Child Care Health and Development最新文献

{"title":"Parenting in the Neonatal Intensive Care Unit: A Qualitative Study","authors":"Gizem Kerimoglu Yildiz,&nbsp;Selda Ates Besirik","doi":"10.1111/cch.70089","DOIUrl":"https://doi.org/10.1111/cch.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This qualitative study is aimed at describing parental feelings, their readiness during discharge, and their needs while their infant is in the neonatal intensive care unit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was conducted with the parents of infants being monitored in a neonatal intensive care unit. A total of 30 in-depth interviews were conducted with 15 parents. This qualitative study was carried out using the Gadamerian-based research method. After parents were informed about the study, written and verbal consent was obtained from them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The content analysis of the interview data resulted in six themes: ‘sense of trust and cocoon effect, anxiety and conflicting emotions, parent–infant bonding and breastfeeding, fear of providing care, readiness/unreadiness and support needs and recommendations’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Parents often feel anxious and fearful about harming their vulnerable infants, with added stress surrounding their ability to provide care and the discharge process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Examination of Movement Behaviours and Guideline Adherence Rates Among Preschool-Aged Children With Disabilities","authors":"Maeghan E. James,&nbsp;Kathleen A. Martin Ginis,&nbsp;Rebecca L. Bassett-Gunter,&nbsp;Krista L. Best,&nbsp;Kelly P. Arbour-Nicitopoulos","doi":"10.1111/cch.70088","DOIUrl":"https://doi.org/10.1111/cch.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Meeting the 24-h movement behaviour guidelines (hereafter ‘guidelines’) supports healthy growth and development. It is recommended that preschool-aged children engage daily in 180 min of physical activity (PA), 60 min of which are moderate-to-vigorous PA (MVPA), along with less than 1 h of screen time and 10–13 h of sleep for optimal health. However, research on movement behaviours among children with disabilities in the early years is limited. This study aimed to describe movement behaviours and guideline adherence rates among preschool-aged children with disabilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional subanalysis was conducted of caregivers of young children (aged 4 years) with a disability (<i>N</i> = 31; 65% boys, 55% with a developmental disability) who were part of a Canadian study on movement behaviours in children and youth with disabilities. Caregiver-reported PA, screen time and sleep behaviours were collected using an online survey. Descriptive statistics were used to describe children's movement behaviours and proportion meeting the guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>On average, children engaged in 108 min (SD = 89.9) of total PA and 40 min (SD = 47.0) of MVPA per day. Children engaged in an average of 3.5 h (SD = 2.4) of screen time per day and slept an average of 10.6 h (SD = 1.0) per night. Overall, 23.1%, 6.9% and 79.3% of children met the guidelines for PA, screen time and sleep, respectively. One child (4.3%) met all three guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Few children with disabilities met the preschool-aged PA and screen time guidelines, though most met the sleep guideline. These findings highlight the need to further examine adherence of movement behaviour guidelines among a more representative sample of young children with disabilities and factors influencing adherence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards Context-Specific EHDI Services: Understanding Caregivers' Priorities and Preferences in South Africa Through a Conjoint Analysis","authors":"Katijah Khoza-Shangase,&nbsp;Ntsako P. Maluleke","doi":"10.1111/cch.70090","DOIUrl":"https://doi.org/10.1111/cch.70090","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Early Hearing Detection and Intervention (EHDI) programmes are critical for addressing hearing impairment in children by ensuring timely diagnosis and intervention. However, systemic barriers such as linguistic diversity, financial constraints and geographic accessibility challenges hinder equitable access to EHDI services in South Africa. This study explores caregivers' preferences for key attributes of EHDI services to inform the development of context-specific and family-centred programmes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A cross-sectional survey utilizing conjoint analysis was conducted with 31 caregivers of children with hearing impairment enrolled in early intervention preschools in Gauteng, South Africa. Participants evaluated five key attributes of EHDI services: language of service provision, location of diagnostic evaluations, mode of early intervention delivery, integration of support services and cost reduction strategies. Data were analysed using the conditional logit model to determine attribute preferences.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Caregivers preferred services provided in their home language, diagnostic evaluations conducted at the nearest healthcare facility, home-based early intervention sessions, regular integration of support services and reductions in the cost of EHDI services. Reluctance to adopt telehealth was also noted, highlighting concerns about technological literacy, internet access and trust in virtual care delivery. These preferences emphasize the need for accessible, linguistically congruent and affordable EHDI services tailored to the South African context.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study provides valuable insights into caregivers' preferences for EHDI services, offering actionable recommendations to address systemic barriers such as designing EHDI services that address systemic barriers to ensure equity in healthcare access. Policymakers and stakeholders should prioritize linguistically diverse service delivery, improve healthcare facility accessibility, incorporate continuous informational counselling and reduce financial burdens to ensure equitable and family-centred EHDI programmes. Future research should explore preferences among a more geographically and socio-economically diverse population to further refine these recommendations. While grounded in South Africa, the results provide insights applicable to other low- and middle-income countries (LMICs) with similar challenges.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posture and Physical Activity Levels of Parents of Children With Esophageal Atresia: A Comparative Study","authors":"Yağmur Elmalı İpek,&nbsp;Tutku Soyer,&nbsp;Numan Demir,&nbsp;Selen Serel Arslan","doi":"10.1111/cch.70086","DOIUrl":"https://doi.org/10.1111/cch.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of this study was to evaluate posture and physical activity of parents of children with Esophageal atresia (EA) and compare them with parents of healthy children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 20 children with EA aged 2–6 years and their parents as study group, and 20 healthy children aged 2–6 years and their parents as control group. The New York Posture Rating Test was used to assess posture, and the International Physical Activity Questionnaire-Short Form was used to assess physical activity of parents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Children in groups were similar in terms of age, gender and weight (<i>p</i> &gt; 0.05). Parents in groups were similar in terms of age, height, weight, educational level and economic status (<i>p</i> &gt; 0.05). Parents in the study group had higher postural impairment (<i>p</i> = 0.01). There was no significant difference between parents in term of physical activity score (<i>p</i> = 0.07). Although not significantly different, 70% (<i>n</i> = 14) of study group were found to be inactive compared to 35% (<i>n</i> = 7) of control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In conclusion, the posture of parents of children with EA was more affected than parents of healthy children, and both groups were similar in terms of physical activity, but parents of children with EA had more inactive lifestyle.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Label: Antipsychotic Prescribing Practices at a Paediatric Neurodisability Service in Australia","authors":"Ella May Huber,&nbsp;Monica Sophie Cooper","doi":"10.1111/cch.70085","DOIUrl":"https://doi.org/10.1111/cch.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The use of antipsychotic medications in children has been increasing in Australia and abroad. Children with complex physical and neurodevelopmental disability remain understudied in the prescribing literature, and we do not have a nuanced understanding of why and to whom antipsychotic medications are prescribed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective review of records to characterise antipsychotic prescription patterns for children with neurodisability at the Royal Children's Hospital, Melbourne, Australia. We used the Electronic Medical Record to identify children under 19 years, newly prescribed an antipsychotic medication by Department of Neurodevelopment and Disability clinicians between 24/09/2018 and 26/09/2022. We identified 167 encounters for 147 patients, representing 4% (147/3673) of the patients seen in that period. Main outcome measures were the frequency of antipsychotic medication prescription by drug, age category and sex; indication frequency; proportion of off-label use; and frequency and level of psychotropic polypharmacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In our cohort, 71% of children had intellectual disability (104/147), 42% autism spectrum disorder (61/147) and 42% cerebral palsy (61/147). Risperidone was the most prescribed antipsychotic medication, in 64% (107/167), followed by olanzapine in 18% (32/167). Off-label prescription was 62% (66/107) for risperidone, 97% (31/32) for olanzapine. The indication for antipsychotic medication was challenging behaviour in 74% (123/167), including aggression in 31% (52/167), agitation in 20% (33/167) and self-injury in 17% (28/167). Nonbehavioural indications included anxiety symptoms in 19% (32/167) and sleep disorders in 14% (24/167). Psychotropic polypharmacy (two or more concurrent psychotropic medications) was present in 78% (130/167), with sedatives (69%, 115/167) and antidepressants (31%, 52/167) most common.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A small proportion of children with neurodisability were prescribed antipsychotic medications, most frequently risperidone for challenging behaviours. Off-label prescription and psychotropic polypharmacy were common. Prescription occurred in a variety of clinical scenarios that sit outside the current field of evidence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clustering of 24-H Movement Behaviours and Its Associations With Eating Behaviours and Adiposity Among Mongolian Preschool Children: A Cross-Sectional Study","authors":"Ankhmaa Byambaa,&nbsp;Rachel A. Jones,&nbsp;Kar Hau Chong,&nbsp;Oyundelger Dechinjamts,&nbsp;Bayasgalan Jambaldorj,&nbsp;Anthony D. Okely","doi":"10.1111/cch.70084","DOIUrl":"https://doi.org/10.1111/cch.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Obesity-related behaviours such as physical activity, sedentary behaviour, sleep, screen time and diet often cluster in children. There is limited evidence on the clustering of movement behaviours among young children from low- and middle-income countries. This paper reports how 24-h movement behaviours cluster in Mongolian preschool children and their associations with eating behaviours and adiposity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional study involved 201 children aged 3–4 years attending kindergartens in urban and rural areas of Ulaanbaatar city, Tuv and Uvurkhangai provinces, Mongolia. Children wore accelerometers to measure physical activity, sedentary behaviour and sleep. Parents completed a questionnaire to report screen time and eating behaviours. To derive clusters, hierarchical and k-means cluster analyses were performed sequentially. Associations between clusters, eating behaviours and BMI z-score were analysed using ANOVA. Logistic regression was applied to estimate the odds of being overweight depending on cluster membership.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three clusters were identified: <i>All-rounders</i>, <i>Non-active Sleepers</i> and <i>Screeners</i>. We found that around half the children exhibited at least one unhealthy behaviour and were classified into clusters with a mix of healthy and unhealthy behaviours. The clusters did not differ by sociodemographic characteristics. No significant association was found between cluster membership and BMI z-score of children. The cluster at highest risk for being overweight was <i>Screeners</i> (odds ratio = 1.7, 95% CI: 0.67–4.33), who exhibited two obesogenic behaviours simultaneously, screen time for &gt; 4 h per day and regular consumption of unhealthy snacks (53%, <i>p</i> = 0.033) and sugary drinks (53%, <i>p</i> = 0.014).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Obesity prevention measures should begin in early childhood and target high-risk clusters, considering the co-occurrence of healthy and unhealthy behaviours. More research is needed in Mongolia to provide evidence for obesity prevention policies and inform targeted interventions to promote healthy behaviours from a young age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence on the Effectiveness of Public Policies for Physical Activity Promotion in the Early Childcare Education and Care Setting: A Systematic Review","authors":"Maike Till,&nbsp;Kevin Volf,&nbsp;Clara Tristram,&nbsp;Stefanie Do,&nbsp;Peter Gelius,&nbsp;Antje Hebestreit,&nbsp;Sylke Oberwöhrmann,&nbsp;Sven Messing","doi":"10.1111/cch.70078","DOIUrl":"https://doi.org/10.1111/cch.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early childhood education and care (ECEC) is crucial for shaping physical activity (PA) behaviours due to the significant time children spend in this setting. In addition, research has shown that public policies can be an important means to create a healthy environment. This systematic review explores the effectiveness of public policies promoting PA in ECEC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nine online databases (Scopus, Pubmed, Web of Science, SportDiscus, Cinahl, IBSS, ERIC, APA PsychINFO and Cochrane library) were searched in August 2023 for studies that examined public policies impacting children's PA behaviour or environments in ECEC. Data were extracted, and a quality assessment was performed using the Downs and Black checklist, and a narrative synthesis was applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 11 articles met the inclusion criteria. The studies from the United States, Canada and Australia involved either the implementation of legally binding policies (<i>n</i> = 6) or voluntary accreditation standards (<i>n</i> = 5). Studies reported on the adherence of ECEC centres to policies, the effects on children's PA behaviour or changes in the environment using both device-based (e.g., accelerometer) and self-report (e.g., questionnaires and interviews) measures as well as observation. Reported adherence rates of childcare centres to new regulations ranged from 74% to 94%. Studies on policies that implemented PA into the curriculum required a mandatory PA time of at least 60 min per day or implemented revised accreditation standards reported positive effects on the ECEC centres PA environment. Effects on the PA behaviour of children remained inconclusive, with studies reporting on both increased and decreased PA levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Public policies have the potential to change the environment and positively influence PA behaviour in preschool children. However, due to the heterogenous methodological approaches in the identified studies, the findings of this review have certain limitations. Future research needs to further investigate the effectiveness of policy approaches to promote PA in early childhood settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Early Life Adversity Limit Delivery of High-Quality Health Care Among Children?","authors":"Héctor E. Alcalá,&nbsp;Zeruiah V. Buchanan,&nbsp;Jun Chu,&nbsp;Dylan H. Roby,&nbsp;Mienah Z. Sharif","doi":"10.1111/cch.70081","DOIUrl":"https://doi.org/10.1111/cch.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adverse childhood experiences (ACEs) have been associated with poor health and underuse of preventive health services. However, less is known about how ACEs are associated with quality of care that children receive, like care that involves shared decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from the 2021–2022 National Survey of Children's Health (<i>n</i> = 47 179) the association between ACEs, both individual and cumulative and (1) needing medical decisions made in the past 12 months and (2) three different measures of always receiving care that involved shared decision-making. Logistic regression models were used to calculate odds of each outcome. Each of the 11 ACEs and the cumulative number of ACEs served as independent variables each in separate models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After accounting for confounders, the number of ACEs experienced, and most individual ACE items were associated with higher odds of needing medical decisions made, and lower odds of receiving health care that involved providers always engaging in the three measures of shared decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study expands the research showing a deleterious impact of ACEs on utilization of health care by showing that ACEs are associated with lower quality health care. This can be particularly determinantal to children with a history of ACEs because they have a greater need for health care and are less likely to use many types of health care. Efforts to improve health care quality for all children will be of particular benefit to vulnerable groups, like those with a history of ACEs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compliance With the 24-h Movement Behaviours Guidelines Among Brazilian Toddlers","authors":"Jessica Gomes Mota,&nbsp;Rafael Miranda Tassitano,&nbsp;Luís Lemos,&nbsp;Anthony Okely,&nbsp;Eline Coppens,&nbsp;Érika Alice dos Santos,&nbsp;Jorge Mota,&nbsp;Matthieu Lenoir,&nbsp;Clarice Maria de Lucena Martins","doi":"10.1111/cch.70083","DOIUrl":"https://doi.org/10.1111/cch.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Compliance with the WHO 24-Hour Movement Guidelines (i.e., physical activity, screen time and sleep duration) has been reported in studies comprising children in the early years. Despite the importance of these behaviours for healthy development, there is limited data on the proportion of toddlers who meet these recommendations. This study reported the compliance with the 24-h movement behaviours guidelines among low-income Brazilian toddlers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Physical activity (PA) was objectively measured using Actigraph wGT3X accelerometer in 144 toddlers (73 girls; 12–35 months of age). Sleep duration and screen time were parent-reported. Descriptive analyses were performed, and toddlers were classified as compliant/noncompliant with the 24-h movement guidelines, according to age and sex. The chi-square test and the Mann–Whitney test were used to explore differences and association according to age and sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Only 21% of the assessed toddlers complied with the overall movement behaviours guidelines. The highest prevalence of compliance was observed for PA among both boys and girls (98.63% and 98.59%, respectively), and among 1- and 2-year-old toddlers (100% and 97.61%, respectively). In contrast, the lowest compliance rates were observed for screen time (23.94% for boys and 32.87% for girls; and 16.66% for 1-year-old and 36.90% for 2-year-old toddlers). More than 60% of the assessed toddlers complied with sleep duration recommendation (74.64% and 67.12% for boys and girls, respectively; 73.33% and 69.04%, for 1-year-old and 2-year-olds, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementing strategies to encourage toddlers’ compliance with the 24-h movement guidelines in Brazilian low-income families should focus on maintaining PA levels and reducing screen time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Sustainability of Self-Help Groups for Caregivers of Children With Disabilities in Kilifi, Kenya: The Changing Context of the COVID-19 Pandemic","authors":"K. Bunning,&nbsp;J. K. Gona,&nbsp;S. W. Wanjala,&nbsp;S. Hartley","doi":"10.1111/cch.70079","DOIUrl":"https://doi.org/10.1111/cch.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Self-help groups offer an approach to empowering the lives of caregivers and their children with disabilities in settings of limited resources and support. A study was conducted over a 5-year period (2018–23) to assess the sustainability of 11 self-help groups in Kilifi, Kenya, during which there was the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An integrated framework of action research and mixed methods was carried out over three stages. Stage 1: pre-pandemic, three self-help groups participated in focus group discussions. Template analysis structured around the five pillars of the WHO community-based rehabilitation matrix (CBR: health, education, livelihood, social, empowerment) was carried out. Stage 2: inter-pandemic, a bespoke questionnaire was administered to monitor each group. Descriptive statistics were reported (Questions 1–6) and the CBR template was applied to free-field responses (Questions 7–8). Stage 3: post-pandemic, a quality of life (QoL) questionnaire was administered to 21 caregivers of children with disabilities and a control group of 11 parents of typically developing children in the same geographical area and 8 caregivers pre- and post-pandemic. Descriptive statistics were applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pre-pandemic, there was food security, medicine availability, school attendance, social connections and livelihood. Group plans involved livelihood and social inclusion developments. However, member commitment, community attitudes and environmental conditions were ongoing challenges. Inter-pandemic, some socially distanced group meetings focus on COVID-19 prevention, livelihood and social support. Livelihood activities were affected variously with reported difficulties including food insecurity, school closures and reduced meeting frequency. Post-pandemic comparison between caregivers and a control group revealed overall significantly higher caregiver QoL scores. Pre- to post-pandemic evaluations demonstrated overall significantly improved caregiver QoL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite the changing context brought by the COVID-19 pandemic, the self-help groups appear to have afforded some protection against the worst psychosocial and economic effects and helped to sustain the caregivers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}