Parent perceived barriers and facilitators of children's adventurous play in Britain: a framework analysis

Implementation of a digital health intervention for young people exposed to Technology Assisted Sexual Abuse

BACKGROUND

The internet has become a place of increased risk of abuse, including sexual abuse, for young people (YP). One potential risk factor to online abuse and exploitation is the ability to mentalise. We developed the i-Minds app, a mentalisation-based digital health intervention (DHI) for YP who have experienced technology assisted sexual abuse (TASA), which we tested in a clinical feasibility trial. Nested within the trial was a qualitative implementation study with clinicians who referred to the trial.

OBJECTIVE

To explore the barriers and enablers to the future integration of i-Minds into clinical practice.

PARTICIPANTS AND SETTING

Twelve HCPs were recruited from across two trial recruitment sites (Manchester and Edinburgh).

METHODS

Semi-structured interviews were informed by Normalisation Process Theory (NPT). Framework analysis was used; transcripts were coded deductively to NPT constructs.

RESULTS

Practitioners were positive about the need for, and added value of, the i-Minds app over existing interventions, including other DHIs. While they felt confident with the app, concerns remained around the safety of using the app without practitioner support. i-Minds promoted changes in practitioners' work and impacted online behaviour of YP. There was an identified need for further training and organisational support.

CONCLUSIONS

Practitioners are aware of TASA but have limited knowledge, skills and tools to work with TASA in clinical practice with YP. There is a need for awareness raising and education about TASA and DHI. i-Minds offers a theory-informed DHI for working with YP exposed to TASA that is acceptable to practitioners and YP.

Gender Differences in Caregivers' Attitudes to Risky Child Play in Britain: A Cross-Sectional Study

BACKGROUND

This study examines gender differences in parental attitudes toward risky play for 5- to 11-year-old boys and girls in Britain.

METHODS

Analyses use data from the cross-sectional, nationally representative British Child Play Survey. Survey respondents were caregivers of primary-school-aged children living in Britain. Parent self-reported their risk tolerance in play via the Tolerance for Risk in Play Scale (TRiPS) and the Risk Engagement and Protection Survey (REPS). The REPS includes subscales that assess caregiver attitudes around "Protection from Injury" (PFI) and "Engagement with Risk" (EWR) in relation to children's play. Multiple linear regression compared caregiver gender differences in TRiPS, REPS-PFI, and REPS-EWR at the item level, and overall. Associations between child gender and these scales were also examined.

RESULTS

Among 1919 caregivers, no significant gender differences emerged in mean TRiPS (P = .72), REPS-EWR (P = .58), and REPS-PFI (P = .34) scores. Activity-specific differences were evident in caregivers' tolerance for individual risky play activities (15/31 activities). Parents of boys exhibited higher risk tolerance (B = -4.48, P < .01) and willingness for their child to engage in risky play (B = -0.63, P < .01) than parents of girls.

CONCLUSIONS

While there was no difference between male and female caregivers overall attitudes, gender differences were prominent for specific play activities and attitudes, with male caregivers demonstrating higher tolerance for the riskiest activities. Parents of boys expressed more permissive attitudes toward engagement in risky play. Further work is needed to identify why there is gender-related variation in these attitudes and should be considered in interventions that support parents in enabling adventurous play opportunities for children.

Is parental propensity to risk associated with their child's medically-attended injuries? A cross-sectional study

BACKGROUND

Societal expectations about safety influence parents' risk perceptions and children's risky play opportunities. This study examined parents' propensity to take risks themselves and their propensity to accept risks for their child, sex-related differences in parents' propensity to accept risks for their child, and the association between parents' propensity to accept risks for their child and that child's medically-attended injury history.

METHODS

A total of 467 parents attending a pediatric hospital with their 6-12-year-old child completed a questionnaire about their risk propensity for themselves and for their child and reported their child's injury history.

RESULTS

Parents' risk propensity for themselves was significantly higher than for their child, and fathers' risk propensity for themselves was higher than mothers'. Linear regressions showed that fathers reported significantly more propensity to accept risks for their child than mothers, but parents did not differentiate between their sons and daughters. A binary logistic regression showed that parents' propensity to accept risks for their child was a significant predictor of pediatric medically-attended injury.

CONCLUSIONS

Parents were more comfortable in taking risks for themselves than for their child. While fathers were more comfortable with their children engaging in risks than mothers, child's sex was not related to parents' propensity to accept risks for their child. Pediatric injury was predicted by parents' propensity to accept risks for their child. Further research investigating injury type and severity related parent risk propensity is needed to determine how parents' attitudes toward risk might relate to severe injury.

Adventurous play for a healthy childhood: Facilitators and barriers identified by parents in Britain

RATIONALE

Adventurous play, where children take age-appropriate risks involving uncertainty, fear, and thrill, is positively associated with children's physical health, mental health, and development. There is growing concern that children's access to and engagement with adventurous play opportunities are declining in Westernised countries, which may have negative implications for children's health.

OBJECTIVE

The current study aimed to ascertain the facilitators of and barriers to children's adventurous play most identified by parents in Britain and to determine whether these differ across socio-demographic and geographic groups.

METHODS

This study analysed the responses of a nationally representative sample of 1919 parents who took part in the British Children's Play Survey. Two open-ended questions asked parents to identify what they perceive to be the facilitators of and barriers to their child's adventurous play. A quantitative coding scheme, developed using the qualitative framework identified by Oliver et al. (2022), was applied to parents' responses.

RESULTS

A diversity in the most identified facilitators and barriers was found, including concerns about the risk of injury from adventurous play and the safety of society, positive attitudes about the benefits of adventurous play, as well as factors related to child attributes. In general, these were consistently identified across different socio-demographic and geographic groups, although some differences were found in barriers.

CONCLUSIONS

The findings of this research support the identification of key targets for those working with parents to improve children's adventurous play opportunities and ultimately their physical and mental health. Future research should seek to design and tailor interventions by asking parents about the support they would value.

Geographical Disparity in Cardiorespiratory Fitness among 3,189,540 Japanese Children and Adolescents before and during the Coronavirus 2019 Pandemic: An Ecological Study

This ecological study aimed to use nationally representative physical fitness (PF) data to investigate the geographical disparities in cardiorespiratory fitness (CRF) among Japanese children across prefectures before and during the coronavirus 2019 (COVID-19) pandemic. The publicly available descriptive PF data of children from Grade 5 (10-11 years; n = 1,946,437) and adolescents from Grade 8 (13-14 years; n = 1,243,103) at the prefecture level (47 prefectures) were obtained from the annual census PF survey in 2019 (before the pandemic) and 2021 (during the pandemic). The 20 m shuttle run performance was used as a measure of CRF. Geographical disparity was evaluated using the coefficient of variation (CV) for CRF across prefectures. There were significant negative relationships between the magnitude of infections (evaluated as the number of confirmed cases) and changes in CRF at the prefecture level (r ≤ -0.293, p < 0.05). This study also found a substantial increase in CVs of CRF across prefectures for Grade 8 students, suggesting that COVID-19-related restrictions had widened the geographical disparity in CRF among Japanese adolescents. Adolescents' CRF is an important marker for current and future health; hence, the findings of widening geographical disparities in CRF are suggestive of widening geographical disparities in health among the Japanese population.