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Developing Children's Health Behaviors within the Family Context

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Children's Health".

Deadline for manuscript submissions: closed (15 November 2021) | Viewed by 36720

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Special Issue Editors

Dr. Stephanie Mazzucca

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Guest Editor

Brown School, Washington University, St. Louis, MO 63130, USA
Interests: public health; nutrition; physical activity; dissemination and implementation research; early care and education settings

Dr. Courtney Luecking

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Guest Editor

Department of Dietetics and Human Nutrition, College of Agricultre, Food and Environment, University of Kentucky, Lexington, KY, USA
Interests: nutrition; public health; dissemination and implementation research; community-based interventions; maternal and child health; family engagement

Dr. Cody Neshteruk

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Guest Editor

Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27707, USA
Interests: physical activity; nutrition; parenting; obesity prevention; obesity treatment; children’s health

Prof. Dr. Dianne S. Ward

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Guest Editor

1. Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
2. Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Interests: behavior science; nutrition; physical activity; children’s health; obesity
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Families play an integral role in children’s development, with great influence on aspects including healthy eating, physical activity, screen time, and sleep behaviors. Understanding the family context and strategies for the promotion of health behaviors have the potential to improve family health outcomes and have lasting impact. The complexities of working with families, including the heterogeneity of the family unit, role of external caregivers, and the social determinants of health, demand special attention. This Special Issue will highlight studies focusing on the development of children’s health behaviors within the family context.

In particular, we are interested in research conducted in the many settings that can support families with health promotion efforts, including primary health care, early care and education settings, schools, faith-based organizations, and social service organizations, among others. We are also interested in work focusing on underserved groups, including racial/ethnic minorities, immigrants, indigenous populations, those living in rural or remote areas, and/or low- and middle-income countries. We will consider a variety of research papers, including reviews, observational studies, and intervention or implementation trials.

We look forward to receiving your excellent submissions.

Dr. Stephanie Mazzucca
Dr. Courtney Luecking
Dr. Cody Neshteruk
Prof. Dr. Dianne S. Ward
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

nutrition
physical activity
screen time
sleep
family
children
social determinants of health
underserved populations

Published Papers (9 papers)

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Research

Jump to: Review

15 pages, 758 KiB

Open AccessArticle

Efficacy of an Enhanced Implementation Strategy to Increase Parent Engagement with a Health Promotion Program in Childcare

by Courtney T. Luecking, Cody D. Neshteruk, Stephanie Mazzucca and Dianne S. Ward

Int. J. Environ. Res. Public Health 2022, 19(1), 106; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010106 - 23 Dec 2021

Cited by 1 | Viewed by 2357

Abstract

Previous efforts to involve parents in implementation of childcare-based health promotion interventions have yielded limited success, suggesting a need for different implementation strategies. This study evaluated the efficacy of an enhanced implementation strategy to increase parent engagement with Healthy Me, Healthy We. This quasi-experimental study included childcare centers from the second of two waves of a cluster-randomized trial. The standard approach (giving parents intervention materials, prompting participation at home, inviting participation with classroom events) was delivered in 2016–2017 (29 centers, 116 providers, and 199 parents). The enhanced approach (standard plus seeking feedback, identifying and addressing barriers to parent participation) was delivered in 2017–2018 (13 centers, 57 providers, and 114 parents). Parent engagement was evaluated at two levels. For the center-level, structured interview questions with providers throughout the intervention were systematically scored. For the parent-level, parents completed surveys following the intervention. Differences in parent engagement were evaluated using linear regression (center-level) and mixed effects (parent-level) models. Statistical significance was set at p < 0.025 for two primary outcomes. There was no difference in parent engagement between approaches at the center-level, β = −1.45 (95% confidence interval, −4.76 to 1.87), p = 0.38l. However, the enhanced approach had higher parent-level scores, β = 3.60, (95% confidence interval, 1.49 to 5.75), p < 0.001. In the enhanced approach group, providers consistently reported greater satisfaction with the intervention than parents (p < 0.001), yet their fidelity of implementing the enhanced approach was low (less than 20%). Results show promise that parent engagement with childcare-based health promotion innovations can positively respond to appropriately designed and executed implementation strategies, but strategies need to be feasible and acceptable for all stakeholders. Full article

(This article belongs to the Special Issue Developing Children's Health Behaviors within the Family Context)

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15 pages, 697 KiB

Open AccessArticle

Family Support as Smoking Prevention during Transition from Early to Late Adolescence: A Study in 42 Countries

by Apolinaras Zaborskis, Aistė Kavaliauskienė, Charli Eriksson, Ellen Klemera, Elitsa Dimitrova, Marina Melkumova and Daniela Husarova

Int. J. Environ. Res. Public Health 2021, 18(23), 12739; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182312739 - 02 Dec 2021

Cited by 7 | Viewed by 2052

Abstract

Family support has a beneficial impact on protecting health-risk behaviour in adolescents. This study aimed to explore whether family support is associated with risk of smoking during transition from early (11 years) to late (15 years) adolescence across 42 countries. The data from the cross-national Health Behaviour in School-aged Children (HBSC) study in 2017/2018 were employed (N = 195,966). Family support was measured using the four-item Family dimension of the Multidimensional Scale of Perceived Social Support (sum score 20 or more was categorised as high family support). Smoking was defined as a reported cigarette smoking at least 1–2 days in the last 30 days. The association between smoking and family support was assessed using a prevalence ratio (PR) obtained from the multivariate Poisson regression. Over two thirds of adolescents reported high levels of support from their family. Family support was found to significantly decrease with age in most of the countries, with the boys reported high level of family support more often than girls. The adolescents who reported having low family support also were more likely to smoke compared to their peers who reported having high family support (PR = 1.81; 95% CI: 1.71–1.91 in boys, and PR = 2.19; 95% CI: 2.08–2.31 in girls). The countries with a stronger effect of family support in reducing smoking risk indicated lower rates of adolescent smoking as well as lower increases in the cigarette smoking prevalence during the age period from 11 to 15 years. This study reinforces the need for family support, which is an important asset helping adolescents to overcome the risk of smoking during their transition from early to late adolescence. Full article

(This article belongs to the Special Issue Developing Children's Health Behaviors within the Family Context)

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9 pages, 312 KiB

Open AccessArticle

Screen Time Parenting Practices and Associations with Preschool Children’s TV Viewing and Weight-Related Outcomes

by Cody D. Neshteruk, Gina L. Tripicchio, Stephanie Lobaugh, Amber E. Vaughn, Courtney T. Luecking, Stephanie Mazzucca and Dianne S. Ward

Int. J. Environ. Res. Public Health 2021, 18(14), 7359; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147359 - 09 Jul 2021

Cited by 10 | Viewed by 3246

Abstract

The purpose of this study was to examine associations between screen time (ST) parenting practices and 2–5-year-old children’s TV viewing and weight status. Data were collected from 252 parent–child dyads enrolled in a randomized parent-focused childhood obesity prevention trial from 2009–2012. ST parenting practices were assessed at baseline using a validated parent-reported survey. Parent-reported child TV viewing and objectively measured anthropometrics were assessed at baseline, post-intervention (35 weeks), and follow-up (59 weeks). Marginal effect models were developed to test the association between baseline ST parenting practices and children’s TV viewing, BMI z-score, and waist circumference across all time points. Limiting/monitoring ST was associated with decreased weekly TV viewing (β = −1.79, 95% CI: −2.61; −0.95), while exposure to TV was associated with more weekly TV viewing over 59 weeks (β = 1.23, 95% CI: 0.71; 1.75). Greater parent use of ST as a reward was associated with increased child BMI z-score (β = 0.15, 95% CI: 0.03; 0.27), while limiting/monitoring ST was associated with decreased BMI z-score (β = −0.16, 95% CI: −0.30; −0.01) and smaller waist circumference (β = −0.55, 95% CI: −1.04; −0.06) over the study period. These findings suggest that modifying parent ST practices may be an important strategy to reduce ST and promote healthy weight in young children. Full article

(This article belongs to the Special Issue Developing Children's Health Behaviors within the Family Context)

19 pages, 359 KiB

Open AccessArticle

Sociodemographic Correlates of Parental Co-Participation in Digital Media Use and Physical Play of Preschool-Age Children

by Elina Hasanen, Henriikka Koivukoski, Lauri Kortelainen, Hanna Vehmas and Arja Sääkslahti

Int. J. Environ. Res. Public Health 2021, 18(11), 5903; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115903 - 31 May 2021

Cited by 6 | Viewed by 3654

Abstract

Young children’s digital media use and physical activity have gained attention in recent research. Parental co-participation has a major impact on children’s health consequences. This study addressed a gap in the research by investigating daily parental co-participation in children’s digital media use and physical play, using the family ecological model theoretical framework. The participants in this nationally representative cross-sectional study were 2512 Finnish parents with two- to six-year-old children. Parents completed a questionnaire. Sociodemographic correlates of co-participation and of the awareness of guidelines regarding co-participation and correlation between co-participation in digital media use and physical play were analysed. Parental co-participation in physical play and digital media use correlated positively. Lower parental age, male parental gender, Finnish and Swedish languages, a fewer number of children, and a male child gender were associated with more co-participation in one or both activities, and parental female gender and low family income were associated with more awareness. The awareness of guidelines was not associated with co-participation in digital media use. There were sociodemographic differences in parental co-participation. From a health counselling perspective, parents may benefit from national recommendations on digital media use and physical activity, but adherence to guidelines depends on the family context. Full article

(This article belongs to the Special Issue Developing Children's Health Behaviors within the Family Context)

12 pages, 324 KiB

Open AccessFeature PaperArticle

Development and Validation of a Parental Health-Related Empowerment Scale with Low Income Parents

by Roger Figueroa, Cristina M. Gago, Jacob Beckerman-Hsu, Alyssa Aftosmes-Tobio, Xinting Yu, Kirsten K. Davison and Janine J. Jurkowski

Int. J. Environ. Res. Public Health 2020, 17(22), 8645; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17228645 - 20 Nov 2020

Cited by 7 | Viewed by 2965

Abstract

Objectives: Consistent with empowerment theory, parental empowerment acts as a mechanism of change in family-based interventions to support child health. Yet, there are no comprehensive, validated measures of parental health-related empowerment to test this important perspective. Informed by empowerment theory and in the context of a community-based obesity intervention, we developed a self-report measure of parental health-related empowerment and tested its preliminary validity with low-income parents. Methods: The Parental Empowerment through Awareness, Relationships, and Resources (PEARR) is a 21-item scale designed to measure three subdimensions of empowerment including resource empowerment, critical awareness, and relational empowerment. In the fall of 2017 or the fall of 2018, low-income parents (n = 770, 88% mothers) from 16 Head Start programs in Greater Boston completed the PEARR. The resulting data were randomly split into two equal samples with complete data. The factorial structure of the PEARR was tested in the first half of the sample using principal component analysis (PCA) and exploratory factor analysis (EFA) and subsequently confirmed with the second half of the sample using confirmatory factor analysis (CFA). Internal consistency coefficients were calculated for the final subscales. Results: Results from the PCA and EFA analyses identified three component factors (eigenvalues = 8.25, 2.75, 2.12) with all items loading significantly onto the hypothesized subdimension (β > 0.59 and p < 0.01). The three-factor model was subsequently confirmed with the second half of the sample using CFA (β > 0.54 and p < 0.01). Fit indices met minimum criteria (Comparative Fit Index = 0.95, Root Mean Square Error of Approximation = 0.05 (0.05, 0.06), Standardized Root-Mean-Square Residual = 0.05). Subscales demonstrated strong internal consistency (α= 0.83–0.90). Conclusions: Results support initial validity of a brief survey measuring parental empowerment for child health among Head Start parents. The PEARR can be utilized to measure changes in parental empowerment through interventions targeting empowerment as a mechanism of change. Full article

(This article belongs to the Special Issue Developing Children's Health Behaviors within the Family Context)

23 pages, 1790 KiB

Open AccessArticle

Testing the Effects of COVID-19 Confinement in Spanish Children: The Role of Parents’ Distress, Emotional Problems and Specific Parenting

by Estrella Romero, Laura López-Romero, Beatriz Domínguez-Álvarez, Paula Villar and Jose Antonio Gómez-Fraguela

Int. J. Environ. Res. Public Health 2020, 17(19), 6975; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17196975 - 24 Sep 2020

Cited by 146 | Viewed by 11692

Abstract

The present study aimed to examine the effects of the Spanish confinement derived from the COVID-19 crisis on children and their families, accounting for child’s age. A range of child negative (e.g., conduct problems) and positive outcomes (e.g., routine maintenance) were examined, along with a set of parent-related variables, including resilience, perceived distress, emotional problems, parenting distress and specific parenting practices (e.g., structured or avoidant parenting), which were modeled through path analysis to better understand child adjustment. Data were collected in April 2020, with information for the present study provided by 940 (89.6%) mothers, 102 (9.7%) fathers and 7 (0.7%) different caregivers, who informed on 1049 Spanish children (50.4% girls) aged 3 to 12 years (M_age = 7.29; SD = 2.39). The results suggested that, according to parents’ information, most children did not show important changes in behavior, although some increasing rates were observed for both negative and positive outcomes. Child adjustment was influenced by a chain of effects, derived from parents’ perceived distress and emotional response to the COVID-19 crisis, via parenting distress and specific parenting practices. While parenting distress in particular triggered child negative outcomes, specific parenting practices were more closely related to child positive outcomes. These findings may help to better inform, for potential future outbreaks, effective guidelines and prevention programs aimed at promoting the child’s well-being in the family. Full article

(This article belongs to the Special Issue Developing Children's Health Behaviors within the Family Context)

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25 pages, 527 KiB

Open AccessArticle

The Association between Parental Involvement Behavior and Self-Esteem among Adolescents Living in Poverty: Results from the K-CHILD Study

by Satomi Doi, Aya Isumi and Takeo Fujiwara

Int. J. Environ. Res. Public Health 2020, 17(17), 6277; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176277 - 28 Aug 2020

Cited by 5 | Viewed by 3927

Abstract

It is not yet known why some adolescents living in poverty show high self-esteem, while others do not. Parental involvement may be an important determinant to promote self-esteem among adolescents living in poverty. The aim of this study is to explore better parenting involvement behavior to promote self-esteem among adolescents living in poverty. Participants included fifth-, eighth-, and 11th-grade students living in Koichi prefecture, Japan. The participants were part of the Kochi Child Health Impact of Living Difficulty (K-CHILD) study, in 2016 (n = 10,784). Participants completed a questionnaire with questions about socioeconomic status and 14 parental involvement behaviors, including 9 specific kinds of parental interactions with their child (e.g., talking about school life), and 5 elements related to parental care for their child’s physical health (e.g., access to health care). The numbers of parental involvement behaviors, parental interactions with their child, and parental care for their child’s physical health were treated as continuous and quartile, to see the association. Overall, the study showed that the larger the number of parental involvement behaviors, the higher the self-esteem score of their off-spring (p < 0.01) among both adolescents living in poverty and not living in poverty, in which interaction between poverty and parental involvement behaviors was not significant. Both parental interaction with their child and parental care for their child’s physical health were associated with higher self-esteem, in which parental interaction with their child had a larger effect than parental care for their child’s physical health. To empower adolescents in poverty, caregivers need to provide both parental interaction with the child and parental care for the child’s physical health. Full article

(This article belongs to the Special Issue Developing Children's Health Behaviors within the Family Context)

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17 pages, 334 KiB

Open AccessArticle

Parental Perspectives and Experiences in Relation to Lifestyle-Related Practices in the First Two Years of a Child’s Life: A Qualitative Study in a Disadvantaged Neighborhood in The Netherlands

by Gülcan Bektas, Femke Boelsma, Vivianne E. Baur, Jacob C. Seidell and S. Coosje Dijkstra

Int. J. Environ. Res. Public Health 2020, 17(16), 5838; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17165838 - 12 Aug 2020

Cited by 5 | Viewed by 2489

Abstract

The first two years of a child’s life are a critical period in preventing several lifestyle-related health problems. A qualitative study was conducted to explore parental experiences and perspectives in relation to lifestyle-related child-rearing practices in order to minimize risk factors at an early stage. Data were collected through interviews (n = 25) and focus groups (n = 4) with parents of children aged 0–2 years, in a disadvantaged neighborhood in Amsterdam, the Netherlands. Results showed that parents were often uncertain about a number of lifestyle-related practices. Ambiguity also appeared regarding the parents’ intentions to engage in certain practices and what they were able to achieve in everyday life. In addition, parents experienced strong sociocultural influences from their family, which interfered with their ability to make their own decisions on lifestyle-related practices. Parents also expressed a need for peer-support and confirmation of their practices. Future studies should focus on supporting parents in their parental practices during the first two years of their child’s life. Any such study should take into account the specific sociocultural context accompanying lifestyle-related parental practices. Full article

(This article belongs to the Special Issue Developing Children's Health Behaviors within the Family Context)

Review

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13 pages, 744 KiB

Open AccessReview

Learned Experience and Resource Dilution: Conceptualizing Sibling Influences on Parents’ Feeding Practices

by Cara F. Ruggiero, Susan M. McHale, Ian M. Paul and Jennifer S. Savage

Int. J. Environ. Res. Public Health 2021, 18(11), 5739; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115739 - 27 May 2021

Cited by 10 | Viewed by 2637

Abstract

Studies from diverse cultures report mixed results in the relationship between birth order and risk for obesity. Explanations may thus lie in the postnatal period when growth is shaped by the family environment, including parental feeding practices, which may be affected by siblings. Consistent with a family systems perspective, we describe two processes that may explain birth order effects on parental feeding practices and child outcomes: learned experience and resource dilution. Parents learn from experience when earlier-born children influence their parents’ knowledge, expectations, and behavior toward later-born siblings through their behaviors and characteristics—which can have both positive and negative implications. Resource dilution is a process whereby the birth of each child limits the time, attention and other resources parents have to devote to any one of their children. The goal of this review is to provide a theoretical basis for examining potential sibling influences on parental responsive feeding toward developing recommendations for future research and practice aimed at preventing obesity throughout family systems. Full article

(This article belongs to the Special Issue Developing Children's Health Behaviors within the Family Context)

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