Parental Health Behaviors Research Articles

Influence of Parental Health Literacy on Change over Time in the Oral Health of American Indian Children.

In cross-sectional studies, parental health literacy (HL) is associated with children’s oral health. It is unclear, however, whether HL influences pediatric outcomes. We examined the relationship of HL with change over time in parental oral health knowledge, beliefs, and behaviors, as well as pediatric oral health outcomes. We used longitudinal data from a study designed to reduce dental decay in American Indian children (N = 579). At baseline and annually for three years, parents answered questions assessing HL; oral health knowledge, beliefs, and behaviors; and pediatric oral health status. The number of decayed, missing, and filled tooth surfaces (dmfs) was computed based on annual dental evaluations. Linear mixed models showed that HL was significantly associated with all constructs, except dmfs, at their reference time points and persistently across the three-year study period. HL predicted change over time in only one variable, parents’ belief that children’s oral health is determined by chance or luck. HL is strongly associated with oral health knowledge, beliefs, behaviors, and status prospectively but is not a key driver of change over time in these oral health constructs.

Alcohol use trajectories across the life course: Influences of childhood predictors and consequences for late-life health

BackgroundThe cumulative, negative health effects of alcohol consumption are exacerbated in older adulthood. We used a ‘life course epidemiology’ approach to explore how alcohol use trajectories develop across the lifespan, what early life events influence these trajectories and their associations with late-life health. MethodsSurvey data combined with retrospective life course history interviews were collected from 749 non-lifetime alcohol abstainer adults aged 61–81 years (51 % female).Frequency and quantity items of the AUDIT-C assessed alcohol use across each decade of life. Early life factors were childhood socioeconomic status, parental health behaviours, and age of drinking onset. Health outcomes were alcohol-related conditions. ResultsLatent class growth analysis yielded two life course trajectories for women: consistently infrequent, low quantity drinking (Group 1: 48 %) and increasingly frequent, low quantity drinking (Group 2: 52 %). Men showed three trajectories: consistently infrequent, low quantity drinking (Group 3: 36 %); increasingly frequent, low quantity drinking (Group 4: 51 %); and drinking with increasing frequency and quantity until midlife, after which consumption gradually declined (Group 5: 13 %). Better childhood socioeconomic status was associated with Groups 2 and 4. Later drinking onset was associated with Groups 1 and 3. Parental alcohol misuse, early drinking initiation and childhood socioeconomic adversity were predictive of Group 5. Those in Group 5 were five-to-seven times more likely to have alcohol-related comorbidities. ConclusionsEarly life experiences influence life course hazardous alcohol use. Interventions across the life course, from childhood, when drinking may be initiated, through to older adulthood, when sensitivity to alcohol increases, are needed.

Parental migrant status and health inequalities at birth: The role of immigrant educational selectivity

Immigrants tend to exhibit better health than natives despite immigrants' more disadvantaged socioeconomic status. This paradox has often been attributed to immigrants' pre-migration selectivity. However, most empirical studies investigating the role of selectivity have focused on adult health; less attention has been paid to children's birth outcomes outside the U.S. context. Using data from the Etude Longitudinale Française depuis l’Enfance (ELFE), a nationally representative sample of over 18000 births in France in 2011, we investigate the role of immigrant parents' educational selectivity in shaping four birth outcomes: birthweight, low birthweight, prematurity, and being born small for gestational age. Results from linear and logistic regressions confirm a health advantage for children of immigrants compared to natives despite lower parental socioeconomic status, mainly among children of Middle Eastern and North African parents. Immigrant parents' positive pre-migration educational selectivity explains most of this health advantage, predominantly among children with two immigrant parents. Further, mediation analyses indicate that the effect of educational selectivity is partially mediated by parental health behaviors, particularly smoking during pregnancy. Furthermore, analyses suggest that selectivity improves birth outcomes only for children of recent arrivals, with less than five years of residence in France. The beneficial effect of selectivity declines with length of residence, suggesting that a process of “unhealthy assimilation,” coupled with the cumulative exposure to health risks and disadvantaged living conditions, may lead to the erosion of the protective effect of immigrant selectivity.

A systematic review of human papillomavirus vaccination among US adolescents.

The human papillomavirus (HPV) causes many anogenital and oral cancers affecting young adults in the United States. Vaccination during adolescence can prevent HPV-associated cancers, but vaccine uptake among adolescents is low and influenced by factors serving as barriers and facilitators to HPV vaccination. In this systematic review, we synthesized research using the socioecological framework model to examine individual-level, relationship-level, community-level, and societal-level factors that influence HPV vaccine initiation and completion among US adolescents. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to guide the methodology for this review. An electronic search was conducted in January 2020 using PubMed, Cumulative Index of Nursing and Allied Health Literature, ProQuest Central, Scopus, and American Psychological Association PsycInfo databases. The Joanna Briggs Institute tools were used to assess the quality for the 57 studies included in this review. The most consistent influences of HPV vaccination included age at vaccination, awareness, and knowledge about HPV vaccination, socioeconomic status, insurance status, race/ethnicity, and preventative care behaviors at the individual level. Provider recommendation, familial/peer support of vaccination, and parental health behaviors were influences at the relationship level. Although fewer findings elucidated community-level and societal-level influences, high-poverty areas, high-risk communities with large proportions of racial/ethnic minority groups, healthcare facilities servicing children, and combined health policies appear to serve as facilitators of HPV initiation and completion. Findings from this review can inform culturally relevant and age-specific interventions and multi-level policies aiming to improve HPV vaccination coverage in the United States.

Pathways Through Which Health Literacy Is Linked to Parental Oral Health Behavior in an American Indian Tribe.

Health literacy (HL) is the "ability to find, understand, evaluate and put information to use to improve decision making and, ultimately, improve health and quality of life." Parents with limited HL are less likely to follow recommended parental oral health behaviors. We tested a theoretical framework designed to clarify mechanisms through which HL may influence parental oral health behavior. The framework proposed that HL: (a) has a direct effect on parental oral health knowledge, beliefs (i.e. self-efficacy; perceived susceptibility, severity, benefits, barriers), and behavior; (b) influences beliefs indirectly through knowledge; and (c) influences behavior indirectly through knowledge and beliefs. We analyzed cross-sectional data from a randomized controlled trial designed to reduce dental decay in American Indian children (N = 521). Parents completed survey questions assessing sociodemographic characteristics, HL, and parental oral health knowledge, beliefs, and behavior. Path analysis was used to test the framework. HL exerted significant direct effects on knowledge and beliefs but not behavior. HL had significant indirect effects on all beliefs through knowledge. Significant indirect effects of HL on behavior occurred through self-efficacy (estimate: 0.99, 95% CI: 0.42, 1.83, p = .005), perceived barriers (estimate: 0.73, 95% CI: 0.29, 1.43, p = .010), knowledge to self-efficacy (estimate: 0.57, 95% CI: .31, 0.98, p = .001), and knowledge to perceived barriers (estimate: 0.24, 95% CI: 0.09, 0.47, p = .012). HL exerted an indirect effect on parental oral health behavior, with knowledge, self-efficacy, and perceived barriers being the primary constructs linking HL to behavior.

Parental Mental Health and Children's Behaviors and Media Usage during COVID-19-Related School Closures.

BackgroundCoronavirus disease 2019 (COVID-19) is different from previous disasters in that it continues to the present and has affected all aspects of family life. During epidemics, psychosocial support is not less important than infection control. During COVID-19-related school closures, prolonged partial closures of schools could have detrimental social and health consequences for children and may increase the burden on the family. Based on a community sample in Korea, this study identified parental concerns, children's media usage, other various factors and examined whether parental stress level or depression were positively associated with problem behaviors, media exposure, and sleep problems of the primary school children during school closure under COVID-19.MethodsParticipants were 217 parents residing in Suwon, South Korea, who had primary school children and responded to a web-based questionnaire on parental concerns from school closure under COVID-19, subjective stress, depression, whether having received mental health services, and family characteristics; children's sleep patterns, problem behaviors, media usage during the online-only class period, and changes in activity level following the pandemic.ResultsDuring school closure, children gained body weight, spent less time in physical activities and more in media usage. Besides online learning content (97.2%), YouTube was highly used content (87.6%), and games followed (78.3%). Parental subjective stress index was highly associated with parental depression (Pearson correlation 0.439, P < 0.001), children's sleep problems (0.283, P < 0.001), tablet time (0.171, P = 0.012) and behavior problems (0.413, P < 0.001). Parental depression was associated with children's sleep problems (0.355, P < 0.001), TV time (0.153, P = 0.024), tablet time (0.159, P = 0.019), and behavior problems (0.524, P < 0.001). Parents who previously received mental services seemed to be more concerned about the problems their children already have getting worse because of COVID-19 than the disease itself. Children's sleep problem was associated with tablet (0.172, P = 0.011) and smartphone time (0.298, P < 0.001), but not its frequency.ConclusionDuring COVID-19-related school closures, many parents and children had various difficulties relating to mental health. Ongoing monitoring of mental health of high-risk groups and multiple support systems may need to be expanded to cover those parents having difficulty in caring for their children.

Zachowania zdrowotne rodziców dzieci nieuleczalnie chorych w aspekcie czynników socjodemograficznych

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Mirczak A. Health behaviors of parents caring for children with incurable diseases regarding sociodemographic factors. Medycyna Paliatywna/Palliative Medicine. 2021;13(1):37-43. doi:10.5114/pm.2021.103451. APA Mirczak, A. (2021). Health behaviors of parents caring for children with incurable diseases regarding sociodemographic factors. Medycyna Paliatywna/Palliative Medicine, 13(1), 37-43. https://doi.org/10.5114/pm.2021.103451 Chicago Mirczak, Anna. 2021. "Health behaviors of parents caring for children with incurable diseases regarding sociodemographic factors". Medycyna Paliatywna/Palliative Medicine 13 (1): 37-43. doi:10.5114/pm.2021.103451. Harvard Mirczak, A. (2021). Health behaviors of parents caring for children with incurable diseases regarding sociodemographic factors. Medycyna Paliatywna/Palliative Medicine, 13(1), pp.37-43. https://doi.org/10.5114/pm.2021.103451 MLA Mirczak, Anna. "Health behaviors of parents caring for children with incurable diseases regarding sociodemographic factors." Medycyna Paliatywna/Palliative Medicine, vol. 13, no. 1, 2021, pp. 37-43. doi:10.5114/pm.2021.103451. Vancouver Mirczak A. Health behaviors of parents caring for children with incurable diseases regarding sociodemographic factors. Medycyna Paliatywna/Palliative Medicine. 2021;13(1):37-43. doi:10.5114/pm.2021.103451.

Engaging fathers in the first 1000 days to improve perinatal outcomes and prevent obesity: Rationale and design of the First Heroes randomized trial

BackgroundEarly pregnancy through the first year of life represents an important period for family health promotion and obesity prevention. Overall, preventive interventions in pregnancy and infancy have insufficiently engaged fathers. We describe the rationale and design of First Heroes, an intervention to improve perinatal and obesity-related outcomes among mother-father-infant triads beginning in pregnancy. Methods/designFirst Heroes is a hybrid type 1 effectiveness-implementation randomized trial of mother-father-infant triads recruited in the second trimester of pregnancy from a large Obstetric practice in eastern Massachusetts and continuing through 12 months of infant age. Triads are randomized to the intervention arm or to an enhanced safety education control group. Triads randomized to the intervention arm receive three virtual visits with a health educator, in the 3rd trimester of pregnancy, at 3–4 weeks, and 3–4 months postpartum, and receive continuous multimedia education through text messaging, print material, and videos. The educational curriculum addresses parent health behaviors, family relationships, social determinants of health, and infant feeding, sleep, and development. The primary outcome is prevalence of rapid infant weight gain from birth to 6 months of age. Secondary outcomes include parent anthropometrics, parent obesogenic behaviors, family functioning, and infant behaviors. DiscussionFirst Heroes will evaluate the extent to which intentional mother-father dyad engagement, coaching on adoption of early life health behaviors, and addressing social determinants of health, influence obesogenic behaviors and outcomes in the first year of life. Findings from this work will inform future obesity prevention efforts, especially those focused on whole family inclusion.

The effect of the presence of children on adult smoking behaviour: empirical evidence based on China family panel studies

BackgroundDespite a number of studies linking family and marriage factors with health behaviour, the effects of children on the health behaviour of parents are still understudied. This study explored the association between the presence of children and adults’ smoking behaviours.MethodsThis study used panel data from the China Family Panel Studies 2010 and 2012, and the data set included 23,157 households and 45,513 adults. Logistic regression was performed to analyse the association of the presence of children on adults’ smoking behaviours. Subgroup regression was used to examine heterogeneous effects.ResultsFull sample regressions showed that the number of children was significantly inversely associated with smoking behaviour (OR = 0.93; 95% 0.90–0.96). Further subsample regression finds that such effect is only significant among the high-education group (OR = 0.92; 95% 0.87–0.97), high-skill workers (OR = 0.89; 95% 0.80–0.99) and couples who had an age gap greater than 2 years (OR = 0.91; 95% 0.88–0.95).ConclusionsOur findings confirm the existence of the upward intergenerational effect of the presence of children on adults’ smoking behaviour in China. However, such effects are not equal across all demographic characteristics. Future research could explore other parts of the upward mechanism and possible pathways for a stronger effect. In resource-poor areas, targeting cessation activities at those who have children at an early age may be an effective strategy.

Family Influences on Caries in Grenada.

If high-conflict family environments are cariogenic across cultures, and can be studied in cultures where both these environments and cariogenic dental practices are particularly prevalent, this would afford the opportunity to examine how these two pathways of risk might interact, laying the stage for culturally competent, integrated prevention efforts. The first investigation involved qualitative data about perceptions of oral health and family stressors in Grenadian families with school-aged children. The second study used a questionnaire and observational data to assess relations among oral health behaviors, relationship satisfaction, parenting, and child behavior; it also included a pilot study of Motivational Interviewing. Most of the themes discussed in focus groups suggested overlap between U.S. and Grenadian parents; possible culture-specific issues were high prevalence of single-parent homes, normativity of physical discipline, less preventive dental care, and more fatalistic view of oral health outcomes. Significant associations were found between parent and child oral health behaviors, between child externalizing and internalizing behaviors, and between family variables (e.g., relationship satisfaction, child behavior) and oral health behaviors (e.g., parent flossing, child brush time). The results strongly support the need for research on the relations between family functioning and oral health to be embedded within culture.

17.F. Workshop: Building preconception care into existing health services: challenges and opportunities

Abstract Maternal health and health behaviours prior to conception have significant short and long term impacts on maternal and child health. The World Health Organization acknowledges the importance of health care before conception-referred to as 'preconception care' (PCC) -to reduce maternal and childhood morbidity and mortality. PCC is an approach to health promotion and preventive medicine that focuses on interventions that identify and modify biomedical, behavioural and social risks to a parental health or pregnancy outcome. By its nature, PCC relates to care before pregnancy, whether it be a first pregnancy or between consecutive pregnancies. PCC has received increased attention due to growing evidence that maternal health prior to conception can directly affect the health of the mother and the fetal environment during pregnancy. PCC research emphasises the impact of the fetal environment on adverse outcomes such as miscarriage, stillbirth, congenital disorders, and macrosomia. Parental preconception health also been found to impact on risk of the development of chronic diseases such as obesity, diabetes and cardiovascular disease, and cancer across the life course through epigenetic and other cellular responses to developmental exposures. Parental health behaviours that are important in the context of PCC include diet, smoking, and alcohol consumption. Similarly, parental exposure to environmental risk factors, such as phthalates, air pollution and pesticides can increase risk of congenital defects, behavioural issues and cancer in the child. Despite the importance of preconception health, and the potential impact of PCC, there are significant translation gaps between the available evidence and public awareness, clinician knowledge and available health services. This workshop aims to facilitate a deep and rich discussion about the challenges and opportunities associated with (1) improving preconception health in the general population and (2) developing PCC services and interventions that align with existing health services and meet population needs and expectations. The workshop will begin with four short presentations (10 minutes) to orient workshop participants to key literature with a focus on the following topics (1) the interface between public health and preconception health and care; (2) nutrition and lifestyle behaviours in the preconception period; (3) environmental exposures in the preconception period; and (4) considerations for person-centred PCC. Following these presentations, the workshop team will facilitate discussions among breakout groups to identify local challenges and opportunities. This workshop will conclude with a shared discussion consolidating the outcomes of the breakout discussions. Key messages Preconception care offers an untapped opportunity to leverage decades of research to develop initiatives that target couples before pregnancy and improve population health for multiple generations. Preconception health initiatives that address local challenges and opportunities may successfully modify parental health behaviours to reduce risk of chronic illness.

Swim Program Pilot for Children with Autism: Impact on Behaviors and Health.

The purpose of this mixed methods pre-/post-pilot intervention study was to assess parental psychological health and child challenging behaviors before and after a swimming program for children with autism. Participants were 10 parent-child dyads. Child's challenging behaviors were lower in the post testing (Cohen's d = 0.07-0.45). Mean scores were improved for parent perception of general health (Cohen's d = 0.22). Three themes emerged from the post swim program focus group: (a) Parent satisfaction with instructors with sub themes (i) firmness (ii) creativity, and (iii) promotion of social interaction and sharing, (b) improved child sleeping, and (c) family dynamics with sub themes (i) siblings wanted to swim and (ii) parents' fear of drowning. Preliminary results point to improved child behaviors and parent perception of general health. Future studies can focus on expanding the swim program to include all family members.

Health Literacy and Parental Oral Health Knowledge, Beliefs, Behavior, and Status Among Parents of American Indian Newborns.

To examine the relationship between health literacy (HL) and parental oral health knowledge, beliefs, behavior, and self-reported oral health status (OHS) among parents of American Indian (AI) children. This analysis used baseline data from a randomized controlled trial that tested an oral health intervention with parents of AI newborns. Participants were recruited in parent-child dyads (N = 579). Parents completed items assessing sociodemographic characteristics, HL, and parental oral health knowledge, beliefs, behavior, and self-reported OHS. We examined the correlation of HL with each oral health construct, controlling for parent age and income. On average, parents felt quite confident in their HL skills, performed well on questions assessing parental oral health knowledge, and endorsed beliefs likely to encourage positive parental oral health behaviors (e.g., confidence that one can successfully engage in such behaviors). Parents with more limited HL had significantly less knowledge, perceived cavities to be less severe, perceived more barriers and fewer benefits to recommended oral health behaviors, were less confident they could engage in these behaviors, and were more likely to believe their children's oral health was under the control of the dentist or a matter of chance (P values < 0.001). Limited HL was not associated with behavior (P > 0.05) but was linked to worse self-reported OHS (P = 0.040). HL was associated with parental oral health knowledge, beliefs, and self-reported OHS. Oral health education interventions targeting AI families should facilitate development of knowledge and positive oral health beliefs among parents with more limited HL skills.

Pathways between parental and individual determinants of dental caries and dental visit behaviours among children: Validation of a new conceptual model.

To delineate the pathways between the parental and individual determinants of dental caries and dental visit behaviours among children, using path analysis. The study employed an observational design; the study sample consisted of 583 parent-child dyads. Data were collected using a sociodemographic and oral health behaviour form, the Parenting Styles and Dimensions Questionnaire, the Corah Dental Anxiety Scale and the Children's Fear Survey Schedule-Dental Subscale. A conceptual model was developed, and it consisted of four endogenous variables (dental caries, children's oral health, dental visit behaviours and children's dental anxiety) and four exogenous ones (parental socioeconomic status, parental dental anxiety, parental oral health behaviours and parenting style). Path analysis was used to test the compatibility of the conceptual model, with a statistical significance at P<.001. 49.1% of participants (n=286) were male. The mean age of participants was 8.3 (SD=2.1). The mean DMFT score was 6.0 (SD=3.0) and the mean Frankl behaviour score 3.0 (SD=1.0). Parental socioeconomic status showed the strongest association with dental caries (β=.276; P<.001), and children's dental anxiety had the strongest association with dental visit behaviours (β=-.414; P<.001). Parental socioeconomic status and oral health behaviours were directly associated with dental caries (P<.001), and parental socioeconomic status had the most association. Parenting style and parental and children's dental anxiety were associated with dental visit behaviours (P<.001). Further, while all parental variables except prior exposure to training about oral and dental health were significantly correlated with dental caries, only educational level and coverage by health insurance were significantly associated with Frankl behaviour scale score. This study developed and validated a conceptual model that delineates the pathways between the parental and individual determinants of children's oral health and dental visit behaviours. The model should help us to understand these pathways to lower the incidence of dental caries and improve dental visit behaviours among children.

Oral Health Knowledge, Attitudes and Behaviour of Parents and Caregivers of Preschool Children: Implications for Oral Health Promotion.

The aim of this study was to describe oral health knowledge, attitudes and behaviours of parents and caregivers of preschool children in order to inform an oral health promotion strategy. A sample of parents and caregivers of children attending nine randomly selected preschools in central Trinidad were invited to complete a self-administered questionnaire on early childhood oral health. A total of 309 parents and caregivers participated: 88% were female, 74.4% were of Indian ethnicity, with 50.4% in manual employment, and 50.2% educated to secondary level. 59.1% felt a child's first dental visit should be when all primary teeth are present. 64% had not taken their child for a dental visit. 81.6% rated their child's oral health as good or better and 28% would want an asymptomatic, decayed primary tooth extracted rather than filled. Over 80% used fluoride toothpaste. 52.8% always supervised their child's toothbrushing, and 44% claimed to be using the recommended pea-size amount. 26.2% reported having used a sweetened feeding bottle or infant feeder at night. Parents and caregivers of preschool children in this sample had reasonable oral health knowledge. However, despite generally positive attitudes towards preventive oral healthcare, confusion regarding dental attendance, supervised toothbrushing, fluoride use and sugar intake suggests that these items require particular emphasis in oral health promotion programmes aimed at improving early childhood oral health.

Social influence of adult children on parental health behavior among South Asian immigrants: findings from the MASALA (Mediators of Atherosclerosis in South Asians Living in America) study

ABSTRACT Objectives: Examine the social influence of adult children on the cardiovascular-related health behaviors of older South Asian (SA) immigrants to inform lifestyle interventions. Design: This mixed-methods study used data from an ancillary study of social networks (2014–2018) in the Mediators of Atherosclerosis in South Asians Living in America cohort. Phase 1 was a quantitative analysis of self-reported diet and physical activity among SA adults (n = 448, mean age = 58 years, SD 8.4) who named at least one adult child to their social network. The Alternative Healthy Eating Index (AHEI) was used to measure parents’ diet; higher numbers indicate a healthier diet (range 0–110). Phase 2 was a thematic content analysis of in-depth qualitative interviews from a subsample of these parents (n = 23, mean age = 55, SD 7.6). Results: Parents with an adult child in their network who consumed uncooked vegetables daily had mean parental AHEI score 1.5 points higher (adjusted p-value = 0.03) than those who had a child in the network who ate uncooked vegetables less often. When at least one adult child in their network ate fresh fruit daily compared to less frequently or when at least one child ate non-SA food daily compared to less frequently, mean parental AHEI scores were higher by 2.0 (adjusted p-value = 0.01) and 1.6 (adjusted p-value = 0.03) points respectively. Parents with an adult child in their network who exercised at least weekly were more likely to meet guideline-recommended physical activity levels than parents with children who exercised less often (76% v. 56%, adjusted p-value = 0.02). Adult children provided social support and were seen as ‘role models’ for healthy behavior, especially when adopting Western health behaviors. Conclusion: Positive role modeling and support from adult children were important facilitators of healthy behavior change in older SA immigrants and can inform health behavior interventions for SA adults.

What Can We Learn from Parents of Caries-Free and Caries-Active Hispanic Children?

This study evaluated strength-based motivators within Hispanic families that support the creation of health in their children. A mixed-methods approach was used to understand differences in Hispanic parental factors between caries-free (CF) and caries-active (CA) children. A cross-sectional survey was conducted with 200 parent-child triads (primary child: between 0 and 6 y; reference child: between 0 and 10 y) recruited from health centers in the Denver Metro area. All the participating children received an oral examination, and the triads were grouped as CF or CA based on the caries status of the primary child. Qualitative data were collected through in-depth individual interviews with the parents. The analysis only involved the primary child. Bivariable analysis were conducted between parent factors (independent variables) and presence or absence of caries (outcome variable). The variables with P < 0.20 in the bivariable analysis were subjected to 2 multivariable logistic regression models. The children in the CF group had mean (SD) age of 2.8 (1.28) y compared to the CA group at 4.0 (1.55) y (P < 0.001). Bivariable analysis demonstrated that parents in the CF group reported higher oral hygiene behavior scores (P = 0.047), perceived fewer barriers (P = 0.009) to accessing preventive dental care, and considered their children more susceptible to cavities (P = 0.001) compared to parents in the CA group. Multivariable model (adjusting for socioeconomic characteristics) demonstrated that parents of CF children perceived high susceptibility to caries for their children (P = 0.040). Multivariable model (adjusting for acculturation) demonstrated an association of parental oral hygiene behavior (P = 0.040) and parent-perceived susceptibility to caries (P = 0.010) with CF child status. Qualitative interviews revealed that parents in the CF group were concerned about their children's higher susceptibility to caries and tried to establish good oral hygiene routines for their children. The results of this study demonstrated that parental behaviors and health beliefs could be significant determinants of caries status in Hispanic children. Results of this study indicate that parental oral health beliefs and behaviors are significant determinants of caries status in children of Hispanic population. Parental beliefs could motivate them to take action or establish behavior that prevents dental caries in their children. Health care providers and caries prevention efforts can incorporate this information to tailor oral health promotional messaging and approaches to improve the oral health of Hispanic children.

Facilitators and Barriers to Access to Pediatric Medical Services in a Community Hospital.

Background: Missed medical appointments decrease continuity of medical care, waste resources, and may affect health outcomes. We examined the factors associated with missed children’s supervision visits in Eastern Brooklyn, NY, USA. Methods: We surveyed guardians whose children received routine medical care at four pediatric clinics. Participants filled out a questionnaire that queried: demographics, food security, recent relocation, parental support of healthy behaviors, and length of knowing provider. Preexisting disease(s) and missed visits were retrieved from medical records. Regression analyses were used to determine factors that were associated with missing medical appointments. Results: Among 213 families, 33% faced food insecurity and 16.4% reported moving within the past 12 months. Forty percent of children missed at least 1 visit. Food insecurity (adjusted odds ratio [aOR] 2.3, 95% confidence interval [CI 1.0% to 5.2%) and recent relocation (aOR 1.8, 95% CI 1.1-3.4 were associated with missed health supervision visits, whereas greater parental healthy behaviors (aOR 0.5, 95% CI 0.3-0.9) and longer length of knowing provider (aOR 0.8, 95% CI 0.7-1.0) were associated with fewer missed appointments. Conclusion: This study indicates that social inequity may contribute to poor adherence to medical appointments through multiple mechanisms, including food insecurity, lack of social stability, and parental health behaviors. Multidimensional proactive prevention, and reactive tolerance should be considered as opportunities to mitigate the impact of social inequity on health outcomes.

Parental health literacy and health behaviors in children: a 2017 cross-sectional survey in Germany

Abstract Background Health literacy (HL) is closely associated with leading health indicators. Parents represent a critical subgroup among the adult population since they are not only responsible for their own health but also for the health of their children. Previous research suggests that parents with low HL are less likely to meet the preventive and health care needs of their children but the relationship between parental HL and child health is not yet well understood. Methods A cross-sectional survey was implemented in 2017 in 28 public schools in Germany. The parent questionnaire was completed by 4217 caregivers and included the short form of the HLS-EU-Q16. The child questionnaire examined health knowledge, behaviors and outcomes. For children under 11 years, the caregiver reported on behalf of their children (N = 1518). In all other cases, the children completed the questionnaires (N = 2776). Bivariate and multivariate analyses were carried out. Results Among the interviewed parents, 45.8% showed a problematic or inadequate HL. Parents with higher HL reported a better subjective health and quality of life, and they judged their children as being healthier. The major determinant of high parental HL was socio-economic status (r=.088***). High parental HL was associated with positive health behaviors in children including higher consumption of fruits and vegetables, fewer sweetened beverages, regular tooth brushing and more physical activity. The relationships between parental HL and smoking, alcohol consumption, sexual activity among children and children’s weight were not significant. Conclusions The results confirm a relationship between low parental HL, SES and some problematic health behaviors in children. Strengthening the HL of vulnerable parents may contribute to improved health outcomes particularly in the areas of children’s nutrition, exercise and dental health, and parents should be integrated in school-based activities of health promotion and prevention. Key messages There is a strong statistical relationship between parental health literacy and socio-economic status. Parental health literacy is associated with child health behaviors (e.g., nutrition, exercise).

Parental active tracking measures and health behaviors during high school and college

Objective: This study developed and tested new measures of youth perceptions of parental active efforts to track their activities during adolescence and college. Participants and Methods: Between March and October 2016, a sample of 314 college students aged 18–25 completed a survey including their perceptions of their parent’s active tracking efforts during high school and college. Items were then analyzed, and internally consistent measures were derived. Results: The new measures demonstrated significant convergent validity with the three sources of parental knowledge constructs (parental solicitation, parental control, and youth disclosure). Greater perceived parental active tracking efforts during adolescence and in college were associated with better health behaviors in both time periods. Conclusions: The newly derived measures represent appropriate and predictive indices of parental tracking behaviors during adolescence and college, designed specifically with these populations in mind, to be used in pre-intervention and intervention work with parents.