Family characteristics and health behaviour as antecedents of school nurses’ concerns about adolescents’ health and development: A path model approach

Abstract

BackgroundFamily socio-economic factors and parents’ health behaviours have been shown to have an impact on the health and well-being of children and adolescents. Family characteristics have also been associated with school nurses’ concerns, which arose during health examinations, about children's and adolescents’ physical health and psychosocial development. Parental smoking has also been associated with smoking in adolescents. ObjectivesThe aim of this study was to determine to what extent school nurses’ concerns about adolescents’ physical health and psychosocial development related to family characteristics are mediated through parents’ and adolescents’ own health behaviours (smoking). DesignA path model approach using cross-sectional data was used. SettingsIn 2008–2009, information about health and well-being of adolescents was gathered at health examinations of the Children's Health Monitoring Study. ParticipantsAltogether 1006 eighth and ninth grade pupils in Finland participated in the study. MethodsThe associations between family characteristics, smoking among parents and adolescents and school nurses’ concerns about adolescents’ physical health and psychosocial development were examined using a structural equation model. ResultsPaternal education had a direct, and, through fathers’ and boys’ smoking, an indirect association with school nurses’ concerns about the physical health of boys. Paternal labour market status and family income were only indirectly associated with concerns about the physical health of boys by having an effect on boys’ smoking through paternal smoking, and a further indirect effect on concerns about boys’ health. In girls, only having a single mother was strongly associated with school nurses’ concerns about psychosocial development through maternal and adolescent girl smoking. ConclusionsSocio-economic family characteristics and parental smoking influence adolescent smoking and are associated with school nurses’ concerns about adolescents’ physical health and psychosocial development. The findings underline the importance of comprehensively taking into account adolescents’ and parents’ health behaviours and the family situation in health-care contacts when providing health counselling.