Child Care Health and Development最新文献

Background: Early childhood educators (ECEs) play a key role in fostering healthy behaviours, such as physical activity (PA), in young children, yet their own PA levels are not well characterized. Understanding ECEs' PA is important given their potential to model active behaviours in childcare settings.

Methods: This systematic review and meta-analysis synthesized ECEs' PA levels, focusing on (1) time spent in moderate-to-vigorous PA (MVPA); (2) the proportion of ECEs meeting the World Health Organization's (WHO) PA recommendation for adults; and (3) associations between ECEs' and children's PA. Seven databases were systematically searched using terms related to PA, childcare/education and childhood. Eligible studies reported quantitative data for at least one objective. Data for objectively measured MVPA and WHO guideline adherence were pooled using meta-analyses, and associations with children's PA were narratively synthesized. Twenty-one studies (5291 participants) met inclusion criteria; 18 reported on MVPA (11 in meta-analysis), 11 on guideline adherence and 6 on associations.

Results: ECEs accumulated an average of 223.6 min/week of MVPA (95% CI: 83.6-363.5), exceeding WHO guidelines but with high variability (I² = 97.6%). Overall, 52.6% (95% CI: 35.9%-68.8%; I² = 97.3%) of educators met the adult 24-h PA guidelines, with study-level proportions ranging from 21% to 92%. Narrative findings indicated modest but generally positive associations between ECEs' and children's PA.

Conclusions: Many ECEs meet or exceed WHO PA guidelines, underscoring their potential as active role models in childcare settings. Strengthening ECEs' capacity to support movement-rich environments could further enhance benefits for both educators and children through consistent, collaborative approaches.

Background: Only half the children in Fiji meet both physical activity (PA) and screen time (ST) recommendations. Understanding factors associated with meeting these recommendations is important to inform the development of policies and programmes to encourage healthy behaviours. This study aimed to examine the association between Fijian caregivers' and children's attitudes, subjective norms and perceived behavioural control and their or their child's adherence to physical activity and screen time guidelines.

Methods: We investigated Fijian caregivers and children aged 5-17 years attitudes, subjective norms and perceived behavioural control towards meeting PA and ST guidelines through an online survey. The survey explored these factors and their associations with meeting the Asia-Pacific Integrated 24-h Activity Guidelines for Children and Adolescents.

Results: A total of 1015 caregivers and 699 of their children completed the survey. Caregivers (OR = 1.4, CI 1.003-1.862) and children 5-8 years (OR = 16.5, CI 1.227-222.665) who believed being active would make them happier were more likely to meet PA recommendations compared to those not meeting PA recommendations. Caregivers who set ST restrictions (OR = 1.5, CI 1.252-1.816) and believed ST rules helped their child meet recommendations (OR = 1.3, CI 1.052-1.505) were more likely to have children who met ST recommendations versus not meet ST recommendations. Children aged 5-8 and older children/adolescents aged 9-17 who had easy access to screens were less likely to meet ST recommendations (OR = 0.5, CI 0.224-0.984) and (OR = 0.5, CI 0.324-0.802), respectively, compared to those who did meet ST recommendations. Children aged 5-8 years who believed it was important to follow the guidance of religious leaders were more likely to meet ST recommendations (OR = 5.4, CI 2.423-12.002) compared to those who did not meet the ST recommendation.

Conclusion: Communicating through trusted community figures (such as teachers and religious leaders for younger children and ministries for caregivers) is recommended for future initiatives to increase adherence to guidelines among children and adolescents in Fiji. These initiatives should also emphasise the link between PA and both happiness and academic performance, while exploring ways to support caregivers in enforcing ST restrictions.

Background: Early identification and diagnosis of autism are essential steps in supporting children and families. In rural communities, families can experience significant challenges in accessing an autism diagnosis.

Methods: We conducted semistructured interviews with four groups of participants: managers (n = 11), diagnosticians (n = 7), clinicians (n = 14) and parents/caregivers (n = 20) across six regions in Northern Ontario to learn of barriers and facilitators in accessing an autism diagnosis. Two independent coders coded each transcript and used inductive thematic analysis to identify themes across participants and regions.

Results: Five themes were generated from participants: (1) Gaps in autism knowledge delay early identification for children requiring an autism assessment; (2) complex systems create navigation barriers for families in knowing where to seek help; (3) families with limited access to resources face delays in the early identification process; (4) staffing challenges exacerbate barriers within the autism diagnostic process; and (5) collaboration among health disciplines while using a culturally responsive approach to care facilitates the autism assessment process.

Discussion: Hopes about the future of accessing an autism diagnosis were shared by families and professionals; although some challenges are fixed (e.g., vast geography), others are amenable to interventions such as building community knowledge and streamlining service navigation.

Background: Adolescents and young adults with chronic health conditions (CHCs) experience significant condition-related stress in addition to everyday stress. This increases their risks of high cumulative stress, which could affect current and future health and well-being. Prior research is limited by including participants in different developmental stages, a narrow focus on one or a few conditions, or exploring concepts other than stress. Few studies have focused on the stress experiences of teens with diverse CHCs who are in one developmental stage, including the stressors they experience and their impact on teens' lives more broadly.

Objective: The purpose of this study was to explore the unique stress experiences of teens with CHCs.

Methods: Semi-structured, audio-only interviews were conducted with teens with CHCs. Interview questions explored everyday and CHC-related stressors and teens' responses to these stressors. Data were analysed using reflexive thematic analysis, with qualitative description as the theoretical foundation. Codes, sub-themes, and themes were identified and defined through an iterative process.

Results: Fifteen teens aged 14-17 years old with a variety of CHCs completed study interviews. Three central themes were generated to reflect teens' condition-related stress experiences: (1) Living with a CHC; (2) My CHC makes me different; and (3) Response to living with a CHC. Teens' experiences were unique and diverse, highlighting the importance of exploring individual perspectives.

Conclusion: This study broadens the understanding of stress experiences in teens with a variety of CHCs, highlighting how condition-related stress can permeate multiple aspects of life. Findings underscore the need for individualized assessment of condition-related stress and the development and implementation of tailored interventions designed to mitigate the impact of condition-related stress on teens' lives.

Background: This study aims to explore for the first time the knowledge, understanding and management of sleep problems in children with ADHD among clinicians who specialise in sleep and ADHD. The aim was to inform the development of digital sleep awareness training for clinicians.

Method: Fifteen clinicians who work with children with ADHD and sleep difficulties in the United Kingdom participated in semistructured qualitative interviews. Data were analysed using a reflexive thematic analysis approach to generate and guide the content of digital sleep awareness training.

Results: Four core themes were developed: 'It's a Problem' highlighted the extent to which children with ADHD were reported to struggle with sleep difficulties and the impact this has on the child and family. Clinicians also discussed the difficulty they had in finding evidence-based information they could share with caregivers. With little to no formal training, most of the advice they gave came from 'learning on the job'. When discussing ADHD specific sleep difficulties and disorders, clinicians reflected on their own 'insight into limitations of knowledge'. 'Learning for practice' highlighted the divergence in the methods of learning preferred by clinicians, despite convergence of learning content needed.

Conclusions: Sleep problems in children with ADHD are common, and clinicians often struggle to support these due to lack of formal training. There is a need for accessible, authoritative training for UK practitioners who work with children with ADHD.

Background: Caregivers of children living with cerebral palsy often experience challenges when living in low-resource communities, such as those found in low-and-middle-income countries. Kusamala is a home-visiting programme that supports families of children with disabilities in Makululu in Kabwe, Zambia.

Methods: Following the nine steps of photovoice, this project aimed to consider the experiences of ten caregivers of children living with cerebral palsy who participated in a 12-month home-visiting programme. Potential recruits for this study completed an informational meeting, where they received information about photovoice and this study. During an all-day training session, participants considered the programme evaluation question, which sought to understand how Kusamala contributed to their ability to care for their child with a disability. During this time, they also provided consent to participate and received cameras and instructions on how to use them. Participants then took photos and reconvened for a focus group session, where they shared their experiences associated with each photo, identified themes and selected images for a community exhibition. The final step involved a community exhibition to share their stories and photographs with the community.

Results: Participants identified three themes: Equality, Business/Having a Source of Income, and Special Care, capturing 39 images that reflected these themes. The first theme described how these caregivers understand and support the full inclusion of their children in their communities. The second theme highlights the need for a sustainable source of income, which is necessary to purchase basic needs for families. The final theme relates to how caregivers learn new skills and activities to support their child's growth and development.

Conclusions: The current study adds to the limited body of knowledge on the impact of community-based programming to help children living with cerebral palsy in a low-and-middle-income country context.

Background: Mothers may resort to digital screen use for their children during the complementary feeding period. Given the pervasiveness of social media use in daily life, mothers' screen-related behaviours during caregiving may be linked to their level of social media addiction. This study aimed to examine the relationship between mothers' social media addiction levels and their children's digital screen exposure during the complementary feeding period.

Methods: This descriptive, comparative and correlational study included 390 mothers with children aged 6-18 months who presented to the paediatric outpatient clinics of a university hospital. Data were collected using the 'Screen Time and Complementary Feeding Information Form' and the 'Social Media Addiction Scale-Adult Form'. Independent-samples t-test, one-way ANOVA and Pearson correlation analysis were used for exploratory data analysis.

Results: The mean maternal social media addiction score was 44.11 ± 10.836 (possible range: 20-100). Approximately one quarter of the children were exposed to digital screens during complementary feeding. Higher maternal addiction scores were observed across several socio-demographic and feeding-related characteristics. In addition, a statistically significant association was found between mothers' social media addiction scores and children's daily screen exposure (p < 0.01).

Conclusion: Maternal social media addiction levels were moderate. These findings highlight the importance of maternal social media use as a potential factor associated with digital screen exposure during complementary feeding. Education on digital media use during complementary feeding should address screen practices as an integral component of infant feeding guidance.

Background: Executive functions are important for navigating daily demands and engaging in goal-driven behaviour. While these functions are associated with motor skills and activity in mid-to-late childhood, there is a paucity of available data among preschool ages. We hypothesized that child activity, motor skills and executive function would be associated among preschool-aged children.

Methods: Children aged 3-4 years wore an Actigraph GT3X+ for 7 days to assess activity levels. Product-oriented motor skills were assessed that measure balance, manual dexterity, agility, strength and coordination. The Early Years Toolbox was used to measure visual-spatial working memory via the Mr. Ant Task and inhibitory control using the Go/No-Go task. Pearson correlations evaluated associations among both physical activity and motor skill performance with executive function. N = 83 children provided data for the analytic sample.

Results: Positive relationships (p < 0.001) were observed among inhibitory control and visual-spatial working memory and standing long jump (r = 0.46, r = 0.28), one-legged balance (r = 0.36, r = 0.40) and grip strength (r = 0.41, r = 0.44). A negative relationship (p < 0.001) was observed between quicker STUG times and inhibitory control and visual-spatial working memory (r = -0.47, r = -0.48).

Conclusions: The bidirectional associations of motor competence and executive function are evident during this rapid time of development. Cognitive functions are required for concerted movement and inhibiting nongoal-directed movements, indicating that this is an important period to provide ample opportunities for learning.

Background: Due to the high HIV/AIDS epidemic and economic underdevelopment in Liangshan Yi Ethnic Minority Autonomous Prefecture located in Southwest China, numerous Yi children become AIDS orphans who lost one or both parents to AIDS-related causes, and quite a few become left-behind children as a result of parental migration for work. The purpose of the present study was to investigate how family and teacher-student relationships interactively influence the self-esteem and school satisfaction of orphans and left-behind children in rural China.

Methods: A cross-sectional survey with 2553 students from four junior high schools was recruited, including 590 single orphans (who have lost only one parent), 106 double orphans (who have lost both parents), 588 left-behind children and 1269 other children as a reference group.

Results: Compared with other children, left-behind children were less satisfied with both family and teacher-student relationships, as well as showed lower levels of self-esteem and school satisfaction. Orphans reported lower family relationship satisfaction but higher teacher-student relationship satisfaction and school satisfaction, compared with left-behind children. Self-esteem played a mediating role between family relationship satisfaction and school satisfaction for other children, left-behind children and single orphans, but not for double orphans. A booster effect on self-esteem-where school resources reinforced home resources-was observed among double orphans. Among other children, a similar booster effect was present, along with a compensatory pattern in which support from one setting offset insufficiency in the other. Notably, this compensation effect on school satisfaction between family and teacher-student relationships was observed only in other children.

Conclusions: Vulnerable children who had experienced parental absence or bereavement generally reported poorer family relationships. Notably, compared with orphans, left-behind children showed lower levels of self-esteem and were less satisfied with their teachers and schools. The analysis further revealed distinct patterns across these groups regarding how family and teacher-student relationships interactively shape self-esteem and school satisfaction.

Background: Early childhood development (ECD) is critical for lifelong outcomes, especially in low- and middle-income countries. The home environment plays a vital role, with high-quality caregiving practices such as reading, storytelling and interactive play strongly linked to developmental outcomes. The family care indicator (FCI) scale, although widely used to assess caregiving quality, may be outdated due to shifts from traditional print materials to digital media in recent years. This study explores how home environment components, especially reading materials and screen usage, affect ECD in rural China and why the FCI may need to be revised in the near future.

Methods: Data were collected from 581 children aged 6-24 months in rural Zhejiang Province in 2024. Child development outcomes were measured using the Bayley Scales of Infant Development, Third Edition, and the home environment was assessed via the FCI, supplemented by questions on caregiver and child screen use and caregivers' self-efficacy in accessing online parenting resources.

Results: Results show that 40% of children exhibited cognitive delays and 42% language delays, whereas 74% of households lacked magazines or newspapers, and nearly half of caregivers never read books at home. Children were exposed to screens for an average of 22 min per day (SD = 45). The FCI reading material subscale was not significantly associated with developmental outcomes, but when caregivers used educational screen content together with their children, it was positively associated with language development (p < 0.05) and cognitive development (p < 0.10). Caregivers' own screen use for parenting knowledge showed no significant association, likely due to low self-efficacy in navigating online resources.

Conclusion: Traditional FCI items on books and newspapers have limited predictive value, whereas educationally oriented screen use appears beneficial, suggesting the FCI should be updated to reflect evolving caregiving practices in the digital age.