Disadvantaged Backgrounds Research Articles

S11-3 Implementation of Community-Based Physical Activity Promotion Focusing on Individuals with Social Disadvantages, Developed Using a Participatory Approach

BackgroundRecently, the German Federal Ministry of Health has provided funding aimed at the sustainable implementation of the National Recommendations for Physical Activity and Physical Activity Promotion in German municipalities. This presentation reports on an ongoing project that employs a participatory action model for population-based physical activity (PA) promotion in these municipalities and gives insights into real-world experiences made during project implementation.MethodsUsing a participatory approach, an action model for PA promotion was developed in collaboration with 64 nationwide stakeholders (Phase I). Based on systematic criteria and in cooperation with the Federal Centre for Health Education (BzGA) and the German Statutory Health Insurance (GKV), three rural districts and three cities were then selected as pilot municipalities. In phase II, the action model was implemented in these six communities. Implementation steps included (1) preparation, (2) assessment, and (3) setting up a steering committee and a cooperative planning group in all communities. The entire process was closely coordinated with local administrations. Currently, cocreated measures adapted to local needs are being (4) developed and (5) implemented, with a particular focus on improving access to the development and usage of these measures for people with social disadvantages.ResultsPreliminary results indicate that steps (1) to (3) have been successfully implemented in all pilot municipalities. ‘Champions’ (persons committed to the local project) were found to be particularly important for each step. The involvement of political stakeholders (n = 2-13), experts (n = 2-12), representatives from the administration (n = 8-25), multipliers (n = 5-16), and citizens (n = 0-4) in the cooperative planning process varied across pilot municipalities. Participants from the administration represented different sectors (e.g. city planning, sports, health administration). Preliminary results show that a broad range of measures was developed to promote personal skills, infrastructures, policy actions, and community action for PA.ConclusionsThe action model proved suitable to promote PA in the pilot municipalities. In all six cases, adaptations had to be made to accommodate the intervention to the respective community-specific context. Our results indicate that involving individuals from a socially disadvantaged background remains a particular challenge of participatory PA promotion.

Preschool participation and students’ learning outcomes in primary school: Evidence from national reform of pre-primary education in Ethiopia

This study examines whether a large expansion of pre-primary education in Ethiopia affected subsequent students’ learning outcomes during the national reform of pre-primary education. The study utilizes two comparable, representative early grade reading assessment data that straddle the reform period from 2010 to 2016, during which enrolment rates in pre-primary education soared by nearly ten times nationwide. We find that associations between preschool participation and literacy outcomes were positive and significant after the expansion, yet no such relationships were observed before the reform. However, there was little heterogeneity in the gains of the preschool participation by gender, urbanity, and parental literacy. We discuss implications for ongoing reform, including strategic and inclusive policy designed to close the learning gap between children from advantaged and disadvantaged backgrounds.

Nursing Student Engagement with Their Learning: A Mixed Methods Study

Student engagement in educational activities is essential for achieving desired learning outcomes. Despite this, little is known about the engagement patterns of nursing students from diverse or disadvantaged backgrounds. A mixed method study was conducted to explore engagement patterns within and outside the classroom but not during clinical placements. Students were asked what engagement means to them and what influences their engagement. Students were also asked how many hours they engaged in each of their undergraduate subjects and the reasons for this. The study was conducted at an Australian education provider. All students (n = 240) enrolled in the Bachelor of Nursing course were invited to participate. Lecture attendance was high at the start of the semester, fluctuated weekly and declined as the semester progressed. Students averaged between 3.5 and 4.4 hours of engagement per subject per week. They defined engagement as actually coming to class and a commitment to learning. Students were engaged by new, interesting content and disengaged by repetitive or complex content and poor tutoring. Most students want to engage but are distracted by intrinsic and extrinsic factors. Research should explore how to best assess students without the concurrent academic workload interfering with their studies.

How unique are terrorist suspects? Investigating similarities and differences between terrorist suspects, their siblings, and other suspects

This article contributes to the debate in terrorism research on how unique terrorist suspects (i.e. individuals suspected of crimes with terrorist intent) actually are and whether or not specific theories are necessary to explain their behavior. Our study compares terrorist suspects from the Netherlands with their siblings and nonterrorist suspects to find out whether and how terrorist suspects are unique. Inspired by criminological theories involving social bonds, regression analyses were conducted utilizing registry data on household compositions, socio-economic status (SES), and criminal histories. A key finding is that terrorist suspects seem to have more in common with other suspects than with their siblings; besides prior criminal involvement, no significant differences were found between terrorist suspects and other suspects. Terrorist suspects were significantly less often married, had a lower SES, and were more often previously suspected of crimes as compared to their siblings. Particularly, lacking employment is a differentiating factor for terrorist suspects and siblings. Our findings stress the necessity to investigate in-depth under what circumstances and how a disadvantaged background (e.g. lack of social bonds, criminal history) can lead to becoming a terrorist suspect.

Are local students disadvantaged? Understanding institutional, local and national sense of belonging in higher education

AbstractResearch on inequality in higher education (HE) is often dominated by class‐based assumptions about traditional and non‐traditional students. This binary distinction emphasising students’ socio‐economic status tends to oversimply the complexity of educational inequality, neglecting crucial factors which affect the perception of social position. Therefore, this study aims to investigate the understanding of inequalities in HE with new data on the meaning of locality, using evidence from comparative studies of institutions. Locality is interpreted as an inclusive concept capturing place identity as well as local attachments based on language, culture and the natural environment. The qualitative and quantitative data were collected from 192 participants in three distinctly different HE institutions, which were deliberately selected according to their socio‐economic, cultural, and institutional status. This mixed methods research confirms the importance of different types of belonging at institutional, local and national levels, and their different effects on student groups. The study captures to what extent geographical mobility is associated with social class, by examining students’ sense of belonging and their interpretation of locality in universities across Wales. It challenges the notion of disadvantaged background, and poses a critical question about cultural and geographical familiarity. This study therefore enriches the current debates about the impact of social inequality alongside social class on students’ belonging, success and retention in HE.

Polarized adult fertility patterns following early parental death

Death of a parent during childhood has become rare in developed countries but remains an important life course event that may have consequences for family formation. This paper describes the link between parental death before age 18 and fertility outcomes in adulthood. Using the large national 2011 French Family Survey (INSEE–INED), we focus on the 1946–66 birth cohorts, for whom we observe entire fertility histories. The sample includes 11,854 respondents who have lost at least one parent before age 18. We find a strong polarization of fertility behaviours among orphaned males, more pronounced for those coming from a disadvantaged background. More often childless, particularly when parental death occurred in adolescence, some seem to retreat from parenthood. But orphaned men and women who do become parents seem to embrace family life, by beginning childbearing earlier and having more children, especially when the deceased parent is of the same sex.

Let’s Stick Together: Peer Effects in Secondary School Choice and Variations by Student Socio-Economic Background

AbstractDespite the vast body of research focusing on peer effects in education, the role of the immediate peer environment in school choice has been understudied to date. We study the extent to which students from the same primary school cluster in the same secondary school, and how this effect varies by a student’s socio-economic background. We use register data from the Netherlands, covering six cohorts of students (2013–2019), that enable us to account for selection into primary schools and other endogeneity issues when identifying peer effects. The results indicate that students are more likely to choose a secondary school when students from their primary school cohort also choose this school, even after accounting for school popularity trends. We find evidence that students from socially disadvantaged backgrounds are more likely to cluster in the same secondary school as their primary school peers, yet these differences are small.

Diagnostika a intervence u sociálně podmíněného mentálního postižení: kvalitativní studie v praxi českých pedagogicko-psychologických poraden

The aim of this pilot qualitative research was to take an insight into how counseling psychologists perceive the concept of socially conditioned intellectual disability (further only SCID). Specifically, to find out if they are aware of this concept, their attitude towards it, diagnostic practice, and potential supportive interventions. Data were obtained through a semi-structured interview of 10 respondents (Median experience = 6 years), from 9 Children´s e­ducational care centres (5 regions of the Czech Republic). The obtained data were analyzed by thematic analysis with the elements of the grounded theory using the technique of open coding. The analysis showed that none of the respondents explicitly use the term SCID, however, the term is implicitly present in their practice. According to the respondents, the concept could serve as an inspiration for a broader reflection on the etiology of „suspiciously low“ scores in intellectual tests and the intellectual potential of the child. In practice, the respondents most often determine the conclusion about the level of intellectual and adaptive abilities based only on standardized tests of intellect. The respondents do not use tests and scales for adaptive behaviour, social and family environment – mainly due to a lack of staff and time capacity. The respondents perceive the differential diagnosis of SCID from intellectual disability as complicated. Half of the respondents see dynamic assessment as a promising approach to differentiate between SCID and intellectual disability. The respondents provide follow-up support and interventions to children who may fit the SCID concept very marginally due to limited capacity. The interviews also provided several potential suggestions for practice – the need to create a clear and generally accepted definition of SCID, conduct an assessment in greater depth and complexity, and intensify cooperation with the family of a child from a socially disadvantaged background and other related institutions.

Blended Learning Challenges During COVID-19: A Case of Cost Accounting 2 Students at a Selected South African Higher Education Institution

Every sector in the twenty-first century makes use of technology for its activities, especially during the COVID-19 pandemic and higher education institutions are not exceptional. However, the cohorts enrolled in the selected higher education institution are from technologically challenged backgrounds. This suggests that in their previous schooling, technology was unemployed as a learning aid. As this may present some challenges for such students, this study aims to investigate challenges experienced by Cost Accounting 2 students who are from a technologically disadvantaged background. To accomplish that, a quantitative approach was used since it permits surveys to be delivered to the entire impacted population while also reducing sampling error. Because of the Coronavirus, online questionnaires were sent to 400 students, but only 119 (n=119) responded. Blended learning was found to be an effective technique for learning Cost Accounting 2 since the university provided sufficient information on how to use the system. However, there was a lot of discussion about internet access, learning materials access, and library resource access. Based on the findings, blended learning is excellent for studying Cost Accounting 2 as long as the learning management system is customised such that students can navigate it effortlessly. Management must work with internet service providers to try stabilise internet connectivity in the students’ neighbourhoods. The additional study can be done using a variety of research methods and target other groups of students.

Active Learning: A Shift from Passive Learning to Student Engagement Improves Understanding and Contextualization of Nutrition and Community Health

Challenging the notion of “teaching by telling,” active learning utilizes a student-oriented approach by emphasizing the concept of knowledge retention through peer interaction. To further examine the potential of active learning, we created a workshop based on didactic education and student collaboration. Participants included undergraduate students from traditionally underrepresented and disadvantaged backgrounds. The workshop was part of our summer academic enrichment program run in an urban, medically underserved community. The workshop focused on clinical and biochemical nutrition, wherein students synthesized information by discussing dietary choices and the socioeconomic aspects of nutrition. Student reception of the workshop was adjudged by anonymous surveys. The survey questions were designed to gauge how the workshop objectives were achieved. Cronbach alpha (0.276) confirmed that there was more than a single theme contained in the questions. The majority of students (97%) agreed that the workshop met the learning objectives: (1) acquire basic clinical knowledge, (2) gain a better understanding of nutrition, (3) formulate a linkage between clinical nutrition and disease, and (4) benefit from peer interaction. Students’ performance in the post-quiz (100% correct answers) had improved significantly compared to the pre-quiz (25% correct answers) suggesting acquisition, understanding and application of nutrition aspects taught in the workshop. Overall, the present study demonstrated the engagement and understanding of students with respect to learning about nutrition and community health in an active learning setting. These types of active-learning-based sessions may have broad applicability for any academic discipline to improve student engagement and knowledge retention.

Effectiveness of Life Skills Intervention for Children From Disadvantaged Backgrounds: Insights Form 4-year Longitudinal Study

The present study examines the effectiveness of an After-School Life Skills (ASLS) intervention to improve the life skills of 110 students from socially disadvantaged backgrounds at public schools of urban Bangalore in south India. These students completed ASLS intervention from 2014 to 2018 during which the life skills were assessed on a yearly interval and the data were analyzed using repeated measure ANOVA. The results show that ASLS intervention significantly improved the students’ life skills. Post hoc comparisons at time 1 shows that young students who participated in ASLS intervention significantly improved their life skills over the 4 years’ time, although no significant variances were observed between measurement periods. The overall effect was found to be significant in improving the life skills, which shows that integrating life skills education in the school curriculum is critical and a timely need.

Protocol for a randomised controlled trial of a family strengthening program to prevent unhealthy weight gain among 5 to 11-year-old children from at-risk families: the Strong Families Trial

BackgroundObesity is an increasing health concern in Australia among adult and child populations alike and is often associated with other serious comorbidities. While the rise in the prevalence of childhood obesity has plateaued in high-income countries, it continues to increase among children from disadvantaged and culturally diverse backgrounds. The family environment of disadvantaged populations may increase the risk of childhood obesity through unhealthy eating and lifestyle practices. The Strong Families Trial aims to assess the effectiveness of a mixed behavioural and lifestyle intervention for parents and carers of at-risk populations, i.e. families from culturally diverse and disadvantaged backgrounds, in preventing unhealthy weight gain among children aged 5 to 11 years.MethodsEight hundred families from low socio-economic areas in Greater Western Sydney, NSW, and Melbourne, VIC, will be recruited and randomised into a lifestyle intervention or control group. The intervention comprises 90-minute weekly sessions for 6 weeks (plus two-booster sessions) of an integrated, evidence-based, parenting and lifestyle program that accounts for the influences of family functioning. Primary (anthropometric data) and secondary (family functioning, feeding related parenting, physical activity, consumption of healthy foods, health literacy, family and household costs) outcome measures will be assessed at baseline, immediately following the intervention, and 12 months post-intervention.DiscussionThis study will elucidate methods for engaging socially disadvantaged and culturally diverse groups in parenting programs concerned with child weight status.Trial RegistrationThis study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619001019190). Registered 16 July 2019.

Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: study protocol for the RETURN randomised controlled trial

BackgroundPeople with disadvantaged backgrounds are less likely to visit the dentist for planned care, even though they have disproportionately poorer oral health. They are correspondingly more likely to experience dental problems and use urgent dental care, general practices and Accident and Emergency departments, which not only makes meeting their needs expensive, but, since these services often rely on prescriptions rather than addressing the clinical cause, can contribute to antimicrobial resistance.MethodsThe RETURN intervention has been developed with substantial community co-production, to be delivered opportunistically in urgent dental care settings. This brief intervention is delivered by dental nurses and involves material relevant to the ‘in-group’ targeted. The material includes booklets relating to barriers to planned dental visiting with corresponding short video clips featuring local people and including a modelling element. Dental nurses are trained to have supportive and non-judgemental conversations, assisting patients to set personal goals and action plans, which are reinforced in a follow-up text within a few weeks. A randomised controlled trial will be undertaken in 3 types of sites: dental practices delivering urgent care (a) within working hours, (b) out of hours, and (c) in a Dental Hospital. The trial will recruit 1180 adult urgent dental care users over 12 months, who have not visited a dentist for a planned care appointment for 2 years or more and do not have a dentist who they visit for routine care. It aims to investigate the effectiveness and cost-effectiveness of the intervention and to explore whether the intervention has different effects across the socio-economic gradient. Participants will be followed up at 6, 12 and 18 months after randomisation. Co-primary outcomes are attendance at a dental practice for planned care within 12 months and self-reported oral health-related quality of life at 12 months.DiscussionThis is a pragmatic trial, evaluating the effectiveness of the intervention under the usual condition in which it might be applied. Since dental practices work as independent contractors to the NHS, this brings implementation and fidelity challenges which will be explored and described in embedded qualitative work.Trial registrationISRCTN registry identifier ISRCTN84666712. Registered 12/04/2021.

Socioeconomic determinants of respiratory health in patients with cystic fibrosis: implications for treatment strategies

Introduction : Great variation exists in the progression and outcomes of cystic fibrosis (CF) lung disease, due to both genetic and environmental influences. Social determinants mediate environmental exposures and treatment success; people with CF from socioeconomically disadvantaged backgrounds have worse health and die younger than those in more advantaged positions. Areas covered : This paper reviews the literature on the mechanisms that are responsible for generating and sustaining disparities in CF health, and the ways by which social determinants translate into health advantages or disadvantages in people with CF. The authors make recommendations for addressing social risk factors in CF clinical practice. Expert opinion : Socioeconomic factors are not dichotomous and their impact is felt at every step of the social ladder. CF care programs need to adopt a systematic protocol to screen for health-related social risk factors, and then connect patients to available resources to meet individual needs. Considerations such as daycare, schooling options, living and working conditions, and opportunities for physical exercise and recreation as well as promotion of self-efficacy are often overlooked. In addition, advocacy for changes in public policies on health insurance, environmental regulations, social welfare, and education would all help address the root causes of CF health inequities.

Uneven impacts of COVID-19 on the attendance rates of secondary school students from different socioeconomic backgrounds in Australia: A quasi-experimental analysis of administrative data.

This paper contributes to the growing body of research that demonstrates uneven impacts of the COVID‐19 pandemic on educational outcomes of students from different socioeconomic status (SES) backgrounds. We evaluate the early impacts of COVID‐19 on student attendance in secondary school and show how these impacts depend on students' SES. We employ a quasi‐experimental design, using difference‐in‐differences (DiD) estimation extended to incorporate third‐order differences over time between low‐SES and other students, and pre‐ versus during‐COVID‐19, leveraging robust administrative data extracted from the registers of the Tasmanian Department of Education. Using data from multiple cohorts of secondary school students in government schools in Tasmania (N = 14,135), we find that while the attendance rates were similar pre‐ and during‐COVID‐19 for high‐SES students, there was a significant drop in attendance rates during COVID‐19 among socioeconomically disadvantaged students, demonstrating the more pronounced impacts of COVID‐19 for these students. The findings demonstrate that even “relatively short” lockdowns, as those in Tasmania in 2020 (30–40 days of home learning), can significantly affect the learning experiences of students from socioeconomically disadvantaged backgrounds. We discuss the implications of this for future pandemic planning in educational policy and practice and how this needs to be addressed in Australia's COVID‐19 recovery.

Exploring the Effects of Gender Differences and Widowhood Status on the Days Spent in Poor Health: A Secondary Data Analysis from India.

The majority of research in India has focused on the impact of widowhood on health status and health care use, while little emphasis has beenpaid to the number of days spent in poor health among widowed population compare to other marital categories. Thus, the current study explores the relationship between widowhood and days spent with poor health outcomes among adultsin India. Additionally, gender differences in the relationship between widowhood and days with poor health outcomes are further studied.The research employed nationally representative cross-sectional data from the 75th round (2017-2018) of the National Sample Survey (NSS). To investigate the associations of marital status (married vs widowed) and other factors with days spent in poor health, a negative binomial regression model was used. Additionally, the interaction model of age and widowhood was estimated separately for men and women.The findings suggest that widowed individuals had consistently prolonged days with an illness, limited activity, and confinement to bed. After adjusting for socioeconomic and demographic characteristics, the findings suggested that widowed women (IRR = 1.141, 95% Confidence interval = 1.01-1.29) were more likely to spend days with limited acitivitiesthan married women. The marital status-age interaction indicated that older widowed women were more likely to have days of restricted activity and confinement to bed than married women, but such link is absent for men.In India, the elderly widow often spends her days confined to bed and prolonged days with limited activity. Policymakers and practitioners in public health should develop effective policies and programmes to enhance the health and well-being of widowed women, particularly those from socioeconomically disadvantaged backgrounds.

Segregation and success in Tasmanian primary school sport carnivals

ABSTRACT Australian schooling is one of the most segregated systems in the OECD, with much focus on the inequality between schools from poorer areas compared with those from wealthier suburbs. These inequalities have been explored in terms of infrastructure and funding, as well as their relative academic achievement. Previous research has also found that children from more disadvantaged backgrounds are more likely to have poorer health than their wealthier peers. To determine whether there is a connection between these findings, this study investigates the impact of social and educational advantage on participation and success in primary school sports carnivals in Tasmania. It examined the results of Tasmanian primary schools across interschool cross-country carnivals between 2009 and 2019 and found that structural segregation existed across all competitions. Multiple regression was used to see if the Index of Community Socio-Educational Advantage (ICSEA), total school enrolments and geographic location predicted school cross-country rank. It was found that school size, geographic region and ICSEA all played an independent role in determining the participation and success of schools. Implications of these findings are discussed.

Returns to education in China: Evidence from the great higher education expansion

China experienced a near 5-fold increase in annual Higher Education (HE) enrolment in the decade starting in 1999. Using the China Household Finance Survey, we show that the Great HE Expansion has exacerbated a large pre-existing urban-rural gap in educational attainment underpinned by the hukou (household registration) system. We instrument the years of schooling with the interaction between urban hukou status during childhood and the timing of the expansion – in essence a difference-in-differences estimator using rural students to control for common time trends. We find that the Great HE raised earnings by 17% for men and 12% for women respectively, allowing for county fixed-effects. These Two Stage Least Squares (2SLS) estimates, which are robust to additional controls for hukou status at birth fully interacted with birth hukou province, can be interpreted as the Local Average Treatment Effect (LATE) of education on earnings for urban students who enrolled in HE only because of the Great HE Expansion. For the selected subsample of respondents with parental education information, we find that the 2SLS returns for students from more disadvantaged backgrounds are at least as high as their more advantaged counterparts, for both genders.

Supporting racial, ethnic minority, and disadvantaged undergraduate nursing students with honors projects.

Underrepresented racial and ethnic minority (UREM) and disadvantaged background (DB) students often feel a lack of belonging and community in higher education. Participation in Honors Programs has been shown to build a sense of belonging and community associated with short and long-term benefits for both students and their academic institutions. To describe the program we implemented (the MM program) to increase UREM and DB student representation in a SON Honors Program. A prospective, descriptive study of SON UREM and DB honors students with a May graduation date of 2017-2020. A total of 129 students completed honors with 23 MM UREM and DB students completing honors. Seven received highest honors award distinction that exemplifies exceptional work at a level beyond usually high expectations. A supportive environment for UREM and DB students with resources are essential for students to consider and also complete an honors project.

Using WhatsApp to Enhance International Distance Education at the University of South Africa.

Open distance e-learning (ODeL) is an essential form of e-learning for students in South Africa. It allows expanded access to higher education for students from rural or socioeconomically disadvantaged backgrounds. One of the key features of ODeL is that students can complete coursework modules virtually, without the need to step onto a physical university campus. Students from rural areas are able to participate in higher education, something they otherwise would not have had access to without ODeL. Information and Communication Technologies (ICTs), including messaging apps like WhatsApp, provide students with informal and formal learning opportunities, increase access to academic and community resources, and mitigate some Internet connectivity issues. Students are able to use WhatsApp to build connections with students and share class materials, without access to an Internet-connected computer. Using ICTs to enhance access to higher education is one way to bridge the wide socioeconomic gap in South Africa. This paper argues for additional non-Western research on socio-technical marginalization and access to ICTs for students enrolled at higher education institutions in South Africa.