Child Care Health and Development最新文献

Background: Physical activity and sedentary time are independently associated with health and developmental outcomes in preschool children. However, the integrated nature of these behaviours on early life outcomes, particularly during childcare hours, is currently understudied. As such, the aim of this study was to examine the association between preschool children's physical activity and sedentary time during childcare and various developmental outcomes (psychosocial, cognitive and fundamental movement skills).

Methods: A total of 107 preschool children (M_age: 41 ± 6 months) recruited from London, Canada, wore ActiGraph wGT3X-BT accelerometers during childcare hours to measure their sedentary time, light intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity (MVPA). Developmental outcomes, including psychosocial health (internalising, externalising, prosocial behaviour), indicators of cognitive development (memory, inhibitory control) and fundamental movement skills (locomotor control, object control, total fundamental movement), were assessed using validated tools. Compositional regression and isotemporal substitution models were estimated to examine how movement compositions in childcare were associated with developmental outcomes.

Results: Engaging in more MVPA relative to LPA and sedentary time was associated with fewer internalising symptoms and better total fundamental movement skills and object control skills, whilst spending more time in LPA relative to MVPA and sedentary time was associated with more internalising symptoms and worse object control skills. Isotemporal substitution models suggested that theoretically increasing sedentary time or engaging in MVPA at the expense of time engaging in LPA during childcare is associated with lower internalising symptoms.

Conclusion: The findings of this study provide preliminary evidence that engaging in MVPA during childcare, at the expense of time in LPA or sedentary time, is associated with children's fundamental movement skills and psychosocial development. Further longitudinal research is required, with larger samples of young children, to assess the mechanisms through which childcare movement behaviour compositions may interact with developmental outcomes, including contextualising both sedentary time and LPA.

Trial registration: ClinicalTrials.gov identifier: NCT05359536.

Background: Transition readiness, or skills and preparation for navigating adult health care, is an important factor in the successful transition from child and adolescent mental health services (CAMHS) to adult care; however, predictors of transition readiness are not fully understood. One factor which may impact transition readiness among youth accessing CAMHS is the presence of a co-occurring physical health condition; however, this has not been previously examined. Within a cohort of youth receiving CAMHS, the objective of this study was to understand if there is an association between co-occurring physical health conditions and transition readiness and if this relationship is impacted by severity of mental health symptoms.

Methods: This study was a secondary analysis of baseline data from the Longitudinal Youth in Transition Study, including 237 16- to 18-year-old youth accessing outpatient CAMHS from four different clinical sites. Participants completed self-report measures on mental health symptoms, functioning, service use, transition readiness, and physical health conditions. Multiple linear regression models were used to measure the association between the presence of health conditions and transition readiness scores as well as determine if there was an interaction between mental health symptoms and physical health conditions to predict transition readiness.

Results: Co-occurring physical conditions were reported by 41% of youth and were associated with greater overall transition readiness. There was no interaction between mental health symptom severity and co-occurring physical conditions, though attention problems were independently associated with lower transition readiness scores.

Conclusions: Youth accessing CAMHS who have a co-occurring physical condition have overall greater transition readiness than youth without a co-occurring condition. Further research should explore the role of frequency and types of healthcare encounters in transition readiness for transition age youth needing ongoing mental health care to better understand how to support self-management and care navigation skill development.

Background: Young carers are children or adolescents who provide significant care to another family member who has an illness or disability. This situation impacts their physical and mental health, and their social and school life. Nonetheless, this vulnerable population is often covert, which makes YCs' identification a major challenge. One of the methods in the literature to identify them consists of obtaining the adolescent's report of a relative's illness or disability, coupled with the standardized psychometric evaluation of their level of care. To date, no research had compared adolescents' and parents' perspectives using this method, while this would enable to gain insights on YCs' identification. The objective of this study was to compare parents' and adolescents' reports on the identification of an ill or disabled relative within the household, and adolescents' levels of caring activities.

Methods: Survey data were collected from 776 adolescents (mean age = 12.76 years; 55.50% of females) and one of their parents (mean age = 44.31 years; 83.76% of females). They completed questionnaires evaluating their sociodemographic characteristics, illnesses or disabilities within their household, and adolescents' levels of caring activities (MACA-YC 18). Cohen's κ for interrater agreement, Student's t-tests and chi-square tests of independence were performed for child-parent responses comparisons.

Results: Fewer adolescents reported that there was an ill or disabled relative within the household compared with their parents. Only 27.56% of the dyads agreed both on the person who was ill or disabled and the illness or disability. The dyads were more often in agreement when the ill or disabled relative had a serious somatic illness and was the mother. On the other hand, adolescents reported engaging in higher levels of caregiving activities than indicated by their parents' assessments.

Conclusion: This study highlights the difference of perception between parents and adolescents both on illness and disability reports, and on adolescents' levels of caring activities. These two points of view seem complementary, suggesting that combining adolescents' and parents' perspectives can aid in better identifying young carers.

Background: The American Academy of Pediatrics recommends that adolescents with chronic health conditions begin to assume responsibility for their own care by age 14. The goal of this qualitative one-time interview study is to learn how 14- to 16-year-old adolescents with chronic health conditions begin to develop self-management skills and the role that caregivers play in the learning process.

Methods: Twenty adolescents ages 14-16 with chronic renal (n = 5), gastrointestinal (n = 5), hematologic (n = 5), or rheumatologic (n = 5) diseases, and 20 caregivers (dyads), completed individual semi-structured interviews discussing the adolescents' current degree of self-management. Six coders analyzed transcripts using thematic framework analysis.

Results: Three primary themes emerged: continuum, motivations, and tools. Both adolescents and caregivers described progress along a self-management continuum with varying levels of responsibility for the adolescents, ranging from passive to responsible. Caregivers' behaviors similarly varied from directive management to supported self-management. Motivations for self-management skills were described in relation to one's health, self, and others. Families utilized a variety of tools to facilitate movement toward supported self-management with the adolescent.

Conclusions: The development of adolescent self-management of their chronic condition is a complex, shifting continuum between caregiver and adolescent. This continuum may be impacted by adolescent motivation and tools/problem solving available to the family. Pediatric healthcare providers can support self-management by assessing and attending to each patient's motivations; building a road map individualized to each patient's skills; and offering time in outpatient clinic to practice self-management strategies.

Background: This study was conducted to examine in depth the disease management experiences of school-age children with celiac disease and the effects of family, friends, and teachers on disease management at school.

Methods: The study employed a qualitative research method using the phenomenology design. Face-to-face, semi-structured, in-depth interviews were conducted with children (n = 14) with celiac disease. The transcripts were analysed using a phenomenological approach and an inductive process.

Results: Three main themes were identified: Individual, Institutional, and Environmental. It was observed that children adapted better to the celiac diet as they got older, but they had difficulty adjusting to the diet in the school environment. In addition, it was found that school-age children had challenges in diagnosing the disease and finding products suitable for the diet in a rural city with limited facilities. It was determined that the approaches of peers and teachers throughout the child's school life affected the disease management levels of children.

Conclusion: The study reveals the emotional, cognitive, and behavioural difficulties that children face while adapting to celiac disease and diet, especially in the school environment. The results emphasize that school-age children with celiac disease should not be ignored and that the school nurse plays an essential role in this process.