1
|
Bijlani C, Vrinten C, Junghans C, Chang K, Lewis E, Mulla U, Seferidi P, Laverty AA, Vamos EP. Changes in diet and physical activity following a community-wide pilot intervention to tackle childhood obesity in a deprived inner-London ward. BMC Public Health 2024; 24:800. [PMID: 38481177 PMCID: PMC10938768 DOI: 10.1186/s12889-024-18192-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Local authorities in England have an important role in shaping healthy local environments contributing to childhood obesity. This study examined changes in diet and physical activity in primary school children following a three-year, complex, community-based intervention in Golborne ward, the second most deprived ward in London. METHODS The Go-Golborne intervention aimed to shape the local environment across multiple settings with the engagement of a large number of local government and community stakeholders in a joint approach. Activities focused on six co-created themes to make changes to local environments and reduce sugary snacks and beverage consumption, increase fruit and vegetable intake, promote healthy snacks, increase active play and travel, and reduce screen time. We analysed changes in self-reported diet and physical activity, collected annually between 2016 and 2019, from 1,650 children aged 6-11 years through six local schools, who all received the intervention. We used multilevel, linear and logistic random-slope regression models adjusted for time on study, baseline age, gender, ethnicity, deprivation quintile, school, and baseline weight status. RESULTS After three years of follow-up, there were reductions in sugar-sweetened beverage consumption (adjusted beta -0·43 occasions/day, 95% CI -0·55 to -0·32), fruit and vegetable consumption (adjusted beta -0.22 portions, 95% CI -0.44 to 0.001) and car travel to and from school (adjusted OR 0·19, 95% CI 0·06 to 0·66), while screen time increased (high versus moderate/low: OR 2·30, 95% CI 1·36 to 3·90). For other behavioural outcomes, there was no statistically significant evidence of changes. CONCLUSION Local authorities have substantial powers to make positive changes to the obesogenic environment but programmes remain under-evaluated. Results from the ambitious Go-Golborne intervention demonstrated mixed results in health behaviours following programme implementation. These results underline the importance of a coordinated and comprehensive policy response to support changes in wider environmental and social conditions as well as appropriate and holistic evaluations of initiatives to inform local actions on obesogenic environments.
Collapse
Affiliation(s)
- Charan Bijlani
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK.
- National Institute of Health Research (NIHR) School of Public Health Research (SPHR), London, UK.
| | - Charlotte Vrinten
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Cornelia Junghans
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
- National Institute for Health and Care Research Applied Research Collaboration Northwest London, London, UK
| | - Kiara Chang
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | | | - UmmeZeinab Mulla
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Paraskevi Seferidi
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Anthony A Laverty
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Eszter P Vamos
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| |
Collapse
|
2
|
Hermeling L, Steinacker JM, Kobel S. Beyond correlates: the social gradient in childhood overweight. Arch Public Health 2024; 82:3. [PMID: 38195594 PMCID: PMC10775653 DOI: 10.1186/s13690-023-01232-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Health (in)equity has a high priority on research and policy agendas. Even though it is known that inequalities in overweight prevalence accumulate with age and are already existent among children below the age of six, research on this topic is scarce. In this young age group, parents play an important role in preventing overweight and associated adverse consequences. This study examines the magnitude of parental misclassification of child weight status and its correlates, focussing on the factors that determine social status and equity. METHODS Preschool children's weight and height was measured objectively. Parents gave information on their socioeconomic background. Family education was dichotomised into tertiary and non-tertiary educational level, according to CASMIN. Binary logistic regression, adjusted for parental BMI, was applied to detect odds of childhood overweight. RESULTS Data on family educational level and anthropometrics were available from 643 children (4.5 ± 0.82 years, 52.7% male) and their parents of which 46.5% (n = 299) had a tertiary educational background. The groups (tertiary vs. non-tertiary educational level) differ significantly in overweight prevalence (3.7% vs. 11.9%, p ≤ 0.001). Odds of overweight were two times higher in children with non-tertiary educational background (OR: 2.123, CI: 1.010-4.461, p < 0.05), adjusted for parental BMI. CONCLUSION Children from families with low educational background have an elevated risk of overweight, already at a very young age. Education in general (not explicitly health education) seems to play a tremendous role in the prevention of overweight and obesity and should therefore be implied in policies enhancing health equity. TRIAL REGISTRATION DRKS-ID: DRKS00010089.
Collapse
Affiliation(s)
- Lina Hermeling
- Division of Sports- and Rehabilitation Medicine, Centre of Medicine, Ulm University Hospital, Ulm, Germany
| | - Jürgen M Steinacker
- Division of Sports- and Rehabilitation Medicine, Centre of Medicine, Ulm University Hospital, Ulm, Germany
| | - Susanne Kobel
- Division of Sports- and Rehabilitation Medicine, Centre of Medicine, Ulm University Hospital, Ulm, Germany.
| |
Collapse
|
3
|
Ke Y, Chen S, Hong J, Liang Y, Liu Y. Associations between socioeconomic status and screen time among children and adolescents in China: A cross-sectional study. PLoS One 2023; 18:e0280248. [PMID: 36952470 PMCID: PMC10035844 DOI: 10.1371/journal.pone.0280248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 12/24/2022] [Indexed: 03/25/2023] Open
Abstract
Background Socioeconomic status (SES) is an important determinant of screen time (ST) in children and adolescents, however, the association between SES and ST is not fully understood in China. This study aimed to investigate the association between SES and ST (operationalized as meeting the ST guidelines; no more than 2 hours per day) in Chinese children and adolescents. Methods Cross-sectional data of 2,955 Chinese children and adolescents aged 8 to 17(53.4% girls) were used. SES was measured using indicators of parental education and perceived family wealth. ST was assessed with detailed items from the Health Behaviour School-aged Children survey questionnaires. Descriptive statistics and a Chi-square test were used to report the sample characteristics and analyse ST differences across different sociodemographic groups. A binary logistic regression was then applied to analyse the association of SES indicators with ST in children and adolescents. Results Overall, 25.3% of children and adolescents met the ST guidelines. Children and adolescents with higher parental education levels were 1.84 [95% CI 1.31–2.57; father] and 1.42 [95% CI 1.02–1.98; mother] times more likely to meet the ST guidelines than those with lower parental education levels. Associations between SES and ST varied across sex and grade groups. Moreover, the associations of SES with ST on weekdays and weekends were different. Conclusions This study demonstrated the association between SES and ST in children and adolescents, highlighting the importance of targeting children and adolescents with low SES levels as an intervention priority. Based on our findings, specific interventions can be tailored to effectively reduce ST. Future studies are encouraged to use longitudinal or interventional designs to further determine the association between SES and ST.
Collapse
Affiliation(s)
- Youzhi Ke
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Jintao Hong
- Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Agency), Shanghai, China
| | - Yahan Liang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Yang Liu
- School of Physical Education, Shanghai University of Sport, Shanghai, China
- Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai, China
- * E-mail:
| |
Collapse
|
4
|
Dow M, Murrin C, O'Malley G, Brinkley A, Bel‐Serrat S. A qualitative study exploring the perceptions of health among pre-teen girls from disadvantaged communities in Dublin. CHILDREN & SOCIETY 2023; 37:579-597. [PMID: 37065771 PMCID: PMC10087344 DOI: 10.1111/chso.12614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/22/2022] [Accepted: 06/29/2022] [Indexed: 06/19/2023]
Abstract
There are disparities in health outcomes between youth from higher and lower socioeconomic backgrounds, and girls are especially vulnerable to changes in health-related behaviours as they develop. Therefore, this study explored how girls from disadvantaged communities in Dublin, Ireland, make sense of 'being healthy.' A phenomenological qualitative design was implemented. Three focus groups were conducted (n = 22, 10-12 years) and data were analysed using thematic analysis. Food and physical appearance featured prominently within the girls' definitions of health. Girls and their families from low-SES backgrounds may experience more difficulties with time scarcity as well as environmental barriers to a healthy lifestyle.
Collapse
Affiliation(s)
- Mckenzie Dow
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports ScienceUniversity College DublinDublinIreland
- W82GO Child and Adolescent Weight Management ServiceChildren's Health IrelandDublinIreland
| | - Celine Murrin
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports ScienceUniversity College DublinDublinIreland
| | - Grace O'Malley
- W82GO Child and Adolescent Weight Management ServiceChildren's Health IrelandDublinIreland
- Obesity Research and Care Group, School of PhysiotherapyRCSI University of Medicine and Health SciencesDublinIreland
| | - Aoife Brinkley
- W82GO Child and Adolescent Weight Management ServiceChildren's Health IrelandDublinIreland
- Childrens Health Ireland at ConnollyDublinIreland
| | - Silvia Bel‐Serrat
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports ScienceUniversity College DublinDublinIreland
| |
Collapse
|
5
|
de la Rie S, Washbrook E, Perinetti Casoni V, Waldfogel J, Kwon SJ, Dräger J, Schneider T, Olczyk M, Boinet C, Keizer R. The role of energy balance related behaviors in socioeconomic inequalities in childhood body mass index: A comparative analysis of Germany, the Netherlands, the United Kingdom, and the United States. Soc Sci Med 2023; 317:115575. [PMID: 36470056 DOI: 10.1016/j.socscimed.2022.115575] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 11/09/2022] [Accepted: 11/24/2022] [Indexed: 11/27/2022]
Abstract
Socioeconomic inequalities in childhood Body Mass Index (BMI) are becoming increasingly more pronounced across the world. Although countries differ in the direction and strength of these inequalities, cross-national comparative research on this topic is rare. This paper draws on harmonized longitudinal cohort data from four wealthy countries-Germany, the Netherlands, the United Kingdom (UK), and the United States (US)-to 1) map cross-country differences in the magnitude of socioeconomic inequalities in childhood BMI, and 2) to examine cross-country differences in the role of three energy-balance-related behaviors-physical activity, screen time, and breakfast consumption-in explaining these inequalities. Children were aged 5-7 at our first timepoint and were followed up at age 8-11. We used data from the German National Educational Panel Study, the Dutch Generation R study, the UK Millennium Cohort Study and the US Early Childhood Longitudinal-Kindergarten Study. All countries revealed significant inequalities in childhood BMI. The US stood out in having the largest inequalities. Overall, inequalities between children with low versus medium educated parents were smaller than those between children with high versus medium educated parents. The role of energy-balance-related behaviors in explaining inequalities in BMI was surprisingly consistent. Across countries, physical activity did not, while screen time and breakfast consumption did play a role. The only exception was that breakfast consumption did not play a role in the US. Cross-country differences emerged in the relative contribution of each behavior in explaining inequalities in BMI: Breakfast consumption was most important in the UK, screen time explained most in Germany and the US, and breakfast consumption and screen time were equally important in the Netherlands. Our findings suggest that what constitutes the most effective policy intervention differs across countries and that these should target both children from medium as well as low educated families.
Collapse
Affiliation(s)
- Sanneke de la Rie
- Department of Public Administration & Sociology, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3000 DR, Rotterdam, Netherlands.
| | - Elizabeth Washbrook
- School of Education, University of Bristol, 35 Berkeley Square, Bristol, BS8 1JA, United Kingdom
| | | | - Jane Waldfogel
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Sarah Jiyoon Kwon
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Jascha Dräger
- School of Education, University of Strathclyde, 141 St James Road, Glasgow, G4 0LT, United Kingdom
| | | | - Melanie Olczyk
- Martin-Luther-Universität Halle-Wittenberg, Paracelsusstr. 22, 06114, Halle (Saale), Germany
| | - Césarine Boinet
- Department of Economics, University of Strathclyde, 199 Cathedral Street, Glasgow, G4 0QU, United Kingdom; French Institute for Demographic Studies (INED), 9 Cours des Humanités CS 50004, 93322, Aubervilliers Cedex, Aubervilliers, France
| | - Renske Keizer
- Department of Public Administration & Sociology, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3000 DR, Rotterdam, Netherlands
| |
Collapse
|
6
|
Shao J, He Z. How does social media drive corporate carbon disclosure? Evidence from China. Front Ecol Evol 2022. [DOI: 10.3389/fevo.2022.971077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
As public concern over global warming increases, there is a growing requirement for companies, as carbon emitters, to disclose (and work to reduce) their carbon emissions. Previous literature has neglected the role of social media as a source of legitimacy pressure to influence corporate carbon disclosure. Based on legitimacy theory, this study analyzed the impact of social media legitimacy pressure on corporate carbon disclosure using data from 3,656 Chinese listed companies from 2009 to 2019. We found that social media legitimacy pressure significantly enhances corporate carbon disclosure. Additionally, this positive relationship is weakened by substantive corporate internal carbon management measures (corporate green innovation and environmental management systems). Accordingly, in order to ensure consistent carbon management practices, companies should focus their efforts on substantive carbon management measures along with carbon disclosure.
Collapse
|
7
|
Almeida C, Azevedo J, Gregório MJ, Barros R, Severo M, Padrão P. Parental practices, preferences, skills and attitudes on food consumption of pre-school children: Results from Nutriscience Project. PLoS One 2021; 16:e0251620. [PMID: 34033667 PMCID: PMC8148319 DOI: 10.1371/journal.pone.0251620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/30/2021] [Indexed: 11/25/2022] Open
Abstract
The association between family environment and child’s eating behaviors is well established but a multidimensional approach to study this relation is lacking. This study aimed to assess the proprieties of a questionnaire created to evaluate parental practices, preferences, skills and attitudes regarding fruit and vegetables (F&V), sugar and salt. Participants (n = 714) were families of pre-school children (aged 2–6 years old) of the Nutriscience Project–a web-based gamification program–who answered a questionnaire assessing socio-demographic characteristics, nutrition knowledge, and a scale evaluating parental practices, preferences, skills and attitudes, at the baseline of the project. Exploratory factorial analysis was applied to the scale: 21 items and 5 factors were extracted (52.4% of explained variance) with a Kaiser-Meyer-Olkin (KMO) value of 0.770: 1. Modelling/active promotion of F&V consumption (α = 0.73), 2. Skills for choosing/preparing healthy food (α = 0.75), 3. Food preferences and satiety perception (α = 0.70), 4. Awareness regarding sugar/salt intake (α = 0.61), 5. Allowance regarding F&V consumption (α = 0.55). Kruskal-Wallis and Mann-Whitney tests were conducted to compare factors according to socio-demographic characteristics. Higher scores for parental modelling and active promotion of F&V consumption were observed in older parents, those with higher nutrition knowledge and who reported to live without income difficulties. Regarding food preferences, higher scores were observed in mothers, with higher nutrition knowledge and from higher educated groups. Higher awareness regarding salt and sugar consumption were observed in older parents, with higher education, higher nutrition knowledge and with female children. Older parents and with female children also registered higher scores of skills for choosing/preparing healthy food. The scale showed satisfactory proprieties and may contribute to assess family food environment using a multidimensional approach. It also highlighted the importance of considering socio-demographic characteristics in interventions to promote healthy eating.
Collapse
Affiliation(s)
- Carla Almeida
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - José Azevedo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal | ITR—Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional
- Faculdade de Letras da Universidade do Porto, Porto, Portugal
| | - Maria João Gregório
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Renata Barros
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal | ITR—Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional
| | - Milton Severo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal | ITR—Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal | ITR—Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional
- * E-mail:
| |
Collapse
|
8
|
Effects of the Preschool-Based Family-Involving DAGIS Intervention Program on Children's Energy Balance-Related Behaviors and Self-Regulation Skills: A Clustered Randomized Controlled Trial. Nutrients 2020; 12:nu12092599. [PMID: 32859118 PMCID: PMC7551940 DOI: 10.3390/nu12092599] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 01/11/2023] Open
Abstract
The study examines the effects of a preschool-based family-involving multicomponent intervention on children’s energy balance-related behaviors (EBRBs) such as food consumption, screen time and physical activity (PA), and self-regulation (SR) skills, and whether the intervention effects differed among children with low or high parental educational level (PEL) backgrounds. The Increased Health and Wellbeing in Preschools (DAGIS) intervention was conducted as a clustered randomized controlled trial, clustered at preschool level, over five months in 2017–2018. Altogether, 802 children aged 3–6 years in age participated. Parents reported children’s consumption of sugary everyday foods and beverages, sugary treats, fruits, and vegetables by a food frequency questionnaire, and screen time by a 7-day diary. Physical activity was assessed by a hip-worn accelerometer. Cognitive and emotional SR was reported in a questionnaire by parents. General linear mixed models with and without repeated measures were used as statistical methods. At follow-up, no differences were detected in EBRBs or SR skills between the intervention and control group, nor did differences emerge in children’s EBRBs between the intervention and the control groups when stratified by PEL. The improvement in cognitive SR skills among low PEL intervention children differed from low PEL control children, the significance being borderline. The DAGIS multicomponent intervention did not significantly affect children’s EBRBs or SR. Further sub-analyses and a comprehensive process evaluation may shed light on the non-significant findings.
Collapse
|
9
|
Männikkö N, Ruotsalainen H, Miettunen J, Marttila-Tornio K, Kääriäinen M. Parental socioeconomic status, adolescents' screen time and sports participation through externalizing and internalizing characteristics. Heliyon 2020; 6:e03415. [PMID: 32099928 PMCID: PMC7029175 DOI: 10.1016/j.heliyon.2020.e03415] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/16/2020] [Accepted: 02/12/2020] [Indexed: 11/19/2022] Open
Abstract
The socioeconomic status of parents is reportedly closely related to the digital screen usage and physical inactivity levels of children and adolescents. Internalizing and externalizing behavior characteristics may be linked to these associations and explain them. The purpose of the present study was to investigate the effects of parents' socioeconomic status (SES) on youths' total screen time along with physical inactivity through internalizing and externalizing behavior characteristics. Thus, we examined associations between parents' socioeconomic status (using scores based on several indicators) and adolescents' total digital screen exposure and physical inactivity level, together with the potentially predicting role of the adolescents' internalizing and externalizing behavior. For this, we assessed the internalizing and externalizing problem characteristics, total screen time exposure, physical inactivity level and parental socioeconomic status of a large cohort sample of Finnish adolescents (the Northern Birth Cohort, 1986 comprised 2899 males and 3059 females). The present study includes data collected in two phases, in 1985–1986 and 2000–2001. Path modeling suggests that a low SES of parents was directly associated with adolescents' physical inactivity level, while externalizing characteristics were a significant and additional contributing factor in adolescents' level of screen exposure in both genders. Gender moderated the relationship between adolescents' internalizing and externalizing characteristics and physical inactivity levels. The results also suggest that parents’ socioeconomic status constitutes a risk factor in relation to media screen exposure only in female adolescents. Implications of the findings are discussed.
Collapse
Affiliation(s)
- Niko Männikkö
- Department of Social Services and Rehabilitation, Oulu University of Applied Sciences, Oulu, Finland
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
- Corresponding author.
| | - Heidi Ruotsalainen
- Department of Social Services and Rehabilitation, Oulu University of Applied Sciences, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Kaisa Marttila-Tornio
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| |
Collapse
|
10
|
Ray C, Kaukonen R, Lehto E, Vepsäläinen H, Sajaniemi N, Erkkola M, Roos E. Development of the DAGIS intervention study: a preschool-based family-involving study promoting preschoolers' energy balance-related behaviours and self-regulation skills. BMC Public Health 2019; 19:1670. [PMID: 31830926 PMCID: PMC6909522 DOI: 10.1186/s12889-019-7864-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 10/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background Preschoolers’ energy balance-related behaviours (EBRBs) and self-regulation skills are important for their later health. Few preschool-based interventions aiming to promote preschoolers’ EBRBs and self-regulation skills, simultaneously reducing differences in EBRBs, due to children’s socio-economic status (SES) background, have been conducted. This study will present the Increased Health and Wellbeing in Preschools (DAGIS) intervention development process applying the Intervention Mapping (IM) framework. Methods The development of the DAGIS intervention study, a preschool level clustered randomized controlled trial (RCT), was based on the IM framework. The protocol in IM guides the development process of an intervention through six steps: needs assessment and logic model of the problem, programme outcomes and objectives, design of the programme, production, implementation plan, and evaluation plan. Results The needs assessment, part of the step 1 in IM, yielded the base for the DAGIS logic model of change. The model includes objectives related to changes in children’s EBRBs, self-regulation skills, and in psychosocial and physical environment that is determined by parents and early educators. A 22-week programme was developed, and materials for preschools and families were produced. A feasibility study of the recruitment processes, acceptability of the materials and methods, and implementation was conducted. The DAGIS intervention study was conducted September 2017–May 2018 as a clustered RCT including a comprehensive effectiveness and process evaluation. The process evaluation was run throughout the intervention targeting preschools and families. Conclusion A preschool-based family-involving programme was developed in the DAGIS intervention study by applying the IM protocol. It was a time- and resource-consuming process. However, the systematic planning, development, and running of the programme have reinforced a comprehensive evaluation, which is a strength in the intervention. The results from the evaluation will enhance the knowledge of how to promote EBRBs and self-regulation skills among preschoolers, and diminish SES differences in them. Trial registration ISRCTN57165350 (Prospectively registered January the 8th, 2015).
Collapse
Affiliation(s)
- Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland. .,Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland.
| | - Riikka Kaukonen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland
| | - Elviira Lehto
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.,Department of Teacher Education, University of Helsinki, P.O. Box 9, 00014, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland
| | - Nina Sajaniemi
- Department of Teacher Education, University of Helsinki, P.O. Box 9, 00014, Helsinki, Finland.,Philosophical Faculty, School of Applied Educational Science and Teacher Education, University of Eastern Finland, P.O. Box 111, 80101 Joensuu, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland.,Department of Public Health, Clinicum, University of Helsinki, P.O. Box 63, 00014, Helsinki, Finland
| |
Collapse
|
11
|
Franse CB, Wang L, Constant F, Fries LR, Raat H. Factors associated with water consumption among children: a systematic review. Int J Behav Nutr Phys Act 2019; 16:64. [PMID: 31409359 PMCID: PMC6693220 DOI: 10.1186/s12966-019-0827-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 07/29/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Water is recommended as the main beverage for daily fluid intake. Previous systematic reviews have studied the consumption of sugar-sweetened beverages (SSBs) among children, but none have focused on water consumption. Insight into factors that are associated with children's water intake is needed to inform the development of interventions aimed at the promotion of water consumption. The objective of this review was therefore to summarize the current evidence on factors associated with water consumption among children aged 2 to 12 years. METHODS A systematic literature search in seven electronic databases was conducted in May, 2018 and retrieved 17,850 unique records. Two additional studies were identified by hand-searching references of included articles. Studies were selected if they had a cross-sectional or longitudinal study design, focused on children aged 2-12 years and published in an English language peer-reviewed journal. Participants from clinical populations, studies that included data of < 10 participants and non-human studies were excluded. RESULTS A total of 63 articles met inclusion criteria and were included in the analysis. We identified 76 factors that were investigated in these studies; 17/76 were investigated in a longitudinal study. There was evidence of positive associations between water consumption and child's self-efficacy, parental education level, parental self-efficacy, use of feeding practices such as restriction or encouraging healthy eating and study year. Evidence was inconsistent (< 60% of studies reported an association) for child's age, sex, BMI, consumption of SSBs and ethnic background of the parent. There was no evidence (≤33% of studies reported an association) of associations between consumption of milk or juice, parental emotional-, modelling- or instrumental feeding practices, eating school lunch or outside temperature and water consumption. The remaining 54 factors were investigated in fewer than three studies. CONCLUSIONS There is some evidence for an association between potentially modifiable parental and child-related factors and water consumption. However, most factors identified in this review were only studied by one or two studies and most studies were cross-sectional. More longitudinal research is necessary to investigate environmental, parental and child-related factors associated with water consumption that are currently under-studied and could further inform intervention strategies. TRIAL REGISTRATION PROSPERO ID# CRD42018093362 , registered May 22, 2018.
Collapse
Affiliation(s)
- Carmen B. Franse
- Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - L. Wang
- Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | | | - Lisa R. Fries
- Nestlé Research, Vers-chez-les-Blanc, Lausanne, Switzerland
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| |
Collapse
|
12
|
Determinants of Child Health Behaviors in a Disadvantaged Area from a Community Perspective: A Participatory Needs Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040644. [PMID: 29614732 PMCID: PMC5923686 DOI: 10.3390/ijerph15040644] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/24/2018] [Accepted: 03/29/2018] [Indexed: 11/17/2022]
Abstract
Children from disadvantaged areas are hard to reach for interventions aimed at promoting healthy lifestyles. We conducted a participatory needs assessment, in which researchers collaborated with a community in a disadvantaged area in Amsterdam to gain an understanding of the health-related issues of children within this community. Qualitative data was collected through: three to four participatory group meetings with three groups of 9-12-year-old children (n = 5-9 per group); nine interviews with professionals working with youth; two interviews with parents and their children; and informal meetings including 31 parents. All transcriptions or summaries were coded and analyzed. Childhood overweight/obesity was indicated as the main health issue. A lack of physical activity and unhealthy dietary behavior were identified as the main risk factors, with underlying determinants such as culture, habits, finances, and social norms. Identified needs included more supervised, low-priced sports activities at a nearby location and more education on adopting a healthy diet. Our participatory health needs assessment resulted in a comprehensive overview of the most relevant risk factors and determinants of childhood overweight/obesity and needs from the community's perspective. This knowledge aids in the development of better tailored, and thereby potentially more effective, interventions.
Collapse
|
13
|
Määttä S, Konttinen H, Haukkala A, Erkkola M, Roos E. Preschool children's context-specific sedentary behaviours and parental socioeconomic status in Finland: a cross-sectional study. BMJ Open 2017; 7:e016690. [PMID: 29101133 PMCID: PMC5695314 DOI: 10.1136/bmjopen-2017-016690] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study examined the associations of parental socioeconomic status (SES) with preschoolers' objectively measured sedentary time (SED) over the course of a week and with parent-reported children's screen and reading times at home as indicators of sedentary behaviours (SB). DESIGN Cross-sectional. SETTING In years 2015 and 2016 in Finland. PARTICIPANTS 864 children, aged 3-6 years, with their parents. OUTCOME MEASURES Children's accelerometer data were transformed into average SED minutes per hour in different contexts (preschool, home during preschool days, weekend and total). Parent-reported children's screen and reading times were expressed as average daily minutes. The SES indicators (maternal and paternal education and relative household income) were grouped into three categories. Linear or logistic regression analyses were used, with municipality, season, and children's gender and age as covariates. CIs were adjusted for clustering at the preschool group level. RESULTS Children with low maternal (β=17.21, 95% CI: 8.71 to 25.71) and paternal (β=10.54, 95% CI: 0.77 to 20.30) education had more overall screen time at home than their more advantaged counterparts. SES differences in overall screen time were mostly explained by TV viewing. Children with low as opposed to high maternal education (β=-2.66, 95% CI: -4.95 to -0.38) had less reading time at home. Children whose fathers were on the middle (β=-1.15, 95% CI: -2.01 to -0.29) educational level had less weekend SED than those with high paternal education. Otherwise, parental SES was not related to objectively measured SED. CONCLUSIONS The results of this study highlight the fact that the associations between parental SES and preschoolers' SB are dependent on the indicators of SES and SBs, and vary between different contexts. Generally, parental SES was not associated with SED, whereas some SES differences existed in screen time and reading time at home. Interventions aiming to diminish SES differences in children's SB should focus on home hours. TRIAL REGISTRATION NUMBER ISRCTN57165350.
Collapse
Affiliation(s)
- Suvi Määttä
- Folkhälsan Research Center, Helsinki, Finland
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Hanna Konttinen
- Department of Social Research, University of Helsinki, Helsinki, Finland
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Ari Haukkala
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Clinicum, Helsinki, Finland
| |
Collapse
|
14
|
Määttä S, Kaukonen R, Vepsäläinen H, Lehto E, Ylönen A, Ray C, Erkkola M, Roos E. The mediating role of the home environment in relation to parental educational level and preschool children's screen time: a cross-sectional study. BMC Public Health 2017; 17:688. [PMID: 28865436 PMCID: PMC5581928 DOI: 10.1186/s12889-017-4694-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 08/22/2017] [Indexed: 01/24/2023] Open
Abstract
Background Previous studies suggest that preschoolers from low socioeconomic backgrounds engage in more screen time. Still, the factors in the social and physical home environment driving these differences in preschool children’s screen time are poorly understood. This study examines potential home environment mediators in the associations between parental educational level and preschoolers’ screen time. Methods A total of 864 children aged 3–6 years and their parents participated in a cross-sectional DAGIS study in 2015–2016. Parents recorded their children’s screen time in a diary (N = 823). For the analyses, the daily average screen time at home was calculated. Parental questionnaires (N = 808) assessed educational level and eight social and physical environment factors in the home (i.e., descriptive norm for children’s screen time, parental screen use in front of children, parental importance for limiting children’s screen time, parental attitude toward societal pressures for children’s screen time, access to screens at home, parental self-efficacy for limiting children’s screen time, satisfaction of children’s screen time, and rules for limiting children’s screen time). Parental education was grouped into low, middle, and high education. The associations were tested by conducting mediation analyses adjusted by season and children’s sex and age. The significant mediators in the single-mediator models were included in the final multiple-mediator models. Results Of the potential eight mediators, the following four had a significant indirect association: descriptive norm for children’s screen time, parental screen use in front of children, parental importance for limiting children’s screen time, and parental attitude toward societal pressures for children’s screen time. Parents with high education had lower descriptive norm and used fewer screens in front of children compared to parents with middle or low education, and in turn, these factors were associated with less screen time among children from parents with a higher education level. Parents with high education placed greater importance on limiting children’s screen time and felt less societal pressures about children’s screen time compared to parents with low education, and in turn, these factors were associated with less screen time among children from parents with a higher education level. Conclusions Our study recognized multiple modifiable mediators in the associations between parental education and preschool children’s screen time. When aiming to diminish socioeconomic status differences in preschool children’s screen time, the focus should be on parental role models, attitudes, and norm related to children’s screen time.
Collapse
Affiliation(s)
- Suvi Määttä
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland.
| | - Riikka Kaukonen
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland
| | - Elviira Lehto
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Anna Ylönen
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Carola Ray
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland
| | - Eva Roos
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland.,Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland.,Clinicum, Department of Public Health, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland
| |
Collapse
|
15
|
Water Consumption in European Children: Associations with Intake of Fruit Juices, Soft Drinks and Related Parenting Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14060583. [PMID: 28561769 PMCID: PMC5486269 DOI: 10.3390/ijerph14060583] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/17/2017] [Accepted: 05/27/2017] [Indexed: 12/15/2022]
Abstract
Background: High intake of fruit juices and soft drinks contributes to excessive weight gain and obesity in children. Furthermore, parenting practices play an important role in the development of children's dietary habits. The way parents play this role in the development of their children's choices of beverages is still unclear. Objectives: To study the associations: (1) of both fruit juices and soft drinks consumption with water consumption of children and (2) The associations between parenting practices towards fruit juices and soft drinks and water consumption of children. Design: Cross-sectional data from 6 to 8 year old children from seven European communities (n = 1187) were collected. Associations among fruit juices, soft drinks, the respective parenting practices and the child's water consumption were assessed by parental questionnaires. Results: The consumption of water was inversely associated with that of soft drinks but not with the consumption of fruit juices. The child's water intake was favorably influenced when stricter parenting practices towards soft drinks were adopted (e.g., less parental allowance, low home availability and high parental self-efficacy in managing intake). There was less influence observed of parenting practices towards fruit juices. Fruit juices were consumed more often than soft drinks. Conclusions: Low consumption of soft drinks-and not of fruit juices-was associated with high water consumption in children in the current study. Moreover, parenting practices towards both fruit juices and soft drinks were associated with the water intake of the children, irrespective of their socio-economic status.
Collapse
|
16
|
Santos A, Silva-Santos S, Andaki A, Mendes EL, Vale S, Mota J. Screen time between Portuguese and Brazilian children: a cross-cultural study. MOTRIZ: REVISTA DE EDUCACAO FISICA 2017. [DOI: 10.1590/s1980-6574201700020006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - Alynne Andaki
- Universidade do Porto, Portugal; Universidade Federal do Triângulo Mineiro, Brazil
| | - Edmar Lacerda Mendes
- Universidade do Porto, Portugal; Universidade Federal do Triângulo Mineiro, Brazil
| | - Susana Vale
- Universidade do Porto, Portugal; Instituto Politécnico do Porto, Portugal
| | | |
Collapse
|
17
|
Mantziki K, Renders CM, Vassilopoulos A, Radulian G, Borys JM, du Plessis H, Gregório MJ, Graça P, de Henauw S, Handjiev S, Visscher TLS, Seidell JC. Inequalities in energy-balance related behaviours and family environmental determinants in European children: changes and sustainability within the EPHE evaluation study. Int J Equity Health 2016; 15:160. [PMID: 27680964 PMCID: PMC5041563 DOI: 10.1186/s12939-016-0438-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 09/07/2016] [Indexed: 11/17/2022] Open
Abstract
Background Increasing social inequalities in health across Europe are widening the gap between low and high socio-economic groups, notably in the prevalence of obesity. Public health interventions may result in differential effects across population groups. Therefore, the EPHE (EPODE for the Promotion of Health Equity) project analysed the added value of community-based programmes, based on the EPODE (Ensemble Prévenons l’Obésité Des Enfants-Together Let’s Prevent Obesity) model, to reduce socio-economic inequalities in energy balance-related behaviours of children and their family-environmental related determinants in seven European communities. This study presents the changes between baseline and follow-up after the one-year interventions and their sustainability one year after. Methods This is a prospective study with a one school-year intervention, followed by one year of follow-up. In all, 1266 children (age 6-8 years) and their families from different socio-economic backgrounds were recruited at baseline. For 1062 children, information was available after one year (T1) and for 921 children after two years (T2). A self-reported questionnaire was completed by the parents to examine the children’s energy balance-related behaviours and family- environmental determinants. Socio-economic status was defined by the educational level of the mother. The Wilcoxon signed-rank test for paired data was used to test the differences between baseline and intermediate, and between intermediate and final, measurements for each of the socio-economic status groups. Results Post-intervention effects in energy-balance related behaviours showed the following improvements among the low socio-economic status groups: increased fruit consumption (Netherlands), decreased fruit juices amount consumed (Romania) and decreased TV time on weekdays (Belgium). Whereas in only the latter case the behavioural change was accompanied with an improvement in a family-environmental determinant (monitoring the time the child watches TV), other improvements in parental rules and practices related to soft drinks/fruit juices and TV exposure were observed. A few of those effects were sustainable, notably in the case of Belgium. Conclusions Inequalities in obesity-related behaviours could be potentially reduced when implementing community-based interventions, tailored to inequality gaps and using the EPODE methodology. Within-group changes varied widely, whereas monitoring of interventions and process evaluation are crucial to understand the observed results. Electronic supplementary material The online version of this article (doi:10.1186/s12939-016-0438-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Krystallia Mantziki
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands.
| | - Carry M Renders
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands
| | - Achilleas Vassilopoulos
- Department of Agricultural Economics and Rural Development, Agricultural University of Athens, Athens, Greece
| | | | | | | | - Maria João Gregório
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Pedro Graça
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.,Directorate General of Health, Lisbon, Portugal
| | | | - Svetoslav Handjiev
- Bulgarian Association for the study of Obesity and related diseases, Sofia, Bulgaria
| | - Tommy L S Visscher
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands.,Research Centre for the Prevention of Overweight, Windesheim University of Applied Sciences Zwolle, Zwolle, The Netherlands.,Research Centre for the Prevention of Overweight, VU University, Zwolle, The Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands
| |
Collapse
|