Parent-Child Dyad's Collective Family Efficacy and Risky Adolescent Health Behaviors

Feasibility and preliminary effects of the mindful healthy family project among rural families

Background/purpose

Rural adults and children are at higher risk for overweight and obesity. However, there are relatively few lifestyle modification programs available for these high-risk families, mainly because of the difficulty in reaching them. This mindfulness-based motivational interviewing (MM-based-MI) pilot aimed to improve parents' healthy eating index (HEI), collective family efficacy, family satisfaction, perceived stress, and depressive symptoms as well as parent-child dyads' eating patterns, physical activity (PA), and body mass index (BMI).

Methods

This randomized controlled trial (RCT) was conducted in the Midwestern US to examine the feasibility (enrollment, attendance, and attrition), acceptability, and preliminary effects of an MM-based-MI intervention that contained nine sessions of health coaching (1-on-1), while the active-control included nine emailed health handouts sent over an 18-week period.

Results

A total of 46 parents (29 intervention, 17 control; Mage = 38.5 years, 85% female) participated. The enrollment rate, intervention attendance rate, and attrition rate were 12.6%, 79.8%, and 23.9% respectively. Although not statistically significant, compared to the control, the MM-based-MI intervention showed positive effects on improving parents' HEI in terms of increasing total HEI score (Cohen's d = 0.43), vegetable intake (d = 0.41), greens/beans (d = 0.59), protein food (d = 0.82), and self-efficacy in exercise (d = 0.21), as well as decreasing total calories (Kcal, d = -0.58), added sugar (d = -0.50), and depressive symptoms (d = -0.42), while controlling for marital status. Controlling for age, sex, and marital status, intervention children had greater improvement in increasing fiber (d = 0.75) and protein (d = 0.72) intake compared to the active-control group. Moreover, parents in both groups reported improvement (small to large effects) in ↑mindful eating, ↑collective family efficacy, ↑family satisfaction, and ↓perceived stress over time.

Conclusions

Despite some limitations (small sample size, virtual at home measurement), our results support the feasibility, acceptability, and preliminary effects of this Mindful Healthy Family program on potentially mitigating some obesogenic behaviors among rural parent-child dyads.

Trial registration: ClinicalTrials.gov identifier: NCT05324969.

Examining the mediating effect of real and cyber self-control on cyberbullying and health risk behaviors among secondary vocational students in China: a cross-sectional study

BACKGROUND

Cyberbullying and health risk behaviors are pervasive issues for secondary vocational students that not only detrimentally impact their academic achievement but also pose a significant threat to overall health. The purpose of this study was to understand the current situation of cyberbullying and health risk behaviors among secondary vocational students in China and to explore the relationships among cyberbullying, self-control, self-control over internet usage, and health risk behaviors through a mediation model.

METHODS

This was a cross-sectional study. From March to April 2023, a self-administered questionnaire was completed by a cluster sample of 1184 students from grades 1 to 3 at three secondary vocational schools in Jilin Province. The researchers utilized a sociodemographic questionnaire, the Cyberbullying and Cybervictimization Scale (CAV), the Adolescent Health Related Risky Behavior Inventory (AHRBI), the Self-Control Scale (SCS), and the Internet Usage Self-Control Scale (IUSCS-CS) to assess the prevalence and impact of cyberbullying and health risk behaviors. Descriptive statistics, spearman correlation analyses. Finally, the Process plug-in V2.16.3 was used to analyze a mediation model for the data.

RESULTS

Among secondary vocational students, 839 individuals (70.86%) experienced cyberbullying and 1036 individuals (87.50%) had one or more health risk behaviors. A chi-square test showed that the differences in cyberbullying incidence were statistically significant (P < 0.05) for being children, type of accommodation, residence, ethnicity, purpose of using the internet, and family composition. Statistically significant differences in health risk behaviors were observed based on gender, type of accommodation, residence, ethnicity, academic achievement, classmate relationships, purpose of using the internet, and family composition (P < 0.05). Health risk behaviors and cyberbullying were correlated (r = 0.60), health risk behaviors and self-control and internet usage self-control were negatively correlated (r = -0.42, -0.50). Mediation analysis indicated that self-control (0.02, 0.08) and internet usage self-control (0.08, 0.17) partially mediated the association between cyberbullying and health risk behaviors.

CONCLUSIONS

Secondary vocational students exhibit a high prevalence of cyberbullying and health risk behaviors. The study confirmed that self-control and internet usage self-control has an important role in mediating cybeibullying and health risk behaviors. Adolescent health promoters should develop targeted strategies to enhance the self-control of secondary vocational school students to mitigate their engagement in health risk behaviors.

Validation of the Family Integration Experience Scale: Chronic Illness for the Portuguese language spoken in Brazil

OBJECTIVE

to conduct the cross-cultural adaptation and psychometric validation of the Family Integration Experience Scale: Chronic Illness in Brazilian Portuguese.

METHOD

a methodological study divided into two stages. In the first stage, the Family Integration Experience Scale: Chronic Illness was cross-culturally adapted for Brazilian culture, when the scale was subjected to translations, back-translations, and a committee of judges - to verify the semantic, linguistic, and contextual equivalence between the original and translated items. The second step was to validate the scale in a sample of families of children and adolescents with chronic illnesses. The participants were 230 families of children with chronic illnesses attending the outpatient clinic of a tertiary public hospital with teaching and research characteristics.

RESULTS

internal consistency was tested using Cronbach's alpha (0.81) and McDonald's omega (0.81). Confirmatory factor analysis was also tested, and the model's fit was acceptable for validation standards.

CONCLUSION

the version of the Family Integration Experience Scale: Chronic Illness showed evidence of validation and can be considered a valid and reliable instrument in Brazilian culture. The Brazilian Portuguese version of the Family Integration Experience Scale: Chronic Illness can be used to measure the experience of family integration in chronic illness.

Identifying the challenges of policy content related to high-risk sexual behaviors, stimulant drugs, and alcohol consumption in adolescents

BACKGROUND

This study aims to identify policy content challenges related to high-risk sexual behaviors, stimulant drugs, and alcohol consumption in Iranian adolescents.

METHODS

This qualitative study analyzed high-level and national documents pertaining to adolescent health, high-risk sexual behaviors, stimulant, and alcohol consumption in adolescents. The documents, which were published by public organizations between January 1979 and February 2023 and publicly available, were complemented by interviews with policymakers and executives. The study involved reviewing 51 papers and conducting interviews with 49 policymakers and executives at the national, provincial, and local levels who were involved in addressing adolescent behaviors related to high-risk sexual behaviors, stimulant, and alcohol consumption. The data collected was analyzed using conventional content analysis.

RESULTS

The study's results involved examining policy content and identifying challenges related to policy content. The analysis revealed that from the beginning of the Iranian revolution in 1979 until the late 1990s, the dominant approach in Iran was to deny the existence of high-risk behaviors among adolescents. However, in the early 2000s, the country began to adopt a new approach that acknowledged the social harms and ineffectiveness of previous strategies. As a result, a new policy framework was introduced to address high-risk behaviors among adolescents. The study's interviews with policymakers and executives identified 12 challenges related to policy content, including parallel programs, lack of institutional mapping, lack of evidence-based policymaking, lack of integrated approach regarding training, late parent training, lack of consideration of all occurrence reasons in adolescents' high-risk behaviors policymaking, and the existence of many abstinence policies regarding high-risk behaviors.

CONCLUSIONS

The study's findings suggest that high-risk behaviors among adolescents in Iran are primarily a health issue, rather than a social or ideological one. Unfortunately, ideological approaches, stigma, and policymaking based on anecdotes rather than evidence have had a significant impact on this area. To improve policymaking in this domain, it is crucial to address these challenges by tackling stigma, adopting an integrated and holistic approach, and implementing evidence-based policies that consider all relevant aspects, including adolescents' subcultures and policy audiences. Such an approach can also be useful for other countries facing similar conditions.

Effect of Gender Attitudes of Young Adults on Levels of Perceived Social Support in Health Behaviors

The current cross-sectional descriptive study was performed to determine the effect of young adults' attitudes regarding social gender roles on perceived social support level in health behaviors. Participants comprised 209 young adults aged 18 to 21 years. Data collection tools included a sociodemographic characteristics form, the Gender Roles Attitude Scale, and Child and Adolescent Social Support Scale for Healthy Behaviors (CASSS-HB). Data were analyzed using percentile, correlation, and regression analysis. A significant positive correlation was found between total CASSS-HB score and the egalitarian gender role subdimension of the Gender Roles Attitude Scale. It was determined that participants with an egalitarian perspective toward gender roles had increased levels of social support in health behaviors. [Journal of Psychosocial Nursing and Mental Health Services, 62(4), 17-23.].

[Cross-cultural adaptation and evidence of psychometric validity of the Family Health Scale for Brazilian Portuguese]

This study aimed to translate and cross-culturally adapt the Family Health Scale into Brazilian Portuguese and analyze evidence of its psychometric validity. The 32 items on family health were cross-culturally adapted, using the content validity index to calculate semantic, idiomatic, cultural, and conceptual characteristics of the scale and its items. A pre-test to identify evidence of validity was applied to 40 families. At another time, the instrument was applied to 354 families in a Brazilian northeastern city. The index of agreement between the raters ranged from 0.84 for the scale items to 0.98 for the total scale, according to Kendall's coefficient. According to Cronbach's alpha, evidence of psychometric validity is adequate. Most families had a moderate degree of health, according to the scale. Therefore, the Brazilian version of the Family Health Scale showed conceptual, semantic, cultural, and operational equivalence with the original items, along with satisfactory psychometric properties for use among the Brazilian population with effectiveness and safety.

Psychometric Properties of the Perceived Collective Family Efficacy Scale in Algeria

The Perceived Collective Family Efficacy Scale is a tool utilized to assess the effectiveness of a family as a functioning system. The scale has a single-factor structure with good validity and reliability. However, there is a shortage of psychometric evidence of the scale in an Arab context. This study aimed to assess the psychometric properties of the Perceived Collective Family Efficacy Scale among Algerian students. A cross-sectional study was conducted to recruit 300 students from Algerian universities. The students completed the 20-item Perceived Collective Family Efficacy Scale, Arabic version, to measure their beliefs regarding collective efficacy within families. Confirmatory factor analysis (CFA) and the Rasch model were employed to assess the psychometric properties and unidimensionality of the scale. Both CFA and Rasch findings supported the single-factor structure for the Perceived Collective Family Efficacy Scale. Specifically, the CFA indicated that the data aligned with a one-dimensional model. The Rasch analysis revealed favorable indicators of unidimensionality for the scale. Moreover, a thorough examination of the Principal Component Analysis of the Rasch residuals confirmed the existence of a single dimension, which is consistent with the original structure of the Perceived Collective Family Efficacy Scale. These findings provide scientific evidence for the validity and unidimensional nature of the Perceived Collective Family Efficacy Scale. Specifically, the satisfactory psychometric properties findings indicate that the Perceived Collective Family Efficacy Scale could be applied in an Arab context (i.e., in Algerian). The scale's unidimensional structure underscores its effectiveness in measuring beliefs in collective efficacy within families. These results enhance our understanding of family dynamics and provide a reliable measurement tool for assessing family efficacy in similar cultural contexts.

The Evaluation of a Family-Engagement Approach to Increase Physical Activity, Healthy Nutrition, and Well-Being in Children and Their Parents

Prevention programs often are directed at either parents or children separately, thereby ignoring the intergenerational aspect of health and well-being. Engaging the family is likely to improve both the uptake and long-term impact of health behavior change. We integrated an intergenerational approach into a frequently used shared assessment tool for children's care needs. The current study's aim was 2-fold: to monitor this family-engagement tool's effects on both children and their parents' health behaviors and well-being, and to examine the different dynamics of health behavioral change within a family. Method: We followed 12 children ages 10-14 years and their parents for 12 weeks using an explanatory mixed-methods design comprising interviews, questionnaires, and an n-of-1 study. During home visits at the beginning and end of the study, we interviewed children and their parents about their expectations and experiences, and measured their height and weight. Furthermore, we collected secondary data, such as notes from phone and email conversations with parents, as well as evaluation forms from professionals. In the n-of-1 study, families were prompted three times a week to describe their day and report on their vegetable intake, minutes of exercise, health behavior goals, and psychosomatic well-being. The interviews, notes, and evaluation forms were analyzed using qualitative content analyses. For the n-of-1 study, we performed multi-level time-series analyses across all families to assess changes in outcomes after consulting the family-engagement tool. Using regression analyses with autocorrelation correction, we examined changes within individual families. Results: Five child-mother dyads and three child-mother-father triads provided sufficient pre- and post-data. The mean minutes of children's physical activity significantly increased, and mothers felt more energetic, but other outcomes did not change. In consultations related to overweight, the family-engagement tool often was used without setting specific or family goals. Conclusions: The family-engagement approach elicited positive effects on some families' health and well-being. For multifaceted health problems, such as obesity, family-engagement approaches should focus on setting specific goals and strategies in different life domains, and for different family members.