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Gong F, Lei Z, Gong Z, Min H, Ge P, Guo Y, Ming WK, Sun X, Wu Y. The Role of Family Health in Mediating the Association between Smartphone Use and Health Risk Behaviors among Chinese Adolescent Students: A National Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13378. [PMID: 36293956 PMCID: PMC9603663 DOI: 10.3390/ijerph192013378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
The direct impact of smartphones on health risk behaviors of adolescent students has been verified. However, the mediating mechanisms that underly this relationship remain largely unknown. Therefore, the aim of the study is to explore the role of family health in mediating the relationship between the frequency of smartphone use and adolescent students' health risk behaviors. A questionnaire was used to collect cross-sectional data from 693 adolescent students aged 12-18 in China and a structural equation model was analyzed. Among the nine health risk behaviors, the most frequent health risk behaviors in Chinese adolescent students were non-compliance walking behaviors (M=Mean; SD = Standard deviation) (M ± SD) (2.78 ± 1.747), eating unhygienic food (M ± SD) (2.23 ± 1.299), being subjected to physical violence (M ± SD) (2.19 ± 0.645), and leaving home (M ± SD) (2.13 ± 0.557). The SEM results showed that the adolescent students' smartphone use had a positive impact on delaying the age of first alcohol consumption (β = 0.167, CI:0.067 0.287) and a negative impact on the non-compliance walking behaviors (β = 0.176, CI:0.011 0.266). Family health plays an indirect-only mediated role (the proportions of indirect-only mediated roles are 11.2%, 12.4%, and 11.5%) in the relationship between smartphone use and adolescent students' partial health risk behaviors: (CI: -0.042 -0.002), (CI: -0.049 -0.005), and (CI: -0.043 -0.002). These findings provided a theoretical and practical basis for better interventions in adolescent health risk behaviors.
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Affiliation(s)
- Fangmin Gong
- School of Literature and Journalism Communication, Jishou University, Jishou 416000, China
| | - Zhaowen Lei
- School of Literature and Journalism Communication, Jishou University, Jishou 416000, China
| | - Zhuliu Gong
- School of Literature and Journalism Communication, Jishou University, Jishou 416000, China
| | - Hewei Min
- School of Public Health, Peking University, Beijing 100871, China
| | - Pu Ge
- Bachelor of Pharmacy Institute of Chinese Medicinal Sciences, University of Macau, Macao 999078, China
| | - Yi Guo
- School of Public Health, Peking University, Beijing 100871, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong 999077, China
| | - Xinying Sun
- School of Public Health, Peking University, Beijing 100871, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing 100871, China
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Crandall A, Weiss-Laxer NS, Broadbent E, Holmes EK, Magnusson BM, Okano L, Berge JM, Barnes MD, Hanson CL, Jones BL, Novilla LB. The Family Health Scale: Reliability and Validity of a Short- and Long-Form. Front Public Health 2020; 8:587125. [PMID: 33330329 PMCID: PMC7717993 DOI: 10.3389/fpubh.2020.587125] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/13/2020] [Indexed: 12/27/2022] Open
Abstract
Families strongly influence the health of communities and individuals across the life course, but no validated measure of family health exists. The absence of such a measure has limited the examination of family health trends and the intersection of family health with individual and community health. The purpose of this study was to examine the reliability and validity of the Family Health Scale (FHS), creating a multi-factor long-form and a uniform short-form. The primary sample included 1,050 adults recruited from a national quota sample Qualtrics panel. Mplus version 7 was used to analyze the data using a structural equation modeling framework. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) confirmed a 32-item, 4-factor long-form scale. The four factors included (1) family social and emotional health processes; (2) family healthy lifestyle; (3) family health resources; and (4) family external social supports. A 10-item short-form of the FHS was also validated in the initial sample and a second sample of 401 adults. Both the long-form and short-form FHS correlated in the expected direction with validated measures of family functioning and healthy lifestyle. A preliminary assessment of clinical cutoffs in the short-form were correlated with depression risk. The FHS offers the potential to assess family health trends and to develop accessible, de-identified databases on the well-being of families. Important next steps include validating the scale among multiple family members and collecting longitudinal data.
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Affiliation(s)
- AliceAnn Crandall
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Nomi S Weiss-Laxer
- Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Eliza Broadbent
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Erin Kramer Holmes
- School of Family Life, Brigham Young University, Provo, UT, United States
| | | | - Lauren Okano
- Puget Sound Educational Service District, Renton, WA, United States
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, United States
| | - Michael D Barnes
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Carl Lee Hanson
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Blake L Jones
- Department of Psychology, Brigham Young University, Provo, UT, United States
| | - Len B Novilla
- Department of Public Health, Brigham Young University, Provo, UT, United States
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Trofholz AC, Tate A, Keithahn H, de Brito JN, Loth K, Fertig A, Berge JM. Family meal characteristics in racially/ethnically diverse and immigrant/refugee households by household food security status: A mixed methods study. Appetite 2020; 157:105000. [PMID: 33053423 DOI: 10.1016/j.appet.2020.105000] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 09/08/2020] [Accepted: 10/09/2020] [Indexed: 11/27/2022]
Abstract
While there is some research examining frequency of family meals by food insecurity (FI) status, there is little research examining other family meal characteristics (e.g., type of food served at meal, emotional atmosphere) or parent feeding practices by FI status. If food and money is scarce, it may be that the broader family meal environment looks different in families with continuous access to food (food secure, FS) compared to families with FI. Using ecological momentary assessment (EMA) and qualitative data, this study explores meal characteristics and parent feeding practices at nearly 4000 family meals in a low-income, racially/ethnically diverse and immigrant/refugee sample. For 8 days, participants (i.e., parents of 5-7-year-old children) completed a survey every time they shared a meal with their child. Additionally, parents completed a qualitative interview regarding family meals. There were many meal characteristics statistically correlated with a family being FI, including: who prepared the meal and how the meal was prepared, the makeup of people at the meal, the meal location and meal atmosphere, and the food served at the meal. Qualitative data illuminated many of these findings from EMA meal surveys. Quantitatively, families with FI and FS reported similar parent feeding practices during family meals. Qualitatively, families with FI and FS reported differences in (1) parent feeding practices; (2) food served at family meals; (3) challenges to having family meals; and 4) adults' role in the family meal. This study provides suggestions for interventionists working with families, including helping families identify time management strategies, including fruits and vegetables into family meals on a budget, reducing screen time at family meals while improving the meal's emotional atmosphere, and developing positive parent feeding practice strategies.
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Affiliation(s)
- Amanda C Trofholz
- Division of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Allan Tate
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | | | - Junia N de Brito
- Division of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Katie Loth
- Division of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Angela Fertig
- Humphrey School of Public Affairs, University of Minnesota, Minneapolis, MN, USA
| | - Jerica M Berge
- Division of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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Abar CC, Koban K, Farnett S, Mendola K, Clark G. Profiles of family routines during adolescence associated with profiles of health behaviors in young adulthood. J Health Psychol 2020; 25:629-639. [DOI: 10.1177/1359105317726149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined associations between profiles of family routines in early adolescence and profiles of health behaviors during young adulthood. In a sample of 4565 individuals, latent transition analysis indicated individuals in a family characterized by low involvement in adolescence were most likely, across classes, to demonstrate a profile characterized by substance use in young adulthood. The high-involvement class during adolescence was least likely to be a substance user but was relatively likely to be in the poor diet and exercise class during young adulthood. Results highlight the utility of examining complex family influences on health using person-centered methods.
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Affiliation(s)
- Caitlin C Abar
- The College at Brockport, State University of New York, USA
| | - Kaitlyn Koban
- The College at Brockport, State University of New York, USA
| | - Sarah Farnett
- The College at Brockport, State University of New York, USA
| | - Kayla Mendola
- The College at Brockport, State University of New York, USA
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Walton K, Horton NJ, Rifas-Shiman SL, Field AE, Austin SB, Haycraft E, Breen A, Haines J. Exploring the Role of Family Functioning in the Association Between Frequency of Family Dinners and Dietary Intake Among Adolescents and Young Adults. JAMA Netw Open 2018; 1:e185217. [PMID: 30646382 PMCID: PMC6324390 DOI: 10.1001/jamanetworkopen.2018.5217] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Eating meals, particularly dinner, with family members has been associated with improved dietary intake among youths. However, existing studies have not examined how family functioning may moderate or confound this association. OBJECTIVE To examine whether level of family functioning is associated cross-sectionally with frequency of family dinners and dietary intake among a US national sample of adolescents and young adults. DESIGN, SETTING, AND PARTICIPANTS Data from the 2011 questionnaire in the Growing Up Today Study 2 were used for this cross-sectional study. Linear regression models examined the extent to which family dinner frequency was associated with self-reported intake of fruits and vegetables, sugar-sweetened beverages, fast food, and takeout food among 2728 adolescents and young adults (age, 14-24 years). To explore effect modification by family functioning, an interaction term for family functioning and family dinner frequency was included for each dietary outcome. To explore confounding, models adjusted for family functioning were run. All models were stratified by sex and included participant age, educational attainment of mother's spouse or partner, and family structure as covariates. Statistical analysis was conducted between January 1, 2017, and August 31, 2018. MAIN OUTCOMES AND MEASURES Dietary intake measured by consumption of fruits and vegetables, sugar-sweetened beverages, takeout food, and fast food; family dinner frequency per week; and family functioning. RESULTS Among the 2728 participants, there were 1559 female and 1169 male participants who were 14 to 24 years of age (mean [SD] age, 19.4 [1.9] years) and were living with their parents in 2011. Most participants (2453 of 2649 [92.6%]) identified as white. More frequent family dinners were associated with higher-quality dietary intake regardless of level of family functioning; interactions between family functioning and family dinner frequency were not significant. Associations between family meal frequency and dietary intake outcomes did not change substantively when adjusting for family functioning. In adjusted models, more frequent family dinners were associated with higher intakes of fruits (female participants: β, 0.09 servings/d; 95% CI, 0.04-0.15 servings/d; male participants: β, 0.07 servings/d; 95% CI, 0.01-0.12 servings/d) and vegetables (female participants: β, 0.21 servings/d; 95% CI, 0.12-0.30 servings/d; male participants: β, 0.19 servings/d; 95% CI, 0.09-0.30 servings/d), and lower intakes of fast food (female participants: β, -0.04 times/wk; 95% CI, -0.07 to 0.00 times/wk; male participants: β, -0.10 times/wk; 95% CI, -0.15 to -0.04 times/wk) and takeout foods (female participants: β, -0.04 times/wk; 95% CI, -0.07 to -0.01 times/wk; male participants: β, -0.06 times/wk; 95% CI, -0.10 to -0.02 times/wk). More frequent family dinners were associated with lower intake of sugar-sweetened beverages for male participants only (β, -0.07 servings/d; 95% CI, -0.13 to -0.02 servings/d). CONCLUSIONS AND RELEVANCE More frequent family dinners are associated with healthful dietary intakes among youths, regardless of level of family functioning. Family dinners may be an appropriate intervention target for improving dietary intake among youths.
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Affiliation(s)
- Kathryn Walton
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Nicholas J. Horton
- Department of Mathematics and Statistics, Amherst College, Amherst, Massachusetts
| | - Sheryl L. Rifas-Shiman
- Harvard Pilgrim Health Care Institute, Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, Massachusetts
| | - Alison E. Field
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - S. Bryn Austin
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Andrea Breen
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
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Goldfarb SS, Locher JL, Preskitt J, Becker D, Davies SL, Sen B. Associations between participation in family activities and adolescent school problems. Child Care Health Dev 2017; 43:361-368. [PMID: 28101953 DOI: 10.1111/cch.12434] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 11/13/2016] [Accepted: 11/17/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Adolescent risk outcomes related to school issues are widespread, with about 20% parents reporting poor school engagement amongst their youth. Previous literature suggests that adolescents who report strong bonds with their parents are often identified as being less likely to engage in risky behaviours, such as substance use. The current study sought to examine the association between the frequencies of selected family activities and school problems amongst adolescents after adjustments for family connectedness and other characteristics. METHODS Data were drawn from the National Longitudinal Survey of Youth, 1997. Of the 8984 youth interviewed, 3855 also had a sibling interviewed who met the selection criteria. School problem outcomes measured were suspension occurrence, poor grades and highest grade completed low for age. Independent variables of interest were self-reported frequency of family dinner, fun and religious activities in a typical week. Multivariable logistic models were estimated for each outcome, and multivariable linear probability models were estimated adjusting for family fixed effects. RESULTS Adjusting for family connectedness, there were significant associations between certain family activities and adolescent school problem measures. However, these results did not remain significant in models with family fixed effects, suggesting that associations could be driven by family-level confounders. DISCUSSION This study did not find strong evidence of a protective relationship between family activities and school problems. Therefore, it suggested that programme and policymakers be cautious in overstating the importance of family activities in preventing adolescent risk outcomes until true causal relationships can be determined.
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Affiliation(s)
- S S Goldfarb
- College of Medicine, Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL, USA
| | - J L Locher
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - J Preskitt
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - D Becker
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - S L Davies
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - B Sen
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA
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McCullough MB, Robson SM, Stark LJ. A Review of the Structural Characteristics of Family Meals with Children in the United States. Adv Nutr 2016; 7:627-40. [PMID: 27422500 PMCID: PMC4942858 DOI: 10.3945/an.115.010439] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Family meals are associated with a range of positive outcomes among children and adolescents. There is inconsistency, however, in the way in which studies have defined and measured family meals. Therefore, a systematic review of the literature was conducted to determine how studies describe family meals with the use of structural characteristics. The current review focused on studies in the United States that included children ages 2-18 y. A total of 33 studies were identified that characterized family meals with the use of ≥1 of the following structural features: frequency or mean number of family meals per week, length of family meal, people present at meal, and where meals occurred. No study characterized family meals by using all 4 family meal features, whereas most studies (81%) characterized family meals by using frequency or mean number of meals per week. Findings not only provide an initial understanding of the structural features used to define family meals but also point to the importance of developing a more comprehensive, sensitive assessment that can accurately capture the complex and multidimensional nature of family meals.
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Affiliation(s)
- Mary Beth McCullough
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; and
| | - Shannon M Robson
- Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; and,Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE
| | - Lori J Stark
- Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; and
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Colson KE, Rudolph KE, Zimmerman SC, Goin DE, Stuart EA, Laan MVD, Ahern J. Optimizing matching and analysis combinations for estimating causal effects. Sci Rep 2016; 6:23222. [PMID: 26980444 PMCID: PMC4793248 DOI: 10.1038/srep23222] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 03/02/2016] [Indexed: 12/03/2022] Open
Abstract
Matching methods are common in studies across many disciplines. However, there is limited evidence on how to optimally combine matching with subsequent analysis approaches to minimize bias and maximize efficiency for the quantity of interest. We conducted simulations to compare the performance of a wide variety of matching methods and analysis approaches in terms of bias, variance, and mean squared error (MSE). We then compared these approaches in an applied example of an employment training program. The results indicate that combining full matching with double robust analysis performed best in both the simulations and the applied example, particularly when combined with machine learning estimation methods. To reduce bias, current guidelines advise researchers to select the technique with the best post-matching covariate balance, but this work finds that such an approach does not always minimize mean squared error (MSE). These findings have important implications for future research utilizing matching. To minimize MSE, investigators should consider additional diagnostics, and use of simulations tailored to the study of interest to identify the optimal matching and analysis combination.
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Affiliation(s)
- K. Ellicott Colson
- Division of Epidemiology, University of California- Berkeley School of Public Health, 50 University Hall, Berkeley, CA 94720-7360, USA
| | - Kara E. Rudolph
- Division of Epidemiology, University of California- Berkeley School of Public Health, 50 University Hall, Berkeley, CA 94720-7360, USA
- Center for Health and Community, University of California- San Francisco, 3333 California St, Suite 465, San Francisco, CA 94143-0844, USA
| | - Scott C. Zimmerman
- Division of Epidemiology, University of California- Berkeley School of Public Health, 50 University Hall, Berkeley, CA 94720-7360, USA
| | - Dana E. Goin
- Division of Epidemiology, University of California- Berkeley School of Public Health, 50 University Hall, Berkeley, CA 94720-7360, USA
| | - Elizabeth A. Stuart
- Departments of Mental Health, Biostatistics, and Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205, USA
| | - Mark van der Laan
- Division of Biostatistics, University of California- Berkeley School of Public Health, 101 Haviland Hall, Berkeley, CA 94720-7358, USA.
| | - Jennifer Ahern
- Division of Epidemiology, University of California- Berkeley School of Public Health, 50 University Hall, Berkeley, CA 94720-7360, USA
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Goldfarb SS, Tarver WL, Locher JL, Preskitt J, Sen B. A systematic review of the association between family meals and adolescent risk outcomes. J Adolesc 2015; 44:134-49. [DOI: 10.1016/j.adolescence.2015.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 04/07/2015] [Accepted: 07/21/2015] [Indexed: 02/06/2023]
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Goldfarb S, Tarver WL, Sen B. Family structure and risk behaviors: the role of the family meal in assessing likelihood of adolescent risk behaviors. Psychol Res Behav Manag 2014; 7:53-66. [PMID: 24627645 PMCID: PMC3931580 DOI: 10.2147/prbm.s40461] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Previous literature has asserted that family meals are a key protective factor for certain adolescent risk behaviors. It is suggested that the frequency of eating with the family is associated with better psychological well-being and a lower risk of substance use and delinquency. However, it is unclear whether there is evidence of causal links between family meals and adolescent health-risk behaviors. Purpose The purpose of this article is to review the empirical literature on family meals and adolescent health behaviors and outcomes in the US. Data sources A search was conducted in four academic databases: Social Sciences Full Text, Sociological Abstracts, PsycINFO®, and PubMed/MEDLINE. Study selection We included studies that quantitatively estimated the relationship between family meals and health-risk behaviors. Data extraction Data were extracted on study sample, study design, family meal measurement, outcomes, empirical methods, findings, and major issues. Data synthesis Fourteen studies met the inclusion criteria for the review that measured the relationship between frequent family meals and various risk-behavior outcomes. The outcomes considered by most studies were alcohol use (n=10), tobacco use (n=9), and marijuana use (n=6). Other outcomes included sexual activity (n=2); depression, suicidal ideation, and suicide attempts (n=4); violence and delinquency (n=4); school-related issues (n=2); and well-being (n=5). The associations between family meals and the outcomes of interest were most likely to be statistically significant in unadjusted models or models controlling for basic family characteristics. Associations were less likely to be statistically significant when other measures of family connectedness were included. Relatively few analyses used sophisticated empirical techniques available to control for confounders in secondary data. Conclusion More research is required to establish whether or not the relationship between family dinners and risky adolescent behaviors is an artifact of underlying confounders. We recommend that researchers make more frequent use of sophisticated methods to reduce the problem of confounders in secondary data, and that the scope of adolescent problem behaviors also be further widened.
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Affiliation(s)
- Samantha Goldfarb
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Will L Tarver
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Bisakha Sen
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
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