Dataset Information

A prospective cohort study to investigate parental stress and child health in low-income Chinese families: protocol paper.

ABSTRACT:

Introduction

Chronic stress has adverse effects on health. Adults and children from low-income families are subject to multiple sources of stress. Existing literature about economic hardship mostly focuses on either adults or children but not both. Moreover, there is limited knowledge on the relationship between parental generalised stress and child health problems. This study aims to explore the bidirectional relationship between parental stress and child health in Chinese low-income families and to identify other modifiable factors influencing this relationship.

Methods and analysis

This prospective cohort study will sample 254 low-income parent-child pairs and follow them up for 24 months with assessments at three time points (baseline, 12 and 24 months) on parental stress, health-related quality of life (HRQOL) and child health and behaviour using both subjective measures and objective physiological parameters. This study will collect data using standardised measures on HRQOL and behaviours of children as well as on HRQOL, mental health and stress levels of parents along with physiological tests of allostatic load and telomere length. The mediating or moderating effect of family harmony, parenting style and neighbourhood conditions will also be assessed. Data will be analysed using latent growth modelling and cross-lagged path analysis modelling to examine the bidirectional effect of parental stress and child health over time. Mediation and moderation analysis will also be conducted to examine the mechanism by which the variables relate.

Ethics and dissemination

This study was approved by the institutional review board of the University of Hong Kong-the Hospital Authority Hong Kong West Cluster, reference no: UW 16-415. The study findings will be disseminated through peer-reviewed publications and international conferences.

Trial registration number

NCT03185273; Pre-results.

SUBMITTER: Wong RSM

PROVIDER: S-EPMC5855257 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Publications

A prospective cohort study to investigate parental stress and child health in low-income Chinese families: protocol paper.

Wong Rosa Sze Man RSM Yu Esther Yee Tak EYT Guo Vivian Yawei VY Wan Eric Yuk-Fai EY Chin Weng-Yee WY Wong Carlos King Ho CKH Fung Colman Siu Cheung CSC Tung Keith Tsz Suen KTS Wong Wilfred Hing-Sang WH Ip Patrick P Tiwari Agnes Fung Yee AFY Lam Cindy Lo Kuen CLK

BMJ open 20180222 2

<h4>Introduction</h4>Chronic stress has adverse effects on health. Adults and children from low-income families are subject to multiple sources of stress. Existing literature about economic hardship mostly focuses on either adults or children but not both. Moreover, there is limited knowledge on the relationship between parental generalised stress and child health problems. This study aims to explore the bidirectional relationship between parental stress and child health in Chinese low-income fa ...[more]

PMID: 29472262

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Project description:BackgroundParental child feeding practices (PCFP) are a key factor influencing children's dietary intake, especially in the preschool years when eating behavior is being established. Instruments to measure PCFP have been developed and validated in high-income countries with a high prevalence of childhood obesity. The aim of this study was to test the appropriateness, content, and construct validity of selected measures of PCFP in a low and middle-income country (LMIC) in which there is both undernutrition and obesity in children.MethodsAn expert panel selected subscales and items from measures of PCFP that have been well-tested in high-income countries to measure both "coercive" and "structural" behaviors. Two sequential cross-sectional studies (Study 1, n = 154; Study 2, n = 238) were conducted in two provinces in Indonesia. Findings of the first study were used to refine subscales used in Study 2. An additional qualitative study tested content validity from the perspective of mothers (the intended respondents). Factorial validation and reliability were also tested. Convergent validity was tested with child nutritional status.ResultsIn Study 1, a confirmatory factor analysis (CFA) model with 11 factors provided good fit (RMSEA = 0.045; CFI = 0.95 and TLI = 0.95) after two subscales were removed. Reliability was good among seven of the subscales. Following a decision to take out an additional subscale, the instrument was tested for factorial validity (Study 2). A CFA model with 10 subscales provided good fit (RMSEA = 0.03; CFI = 0.92 and TLI = 0.90). The reliability of subscales was lower than in Study 1. Convergent validity with nutrition status was found with two subscales.ConclusionsThe two studies provide evidence of acceptable psychometric properties for 10 subscales from tested instruments to measure PCFP in Indonesia. This provides the first evidence of the validity of these measures in a LMIC setting. Some shortcomings, such in the reliability of some subscales and further tests of predictive validity, require further investigation.

Project description:BackgroundParent feeding styles have been linked to child weight status across multiple studies. However, to our knowledge, the link between feeding styles and children's dietary quality, a more proximal outcome, has not been investigated.ObjectiveThe purpose of this study was to examine the relation between parent feeding styles and dietary quality of Head Start preschoolers' dinner meals.DesignThe amount of food served and consumed by children was measured by using a standardized digital photography method during 3 in-home dinner observations of low-income minority families in Houston, Texas. Trained dietitians entered food served and consumed into the Nutrient Data System for Research 2009 for nutrient analysis. Overall dietary quality of the food served and consumed at dinner was evaluated by using the Healthy Eating Index 2010 (HEI-2010). Parent feeding style was assessed with the use of the Caregiver's Feeding Style Questionnaire (CFSQ). On the basis of a parent's level of demandingness and responsiveness to his or her child during feeding, the CFSQ categorizes parent feeding into 4 styles: authoritative (high demandingness and high responsiveness), authoritarian (high demandingness and low responsiveness), indulgent (low demandingness and high responsiveness), or uninvolved (low demandingness and low responsiveness).ResultsFor the overall sample, the mean ± SD HEI score for dinner served was 44.2 ± 8.4, and the mean ± SD HEI score for dinner consumed was 43.4 ± 7.0. In the fully adjusted model, ANCOVA indicated that the authoritative parent feeding style was associated with significantly higher child dietary quality compared with the authoritarian feeding style (mean ± SEE HEI consumed-authoritative 45.5 ± 0.9; authoritarian: 41.9 ± 0.7; P = 0.001).ConclusionsParent feeding style contributes to the overall dietary quality of children, and among low-income minority preschoolers an authoritative feeding style was associated with the highest dietary quality of the 4 feeding styles. Interventions to promote feeding practices that contribute to authoritative feeding are needed to improve the dietary quality of preschool children at dinner. This trial was registered at https://clinicaltrials.gov as NCT02696278.

Dataset Information

A prospective cohort study to investigate parental stress and child health in low-income Chinese families: protocol paper.

Introduction

Methods and analysis

Ethics and dissemination

Trial registration number

Publications

A prospective cohort study to investigate parental stress and child health in low-income Chinese families: protocol paper.

Similar Datasets

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