwives in the public health response to child abuse and neglect: A policy review. Collegian 2022. [DOI: 10.1016/j.colegn.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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32
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Chung A, Zorbas C, Peeters A, Backholer K, Browne J. A Critical Analysis of Representations of Inequalities in Childhood Obesity in Australian Health Policy Documents. Int J Health Policy Manag 2022; 11:1767-1779. [PMID: 34380204 PMCID: PMC9808209 DOI: 10.34172/ijhpm.2021.82] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 07/10/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND In Australia, childhood obesity follows a socioeconomic gradient whereby children with lower socioeconomic position are disproportionately burdened. To reduce these inequalities in childhood obesity requires a multi-component policy-driven response. Action to address health issues is underpinned by the ways in which they are represented as 'problems' in public policy. This study critically examines representations of inequalities in childhood obesity within Australian health policy documents published between 2000-2019. METHODS Australia's federal, state and territory government health department websites were searched for health policy documents including healthy weight, obesity, healthy eating, food and nutrition strategies; child and youth health strategies; and broader health and wellbeing, prevention and health promotion policies that proposed objectives or strategies for childhood obesity prevention. Thematic analysis of eligible documents was guided by a theoretical framework informed by problematization theory, ecological systems theory, and theoretical principles for equity in health policy. RESULTS Eighteen policy documents were eligible for inclusion. The dominant representation of inequalities in childhood obesity was one of individual responsibility. The social determinants of inequalities in childhood obesity were acknowledged, yet policy actions predominantly focused on individual determinants. Equity was positioned as a principle of policy documents but was seldom mentioned in policy actions. CONCLUSION Current representations of inequalities in childhood obesity in Australian health policy documents do not adequately address the underlying causes of health inequities. In order to reduce inequalities in childhood obesity future policies will need greater focus on health equity and the social determinants of health (SDoH).
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Affiliation(s)
- Alexandra Chung
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Christina Zorbas
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Anna Peeters
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Kathryn Backholer
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Jennifer Browne
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
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Bessell S, Vuckovic C. How child inclusive were Australia's responses to COVID-19? THE AUSTRALIAN JOURNAL OF SOCIAL ISSUES 2022; 58:AJS4232. [PMID: 36247405 PMCID: PMC9537785 DOI: 10.1002/ajs4.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 06/16/2023]
Abstract
From March 2020, Australia introduced a range of policies to respond to COVID-19, most of which impacted significantly on the lives of children. This article applies a child-centred framework, developed from rights-based participatory research with children, to analyse how children have been represented in policy narratives around COVID-19 and the extent to which policy responses have been child-inclusive or child-centred. We argue that, overall, COVID-19 policy responses have failed to be child-inclusive or child-centred. This has important implications not only for understanding the impact of COVID-19 on children but also in understanding-and potentially rethinking-the place of children in policies as Australia emerges from COVID-19 restrictions.
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Affiliation(s)
- Sharon Bessell
- Crawford School of Public PolicyThe Australian National UniversityCanberraAustralia
| | - Celia Vuckovic
- Crawford School of Public PolicyThe Australian National UniversityCanberraAustralia
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Saunders V, Beck M, McKechnie J, Lincoln M, Phillips C, Herbert J, Davey R. A Good start in life: Effectiveness of integrated multicomponent multisector support on early child development—Study protocol. PLoS One 2022; 17:e0267666. [PMID: 35921322 PMCID: PMC9348669 DOI: 10.1371/journal.pone.0267666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/13/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction
Early childhood experiences have a lifelong impact on a child’s future. Social and environmental experiences and interactions have a profound relational effect on children’s physical and mental health which transfers agency to parents, caregivers and duty-bearers to care for the child’s welfare. In the Australian context early child development indices have been in decline in some communities. Hence, there is a sense of urgency to reverse these trends from an integrated perspective. A multisector, multi component program of interventions named A Good Start in Life is proposed and is being tested in the Australian Capital Territory across suburbs with high levels of early childhood development disadvantage. The aim of this study is to evaluate the outcomes and processes related to targeted interventions, designed to integrate child and family services within the local district and embed allied health programs into early childhood education, care services and playgroups.
Methods and analysis
The Good Start in Life study will use a quasi-experimental design (with a matched control geographical area) consisting of a combination of interventions that will build multisectoral collaboration across education, health and social services that connect and support families with children from birth to 5 years. The control area will be matched on demographic characteristics and early child development outcomes and trends over the pre-intervention period. Evaluation data will be collected at baseline, and then on an annual basis for a further three years. A mixed methods approach will be used to evaluate delivery processes: quantitative (checklists, questionnaires) and qualitative methods (observations, focus groups and key stakeholder interviews). Effectiveness of the programme will be evaluated by comparing early child development outcomes between the comparator areas from the Australian Early Development Census in 2024. The primary focus will be on reducing the number of children who are developmentally vulnerable on at least one early development index (EDI). Separate tests will be conducted for significant differences in the percentage of children at risk in each of the five individual EDI domains. These domains are physical health and wellbeing, social competence, emotional maturity, language and cognitive skills, and communication and general knowledge.
Trial registration
ACTRN12621001140842.
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Affiliation(s)
- Vicky Saunders
- Health Research Institute, University of Canberra, Bruce, ACT, Australia
- * E-mail: (MB); (VS)
| | - Maddison Beck
- Health Research Institute, University of Canberra, Bruce, ACT, Australia
- * E-mail: (MB); (VS)
| | | | - Michelle Lincoln
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | | | - Jane Herbert
- University of Wollongong, Northfields Avenue, Wollongong, NSW, Australia
| | - Rachel Davey
- Health Research Institute, University of Canberra, Bruce, ACT, Australia
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35
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Russell J, Grant CC, Morton S, Denny S, Paine (Tūhoe) SJ. Prevalence and predictors of developmental health difficulties within New Zealand preschool-aged children: a latent profile analysis. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2083188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Jin Russell
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Developmental Paediatrics, Neuroservices, Starship Children’s Health, Auckland, New Zealand
| | - Cameron C. Grant
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand
- General Paediatrics, Starship Children’s Health, Auckland, New Zealand
| | - Susan Morton
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Simon Denny
- Mater Research, Health Services Research Group, South Brisbane, Australia
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Atashbahar O, Sari AA, Takian A, Olyaeemanesh A, Mohamadi E, Barakati SH. The impact of social determinants of health on early childhood development: a qualitative context analysis in Iran. BMC Public Health 2022; 22:1149. [PMID: 35676642 PMCID: PMC9178833 DOI: 10.1186/s12889-022-13571-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social determinants have a significant impact on children's development and their abilities and capacities, especially in early childhood. They can bring about inequity in living conditions of children and, as a result, lead to differences in various dimensions of development including the social, psychological, cognitive and emotional aspects. We aimed to identify and analyze the social determinants of Early Childhood Development (ECD) in Iran and provide policy implications to improve this social context. METHODS In a qualitative study, data were collected through semi-structured interviews with 40 experts from October 2017 to June 2018. Based on Leichter's (1979) framework and using the deductive approach, two independent researchers conducted the data analysis. We used MAXQDA.11 software for data management. RESULTS We identified challenges related to ECD context in the form of 8 themes and 22 subthemes in 4 analytical categories relevant to the social determinants of ECD including: Structural factors (economic factors: 6 subthemes, political factors: 2 subthemes), Socio-cultural factors (the socio-cultural setting of society: 6 subthemes, the socio-cultural setting of family: 4 subthemes), Environmental or International factors (the role of international organizations: 1 subtheme, political sanctions: 1 subtheme), and Situational factors (genetic factors: 1 subtheme, the phenomenon of air pollution: 1 subtheme). We could identify 24 policy recommendations to improve the existing ECD context from the interviews and literature. CONCLUSION With regard to the challenges related to the social determinants of ECD, such as increasing social harms, decreasing social capital, lack of public awareness, increasing socio-economic inequities, economic instability, which can lead to the abuse and neglect of children or unfair differences in their growth and development, the following policy-making options are proposed: focusing on equity from early years in policies and programs, creating integration between policies and programs from different sectors, prioritizing children in the welfare umbrella, empowering families, raising community awareness, and expanding services and support for families, specially the deprived families subject to special subsidies.
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Affiliation(s)
| | - Ali Akbari Sari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Takian
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Health Equity Research Centre (HERC), Tehran University of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd, Tehran, 1416833481, Iran
| | - Alireza Olyaeemanesh
- Health Equity Research Centre (HERC), Tehran University of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd, Tehran, 1416833481, Iran
| | - Efat Mohamadi
- Health Equity Research Centre (HERC), Tehran University of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd, Tehran, 1416833481, Iran.
| | - Sayyed Hamed Barakati
- Population, Family and School Health Office, Ministry of Health and Medical Education, Tehran, Iran
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Miller AL, Stein SF, Sokol R, Varisco R, Trout P, Julian MM, Ribaudo J, Kay J, Pilkauskas NV, Gardner-Neblett N, Herrenkohl TI, Zivin K, Muzik M, Rosenblum KL. From zero to thrive: A model of cross-system and cross-sector relational health to promote early childhood development across the child-serving ecosystem. Infant Ment Health J 2022; 43:624-637. [PMID: 35638583 DOI: 10.1002/imhj.21996] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 11/30/2021] [Indexed: 11/05/2022]
Abstract
Early relational health between caregivers and children is foundational for child health and well-being. Children and caregivers are also embedded within multiple systems and sectors, or a "child-serving ecosystem", that shapes child development. Although the COVID-19 pandemic has made this embeddedness abundantly clear, systems remain siloed and lack coordination. Fostering relational health amongst layers of this ecosystem may be a way to systematically support young children and families who are facing adversity. We integrate theory, examples, and empirical findings to develop a conceptual model informed by infant mental health and public health frameworks that illustrates how relational health across the child-serving ecosystem may promote child health and well-being at a population level. Our model articulates what relational health looks like across levels of this ecosystem from primary caregiver-child relationships, to secondary relationships between caregivers and child-serving systems, to tertiary relationships among systems that shape child outcomes directly and indirectly. We posit that positive relational health across levels is critical for promoting child health and well-being broadly. We provide examples of evidence-based approaches that address primary, secondary, and tertiary relational health, and suggest ways to promote relational health through cross-sector training and psychoeducation in the science of early development. This model conceptualizes relational health across the child-serving ecosystem and can serve as a template for promoting child health and well-being in the context of adversity.
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Affiliation(s)
- Alison L Miller
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sara F Stein
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Rebeccah Sokol
- School of Social Work, Wayne State University, Detroit, Michigan, USA
| | - Rachel Varisco
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Phoebe Trout
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,Ford School of Public Policy, University of Michigan, Ann Arbor, Michigan, USA
| | - Megan M Julian
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Julie Ribaudo
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Joshua Kay
- University of Michigan Law School, Ann Arbor, Michigan, USA
| | | | | | - Todd I Herrenkohl
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Kara Zivin
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Maria Muzik
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Katherine L Rosenblum
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Mutic AD, Mauger DT, Grunwell JR, Opolka C, Fitzpatrick AM. Social Vulnerability Is Associated with Poorer Outcomes in Preschool Children With Recurrent Wheezing Despite Standardized and Supervised Medical Care. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY: IN PRACTICE 2022; 10:994-1002. [PMID: 35123099 PMCID: PMC9007879 DOI: 10.1016/j.jaip.2021.12.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/13/2021] [Accepted: 12/31/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Social determinants of health are associated with disparate asthma outcomes in school-age children. Social determinants have not been studied in preschool children with recurrent wheezing. OBJECTIVE We hypothesized that preschool children with recurrent wheezing at highest risk of social vulnerability would have more frequent symptoms and exacerbations when followed over 1 year, despite receiving standardized and supervised asthma care. METHODS A multicenter population of adherent preschool children receiving standardized and supervised care for wheezing was stratified by a composite measure of social vulnerability based on individual-level variables. Primary outcomes included days with upper respiratory infections and days with asthma symptom flares. Other outcomes included symptom scores during upper respiratory infections and respiratory symptom flare days, exacerbation occurrence, quality of life during the exacerbation, and hospitalization. RESULTS Preschool children at highest risk of social vulnerability did not have more frequent upper respiratory infections, respiratory symptoms, or exacerbations, but instead had more severe symptoms during upper respiratory infections and respiratory flare days, as well as more severe exacerbations with significantly poorer caregiver quality of life. Children at highest risk of social vulnerability also lived in poorer housing conditions with differing exposures and self-reported triggers. CONCLUSIONS Individual-level social determinants of health reflecting social vulnerability are associated with poorer outcomes in preschool children with recurrent wheezing despite access to supervised and standardized care. Comprehensive assessment of social determinants of health is warranted in even the youngest children with wheezing, because mitigation of these social inequities is an essential first step toward improving outcomes in pediatric patients.
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Affiliation(s)
- Abby D Mutic
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Ga
| | - David T Mauger
- Division of Biostatistics and Bioinformatics, Pennsylvania State University, Hershey, Pa
| | - Jocelyn R Grunwell
- Department of Pediatrics, Emory University, Atlanta, Ga; Division of Pediatric Critical Care Medicine, Children's Healthcare of Atlanta, Atlanta, Ga
| | - Cydney Opolka
- Division of Pediatric Critical Care Medicine, Children's Healthcare of Atlanta, Atlanta, Ga
| | - Anne M Fitzpatrick
- Department of Pediatrics, Emory University, Atlanta, Ga; Division of Pediatric Pulmonology, Children's Healthcare of Atlanta, Atlanta, Ga.
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Nelson HJ, Munns A, Ong S, Watson L, Burns S. Identification of models, theoretical design and formal evaluation of integrated specialist community health service provision for the first 2000 days: a protocol for a scoping review. BMJ Open 2022; 12:e054807. [PMID: 35296481 PMCID: PMC8928289 DOI: 10.1136/bmjopen-2021-054807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The first 2000 days of a child's life (during pregnancy up to age 5 years) represent a critical period, in which early interventions reduce risk associated with developmental delay, disability and intergenerational disadvantage. The risk is exacerbated by barriers to specialised early intervention for children and families. This scoping review seeks to contribute to the evidence for sustaining integrated community-based specialist care in these earliest years of a child's life. METHODS AND ANALYSIS The Joanna Briggs Institute scoping review framework will be followed. Inclusion and exclusion criteria for screening of literature is predefined, guided by the criteria of population, concept and context. The review will identify models of care delivery, and will identify quality of care outcomes that have been measured, including evidence of reliability and validity. Sources of evidence will include CINAHL, Cochrane databases, Medline, PsycINFO and Scopus. ETHICS AND DISSEMINATION In a three-part study, evidence synthesis from the scoping review of the literature; mapping of existing specialist early years services in one community and a consumer consultation (Curtin University Human Research Ethics approval HRE2021-0546) in the same community will inform a model of integrated care that accounts for the context of the community it seeks to serve. Results will be disseminated by peer-reviewed publications and conference presentations, contributing to the evidence base for delivering sustainable community-based integrated care in the context of the first 2000 days. This protocol is specific to the scoping review.
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Affiliation(s)
| | - Ailsa Munns
- School of Nursing, Curtin University, Perth, Western Australia, Australia
- Child and Adolescent Health Service, Nedlands, Western Australia, Australia
| | - Sarah Ong
- Child and Adolescent Health Service, Nedlands, Western Australia, Australia
| | - Leanne Watson
- Carey Community Resources, Harrisdale, Western Australia, Australia
- East Metropolitan Health Service, Perth, Western Australia, Australia
| | - Sharyn Burns
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Perth, Western Australia, Australia
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40
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Edyburn KL, Bertone A, Raines TC, Hinton T, Twyford J, Dowdy E. Integrating Intersectionality, Social Determinants of Health, and Healing: A New Training Framework for School-Based Mental Health. SCHOOL PSYCHOLOGY REVIEW 2022. [DOI: 10.1080/2372966x.2021.2024767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kelly L. Edyburn
- University of California, San Francisco
- Zuckerberg San Francisco General Hospital
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41
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Goodyear M, Zechmeister-Koss I, Bauer A, Christiansen H, Glatz-Grugger M, Paul JL. Development of an Evidence-Informed and Codesigned Model of Support for Children of Parents With a Mental Illness- "It Takes a Village" Approach. Front Psychiatry 2022; 12:806884. [PMID: 35173638 PMCID: PMC8841827 DOI: 10.3389/fpsyt.2021.806884] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022] Open
Abstract
Providing support to parents and their children to help address the cycle of intergenerational impacts of mental illness and reduce the negative consequences for children is a key focus of selective prevention approaches in public mental health. However, a key issue for children of parents with a mental illness is the lack of access to early intervention and prevention support when needed. They are not easily identifiable (until presenting with significant mental health issues of their own) and not easily accessing the necessary support that address the complex interplay of parental mental illness within families. There are significant barriers to the early identification of these children, particularly for mental health care. Furthermore, there is a lack of collaborative care that might enhance identification as well as offer services and support for these families. The "It takes a Village" project seeks to improve mental health outcomes for children through the co-development, implementation and evaluation of an approach to collaborative practice concerned with the identification of families where a parent has a mental illness, and establishing a service model to promote child-focused support networks in Austria. Here we describe the development of service delivery approach for the "It takes a Village" project that aims to improve identification and support of these children within enhancements of the existing service systems and informal supports. The paper describes the use of codesign and other implementation strategies, applied to a research setting, with the aim of impacting the sustainability of workforce reform to achieve lasting social impact. Results highlight the steps involved in translating evidence-based components, local practice wisdom and lived experience into the "It takes a Village" practice model for Tyrol, Austria. We highlight through this paper how regional context-specific solutions are essential in the redesign of care models that meet the complex needs of children of parents with a mental illness. Service system and policy formation with local and experienced stakeholders are also vital to ensure the solutions are implementation-ready, particularly when introducing new practice models that rely on organizational change and new ways of practice with vulnerable families. This also creates a solid foundation for the evaluation of the "It take a Village" approach for children of parents with a mental illness in Austria.
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Affiliation(s)
- Melinda Goodyear
- School of Rural Health, Monash University, Melbourne, VIC, Australia
- Emerging Minds, National Workforce Centre for Child Mental Health, Hilton, SA, Australia
| | | | - Annette Bauer
- Department of Health Policy, Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Hanna Christiansen
- Department of Psychology, Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Martina Glatz-Grugger
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria
| | - Jean Lillian Paul
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
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Simelane SRN, de Vries PJ. Child and adolescent mental health services and systems in low and middle-income countries: from mapping to strengthening. Curr Opin Psychiatry 2021; 34:608-616. [PMID: 34419969 DOI: 10.1097/yco.0000000000000740] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Most of the world's children and adolescents live in low and middle-income countries (LMICs) where mental health services are very limited. Here, we reviewed literature over the last 18 months describing the current landscape of child and adolescent mental health services and systems (CAMHSS) in LMICs, and present findings from systems strengthening research. RECENT FINDINGS The challenges in CAMHSS are well described with little change over the last two decades. Fortunately, research has started to move from 'mapping' towards systems 'strengthening'. Using the WHO Assessment Instrument for Mental Health Systems (WHO-AIMS) framework, we reviewed recent CAMHSS innovations. Clinical care and human resource innovations focused on primary care with validation of screening tools, training and task-sharing for capacity-building. Intersectoral collaboration emerged as a priority domain for strengthening, alongside a theme around the importance of participatory research to inform policy reforms. The potential role of digital technology to strengthen CAMHSS was identified as an emerging theme. SUMMARY There is an urgent need to increase the priority of CAMHSS in LMICs. This will require innovations at multiple levels aimed at all CAMHSS domains, with active participation of all relevant local stakeholders to ensure the translation of research into policy and practice.
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Affiliation(s)
- Simphiwe R N Simelane
- Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
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Perkins A, Clarke J, Smith A, Oberklaid F, Darling S. Barriers and enablers faced by regional and rural schools in supporting student mental health: A mixed-methods systematic review. Aust J Rural Health 2021; 29:835-849. [PMID: 34687477 DOI: 10.1111/ajr.12794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/05/2021] [Accepted: 08/12/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Australian policy reports recommended schools to be leveraged to better support student mental health, with a focus on regional and rural areas where students have poorer mental health outcomes. In designing solutions to address this systemic gap, decision-makers require an understanding of the barriers and facilitators experienced by regional and rural schools. However, current literature has focused on metropolitan schools and neglected to explore facilitators. OBJECTIVE To review the evidence on barriers and facilitators in delivering student mental health support experienced by regional and rural schools in Organisation for Economic Co-operation and Development nations. DESIGN A mixed-methods systematic review of peer-reviewed and grey literature. FINDINGS The search identified 4819 studies. A full-text review by 2 reviewers resulted in 5 papers, which met the inclusion criteria and were assessed using methodological appraisal. One study used qualitative data, 2 studies used quantitative data, and 2 studies were a mixed-methods design. DISCUSSION While there was a paucity of studies, this review draws together the most up-to-date research. The barriers and facilitators were categorised into 3 themes: access to services and resources; mental health literacy of staff and parents; and communication and collaboration between stakeholders. CONCLUSION This review presents a comprehensive synthesis of the literature and highlights opportunities to leverage rural and regional schools to support student mental health, focusing on the quality of communication and collaboration, and increasing access to services and resources, and mental health literacy. Research should explore the unique advantages of rural and regional areas to inform policy, including a focus on strengths.
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Affiliation(s)
- Alexandra Perkins
- Centre of Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia
| | - Jessica Clarke
- Centre of Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia
| | - Ashlee Smith
- Centre of Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia
| | - Frank Oberklaid
- Centre of Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Simone Darling
- Centre of Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
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Barboza M, Marttila A, Burström B, Kulane A. Covid-19 and pathways to health inequities for families in a socioeconomically disadvantaged area of Sweden - qualitative analysis of home visitors' observations. Int J Equity Health 2021; 20:215. [PMID: 34565387 PMCID: PMC8474881 DOI: 10.1186/s12939-021-01556-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/17/2021] [Indexed: 12/04/2022] Open
Abstract
Background Lack of control over life situations is an important social determinant that may negatively affect parental and child health. This study took place in an area of Stockholm, Sweden with high indications of socioeconomic disadvantage, a large part of the population with foreign background, as well as higher levels of poor health than the county average. It investigated staff perceptions of pathways from situations of low control, potentially leading to health inequities, affecting families enrolled in an early childhood home visiting programme during the Covid-19 pandemic. Methods Semi-structured interviews were carried out with 23 child health care nurses and parental advisors working in a home visiting programme. The data was analysed using Reflexive Thematic Analysis. Results The analysis resulted in five pathways on two explanatory levels, affecting parents’ health and parenting capacity and children’s health and well-being, potentially damaging health and leading to health inequities. The first four pathways related to control at the personal explanatory level: Families facing instability and insecurity; Caring for children in crowded and poor housing conditions; Experiencing restricted access to resources; and Parenting with limited social support. The fifth pathway, Living in a segregated society, covered the collective experience of lack of control on community level. The Covid-19 pandemic was observed to negatively affect all pathways and thus potentially aggravate health inequities for this population. The pandemic has also limited the delivery of home visits to the families which creates further barriers in families’ access to resources and increases isolation for parents with already limited social support. Conclusions The diversity of pathways connected to health inequities presented in this study highlights the importance of considering this variety of influences when designing interventions for socioeconomically disadvantaged areas. The additional negative consequences of Covid-19 indicate the need for sustainable preventive early childhood interventions for families in such areas. The study also emphasizes the need for further research as well as policy action on possible long-term effects of changing behaviours during the Covid-19 period on child health and health equity. Trial registration The study was retrospectively registered (11 August 2016) in the ISRCTN registry (ISRCTN11832097). Supplementary Information The online version contains supplementary material available at 10.1186/s12939-021-01556-6.
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Affiliation(s)
- Madelene Barboza
- Department of Global Public Health, Equity and Health Policy Research Group, Karolinska Institutet, 17177, Stockholm, Sweden.
| | - Anneli Marttila
- Department of Global Public Health, Equity and Health Policy Research Group, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Bo Burström
- Department of Global Public Health, Equity and Health Policy Research Group, Karolinska Institutet, 17177, Stockholm, Sweden.,Region Stockholm, Centre for Epidemiology and Community Medicine, Box 45436, 104 31, Stockholm, Sweden
| | - Asli Kulane
- Department of Global Public Health, Equity and Health Policy Research Group, Karolinska Institutet, 17177, Stockholm, Sweden
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Atashbahar O, Sari AA, Takian A, Olyaeemanesh A, Mohamadi E, Barakati SH. Integrated early childhood development policy in Iran: a stakeholder analysis. BMC Health Serv Res 2021; 21:971. [PMID: 34526031 PMCID: PMC8444469 DOI: 10.1186/s12913-021-06968-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/02/2021] [Indexed: 11/30/2022] Open
Abstract
Background Many stakeholders are involved in the complicated process of policy making in integrated early childhood development (IECD). In other words, there are many challenges for IECD policy making in developing countries, including Iran. The aim of this study was to identify potential stakeholders and their interactions in IECD policy making in Iran. Method A mixed-methods study was conducted in two phases in 2018. First, forty semi-structured interviews and a review of IECD-related documents were conducted to identify potential stakeholders and their roles. Second, using a designed checklist, these stakeholders were assessed for power, interest, and position in IECD policy making. Then, a map of stakeholders and a three-dimensional stakeholder analysis figure were designed. Results The results of this study showed that various stakeholders, including governmental, semi-governmental, social, non-governmental and international organizations, potentially influence IECD policy in Iran. They were found to have diverse levels of power, interest and position in this regard, leading to their different impacts on the process. This diversity is assumed to have affected their levels of participation and support. Also, we found that the stakeholders with a high-power level do not have a high level of interest in, or support for, IECD policy. In general, organizational competition, complicated inter-sectoral nature of this process, insufficient budget, insufficient awareness about the importance of IECD, lack of priority given to IECD in relevant organizations, economical views rather than developmental perspectives, and lack of commitment among top managers are the reasons why this policy enjoys a low degree of support. Conclusions There are weaknesses in effective interactions and relationships among IECD policy stakeholders. This will lead to the lack of equal opportunities for optimal early childhood development. To improve this process, advocacy from high-level authorities of the organizations, negotiation with child-friendly groups, establishing a body to coordinate and oversee children’s affairs, using the capacity of non-governmental organizations, strengthening inter-sectoral collaboration by clarifying the roles and responsibilities of stakeholders and the relationships between them, and increasing public awareness can be helpful.
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Affiliation(s)
| | - Ali Akbari Sari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Takian
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Health Equity Research Center (HERC), Tehran University of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd, 1416833481, Tehran, Iran.,Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Olyaeemanesh
- National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran.,Health Equity Research Center (HERC), Tehran University of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd, 1416833481, Tehran, Iran
| | - Efat Mohamadi
- Health Equity Research Center (HERC), Tehran University of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd, 1416833481, Tehran, Iran.
| | - Sayyed Hamed Barakati
- Population, Family and School Health Office, Ministry of Health and Medical Education, Tehran, Iran
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46
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Yaseen W, Steckle V, Sgro M, Barozzino T, Suleman S. Exploring Stakeholder Service Navigation Needs for Children with Developmental and Mental Health Diagnoses. J Dev Behav Pediatr 2021; 42:553-560. [PMID: 34518497 DOI: 10.1097/dbp.0000000000000924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/11/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Service navigation programs are necessary for children with neurodevelopmental and/or mental health diagnoses to facilitate access to specialized therapies, social services, and community programs, especially those who are socially and economically marginalized. Few studies have included diverse stakeholders in the development and implementation of such programs in resource-limited settings. In this qualitative formative study, we aimed to explore stakeholder experiences after the implementation of a pilot service navigation program in resource-limited settings and identify the perceived elements of an effective service navigator, to develop a revised service navigation program for this patient population. METHODS A novel navigation pilot program was implemented in an urban inner-city setting. Using phenomenology as a methodology, we conducted qualitative in-depth interviews with patient caregivers, pediatricians, allied health staff, clinic administrators, and the patient navigator. Data were analyzed within and across stakeholder groups using thematic analysis and supported by group discussion. RESULTS Twenty-five stakeholders participated. All stakeholders reported challenges with accessing services before the implementation of the navigation program. Caregivers expressed frustration navigating a fragmented health care system, while providers felt limited by time and knowledge. The navigator's role was described as multifaceted: finding and completing applications for funding and programs, offering emotional support, liaising between physicians and patients, and advocating with schools and agencies. Based on stakeholder input, a revised service navigation model of care is proposed. CONCLUSION Caregivers and providers face immense barriers trying to help children with mental health and developmental diagnoses access necessary services and funding. Service navigation programs can be effectively embedded within pediatric clinical teams to improve access to required services for this patient population.
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Affiliation(s)
- Wid Yaseen
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Valerie Steckle
- Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada
| | - Michael Sgro
- Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tony Barozzino
- Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Shazeen Suleman
- Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Neale G, Gaihre S, O'Gorman P, Price RK, Balzategi AG, Barrientos CH, Rawal S, Morgan M, McNulty H. Review of recent innovations in portable child growth measurement devices for use in low- and middle-income countries. J Med Eng Technol 2021; 45:642-655. [PMID: 34309474 DOI: 10.1080/03091902.2021.1946181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Improving nutritional status is fundamental to addressing challenges in child health in low- and middle-income countries (LMICs) and a priority for international organisations such as the United Nations Children's Fund (UNICEF) and the World Health Organisation (WHO). Despite the global consensus that child growth is a key indicator of child nutrition and health, the development of low-cost, accurate and child-friendly growth measurement devices that are fit for purpose in LMICs remains elusive. Recognising these limitations, UNICEF recently published a Target Product Profile (TPP) calling for the development of new state-of-the-art height and length measurement devices. The purpose of this review was to examine current growth measurement devices in relation to this UNICEF TPP requirement and set the stage for the development of new devices. The findings show that there is a gap in the product market for accurate portable length and height measurement devices. In particular, our review indicates that devices in current use generally lack capabilities for automated data recording and transfer of data to a central database, and are often not child-friendly. We conclude that future innovations in length and height measurement devices should focus on addressing these issues.
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Affiliation(s)
- Geoffrey Neale
- School of Engineering, Ulster University, Jordanstown, United Kingdom of Great Britain and Northern Ireland.,Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland
| | - Santosh Gaihre
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland
| | - Pearse O'Gorman
- School of Engineering, Ulster University, Jordanstown, United Kingdom of Great Britain and Northern Ireland
| | - Ruth K Price
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland
| | - Ane Galdos Balzategi
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland.,Fundacion Cantaro Azul, San Cristóbal de las Casas, Mexico
| | - Catalina Herrera Barrientos
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland.,Centro de Ciencia y Tecnología de Antioquia (CTA), Medellín, Colombia
| | - Shweta Rawal
- South Asian Infant Feeding Research Network, Kathmandu, Nepal
| | - Margaret Morgan
- School of Engineering, Ulster University, Jordanstown, United Kingdom of Great Britain and Northern Ireland
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland
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Bozzini AB, Bauer A, Maruyama J, Simões R, Matijasevich A. Factors associated with risk behaviors in adolescence: a systematic review. ACTA ACUST UNITED AC 2021; 43:210-221. [PMID: 32756805 PMCID: PMC8023154 DOI: 10.1590/1516-4446-2019-0835] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 04/15/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Understanding the distal (≤ 6 years of age) and proximal (between 6 years of age and early adolescence) factors in adolescent risk behavior is important for preventing and reducing morbidity and mortality in this population. This study sought to investigate the factors associated with the following adolescent risk behaviors: i) aggressiveness and violence, ii) tobacco, alcohol, and illicit substance use, iii) depressive behavior and self-harm (including suicidal ideation and attempts), iv) sexual risk behavior, and v) multiple risk behavior. METHODS A systematic review was conducted to identify longitudinal studies that examined factors associated with adolescent risk behaviors. The PubMed, PsycINFO, and LILACS databases were searched. RESULTS Of the 249 included studies, 23% reported distal risk factors, while the remaining reported proximal risk factors. Risk factors were related to sociodemographic characteristics (neighborhood, school, and peers), family patterns, and the presence of other adolescent risk behaviors. CONCLUSION Distal and proximal factors in adolescent risk behavior that are not exclusively socioeconomic, familial, environmental, or social should be explored more thoroughly.
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Affiliation(s)
- Ana Beatriz Bozzini
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Andreas Bauer
- Department of Psychology, University of Bath, Bath, Somerset, UK
| | - Jessica Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Ricardo Simões
- Departamento de Ginecologia, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Departamento de Epidemiologia, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
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Molloy C, Moore T, O'Connor M, Villanueva K, West S, Goldfeld S. A Novel 3-Part Approach to Tackle the Problem of Health Inequities in Early Childhood. Acad Pediatr 2021; 21:236-243. [PMID: 33359515 DOI: 10.1016/j.acap.2020.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/24/2020] [Accepted: 12/17/2020] [Indexed: 11/29/2022]
Abstract
The first 5 years of a child's life are crucial in laying the foundation for their health and developmental trajectory into adulthood. These early years are especially influenced by the surrounding environments in which children live and grow. A large international body of evidence demonstrates that children who experience disadvantage tend to fall increasingly behind over time. At the societal level, these inequities can cause substantial social burdens and significant costs across health, education, and welfare budgets. A contributing factor is that children experiencing adversity are less likely to have access to the environmental conditions that support them to thrive. Many of these factors are modifiable at the community or place level. We argue for three key-though not exhaustive-ideas that collectively could achieve more equitable outcomes for children facing disadvantage and experiencing adversity:We conclude that if adopted, these 3 ideas could contribute to the ability of local communities and networks to identify and respond to factors that address early childhood inequalities.
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Affiliation(s)
- Carly Molloy
- Policy and Equity, Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital (C Molloy, T Moore, M O'Connor, K Villanueva, S West, and S Goldfeld), Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne (C Molloy, T Moore, M O'Connor, and S Goldfeld), Melbourne, Victoria, Australia
| | - Tim Moore
- Policy and Equity, Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital (C Molloy, T Moore, M O'Connor, K Villanueva, S West, and S Goldfeld), Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne (C Molloy, T Moore, M O'Connor, and S Goldfeld), Melbourne, Victoria, Australia
| | - Meredith O'Connor
- Policy and Equity, Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital (C Molloy, T Moore, M O'Connor, K Villanueva, S West, and S Goldfeld), Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne (C Molloy, T Moore, M O'Connor, and S Goldfeld), Melbourne, Victoria, Australia
| | - Karen Villanueva
- Policy and Equity, Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital (C Molloy, T Moore, M O'Connor, K Villanueva, S West, and S Goldfeld), Melbourne, Victoria, Australia; Centre for Urban Research, RMIT University (K Villanueva), Melbourne, Victoria, Australia
| | - Sue West
- Policy and Equity, Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital (C Molloy, T Moore, M O'Connor, K Villanueva, S West, and S Goldfeld), Melbourne, Victoria, Australia
| | - Sharon Goldfeld
- Policy and Equity, Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital (C Molloy, T Moore, M O'Connor, K Villanueva, S West, and S Goldfeld), Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne (C Molloy, T Moore, M O'Connor, and S Goldfeld), Melbourne, Victoria, Australia.
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50
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Rudenstine S, McNeal K, Schulder T, Ettman CK, Hernandez M, Gvozdieva K, Galea S. Depression and Anxiety During the COVID-19 Pandemic in an Urban, Low-Income Public University Sample. J Trauma Stress 2021; 34:12-22. [PMID: 33045107 PMCID: PMC7675401 DOI: 10.1002/jts.22600] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 02/06/2023]
Abstract
Mental health disparities in the aftermath of national disasters and the protective role of socioeconomic status are both well documented. We assessed the prevalence of depression and anxiety symptoms among underresourced public university students during the COVID-19 pandemic in New York City. Between April 8, 2020, and May 2, 2020, adult students (N = 1,821) across the CUNY system completed an online survey examining COVID-19-related stressors and mental health and sociodemographic factors. Using multivariable logistical regression to assess the association between COVID-19-related stressors and depression and anxiety symptoms, we found a high prevalence and severity of depression and anxiety symptoms. We also observed that more exposure to COVID-19-related stressors was associated with increased depressive (27.0%, 41.4%, and 63.1% for low-, medium-, and high-level stressors, respectively) and anxiety symptoms (19.3%, 34.6%, 52.2%). In addition, the degree of exposure to COVID-19-related stressors served as an important predictor of depression and anxiety symptoms. Compared to high levels of stressors, the odds of depression were 0.2, 95% CI [0.2, 0.3] for low- and 0.4, 95% CI [0.3, 0.5] for medium-level stressors; for anxiety, the odds were 0.2, 95% CI [0.2, 0.3] for low and 0.05, 95% CI [0.4, 0.6] for medium stressors. Finally, household savings of less than $5,000 increased the risk of anxiety but not depression symptoms, OR = 1.3, 95% CI [1.0,1.6]. Together, these findings tell a devastating story of psychological distress among students from lower socioeconomic groups living in the COVID-19 epicenter of the U.S. pandemic.
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Affiliation(s)
- Sasha Rudenstine
- Department of PsychologyCity College of New YorkNew YorkNew YorkUSA
| | - Kat McNeal
- Department of PsychologyCity College of New YorkNew YorkNew YorkUSA
| | - Talia Schulder
- Department of PsychologyCity College of New YorkNew YorkNew YorkUSA
| | | | | | | | - Sandro Galea
- School of Public HealthBoston UniversityBostonMassachusettsUSA
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