Children In Vulnerable Families Research Articles

Verification of Longitudinal Reciprocal Causality Between Social Capital and Resilience for the Children in Vulnerable Families

Verification of Longitudinal Reciprocal Causality Between Social Capital and Resilience for the Children in Vulnerable Families

The effects of an early childhood education care program on child development as a function of length of exposure in Ecuador

Investment in early childhood education can reduce the inequality gap, promote schooling, and reduce criminal activity. Centros de Desarrollo Infantil (CDI) is a public program that provides early childhood education to children in vulnerable families at no cost. This paper uses a treatment intensity analysis to identify the effects of exposure to a CDI program on children's cognitive, socio-emotional, and nutritional development. We analyzed 16,322 observations collected from 2016 to 2018 in six different evaluations in Quito Centro, Ecuador. The results indicated CDI's positive and significant effects on cognitive and socio-emotional development as time exposure to the program increased. There was no significant gain in nutritional development due to program exposure.

The impact of school closure and social isolation on children in vulnerable families during COVID-19: a focus on children’s reactions

For children the consequences of the COVID-19 public health measures may have long-term effects into adulthood. By exploring children’s reactions more broadly, we are better placed to understanding the breadth of implications of home school and social isolation under COVID-19. The present study explored how COVID-19 related variables, namely, home school experience, child perceived family stress and instability, screen time use, missing friends and worry about virus infection are associated with children’s emotional, somatic/cognitive and worry reactions, respectively. A total of 442 children (M = 11.43 years, SD = 2.59) from the longitudinal FamilieForSK-study participated and a series of hierarchical linear regression models were applied controlling for background variables including children’s psychological vulnerability. Results showed significant associations between all COVID-19 related predictors, except screen time use, and the three outcomes. Family stress and instability had the strongest effects with standardised betas ranging from .356 to .555 and collectively, predictors explained between 20.7 and 44.1% of variance in outcomes. Furthermore, several associations were moderated by age and older children were more negatively impacted (i.e., higher level of reported reactions). The present study provides more conclusive evidence of the effects of home school and social isolation under COVID-19 on children. It also exemplifies the importance of focusing on children’s reactions more broadly, as there was evidence that children on average had fewer emotional reactions compared to before the pandemic.

Unmet Healthcare Needs of Children in Vulnerable Families in South Korea: Finding from the Community Child Center Child Panel Survey.

Presented in this paper is a study that examined the status of unmet healthcare needs of children in vulnerable families and identified factors affecting such unmet needs. The Community Child Center (CCC) Child Panel Survey data in Korea were used. A multiple stepwise logistic regression analysis was performed to examine factors influencing unmet healthcare needs of children. Influencing factors comprised predisposing, enabling, and need factors based on the Andersen Behavioral Model of Health Services Utilization. A total of 340 sixth-graders from vulnerable families participated, and 96 (28.2%) children had unmet healthcare needs. Factors included absence of an after-school caregiver (OR = 1.95, 95% CI [1.16, 3.27]), perceived physical symptoms (OR = 1.33, 95% CI [1.02, 1.73]), parental indifference (OR = 1.33, 95% CI [1.002, 1.77]), duration of daily stay at CCCs (OR = 1.32, 95% CI [1.01, 1.71]), and satisfaction with CCC teachers (OR = 0.65, 95% CI [0.49, 0.85]). The relationship with parents and CCC teachers had the strongest influence on unmet healthcare needs of children. In order to reduce the unmet healthcare needs of children in vulnerable families, existing support structures should be expanded to offer financial and administrative support for children’s parents and CCC teachers.

COVID-19 and Nutrition: The Need for Initiatives to Promote Healthy Eating and Prevent Obesity in Childhood.

COVID-19 and Nutrition: The Need for Initiatives to Promote Healthy Eating and Prevent Obesity in Childhood.

Association of Maternal Nativity Status and Race/Ethnicity on Emergency Department Utilization Among Children in Vulnerable Families.

We aimed to determine the role of mothers' nativity and race/ethnicity on their children's emergency department utilization. Data from the Fragile Families and Child Wellbeing Study was used for the analyses. Descriptive and regression analyses were conducted to compare use of ED services between children of foreign-born versus US-born mothers within different racial groups. The sample in this analysis contained 3426 mother-child pairs, of which 14.2% were foreign-born mothers. Adjusting for mother's race, education, and marital status, child's insurance coverage, and caregiver's perception of child's health, children of foreign-born mothers were less likely to use ED services compared with those born to US-born mothers (risk ratio [RR], 0.71 [0.54-0.94]). Emergency department utilization was lower among children of Hispanic, foreign-born mothers (RR, 0.67 [0.46-0.96]) and among children of non-Hispanic Asian or other race, foreign-born mothers (RR, 0.32 [0.14-0.74]) when compared with children of their US-born counterparts in the respective race. Maternal nativity status and race influence child's use of emergency department services. Future research should explore the intersection of parental nativity, immigrant documentation status, and citizenship status and how that may influence children's health care usage.

Revision and validation of a short scale to assess home environment for elementary school children in transnational families in Taiwan

PurposeTo develop and test a brief scale of the home environment of elementary school children in transnational families or vulnerable families. Design and methodsThe scale development process took place in three phases. In the first phase, a 61-item scale was generated by an expert panel based upon related literature and Chinese Home Observation for Measurement of the Environment (C-HOME). In the second phase 15 individual transnational families with elementary school children were interviewed, and items were reduced from 61 to 55 due to understandability or other practical considerations. Phase three's item analysis with 200 such families, reduced items to 41. Factor analysis followed, further reducing items to 27. Finally, the resulting 27-item scale underwent a test-retest with 57 subsample participants. ResultsAn iterative process of item and factor analyses identified a seven-dimensional, 27-item Home Environment Assessment Scale (HEAS), which accounted for 52.28% of the total variance. K-R 20 was 0.76. The test-retest reliability for the full sample total score was 0.97. ConclusionsThe results provide evidence supporting the scale consistency, content validity, and construct validity, and offer a useful instrument for health care professionals, especially pediatric nurses, to identify home environment interventions for young children in vulnerable families. Practice implicationsThe findings of HEAS-27 can serve to guide pediatric health care professionals in promptly screening, evaluating, and teaching families so that children in a vulnerable population have adequate quality and quantity of support in the home environment.

Confident and Understanding Parents (CUPs) - a child nutrition and active play pilot intervention for disadvantaged families attending Supported Playgroups in Victoria, Australia.

Health and nutrition inequalities are prevalent among families from socio-economically disadvantaged backgrounds. However, there is limited evidence of targeted early childhood nutrition and active play approaches due to the methodological challenges in engaging vulnerable families in research. The aim of this paper was to report findings from a pilot intervention called Confident and Understanding Parents (CUPs). CUPs aims to improve child nutrition and active play-related outcomes for children in vulnerable families. The intervention was delivered in six Supported Playgroups (SPs) in two disadvantaged locations in Victoria. Surveys incorporated knowledge and confidence measures and were administered pre- and post-training of SP facilitators along with pre-, immediately post and and 3 months postintervention to SP facilitators and parents. Qualitative data were collected via debriefing discussions with SP facilitators and ethnographic observations during SP sessions. Thematic analyses of qualitative data and statistical quantitative analyses were conducted. Nine SP facilitators completed training, of whom six delivered CUPs in SPs with 64 parents of children aged 0 to 4years from socially disadvantaged backgrounds. Forty-three parents (66%) attended a minimum of 50% of SP sessions with CUPs delivery. SP facilitators and parents demonstrated improved knowledge and confidence following the pilot. Learnings for implementation were identified. Overall, the CUPs intervention reached and engaged vulnerable families. A strength of the intervention is the flexibility offered to SP facilitators in selecting key messages and the strong focus on "local" translation of key child nutrition and active play messages within existing early childhood settings. A further strength was the adaptation of evaluation methodology to optimise the engagement of vulnerable families. SO WHAT?: This pilot study provides insights about engaging vulnerable families in a nutrition and active play intervention to promote child health. These promising findings warrant further implementation and rigorous evaluation of CUPs.

The role of formal support in the lives of children of mothers with intellectual disability.

Mothers with intellectual disability face socioeconomic disadvantage and social isolation, which is associated with poorer child outcomes. Social services feature prominently in the lives of mothers with intellectual disability especially those without informal support; however, the role of formal support in the lives of their children has not been explored. Seven children aged 7-11years took part in semi-structured interviews to explore their social experiences. Stories about interactions at home, school and with peers were analysed to illuminate influences, including social support, in their lives. Formal support can provide an enduring relationship for children from socially restricted homes when it focuses on the child's abilities, interests and needs as distinct from those of their mother. Child-focused support can be from a paid worker or volunteer. Family support services need to apply a child focus to improve the well-being of children in vulnerable families.

Predictors of Emergency Department Utilization Among Children in Vulnerable Families.

The aim of this study was to identify factors associated with high ED utilization among children in vulnerable families. The Fragile Families and Child Wellbeing Study is a longitudinal cohort of approximately 5000 vulnerable children. Data from the 9-year follow-up survey were used in this analysis. Bivariate and multivariate logistic regression analyses were performed to identify correlates with high ED utilization (≥4 visits per year). 2631 children were included in the analysis. In a multivariate model controlling for the child's sex, race, household income, and insurance status, 4 variables were significant predictors of ED utilization: history of hospitalization within the last year (odds ratio [OR], 15.97; 95% confidence interval [CI], 6.64-38.41; P < 0.001), diagnosis of asthma (OR, 2.53; 95% CI, 1.17-5.44; P = 0.02), number of child's office/clinic visits within the last year (OR, 1.22; 95% CI, 1.12-1.33; P < 0.001), and number of primary caregiver ED visits within last year (OR, 1.15; 95% CI, 1.03-1.28; P = 0.01). History of hospitalization, outpatient visits, primary caregiver ED utilization, and diagnosis of asthma independently predict high ED utilization by 9-year-old children in fragile families. Augmented continuity of care, disease management, and caregiver education may reduce high ED utilization in this population.

An Empirical Study on Performance of the Community Social Service Investment Program: Focused on Effects of Intensive Management Program for the Children in Vulnerable Families

한미현.March, 2012.지역사회서비스투자사업의 성과에 대한 실증 연구(An empirical study on performance of the community social service investment program),Report,서울한국보건사회연구원,24

Injury and Health Among Children in Vulnerable Families

Injury is the leading cause of death for children older than 1 year. The incidence of childhood injury varies greatly depending on social factors, including income, family violence, and other social stressors. This study reports the incidence of injury among children aged 5 years in a cohort of vulnerable families. The Fragile Families and Child Wellbeing Study is a longitudinal cohort of approximately 5,000 at-risk families across the United States. Data from interviews with mothers conducted shortly after giving birth and follow-up surveys at 1 year, 3 years, and 5 years were used. Multivariate regression analysis was used to identify independent risk factors for injury in year 5. Five-year follow-up data on injury was complete for 2,397 families. Two hundred ninety-six children were injured at the age of 5 years (12.3%). Multivariate regression found that the strongest predictors of injury in year 5 were male gender (OR, 2.62; 95% CI, 1.02-6.75; p = 0.04) and being in the lowest income stratum (OR, 1.23; 95% CI, 1.01-1.49; p = 0.03). Children in vulnerable families are at higher risk for injury. The incidence of 12.3% found in this cohort is substantially higher than CDC risk for 5-year-old children, that is, overall 9.3%. This longitudinal cohort has demonstrated a persistently elevated risk of childhood injury, but risk factors for injury have changed with age. As these children reached school age, low household income and male gender were risk factors for injury. This suggests that recognition of gender differences and targeted interventions for caregivers and play environments may be useful.

Injury and Health Among Toddlers in Vulnerable Families

Injury is consistently a leading cause of death for young children, and social stressors can increase injury risk. We investigated the incidence of injury and developmental and health outcomes among children up to 3 years of age in a cohort of vulnerable families. The Fragile Families and Child Wellbeing Study is a longitudinal cohort of approximately 5,000 families across the United States, which deliberately oversamples unwed couples and lower income families. Data from interviews with mothers conducted shortly after birth and follow-up surveys at 1 year and 3 years were used for this analysis. Multivariate regression analysis was used to identify independent risk factors for injury. Three-year follow-up data on injury were complete for 3,153 families. Three hundred nineteen children (10.2%) were injured in the first year and 386 (12.4%) in the third year. Eighty-one children suffered injuries noted in both survey periods. Children injured in the first year were twice as likely to have been reinjured in the third year, and previous injury was the strongest predictor of subsequent injury (OR, 1.96; 95% confidence interval, 1.41-2.71; p < 0.01). Injured children who were healthy as infants were nearly twice as likely to have "poor" or "fair" health as uninjured children in their third year (p < 0.01). Children in vulnerable families are at high risk for injury. In particular, children injured within the first year of life are at high risk for recurrent injury and poor health outcomes. Increased support and targeted interventions may improve outcomes and decrease childhood injury burden among at-risk families.