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Wang X, Wu Y, Bai X, Qiao Q, Yu L, Ge L, Qi L, Zang S. Acceptance level of advance care planning and its associated factors among the public: A nationwide survey. BMC Palliat Care 2024; 23:201. [PMID: 39107758 PMCID: PMC11301855 DOI: 10.1186/s12904-024-01533-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 07/29/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Advance care planning (ACP) can contribute to individuals making decisions about their healthcare preferences in advance of serious illness. Up to now, the acceptance level and associated factors of ACP among the public in China remain unclear. This study aims to investigate the acceptance level of ACP in China and identify factors associated with it based on the socioecological model. METHODS A total of 19,738 participants were included in this survey. We employed a random forest regression analysis to select factors derived from the socioecological model. Multivariate generalized linear model analysis was then conducted to explore the factors that were associated with the acceptance level of ACP. RESULTS On a scale ranging from 0 to 100, the median score for acceptance level of ACP was 64.00 (IQR: 48.00-83.00) points. The results of the multivariate generalized linear model analysis revealed that participants who scored higher on measures of openness and neuroticism personality traits, as well as those who had greater perceptions of social support, higher levels of health literacy, better neighborly relationships, family health, and family social status, were more likely to accept ACP. Conversely, participants who reported higher levels of subjective well-being and greater family communication levels demonstrated a lower likelihood of accepting ACP. CONCLUSIONS This study identified multiple factors associated with the acceptance level of ACP. The findings offer valuable insights that can inform the design and implementation of targeted interventions aimed at facilitating a good death and may have significant implications for the formulation of end-of-life care policies and practices in other countries facing similar challenges.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Yibo Wu
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xinghua Bai
- Department of Radiation Oncology, The First Hospital of China Medical University, No.155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, China
| | - Qiao Qiao
- Department of Radiation Oncology, The First Hospital of China Medical University, No.155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, China
| | - Ling Yu
- Phase I Clinical Trails Center, The First Hospital of China Medical University, No.155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, China
| | - Lina Ge
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping Area, Shenyang, 110004, Liaoning Province, China
| | - Li Qi
- School of Nursing, Qiqihar Medical University, No.333, Bukui North Street, Jianhua District, Qiqihar City, 161006, Heilongjiang Province, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China.
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Melwani S, Cleland V, Patterson K, Nash R. Health literacy and non-communicable disease knowledge of pregnant women and mothers in Tasmania: Qualitative exploration. Health Promot J Austr 2024. [PMID: 39020439 DOI: 10.1002/hpja.902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/11/2024] [Accepted: 06/29/2024] [Indexed: 07/19/2024] Open
Abstract
ISSUE ADDRESSED The World Health Organisation is prioritising health literacy development to address the growing burden of non-communicable diseases (NCDs). Empowering pregnant women and mothers through health literacy development may help to reduce the intergenerational impact of NCDs. However, significant gaps exist in understanding the health literacy needs of this priority population globally. METHODS This study aimed to qualitatively explore the health literacy strengths and challenges as well as NCDs knowledge and beliefs of pregnant women and mothers with young children (0-8 years) in Tasmania. Data were collected online using in-depth semi-structured interviews and analysed inductively using reflexive thematic analysis. RESULTS Twenty women (mean age 35.5 years, standard deviation 5.13) participated. Four parent themes were generated from the data: perceived knowledge and awareness of NCDs and their causative factors; social determinants of health and the surrounding environment; social networks and peer support as health navigator; and trust in health services and social connections. These themes highlighted diverse factors that influenced the participant's access and use of health information and services and their engagement in healthy lifestyle practices and active health management. CONCLUSION Participants demonstrated good knowledge and awareness about NCDs and associated risk factors but experienced numerous health literacy strengths and challenges which influenced their access to health care and engagement in healthy lifestyle practices. SO WHAT This study highlights the need to address the diverse health literacy needs of pregnant women and mothers through codesigning locally informed health literacy development strategies combined with the creation of enabling service environments to reduce the growing burden of NCDs.
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Affiliation(s)
- Satish Melwani
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Verity Cleland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Kira Patterson
- School of Education, University of Tasmania, Launceston, Tasmania, Australia
| | - Rosie Nash
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Tong LK, Au ML, Zheng MR, Liu YB, Fu GL, Li YY. The effect of family health on suboptimal health status: The parallel mediation role of sleep quality and health behaviour. J Glob Health 2024; 14:04071. [PMID: 38574356 PMCID: PMC10994672 DOI: 10.7189/jogh.14.04071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
Background The prevalence of suboptimal health status has been increasing worldwide, posing a significant challenge to public health. Meanwhile, family health has been recognised as an important factor influencing individual health outcomes. However, the mechanisms through which family health affects suboptimal health status remain unclear. We aimed to investigate the parallel mediation role of sleep quality and health behaviour in the relationship between family health and suboptimal health status. Methods We conducted a cross-sectional online survey with a sample of adults >18 years old from four provinces in China. The survey questionnaires queried their demographic characteristics, family health, suboptimal health status, sleep quality, and health behaviour. We assessed family health by the Family Health Scale-Short Form and suboptimal health status using the Suboptimal Health Status Questionnaire. We employed structural equation modelling to analyse the data and test the proposed mediation model. Results we collected 4918 valid questionnaires. The mean age of the participants was 30.1 years (standard deviation = 12.5). The correlation analysis demonstrated a significant negative association between family health and suboptimal health status (r = -0.44; P < 0.001). The results of the parallel mediation analysis showed that family health had a significant indirect effect on suboptimal health status through both sleep quality (β = -0.350; P < 0.001) and health behaviour (β = -0.137; P < 0.001). The total indirect effect of family health on suboptimal health status through both sleep quality and health behaviour was also significant (β = -0.569, P < 0.001). Conclusions This study highlights the significance of family health as a predictor of suboptimal health status and suggests that sleep quality and health behaviour are parallel mediators in this relationship. By understanding the role of family health, sleep quality, and health behaviour, interventions can be targeted to improve overall health outcomes.
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Affiliation(s)
- Lai Kun Tong
- Research Management and Development Department, Kiang Wu Nursing College of Macau, Macao, China
| | - Mio Leng Au
- Education Department, Kiang Wu Nursing College of Macau, Macao, China
| | - Mu Rui Zheng
- Faculty of Health Sciences, University of Macau, Macao, China
| | - Yong Bing Liu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Guang Lei Fu
- Infectious Disease Department, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yue Yi Li
- Education Department, Kiang Wu Nursing College of Macau, Macao, China
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Middleton G, Golley RK, Patterson KA, Coveney J. The family meal, a ritual frozen in time; an Australian grounded theory study. Health Promot Int 2023; 38:daad124. [PMID: 37791593 PMCID: PMC10548410 DOI: 10.1093/heapro/daad124] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Family meals are recognized as an opportunity to promote the health of families. Popular discourse posits that changes to contemporary family life have made family meals harder to achieve and promotion of the 'traditional' family meal may be adding pressures to contemporary families. While research has been conducted on family meals over the last three decades, there is no explicit investigation of the experiences and practices of family meals over this time. Understanding the evolution of family meal practices across time is important for developing achievable expectations in relation to this ritual. Qualitative interviews were conducted with a diverse population of South Australian parents in the 1990s (n = 32) and with a separate population of parents in 2020 (n = 22) to gather their experiences of family meal practices. A comparative analysis, informed by grounded theory, was undertaken to identify similarities and differences in experiences across these two time periods. The results indicated stability in many family meal experiences across time, particularly in their value and significance in family life. Negotiations balancing time, cost, food preferences and responsibility persisted. The stability of family meal values and practices is important to consider when making recommendations, designing interventions and creating services targeting the family meal.
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Affiliation(s)
- Georgia Middleton
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
- College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
| | - Rebecca K Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
- College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
| | - Karen A Patterson
- College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
| | - John Coveney
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
- College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
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Wang D, Sun X, He F, Liu C, Wu Y. The mediating effect of family health on the relationship between health literacy and mental health: A national cross-sectional survey in China. Int J Soc Psychiatry 2023; 69:1490-1500. [PMID: 37095729 DOI: 10.1177/00207640231166628] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
BACKGROUND Mental health problems significantly affect people's well-being and result in a huge health burden. Health literacy and family health are critical to reducing people's mental health problems. However, limited studies have addressed their complex interaction. Thus, this study aims to elucidate the mediating effect of family health on the relationship between health literacy and mental health. METHODS A national cross-sectional study based on multistage random sampling was conducted from July 10 to Sep 15, 2021, in China. Information about the public's health literacy, family health, and the level of three common mental health problems (depression, anxiety, and stress) was collected. A structural equation model (SEM) was applied to explore the mediating effect of family health on the relationship between health literacy and mental health. RESULTS A total of 11,031 participants were investigated. Approximately 19.93 and 13.57% of participants experienced moderate or severe depressive and anxiety symptoms, respectively. The SEM showed that health literacy was directly associated with mental health, with higher health literacy resulting in lower levels of depression (coefficient: -0.018, p = .049), anxiety (coefficient: -0.040, p < .001), and stress (coefficient: -0.105, p < .001). In addition, family health played a significant mediating effect (p < .001) between health literacy and mental health, contributing to 47.5, 70.9, and 85.1% of the total effect of health literacy on personal stress, anxiety, and depression, respectively. CONCLUSIONS This study revealed that the improvement of health literacy is directly and indirectly associated with less likelihood of people's mental health problems via family health. Thus, future mental health interventions should be integrated and targeted both at individual level and the family level.
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Affiliation(s)
- Dan Wang
- School of Management, Hubei University of Chinese Medicine, Wuhan, China
| | - Xinying Sun
- School of Public Health, Peking University, Beijing, China
| | - Feiying He
- School of Public Health, Southern Medical University, GuangZhou, China
| | - Chenxi Liu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
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Li H, Wu Y, Bai Z, Xu X, Su D, Chen J, He R, Sun J. The Association Between Family Health and Frailty With the Mediation Role of Health Literacy and Health Behavior Among Older Adults in China: Nationwide Cross-Sectional Study. JMIR Public Health Surveill 2023; 9:e44486. [PMID: 37368463 DOI: 10.2196/44486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/07/2023] [Accepted: 05/17/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Family health develops from the intersection of the health of each family member and their interactions and capacities as well as the family's internal and external resources. Frailty is the most prominent and typical clinical manifestation during population aging. Family health may be effective in addressing frailty, and this association may be mediated by health literacy and health behaviors. Until now, it is unclear whether and how family health affects frailty in older adults. OBJECTIVE This study aimed to examine the associations between family health and frailty and the mediation roles of health literacy and health behaviors. METHODS A total of 3758 participants aged ≥60 years were recruited from a national survey conducted in 2022 in China for this cross-sectional study. Family health was measured using the Short Form of the Family Health Scale. Frailty was measured using the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) scale. Potential mediators included health literacy and health behaviors (not smoking, not having alcohol intake, physical exercise for ≥150 minutes per week, longer sleep duration, and having breakfast every day). Ordered logistic regression was applied to explore the association between family health and frailty status. Mediation analysis based on Sobel tests was used to analyze the indirect effects mediated by health literacy and behaviors, and the Karlson-Holm-Breen method was used to composite the indirect effects. RESULTS Ordered logistic regression showed that family health is negatively associated with frailty (odds ratio 0.94, 95% CI 0.93-0.96) with covariates and potential mediators controlled. This association was mediated by health literacy (8.04%), not smoking (1.96%), longer sleep duration (5.74%), and having breakfast every day (10.98%) through the Karlson-Holm-Breen composition. CONCLUSIONS Family health can be an important intervention target that appears to be negatively linked to frailty in Chinese older adults. Improving family health can be effective in promoting healthier lifestyles; improving health literacy; and delaying, managing, and reversing frailty.
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Affiliation(s)
- Haomiao Li
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
| | - Zhongliang Bai
- School of Health Services Management, Anhui Medical University, Hefei, China
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Xiwu Xu
- Beijing Hospital, Beijing, China
| | - Dai Su
- Department of Health Management and Policy, School of Public Health, Capital Medical University, Beijing, China
| | - Jiangyun Chen
- Institute of Health Management, Southern Medical University, Guangzhou, China
| | - Ruibo He
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
- College of Finance and Public Administration, Hubei University of Economics, Wuhan, China
| | - Ju Sun
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
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7
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Robledo de Dios T, Rollán Gordo A, Peña Rey I. [Qualitative study on food perceptions, dietary practices and healthy lifestyles in the adolescent population.]. Rev Esp Salud Publica 2023; 97:e202305037. [PMID: 37161737 PMCID: PMC10560529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/01/2023] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVE Child and adolescent obesity is a biggest public health challenge. Adolescence is a critical stage for growth and development. The objective of the research was to explore and understand the perceptions of the adolescent population about eating and healthy lifestyle habits, and the identification of barriers and facilitators. METHODS A multicenter qualitative research was made, in schoolchildren from twelve to fourteen years old, from four Secondary Schools, distributed in four municipalities. During the first quarter of the 2021-2022 school year, ten Discussion Groups were conducted, with 7-11 participants per group, and two ninety-minute work sessions per group. The proceedings were followed by two deliberative sessions. The Atlas.ti version 8 software was used for data content analysis, following the methodological recommendations of Mayring and Cáceres, and the open coding technique was used. RESULTS A relationship was observed between the foods most consumed in the family home and the ones that teenagers liked most. Also the extracurricular sports activity was highlighted as the main source of physical activity as well as the connection between mental health and healthy practices, and the emphasis about the variety of foods, the importance given to sustainability and the relationship of an unhealthy diet with excess intake of sugar, sweets, soft drinks, fast food and fats. The family was revealed as one of the most influential factors, followed by professionals, the media and high schools. Among the perceived barriers were the socioeconomic level, lack of time, food supply in canteens and social pressure. CONCLUSIONS The main barriers and motivations linked to the food environment, socioeconomic level, body image and emotional well-being are identified. Adolescents express interest in participating in public policies.
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Affiliation(s)
- Teresa Robledo de Dios
- ubdirección General de Nutrición, Agencia Española de Seguridad Alimentaria y Nutrición (AESAN), Ministerio de ConsumoMinisterio de ConsumoMadridSpain
| | - Almudena Rollán Gordo
- ubdirección General de Nutrición, Agencia Española de Seguridad Alimentaria y Nutrición (AESAN), Ministerio de ConsumoMinisterio de ConsumoMadridSpain
| | - Isabel Peña Rey
- Dirección Ejecutiva, Agencia Española de Seguridad Alimentaria y Nutrición, Ministerio de ConsumoMinisterio de ConsumoMadridSpain
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Ostovarfar J, Kaveh MH, Vardanjani HM, Ghahramani L, Karimi M, Asadollahi A, Zare R. Improving family health climate, effect of role modeling and maternal support in female students. BMC PRIMARY CARE 2023; 24:70. [PMID: 36907853 PMCID: PMC10008707 DOI: 10.1186/s12875-023-02015-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/22/2023] [Indexed: 03/14/2023]
Abstract
INTRODUCTION Girls can use their mother's emotional, informational and behavioral support to perform healthy behaviors due to their constant access to their mothers. This study aimed to evaluate the effect of role modeling and maternal support in the family to improve healthy behaviors and perceived Family Health Climate (FHC) in female students. METHODS In this educational quasi-experimental study, 261 female students (133 in the intervention group and 128 in the control group) and 223 mothers (109 intervention and 114 control) were selected using the cluster multi-stages sampling method and entered the study. Participants (intervention and control groups) completed the FHC scale at three stages (before intervention, immediately after the intervention, and 2 months after intervention). A training program that comprised 12 sessions for students and six sessions for their mothers using collaborative learning techniques and printed materials was conducted with the experimental group. Also after completing the questionnaire in the follow-up phase, pamphlets and educational videos were given to the control group. Data were analyzed using SPSS20 via a chi-square test, independent t-test, and Repeated Measures ANOVA at a significance level of 0.05. RESULTS Before the intervention, there was no significant difference between demographic variables and the score of the FHC scale in both groups (p < 0.05). Immediately and 2 months after the intervention, the experimental group (female students and their mothers) showed a significant increase in dimensions of FHC, including FHC-NU (Family Health Climate-Nutrition) and FHC-PA (Family Health Climate-Physical Activity), compared to the control group (p < 0.05). CONCLUSIONS Educating and informing mothers about the impact of their role modeling on their children, especially girls, can make them more aware of health-oriented behaviors towards their children. Such findings reinforced the importance of focusing on actions to encourage a healthy lifestyle (healthy diet and physical activity) in students with a focus on role modeling and parental support, especially mothers.
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Affiliation(s)
- Jeyran Ostovarfar
- grid.412571.40000 0000 8819 4698MPH Program, Medical School, Shiraz University of Medical Sciences, Setad Square, Shiraz, Fars Iran
| | - Mohammad Hossein Kaveh
- grid.412571.40000 0000 8819 4698Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Molavi Vardanjani
- grid.412571.40000 0000 8819 4698MPH Program, Medical School, Shiraz University of Medical Sciences, Setad Square, Shiraz, Fars Iran
| | - Leila Ghahramani
- grid.412571.40000 0000 8819 4698Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Karimi
- grid.412571.40000 0000 8819 4698Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolrahim Asadollahi
- grid.412571.40000 0000 8819 4698Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Razie Zare
- grid.412504.60000 0004 0612 5699Department of Industrial & Organizational Psychology, Faculty Education & Psychology, Shahid Chamran University, Ahvaz, Iran
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Ali SH, Rouf R, Mohsin FM, Meltzer G, Sharma P, DiClemente RJ. The influence of routine and leisure family activities on the ability of young Asian Americans to maintain a healthy lifestyle: findings from a nationwide survey. J Behav Med 2022; 45:962-974. [PMID: 35948698 PMCID: PMC9365227 DOI: 10.1007/s10865-022-00352-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/18/2022] [Indexed: 11/08/2022]
Abstract
Family is uniquely influential in the health of young Asian Americans (AAs), yet little is known on the impact of specific shared family activities. This study explores different types and frequencies of AA young adult shared family activities on perceived familial influence on the ability to maintain a healthy lifestyle (diet, physical activity, sleep, social relationships, stress, and risky substances). A nationwide sample of 18-35-year-old AAs was surveyed in March 2021 on a list of 30 shared family activities with mothers, fathers, siblings, or extended family. Overall, 984 unique family relationships reported by 616 young AAs were analyzed. Confirmatory factor analysis synthesized a reliable two-factor (routine, leisure activities) 10-item Shared Activities with Family (SAF) scale. Mothers were most influential (mean 3.25, SD = 1.14), although shared activities among South Asians or with extended family were most associated with changes in perceived influence. Routine shared activities were more strongly associated with perceived influence on sleep, diet, and risky substances, while leisure shared activities were more associated with influence on developing healthy social relationships. Family-based, dyadic interventions for young AAs may incorporate shared activities (both routine and leisure) to promote healthy behaviors, although further research to explore mechanisms and directionality of influence is needed to inform action.
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Affiliation(s)
- Shahmir H Ali
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, 708 Broadway, New York, NY, 10003, USA.
| | - Rejowana Rouf
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Farhan M Mohsin
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, USA
| | - Gabriella Meltzer
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, 708 Broadway, New York, NY, 10003, USA
| | - Priyanshi Sharma
- College of Letters and Sciences, University of California, Berkeley, CA, USA
| | - Ralph J DiClemente
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, 708 Broadway, New York, NY, 10003, USA
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Pudpong N, Julchoo S, Sinam P, Uansri S, Kunpeuk W, Suphanchaimat R. Family Health among Families with Primary School Children during the COVID Pandemic in Thailand, 2022. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15001. [PMID: 36429719 PMCID: PMC9690226 DOI: 10.3390/ijerph192215001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/10/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Abstract
Despite evidence suggesting that the COVID pandemic has negatively affected the mental health and well-being of school aged children and parents, there are limited studies describing the state of family well-being. This study aimed to use the family health lens to assess the well-being of Thai families with primary school children and to identify its associated factors. A cross-sectional survey was conducted during January and March 2022, a period of school closure when onsite education was replaced by online education from time to time. The family health scale (FHS) questionnaire survey was carried out among 701 parents of Thai families with primary school children. The questionnaire comprised 10 questions regarding family belief, health, relationships, financial security, and housing environment. Independent variables included: (1) parental/household factors; (2) online learning related issues; (3) children's mental health; and (4) parents' health behaviors. Multinomial logistic regression was undertaken. Results showed that half of Thai families (54.6%) reported having moderate health status. Factors that were associated with lower levels of family health, such as poor or moderate levels, included families with a child that had mental health problems (adjusted odd ratio (AOR) = 5.0 [95% CI = 2.6-9.5] for poor v. excellent, and AOR = 2.7 [95% CI = 1.9-4.0] for moderate v. excellent), single parents (AOR = 2.5 [95% CI = 1.2-5.2] for poor v. excellent), a higher number (≥3) of children (AOR = 2.1 [95% CI = 1.0-4.0] for moderate v. excellent), and smoking parents (AOR = 6.5 [95% CI =1.2-34.8] for poor v. excellent). During health emergencies, health policy for providing adequate assistance to single parents, especially those that have a child with mental health problems, is of utmost importance. The design of health promotion activities and interventions should be targeted not only at single families, but also families with higher numbers of children and parents who smoke at home.
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Affiliation(s)
| | - Sataporn Julchoo
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Pigunkaew Sinam
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Sonvanee Uansri
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Watinee Kunpeuk
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Rapeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
- Department of Disease Control, Division of Epidemiology, Nonthaburi 11000, Thailand
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11
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Ho YCL, Chew MSL, Ho CZH, Latib AB, Lee VSY, Lin GJ, Thumboo J, Doshi K. The validation of culturally appropriate scales to assess the family health climate in a multi-ethnic Asian population. Front Public Health 2022; 10:988525. [PMID: 36276392 PMCID: PMC9584639 DOI: 10.3389/fpubh.2022.988525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/12/2022] [Indexed: 01/26/2023] Open
Abstract
Background The Family Health Climate (FHC) is a family environment attribute postulated to influence the health behaviors of family members. It can be measured by domain scales for physical activity (FHC-PA) and nutrition (FHC-NU), which have been validated and used to identify health climate patterns in families in Western populations. To extend the use of the scales to Asian settings, this study aimed to adapt and validate the instruments for use in the multi-ethnic population of Singapore, accounting for language and cultural differences. Methods In Part A (n = 40) to adapt the scales for the Singapore population, we performed cognitive interviews, face validity testing and pre-testing of the instruments (n = 40). Besides English, the scales were translated into Chinese and Malay. In Part B (n = 400), we performed exploratory and confirmatory factor analyses respectively on two random samples. We also tested for item discriminant validity, internal consistency reliability, construct validity, and measurement invariance. Results The findings from the cognitive interviews in Part A led to scale adaptations to accommodate cultural and linguistic factors. In Part B, EFA on Sample I resulted in a three-factor model for the PA scale (accounting for 71.2% variance) and a four-factor model for the NU scale (accounting for 72.8% variance). CFA on Sample II indicated acceptable model fits: FHC-PA: χ2 = 192.29, df = 101, p < 0.001, χ2/df = 1.90; SRMR = 0.049; RMSEA = 0.067; CFI = 0.969; TLI = 0.963; FHC-NU: χ2 = 170.46, df = 98, p < 0.001, χ2/df = 1.74; SRMR = 0.036; RMSEA = 0.061; CFI = 0.967; TLI = 0.960. The scores of family members demonstrated significant agreement on the FHC-PA (Sg) [ICC(2, 2) = 0.77] and FHC-NU (Sg) [ICC(2, 2) = 0.75] scales. Findings suggest good evidence for item discriminant validity, internal consistency reliability, construct validity, and measurement invariance. Short versions of the scales were also developed. Conclusion We adapted, translated and validated the scales for assessing the health climate of families in Singapore, including the development of short versions. The results showed good psychometric properties and the constructs had significant relationships with health behaviors and routines. Improving our understanding of family influences on individual health behavior will be important in developing multi-level strategies for health promotion and chronic disease prevention.
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Affiliation(s)
- Yi-Ching Lynn Ho
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Mary Su-Lynn Chew
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
| | - Clement Zhong-Hao Ho
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
| | - Aisyah Binte Latib
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
| | - Vivian Shu-Yi Lee
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
| | - Gladis Jing Lin
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Julian Thumboo
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Kinjal Doshi
- Department of Neurology, Singapore General Hospital, Singapore, Singapore
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Quiñones-Laveriano DM, Cervera-Ocaña MS, Porro-Diaz LV, Reynel KJ, De La Cruz-Vargas JA. Correlation between stress and lifestyle in teachers at some schools in Lima, Peru, during telework in 2020. Work 2022; 72:409-419. [DOI: 10.3233/wor-211224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Stress and unhealthy lifestyle are serious problems in public health and education, particularly due to their significant relevance in the context of the COVID-19 pandemic. OBJECTIVES: To determine the correlation between stress and lifestyle in teachers at some schools in Lima, Peru, during telework in 2020. METHODS: This observational, quantitative, analytical, cross-sectional study was conducted in 217 school teachers from Lima. Lifestyle was measured using the FANTASTIC questionnaire; stress was measured using the Teaching Stress Scale (ED-6), comprised of the anxiety, depression, maladaptive beliefs, work pressure and poor coping dimensions. The Spearman correlation between numerical variables, and the difference of the FANTASTIC score according to the categorical variables, were analyzed with the Mann–Whitney U test or Kruskal–Wallis test, as necessary. Multivariable analysis was done with a multiple linear regression model to find raw and adjusted β (βa). RESULTS: The median of the ED-6 scale was 81 (RI: 64–105). Sixty-four percent of the teachers had a good-excellent lifestyle; 27.2%, regular; and 8.49%, bad-dangerous. The FANTASTIC score had an inverse correlation with ED-6 (βa: –0.16, 95%; CI: –0.20 to –0.12) adjusted for age and cohabitation with children. Likewise, teachers between 40 and 49 years old (βa: 2.89, 95%; CI: 0.17 to 5.62) had a better lifestyle; and teachers who lived with children (βa: –5.48, 95%; CI: –7.89 to –3.06), a worse lifestyle. CONCLUSIONS: As stress increased, the lifestyle quality worsened in teachers at some schools in Lima, Peru, during telework in 2020.
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Affiliation(s)
| | - Martha Sofia Cervera-Ocaña
- Facultad de Ciencias Médicas, Universidad César Vallejo, Trujillo, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad César Vallejo, Trujillo, Peru
| | | | | | - Jhony A. De La Cruz-Vargas
- Instituto de Investigaciones Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Peru
- Facultad de Medicina Humana, Universidad Ricardo Palma, Lima, Peru
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Berchtold A. Relationship between the COVID-19 Pandemic and the Well-Being of Adolescents and Their Parents in Switzerland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6789. [PMID: 35682373 PMCID: PMC9180000 DOI: 10.3390/ijerph19116789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/30/2022] [Accepted: 05/30/2022] [Indexed: 02/01/2023]
Abstract
This study is based on two waves of data collected by the Swiss Household panel, the first one in 2019, before the beginning of the COVID-19 pandemic, and the second one in May-June 2020, just after the end of the partial lockdown that was decided by the Swiss government. We considered "couples" of adolescents (age 14-24, mean = 18.82, 51.96% female) and their parents living together (n = 431). Our main goal was to determine whether the evolution of the well-being among adolescents was similar to the evolution of the well-being among parents. Ten indicators of well-being were measured identically in both waves and for both adolescents and their parents. Results indicate that while almost all indicators of well-being decreased during partial lockdown for both adolescents and their parents, adolescents were more strongly impacted than their parents. Furthermore, the change observed in adolescents was virtually unaffected by the change observed in their parents, and vice versa. This research is a reminder that while different population groups may be affected differently by a sudden and extreme event, it is not only older people who will be most affected. Here, adolescents appear to have been more adversely affected than adults.
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Affiliation(s)
- André Berchtold
- Institute of Social Sciences & Centre LIVES, University of Lausanne, CH-1015 Lausanne, Switzerland
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