School social fragmentation, economic deprivation and social cohesion and adolescent physical inactivity: a longitudinal study

Exploring the role of socioeconomic status and psychological characteristics on talent development in an English soccer academy

Social factors and psychological characteristics can influence selection and development in talent pathways. However, the interaction between these two factors is relatively unknown. The aim of this study was to investigate the implications of socioeconomic status and psychological characteristics in English academy soccer players (n = 58; aged 11 to 16 years). To assess socioeconomic status, participants' home postcodes were coded according to each individual's social classification and credit rating, applying the UK General Registrar Classification system and CameoTM geodemographic database, respectively. Participants also completed the six factor Psychological Characteristics for Developing Excellence Questionnaire (PCDEQ). A classification of 'higher-potentials' (n = 19) and 'lower-potentials' (n = 19) were applied through coach potential rankings. Data were standardised using z-scores to eliminate age bias and data were analysed using independent sample t-tests. Results showed that higher-potentials derived from families with significantly lower social classifications (p = 0.014) and reported higher levels for PCDEQ Factor 3 (coping with performance and developmental pressures) (p = 0.007) compared to lower-potentials. This study can be used to support the impetus for researchers and practitioners to consider the role of social factors and psychological characteristics when selecting and developing sporting talent. For example, facilitating player-centred development within an academy and, where necessary, providing individuals with additional support.

Conceptualisation and Measurement of Social Cohesion within the Sport and Physical Activity Context: A Scoping Review

Sport, physical activity and social cohesion are increasingly linked within the academic literature. Indeed, studies recognise both the importance of social cohesion for promoting physical activity and the potential of sport to support social cohesion. Up until now, however, the ways in which social cohesion has been defined and measured in the context of sport and physical activity have not been the subject of much academic attention. Through a scoping review of studies measuring social cohesion in the sport and physical activity context, we aim to uncover how social cohesion is defined and measured, thus allowing us to better grasp how the concept is understood and operationalised in this field. As such, full-text inclusion occurred when studies quantitatively measured social cohesion through a questionnaire/survey instrument in connection with sport or physical activity participation or within programmes using sport to foster social cohesion. A total of 40 papers were included in the review, showing broad support for the argument that social cohesion is positively related to sport or physical activity participation. However, the retained texts engage on only a surface level with the concept of social cohesion, with around half not defining the term and the associated measurement tools using only a fraction of the dimensions typically associated with social cohesion. To conclude, we propose future directions to enhance conceptual engagement with and measurement of social cohesion.

Child dental neglect and legal protections: a compendium of briefs from policy reviews in 26 countries and a special administrative region of China

Background

Child neglect is a public health, human rights, and social problem, with potentially devastating and costly consequences. The aim of this study was to: (1) summarize the oral health profile of children across the globe; (2) provide a brief overview of legal instruments that can offer children protection from dental neglect; and (3) discuss the effectiveness of these legal instruments.

Methods

We summarized and highlighted the caries profile and status of implementation of legislation on child dental neglect for 26 countries representing the World Health Organization regions: five countries in Africa (Nigeria, South Africa, Sudan, Tanzania, Zimbabwe), eight in the Americas (Argentina, Brazil, Canada, Chile, Mexico, Peru, Unites States of America, Uruguay), six in the Eastern Mediterranean (Egypt, Iran, Libya, Jordan, Qatar, Saudi Arabia), four in Europe (Italy, Latvia, Serbia, United Kingdom), two in South-East Asia (India and Indonesia) and one country (China) with its special administrative region (Hong Kong) in the Western Pacific.

Results

Twenty-five of the 26 countries have legal instruments to address child neglect. Only two (8.0%) of these 25 countries had specific legal instruments on child dental neglect. Although child neglect laws can be interpreted to establish a case of child dental neglect, the latter may be difficult to establish in countries where governments have not addressed barriers that limit children's access to oral healthcare. Where there are specific legal instruments to address child dental neglect, a supportive social ecosystem has also been built to facilitate children's access to oral healthcare. A supportive legal environment, however, does not seem to confer extra protection against risks for untreated dental caries.

Conclusions

The institution of specific country-level legislation on child dental neglect may not significantly reduce the national prevalence of untreated caries in children. It, however, increases the prospect for building a social ecosystem that may reduce the risk of untreated caries at the individual level. Social ecosystems to mitigate child dental neglect can be built when there is specific legislation against child dental neglect. It may be more effective to combine public health and human rights-based approaches, inclusive of an efficient criminal justice system to deal with child dental neglect.

Review of Major Social Determinants of Health in Schizophrenia-Spectrum Psychotic Disorders: I. Clinical Outcomes

BACKGROUND

Social determinants of health (SDoHs) are receiving growing attention and are particularly relevant to persons with schizophrenia-spectrum psychotic disorders (SSPDs), considering their heightened risk of comorbidities, cognitive and functional decline, and early mortality. Yet, we did not find any comprehensive review of multiple SDoHs in SSPD.

STUDY DESIGN

We conducted a scoping review of meta-analyses and systematic reviews of nine major SDoHs in SSPD.

STUDY RESULTS

Childhood abuse, parental psychopathology, parental communication problems, bullying, and urban settings with lower socioeconomic status were major risk factors for the greater incidence of SSPD and/or worse health. Social network size was inversely associated with overall psychopathology and negative symptoms. Experiences of racial/ethnic discrimination correlated with the prevalence of psychotic symptoms and experiences. Compared to native populations, the risk of psychosis was higher in immigrants, refugees, and asylees. Social fragmentation was associated with an increased prevalence of schizophrenia. Homeless populations had a 30-fold higher prevalence of schizophrenia than the general population. Seriously mentally ill people were 2.7 times more likely to report food insecurity than controls. The prevalence of non-affective psychosis in prisoners was 2.0%-6.5%, compared to 0.3% in the general population. Certain potentially positive factors like family and community resilience remain poorly studied.

CONCLUSIONS

SDoHs are associated with higher rates of and worse outcomes in SSPD. Well-designed longitudinal studies are needed to understand SDoHs' contribution to health in persons with SSPD, to develop interventions, and to implement changes in clinical care and public health policies that would reduce adverse health impacts of SDoHs. Positive SDoHs deserve greater attention.

School-Level Factors within Comprehensive School Health Associated with the Trajectory of Moderate-to-Vigorous Physical Activity over Time: A Longitudinal, Multilevel Analysis in a Large Sample of Grade 9 and 10 Students in Canada

(1) The majority of Canadian youth are insufficiently active, and moderate-to-vigorous physical activity (MVPA) decreases substantially during secondary school. School factors within the comprehensive school health (CSH) framework may help attenuate this decline. This study aimed to examine how youth MVPA changes over a three-year period and evaluate the school characteristics associated with preventing the decline in MVPA over time, guided by the CSH framework. (2) This study uses COMPASS survey data from 78 secondary schools in Ontario and Alberta that participated in Year 2 (2013/14), Year 3 (2014/15), and Year 4 (2015/16), and 17,661 students attending these schools. Multilevel (linear mixed effects) models were used to determine the association between school-level factors and student MVPA (weekly minutes) over time, stratified by gender. (3) Both male and female students had a significant decline in MVPA across the 3 years, with a greater decrease observed among female students. Within the CSH framework, the school's social environment, partnerships, and policies were associated with student MVPA over time, however the specific school factors and directions of associations varied by gender. (4) School-based interventions (e.g., public health partnerships) may help avoid the decline in MVPA observed in this critical period and support student health.

The Effect of Social Cohesion on Interest, Usefulness, and Ease of Use of a Driving Assistance System in Older Adults

This study examined the relationship between social cohesion and the perceived interest in, the usefulness of, and the ease of use of an instructor-based driver assistance system in a sample of older adults. With the aging of the population, the use of technologies to support the driving skills of the elderly is expected, and it is necessary to clarify the conditions under which the elderly will be interested in these advanced technologies. Traditionally, social cohesion has been focused on as a function of instrumental and practical support in the lives of the elderly. Since social cohesion reflects the intention to help each other, it could be an opportunity to provide information on advanced driving skill techniques to older people who are becoming more difficult to drive. As an initial exploration, this study examined whether social cohesion was associated with the interest in, the usefulness of, and the ease of use of an instructor-based driver assistance system in 150 elderly people. The results showed that a greater social cohesion was significantly associated with these evaluations, and that a comprehension of the system also contributed. The possession of a license was significantly associated with interest in the program. These findings are an essential step toward the understanding of the roles of social cohesion and positive perception of advanced technology in older adults.

Social Cohesion in Health: A Concept Analysis

The concept of social cohesion has been indicated to be a critical social determinant of health in recent literature. Inconsistencies surrounding the conceptualization and operationalization have made utilizing these findings to inform health intervention and policy difficult. The objective of this article is to provide a theoretical clarification of the concept "social cohesion," as it relates to health behaviors and outcomes by using the Rodgers' evolutionary method for concept analyses. This article uncovers the critical attributes, antecedents, and consequences of social cohesion and provides reflection on future use of social cohesion in health literature.

Mapping urban greenspace use from mobile phone GPS data

Urban greenspace is a valuable component of the urban form that has the potential to improve the health and well-being of residents. Most quantitative studies of relationships between health and greenspace to date have investigated associations only with what greenspace exists in the local environment (i.e. provision of greenspace), rather than to what extent it is used. This is due to the difficulty of obtaining usage data in large amounts. In recent years, GPS functionality integrated into mobile phones has provided a potential solution to this problem by making it possible to track which parts of the environment people experience in their day-to-day lives. In this paper, we demonstrate a method to derive cleaned, trip-level information from raw GPS data collected by a mobile phone app, then use this data to investigate the characteristics of trips to urban greenspace by residents of the city of Sheffield, UK. We find that local users of the app spend an average of an hour per week visiting greenspaces, including around seven trips per week and covering a total distance of just over 2.5 km. This may be enough to provide health benefits, but is insufficient to provide maximal benefits. Trip characteristics vary with user demographics: ethnic minority users and users from more socioeconomically deprived areas tend to make shorter trips than White users and those from less deprived areas, while users aged 34 years and over make longer trips than younger users. Women, on average, make more frequent trips than men, as do those who spent more time outside as a child. Our results suggest that most day-to-day greenspace visits are incidental, i.e. travelling through rather than to greenspace, and highlight the importance of including social and cultural factors when investigating who uses and who benefits from urban greenspace.

Physical Activity, Screen-Based Sedentary Behavior and Physical Fitness in Chinese Adolescents: A Cross-Sectional Study

Purpose: The aim of this study is to explore the relationship between screen-based sedentary behavior, physical activity and physical fitness among Chinese adolescents. Methods: This study randomly selected adolescents from 10 administrative districts in Shandong, China. The data gathering tools for demographic and other characteristics (gender, age, body mass index and socioeconomic status), PA (PAQ-A) and screen-based sedentary behavior (YRBSS) and physical fitness (NSPFH 2014) were utilized in this study. Statistical analysis was performed by T-test, chi-square test and multiple linear regression. Results: 10,002 adolescents (14.39 years ± 1.79) participated in the study. The results demonstrated that BMI and high TV viewing time had a significant negative correlation with physical fitness, but there was no association between the amount of time spent playing computer/video games and physical fitness among adolescents. High SES and physical activity in leisure time five or more times per week were significantly associated with most dimensions of physical fitness. Conclusions: the results suggest that we not only need to focus on adolescent risk behavior associated with low socioeconomic status and obesity, but also enforce physical activity and reduce sedentary television-watching behavior, which will be crucial pathways and strategies to improve the physical fitness of Chinese adolescents.

Relation between neighborhood socio-economic characteristics and social cohesion, social control, and collective efficacy: Findings from the Boston Neighborhood Study

Little is known about the determinants of collective efficacy, a neighborhood social process comprised of social cohesion and social control, which has shown to be beneficially associated with health. Our goal was to identify determinants of collective efficacy, social cohesion and social control. We used data collected from the Boston Neighborhood Survey, a cross-sectional survey conducted in 38 Boston neighborhoods in 2010 (n = 1710). We used multi-level logistic regression analyses to identify the relationship between the neighborhood-level characteristics and collective efficacy, social cohesion, and social control. High social fragmentation was associated with a decreased likelihood of reporting high collective efficacy (OR = 0.71, 95% CI = 0.54,0.95). and high social cohesion (OR = 0.63, 95% CI = 0.46, 0.86). High social fragmentation (OR = 0.80, 95% CI = 0.64, 0.99), and moderate economic deprivation (OR = 0.64, 95% CI = 0.47, 0.88) were associated with a decreased likelihood of reporting high social control, while high trust in police was associated with an increased likelihood in reporting high social control (OR = 1.86, 95% CI = 1.16, 3.00). Further research should be undertaken to better understand the direction of effect of these associations and how interventions to promote social processes can utilize these findings to improve health.

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We tested the association between neighborhood characteristics and social processes.

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Social Fragmentation was associated with decreased odds for Social Cohesion.

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Trust in Police was associated with increased odds for Social Control.

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Social Fragmentation was associated with decreased odds for Collective Efficacy.

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Future work should be conducted to determine if these associations are causal.

The Influence of Neighborhood Social Capital on Leisure-Time Physical Activity: a Population-Based Study in Brazil

Environmentally targeted approaches to promote physical activity are emerging in recent years as a complementary strategy to the traditional individual approaches. This study explored the relation between community social capital and leisure-time physical activity in an adult population-based sample in Brazil. We applied a generalized estimating equation approach to analyze a cross-sectional survey of 3667 adults living in 149 neighborhoods. Social capital was assessed by scales that measured collective efficacy and social cohesion in the neighborhood. We find that individuals living in areas with higher level of social cohesion were more likely to be physically active even after controlling for potentially confounding individual and area-level covariates (PR = 1.56; 95% CI = 1.13, 2.16). Collective efficacy was not significantly associated with leisure-time physical activity. Interventions to strengthen social cohesion in the community may be an avenue for promoting physical activity.

Health promotion initiatives at school related to overweight, insulin resistance, hypertension and dyslipidemia in adolescents: a cross-sectional study in Recife, Brazil

Background

The emergence of diseases such as dyslipidemia, systemic arterial hypertension, insulin resistance and metabolic syndrome in children and adolescents has brought about a change in the epidemiologic profile of the pediatric population. As action to promote health in the school environment is a useful tool for changing the pattern of health/disease in the young population, the present study aimed to identify schools that promote healthy eating and physical activity and to study the relationship between these practices and the prevalence of overweight, hypertension, insulin resistance and hypercholesterolemia in adolescents.

Methods

A cross-sectional population-based study was conducted with 2400 adolescents aged from 12 to 17 years old and participating in the “Study of Cardiovascular Risk in Adolescents” (ERICA – Estudo de Riscos Cardiovasculares em Adolescente). The association between dependent (overweight, insulin resistance, hypertension and dyslipidemia) and independent variables (implementation of health promoting initiative in schools) was investigated using the chi-square test and prevalence ratio (PR) with a confidence index (CI) of 95%.

Results

The unsatisfactory implementation of a “health promoting environment” (PR = 1.02; CI 95%: 1.0; 1.04) and “partnerships with the health sector” (PR = 1.03; CI 95%: 1.01; 1.05) were linked to a high prevalence of overweight in adolescents. Hypercholesterolemia was found to be higher in the schools with unsatisfactory implementation of “healthy eating and health on the scholar curriculum” (PR = 1.71; CI 95%: 1.22; 2.44) and those lacking a “healthy-eating promoting environment” (PR = 1.29; CI 95%: 1.10; 1.54). Schools with unsatisfactory implementation of a “health-eating promoting environment” (PR = 1.36; CI 95%: 1.04; 1.79) and those lacking “partnership with the health sector” (PR = 2.12; CI 95%: 1.38; 3.24) had more adolescents with insulin resistance. There was no association between hypertension and any other component studied.

Conclusion

Schools which have implemented adequate health promotion in their curriculums showed a lower prevalence of overweight, insulin resistance and hypercholesterolemia in adolescents.

Gender differences in risk factors for cigarette smoking initiation in childhood

INTRODUCTION

We investigated whether established risk factors for initiating cigarette smoking during adolescence (parents, siblings, friends smoke; home smoking rules, smokers at home, exposure to smoking in cars, academic performance, susceptibility to smoking, depressive symptoms, self-esteem, school connectedness, use of other tobacco products) are associated with initiation in preadolescents, and whether the effects of these factors differ by gender.

METHODS

In spring 2005, baseline data were collected in self-report questionnaires from 1801 5th grade students including 1553 never-smokers (mean age=10.7years), in the longitudinal AdoQuest I Study in Montréal, Canada. Follow-up data were collected in the fall and spring of 6th grade (2005-2006). Poisson regression analyses with robust variance estimated the effects of each risk factor on initiation and additive interactions with gender were computed to assess the excess risk of each risk factor in girls compared to boys.

RESULTS

101 of 1399 participants in the analytic sample (6.7% of boys; 7.7% of girls) initiated smoking during follow-up. After adjustment for age, gender and maternal education, all risk factors except academic performance and school connectedness were statistically significantly associated with initiation. Paternal and sibling smoking were associated with initiation in girls only, and girls with lower self-esteem had a significant excess risk of initiating smoking in 6th grade.

CONCLUSIONS

Risk factors for smoking initiation in preadolescents mirror those in adolescents; their effects do not differ markedly by gender. Preventive programs targeting children should focus on reducing smoking in the social environment and the dangers of poly-tobacco use.

Predictors of Cigarette Smoking Initiation in Early, Middle, and Late Adolescence

PURPOSE

Little is known about age-related differences in risk factors for cigarette smoking initiation. We identified predictors of initiation in early, middle, and late adolescence from among sociodemographic factors, indicators of smoking in the social environment, psychological characteristics, lifestyle indicators, and perceived need for cigarettes.

METHODS

Data were drawn from a longitudinal study of 1,801 children recruited at age 10-11 years from 29 elementary schools in Montreal, Canada. Multivariable logistic regression within a generalized estimating equations framework was used to identify predictors among never smokers across three 2-year windows: age 11-13 years (n = 1,221); age 13-15 years (n = 737); and age 15-17 years (n = 690).

RESULTS

Among the 18 risk factors investigated, two differed across age. Friends' smoking, a strong risk factor in early adolescence (odds ratio [95% confidence interval] = 5.78 [3.90-8.58]), lost potency in late adolescence (1.83 [1.31-2.57]). Depressive symptoms, a risk factor in early and middle adolescence (1.60 [1.26-2.02] and 1.92 [1.45-2.54], respectively), were inversely associated in late adolescence (.76 [.58-1.00]). Sex, TV viewing, and weight-related goals were not associated with initiation at any age. All other factors were significant in two or three age groups.

CONCLUSIONS

Most risk factors for smoking initiation were stable across age. Tobacco control interventions may be robust for risk factors across age groups and may not need adjustment. At all ages, interventions should focus on eliminating smoking in the social environment and on reducing the availability of tobacco products.

Social Capital is Associated With Late HIV Diagnosis: An Ecological Analysis

BACKGROUND

Late HIV diagnosis is associated with higher medical costs, early mortality among individuals, and HIV transmission in the population. Even under optimal configurations of stable or declining HIV incidence and increase in HIV case findings, no change in proportion of late HIV diagnosis is projected after year 2019. We investigated the association among social capital, gender, and late HIV diagnosis.

METHODS

We conduct ecological analyses (ZIP code, N = 166) using negative binomial regression of gender-specific rates of late HIV diagnoses (an AIDS defining illness or a CD4 count ≤200 cell/μL within 12 months of a new HIV diagnosis) in 2005 and 2006 obtained from the New York City HIV Surveillance Registry, and social capital indicators (civic engagement, political participation, social cohesion, and informal social control) from the New York Social Indicators Survey, 2004.

RESULTS

Overall, low to high political participation and social cohesion corresponded with significant (P < 0.0001) decreasing trends in late HIV diagnosis rates. Among men [relative risk (RR) = 0.66, 95% CI: (0.47 to 0.98)] and women [RR = 0.43, 95% CI: (0.28 to 0.67)], highest political participation was associated with lower relative odds of late HIV diagnosis, independent of income inequality. Highest informal social control [RR = 0.67, 95% CI: (0.48 to 0.93)] among men only and moderate social cohesion [RR = 0.71, 95% CI: (0.55 to 0.92)] among women only were associated with the outcome adjusting for social fragmentation, income inequality, and racial composition.

DISCUSSION

The magnitude of association between social capital and late HIV diagnosis varies by gender and by social capital indicator.

Socioeconomic Factors Influence Physical Activity and Sport in Quebec Schools

BACKGROUND

School environments providing a wide selection of physical activities and sufficient facilities are both essential and formative to ensure young people adopt active lifestyles. We describe the association between school opportunities for physical activity and socioeconomic factors measured by low-income cutoff index, school size (number of students), and neighborhood population density.

METHODS

A cross-sectional survey using a 2-stage stratified sampling method built a representative sample of 143 French-speaking public schools in Quebec, Canada. Self-administered questionnaires collected data describing the physical activities offered and schools' sports facilities. Descriptive and bivariate analyses were performed separately for primary and secondary schools.

RESULTS

In primary schools, school size was positively associated with more intramural and extracurricular activities, more diverse interior facilities, and activities promoting active transportation. Low-income primary schools were more likely to offer a single gym. Low-income secondary schools offered lower diversity of intramural activities and fewer exterior sporting facilities. High-income secondary schools with a large school size provided a greater number of opportunities, larger infrastructures, and a wider selection of physical activities than smaller low-income schools.

CONCLUSIONS

Results reveal an overall positive association between school availability of physical and sport activity and socioeconomic factors.

Caries prevalence and impact on oral health-related quality of life in children with sickle cell disease: cross-sectional study

BACKGROUND

Children with sickle cell disease (SCD) may present oral conditions that can compromise children's health even more. However, there is still no consensus on the association between SCD and dental caries. The aim of this study was to assess caries prevalence in children with sickle cell disease (SCD), and the association of dental caries with socioeconomic factors, disease severity, and oral-health related to quality of life (OHRQoL).

METHODS

The sample was comprised of 106 children with SCD aged 8 to 14 years who were attending the Center for Hematology (Hemominas) in Belo Horizonte, Brazil. They were matched to 385 healthy peers. Data collection included interviews with guardians concerning SCD characteristics, and previous social and oral examinations to determine the caries prevalence. Caries prevalence as measured through the Decayed, Missing and Filled (dmft and DMFT) indices. OHRQoL was evaluated through the Brazilian versions of the Child Perceptions Questionnaires (CPQ8-10, and CPQ11-14 short-form version). Statistical analyses were performed using the chi-square test or Fisher`s exact test and the Mann Whitney test, as well as linear regression.

RESULTS

The DMFT index was 1.3 (SD: 2.1) in younger children with SCD and 1.5 (SD: 1.9) in SCD teens. Younger children with SCD had lower caries experience compared to healthy peers (p = .03). The experience of dental caries among teens with SCD was similar to healthy peers (p > 0.05). In addition, we did not see a significant difference on the mean overall scores of CPQ8-10 between SCD younger children and controls. There was no statistically significant difference in the mean overall scores of teens CPQ11-14 between SCD and the control group. Socioeconomic variables were not associated with dental caries in the participants with SCD. However, SCD severity was associated with higher DMFT indexes (p < 0.05).

CONCLUSIONS

Younger children with SCD had a low experience of dental caries. The dental caries experience in teenagers with SCD was similar to their healthy peers. OHRQoL was similar between SCD participants and controls.

The relationship between neighborhood socioeconomic characteristics and physical inactivity among adolescents living in Boston, Massachusetts

OBJECTIVES

We sought to determine whether the socioeconomic environment was associated with no participation in physical activity among adolescents in Boston, Massachusetts.

METHODS

We used cross-sectional data from 1878 urban adolescents living in 38 neighborhoods who participated in the 2008 Boston Youth Survey, a biennial survey of high school students (aged 14-19 years). We used multilevel multiple regression models to determine the association between neighborhood-level exposures of economic deprivation, social fragmentation, social cohesion, danger and disorder, and students' reports of no participation in physical activity in the previous week.

RESULTS

High social fragmentation within the residential neighborhood was associated with an increased likelihood of being inactive (odds ratio = 1.53; 95% confidence interval = 1.14, 2.05). No other neighborhood exposures were associated with physical inactivity.

CONCLUSIONS

Social fragmentation might be an important correlate of physical inactivity among youths living in urban settings. Interventions might be needed to assist youths living in unstable neighborhoods to be physically active.