Environmental impact on young children's participation in home-based activities.
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ABSTRACT: Aim
To test the effect of child, family, and environmental factors on young children's participation in home-based activities.Method
Caregivers of young children were recruited using convenience and snowball sampling. Participants were 395 caregivers of children (222 males, 173 females) aged from 1 month to 5 years and 11 months. Demographic items and the home section of the Young Children's Participation and Environment Measure were administered online, followed by completion of the daily activities, mobility, and social/cognitive domains of the Pediatric Evaluation of Disability Inventory Computer Adaptive Test by telephone interview.Results
A structural equation model fitted the data well (comparative fit index=0.91) and explained 31.2% of the variance in perceived environmental support and 42.5% of the variance in home involvement. Functional limitations and performance had an indirect effect on young children's participation through their effect on perceived environmental support. Specifically, fewer functional limitations and higher task performance were associated with greater environmental support, which in turn predicted higher levels of home involvement.Interpretation
Results suggest the importance of a young child's functional abilities and task performance on caregiver perceptions of environmental support at home, and the impact of environmental support on a child's participation in home-based activities during the early childhood period. Results warrant replication with more diverse samples to evaluate model generalizability.
SUBMITTER: Albrecht EC
PROVIDER: S-EPMC5334138 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundYoung children with developmental disabilities and delays spend significant amounts of time at home, show decreased participation in home-based activities, and receive home-based early intervention services to improve participation in activities. Yet, knowledge about the relationship between EI service use and children's home participation in activities remains poorly understood but needed for program improvement. The purpose of this study was to understand the relationships between EI service use and children's home participation.MethodsIn a cross-sectional design, data were gathered from caregivers (N = 139) who enrolled in a pilot trial of the Young Children's Participation in Environment Measure (YC-PEM) electronic patient-reported outcome (e-PRO), as implemented within 1 month of their child's next EI progress evaluation. A series of path analytic models were used to estimate EI service intensity as a predictor of parent-reported young children's home participation 1) frequency, 2) level of involvement, and 3) desired change, adjusting for family and child social and functional characteristics. Models included caregiver perceptions of home environmental support to test its indirect (i.e., mediation) effects on the relationship between EI service intensity and each of the three home participation dimensions.ResultsAll three models fit the data well (comparative fit index = 1.00). EI service intensity was not a significant predictor of participation frequency. However, EI service intensity had a significant direct effect on a child's participation according to level of involvement and desired change, explaining between 13.3-33.5% of the variance in home participation. Caregiver perceptions of environmental support had a small yet significant indirect effect on the relationship between EI service intensity and level of involvement and desired change; these models explained between 18.5-38.1% of the variance in home participation.ConclusionsEI service intensity has important links with involvement in and desired change for home-based activities. Caregiver perceptions of environmental support appears to be a factor in the relationship between EI service intensity and home participation. Results warrant longitudinal replication with a control group, which would be possible with the implementation of the YC-PEM e-PRO in a routine EI clinical workflow.Trial retrospectively registeredNCT03904797 .
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Project description:Young children spend a lot of time at home, yet there is little empirical research on how they spend that time and how it relates to developmental outcomes. Prior research suggests less-structured time-where children practice making choices and setting goals-may develop self-directed executive function in 6-year-olds. But less-structured time may be related to executive function for other reasons-for example, because it provides opportunities to acquire conceptual knowledge relevant to using executive function on tasks. We thus tested the possibility that less-structured time is also related to younger children's externally cued executive function. In this remote online study, caregivers of 93 3- to 5-year-olds indicated the amount of time their child was typically spending in various activities while at home during the early phase of the COVID-19 pandemic. Activities were categorized as structured (primarily lessons with specific goals defined by adults or an app), less-structured (wide range of activities permitting choice and interaction with caregiver), passive (e.g., watching TV or videos), and primarily physical (e.g., bike riding). Children's externally cued executive function was assessed via the Dimensional Change Card Sort (DCCS). Time and variety in less-structured activities were related to successful switching on the DCCS, controlling for age, family income, caregiver education, and verbal knowledge. Caregivers were more involved in less-structured versus structured activities. Caregiver ratings of children's temperament were related to how children's time was spent. These findings suggest several new avenues for studying young children's activities at home and their relations with developmental outcomes. A video abstract of this article can be viewed at https://youtu.be/3aGmpSnjuCs.
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Project description:BackgroundPediatric critical care is often accompanied by a variety of functional impairments. Preliminary evidence suggests children's participation in home activities has a slow trajectory post-pediatric intensive care unit (PICU) discharge, however, additional and more granular knowledge on specific problematic activities is needed to inform patient-centric rehabilitative care. The objectives of this study are to identify common home activities in which caregivers' report dissatisfaction and to determine predictors of caregivers' dissatisfaction with their child's participation in home activities post-PICU discharge.MethodsSecondary analyses of data from a prospective cohort study, the Wee-Cover study, using a subsample of caregivers (N = 170) of children 1-17 years, admitted to a PICU ≥48 h with data on our primary outcome measure from at least one time point. Data were gathered at enrollment and at 3 and 6 months post-PICU discharge. Caregivers reported on their dissatisfaction with their child's participation in home activities via the Participation and Environment Measure. Common activities were identified by plotting caregiver dissatisfaction for each activity pre-and post-PICU, reporting activities in which ≥50% of caregivers reported dissatisfaction with post-PICU, and assessing for significantly different dissatisfaction levels between time-points for each activity. Predictors of caregiver dissatisfaction were assessed using Poisson generalized estimated equation models.ResultsThere was variability in reported dissatisfaction across all activities; ≥50% of caregivers reported dissatisfaction with five activities, including getting clean, personal care management, and mealtime for younger children and household chores and homework for school-aged children and youth. Four activities had significantly higher caregiver dissatisfaction post-PICU: sleep (children < 5 years), homework, indoor play and games, and computer/video games (children ≥5 years). Home environmental support and the interaction of having participation-focused strategies with receiving PICU-based rehabilitation services were negatively associated with caregiver dissatisfaction. Increased caregiver stress and functional performance were associated with increased dissatisfaction.ConclusionsIndividualized PICU-based rehabilitation services to determine family priorities and develop participation-focused strategies, specifically those increasing environmental supports within the home, may ease the family's transition home post-PICU.Trial registrationClinicalTrials.gov Identifier NCT02148081 05/28/2014.
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Project description:According to the Home Literacy Model (Sénéchal and LeFevre, 2002, 2014), young children can be exposed to two distinct types of literacy activities at home. First, meaning-related literacy activities are those where print is present but is not the focus of the parent-child interaction, for example, when parents read storybooks to their children. In contrast, code-related literacy activities focus on the print, for example, activities such as when parents teach their children the names and sounds of letters or to read words. The present study was conducted to expand the Home Literacy Model by examining its relation with children's engagement in literacy activities at home and at school as Finnish children transitioned from kindergarten to Grades 1 and 2. Two facets of children's engagement were examined, namely, children's independent reading at home and their interest in literacy activities. Children (N = 378) were tested and interviewed at the ends of kindergarten, Grade 1, and Grade 2. Mothers completed questionnaires on their home literacy activities at each test time, and they reported the frequency with which their children read independently twice when children were in grade school. Tested was a longitudinal model of the hypothesized relations among maternal home literacy activities (shared reading and teaching of reading), children's reading skills, independent reading, and their interest in literacy activities/tasks as children progressed from kindergarten to Grade 2. Stringent path analyses that included all auto-regressors were conducted. Findings extended previous research in four ways. First, the frequency of shared reading and teaching of reading at home predicted the frequency of children's independent reading 1 year later. Second, children with stronger early literacy skills in kindergarten read independently more frequently once they were in Grade 1. Third, parents adapted, from kindergarten to Grade 1, their teaching behaviors to their children's progress in reading, whereas shared reading decreased over time. Fourth, children's own reports of interest in literacy activities were mostly not linked to other variables. Taken together, these results add another layer to the Home Literacy Model.
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Project description:BackgroundIncome inequalities in sports participation are shaped by a system in which individuals and the environment interact. We developed an agent-based model (ABM) that could represent this system and used it to provide a proof-of-concept of its potential to explore the impact of individual and environmental interventions on reducing inequalities in sports participation.MethodsOur ABM simulates sports participation of individuals in the Dutch city of Eindhoven. In the model, sports participation is determined by an individual's tendency to start sports (at a fitness center, sports club or self-organized), which is influenced by attributes of individuals (i.e. age, sex, income), sports facilities (i.e. price, accessibility) and the social environment (i.e. social cohesion, social influence). Sports facilities can adapt to changes in the demand by closures or startups, which in turn influence the tendency of individuals to participate in sport. We explored the impact of five interventions scenarios.ResultsExplorative results show that providing health education, increasing the availability of sports facilities, lowering prices of facilities and improving safety levels can increase sports participation and modestly reduce absolute income inequalities in sports participation. The largest gain can be attained through health education, if the effect and reach is sufficiently large. Environmental interventions alone have a modest impact. Marked effects are only achieved after five to 10 years.ConclusionsABMs have much potential to test the population-level effects of various interventions in the context of a system. Our study highlights the challenges of ABM development and reveals gaps in empirical data. With further refinements, our model could aid in understanding and finding optimal pathways to reduce income inequalities in sports participation.
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Project description:Air pollution exposures are linked to cognitive and olfaction deficits, oxidative stress, neuroinflammation and neurodegeneration including frontal hyperphosphorylated tau and diffuse amyloid plaques in Mexico City children and young adults. Mexico City residents are chronically exposed to fine particulate matter (PM(2.5)) concentrations (containing toxic combustion and industrial metals) above the annual standard (15 ?g/m(3)) and to contaminated water and soil. Here, we sought to address the brain-region-specific effects of metals and key neuroinflammatory and DNA repair responses in two air pollution targets: frontal lobe and olfactory bulb from 12 controls vs. 47 Mexico City children and young adults average age 33.06±4.8 SE years. Inductively coupled plasma mass spectrometry (metal analysis) and real time PCR (for COX2, IL1? and DNA repair genes) in target tissues. Mexico City residents had higher concentrations of metals associated with PM: manganese (p=0.003), nickel and chromium (p=0.02) along with higher frontal COX2 mRNA (p=0.008) and IL1? (p=0.0002) and COX2 (p=0.005) olfactory bulb indicating neuroinflammation. Frontal metals correlated with olfactory bulb DNA repair genes and with frontal and hippocampal inflammatory genes. Frontal manganese, cobalt and selenium increased with age in exposed subjects. Together, these findings suggest PM-metal neurotoxicity causes brain damage in young urbanites, the olfactory bulb is a target of air pollution and participates in the neuroinflammatory response and since metal concentrations vary significantly in Mexico City urban sub-areas, place of residency has to be integrated with the risk for CNS detrimental effects particularly in children.
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Project description:Background The extent to which poor oral health in young children impacts developmental milestones is unclear.Aim To review the evidence of association between poor oral health and development of young children (0-5 years).Method A rapid review was conducted. Medline was searched for articles in English published from 2000 onwards. The outcomes considered were the impact of poor oral health on speech and language development, oral health-related quality of life (OHRQoL), school performance and attendance.Results In total, 15 studies were included: four systematic reviews, a critical review and 10 primary studies. All data were from observational or cross-sectional studies. Premature extraction of primary maxillary incisors was associated with change in speech sounds and articulation. Two primary studies found associations between early childhood caries and physical and psychomotor deficiencies, while acknowledging a web of causation with other factors, including socioeconomic status. Children with dental caries reported lower OHRQoL. Studies found caries experience was associated with preschool absenteeism.Conclusion Poor oral health in young children appears to be associated with speech and language development, OHRQoL, and school attendance and performance. However, there are significant limitations in the existing evidence, with further high-quality, observational, longitudinal research required to fully understand the impact of poor oral health on the development of young children. Strategies to improve oral health by health and education professionals are needed to ensure young children reach their potential.
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Project description:PURPOSE:Further research on patient experience and involvement is recommended in order to develop evidence-based and meaningful care pathways for lymphoma survivors. This study aims to explore the experience of a sample of lymphoma survivors participating in a home-based intervention following chemotherapy. METHODS:Eligible participants who completed a 12-week home-based intervention were invited to complete the End of Study Questionnaire designed to explore perceptions, preferences and barriers to participation. Content analysis was used to generate codes, describe frequencies and identify themes. RESULTS:Participating in a home-based intervention post-treatment was a positive experience overall, and aided recovery in this sample of lymphoma survivors (n?=?35). Participants felt the programme provided structure, motivation and liked contact with the researcher. Participants highlighted their need for advice on healthy lifestyle, diet in particular. CONCLUSIONS:Lymphoma survivors in this study reported participation in a home-based intervention following treatment beneficial and aided recovery. IMPLICATIONS FOR CANCER SURVIVORS:A large proportion of lymphoma survivors would benefit from a rehabilitation intervention post-chemotherapy. Intervention programmes should include follow-ups to monitor progress and provide support and motivation. Health professionals should recommend healthy lifestyle guidelines to survivors on completion of treatment or refer patients to appropriate services for rehabilitation and advice.
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Project description:INTRODUCTION:Falls are the second leading reason for incidental or unexpected deaths worldwide. Many older adults who fall, regardless of whether they are injured or not, tend to experience fear of fall and this can lead to decreased participation in activities of daily living (ADLs). Subsequent falls lead to weakness, a decline in physical functioning, increased chances of falling and a negative impact on the instrumental ADLs. Here, we present our scoping review protocol to appraise the literature to describe and explain the home-modification interventions used by occupational therapists to address falls and participation in ADLs among community-dwelling older adults. We are aiming to review the available home-modification intervention protocols, facilitators and barriers to such interventions, and the experiences of occupational therapists and clients after receiving these interventions. METHODS AND ANALYSIS:This scoping review protocol follows existing guidelines for scoping reviews with a particular attention on Arksey and O'Malley (2005) and Colquhoun et al (2014). We will include the following databases: Scopus, Web of Science, PubMed, ProQuest, Cumulative Index to Nursing and Allied Health Literature and Google Scholar. We plan to conduct the literature search from August 16, 2020 to September 15, 2020. Two reviewers will independently screen eligible studies for inclusion. We will extract the bibliographic data, study design, details of the intervention provided, outcomes and experiences of occupational therapists and clients, and further organise them for better understanding. ETHICS AND DISSEMINATION:As secondary data analysis, this scoping review does not require ethics approval. Results will summarise and disseminate the existing literature related to home-modification interventions provided by occupational therapists addressing falls and participation in ADLs among community-dwelling older adults. We plan to disseminate the results through peer-reviewed journals and conferences, targeting occupational therapists, other rehabilitation workers, researchers and policy makers.
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