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van Zwieten A, Teixeira-Pinto A, Lah S, Nassar N, Craig JC, Wong G. Life-Course Approaches to Socioeconomic Inequities in Educational Outcomes Across Childhood and Adolescence: An Update. Acad Pediatr 2024:S1876-2859(24)00117-7. [PMID: 38561060 DOI: 10.1016/j.acap.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/29/2024] [Accepted: 03/28/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Anita van Zwieten
- Sydney School of Public Health (A van Zwieten, A Teixeira-Pinto, and G Wong), Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Centre for Kidney Research (A van Zwieten, A Teixeira-Pinto, and G Wong), The Children's Hospital at Westmead, Westmead, NSW, Australia.
| | - Armando Teixeira-Pinto
- Sydney School of Public Health (A van Zwieten, A Teixeira-Pinto, and G Wong), Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Centre for Kidney Research (A van Zwieten, A Teixeira-Pinto, and G Wong), The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Suncica Lah
- School of Psychology (S Lah), University of Sydney, Sydney, NSW, Australia; Australian Research Council Centre of Excellence for Cognition and Its Disorders (ARC CCD) (S Lah), Macquarie University, Sydney, NSW, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research (N Nassar), Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health (JC Craig), Flinders University, Adelaide, SA, Australia
| | - Germaine Wong
- Sydney School of Public Health (A van Zwieten, A Teixeira-Pinto, and G Wong), Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Centre for Kidney Research (A van Zwieten, A Teixeira-Pinto, and G Wong), The Children's Hospital at Westmead, Westmead, NSW, Australia; Department of Renal Medicine (G Wong), Westmead Hospital, Westmead, NSW, Australia
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Smith LH, Nist MD, Fortney CA, Warren B, Harrison T, Gillespie S, Herbell K, Militello L, Anderson CM, Tucker S, Ford J, Chang MW, Sayre C, Pickler R. Using the life course health development model to address pediatric mental health disparities. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12452. [PMID: 38368550 DOI: 10.1111/jcap.12452] [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: 05/04/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 02/19/2024]
Abstract
TOPIC Early-life experiences, the transmission of health and disease within families, and the influence of cumulative risks as well as protective factors throughout life shape the trajectory of health, including mental health. Long-term health trajectories established early in life are influenced by biologic, social, and environmental factors. Negative trajectories may be more salient if exposures to adversity occur during critical developmental periods. PURPOSE The purpose of this brief is to (a) review pediatric health disparities related to depression and the intergenerational transmission of pediatric depression using a Life Course Health Development (LCHD) model and (b) provide recommendations for pediatric mental health research. SOURCES Peer-reviewed papers available for PubMed, CINAL, and Medline. Other sources include published books, papers, and gray materials. CONCLUSIONS The LCHD model is a perspective to guide and foster new scientific inquiry about the development of mental health outcomes over the life course. The model enables synthesis of mental health, nursing, and public health, linking mental health prevention, risk reduction, and treatment in children.
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Affiliation(s)
- Laureen H Smith
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Marliese D Nist
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Christine A Fortney
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Barbara Warren
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Tondi Harrison
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Shannon Gillespie
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Kayla Herbell
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Lisa Militello
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Cindy M Anderson
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Sharon Tucker
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Jodi Ford
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Mei-Wei Chang
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Christine Sayre
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
| | - Rita Pickler
- College of Nursing, Martha S. Pitzer Center for Women Children and Youth, The Ohio State University, Columbus, Ohio, USA
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Litt JS, Halfon N, Msall ME, Russ SA, Hintz SR. Ensuring Optimal Outcomes for Preterm Infants after NICU Discharge: A Life Course Health Development Approach to High-Risk Infant Follow-Up. CHILDREN (BASEL, SWITZERLAND) 2024; 11:146. [PMID: 38397258 PMCID: PMC10886801 DOI: 10.3390/children11020146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/18/2024] [Accepted: 01/20/2024] [Indexed: 02/25/2024]
Abstract
Children born prematurely (<37 weeks' gestation) have an increased risk for chronic health problems and developmental challenges compared to their term-born peers. The threats to health and development posed by prematurity, the unintended effects of life-sustaining neonatal intensive care, the associated neonatal morbidities, and the profound stressors to families affect well-being during infancy, childhood, adolescence, and beyond. Specialized clinical programs provide medical and developmental follow-up care for preterm infants after hospital discharge. High-risk infant follow-up, like most post-discharge health services, has many shortcomings, including unclear goals, inadequate support for infants, parents, and families, fragmented service provisions, poor coordination among providers, and an artificially foreshortened time horizon. There are well-documented inequities in care access and delivery. We propose applying a life course health development framework to clinical follow-up for children born prematurely that is contextually appropriate, developmentally responsive, and equitably deployed. The concepts of health development, unfolding, complexity, timing, plasticity, thriving, and harmony can be mapped to key components of follow-up care delivery to address pressing health challenges. This new approach envisions a more effective version of clinical follow-up to support the best possible functional outcomes and the opportunity for every premature infant to thrive within their family and community environments over their life course.
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Affiliation(s)
- Jonathan S. Litt
- Division of Newborn Medicine, Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
- Department of Social and Behavioral Pediatrics, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Neal Halfon
- Center for Healthier Children, Families, and Communities, University of California, Los Angeles, CA 90024, USA; (N.H.); (S.A.R.)
- Department of Pediatrics, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90024, USA
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA 90095, USA
- Department of Public Policy, UCLA Luskin School of Public Affairs, Los Angeles, CA 90095, USA
| | - Michael E. Msall
- Department of Pediatrics, Sections of Developmental and Behavioral Pediatrics and Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, University of Chicago Medicine, Chicago, IL 60637, USA;
| | - Shirley Ann Russ
- Center for Healthier Children, Families, and Communities, University of California, Los Angeles, CA 90024, USA; (N.H.); (S.A.R.)
- Department of Pediatrics, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90024, USA
| | - Susan R. Hintz
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 94305, USA;
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Goldfeld S, Downes M, Gray S, Pham C, Guo S, O'Connor E, Redmond G, Azpitarte F, Badland H, Woolfenden S, Williams K, Priest N, O'Connor M, Moreno-Betancur M. Household income supplements in early childhood to reduce inequities in children's development. Soc Sci Med 2024; 340:116430. [PMID: 38048739 DOI: 10.1016/j.socscimed.2023.116430] [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: 06/09/2023] [Revised: 10/03/2023] [Accepted: 11/12/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Early childhood interventions have the potential to reduce children's developmental inequities. We aimed to estimate the extent to which household income supplements for lower-income families in early childhood could close the gap in children's developmental outcomes and parental mental health. METHODS Data were drawn from a nationally representative birth cohort, the Longitudinal Study of Australian Children (N = 5107), which commenced in 2004 and conducted follow-ups every two years. Exposure was annual household income (0-1 year). Outcomes were children's developmental outcomes, specifically social-emotional, physical functioning, and learning (bottom 15% versus top 85%) at 4-5 years, and an intermediate outcome, parental mental health (poor versus good) at 2-3 years. We modelled hypothetical interventions that provided a fixed-income supplement to lower-income families with a child aged 0-1 year. Considering varying eligibility scenarios and amounts motivated by actual policies in the Australian context, we estimated the risk of poor outcomes for eligible families under no intervention and the hypothetical intervention using marginal structural models. The reduction in risk under intervention relative to no intervention was estimated. RESULTS A single hypothetical supplement of AU$26,000 (equivalent to ∼USD$17,350) provided to lower-income families (below AU$56,137 (∼USD$37,915) per annum) in a child's first year of life demonstrated an absolute reduction of 2.7%, 1.9% and 2.6% in the risk of poor social-emotional, physical functioning and learning outcomes in children, respectively (equivalent to relative reductions of 12%, 10% and 11%, respectively). The absolute reduction in risk of poor mental health in eligible parents was 1.0%, equivalent to a relative reduction of 7%. Benefits were similar across other income thresholds used to assess eligibility (range, AU$73,329-$99,864). CONCLUSIONS Household income supplements provided to lower-income families may benefit children's development and parental mental health. This intervention should be considered within a social-ecological approach by stacking complementary interventions to eliminate developmental inequities.
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Affiliation(s)
- Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia.
| | - Marnie Downes
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Sarah Gray
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Cindy Pham
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Elodie O'Connor
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Gerry Redmond
- College of Business, Government and Law, Flinders University, Adelaide, Australia
| | - Francisco Azpitarte
- School of Social Sciences, Loughborough University, Loughborough, United Kingdom
| | - Hannah Badland
- Social and Global Studies Centre, RMIT University, Melbourne, Australia
| | - Sue Woolfenden
- Sydney Medical School, The Faculty of Medicine and Health, University of Sydney, Australia; Discipline of Pediatrics, University of New South Wales, Sydney, Australia
| | - Katrina Williams
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Department of Pediatrics, Monash University, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Naomi Priest
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Centre for Social Research & Methods, The Australian National University, Canberra, Australia
| | - Meredith O'Connor
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Melbourne Children's LifeCourse Initiative, Murdoch Children's Research Institute, Melbourne, Australia; Faculty of Education, University of Melbourne, Melbourne, Australia
| | - Margarita Moreno-Betancur
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
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Bentley B, Hoang TMH, Arroyo Sugg G, Jenkins KV, Reinhart CA, Pouw L, Accove AM, Tabb KM. Parent Perceptions of an Early Childhood System's Community Efforts: A Qualitative Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1001. [PMID: 37371233 DOI: 10.3390/children10061001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
Understanding how parents, and other primary caregivers, perceive and experience early childhood programs and services is essential for identifying family-centered facilitators and barriers to service utilization. Therefore, this paper aims to explore parent knowledge of and experiences with community efforts of an early childhood system in Illinois: the All Our Kids Early Childhood Networks (AOK Networks). Our research team conducted focus group interviews with 20 parents across four Illinois counties. A semi-structured interview guide was used to examine parent perceptions of an early childhood system's community efforts in promoting the health and well-being of children aged from birth to five. Thematic network analysis was used to analyze all focus group data. Parents indicated three salient themes, including: (1) comprehensive information sharing practices, (2) diverse service engagement, and (3) barriers to service access. Overall, parents reported general satisfaction with the quality of available services and provided feedback regarding identified areas of need to increase the accessibility and utilization of local services. Engaging parents as partners is essential to the effective implementation of family-centered early childhood services. Families are the experts of their lived experiences, and incorporating their voices in program development and evaluation efforts works to increase positive child and family outcomes.
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Affiliation(s)
- Brandie Bentley
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Tuyet Mai Ha Hoang
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Gloria Arroyo Sugg
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Karen V Jenkins
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Crystal A Reinhart
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Leah Pouw
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | | | - Karen M Tabb
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
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Tyack Z. The greatest challenges and solutions to improve children's health and well-being worldwide in the next decade and beyond: Using complex systems and implementation science approaches. Front Pediatr 2023; 11:1128642. [PMID: 36923277 PMCID: PMC10009164 DOI: 10.3389/fped.2023.1128642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/07/2023] [Indexed: 03/02/2023] Open
Abstract
The health and well-being of children is paramount to health and well-being of society and is the foundation of health and well-being later in life. This paper presents the perspective that a complex systems approach that embeds implementation science is needed to address the rising challenges to child health and well-being in this decade (2020-2030) and beyond. Reflection on facilitators of the success of programs deemed promising to address child health and well-being in the past decade (2010-2020) is presented, to advance programs to address children's health and well-being. A priority that needs to be addressed is developing, testing and using theories of child and family health and well-being (and related initiatives) that can be used to build on existing successes to make progress. Understanding context including further elucidating the drivers of child health and well-being at multiple levels of relevant systems (e.g., health, education, community) across the life course, and considering implications for caregivers also require greater consideration. Methods to address future challenges to child health and well-being include co-designing initiatives that support child health and well-being with children and families themselves rather than using predesigned initiatives, thoughtful outcome selection, and reporting the challenges of implementing future programs to promote learning. The approaches, priorities and methods presented can be used to design or refine interventions, models or care or community-based initiatives and provide new direction to fields of child health enquiry.
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Affiliation(s)
- Zephanie Tyack
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
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Steps towards equity in research. J Clin Transl Sci 2023; 7:e65. [PMID: 37008602 PMCID: PMC10052396 DOI: 10.1017/cts.2023.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 01/17/2023] [Indexed: 03/06/2023] Open
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Boelens M, Raat H, Jonkman H, Hosman CMH, Wiering D, Jansen W. Effectiveness of the Promising Neighbourhoods community program in 0-to 12-year-olds : A difference-in-difference analysis. SSM Popul Health 2022; 19:101166. [PMID: 35859931 PMCID: PMC9289725 DOI: 10.1016/j.ssmph.2022.101166] [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: 04/04/2022] [Revised: 07/04/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022] Open
Abstract
Objective The purpose of this study was to evaluate a collaborative community-based program that aims to a) increase the health, safety and talent development of youth, and b) contribute to the reduction of socioeconomic inequalities. Methods A difference-in difference design with two separate cross-sectional samples in 2018 (n = 984) and 2021 (n = 413) among 0- to 12-year-olds with an intervention and comparator condition was used. The program, called Promising Neighbourhoods, consists of collaboration with community stakeholders, data-based priority setting, knowledge-and theory-based policies, and evidence-based interventions. The program was implemented in three neighbourhoods which were compared with three similar comparator neighbourhoods in which the program was not implemented. Logistic difference-in-difference regression was used to test effectiveness of the intervention on informal parenting support, outdoor-play, sport club membership, general health and risk of emotional and behavioural difficulties and to examine differences in intervention effects between children with a lower or higher socioeconomic status. Results A significant intervention effect of the Promising Neighbourhoods program after two-years was found for outdoor-play (OR 0.61; 95%CI 0.37, 0.99). No other significant intervention effects were found for other outcomes. No different interventions effects were found for children with a lower or higher socioeconomic status on outcomes. Conclusion The findings of this study indicate a positive intervention effect for one of the outcomes in 0- to 12-year-olds. Further mixed-methods evaluation research and using longer follow-up periods are needed to examine the value of these type of programs. Further development of Promising Neighbourhoods seems warranted. Trial registration This study was prospectively registered in the Netherlands National Trial Register (Number: NL7279) on 26 September 2018. A collaborative neighbourhood program involving stakeholders was evaluated. The program included joint priority setting to promote child health/well-being. A positive intervention effect was found for one outcome in 0- to 12-year-olds. No reduction in socioeconomic inequalities was found in 0- to 12-year-olds.
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Affiliation(s)
- Mirte Boelens
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Clemens M H Hosman
- Department of Health Promotion, Maastricht University, Maastricht, the Netherlands.,Department of Clinical Psychology, Radboud University, Nijmegen, the Netherlands.,Hosman Prevention and Innovation Consultancy, Berg en Dal, the Netherlands
| | - Denis Wiering
- Department of Social Development, Municipality of Rotterdam, Rotterdam, the Netherlands
| | - Wilma Jansen
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Social Development, Municipality of Rotterdam, Rotterdam, the Netherlands
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Goldfeld S, Gray S, Pham C, Badland H, Woolfenden S, Schor E, O'Connor M. Leveraging Research to Drive More Equitable Reading Outcomes: An Update. Acad Pediatr 2022; 22:1115-1117. [PMID: 35417779 DOI: 10.1016/j.acap.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/28/2022] [Accepted: 04/02/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Sharon Goldfeld
- Centre for Community Child Health (S Goldfeld, S Gray, C Pham), Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics (S Goldfeld, S Gray, M O'Connor), University of Melbourne, Melbourne, Australia.
| | - Sarah Gray
- Centre for Community Child Health (S Goldfeld, S Gray, C Pham), Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics (S Goldfeld, S Gray, M O'Connor), University of Melbourne, Melbourne, Australia
| | - Cindy Pham
- Centre for Community Child Health (S Goldfeld, S Gray, C Pham), Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health (C Pham), University of Melbourne, Melbourne, Australia; Melbourne Children's LifeCourse Initiative (C Pham, M O'Connor), Murdoch Children's Research Institute, Melbourne, Australia
| | - Hannah Badland
- Centre for Urban Research (H Badland), RMIT University, Melbourne, Australia
| | - Sue Woolfenden
- Department of Community Child Health (S Woolfenden), Sydney Children's Hospital Network, Sydney, Australia; Discipline of Pediatrics (S Woolfenden), University of New South Wales, Sydney, Australia
| | - Edward Schor
- Department of Pediatrics (E Schor), School of Medicine, Stanford University, Stanford, Calif
| | - Meredith O'Connor
- Department of Pediatrics (S Goldfeld, S Gray, M O'Connor), University of Melbourne, Melbourne, Australia; Melbourne Children's LifeCourse Initiative (C Pham, M O'Connor), Murdoch Children's Research Institute, Melbourne, Australia
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10
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Yang J, Shen Y, Deng Y, Liao Z. Grandchild care, inadequate medical insurance protection, and inequalities in socioeconomic factors exacerbate childhood obesity in China. Front Public Health 2022; 10:950870. [PMID: 36091537 PMCID: PMC9453265 DOI: 10.3389/fpubh.2022.950870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/22/2022] [Indexed: 01/24/2023] Open
Abstract
This study examines the influences of grandchild care and medical insurance on childhood obesity. Nationally representative longitudinal data-from the China Family Panel Studies 2010-2020-of 26,902 school-age children and adolescents aged 6-16 years and China's new reference standard ("WS/T586-2018") are used to identify a child's obesity status. Using binary mixed-effects logistic regression models and the Blinder-Oaxaca decomposition method, this study explores the roots of obesity inequalities and finds that at least 15% of Chinese children aged 6-16 were obese in the 2010s. The logistic regression analysis results indicate that grandchild care, public medical insurance, and commercial medical insurance are key risk factors of child obesity. However, the influences are heterogeneous in different groups: Grandchild care and public medical insurance increase urban-rural obesity inequalities because of a distribution effect, and grandchild care may also exacerbate children obesity inequalities between left-behind and non-left-behind children owing to the event shock of parental absence. Inequalities in socioeconomic status (SES) factors such as income, education, and region also cause obesity inequalities. These results indicate that child obesity and its inequalities are rooted in multidimensional environmental inequalities, including medical protection policies and its benefit incidence; intergenerational behavior and family SES factors; and urban-rural and left-behind risk shocks. This study provides new evidence for the development of population-based interventions and equitable medical insurance policies to prevent the deterioration of child obesity among Chinese school-age children and adolescents.
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Affiliation(s)
- Jing Yang
- School of Public Administration, Hunan University, Changsha, China
| | - Yun Shen
- School of Economics, Sichuan Agricultural University, Ya'an, China
| | - Yue Deng
- Institute of Quality Development Strategy, Wuhan University, Wuhan, China
| | - Zangyi Liao
- School of Political Science and Public Administration, China University of Political Science and Law, Beijing, China
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Naccarella L, Guo S. A Health Equity Implementation Approach to Child Health Literacy Interventions. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9091284. [PMID: 36138593 PMCID: PMC9497842 DOI: 10.3390/children9091284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/12/2022] [Accepted: 08/23/2022] [Indexed: 01/05/2023]
Abstract
Health and behavioural inequalities exist in all populations, including children. As a social determinant of health, health literacy is a crucial driver of equitable health outcomes in children. With the increasing calls for more actions on addressing low health literacy and inequalities, health literacy interventions to improve children's healthy behaviours have emerged as a key strategy to reduce health inequities. However, health literacy interventions face implementation challenges impacting upon potential outcomes, and disparities in the implementation of health literacy interventions also occur. Variation exists in child health literacy intervention target groups, timing, content and formats, and there is a lack of implementation specificity, resulting in a lack of clarity about which intervention strategies are the most effective in improving health literacy, related health behaviours, and associated health outcomes. While actions to facilitate child health intervention implementation exist, to minimise further perpetuation of child health inequities, this perspective calls for a health equity implementation approach to child health literacy interventions.
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Affiliation(s)
- Lucio Naccarella
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3053, Australia
- Correspondence:
| | - Shuaijun Guo
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3053, Australia
- Centre for Community Child Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC 3052, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC 3052, Australia
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