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Duko B, Gebremedhin AT, Tessema GA, Pereira G. Influence of preterm birth on the association between gestational diabetes mellitus and childhood developmental vulnerability: a causal mediation analysis. World J Pediatr 2024; 20:54-63. [PMID: 37523007 PMCID: PMC10827844 DOI: 10.1007/s12519-023-00741-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/09/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Epidemiological studies examining the direct and indirect effects of gestational diabetes mellitus (GDM) on offspring early childhood developmental vulnerability are lacking. Therefore, the aims of this study were to estimate the direct and indirect effects of GDM (through preterm birth) on early childhood developmental vulnerability. METHODS We conducted a retrospective population-based cohort study on the association between gestational diabetes mellitus and early childhood developmental vulnerability in children born in Western Australia (WA) using maternal, infant and birth records from the Midwives Notification, Hospitalizations, Developmental Anomalies, and the Australian Early Development Census (AEDC) databases. We used two aggregated outcome measures: developmentally vulnerable on at least one AEDC domain (DV1) and developmentally vulnerable on at least two AEDC domains (DV2). Causal mediation analysis was applied to estimate the natural direct (NDE), indirect (NIE), and total (TE) effects as relative risks (RR). RESULTS In the whole cohort (n = 64,356), approximately 22% were classified as DV1 and 11% as DV2 on AEDC domains. Estimates of the natural direct effect suggested that children exposed to GDM were more likely to be classified as DV1 (RR = 1.20, 95% CI: 1.10-1.31) and DV2 (RR = 1.34, 95% CI: 1.19-1.50) after adjusting for potential confounders. About 6% and 4% of the effect of GDM on early childhood developmental vulnerability was mediated by preterm birth for DV1 and DV2, respectively. CONCLUSION Children exposed to gestational diabetes mellitus were more likely to be developmentally vulnerable in one or more AEDC domains. The biological mechanism for these associations is not well explained by mediation through preterm birth.
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Affiliation(s)
- Bereket Duko
- Australian Centre for Precision Health, UniSA Clinical and Health Sciences, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia.
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA, 6102, Australia.
| | - Amanuel Tesfay Gebremedhin
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA, 6102, Australia
| | - Gizachew Assefa Tessema
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA, 6102, Australia
| | - Gavin Pereira
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA, 6102, Australia
- enAble Institute, Curtin University, Kent Street, Bentley, WA, 6102, Australia
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
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Volodina A, Weinert S, Washbrook E, Waldfogel J, Kwon SJ, Wang Y, Perinetti Casoni V. Explaining gaps by parental education in children’s early language and social outcomes at age 3–4 years: evidence from harmonised data from three countries. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03754-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractChild outcomes vary by family’s socioeconomic status (SES). Research on explanatory factors underlying early SES-related disparities has mainly focused on specific child outcomes (e.g., language skills) and selected influencing factors in single countries often with a focus on individual differences but not explicitly on early SES-related gaps. This study uses harmonised data from longitudinal large-scale studies conducted in the United Kingdom, United States, and Germany to examine parental education-related gaps in early child language and social skills. Twelve theoretically proposed family-, child-, and childcare-related factors were systematically evaluated as explanatory factors. In all countries, parental education-related gaps were particularly pronounced for early child language compared to social skills. In the decomposition analyses, the home learning environment was the only measure that significantly explained gaps in all child outcomes across all countries. Early centre-based care attendance, family income, and maternal age at childbirth contributed to gaps in child outcomes with the specific pattern of results varying across outcomes and countries. Maternal depressive feelings significantly contributed only to explaining gaps in children’s social skills. Thus, while some mechanisms found to underpin early parental education-related gaps can be generalized from single-country, single-domain studies, others are outcome- and context-specific.
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Lim M, Van Hulst A, Pisanu S, Merry L. Social Isolation, Loneliness and Health: A Descriptive Study of the Experiences of Migrant Mothers With Young Children (0–5 Years Old) at La Maison Bleue. Front Glob Womens Health 2022; 3:823632. [PMID: 35814837 PMCID: PMC9265247 DOI: 10.3389/fgwh.2022.823632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 06/02/2022] [Indexed: 11/24/2022] Open
Abstract
Background Migrant women with young children, including asylum seekers and refugees, have multiple vulnerability factors that put them at increased risk of social isolation and loneliness, which are associated with negative health outcomes. This study explored the experiences of social isolation and loneliness among migrant mothers with children aged 0–5 years as well as their perceptions on possible health impacts. Methods A qualitative descriptive study was conducted at La Maison Bleue, a non-profit organization providing perinatal health and social services to vulnerable women in Montreal, Canada. Recruitment and data collection occurred concurrently during the COVID-19 pandemic, between November and December 2020. Eleven women participated in individual semi-structured interviews and provided socio-demographic information. Interview data were thematically analyzed. Results Migrant women in this study described social isolation as the loss of family support and of their familiar social/cultural networks, and loneliness as the feelings of aloneness that stemmed from being a mother in a new country with limited support. Multiple factors contributed to women's and children's social isolation and loneliness, including migration status, socioeconomic circumstances, language barriers, and being a single mother. Women expressed that the COVID-19 pandemic exacerbated pre-existing experiences of social isolation and loneliness. Mothers' experiences affected their emotional and mental health, while for children, it reduced their social opportunities outside the home, especially if not attending childcare. However, the extent to which mothers' experiences of social isolation and loneliness influenced the health and development of their children, was less clear. Conclusion Migrant mothers' experiences of social isolation and loneliness are intricately linked to their status as migrants and mothers. Going forward, it is critical to better document pandemic and post-pandemic consequences of social isolation and loneliness on young children of migrant families. Supportive interventions for migrant mothers and their young children should not only target social isolation but should also consider mothers' feelings of loneliness and foster social connectedness and belongingness. To address social isolation and loneliness, interventions at the individual, community and policy levels are needed.
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Affiliation(s)
- Mona Lim
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | | | | | - Lisa Merry
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
- West Central Montreal CIUSSS, SHERPA University Institute, Montreal, QC, Canada
- InterActions Centre de recherche et de partage des savoirs, CIUSSS du Nord-de-l'île-de-Montréal, Montreal, QC, Canada
- *Correspondence: Lisa Merry
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Atashbahar O, Sari AA, Takian A, Olyaeemanesh A, Mohamadi E, Barakati SH. The impact of social determinants of health on early childhood development: a qualitative context analysis in Iran. BMC Public Health 2022; 22:1149. [PMID: 35676642 PMCID: PMC9178833 DOI: 10.1186/s12889-022-13571-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social determinants have a significant impact on children's development and their abilities and capacities, especially in early childhood. They can bring about inequity in living conditions of children and, as a result, lead to differences in various dimensions of development including the social, psychological, cognitive and emotional aspects. We aimed to identify and analyze the social determinants of Early Childhood Development (ECD) in Iran and provide policy implications to improve this social context. METHODS In a qualitative study, data were collected through semi-structured interviews with 40 experts from October 2017 to June 2018. Based on Leichter's (1979) framework and using the deductive approach, two independent researchers conducted the data analysis. We used MAXQDA.11 software for data management. RESULTS We identified challenges related to ECD context in the form of 8 themes and 22 subthemes in 4 analytical categories relevant to the social determinants of ECD including: Structural factors (economic factors: 6 subthemes, political factors: 2 subthemes), Socio-cultural factors (the socio-cultural setting of society: 6 subthemes, the socio-cultural setting of family: 4 subthemes), Environmental or International factors (the role of international organizations: 1 subtheme, political sanctions: 1 subtheme), and Situational factors (genetic factors: 1 subtheme, the phenomenon of air pollution: 1 subtheme). We could identify 24 policy recommendations to improve the existing ECD context from the interviews and literature. CONCLUSION With regard to the challenges related to the social determinants of ECD, such as increasing social harms, decreasing social capital, lack of public awareness, increasing socio-economic inequities, economic instability, which can lead to the abuse and neglect of children or unfair differences in their growth and development, the following policy-making options are proposed: focusing on equity from early years in policies and programs, creating integration between policies and programs from different sectors, prioritizing children in the welfare umbrella, empowering families, raising community awareness, and expanding services and support for families, specially the deprived families subject to special subsidies.
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Affiliation(s)
| | - Ali Akbari Sari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Takian
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Health Equity Research Centre (HERC), Tehran University of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd, Tehran, 1416833481, Iran
| | - Alireza Olyaeemanesh
- Health Equity Research Centre (HERC), Tehran University of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd, Tehran, 1416833481, Iran
| | - Efat Mohamadi
- Health Equity Research Centre (HERC), Tehran University of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd, Tehran, 1416833481, Iran.
| | - Sayyed Hamed Barakati
- Population, Family and School Health Office, Ministry of Health and Medical Education, Tehran, Iran
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Atashbahar O, Sari AA, Takian A, Olyaeemanesh A, Mohamadi E, Barakati SH. Integrated early childhood development policy in Iran: a stakeholder analysis. BMC Health Serv Res 2021; 21:971. [PMID: 34526031 PMCID: PMC8444469 DOI: 10.1186/s12913-021-06968-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/02/2021] [Indexed: 11/30/2022] Open
Abstract
Background Many stakeholders are involved in the complicated process of policy making in integrated early childhood development (IECD). In other words, there are many challenges for IECD policy making in developing countries, including Iran. The aim of this study was to identify potential stakeholders and their interactions in IECD policy making in Iran. Method A mixed-methods study was conducted in two phases in 2018. First, forty semi-structured interviews and a review of IECD-related documents were conducted to identify potential stakeholders and their roles. Second, using a designed checklist, these stakeholders were assessed for power, interest, and position in IECD policy making. Then, a map of stakeholders and a three-dimensional stakeholder analysis figure were designed. Results The results of this study showed that various stakeholders, including governmental, semi-governmental, social, non-governmental and international organizations, potentially influence IECD policy in Iran. They were found to have diverse levels of power, interest and position in this regard, leading to their different impacts on the process. This diversity is assumed to have affected their levels of participation and support. Also, we found that the stakeholders with a high-power level do not have a high level of interest in, or support for, IECD policy. In general, organizational competition, complicated inter-sectoral nature of this process, insufficient budget, insufficient awareness about the importance of IECD, lack of priority given to IECD in relevant organizations, economical views rather than developmental perspectives, and lack of commitment among top managers are the reasons why this policy enjoys a low degree of support. Conclusions There are weaknesses in effective interactions and relationships among IECD policy stakeholders. This will lead to the lack of equal opportunities for optimal early childhood development. To improve this process, advocacy from high-level authorities of the organizations, negotiation with child-friendly groups, establishing a body to coordinate and oversee children’s affairs, using the capacity of non-governmental organizations, strengthening inter-sectoral collaboration by clarifying the roles and responsibilities of stakeholders and the relationships between them, and increasing public awareness can be helpful.
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Affiliation(s)
| | - Ali Akbari Sari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Takian
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Health Equity Research Center (HERC), Tehran University of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd, 1416833481, Tehran, Iran.,Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Olyaeemanesh
- National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran.,Health Equity Research Center (HERC), Tehran University of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd, 1416833481, Tehran, Iran
| | - Efat Mohamadi
- Health Equity Research Center (HERC), Tehran University of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd, 1416833481, Tehran, Iran.
| | - Sayyed Hamed Barakati
- Population, Family and School Health Office, Ministry of Health and Medical Education, Tehran, Iran
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Quality of the home, daycare and neighborhood environment and the cognitive development of economically disadvantaged children in early childhood: A mediation analysis. Infant Behav Dev 2021; 64:101619. [PMID: 34385051 DOI: 10.1016/j.infbeh.2021.101619] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/20/2021] [Accepted: 07/24/2021] [Indexed: 11/20/2022]
Abstract
The objective of this study was to investigate how socioeconomic factors and the quality of ecological environments affect motor and cognitive development of economically disadvantaged children. This is a cross-sectional, predictive and correlational study using structural equation modeling to analyze data on 147 economic disadvantage children of 24-36 months attending public daycare. The Bayley-III Scales, the Home Observation for Measurement of the Environment Inventory, the Infant/Toddler Environment Rating Scale-Revised Edition, a socioeconomic index and a specifically designed questionnaire on neighborhood quality were applied. The ecological environments did not affect motor development, but 25 % of variations in cognitive development were explained by socioeconomic differences and differences in the quality of the neighborhood, home and daycare. However, only the quality of the home and daycare had a direct impact, with the other factors affecting the outcome indirectly and to a lesser extent. In conclusion, this study investigated the association between the ecological contexts of economically disadvantaged children and their cognitive and motor development. The findings showed that the environmental context had effect on cognitive development. The home was the environment that exerted the most significant direct effect, followed by daycare and, indirectly and to a lesser extent, the neighborhood. Therefore, the coordination of public policies between health, education and social assistance sectors, aiming at the three ecological environments is important in order to promote the cognitive development of economically disadvantaged children.
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Desharnais-Préfontaine N, Pisanu S, Bellemare AM, Merry L. Les politiques publiques affectant négativement les familles demandeuses d'asile avec des jeunes de 0 à 5 ans au Québec. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2021; 112:128-131. [PMID: 32783145 PMCID: PMC7851264 DOI: 10.17269/s41997-020-00392-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/14/2020] [Indexed: 11/17/2022]
Abstract
In 2019, 30,615 asylum claims were made in Quebec, representing almost half of the claims made in Canada. Asylum-seeking families with young children (0 to 5 years) represent a significant proportion of this population. Canada, as well as Quebec, have a responsibility to protect asylum seekers and to ensure that public policies promote health and well-being, especially among children. However, certain existing public policies exclude asylum seekers and are negatively affecting families. This commentary seeks to raise awareness among all those involved in policymaking, especially decision-makers, regarding asylum-seekers and three policy domains that are contributing to poverty, social isolation, and reduced access to care among asylum-seeking families with young children. These include the lack of eligibility for child benefits, the limited access to affordable daycare, and barriers to accessing family doctors. Consequently, both parents and children suffer impacts to their health and well-being. We are calling on our governments to assume their responsibilities and eliminate these inequities, and to ensure that the health of asylum seekers is considered in all policies.
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Affiliation(s)
| | | | | | - Lisa Merry
- Faculté des sciences infirmières, Université de Montréal, Institut universitaire SHERPA, CIUSSS du Centre-Ouest-de-l'île-de-Montréal et InterActions- Centre de recherche et de partage des savoirs, CIUSSS du Nord-de-l'île-de-Montréal, Montréal, QC, Canada.
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8
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Falster K, Hanly M, Edwards B, Banks E, Lynch JW, Eades S, Nickel N, Goldfeld S, Biddle N. Preschool attendance and developmental outcomes at age five in Indigenous and non-Indigenous children: a population-based cohort study of 100 357 Australian children. J Epidemiol Community Health 2020; 75:jech-2020-214672. [PMID: 33293290 DOI: 10.1136/jech-2020-214672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 09/11/2020] [Accepted: 10/15/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Policies to increase Australian Indigenous children's participation in preschool aim to reduce developmental inequities between Indigenous and non-Indigenous children. This study aims to understand the benefits of preschool participation by quantifying the association between preschool participation in the year before school and developmental outcomes at age five in Indigenous and non-Indigenous children. METHODS We used data from perinatal, hospital, birth registration and school enrolment records, and the Australian Early Development Census (AEDC), for 7384 Indigenous and 95 104 non-Indigenous children who started school in New South Wales, Australia in 2009/2012. Preschool in the year before school was recorded in the AEDC. The outcome was developmental vulnerability on ≥1 of five AEDC domains, including physical health, emotional maturity, social competence, language/cognitive skills and communication skills/general knowledge. RESULTS 5051 (71%) Indigenous and 68 998 (74%) non-Indigenous children attended preschool. Among Indigenous children, 33% of preschool attenders and 44% of the home-based care group were vulnerable on ≥1 domains, compared with 17% of preschool attenders and 33% in the home-based care group among non-Indigenous children. In the whole population model, the adjusted risk difference for developmental vulnerability among preschool attenders was -7.9 percentage points (95% CI, -9.8 to -6.1) in non-Indigenous children and -2.8 percentage points (95% CI -4.8 to -0.7) in Indigenous children, compared with Indigenous children in home-based care. CONCLUSIONS Our findings suggest a likely beneficial effect of preschool participation on developmental outcomes, although the magnitude of the benefit was less among Indigenous compared with non-Indigenous children.
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Affiliation(s)
- Kathleen Falster
- School of Population Health, University of New South Wales, Sydney, Australia
- ANU Centre for Social Research Methods, The Australian National University, Canberra, Australia
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Mark Hanly
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Ben Edwards
- ANU Centre for Social Research Methods, The Australian National University, Canberra, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - John W Lynch
- School of Public Health, The University of Adelaide, Adelaide, Australia
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sandra Eades
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Nathan Nickel
- Department of Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada
| | - Sharon Goldfeld
- Policy and Equity, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Nicholas Biddle
- ANU Centre for Social Research Methods, The Australian National University, Canberra, Australia
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Charrois J, Côté SM, Paquin S, Séguin JR, Japel C, Vitaro F, Kim-Cohen J, Tremblay RE, Herba CM. Maternal depression in early childhood and child emotional and behavioral outcomes at school age: examining the roles of preschool childcare quality and current maternal depression symptomatology. Eur Child Adolesc Psychiatry 2020; 29:637-648. [PMID: 31410578 DOI: 10.1007/s00787-019-01385-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 07/31/2019] [Indexed: 11/27/2022]
Abstract
Recent studies have shown that the association between maternal depression and child outcome can be moderated by children's experience of childcare (e.g., daycare) during early childhood (0-5 years). We also know that maternal depression in the child's early years has long-term associations with child development. However, the moderating role of childcare quality on long-term associations between maternal depression and child outcome has not been thoroughly investigated. This article examined longitudinal associations between probable maternal depression (PMD) during early childhood (0-5 years) and childcare quality on children's emotional and behavioral development at the age of 7-8 years (N = 207). Childcare quality was evaluated through observations within the settings. PMD during early childhood was assessed using complementary information from interviews conducted with the mother and current maternal symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Internalizing and externalizing behaviors were reported by the mother, father and the child at age 7-8 years. Results indicate that when mothers reported clinically relevant depression in early childhood, 7-8-year-old children demonstrate fewer behavioral problems if they attended a higher quality childcare setting. The moderating role of childcare quality remained after considering current maternal depression symptoms. Therefore, it is important to ensure high-quality childcare during early childhood to optimize child development.
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Affiliation(s)
- Justine Charrois
- Psychology Department, Université du Québec à Montréal, C.P. 8888, Succ. Centre-Ville, Montreal, H3C 3P8, Canada.,Centre de Recherche du CHU Sainte-Justine, Montreal, Canada
| | - Sylvana M Côté
- Centre de Recherche du CHU Sainte-Justine, Montreal, Canada.,Department of Social and Preventive Medicine, Université de Montréal, Montreal, Canada.,Université de Bordeaux, INSERM U1219, Centre Hospitalier Perrens, Bordeaux, France
| | - Stéphane Paquin
- Department of Sociology, Université de Montréal, Montreal, Canada
| | - Jean R Séguin
- Centre de Recherche du CHU Sainte-Justine, Montreal, Canada.,Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Christa Japel
- Psychology Department, Université du Québec à Montréal, C.P. 8888, Succ. Centre-Ville, Montreal, H3C 3P8, Canada.,Department of Education and specialized training, Université du Québec à Montréal, Montreal, Canada
| | - Frank Vitaro
- Centre de Recherche du CHU Sainte-Justine, Montreal, Canada.,Department of Psycho-education, Université de Montréal, Montreal, Canada
| | - Julia Kim-Cohen
- Department of Psychology, University of Illinois, Chicago, USA
| | - Richard E Tremblay
- Centre de Recherche du CHU Sainte-Justine, Montreal, Canada.,Departments of Pediatrics and Psychology, Université de Montréal, Montreal, Canada.,School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Catherine M Herba
- Psychology Department, Université du Québec à Montréal, C.P. 8888, Succ. Centre-Ville, Montreal, H3C 3P8, Canada. .,Centre de Recherche du CHU Sainte-Justine, Montreal, Canada. .,Department of Psychiatry, Université de Montréal, Montreal, Canada.
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Chang-Martinez C, Ahmed NU, Natale RA, Messiah SE. State-Mandated Nutrition, Physical Activity, and Screen Time Policies in Child Care Centers. Health Promot Pract 2017; 19:411-417. [PMID: 28891723 DOI: 10.1177/1524839917729125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The child care center (CCC) environment presents opportunities for healthy weight promotion in preschoolers. Our study examined the current state of CCC adherence to nutrition, physical activity, and screen time legislative regulations and the differences in their adherence by center socioeconomic position (SEP: low, middle, high) in Miami-Dade County. METHOD In 34 CCC, we used the Environment and Policy Assessment and Observation tool to evaluate nutrition, physical activity, and screen time practices during 1-school day. RESULTS Twenty-five of the centers (73.5%) were participants of the Child and Adult Care Food Program. Almost 80% of the centers adhered to serving low-fat/fat-free milk to children older than 2 years. Only 34.5% served vegetables and 75.9% served whole fruits during meals/snacks. Ninety-four percent of the centers had quiet and active play incorporated into their daily routines. All centers adhered to the 2-hour screen time limit for children older than 2 years. Low- and middle-SEP centers fared better in the serving of fruits, vegetables, and low-fat/fat-free milk. The centers averaged 1 hour in outdoor play regardless of SEP. High-SEP centers had no TV or screen time during day of observation. CONCLUSION CCC practices highlight opportunities for improvement in nutrition, physical activity, and screen time practices in the prevention of overweight in early childhood.
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Affiliation(s)
| | | | - Ruby A Natale
- 2 University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sarah E Messiah
- 2 University of Miami Miller School of Medicine, Miami, FL, USA
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