Family Relationships and Adolescents' Health Attitudes and Weight: The Understudied Role of Sibling Relationships

The effect of health literacy on health behaviors in a sample of Turkish adolescents

PURPOSE

Health literacy is a strong factor in the health outcomes and behaviors of adolescents. This study was conducted to examine the health literacy levels of adolescents, their health behaviors, and the effect of health literacy on health behaviors.

DESIGN AND METHODS

This cross-sectional study was conducted with a total of 649 adolescents between the ages of 14 and 18. Data were collected using the Adolescent Lifestyle Profile II (ALP-R2) and the Health Literacy Scale for School-Age Children (HLSAC). A multiple regression analysis was conducted to determine the effects of health literacy on health behaviors and the factors associated with health behaviors.

RESULTS

The mean total ALP-R2 score of the participants was 114.35 ± 17.48, and their mean HLSAC score was 28.95 ± 5.79. Among the participants, 26% had low health literacy, 61.9% had moderate health literacy, and 12% had high health literacy. The regression analysis revealed that the health literacy levels of the participants significantly predicted all dimensions of health behaviors and total health behaviors (p < 0.001). The health literacy levels of the participants, the community where the adolescent lived, their participation in social activities, family relationships, friend relationships, and health perceptions significantly predicted their total health behaviors (R2 = 0.347; p < 0.001).

CONCLUSIONS

The health literacy levels and health behaviors of adolescents were found to be moderate, and their health behaviors increased as their levels of health literacy increased. The results showed that the health literacy and health behaviors of adolescents need to be improved.

IMPLICATIONS FOR PRACTICE

Nurses should provide training to increase the healthy lifestyle behaviors and health literacy of adolescents.

Association of Social Network Characteristics with Substance Use among College-Going Young Adults: A Cross-Sectional Study

Background

Family members, peers, and significant others are part of a college student's social network. This cross-sectional study aimed to Assess substance use prevalence and patterns among college students,Compare the social network characteristics of substance users (SUs) and non-users (NUs), andExplore the association of social factors with substance use.

Methods

The study involved 902 students from 11 Government and aided private degree colleges. Demographic and clinical data sheet, ASSIST, and Social Network Questionnaire were used to collect the data.

Results

Prevalence of substance use was 26.9% and higher among males (21.5%). Alcohol (20%) and tobacco (15.5%) were the commonly used substances. SUs' network was composed of unmarried persons (p<0.002), male members (p<0.001), and friends (p<0.001) with substance use. In contrast, the NUs' network comprised parents (p<0.016) and siblings (p<0.001). NUs had a higher number of influential members in the network, whereas SUs had more closeness with members and received higher financial support (p<0.001). Participant's age (OR 1.27), family history of substance use (OR 2.46), parents' occupation (Business: OR 1.79, being employee in the government or industry: OR 1.76),and having three substance-using members in the network (OR .211) were found to be risk factors.

Conclusion

Social network has an association with substance use among college students. Social-network-based interventions may benefit them.

Prospective association of family members' sugar-sweetened beverages intake with children's sugar-sweetened beverages consumption in China

PURPOSE

We aimed to investigate whether parental and siblings' sugar-sweetened beverage (SSB) intake had prospective impact on children's SSB consumption, and the potential sex difference in these associations.

METHODS

This study included a total of 904 children and their parents enrolled from 2004 to 2011 China Health and Nutrition Survey (CHNS) cohort study. SSB consumption information was estimated using a short dietary questionnaire and total energy intake was assessed with three-day 24-h dietary assessments at recruitment and follow-up surveys. Multivariate logistic or linear regression analyses were used to assess the association for SSB consumption between parents, siblings and children after adjusting for age, body mass index (BMI) z-score, household income and parental educational level.

RESULTS

In this study, a majority (87.6%) of children consumed SSB. Among them, the median consumption of SSB was 70.3 ml/day per capita and 205.4 ml/day per consumer. Parental SSB consumption was relevant to children's SSB consumption, and this association was more pronounced in boys than in girls. Meanwhile, fathers seemed to have a stronger impact on whether children consume SSB than mothers which was reflected by lower P and higher OR. Additionally, children's SSB intake was prospectively associated with their older siblings' SSB consumption (P _{for trend} < 0.03).

CONCLUSIONS

Parental and older siblings' SSB consumption was relevant to children's SSB intake. Particularly, boys were more susceptible to parental impact than girls, and fathers seemed to have a greater influence on children than mothers.

The Family Transmission of Ethnic Prejudice: A Systematic Review of Research Articles with Adolescents

Ethnic prejudice is one of the most studied topics in social psychology. Empirical research on its development and intergenerational transmission is increasing but still scarce. This systematic review collected and analyzed psychosocial studies focused on the transmission of ethnic prejudice within families with adolescents. Specifically, it aimed at addressing the following research questions: (a) To what extent is there a vertical (between parents and children) and horizontal (between siblings) transmission of ethnic prejudice within the family? (b) Is this process unidirectional (from parents to children) or bidirectional (between parents and children)? (c) Which individual and/or relational variables influence this process? (d) Can adolescents’ intergroup contact experiences affect the family influence on adolescents’ ethnic prejudice? The literature search of four databases (Ebsco, Scopus, PubMed, and Web of Science), carried out from February 2021 to May 2021, following the PRISMA guidelines, yielded 22 articles that matched the eligibility criteria. The findings highlighted a moderate bidirectional transmission of ethnic prejudice between parents and adolescents, which was influenced by several individual and relational variables (e.g., the adolescents’ age and sex and the family relationship quality). Moreover, the adolescents’ frequent and positive contacts with peers of different ethnicities reduced the parents’ influence on the adolescents’ ethnic prejudice. The findings are discussed, and their limitations and implications for intervention and future research are considered.

Mediating Effects of Intimacy Between Body Talk and Girls' Body Dissatisfaction: The Forgotten Sibling Relationship

Teasing and pressure from family members influences the development of body dissatisfaction. Body dissatisfaction is a common experience for girls and can lead to eating disorders. However, most body image disturbance research to date neglects the possible influence of siblings. In light of this, the present study investigated the associations between sibling negative appearance-based talk, intimacy, and body dissatisfaction. The sample consisted of 113 mostly White, female adolescents, whose ages ranged from 12 to 19 years with a mean age of 14.85 (SD = 1.62). This study first examined direct associations between negative body talk, including appearance related teasing and pressure from siblings, and girls' body dissatisfaction. Second, indirect effects models with intimacy included were examined. There were significant direct links between appearance related pressure from siblings and body dissatisfaction, and significant indirect effects such that sibling teasing and pressure were associated with sibling intimacy, which was associated with body dissatisfaction. These results indicate that siblings play an important role in the development of girls' body dissatisfaction.

"It's Just Not Something We Do at School". Adolescent Boys' Understanding, Perceptions, and Experiences of Muscular Fitness Activity

BACKGROUND

English youth typically do not sufficiently engage in the types and intensities of physical activity that develop muscular fitness. The aim of this study was to use a combination of qualitative techniques to explore adolescent boys' understanding, perceptions, and experiences of physical activity and the role muscular fitness plays within boys' physically active lifestyles.

METHODS

Focus group interviews with a write, draw, show, and tell activity were conducted with 32 adolescent boys aged 14-16 years from 3 secondary schools. Three separate sources of data (frequency counts, verbatim transcripts, and visual data) were generated and were pooled together and triangulated. Data were analysed deductively, first using the Youth Physical Activity Promotion model as a thematic framework, and then inductively.

RESULTS

Physical activity was frequently associated with organised sport, and most boys were unaware of current UK physical activity guidelines. Co-participation was frequently reported as a reinforcing factor to physical activity.

CONCLUSIONS

There was a perceived lack of opportunity to participate in muscular fitness activities, particularly in school, and knowledge of how to conduct muscular fitness activities was limited. The contribution of physical education was highlighted as being key to facilitating exposure to muscular fitness activities.

Daily Family Connection and Objective Sleep in Latinx Adolescents: The Moderating Role of Familism Values and Family Communication

Spending time with family ("family connection") is a salient aspect of adolescents' daily lives linked with healthy sleep. Less is known regarding the unique effects of parent and sibling connection on sleep. This study examined daily and average associations between parent/sibling connection and objective sleep (duration, efficiency) in a sample of Latinx adolescents (N = 195; Mage = 18.11, SD = 0.41; 65.6% female) and explored familism values and family communication as moderators. Adolescents slept longer on days that they spent more time with siblings, and youth who typically spent more time with parents had longer sleep durations. Family communication and familism-obligation moderated associations between family connection and sleep. These results provide support for the role of family interactions in promoting healthy sleep among Latinx adolescents.

Difference in Objectively Measured Physical Activity and Obesity in Children With and Without Siblings

Background/Context: Children without siblings (singletons) have higher rates of obesity than do children with siblings (nonsingletons). Higher moderate to vigorous physical activity (PA) and less sedentary behavior (SB) are associated with lower childhood obesity.

PURPOSE

To examine the difference in PA and SB between singleton and nonsingleton children.

METHODS

Mothers of children ages 5.0-7.9 years old who were singletons or nonsingletons with a sibling between the ages of 2.0 and 4.9 years old were recruited. Height, weight, and waist circumference of the 5.0- to 7.9-year-old children were measured, and age and sex percentiles were calculated. Accelerometry measured SB and PA, including light PA, moderate to vigorous PA, and counts per minute.

RESULTS

Fifty-six mother-child dyads (23 singletons and 33 nonsingletons) with an average child age of 5.7 (0.7) years participated. More singletons were classified as overweight or obese than were nonsingletons (49% vs 17%, P = .04). In adjusted linear models, singletons had less light PA per day (β = -38.1, SE = 19.2, P = .001) and more SB (β = 38.0, SE = 16.5, P = .02) than did nonsingletons, with no difference in moderate to vigorous PA or counts per minute.

CONCLUSION

In this sample, singletons had higher obesity and lower light PA than did nonsingleton children. Investigation into differences in singleton/nonsingleton families, including family health behaviors, may help assess sibling influence in early behavior development.

Parental Differential Treatment of Siblings and Adolescents' Health-Related Behaviors: The Moderating Role of Personality

Youth who receive comparatively poorer parental treatment than a sibling are at risk for maladaptive behaviors in a variety of domains, but research has yet to examine links with adolescents' health-related behaviors nor consider how those links may vary based on adolescents' personality traits, namely conscientiousness and agreeableness. Two siblings (n = 590 adolescents; 53% female; M_age = 15.86, SD = 1.73) from 295 families reported on their differential conflict and closeness with their fathers and mothers as well as on their personality, sleep habits, exercise habits, and general health habits. Multilevel modeling revealed that, generally, the less conscientious adolescents had better health habits when they had comparatively warmer relationships with their mothers. Less conscientiousness adolescents may be less distressed by inequality in the family, and thus may experience positive effects of relatively better treatment.

The Relative Impacts of Sibling Relationships on Adolescent Body Perceptions

The sibling relationship is the longest relationship of the life course and has been found to influence youth adjustment (Dunn, 2002 ). Given that adolescence is a time of increased body awareness, the authors examined the potential role of siblings' body conceptions and sibling relationship quality on adolescent body conceptions. In a sample of 101 predominantly White, middle-class adolescent sibling dyads, the authors found that positive sibling relationship quality was associated with higher physical self-worth in adolescents, but that this differed by sibling gender and sibling physical self-worth. Alternatively, negative sibling relationship quality was associated with lower physical self-worth for adolescents, but differed based on birth order, sibling physical self-worth, and adolescent gender.

Socioeconomic Disparities in Diet Vary According to Migration Status among Adolescents in Belgium

Little information concerning social disparities in adolescent dietary habits is currently available, especially regarding migration status. The aim of the present study was to estimate socioeconomic disparities in dietary habits of school adolescents from different migration backgrounds. In the 2014 cross-sectional “Health Behavior in School-Aged Children” survey in Belgium, food consumption was estimated using a self-administrated short food frequency questionnaire. In total, 19,172 school adolescents aged 10–19 years were included in analyses. Multilevel multiple binary and multinomial logistic regressions were performed, stratified by migration status (natives, 2nd- and 1st-generation immigrants). Overall, immigrants more frequently consumed both healthy and unhealthy foods. Indeed, 32.4% of 1st-generation immigrants, 26.5% of 2nd-generation immigrants, and 16.7% of natives consumed fish ≥two days a week. Compared to those having a high family affluence scale (FAS), adolescents with a low FAS were more likely to consume chips and fries ≥once a day (vs. <once a day: Natives aRRR = 1.39 (95%CI: 1.12–1.73); NS in immigrants). Immigrants at schools in Flanders were less likely than those in Brussels to consume sugar-sweetened beverages 2–6 days a week (vs. ≤once a week: Natives aRRR = 1.86 (95%CI: 1.32–2.62); 2nd-generation immigrants aRRR = 1.52 (1.11–2.09); NS in 1st-generation immigrants). The migration gradient observed here underlines a process of acculturation. Narrower socioeconomic disparities in immigrant dietary habits compared with natives suggest that such habits are primarily defined by culture of origin. Nutrition interventions should thus include cultural components of dietary habits.

Sibship, physical activity, and sedentary behavior: a longitudinal, observational study among Mexican-heritage sibling dyads

BACKGROUND

Shared genetic and environmental factors suggest that family relationships are important predictors of obesity-related behaviors, yet little is known about how siblings influence physical activity and sedentary behaviors. This study examined physical activity and sedentary behavior between sibling dyads across summer and fall time points and determined if birth order and gender modify the relationship between sibling behaviors.

METHODS

Mexican-heritage families residing in colonias along the United States-Mexico border were recruited using promotoras de salud to participate in summer and school year surveys. Eighty-seven sibling dyads had complete data for the physical activity sub-study: 21 older brother-younger brother, 21 older brother-younger sister, 23 older sister-younger brother, and 22 older sister-younger sister dyads. Physical activity and sedentary behavior were measured using a validated 7-day recall instrument to create summary measures of weekly active, moderate-to-vigorous physical activity (MVPA) metabolic equivalents (MET), sitting, and screen time minutes. We used linear regression analyses to examine changes over time and the association between older and younger sibling behavior.

RESULTS

During summer, older siblings (mean age = 11.2 years) reported 1069 active minutes and 1244 sitting minutes per week; younger siblings (mean age = 8.3 years) reported 1201 active minutes and 1368 sitting minutes per week. Younger brothers reported fewer active minutes (mean = - 459.6; p = 0.01) and fewer MVPA MET-minutes (mean = - 2261.7; p = 0.02) of physical activity during the fall. Within all 87 dyads, older sibling physical activity was significantly associated with younger sibling active minutes (B = 0.45;p = 0.004) and MET-minutes (B = 0.45;p = 0.003) during summer but not fall; older sibling sedentary behavior was significantly associated with younger sibling sitting (B = 0.23;p = 0.01) and screen time minutes (B = 0.23;p = 0.004) during fall but not summer. After stratifying by gender dyad groups, younger brother behavior was strongly associated with older brother behavior at both time points.

CONCLUSION

Younger siblings appear to emulate the physical activity behaviors of their older siblings during non-school summer months and sedentary behaviors of older siblings during school-time fall months, especially older brother-younger brother dyads. Family-based interventions to increase physical activity and decrease sedentary behavior are growing in popularity, but more work is needed to understand the role of sibling influences.

Sibling influence on children's objectively measured physical activity: a meta-analysis and systematic review

Abstract

Children without siblings (only children) have higher rates of obesity than children with siblings. Childhood obesity may be prevented by minimising sedentary behaviour and accumulating sufficient physical activity in young children. A growing number of articles have examined the influence of siblings on physical activity and sedentary behaviour, yet these articles have not been synthesised.

Objective

To synthesise literature and describe the influence of siblings on objectively measured physical activity and sedentary behaviour of children (ages 2–18 years).

Design

Outcomes were analysed in a systematic review and meta-analysis.

Data sources

PubMed, EMBASE, Web of Science and Medline OVID were searched for articles related to siblings, physical activity, sedentary behaviour and obesity outcomes from 1947 to March 2018.

Eligibility criteria

Articles that evaluated sibling status on physical activity objectively measured by accelerometer or pedometer were included.

Results

Nineteen articles, representing 17 independent datasets, were included in the review. Nine were included in the quantitative analysis. Pooled data from nine articles indicated children with siblings had higher moderate-to-vigorous physical activity (MVPA) relative to only children, with a potential dose response for higher number of children in household and higher MVPA (Mean Difference=3.13, 95% CI 1.90 to 4.35, p=0.001). Findings were mixed for the influence of siblings on sedentary behaviour and light physical activity.

Summary/Conclusion

Children with siblings had healthier physical activity patterns, as measured by accelerometer or pedometer, than did only children. Suggested mechanisms include peer modelling, encouraging active transport and sports participation, opportunity for playmate and serving as additional caregivers.

Trial registration number

CRD42017055463.

Victimization by Siblings in Children with Disability or Weight Problems

OBJECTIVE

Children with a physical disability, psychological disorder, or of nonnormative weight are often targets of peer victimization. Sibling victimization, however, is more common than peer victimization, but rarely explored. We investigated linkages between sibling victimization and whether children had a physical disability, psychological disorder (i.e., internalizing disorder, attention deficit disorder/attention-deficit hyperactivity disorder), and were perceived by parents as being thinner than average or overweight. Also, we explored how the extent and kinds of sibling victimization experiences were related to these characteristics in childhood.

METHODS

A US probability sample of adult caregivers of a child aged 0 to 9 (N = 780; 50% women; mean age 4.58) in 2-child households who completed a telephone interview.

RESULTS

Controlling for other forms of maltreatment and individual and family characteristics, children with a physical disability and parent-perceived children who are thinner than average and children who are overweight experienced more sibling victimization. Children with an internalizing disorder experienced less sibling victimization. Sibling victimization did not differ for children with and without ADHD. Children perceived to be overweight by parents and children with a physical disability were at increased risk of experiencing more types of sibling victimization. Children with a physical disability had greater odds of being victims of property victimization by a sibling.

CONCLUSION

Children with a physical disability or perceived as different from average weight are at risk for sibling victimization. Using a nationally representative sample, this is the first study to highlight the importance of screening for sibling victimization in families of children with a disability and/or nonnormative weight status.

Associations between parent-child relationship quality and obesogenic risk in adolescence: a systematic review of recent literature

Adolescence is a period of significant cognitive, social and physiological change, presenting unique risk factors for weight gain. Childhood obesity research has traditionally focused on the influence of parent-level factors on children's eating and weight status. Increasingly, emphasis is turning towards the reciprocal nature of the parent-child relationship and its influence on health behaviour. A systematic literature review was conducted to investigate the relationship between parent-child relationship quality (defined as the felt emotional bond between parent and child) and obesogenic risk (weight status, eating attitudes and behaviours, level of physical activity and sedentary behaviour) in adolescence; 26 papers were included in the review. The results neither support nor challenge an association between parent-child relationship quality and weight, with study design flaws and limited measurement of the parent-child relationship precluding robust conclusions. The review does however suggests that several aspects of the parent-child relationship are important in understanding eating attitudes and behaviours, including the felt emotional bond between the parent and child, the child's perception of how much the parent cares for them and the mother's sensitivity towards the child. The need for further longitudinal research into the association between parent-child relationship quality and obesity risk across this developmental period is discussed.

A qualitative study of the role of food in family relationships: An insight into the families of Brazilian obese adolescents using photo elicitation

Obesity in adolescence is a major public health issue in Brazil. The relation between food and family plays an important role in both prevention and treatment, although its precise effect has not been clearly established. The purpose of this study is to investigate the meanings of food for Brazilian obese adolescents and their parents. Semi-structured interviews were conducted with 19 individuals from two medical centers in Fortaleza-CE, Brazil: seven adolescents with obesity (six girls and one boy aged between 12 and 18 years) and their parents (seven mothers, four fathers and one grandmother). The researchers used photo elicitation for the interview; that is, one photograph taken by each adolescent was used to evoke the statements we analyze here, according to Interpretative Phenomenological Analysis. The results were categorized into two principal superordinate themes. The first described the role of food in the parent-child relationship and the second, the organization of the family group. Results show that food reinforces the adolescents' dependence on their parents and the conflicts related to parental control of their food and what they can eat. The interrelations between food and family dynamics must be considered in developing therapeutic strategies for Brazilian obese adolescents and their families. These strategies must include siblings as well as grandparents.

All in the family: correlations between parents' and adolescent siblings' weight and weight-related behaviors

OBJECTIVE

To examine whether and how parents' and adolescent siblings' weight and weight-related behaviors are correlated. Results will inform which family members may be important to include in adolescent obesity prevention interventions.

METHODS

Data from two linked population-based studies, EAT 2010 and F-EAT, were used for cross-sectional analyses. Parents (n = 58; 91% females; mean age = 41.7 years) and adolescent siblings (sibling #1 n = 58, 50% girls, mean age = 14.3 years; sibling #2 n = 58, 64% girls, mean age = 14.8 years) were socioeconomically and racially/ethnically diverse.

RESULTS

Some weight-related behaviors between adolescent siblings were significantly positively correlated (i.e., fast food consumption, breakfast frequency, sedentary patterns, p < 0.05). There were no significant correlations between parents' weight and weight-related behaviors and adolescent siblings' same behaviors. Some of the significant correlations found between adolescent siblings' weight-related behaviors were statistically different from correlations between parents' and adolescent siblings' weight-related behaviors.

CONCLUSIONS

Although not consistently, adolescent siblings' weight-related behaviors were significantly correlated as compared with parents' and adolescent siblings' weight-related behaviors. It may be important to consider including siblings in adolescent obesity prevention interventions or in recommendations healthcare providers give to adolescents regarding their weight and weight-related behaviors.