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Haug E, Smith ORF, Ng K, Samdal O, Marques A, Borraccino A, Kopcakova J, Oja L, Fismen AS. Family structure and the association with physical activity-Findings from 40 countries participating in the Health Behaviour in School-aged Children (HBSC) study. PLoS One 2024; 19:e0300188. [PMID: 38630701 PMCID: PMC11023480 DOI: 10.1371/journal.pone.0300188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/23/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The family has been acknowledged as central to developing physical activity (PA) beliefs and behaviours. However, increased diversity in family structures has developed over the last decades. This study examines the association between family structure and PA among adolescents and cross-national variations in the associations. METHODS The data are from the 2013/14 Health Behaviours in School-Aged Children study, involving nationally representative samples of 11-, 13- and 15-year-olds (n = 211,798) from 40 countries. Multilevel Poisson regression analysis was used to examine the associations between family structure and moderate to vigorous physical activity (MVPA) and vigorous physical activity (VPA) by age, gender, socioeconomic status (SES), and geographic region. RESULTS Living with one versus two parents was associated with a reduced likelihood of daily 60 min MVPA for boys (IRR = 0.96, 95% CI: 0.92, 0.99) and ≥ 4 times/week VPA (IRR 0.93, 95% CI: 0.91, 0.95). This impact on MVPA differed across individual-level SES (high SES; IRR = 0.92, (p <0.05), low SES; IRR = 1.04, (ns)), and was for VPA only significant for those with siblings (IRR = 0.93, 95% CI: 0.91, 0.96). Cross-country variations in the association between living with one versus two parents were observed, most pronounced for VPA. These differences varied by region, primarily explained by country-level SES differences between regions. The likelihood of daily 60 min MVPA also increased with siblings in the main house (IRR 1.11, 95% CI: 1.07, 1.14), and ≥ 4 times/week VPA decreased with grandparents in the main house (IRR 0.91, 95% CI: 0.89,0.94). CONCLUSIONS Family structure correlated with PA, but cross-country differences exist. The findings are relevant for the development of policies and programs to facilitate PA, especially in countries where living with one versus two parents was unfavourable. Additional country-specific research is needed to identify challenges for engaging in PA related to family structure.
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Affiliation(s)
- Ellen Haug
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
- Department of Teacher Education, NLA University College, Bergen, Norway
| | - Otto Robert Frans Smith
- Department of Teacher Education, NLA University College, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Kwok Ng
- Faculty of Education, University of Turku, Turku, Finland
- Physical Activity for Health Research Centre, Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
- School of Educational Sciences and Psychology, University of Eastern Finland, Finland
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Oddrun Samdal
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- ISAMB, Universidade de Lisboa, Lisbon, Portugal
| | - Alberto Borraccino
- Department of Clinical and Biological Sciences Public Health and Paediatrics, University of Torino, Orbassano (TO), Italy
| | - Jaroslava Kopcakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University in Kosice, Kosice, Slovakia
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Leila Oja
- National Institute for Health Development, Estonia
| | - Anne-Siri Fismen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien, Bergen, Norway
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Song M, Bessette HC, Musil CM, Lyons KS, Winters-Stone KM, Hayman LL. Assessing Life's Essential 8 and Adverse Childhood Experiences in Grandparent-Grandchild Co-residing Dyads. J Cardiovasc Nurs 2024; 39:E44-E50. [PMID: 37278650 DOI: 10.1097/jcn.0000000000001011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We assessed a subset of behavioral indicators from the American Heart Association Life's Essential 8 cardiovascular health (CVH) construct-diet, physical activity, sleep, and nicotine exposure-and quantified associations in scores between members of 12 grandparent-grandchild dyads (grandparents, 52-70 years old; children, 7-12 years old). We also assessed the number of adverse childhood experiences from the dyads. Using the Life's Essential 8 scoring algorithm (0-100, with 100 as optimal), we calculated averages and used Spearman's ρ correlation to quantify associations. Mean score was 67.5 (±12.4) for grandparents and 63.0 (±11.2) for grandchildren. Mean scores for the dyad members were significantly correlated ( r = 0.66, P < .05). The mean numbers of adverse childhood experiences were 7.0 and 5.8 for the grandparents and grandchildren, respectively. The results indicate that CVH in these dyads was suboptimal and interrelated. Adverse childhood experiences in this analysis surpass levels reported as high risk for poor CVH. Our findings suggest that dyadic-based interventions to improve CVH are warranted.
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Likoko S, Akokuwebe ME, Osuafor GN, Idemudia ES. "Health Outcomes of Grandparents Caring for Double Orphans in South Africa": What Are the Determinants? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7158. [PMID: 38131710 PMCID: PMC10743013 DOI: 10.3390/ijerph20247158] [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: 09/02/2023] [Revised: 12/04/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
In the 21st century, grandparenthood is a significant phenomenon in the fields of demography, gerontology, and sociology. It is mainly explored in the context of ageing, as it is poised to become one of the most significant demographic phenomena and social issues in contemporary South Africa. Therefore, this study examined the determinants associated with grandparents who are parenting as caregivers and the health challenges they are exposed to as caregivers. The National Income Dynamics Study (NIDS) Wave 5 dataset was utilised, and a total of 302,476 grandparents aged 25 years and older, who were reported to be primary caregivers of double orphans, were included in the analysis. Both bivariate and multivariate binary logistic regressions were performed to determine the predictors of the determinants of grandparents parenting as caregivers and their health challenges in South Africa. Estimated odds ratios (ORs) with 95% confidence intervals (CIs) were used, and the threshold for statistical significance was established at ρ < 0.05. A majority of the male and female grandparent caregivers were aged 24-34 years, were Black Africans (69.8%), had secondary education (46.9%), reported health challenges (HC) (59.7%), with 26.4% reporting headaches in the last 30 days. Logistic regression revealed that grandparent caregivers aged 55-64 years were 8.9 times more likely to report health challenges compared to those aged 25-34 years. Non-Black African grandparent caregivers were found to be 0.61 times less likely to report health challenges, compared to Black African grandparent caregivers. Those with perceived poor health status were 3.3 times more likely to report health challenges, compared to those with excellent perceived health status. Therefore, there is an urgent need to redesign health interventions to address these health burdens among grandparent caregivers and to take cognisance of providing economic and social support for these vulnerable populations.
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Affiliation(s)
- Salmon Likoko
- Statistics South Africa, ISIbalo House, Pretoria 0002, South Africa;
| | | | - Godswill Nwabuisi Osuafor
- Department of Population Studies and Demography, North-West University, Mafikeng 2735, South Africa;
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Akinbule OO, Onabanjo OO, Sanni SA, Adegunwa MO, Akinbule AS, Sosanya SK, Afolabi I. Amino acid composition and protein quality of commonly consumed cooked foods in Nigeria. J Food Compost Anal 2023. [DOI: 10.1016/j.jfca.2023.105295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Sheikomar OB, Ghattas H, Sahyoun NR. Relationship between Live-In Grandparents and Grandchild's Health and Well-Being in Palestinian Refugees in Lebanon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:370. [PMID: 36612692 PMCID: PMC9819156 DOI: 10.3390/ijerph20010370] [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: 11/04/2022] [Revised: 12/16/2022] [Accepted: 12/18/2022] [Indexed: 06/17/2023]
Abstract
Grandparents (GP) play influential roles in grandchildren's health, behavior, and life. However, this relationship has not been examined in the Arab region. This study assesses whether the presence of GP in the household is associated with grandchildren's health and wellbeing. Health status was determined by a child experiencing chronic health conditions or an acute illness, and wellbeing was determined based on school attendance and child labor. Data were collected through surveys conducted in 2010 and 2015 of representative samples of Palestinian refugees living in Lebanon. Multivariate logistic regression showed that, even after controlling for potential confounders, including the presence of parents in the household and household food insecurity (FI), the presence of live-in GP was associated with lower odds of children experiencing acute illnesses (OR 0.74 95% CI 0.62-0.92) and higher odds of attending school (OR 2.22 95% CI 1.28-5.33), but not child labor. The presence of GP in the household may be protective to grandchildren's health status and school attendance in this population.
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Affiliation(s)
- Olfat B. Sheikomar
- Department of Nutrition and Food Science, College Park, University of Maryland, College Park, MD 20742, USA
- Department of Food and Nutrition, King Abdulaziz university, Jeddah 21589, Saudi Arabia
| | - Hala Ghattas
- Center for Research on Population and Health, American University of Beirut, Beirut 1107 2020, Lebanon
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Nadine R. Sahyoun
- Department of Nutrition and Food Science, College Park, University of Maryland, College Park, MD 20742, USA
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Food abundance in men before puberty predicts a range of cancers in grandsons. Nat Commun 2022; 13:7507. [PMID: 36473854 PMCID: PMC9726939 DOI: 10.1038/s41467-022-35217-1] [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: 01/30/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
Nutritional conditions early in human life may influence phenotypic characteristics in later generations. A male-line transgenerational pathway, triggered by the early environment, has been postulated with support from animal and a small number of human studies. Here we analyse individuals born in Uppsala Sweden 1915-29 with linked data from their children and parents, which enables us to explore the hypothesis that pre-pubertal food abundance may trigger a transgenerational effect on cancer events. We used cancer registry and cause-of-death data to analyse 3422 cancer events in grandchildren (G2) by grandparental (G0) food access. We show that variation in harvests and food access in G0 predicts cancer occurrence in G2 in a specific way: abundance among paternal grandfathers, but not any other grandparent, predicts cancer occurrence in grandsons but not in granddaughters. This male-line response is observed for several groups of cancers, suggesting a general susceptibility, possibly acquired in early embryonic development. We observed no transgenerational influence in the middle generation.
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Ho YCL, Mahirah D, Ho CZH, Thumboo J. The role of the family in health promotion: a scoping review of models and mechanisms. Health Promot Int 2022; 37:daac119. [PMID: 36398941 PMCID: PMC9673498 DOI: 10.1093/heapro/daac119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
The family is an important contributor to the cultural conditions that support health. Current challenges in family health promotion interventions include programme design that is not always guided by theory and change mechanisms. Multifaceted programmes also make it hard to examine what works for whom, given different family roles and the range of lifestyle behaviour and mechanisms examined within diverse conceptual frameworks and cultures. We performed a scoping review on the heterogeneous literature to map and categorize the models and mechanisms by which a family may promote health behaviours among its members. We searched five electronic databases and grey literature up to 2020. Publications were included if they examined health-promoting behaviours, influences at the family level, and outlined the behavioural mechanisms involved. Two hundred and forty studies were identified. Ecological systems theory, social cognitive theory, family systems theory and the theory of planned behaviour were the frameworks most widely used in explaining either study context and/or mechanism. The most frequently studied family mechanisms involved aspects of family support, supervision and modelling, while some studies also included individual-level mechanisms. Majority of the studies investigated parental influence on the child, while few studies assessed the elderly family member as a recipient or actor of the influences. Studies on African, Asian and Middle Eastern populations were also in the minority, highlighting room for further research. Improving the understanding of context and behavioural mechanisms for family health promotion will aid the development of public health policy and chronic disease prevention programmes, complementing efforts targeted at individuals.
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Affiliation(s)
- Yi-Ching Lynn Ho
- Centre for Population Health Research and Implementation (CPHRI), Singapore Health Services, Singapore
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Dhiya Mahirah
- Centre for Population Health Research and Implementation (CPHRI), Singapore Health Services, Singapore
| | - Clement Zhong-Hao Ho
- Centre for Population Health Research and Implementation (CPHRI), Singapore Health Services, Singapore
| | - Julian Thumboo
- Centre for Population Health Research and Implementation (CPHRI), Singapore Health Services, Singapore
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore
- Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
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Vázquez‐Vázquez ADP, Fewtrell MS, Chan‐García H, Batún‐Marrufo C, Dickinson F, Wells JCK. Do maternal grandmothers influence breastfeeding duration and infant nutrition? Evidence from Merida, Mexico. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2022; 179:444-459. [PMID: 36790606 PMCID: PMC9826188 DOI: 10.1002/ajpa.24623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/25/2022] [Accepted: 08/29/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Breast-feeding is sensitive to somatic, hormonal, behavioral and psychological components of maternal capital. However, through grandmothering, older women may also influence breast-feeding by transferring informational resources to their daughters. We hypothesized that mothers with prolonged instrumental support from their own mother are more likely to have received advice and to have favorable attitudes/practices regarding breastfeeding, compared to those lacking such support, with implications for the grandchild's somatic capital. METHODS We recruited 90 mother-infant dyads (52 with grandmaternal support, 38 without) in Merida, Yucatan, Mexico. All children were first-borns, aged ~2 years. Anthropometry and body composition were assessed. Data on grandmother's breastfeeding advice and maternal breastfeeding duration were obtained by questionnaire. Maternal attitudes to breast-feeding were assessed using the Iowa Infant Feeding Attitude Scale. RESULTS Women with instrumental support were more likely to have received grandmaternal advice during pregnancy/infancy on exclusive breast-feeding duration (60% vs. 37%, p = 0.033) and the type of first complementary food (81% vs. 47%, p = 0.001). However, women with support had a less favorable attitude to breastfeeding than those without and breastfed their children for less time (median 5 vs. 10.5 months, p = 0.01). No group differences were found in children's length, weight, skinfolds or lean mass z-score. DISCUSSION Although grandmothers providing instrumental support provided advice regarding breastfeeding, their attitudes may reflect issues beyond nutritional health. Advice of maternal grandmothers did not promote extended breastfeeding, however the differences in breastfeeding attitudes were not associated with the children's nutritional status. Grandmothers should be included in public health interventions promoting breastfeeding.
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Affiliation(s)
| | - Mary S. Fewtrell
- Childhood Nutrition Research Centre, UCLGreat Ormond Street Institute of Child HealthLondonUK
| | - Hidekel Chan‐García
- Human Ecology DepartmentCentre for Research and Advanced Studies (Cinvestav)MeridaYucatanMexico
| | - Carolina Batún‐Marrufo
- Human Ecology DepartmentCentre for Research and Advanced Studies (Cinvestav)MeridaYucatanMexico
| | - Federico Dickinson
- Human Ecology DepartmentCentre for Research and Advanced Studies (Cinvestav)MeridaYucatanMexico
| | - Jonathan C. K. Wells
- Childhood Nutrition Research Centre, UCLGreat Ormond Street Institute of Child HealthLondonUK
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Xu Y, Wang Y, McCarthy LP, Harrison T, Doherty H. Mental/behavioural health and educational outcomes of grandchildren raised by custodial grandparents: A mixed methods systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:2096-2127. [PMID: 35712998 PMCID: PMC10084073 DOI: 10.1111/hsc.13876] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 05/07/2022] [Accepted: 05/28/2022] [Indexed: 05/27/2023]
Abstract
Grandparents caring for grandchildren has increased globally in the past two decades, but we have a limited understanding of its effects on custodial grandchildren's mental/behavioural health and educational outcomes. This mixed methods systematic review aims to synthesise mental/behavioural health and educational outcomes of custodial grandchildren within custodial grandparent-headed families and with comparison to other types of household structure and further examine factors associated with these outcomes. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. We searched ERIC, Family Studies Abstracts, PsycINFO, PubMed, Scopus, Social Work Abstract and SocINDEX in March 2021 and screened 14,515 articles, which resulted in the inclusion of 42 studies, including 33 quantitative, seven qualitative and two mixed methods studies. The quality of included studies was assessed. This review covered 10 countries, yet most studies revealed that grandchildren raised by grandparents had adverse mental/behavioural health and educational outcomes compared to their peers raised by biological parents. This review further identified multi-level factors contributing to custodial grandchildren's adverse outcomes. Methodological limitations and implications for future practice and research were discussed.
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Affiliation(s)
- Yanfeng Xu
- University of South Carolina College of Social WorkColumbiaSouth CarolinaUSA
| | - Yao Wang
- University of Maryland School of Social WorkBaltimoreMarylandUSA
| | | | - Theresa Harrison
- University of South Carolina College of EducationColumbiaSouth CarolinaUSA
| | - Hanna Doherty
- University of South Carolina College of Social WorkColumbiaSouth CarolinaUSA
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Lu C, Shen T, Huang G, Corpeleijn E. Environmental correlates of sedentary behaviors and physical activity in Chinese preschool children: A cross-sectional study. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:620-629. [PMID: 32360638 PMCID: PMC9532589 DOI: 10.1016/j.jshs.2020.02.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/10/2019] [Accepted: 02/13/2020] [Indexed: 05/11/2023]
Abstract
OBJECTIVE This cross-sectional study examined environmental correlates of sedentary behavior (SB) and physical activity (PA) in preschool children in the urban area of Tianjin, China. METHODS Data were collected from the Physical Activity and Health in Tianjin Chinese Children study, involving healthy children 3-6 years old and their families. In all children (n = 980), leisure-time SB (LTSB) and leisure-time PA (LTPA) were reported in min/day by parents. In a subgroup (n = 134), overall sedentary time, light PA, and moderate-to-vigorous PA (MVPA) were objectively measured using ActiGraph accelerometry (≥3 days, ≥10 h/day). Environmental correlates were collected using a questionnaire that included home and neighborhood characteristics (e.g., traffic safety, presence of physical activity facilities) and children's behaviors. Potential correlates were identified using linear regression analysis. RESULTS Multiple linear regression analysis showed that "having grandparents as primary caregivers" (βs and 95% confidence intervals (95%CIs) for overall sedentary time: 29.7 (2.1-57.2); LTSB (ln): 0.19 (0.11-0.28)) and "having a television (for LTSB (ln): 0.13 (0.00-0.25)) or computer (for LTSB (ln): 0.13 (0.03-0.23)) in the child's bedroom" were both associated with higher SB. Furthermore, "having grandparents as primary caregivers" was associated with less MVPA (β (95%CI): -7.6 (-14.1 to -1.2)), and "active commuting to school by walking" correlated with more MVPA (β (95%CI): 9.8 (2.2-17.4)). The path model showed that "more neighborhood PA facilities close to home" was indirectly related to higher LTPA (ln), which was partly mediated by "outdoor play" (path coefficients (95%CI): 0.005 (0.002-0.008)) and "going to these facilities more often" (path coefficients (95%CI): 0.013 (0.008-0.018)). Traffic safety was not a correlate. CONCLUSION Family structure and media exposure in the home maybe important factors in shaping preschoolers' PA patterns. Built environmental correlates could indirectly influence preschoolers' LTPA through parental help with engaging in active behaviors.
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Affiliation(s)
- Congchao Lu
- School of Public Health, Tianjin Medical University, Tianjin 300070, China; Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, the Netherlands; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China.
| | - Tong Shen
- Tianjin University Kindergarten, Tianjin University, Tianjin 300072, China
| | - Guowei Huang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China; Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, the Netherlands
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Iguacel I, Perez-Cornago A, Schmidt JA, Van Puyvelde H, Travis R, Casagrande C, Nicolas G, Riboli E, Weiderpass E, Ardanaz E, Barricarte A, Bodén S, Bruno E, Ching-López A, Aune D, Jensen TE, Ericson U, Johansson I, Ma Huerta J, Katzke V, Kühn T, Sacerdote C, Schulze MB, Skeie G, Ramne S, Ward H, Gunter MJ, Huybrechts I. Evaluation of protein and amino acid intake estimates from the EPIC dietary questionnaires and 24-h dietary recalls using different food composition databases. Nutr Metab Cardiovasc Dis 2022; 32:80-89. [PMID: 34696945 DOI: 10.1016/j.numecd.2021.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/21/2021] [Accepted: 09/09/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS This study aimed to expand the European Prospective Investigation into Cancer and Nutrition (EPIC) nutrient database (ENDB) by adding amino acid (AA) values, using the U.S. nutrient database (USNDB). Additionally, we aimed to evaluate these new protein and AA intake estimates from the EPIC dietary questionnaires (DQ) and 24-h dietary recalls (24-HDR) using different matching procedures. METHODS AND RESULTS Dietary energy, protein and AA intakes were assessed via DQ and 24-HDR by matching with the USNDB food composition table. Energy and protein intakes calculated using USNDB matching were compared with those calculated using ENDB, that uses country specific food composition tables. Pearson correlations, Cohen's weighted kappa statistic and Bland-Altman plots were used to compare data resulting from USNDB matching with our reference from ENDB matching. Very high correlations were found when comparing daily energy (r = 0.99) and dietary protein intakes (r = 0.97) assessed via USNDB with those obtained via ENDB (matching for DQ and 24-HDR). Significant positive correlations were also found with energy and protein intakes acquired via 24-HDRs in the EPIC calibration sample. CONCLUSION Very high correlations between total energy and protein intake obtained via the USDA matching and those available in ENDB suggest accuracy in the food matching. Individual AA have been included in the extended EPIC Nutrient database that will allow important analyses on AA disease prospective associations in the EPIC study.
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Affiliation(s)
- Isabel Iguacel
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, 69372 Lyon Cedex 08, France; Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón, Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Zaragoza, Spain.
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Heleen Van Puyvelde
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, 69372 Lyon Cedex 08, France; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
| | - Ruth Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Corinne Casagrande
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, 69372 Lyon Cedex 08, France
| | - Genevieve Nicolas
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, 69372 Lyon Cedex 08, France
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, 69372 Lyon Cedex 08, France
| | - Eva Ardanaz
- Navarra Public Health Institute, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Aurelio Barricarte
- Navarra Public Health Institute, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Stina Bodén
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Eleonora Bruno
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian, 1, 20133 Milano, Italy
| | - Ana Ching-López
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Nutrition, Bjørknes University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Torill E Jensen
- Department of Community Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Ulrika Ericson
- Department of Clinical Sciences Malmö, Medical Faculty, Lund University, Sweden
| | - Ingergerd Johansson
- Department of Odontology, Section of Cardiology, Biobank Research, Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - José Ma Huerta
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Verena Katzke
- German Cancer Research Center (DKFZ), Foundation under Public Law, Heidelberg, Germany
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Foundation under Public Law, Heidelberg, Germany
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Stina Ramne
- Department of Clinical Sciences Malmö, Medical Faculty, Lund University, Sweden
| | - Heather Ward
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Marc J Gunter
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, 69372 Lyon Cedex 08, France
| | - Inge Huybrechts
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, 69372 Lyon Cedex 08, France
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12
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Formative Development of a Technology-Based Physical Activity Intervention for Grandparents and Grandchildren. J Aging Phys Act 2021; 30:482-494. [PMID: 34611054 DOI: 10.1123/japa.2020-0481] [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: 11/28/2020] [Revised: 06/17/2021] [Accepted: 08/17/2021] [Indexed: 11/18/2022]
Abstract
Physical inactivity is a major public health issue among older adults and children. This study presents preliminary results that will inform the development of a technology-based physical activity intervention for grandparents and grandchildren (ages 6-12 years old). The authors used an iterative user-centered design framework to gather quantitative data from grandparents (n = 35) and subsequently invited a subset of 12 of them to engage in qualitative interviews. Participants were 63.1 ± 9.8 years old, 80% female, 64% U.S.-born, 43% Hispanic, 66% single, and 40% <$15K income. The majority of grandparents reported mobile device proficiency, very close relationships with their grandchildren, and interest in participating in an intergenerational intervention. Four key themes related to family closeness, dynamics, routines, and technology informed intervention development. Next steps involved a pilot trial using Fitbits and a fully functioning technology-based prototype. Grandparents are uniquely positioned within their families to serve as agents of change in health-promoting interventions.
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13
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Chambers SA, Dobbie F, Radley A, Rowa-Dewar N. Grandmothers' care practices in areas of high deprivation of Scotland: the potential for health promotion. Health Promot Int 2021; 37:6325629. [PMID: 34293129 PMCID: PMC9067444 DOI: 10.1093/heapro/daab104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
In many families grandparents play an essential role by providing secondary care for grandchildren. The family is a key setting for promoting children’s health; however, studies describing health initiatives with grandparents are rare. Grandparents could play an important role in promoting health for their grandchildren within their families and communities. The aim of this study was to examine the care practices of grandparents in families living in areas of high deprivation, and to consider the extent to which grandparents could be at the centre of health-promoting initiatives for children. A family practices approach was used to examine care practices within the framework of family resource (assets/capitals) use. In-depth interviews were carried out with grandmothers (n = 15) and mothers (n = 15) living in areas of high deprivation in Scotland. The results are presented as three economies of family living—political, moral and emotional. Grandparent care was described as a form of social capital, central to the wellbeing of the families, and enabled parents to access education and employment. Grandparent care was supported through families’ ability to access cultural amenities and green space (political). Grandparents’ care practices were described as either being responsible or fun (moral). Love appeared to be at the centre of grandparents’ care (emotional). The strengths and weaknesses of this framework were examined in relation to developing initiatives with grandparents. With further development work, grandparents could be the focus of health initiatives with their grandchildren with the support of appropriate policies and resources within their communities. In many families, grandparents help by providing childcare. Children’s health is linked to their family’s overall wellbeing and there have been programmes to improve children’s health within the family. These programmes do not usually include grandparents. In this study, we spoke with 15 grandmothers and 15 mothers living in Scotland about the care that grandparents provide to their grandchildren. They described the different ways in which this care was managed in relation to other aspects of family life, like work. Grandmother care was described in two main ways—as either being responsible or as fun. The main driver of grandparent care was emotional—the love grandmothers held for their grandchildren. We consider the ways in which grandparents, with appropriate support from government at different levels, might help promote health in their grandchildren.
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Affiliation(s)
- Stephanie A Chambers
- School of Social and Political Sciences, Adam Smith Building, 28 Bute Gardens, Glasgow G12 8RS, UK.,MRC/CSO Social and Public Health Sciences Unit, University of Glasgow G3 7H3, UK
| | - Fiona Dobbie
- Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Andrew Radley
- Directorate of Public Health, NHS Tayside, Dundee DD1 9AG, UK
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14
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Green MJ, Pearce A, Parkes A, Robertson E, Katikireddi S. Pre-school childcare and inequalities in child development. SSM Popul Health 2021; 14:100776. [PMID: 33768138 PMCID: PMC7980060 DOI: 10.1016/j.ssmph.2021.100776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/12/2021] [Accepted: 03/06/2021] [Indexed: 01/21/2023] Open
Abstract
Centre-based childcare may benefit pre-school children and alleviate inequalities in early childhood development, but evidence on socio-emotional and physical health outcomes is limited. Data were from the UK Millennium Cohort Study (n = 14,376). Inverse-probability weighting was used to estimate confounder-adjusted population-average effects of centre and non-centre-based childcare (compared to parental care only) between ages 26-31 months on (age 3): internalising and externalising symptoms, pro-social behaviour, independence, emotional dysregulation, vocabulary, school readiness, and body mass index. To assess impacts on inequalities, controlled direct effects of low parental education and lone parenthood on all outcomes were estimated under two hypothetical scenarios: 1) universal take-up of centre-based childcare; and 2) parental care only. On average, non-centre based childcare improved vocabulary and centre-based care improved school readiness, with little evidence of other benefits. However, socio-economic inequalities were observed for all outcomes and were attenuated in scenario 1 (universal take-up). For example, inequalities in externalising symptoms (according to low parental education) were reduced from a confounder-adjusted standard deviation difference of 7.8 (95% confidence intervals: 6.7-8.8), to 1.7 (0.6-2.7). Inequalities by parental education in scenario 2 (parental care only) were wider than in scenario 1 for externalising symptoms (at 3.4; 2.4-4.4), and for emotional dysregulation and school readiness. Inequalities by lone parenthood, which were smaller, fell in scenario 1, and fell further in scenario 2. Universal access to centre-based pre-school care may alleviate inequalities, while restricted access (e.g. during lockdown for a pandemic such as Covid-19) may widen some inequalities in socioemotional and cognitive development.
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Affiliation(s)
- Michael J. Green
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, 99 Berkeley Street, Glasgow, G3 7HR, United Kingdom
| | - Anna Pearce
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, 99 Berkeley Street, Glasgow, G3 7HR, United Kingdom
| | - Alison Parkes
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, 99 Berkeley Street, Glasgow, G3 7HR, United Kingdom
| | - Elaine Robertson
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, 99 Berkeley Street, Glasgow, G3 7HR, United Kingdom
| | - S.Vittal Katikireddi
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, 99 Berkeley Street, Glasgow, G3 7HR, United Kingdom
- Public Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, United Kingdom
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15
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Korn AR, Economos CD, Hammond RA, Hennessy E, Kalkwarf HJ, Must A, Woo JG. Associations of mothers' source of feeding information with longitudinal trajectories of sugar-sweetened beverage intake, 100% juice intake and adiposity in early childhood. Pediatr Obes 2021; 16:e12746. [PMID: 33141511 DOI: 10.1111/ijpo.12746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/17/2020] [Accepted: 10/14/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND There remains a need to understand how information sources can promote young children's healthy beverage consumption and prevent obesity. OBJECTIVES To examine associations of mothers' primary feeding information source with children's sugar-sweetened beverage (SSB) intake, 100% juice intake and adiposity between ages 3 and 7 years. METHODS We analyzed data from a prospective cohort study (n = 371 children; 13 visits). Mothers reported their primary feeding information source at baseline and completed child 3-day dietary records each visit. Child adiposity indicators were calculated from repeated height/weight measurements and dual-energy X-ray absorptiometry. Longitudinal models examined beverage intakes and adiposity over time by source. RESULTS Primary feeding information sources included doctors (48.2%), mothers (17.5%), grandmothers (13.5%), other healthcare professionals (11.3%) and other family/friends (9.4%). Children's juice intake with age differed by source (P interaction = 0.03), with steepest and slightest intake decreases in the doctor (-19.7% each year; 95% CI: -23.7%, -15.5%) and grandmother (-5.0%; -14.5%, 5.5%) subgroups, respectively. Children's SSB intake did not differ by source, but increased annually by 7.1% (4.5%, 9.8%) overall. The grandmother subgroup had the greatest child adiposity over time. CONCLUSIONS Mothers' primary feeding information source may have important, yet heterogeneous, influences on young children's beverage intakes and adiposity over time. Consistent evidence-based messages are likely needed.
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Affiliation(s)
- Ariella R Korn
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Christina D Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Ross A Hammond
- Center on Social Dynamics and Policy, Brookings Institution, Washington, District of Columbia, USA.,Brown School at Washington University, St. Louis, Missouri, USA
| | - Erin Hennessy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Heidi J Kalkwarf
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Aviva Must
- Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Jessica G Woo
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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16
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Marr C, Reale S, Breeze P, Caton SJ. Grandparental dietary provision, feeding practices and feeding styles when caring for preschool-aged grandchildren: A systematic mixed methods review. Obes Rev 2021; 22:e13157. [PMID: 33174344 DOI: 10.1111/obr.13157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/24/2020] [Accepted: 09/24/2020] [Indexed: 01/15/2023]
Abstract
Grandparents are frequently relied upon to care for their preschool-aged grandchildren. These early years are a crucial age in the development of dietary habits and preferences. This review aims to determine grandparental dietary provision, feeding practices and feeding styles when caring for their preschool-aged grandchildren. Medline, PsycInfo and Web of Science were searched in January 2020. A systematic mixed methods approach was used to synthesize the qualitative (n = 13) and quantitative (n = 7) articles describing grandparents' feeding styles (n = 9), feeding practices (n = 14) and dietary provision (n = 18). Grandparents are serving large portion sizes and encouraging their grandchildren to eat frequently. Results are mixed for the types of foods provided; grandparents provide discretionary foods high in sugar and fat, and some also choose more expensive core foods as treats (e.g., berries). Grandparents engage in feeding practices that promote healthy eating (e.g., creating a healthy feeding environment) and promote autonomy and independence (e.g., considering their grandchild's preferences). However, they also use some coercive feeding practices (e.g., using food as a reward) and may be using indulgent feeding styles, which can be conducive to obesogenic dietary intakes. Interventions targeting grandparents could be an effective way to improve dietary-related health outcomes in young children.
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Affiliation(s)
- Colette Marr
- Public Health, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Sophie Reale
- Allied Health Professions, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Penny Breeze
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Samantha J Caton
- Public Health, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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17
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St. George SM, Noriega Esquives B, Agosto Y, Kobayashi M, Leite R, Vanegas D, Perez AT, Calfa C, Schlumbrecht M, Slingerland J, Penedo FJ. Development of a multigenerational digital lifestyle intervention for women cancer survivors and their families. Psychooncology 2019; 29:182-194. [DOI: 10.1002/pon.5236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 08/28/2019] [Accepted: 09/07/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Sara M. St. George
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Florida
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
| | | | - Yaray Agosto
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Florida
| | - Marissa Kobayashi
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Florida
| | - Rafael Leite
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Florida
| | - Dario Vanegas
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Florida
| | - Alejandra T. Perez
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
| | - Carmen Calfa
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
| | - Matthew Schlumbrecht
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
| | - Joyce Slingerland
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
| | - Frank J. Penedo
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
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18
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Fries LR, Chan MJ, Quah PL, Toh JY, Fogel A, Goh AT, Aris IM, Broekman BFP, Cai S, Tint MT, Chong YS, Shek LP, Lee YS, Yap F, Tan KH, Gluckman PD, Godfrey KM, Silva Zolezzi I, Forde CG, Chong MFF. Maternal feeding practices and children's food intake during an ad libitum buffet meal: Results from the GUSTO cohort. Appetite 2019; 142:104371. [PMID: 31323246 PMCID: PMC6682493 DOI: 10.1016/j.appet.2019.104371] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/24/2019] [Accepted: 07/15/2019] [Indexed: 12/16/2022]
Abstract
Parents' feeding practices have been shown to be associated with children's food intake and weight status, but little is known about feeding practices in Asian countries. This study used behavioral observation to explore the feeding practices of 201 mothers of 4.5 year-old children in Singapore during an ad libitum buffet lunch. Feeding practices were coded from videos, focusing on behaviors used to prompt the child to eat more food (autonomy-supportive and coercive-controlling prompts to eat, suggesting items from buffet), those to reduce intake (restriction, questioning food choice), and those related to eating rate (hurrying or slowing child eating). Child outcome measures included energy consumed, variety of food items selected, and BMI. Maternal restriction and trying to slow child eating rate were associated with higher energy consumed by the child (r = 0.19 and 0.13, respectively; p < 0.05). Maternal autonomy-supportive prompts and restriction were associated with a greater variety of items selected by children (r = 0.19 and 0.15, respectively; p < 0.05). The frequency of maternal feeding practice use differed across ethnic groups, with Malay mothers using the most prompts to eat (p < 0.05), Chinese mothers most likely to question a child's food choice (p < 0.01), and Indian mothers the last likely to tell the child to eat faster (p < 0.001). There were no differences between ethnic groups for other feeding practices. No associations were found between feeding practices and child BMI. It is possible that feeding practices related to restriction and slowing child eating are adopted in response to children who consume larger portions, although longitudinal or intervention studies are needed to confirm the direction of this relationship and create local recommendations.
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Affiliation(s)
- Lisa R Fries
- Nestlé Research, Vers-chez-les-Blanc, Case Postale 44, CH-1000, Lausanne, Switzerland.
| | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Anna Fogel
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore.
| | - Ai Ting Goh
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore.
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Psychiatry, VU Medical Centre, Amsterdam, The Netherlands, Research & Innovation, Location GGZ InGeest, Oldenaller 1, 1081, HJ, Amsterdam, the Netherlands.
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
| | - Mya Thway Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
| | - Lynette P Shek
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, 5 Lower Kent Ridge Road, 119074, Singapore.
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, 5 Lower Kent Ridge Road, 119074, Singapore.
| | - Fabian Yap
- Pediatric Endocrinology, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-National University of Singapore Graduate Medical School, 8 College Road, 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, 59 Nanyang Drive, 636921, Singapore.
| | - Kok Hian Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, 59 Nanyang Drive, 636921, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Level 3, Singapore, 229899.
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand.
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS FT, Tremona Road, SO16 6YD, Southampton, UK.
| | - Irma Silva Zolezzi
- Nestlé Research Singapore Hub, 21 Biopolis Road Nucleos (South Tower), #04-22/23, 138567, Singapore.
| | - Ciaran G Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, 117549, Singapore.
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19
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Pearce A, Dundas R, Whitehead M, Taylor-Robinson D. Pathways to inequalities in child health. Arch Dis Child 2019; 104:998-1003. [PMID: 30798258 PMCID: PMC6889761 DOI: 10.1136/archdischild-2018-314808] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 12/04/2022]
Abstract
From birth, children living in disadvantaged socioeconomic circumstances (SECs) suffer from worse health than their more advantaged peers. The pathways through which SECs influence children's health are complex and inter-related, but in general are driven by differences in the distribution of power and resources that determine the economic, material and psychosocial conditions in which children grow up. A better understanding of why children from more disadvantaged backgrounds have worse health and how interventions work, for whom and in what contexts, will help to reduce these unfair differences. Macro-level change is also required, including the reduction of child poverty through improved social security systems and employment opportunities, and continued investment in high-quality and accessible services (eg, childcare, key workers, children's centres and healthy school environments). Child health professionals can play a crucial role by being mindful of the social determinants of health in their daily practice, and through advocating for more equitable and child-focussed resource allocation.
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Affiliation(s)
- Anna Pearce
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Ruth Dundas
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Margaret Whitehead
- Department of Public Health and Policy, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - David Taylor-Robinson
- Department of Public Health and Policy, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
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20
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Sadruddin AFA, Ponguta LA, Zonderman AL, Wiley KS, Grimshaw A, Panter-Brick C. How do grandparents influence child health and development? A systematic review. Soc Sci Med 2019; 239:112476. [PMID: 31539783 DOI: 10.1016/j.socscimed.2019.112476] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 01/09/2023]
Abstract
Grandparents are often a key source of care provision for their grandchildren, yet they are sidelined in caregiving research and policy decisions. We conducted a global, systematic review of the literature to examine the scope and quality of studies to date (PROSPERO database CRD42019133894). We screened 12,699 abstracts across 7 databases, and identified 206 studies that examined how grandparents influence child health and development. Indicators of grandparent involvement were contact, caregiving behaviors, and financial support. Our review focused on two research questions: how do grandparents influence child health and development outcomes, and what range of child outcomes is reported globally? We examined study design, sample characteristics, key findings, and outcomes pertaining to grandchildren's physical health, socio-emotional and behavioral health, and cognitive and educational development. Our search captured studies featuring grandparent custodial care (n = 35), multigenerational care (n = 154), and both types of care (n = 17). We found substantial heterogeneity in the data provided on co-residence, caregiving roles, resources invested, outcomes, and mechanisms through which "grandparent effects" are manifested. We identified two important issues, related to operationalizing indicators of grandparent involvement and conceptualizing potential mechanisms, leading to gaps in the evidence base. Currently, our understanding of the pathways through which grandparents exert their influence is constrained by limited data on what grandparents actually do and insufficient attention given to interpersonal and structural contexts. We present a conceptual framework to explicitly measure and theorize pathways of care, with a view to inform research design and policy implementation. We underscore the need for more robust data on three indicators of caregiver involvement-contact, behavior, and support-and for careful description of structural and interpersonal contexts in caregiving research.
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21
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Association between grandparent co-residence, socioeconomic status and dental caries among early school-aged children in Japan: A population-based prospective study. Sci Rep 2019; 9:11345. [PMID: 31383895 PMCID: PMC6683122 DOI: 10.1038/s41598-019-47730-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/23/2019] [Indexed: 02/01/2023] Open
Abstract
Globally many children are living with grandparents, and it has been suggested that grandparent co-residence may be associated with dental caries in infants and toddlers possibly through passive parenting style, accompanied by children's cariogenic behaviors such as feeding sugary sweets. However, little is known about this association in schoolchildren, adjusted for socioeconomic status. Therefore, this study investigates the association between grandparent co-residence, socioeconomic status, and dental caries among schoolchildren. All caregivers of first-grade children (age 6-7 years) in Adachi City, Tokyo, were administered a questionnaire about children's grandparent co-residence status and oral health-related behaviors, and responses were linked with dental examination records conducted by school dentists (N = 3,578). Multilevel Poisson regression analysis was applied to examine the association between grandparent co-residence, socioeconomic status, and dental caries status for each individual tooth, adjusting for potential covariates. The percentage of dental caries experience was higher among children living with grandparents (48.9%) than among children living without grandparents (44.0%). The risk for caries, however, did not differ according to grandparent co-residence status when tooth type, child's age and sex, and parental socio-economic status and structure were adjusted (PR, 1.13; 95%CI, 0.90, 1.42). The association between grandparent co-residence and dental caries among early school-aged children in urban Japan was confounded by socioeconomic status.
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22
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Treats are a tool of the trade: an exploration of food treats among grandparents who provide informal childcare. Public Health Nutr 2019; 22:2643-2652. [DOI: 10.1017/s1368980019000685] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:Globally, grandparents are the main informal childcare providers with one-quarter of children aged ≤5 years regularly cared for by grandparents in Australia, the UK and USA. Research is conflicting; many studies claim grandparents provide excessive amounts of discretionary foods (e.g. high in fat/sugar/sodium) while others suggest grandparents can positively influence children’s diet behaviours. The present study aimed to explore the meaning and role of food treats among grandparents who provide regular informal care of young grandchildren.Design:Qualitative methodology utilising a grounded theory approach. Data were collected using semi-structured interviews and focus groups, then thematically analysed.Setting:Participants were recruited through libraries, churches and playgroups in South Australia.Participants:Grandparents (n 12) caring for grandchild/ren aged 1–5 years for 10 h/week or more.Results:Three themes emerged: (i) the functional role of treats (e.g. to reward good behaviour); (ii) grandparent role, responsibility and identity (e.g. the belief that grandparent and parent roles differ); and (iii) the rules regarding food treats (e.g. negotiating differences between own and parental rules). Grandparents favoured core-food over discretionary-food treats. They considered the risks (e.g. dental caries) and rewards (e.g. pleasure) of food treats and balanced their wishes with those of their grandchildren and parents.Conclusions:Food treats play an important role in the grandparent–grandchild relationship and are used judiciously by grandparents to differentiate their identity and relationship from parents and other family members. This research offers an alternative narrative to the dominant discourse regarding grandparents spoiling grandchildren with excessive amounts of discretionary foods.
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Emm-Collison LG, Lewis S, Reid T, Matthews J, Sebire SJ, Thompson JL, Jago R. Physical Activity during the School Holidays: Parent Perceptions and Practical Considerations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101697. [PMID: 31091825 PMCID: PMC6572055 DOI: 10.3390/ijerph16101697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 05/07/2019] [Accepted: 05/08/2019] [Indexed: 12/05/2022]
Abstract
Children’s physical activity decreases during school holidays. Less structured days and reduced participation in organised activities may account for some of the decrease. Little is known about the factors that influence parents’ decision to enrol their child in organised activity such as holiday clubs. This paper sought to explore parents’ perceptions of their child’s physical activity during school holidays and the factors that influence holiday activity-based decision making. Semi-structured telephone interviews were conducted with 42 parents of children aged 10–11 years in July 2017 or March 2018. Data were analysed using a combination of inductive and deductive content analysis to explore parents’ perceptions of holiday-based physical activity and the factors associated with how they provide physical activity opportunities for their children. The data revealed that most parents consider their child’s physical activity levels when planning for the school holidays. However, work commitments in the holidays meant many parents had to rely on both informal and formal childcare. Grandparents were the primary source of informal childcare, despite a perception that children were not as physically active when with them. Holiday clubs were also a viable option, but the cost, location and age-appropriateness of provision inhibit parents signing older children up to these regularly.
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Affiliation(s)
- Lydia G Emm-Collison
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
| | - Sarah Lewis
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
| | - Thomas Reid
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
| | - Joe Matthews
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
| | - Simon J Sebire
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
| | - Janice L Thompson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
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Lidgate ED, Li B, Lindenmeyer A. A qualitative insight into informal childcare and childhood obesity in children aged 0-5 years in the UK. BMC Public Health 2018; 18:1229. [PMID: 30400788 PMCID: PMC6219155 DOI: 10.1186/s12889-018-6131-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 10/19/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Previous studies in various countries have found that informal childcare (provided by relatives, friends etc.) was associated with an increased risk of obesity in children aged 0-5 years. However, no qualitative research has been done to explore possible reasons for such a relationship and potential interventions to tackle it. We conducted a qualitative study with both parents and informal carers to explore their 1) experiences in receiving or giving informal childcare for British children aged 0-5 years; 2) perceived explanations of the relationship between informal childcare and childhood obesity and 3) preferred intervention ideas and delivery strategies for preventing obesity among those children under informal care. METHODS Four in-depth focus groups with a total of 14 participants (7 parents, 7 informal caregivers) were conducted in Birmingham and Edinburgh (1 parent group and 1 informal caregiver group in each city). Data were audio recorded, transcribed verbatim and analysed using a thematic approach. RESULTS The significance of informal care to parents, carers, and society was recognised (theme one). Informal carers were identified to have practical and emotional support roles for the parents (theme two). Informal care was perceived to contribute to childhood obesity in four ways (theme three): cross-generation conflict preventing adoption of healthy practices; the trade-off for parents between receiving childcare and maintaining control; reduced energy capacity of carers; and increased snacking. Potential intervention ideas and delivery strategies (theme four) were identified. Examples of identified ideas included providing carers with up-to-date weaning advice, and suggestions of healthy snacks and ways to increase physical activity level in informal care. The suggestion of utilising existing primary care platforms (e.g. health visitor check-ups) to reach and deliver low-cost information based interventions, to all children aged 0-5 years who receive informal care, was highlighted. CONCLUSIONS This exploratory qualitative study provided novel insights into potential explanations for the evidenced link between informal care and childhood obesity in children aged 0-5 years, despite a small size and limited participants in each focus group. Our findings support the idea of and inform the development towards an information based and low-cost intervention delivered through existing primary care platforms.
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Affiliation(s)
- Eleanor Diana Lidgate
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, West Midlands UK
| | - Bai Li
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, West Midlands B15 2TT UK
| | - Antje Lindenmeyer
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, West Midlands B15 2TT UK
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Glaser K, Stuchbury R, Price D, Di Gessa G, Ribe E, Tinker A. Trends in the prevalence of grandparents living with grandchild(ren) in selected European countries and the United States. Eur J Ageing 2018; 15:237-250. [PMID: 30310371 PMCID: PMC6156723 DOI: 10.1007/s10433-018-0474-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Research from the United States has shown significant increases in the prevalence of three-generation households and in households consisting solely of grandparents and grandchildren. Such shifts in household composition, which are associated with socio-economic disadvantage, may reflect the activation of grandparents as a latent network of support in response to social and demographic changes such as rising partnership disruption. However, to date, little is known in Europe about trends in grandparent households or whether these households are also likely to be disadvantaged. Moreover, we know little about how the familistic and defamilised policy environments in Europe may affect the activation of such latent kin networks. Employing the Integrated Public Use Microdata Series-International and the Office for National Statistics' Longitudinal Study for England and Wales, we used multivariate techniques to investigate changes in prevalence over time in co-residence with a grandchild across Austria, England and Wales, France, Greece, Portugal, Romania, and the United States. We expected increases in grandparent households in Portugal and Greece, familistic societies with few public alternatives to family support. However, only Romania (like the US) showed an increase in the percentage of people aged 40 and over co-residing with their grandchildren in three-generation households between the late 1970s and 2002. Given rises in poverty and limited support for low-income families in Romania, rises in grandparent coresidence may reflect a coping strategy among poorer families to increasing financial hardship. Regardless of the trends, grandparent households in all the countries studied remained associated with socio-economic disadvantage.
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Affiliation(s)
- Karen Glaser
- Institute of Gerontology, Department of Global Health & Social Medicine, School of Global Affairs, Faculty of Social Science and Public Policy, King’s College London, London, UK
| | - Rachel Stuchbury
- CeLSIUS, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK
| | - Debora Price
- Manchester Institute for Collaborative Research on Ageing, University of Manchester, Manchester, UK
| | - Giorgio Di Gessa
- Institute of Gerontology, Department of Global Health & Social Medicine, School of Global Affairs, Faculty of Social Science and Public Policy, King’s College London, London, UK
| | - Eloi Ribe
- Institute of Gerontology, Department of Global Health & Social Medicine, School of Global Affairs, Faculty of Social Science and Public Policy, King’s College London, London, UK
| | - Anthea Tinker
- Institute of Gerontology, Department of Global Health & Social Medicine, School of Global Affairs, Faculty of Social Science and Public Policy, King’s College London, London, UK
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26
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Shan LC, McCafferty C, Tatlow-Golden M, O'Rourke C, Mooney R, Livingstone MBE, Pourshahidi LK, Corish C, Kearney JM, Wall P, Murrin C. Is it still a real treat? Adults' treat provision to children. Appetite 2018; 130:228-235. [PMID: 30118786 DOI: 10.1016/j.appet.2018.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/06/2018] [Accepted: 08/13/2018] [Indexed: 01/14/2023]
Abstract
Consumption of high-energy foods in the absence of hunger has been identified as a key target to address in the area of obesity. For children, such foods are often provided by adults as treats. There is limited understating of adults' treat giving. The present study aimed to understand adults' provision of treats to children on the Island of Ireland. A total of 1039 participants, including parents, grandparents, child minders and education practitioners completed a face-to-face survey in their home. Participants defined their treats for children primarily as 'something nice', 'deserved/earned' and 'something special'. The top three motivations for treat foods provision were 'to reward for good behaviour' (42.3%), 'because the child(ren) ask' (42.2%) and 'to make the child(ren) feel better' (29.4%). Almost all participants would provide treat foods at celebrations and 52.5% always did so. In addition, 68% participants had structured weekly and/or daily treat for children. Treats provided to children were dominated by energy-dense foods. The top three were sweets, chocolates and ice-creams, being used by 45.2%, 45.1% and 38.8% participants. Variations were observed across different adult groups, in terms of their treat giving behaviour. The main observation was that adults' treat foods provision has become habitual. The findings can help develop targeted strategies to encourage the reduction or replacement of food treats for children.
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Affiliation(s)
- Liran Christine Shan
- School of Public Health, Physiotherapy and Sports Science, Woodview House, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Claire McCafferty
- School of Public Health, Physiotherapy and Sports Science, Woodview House, University College Dublin, Belfield, Dublin 4, Ireland
| | - Mimi Tatlow-Golden
- Faculty of Wellbeing, Education & Language Studies, The Open University, Stuart Hall Building, 2nd Floor, Walton Hall, Milton Keynes, MK7 6AA, UK
| | - Claire O'Rourke
- Amárach Research, Citywest Business Campus, Dublin 24, Ireland
| | - Robert Mooney
- Amárach Research, Citywest Business Campus, Dublin 24, Ireland
| | - M Barbara E Livingstone
- Nutrition Innovation Centre for Food and Health (NICHE), University of Ulster, Cromore Road, Coleraine, Co. Londonderry, BT52 1SA, UK
| | - L Kirsty Pourshahidi
- Nutrition Innovation Centre for Food and Health (NICHE), University of Ulster, Cromore Road, Coleraine, Co. Londonderry, BT52 1SA, UK
| | - Clare Corish
- School of Public Health, Physiotherapy and Sports Science, Woodview House, University College Dublin, Belfield, Dublin 4, Ireland
| | - John M Kearney
- School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Ireland
| | - Patrick Wall
- School of Public Health, Physiotherapy and Sports Science, Woodview House, University College Dublin, Belfield, Dublin 4, Ireland
| | - Celine Murrin
- School of Public Health, Physiotherapy and Sports Science, Woodview House, University College Dublin, Belfield, Dublin 4, Ireland
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Coupe N, Cotterill S, Peters S. Tailoring lifestyle interventions to low socio-economic populations: a qualitative study. BMC Public Health 2018; 18:967. [PMID: 30075716 PMCID: PMC6076398 DOI: 10.1186/s12889-018-5877-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/24/2018] [Indexed: 11/18/2022] Open
Abstract
Background People living in deprived areas are more likely to be overweight or obese, have poorer health outcomes, and tend to benefit less from interventions than those from more affluent backgrounds. One approach to address such health inequalities is to tailor existing interventions to low socio-economic populations, yet there is limited evidence to inform their design. This study aims to identify how best to tailor lifestyle interventions to low socio-economic populations to improve outcomes. Methods Following direct observations of community-run weight loss groups, we interviewed 11 group facilitators and 14 service users from a health improvement service in a low socio-economic area in the North West of England. Audio-recorded interviews were transcribed verbatim and analysed thematically. Results We identified two overarching themes within the data. The first theme, managing diversity, included challenges faced in delivering a generic intervention to a diverse population in terms of knowledge, language and literacy skills, and cultural diversity. The second theme incorporated all issues relating to the environment, such as cost, access and availability of food and leisure facilities, and ‘life gets in the way’. Conclusions Tailoring interventions for this population is necessary, and more attention is needed to develop ways to ensure service providers and users engage with behaviour change techniques such as goal setting, rather than focusing on information provision alone. Interventions should also be mindful of cost, cultural diversity, and language and literacy barriers, as well as potential for disengaging this hard to reach population.
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Affiliation(s)
- Nia Coupe
- Manchester Centre for Health Psychology, School of Health Sciences, The University of Manchester, Manchester, UK.
| | - Sarah Cotterill
- Centre for Biostatistics, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Sarah Peters
- Manchester Centre for Health Psychology, School of Health Sciences, The University of Manchester, Manchester, UK
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