A description of 5- to 12-year old children's conception of health within the context of their daily life

Abstract

This study describes children's conception of health within the context of their daily life. Participants were boys and girls (n = 1,674) from three age groups (5–6, 8–9, and 11–12 years old) from different socio-economic living environments in urban and rural areas. In general, the results indicate that children's conception of health is multidimensional and is rooted in their daily-life experiences. Essentially, it is organized around three main dimensions, functionality, adherence to good lifestyle health habits, and mental health. Variations by age and living environment differences suggest that children's conception of health may reflect differences in their organization of information into schemata on the basis of their experience as well as structural changes in cognitive development.     

Condom Use and Contraception Non-Use Amongst 16-19 Year Olds: A Within Subjects Comparison

Abstract

The present study used a within subject design to examine which situation specific factors discriminated between the use of condoms and non-use of contraception in the context of preventing unwanted pregnancy. Adapting the methodology of Gold et al (1991, 1992), 215 16 to 19 year olds completed a questionnaire concerning the most recent time they had experienced sexual intercourse without using contraception (the “without contraception” encounter) and me most recent time they had experienced sexual intercourse using a condom (the “with a condom” encounter). The results showed that although past behaviour did not differentiate between the two encounters, situational factors relating to preparation for action, affect and interpersonal interaction were important. However, when analysed for men and women separately most of the differences were only found for women. In particular, the results suggest that women report non-contraception use as associated with feeling more guilty, having a partner who is less motivated to use contraception than they are, with neither themselves nor their partner raising the desire to use contraception, not expecting to have sex and not discussing contraception and not having contraception available. In contrast, for men, only the availability of contraception appeared to differentiate between the two encounters. The results are discussed in terms of the usefulness of the methodology and the associated shift in emphasis from users and non-users of contraception to use and non-use. The implications of the results in terms of health education interventions are also considered.     

Process Evaluation of A Physical Activity Self-Management Program For Children: Spark

Abstract

SPARK is a controlled field study of a multi-component elementary school program to promote physical activity. One component is a weekly classroom-based self-management program, with the goal of increasing physical activity outside of school. The curriculum included goal setting, behavioral skills training, a reward system, and parent involvement. An evaluation of curriculum implementation and association between process and outcome was conducted using direct observation of lessons, subjective ratings by 24 teachers and 391 parents, and participation records of 549 students. Teachers viewed the self-management curriculum less positively than the physical education curriculum. Teachers were observed implementing an average of 65% of curriculum elements, which may have contributed to the limited effects of the self-management program. Student participation in the program, measured by points earned for doing out of school physical activity, was correlated significantly with changes in body mass index and multiple psychosocial variables among boys but not girls. Barriers to full program implementation were identified, and a remaining challenge is to improve self-management curriculum implementation by teachers.     

Physical activity levels in young adult Hispanics and Whites: Social cognitive theory determinants

The psychosocial determinants of health-impairing physical inactivity among Hispanic populations have not been well explored nor have systematic comparisons been made with White populations using Social Cognitive Theory (SCT) measures. Three exercise-relevant efficacy measures (task, scheduling, and response efficacy), three exercise-relevant expectancy measures (physical health, psychological health, and self-evaluative), and self reports of activity levels were obtained from 20-year-old male and female Hispanics (n?=?94) and Whites (n?=?94). Activity levels for the two groups were analyzed in separate regression analyses that included the six SCT measures and gender as predictors. The set of seven predictors accounted for 51% of the variance in self-reported activity levels in each analysis. For young adult Hispanics, task efficacy, response efficacy, mental-health expectancies, and self-evaluative expectancies predicted activity level. For young adult Whites, scheduling efficacy and self-evaluative expectancies predicted activity level. Gender was not a significant predictor of activity level for either group. A multivariate analysis of variance indicated that the only SCT predictor on which Hispanics and Whites significantly differed was mental-health expectancies. The results of this study indicate that the psychosocial determinants of exercise are qualitatively different for the two groups and that the determinants of physical activity levels for young adult Hispanics may not be as effective as those of young adult Whites in sustaining lifelong exercise habits. Thus the present study offers a promising strategy for detecting inactivity-related physical- and mental-health risks at an age when lifelong habits of physical activity are still being formed.     

Engagement with meditation as a positive health trajectory: Divergent narratives of progress in male meditators

Objective: Studying personal narratives can generate understanding of how people experience physical and mental illness. However, few studies have explored narratives of engagement in health positive behaviours, with none focusing on men specifically. Thus, we sought to examine men’s experiences of their efforts to engage in and maintain healthy behaviours, focusing on meditation as an example of such behaviour.

Design: We recruited 30 male meditators, using principles of maximum variation sampling, and conducted two in-depth interviews with each, separated by a year. Main outcome measures: We sought to elicit men’s narratives of their experiences of trying to maintain a meditation practice.

Results: We identified an overall theme of a ‘positive health trajectory,’ in particular, making ‘progress’ through meditation. Under this were six main accounts. Only two articulated a ‘positive’ message about progress: Climbing a hierarchy of practitioners, and progress catalysed in other areas of life. The other four reflected the difficulties around progress: Progress being undermined by illness; disappointment with progress; progress ‘forgotten’ (superseded by other concerns); and progress re-conceptualised due to other priorities.

Conclusion: Men’s narratives reveal the way they experience and construct their engagement with meditation – as an example of health behaviour – in terms of progress.     

Psychology,health and health care

This article traces the development of the World Health Organization's emphasis on psychological and behavioural factors in health and notes its encouragement of recognition of these factors by member states. The article further outlines the reasons for this increasing recognition and stresses the important role of psychological and behavioural factors in the maintenance of health and prevention of illness.     

Young women’s construction of their post-cancer fertility

Younger women diagnosed with cancer often face compromised fertility as a result of their treatment. However, previous research has adopted a biomedical model of fertility and utilised hypothetico-deductive research methods which have not allowed for full exploration of women’s subjectivity. This study explored younger women’s construction of their fertility post-cancer, and their discussions of fertility with healthcare professionals, from a social constructionist epistemology. Semi-structured one-to-one interviews were conducted with eight women aged 18–26, across a variety of cancer types. Foucaultian Discourse Analysis identified three subject positions associated with fertility concerns: ‘Inadequate woman: Accepting the motherhood mandate’; ‘Adequate woman: Resisting the motherhood mandate’; and ‘Survival of the fittest: Woman as genetically defective’. Implications of these subject positions included feelings of inadequacy, fear and devastation; feeling undesirable to romantic partners; and concern about passing on cancer-positive genes. In describing healthcare professional interactions, women adopted positions of ‘Satisfied patient’; ‘Passive recipient patient’; or ‘Resisting the passive patient position’. Accounts of inadequate information provision were associated with anger and frustration, whereas feeling adequately informed was associated with satisfaction at making decisions about fertility preservation. These results suggest that fertility is of importance to young women cancer survivors, and that compromised fertility can negatively impact subjectivity.     

Examining the role of parental self-regulation in family physical activity: A mixed-methods approach

Physical activity (PA) is essential for good health. However, parents risk becoming less active because of the demands of parenting. This has consequences for children as parents are role models. The present study used a mixed-methods approach to explore parental self-regulation associated with PA. Data were collected from 36 parents with preschool-aged children. They were interviewed about their PA and their family’s PA. Parents also completed PA and self-regulation questionnaires and wore an accelerometer for five days. Qualitative data were examined using an inductive approach to thematic analysis. It showed that parents felt that they had limited time for personal PA. Mothers’ self-regulation was driven by an ethic of care and subjective norms, whereas fathers’ self-regulation was driven by beliefs about the importance of autonomy. Nevertheless, both parents saw caring for their children as the main priority. Quantitative data were examined using multiple regression analyses. Results showed that different self-regulatory behaviours predicted the PA of mothers and fathers. Which predictors were significant depended on the type of activity and how it was measured. The findings warrant longitudinal research that would enable the effect of family dynamics on self-regulation associated with PA to be assessed.     

Being and feeling liked by others: How social inclusion impacts health

This study examined the effects of perceived and actual social inclusion on health across and within individuals from a network perspective. During the first semester, 75 freshmen students provided bi-weekly ratings on their perceived social inclusion and health. To capture actual social inclusion, each student nominated liked and disliked fellow students. Perceived social inclusion mediated the effect of actual social inclusion on health. Specifically, students with more ‘likes’ perceived more social inclusion and those with higher perceived inclusion reported a better health status (between-person effect). In addition, at time points, when students received more ‘likes’ they also perceived more social inclusion. They reported better health at times when they felt more included (within-person effect). Thus, the perception of social inclusion is rooted in reality and actual social inclusion has an impact on health when passing the filter of perception.     

Social cognitions measured in 4 to 6 year olds are predictive of objectively measured physical activity

Objective: This study tested whether social cognitions from the reasoned action approach (RAA) can be reliably measured in a sample of primary school children (aged 4–6 years) and whether these RAA measures are predictive of physical activity.

Design: Longitudinal observational study with repeated measures over six months.

Measures: RAA variables were measured using a novel choice paradigm between physically active and sedentary pastimes. Relative reinforcing value, covariates (sex, age, deprivation and BMI) and physical activity by accelerometry (primary outcome) were also measured.

Results: RAA cognitions could be measured with acceptable retest reliability and discriminant validity and social norms regarding parents and teachers (but not friends) were correlated with physical activity and change in physical activity when relative reinforcing value and other covariates were controlled for.

Conclusions: RAA cognitions can be reliably measured in primary school children aged 4–6 and RRA measures appear useful in understanding children’s activity choices and may potentially inform future interventions.