CABLEChild and Adolescent

Behaviors in Long-term Evolution: A School-Based Health Lifestyle Study

CABLEChild and Adolescent

Behaviors in Long-term Evolution: A School-Based Health Lifestyle Study

PIPI ：： Lee-Lan Yen Lee-Lan Yen (( 李 蘭李 蘭 ))Szu-Hsien T. Lee (Szu-Hsien T. Lee ( 李思賢李思賢 ) Chuhsing K. Hsiao () Chuhsing K. Hsiao ( 蕭朱杏蕭朱杏 ) ) Ling-Yen Pan ( Ling-Yen Pan ( 潘怜燕潘怜燕 ) Wen-Chi Wu ) Wen-Chi Wu (( 吳文琪吳文琪 ))

CABLE Research TeamCABLE Research Team

Outline

Background

Study Design

Work Completed in 2004

Work Will Be Conducted in 2005

Background

Childhood is an important developmental stage. Early and successful interventions can improve children’s health behaviors and health status.A lifestyle based study following the development of children and their health related behaviors has never previously been conducted in Taiwan.

Specific AimsTo understand the status and types of health lifestyle among children.

To investigate the developments and changes of children’s health lifestyle over time.

To explore the determinants of children’s health lifestyle.

To analyze the correlation between children’s health lifestyle and health status.

Study Design (1)

Cross-sectionalLongitudinal IndividualFamily/GroupCommunity/SocietyChangeability

Study Design (2)

2001 2010

Observational Follow-up

-- Yearly Survey

2005

Study Design (3)

Year Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9

2001 A1 B1 C1 D1

2002 A2 B2 C2 D2

2003 A3 B3 C3 D3

2004 A4 B4 C4 D4

2005 A5 B5 C5 D5

2006 A6 B6 C6 D6

A1-A6: The 1st cohort of Taipei from 2001-2006

B1-B6: The 1st cohort of Hsinchu from 2001-2006

C1-C6: The 2nd cohort of Taipei from 2001-2006

D1-D6: The 2nd cohort of Hsinchu from 2001-2006

Study Framework~ Cross-Sectional Survey ~

Intrapersonal Factors

Interpersonal Factors

Organizational Factors

Health Lifestyle

Health Status

Independent Variables

1.Children & Parental Factors (demographics, health history,

personal characteristics, etc.)

2.Family Factors (family structure, SES, etc.)

3.School & Community Factors (size, resources, etc.)

4.Other Factors (survey time, study area, etc.)

Dependent Variables

Health Lifestyle

Health Status

Intermediate Variables

Interpersonal Factors

Intrapersonal Factors

Organizational Factors

Time 1 Time i

Time 1 Time i

Time 1 Time i

Time 1 Time i

Time 1 Time i

Study Framework~ Longitudinal Follow-up ~

2218 2085 1939

645637

0

500

1000

1500

2000

2500

3000

2001 2002 2003 year

person2001 participants 2002 new participants

Study Subjects of Cohort 1

1st grade 2nd grade 3rd grade

2730 2576

94.0%-6.0%

93.0%-7.0%

Study Subjects of Cohort 2

2075 1876 1812

634 637

0

500

1000

1500

2000

2500

3000

2001 2002 2003 year

person2001 participants 2002 new participants

4th grade 5th grade 6th grade

2510 2449

90.4%-9.6%

96.6%

-3.4%

Study Instruments

Questionnaires student parent teacher

Documents student health record school profile community profile

Data Collection

Intrapersonal

Factors

Interpersonal Factors

OrganizationalFactors

Health Lifestyle

Health Status

CABLE Questionnaires

School & Community Profiles

School Health Records

Field Survey, 2001-2003

Student name list

Informed consent

Subject name

list

Interviewer training

Field Survey

-- Children-- Parents

2001 & 2002

Subject name list

2003

Checkname list

Interviewer training

Field Survey

-- Children-- Parents

Field Survey, 2004 & 2005

Subject name list

Rearrange name

list

Interviewer training

Field Survey

-- Children-- Parents

Cohort 2(Grade 7 &

8)Subject name list

Check name list

Interviewer training

Cohort 1(Grade 4 &

5)

Field Survey

-- Children-- Parents

Mail Survey-- Children-- Parents

Data Management

Coding, key in, and checking

data

Creating different data files

Statistical analysis for specific

purposes

Work Completed in 2004

Data collection & management

Paper writing & publishingResults disseminationProfessional training

Data collection

teacher survey school profile community profile focus groups field & mail surveys

Data management

data files statistical

analyses

Paper Writing & Publishing in 2004

Conference papers2004 TPHA Annual Meeting (4 papers)132th APHA Annual Meeting (3 papers)2005 Biennial Meeting of SRCD (1 paper)First Conference on Statistical Methodology

(1 paper)

Journal articles1 paper published in Journal of Medical Science4 papers submitted to domestic and international journals

Results Dissemination in 2004

Annual reports Annual Report 2002 has been published

Annual Report 2003 is under preparation

Reference for parentsApplication of CABLE questionnaires

Professional Training

Master Doctor

2001

2002

2003

2004

Work Will Be Conducted

in 2005

Data Collection in 2005

Fifth graders (1st cohort) :

Subjects: students + parents

Field survey at 19 primary schools in 2 areas

Eighth graders (2nd cohort):

Subjects: students + parents

Field Survey at 27 junior high schools

+ mail survey

Data Analysis in 2005

Cross-sectional data analyses Multiple / logistic regression Multilevel analysis Structural equation model, etc.

Longitudinal data analyses Time series analysis Growth mixture model, etc.

Growth Mixture Model (GMM) (Muthen, 2004)

Use both continuous and categorical latent variables to represent individual differences in development.

Will be able to establish developmental typology of trajectories for child health lifestyle and also behavior problems.

The CABLE Project Website

CABLE s Homepage Sitemap

Overview Methods Publications News

Introduction

Memorandum of Events

Logo

Research Team

Contact Us

Study Design

Sampling

Data Collection

Field surveys

Student profiles

Health records

School profiles

Questionnaires

Student

Female caregiver

Male caregiver

Teacher

School

Journal Articles

Conference Papers

Annual Reports

Theses Abstracts

Links

Latest News

Major Findings

Longitudinal

Programs

Journals

Conferences

Members

Submit / Login

Member s Rights

Data

Discussion

Data ReleasePurpose: to maximize the contribution of the valuable CABLE datasets.A data-releasing guideline has been drawn-up in October, 2003.Three domestic researchers are working closely with CABLE research team currently.Connection with foreign scholars is building up.

2nd CABLE Conference

Will be held in early spring of 2005Target audiences:

Principles and teachers from study schools Officers from health and education departmentsResearchers and graduate students from academic institutes

CABLE Research TeamDivision of Health Policy Research,National Health Research Institutes

Institute of Health Policy and Management,College of Public Health, National Taiwan University

Department of Humanities and Social Sciences,National Defense Medical Center, National Defense University

~Thank You~

(1) Changes in Health-(1) Changes in Health-Related Behaviors Related Behaviors

Between 2001 and 2002 Between 2001 and 2002 Among Two Child Cohorts Among Two Child Cohorts

of the CABLE Studyof the CABLE Study

(1) Changes in Health-(1) Changes in Health-Related Behaviors Related Behaviors

Between 2001 and 2002 Between 2001 and 2002 Among Two Child Cohorts Among Two Child Cohorts

of the CABLE Studyof the CABLE StudyLee-Lan Yen, Ling-Yen Pan, Likwang Chen,Lee-Lan Yen, Ling-Yen Pan, Likwang Chen,

Szu-Hsien Lee, Chuhsing Hsiao, Szu-Hsien Lee, Chuhsing Hsiao,

Major FindingsMost of the positive health behaviors showed similar or increased rates over the two years. Decreased rates were only found in “wearing a motorcycle helmet” and “brushing teeth before sleeping”.

The prevalence rates of performing negative health behaviors and the rates of children who changed to good or bad behaviors over the two years varied depending on the behavioral item, cohort, and area.

Using vulgar language, drinking alcohol, and suicidal ideas are three problem behaviors with great potential in increase among children.

(2) The Influence of Family (2) The Influence of Family Interaction on the Initiation Interaction on the Initiation

of Smoking Among of Smoking Among Elementary Students in Elementary Students in

TaiwanTaiwan

(2) The Influence of Family (2) The Influence of Family Interaction on the Initiation Interaction on the Initiation

of Smoking Among of Smoking Among Elementary Students in Elementary Students in

TaiwanTaiwanLing-Yen Pan, Lee-Lan YenLing-Yen Pan, Lee-Lan Yen

Major FindingsThere were 3,961 students who completed the questionnaires both in 2001 and 2002.Regarding the initiation of cigarette smoking :

New triers : 2.89% Continuous triers : 7.74%

After controlling the children’s and family’s characteristics, those children with less family support and those receiving more punishment were more likely to be new triers.

Research Topics of Annual Report 2003

Lee-Lan Yen ( 李蘭 ): Change patterns of health behaviors from 2001 to 2003.

Tony Szu-Hsien Lee ( 李思賢 ): Test-retest the validity and reliability of psychological instruments for CABLE study.

Ling-Yen Pan ( 潘怜燕 ): Family interaction, parental psychological state and children’s suicidal ideation: Results from CABLE cohort study.

Wen-Chi Wu ( 吳文琪 ): Effects of school and class factors on the 6th graders’ health behaviors in northern Taiwan: Results of CABLE study, 2003.

Master ThesesHung-Chieh Chang ( 張弘潔 ): Social Capital of Family and School – Its Relationship with Children’s Internalized Behavioral Problems.

Jian-Tai Fu ( 傅健泰 ): The Impact of Leisure Activities on Sleep Deprivation and Negative Behaviors among Sixth-Graders ： Playing Computer Games as An Example.

Chi-Hsien Kao ( 高啟賢 ): The Relationship between Children’s Depression and Family Interaction Types.

Hsin-I Liu ( 劉欣怡 ): The Relationship Between Parent’s Working Time and Children’s Overweight and Obesity Among The Fifth Graders.

Social Capital of Family and School ─ Its Relationship with Children’s Internalized Behavioral Problems

Major Finding：Those who are in lack of family social capital (low family interaction and high family conflict) and school social capital (low school identification) have more internalized behavioral problems. Besides, social capital might have more influence on girls than on boys.

Master: Hung-Chieh Chang Advisor: Lee-Lan YenMaster: Hung-Chieh Chang Advisor: Lee-Lan Yen

The Impact of Leisure Activities on Sleep Deprivation and Negative Behaviors among Sixth-Graders： Playing Computer Games as An Example

Major Finding：The rates of children who playing PC games frequently and everyday are 21% and 9% respectively. Playing PC games was found to be associated with children’s sleep deprivation and negative behaviors.

Master:Jian-Tai Fu Advisor:Lee-Lan YenMaster:Jian-Tai Fu Advisor:Lee-Lan Yen

The Relationship between Children’s Depression and Family Interaction Types

Major Findings ：

Children were more likely to be depressed when their mothers have had psychological problems or fathers have performed violent behaviors.

Four types of family interaction: disciplinary, authoritative, supportive, and conflictive.

Children from authoritative or conflictive families were more likely to be depressed.

Master: Chi-Hsien Kao Advisor: Lee-Lan YenMaster: Chi-Hsien Kao Advisor: Lee-Lan Yen

The Relationship between Parent’s Working Time and Children’s Overweight and Obesity Among Fifth Graders

Major Findings ：

Overweight: 11.8%(male); 10.5%(female)Obesity: 4.0%(male); 2.8%(female). Maternal working time (over 50 hrs/wk) was found to be associated with children’s overweight.

Master: Hsin-I Liu Advisor; Lee-Lan YenMaster: Hsin-I Liu Advisor; Lee-Lan Yen Likwang ChenLikwang Chen