Children's Health-related Behaviors Research Articles

Primary school-based behavioural interventions for preventing caries

Dental caries is one of the most common global childhood diseases and is, for the most part, entirely preventable. Good oral health is dependent on the establishment of the key behaviours of toothbrushing with fluoride toothpaste and controlling sugar snacking. Primary schools provide a potential setting in which these behavioural interventions can support children to develop independent and habitual healthy behaviours. To assess the clinical effects of school-based interventions aimed at changing behaviour related to toothbrushing habits and the frequency of consumption of cariogenic food and drink in children (4 to 12 year olds) for caries prevention. We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 18 October 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 4), MEDLINE via OVID (1948 to 18 October 2012), EMBASE via OVID (1980 to 18 October 2012), CINAHL via EBSCO (1981 to 18 October 2012) and PsycINFO via OVID (1950 to 18 October 2012). Ongoing trials were searched for using Current Controlled Trials (to 18 October 2012) and ClinicalTrials.gov (to 18 October 2012). Conference proceedings were searched for using ZETOC (1993 to 18 October 2012) and Web of Science (1990 to 18 October 2012). We searched for thesis abstracts using the Proquest Dissertations and Theses database (1950 to 18 October 2012). There were no restrictions regarding language or date of publication. Non-English language papers were included and translated in full by native speakers. Randomised controlled trials of behavioural interventions in primary schools (children aged 4 to 12 years at baseline) were selected. Included studies had to include behavioural interventions addressing both toothbrushing and consumption of cariogenic foods or drinks and have a primary school as a focus for delivery of the intervention. Two pairs of review authors independently extracted data related to methods, participants, intervention design including behaviour change techniques (BCTs) utilised, outcome measures and risk of bias. Relevant statistical information was assessed by a statistician subsequently. All included studies contact authors were emailed for copies of intervention materials. Additionally, three attempts were made to contact study authors to clarify missing information. We included four studies involving 2302 children. One study was at unclear risk of bias and three were at high risk of bias. Included studies reported heterogeneity in both the intervention design and outcome measures used; this made statistical comparison difficult. Additionally this review is limited by poor reporting of intervention procedure and design. Several BCTs were identified in the trials: these included information around the consequences of twice daily brushing and controlling sugar snacking; information on consequences of adverse behaviour and instruction and demonstration regarding skill development of relevant oral health behaviours.Only one included study reported the primary outcome of development of caries. This small study at unclear risk of bias showed a prevented fraction of 0.65 (95% confidence interval (CI) 0.12 to 1.18) in the intervention group. However, as this is based on a single study, this finding should be interpreted with caution.Although no meta-analysis was performed with respect to plaque outcomes (due to differences in plaque reporting between studies), the three studies which reported plaque outcomes all found a statistically significant reduction in plaque in the intervention groups with respect to plaque outcomes. Two of these trials involved an 'active' home component where parents were given tasks relating to the school oral health programme (games and homework) to complete with their children. Secondary outcome measures from one study reported that the intervention had a positive impact upon children's oral health knowledge. Currently, there is insufficient evidence for the efficacy of primary school-based behavioural interventions for reducing caries. There is limited evidence for the effectiveness of these interventions on plaque outcomes and on children's oral health knowledge acquisition. None of the included interventions were reported as being based on or derived from behavioural theory. There is a need for further high quality research to utilise theory in the design and evaluation of interventions for changing oral health related behaviours in children and their parents.

Health-related behaviours and wellbeing in children aged 10–13 years

Children's diets, lifestyle and health-related behaviours have changed in recent years. For example, physical activity now has to compete with the internet and social media, mobile phones and 24-hour television. Fruit and healthy snacks have to compete with a vast variety of sweets, chocolates, cakes, biscuits and crisps. In order to improve children's health and wellbeing it is important to have a firm understanding of children's health-related behaviours. School nurses have unique access to school children and have the ability to positively influence children, their parents and the education system to empower them to make healthy choices and improve their lifestyle. This study critically examines health-related behaviours in children aged 10–13 years in a rural area in Scotland. It aims to establish how often the children participate in physical exercise and how much time they spend on sedentary behaviour, their diet and their perception of their own health.

Parenting styles, communication and child/adolescent diets and weight status: let's talk about it

Parenting styles have been associated with health-related behaviours in children and adolescents. We present a series of studies. Study 1 investigated parenting styles and parent–child communication styles as cross-sectional predictors of dietary patterns in children, and study 2 as cross-sectional predictors of weight status in adolescents. Data were collected from parents of 382 children aged 2–12 in study 1, and from parents of 72 adolescent children aged 12–18 in study 2. Controlling for confounders, laxness and over-reactivity predicted lower fruit/vegetable and higher non-core food consumption in study 1. Incendiary parent–adolescent communication predicted higher adolescent body mass index in study 2. These findings suggest that different parent–child parenting styles are associated with diet and weight in children and adolescents. Improving ways in which parents communicate with their children may be an important consideration in the development of effective parent-targeted treatment programmes for child diet quality and subsequent adolescent overweight/obesity.

Healthy-lifestyle behaviors associated with overweight and obesity in US rural children

BackgroundThere are disproportionately higher rates of overweight and obesity in poor rural communities but studies exploring children’s health-related behaviors that may assist in designing effective interventions are limited. We examined the association between overweight and obesity prevalence of 401 ethnically/racially diverse, rural school-aged children and healthy-lifestyle behaviors: improving diet quality, obtaining adequate sleep, limiting screen-time viewing, and consulting a physician about a child’s weight.MethodsA cross-sectional analysis was conducted on a sample of school-aged children (6–11 years) in rural regions of California, Kentucky, Mississippi, and South Carolina participating in CHANGE (Creating Healthy, Active, and Nurturing Growing-up Environments) Program, created by Save the Children, an independent organization that works with communities to improve overall child health, with the objective to reduce unhealthy weight gain in these school-aged children (grades 1–6) in rural America. After measuring children’s height and weight, we17 assessed overweight and obesity (BMI ≥ 85th percentile) associations with these behaviors: improving diet quality18 (≥ 2 servings of fruits and vegetables/day), reducing whole milk, sweetened beverage consumption/day; obtaining19 adequate night-time sleep on weekdays (≥ 10 hours/night); limiting screen-time (i.e., television, video, computer,20 videogame) viewing on weekdays (≤ 2 hours/day); and consulting a physician about weight. Analyses were adjusted 21 for state of residence, children's race/ethnicity, gender, age, and government assistance.ResultsOverweight or obesity prevalence was 37 percent in Mississippi and nearly 60 percent in Kentucky. Adjusting for covariates, obese children were twice as likely to eat ≥ 2 servings of vegetables per day (OR=2.0,95% CI 1.1-3.4), less likely to consume whole milk (OR=0.4,95% CI 0.2-0.70), Their parents are more likely to be told by their doctor that their child was obese (OR=108.0,95% CI 21.9-541.6), and less likely to report talking to their child about fruits and vegetables a lot/sometimes vs. not very much/never (OR=0.4, 95%CI 0.2-0.98) compared to the parents of healthy-weight children.ConclusionsRural children are not meeting recommendations to improve diet, reduce screen time and obtain adequate sleep. Although we expected obese children to be more likely to engage in unhealthy behaviors, we found the opposite to be true. It is possible that these groups of respondent parents were highly aware of their weight status and have been advised to change their children’s health behaviors. Perhaps given the opportunity to participate in an intervention study in combination with a physician recommendation could have resulted in actual behavior change.

Parenting Style, Parenting Stress, and Childrenʼs Health-Related Behaviors

Parental guidance is critical to the development of children's health-related behaviors. The purpose of this study was to look at the relationship between parenting factors, including parenting style and parenting stress, and children's health-related behaviors. In this descriptive, correlational study, 284 parents of preschool children were interviewed using the Child Rearing Questionnaire and the Korean Parenting Stress Index-Short Form. Parent distress, authoritative and permissive parenting styles, family income, and mother's education were significantly associated with children's health-related behaviors. These findings suggest that higher levels of warmth, characteristics of both parenting styles, may be a critical factor in the development of health-related behaviors.

Virtual reality stroke rehabilitation - hype or hope?

Virtual reality stroke rehabilitation - hype or hope?

Child public health and child (health)care: too far apart?

Child public health denotes both the health of the young population and the societal efforts to improve this health. Measured by for instance the contents of the Journal or the number of lectures at the annual meetings of Eupha, it constitutes a substantial part of European public health. In the current issue of the Journal, again several publications provide information on child public health in Europe. Koupil et al .1 studied inequalities in infant mortality in Estonia. Efforts to lower infant mortality have been in the roots of public since long ago. Interestingly their study shows a large decrease in infant mortality since 1991, the year in which Estonia regained independence. Relative differences in mortality by socioeconomic position remained rather stable though, similar to the trend in other countries. Health-related behaviours in children and adolescents have …

Effects of a Web-Based Health Program on Fifth Grade Children's Physical Activity Knowledge, Attitudes and Behavior

American children continue to be less physically active than they were a decade ago. Web-based programs (e-Learning), requiring minimal teacher training and expertise, could contribute to improvements in children's health-related knowledge, attitudes and behaviors. The purpose of this study was to evaluate the impact of the e-Learning module Healthy Hearts 4 Kids (HH) on the physical activity knowledge, attitudes and behaviors of 233 fifth grade children. A 2×3 repeated measures design was employed and significant changes in knowledge and attitude were found upon completion of the module and also six weeks after the post-test was completed. Results of this study suggest HH could be an effective component of a coordinated school health program (CSHP).

Psychological predictors of health-related behaviour in children

Psychological variables such as self-efficacy, stress, and coping have proven their predictive power on health protective and health risk behaviour in adolescence and adulthood. Furthermore, health-related behaviour at early stages of development is seen as an important factor in determining health-related behaviour at later stages of development. Consequently, research on psychological variables predicting health-related behaviours at early stages of development should be an important topic with regard to health promotion and disease prevention, although this is still a neglected research area. Therefore, the purpose of the present study is to analyse the importance of psychological variables in predicting health-risky and health protective behaviour in elementary school children. The study sample consisted of 345 fourth-graders (193 girls and 152 boys) with a mean age of 10.1 and 10.0 years, respectively, assessed three times within 1 year. The results showed that negative health-related behaviour is primarily influenced by stress experiences and maladaptive coping. Self-efficacy provides additional effects in girls. For positive health-related behaviour, self-efficacy is the dominant predictor in both girls and boys. The significance of the results for health-promotion during early developmental stages is discussed.

Impact of a Field Trip to a Health Museum on Children's Health-Related Behaviors and Perceived Control over Illness

A field-trip program was developed at the Hall of Health (HOH), a museum in Berkeley, CA, to show children how they can take control of their own health. Pre- and postvisit surveys collected from 1,170 students in fourth through sixth grades indicated that 2 weeks after attending the HOH program, students reported brushing their teeth more often. They also reported a greater sense of control over whether they would get heart disease, bladder infections, lung cancer, skin cancer, and intestinal cancer. Interviews with 34 randomly selected students revealed that all of them could state specific things they learned about the relationship between behavior and health. Students in the comparison group reported wearing a safety belt more often when riding in a car and stated more often that it is never okay to drink alcohol in high school. Students in both the experimental and comparison groups reported more often eating fruits and vegetables, using sunscreen, washing their hands, and wearing a helmet when riding a bicycle, and having an increased sense of control over whether they would have broken bones, colds, flu, and stomachaches.

Talking to young children about health: methods and findings

THIS paper reports the methods and some findings from a study of young children's health-related beliefs and behaviours. The 52 children, aged four to 12 years, are the offspring of a sample of middle-class couples who participated in an in-depth multi-inter view qualitative study: "The social context of the development of health-related beliefs and behav iours, with special reference to the family". The field- work for both of these studies was carried out in Edinburgh from 1987 to 1989. After completion of their parents' study, the children were interviewed privately at home using a variety of innovative meth odological techniques appropriate to their ages. Each mode of questioning elicited different kinds of responses which, taken as a whole, illustrated: that children give both "public" and "private" accounts of health and illness; can hold apparently inconsist ent views about health simultaneously; often show limited knowledge or understanding of parents' health-related behaviours; and may reveal weak links between health-related attitudes and beliefs and behavioural practices.

Relationships among children's health-related behaviors: A multivariate, developmental perspective

Considerable evidence documents the aggregation of cardiovascular risk factors in children; yet, very little is known about the covariation of children's health practices. Accordingly, using a multivariate and developmental perspective, the present research examines the interrelationships among multiple health behaviors (i.e., physical activity, eating habits, smoking, alcohol use, and stress-related behaviors) in 1,092 predominantly low-socioeconomic status, rural schoolchildren (ages 11–18, grades 6–12). Our data provide support for a multidimensional view of children's health habits and suggest that patterns of interrelationships may vary at different developmental levels. Implications of these results are discussed and directions for future research are highlighted.