CABLEChild and Adolescent

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

CABLEChild and Adolescent

Behaviors in Long-term Evolution: A School-Based Healthy 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 ) Likwang Chen () Likwang Chen ( 陳麗光陳麗光 ) ) Chuhsing K. Hsiao (Chuhsing K. Hsiao ( 蕭朱杏蕭朱杏 ) Ling-Yen Pan () Ling-Yen Pan ( 潘怜燕潘怜燕 ))

CABLE Research TeamCABLE Research Team

Outline

Background & Study DesignPrevious Work Accomplished Proposal of Year 2004Significance of CABLE ProjectFuture Directions

Background &

Study Design

BackgroundChildhood 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 Aims of CABLE ProjectTo understand the status and types of health lifestyle among the selected metropolitan and rural students in Taiwan.

To investigate their developments and changes of health lifestyle over time.

To explore the factors on determinants of student’s healthy/unhealthy lifestyle.

To analyze the relationship between health lifestyle and health status among the selected students.

To conduct interventions to promote students’ health.

Study Design (1)

Cross-sectionalLongitudinal IndividualFamily/GroupCommunity/SocietyChangeability

Study Design (2)

2001 2010

Observational Follow-up

-- Yearly Survey

Interventions

2005 2006

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 2001-2005 in Taipei City

B1-B6: The 1st cohort of 2001-2005 in Hsinchu County

C1-C6: The 2nd cohort of 2001-2005 in Taipei City

D1-D6: The 2nd cohort of 2001-2005 in Hsinchu County

Observational Follow-up

Sampling Design

Hsinchu Taipei

Large 1 1

Middle 2 2

Small 6 6

Participants of each grade 400x3 400x3

Total participants 1200x2 1200x2

Students and their parents are also our study participants

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 ~

Data Collection

Intrapersonal

Factors

Interpersonal Factors

OrganizationalFactors

Health Lifestyle

Health Status

Questionnaires

School & Community Profiles

Health Records

School Records

Instruments

Questionnaires for children Questionnaires for parentsChildren’s school recordsChildren’s health recordsSchool resources profile

Procedures of Field Survey

Contact schools Informed consents

Interviewer training

Field Survey-- Children-- Parents

student name lists

Study Subjects in 2001First grade Fourth grade

　 Taipei HsinChu Sub-total 　 Taipei HsinChu

Sub-total

Population (n) 33652 7072 40764 　 35242 6864 42106

Sample selected (n) 1950 1634 3584 1842 1770 3612

Sample participated (n) 1314 941 2255 1108 1010 2118

Participation rate (%) 66.5% 56.4% 61.9% 59.1% 55.7% 57.4%

Sample completed (n)

Children 1297 921 2218 1089 986 2075

Children’s fathers 991 736 1727 867 837 1704

Children’s mothers 1167 796 1963 1007 881 1888

Completion rate (%)

Children 98.7% 97.9% 98.4% 98.3% 97.6% 98.0%

Children’s fathers 76.4% 79.9% 77.9% 79.6% 84.9% 82.1%

Children’s mothers 90.0% 86.4% 88.5% 　 92.5% 89.4% 91.0%

Study Subjects in 2002Second grade Fifth grade

　 Taipei HsinChu Sub-total 　 Taipei HsinChu

Sub-total

Sample selected (n) 1947 1633 3580 1864 1651 3515

Sample participated (n) 1582 1189 2771 1396 1145 2541

Participation rate (%) 81.3% 72.8% 77.4% 74.9% 69.4% 72.3%

Sample completed (n)

Children 1556 1174 2730 1364 1135 2510

Children’s fathers 1300 993 2293 1102 974 2076

Children’s mothers 1442 1050 2492 1234 1022 2255

Completion rate (%)

Children 98.4% 98.7% 98.5% 97.7% 99.1% 98.8%

Children’s fathers 82.2% 83.5% 82.7% 78.9% 85.1% 81.7%

Children’s mothers 91.2% 88.3% 89.9% 　 88.4% 89.3% 88.7%

Children Followed in 2002

First grade in 2001 Fourth grade in 2001 　 Taipei HsinChu Sub-total 　 Taipei HsinChu Sub-total

n 1215

870 2085 1003 873 1876

% 93.7 94.5 94.0 　 92.1 88.5 90.4

Data Management

Coding, key in, and checking dataCreating different data filesStatistical analysis for specific purposes

Previous Work Accomplished

Data collection & management

Paper writing & publishingResults disseminationProfessional training

Data collection & management

CABLE 2001 & 2002 surveys were conductedStudents’ academic & health records were collectedSchool profiles were collected Various data files were created & analyzed The third wave survey will be conducted at the end of 2003

Paper Writing & Publishing

Conference papersInternational Conference on Adolescent Health; Annual Meeting of Taiwan Public Health Association; 130th APHA Annual Meeting, etc.

Journal articlesPublished in IUHPE-Promotion and EducationTarget journals: Journal of School Health, Preventive Medicine, Taiwan Journal of Public Health, Medical Education, etc.

General articles

Results DisseminationAnnual reports

CABLE 2001 has been published

CABLE 2002 is under preparation

CABLE conference Held in August, 2002

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

Professional Training

Master Doctor

2001

2002

2003

Proposal of

CABLE 2004

SPECIFIC AIMS ~ quantitative study~

To keep abreast of the trends of children’s health behaviors and health status.To explore factors associated with the trends of children’s health behaviors and health status.To improve existing statistical models or develop new statistical models for trend analysis and multilevel analysis.

SPECIFIC AIMS ~ qualitative study ~

To explore the formation and determinants of children’s concepts, values, and behaviors related to cigarette smoking.To investigate the children’s cognition, perception, attribution, and resolution of parents’ marital conflicts, and their impact on child adjustment.To explore how parents’ expectations toward achievements affect children’s psychological well-being and suicidal ideation.

METHODS - 1

A follow-up survey using same instruments (with some modification) will be implemented among four student cohorts with their parents.

Fourth graders: Following previous protocol to collect data.

Seventh graders: Mail or field survey will be used to collect data.

Mail survey

The students’ permanent addresses will be collect and verify in June, 2004, before they graduate from the elementary schools.

A set of questionnaires and a stamped addressed return envelope will be mailed to the subjects in October, 2004.

After two weeks, a reminding postcard will be sent to those who have not returned the questionnaires.

Following another two weeks, the whole set of questionnaires will be sent out again to the non-respondents.

METHODS - 2

A series of focus group discussions will be conducted to collect qualitative data among the fourth graders and their parents.

Topics will be discussed in focus groups

A. The formation and determinants of cigarette

smoking among the students

B. Marital conflict, attribution and conflict

resolution among the students

C. The relationship between Parental expectation

and children’s performance and happiness.

Participants of Focus Groups~ students ~

Each school from Taipei City and Hsin-Chu County, separate from CABLE schools, will be purposively selected to avoid contaminating the natural observation of existing CABLE cohorts.

– Three classes of fourth graders will be randomly selected.

– In each class, students will be randomly assigned into three groups.

– Each group will be randomly assigned to a research topic.

Participants of Focus Groups~ Parents and Teachers ~

Parents:

– Invitation letters will be sent out.

– The volunteers will be randomly assigned to 6 groups. (3 groups for topic a and 3 groups for topic c)

Teachers:

– 10 teachers in each schools, who are in charge of teaching fourth graders, will be invited to attend the focus group interviews for topic a.

Significance Of

CABLE Project

Significance (1)

To establish a model for long-term study in the field of health behavioral sciences.

To help the development of theories related to health behaviors.

To systematically describe the patterns of behavioral developments and changes in childhood and adolescence.

To identify the factors influencing children’s and adolescents’ lifestyles.

Significance (2)

To Build up longitudinal datasets and open to

public use.

To provide our government the research

results as references for making health

policies for children and adolescents.

To strengthen the research abilities and

experiences of research teams.

To establish a cooperative relationship

between the universities and the NHRI.

Future Directions

Future DirectionsTo continue following the development and

changes of children’s health and behaviors.To intensively investigate the impact of

behavioral, psychological and social factors on health using qualitative methodology.

To conduct a series of interventional experiments in order to develop school health promotion models.

To empower the faculty and staff of study schools.

CABLE Research Team

Division 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~

Thank You!Thank You!Thank You!Thank You!

(1) (1) Distribution of Health Distribution of Health Behaviors in 2001Behaviors in 2001

(1) (1) Distribution of Health Distribution of Health Behaviors in 2001Behaviors in 2001

Lee-Lan Yen, Likwang Chen, Szu-Hsien LeLee-Lan Yen, Likwang Chen, Szu-Hsien Lee, Chuhsing Hsiao, Ling-Yen Pane, Chuhsing Hsiao, Ling-Yen Pan

Behaviors Positive to Health

65-90% of both first and fourth graders.

walking, seatbelt, helmet, washing hands, brushing teeth, breakfast, fruit and vegetables and drinking water.

Exercise (apart from school physical education classes) was relatively lower, at about 55 to 65%.

Behaviors Negative to Health

Unhealthy behaviors reported by more than 50% of subjects

First graders: staying up late, eating fast food, watching TV, and eating late at night. Fourth graders: staying up late, eating food late at night, watching TV, eating fast food, using vulgar language, getting into fights, and suppressing urination.

ConclusionThe proportion of students with positive behaviors was less than ideal. The proportion of children displaying negative behaviors was by no means low. Despite variations in health behaviors according to sex, area and grade, the results demonstrate that all students need to establish healthier lifestyles.

(2) Family Interaction and (2) Family Interaction and Children’s Mental Children’s Mental

HealthHealth

(2) Family Interaction and (2) Family Interaction and Children’s Mental Children’s Mental

HealthHealth

Ling-Yen Pan, Lee-Lan Yen,Ling-Yen Pan, Lee-Lan Yen, Wen-Chi Wu, Yi-Chen ChiangWen-Chi Wu, Yi-Chen Chiang

Objectives

To understand family interaction patterns in fourth graders’ families.

To examine the relationship between family interaction and the mental health status of these children (including depression, social loneliness, and social

anxiety).

Methods

1959 fourth graders from 18 primary schools participating in the 2001 survey.

1008 male ； 951 female

1037 from Taipei City ； 922 from HsinChu County

ConclusionIn regards to family support, functional support is more common.Majority of parents still use traditional methods such as scolding to punish their child.Family activities and family support were negatively related to negative mental health status.The causal relationship between family interaction and children’s mental health needs to be clarified.

(3) The Relationship(3) The Relationship between Parents’ and between Parents’ and Children’s Health Children’s Health BehaviorsBehaviors

(3) The Relationship(3) The Relationship between Parents’ and between Parents’ and Children’s Health Children’s Health BehaviorsBehaviors

Likwang Chen, Lee-Lan Yen,Likwang Chen, Lee-Lan Yen, Ya-Ling Chiu, Chen-Lin Yeh, Wei-Chih YangYa-Ling Chiu, Chen-Lin Yeh, Wei-Chih Yang

Objectives

The links between parents and children in some behaviors that play a significant role in obesity, injury, and oral and visual health.Differences between paternal and maternal modeling effects.Differences in parental modeling effects between the first and fourth grades.

Methods

Types of health behaviors investigatedDietary habits(4)

Physical activity(1)

Behaviors related to injuries(2)

Behaviors related to oral health(2)

Behaviors related to visual health(1)

Statistical model: the logit model

Conclusion (1)The existence of parental modeling effects on some child health behaviors, such as eating breakfast, drinking water, eating late at night, protective practice for traffic injuries, oral hygiene practice, dental care utilization and some pattern of watching television.

No evidence for supporting the existence of parental modeling effects on fruit and vegetable consumption, physical activity, and violent behavior.

Conclusion (2)

No substantial statistical evidence for supporting the point that maternal modeling effects are stronger than paternal modeling effects.

No substantial statistical evidence for supporting the point that parental modeling effects are stronger in the fourth grade than in the first grade.

(4) The Association of Child(4) The Association of Child Behavioral Problems Behavioral Problems and and Maternal Psychiatric Maternal Psychiatric DisturbanceDisturbance

(4) The Association of Child(4) The Association of Child Behavioral Problems Behavioral Problems and and Maternal Psychiatric Maternal Psychiatric DisturbanceDisturbance

Szu-Hsien Lee, Lee-Lan Yen, Li-Ting ChenSzu-Hsien Lee, Lee-Lan Yen, Li-Ting Chen

Objective

Intended to examine the relationship between psychopathology in mothers, inter-parental conflict and children’s internalizing and externalizing behavioral problems

Methods2,218 first graders and 2,075 fourth gradersDependent variables

Externalizing behavioral problems Conduct behavior and Substance use

Internalizing behavioral problemsDepression, Social anxiety, and Social loneliness

Independent variablesDemographicsInter-parental conflictMaternal psychiatric status

ConclusionHigher inter-parental conflict was associated with more internalizing and externalizing problems for both grades.Fourth-grade girls were more likely to have internalizing problems than boys, but boys were more likely than girls to have externalizing problems.Maternal psychiatric disturbance was not significantly predictive for internalizing and externalizing problem behaviors. The findings suggest that psychopathology in mothers may have no influence on behavioral development of a regular child.

(5) The Differences in Children’s Health Behaviors between 2001 and 2002

(5) The Differences in Children’s Health Behaviors between 2001 and 2002

The rates of performing positive behaviors among children in Taipei city, 2001 & 2002

Taipei City Boy Girl Total Behavior

a b c d

χ2

a b c d

χ2

a b c d

χ2

Walking carefully 75.0 6.8 14.9 3.3 *** 77.2 4.8 15.3 2.7 *** 76.1 5.8 15.1 3.0 ***

Wearing a seatbelt 69.3 8.1 18.8 3.8 *** 74.7 5.8 2.9 16.6 *** 72.0 7.00 17.7 3.3 ***

Wearing a motorcycle helmet 70.9 11.7 10.6 6.8 -- 69.2 12.5 11.1 7.2 -- 70.1 12.0 10.9 7.0 --

Washing hands before eating 56.4 14.5 16.8 12.3 -- 66.4 10.9 14.1 8.6 -- 61.3 12.7 15.5 10.5 --

Brushing teeth before sleeping 70.8 9.1 9.5 10.6 -- 79.0 7.9 8.0 5.1 -- 74.8 8.5 8.8 7.9 --

Eating breakfast 84.7 5.2 8.3 1.8 * 85.4 4.8 7.7 2.1 * 85.1 5.0 8.0 1.9 **

Eating fruit and vegetables 61.4 16.5 15.4 6.7 -- 64.4 14.0 14.1 7.5 -- 62.9 15.3 14.8 7.0 --

Drinking water 73.4 10.8 12.1 3.7 -- 76.0 7.4 12.5 4.1 ** 74.7 9.1 12.3 3.9 *

Doing exercise 41.2 19.8 18.8 20.2 -- 39.7 21.7 18.8 19.8 -- 40.4 20.7 18.8 20.1 --

a: high performance in 2001→high performance in 2002 b: high performance in 2001→low performance in 2002c: low performance in 2001→high performance in 2002d: low performance in 2001→low performance in 2002

The rates of performing positive behaviors among children in Hsinchu country, 2001 & 2002

Hsinchu County Boy Girl Total Behavior

a b c d χ2 a b c d χ

2 a b c d χ2

Walking carefully 72.5 8.3 16.0 3.2 ** 76.9 6.1 14.6 2.4 *** 74.6 7.3 15.3 2.8 ***

Wearing a seatbelt 62.1 11.6 20.2 6.1 ** 69.6 8.4 19.1 2.9 *** 65.7 10.0 19.7 4.6 ***

Wearing a motorcycle helmet 53.1 19.4 12.9 14.6 * 47.8 20.7 17.6 13.9 -- 50.6 20.0 15.1 14.3 *

Washing hands before eating 55.0 17.4 17.0 10.6 -- 62.5 16.7 12.6 8.2 -- 58.6 17.1 14.8 9.5 --

Brushing teeth before sleeping 61.8 17.7 10.7 9.8 ** 66.6 11.5 11.8 10.1 -- 64.2 14.7 11.2 9.9 *

Eating breakfast 76.9 7.9 12.7 2.5 * 80.3 7.0 10.8 1.9 -- 78.5 7.5 11.8 2.2 **

Eating fruit and vegetables 47.0 20.5 16.4 16.1 -- 52.5 20.2 17.6 9.7 -- 49.7 20.4 16.9 13.0 --

Drinking water 60.3 17.1 16.2 6.4 -- 64.3 14.1 13.9 7.7 -- 62.3 15.6 15.1 7.0 --

Doing exercise 39.9 19.9 19.2 21.0 -- 40.7 23.4 20.0 15.9 -- 40.3 21.6 19.6 18.5 --

a: high performance in 2001→high performance in 2002 b: high performance in 2001→low performance in 2002c: low performance in 2001→high performance in 2002d: low performance in 2001→low performance in 2002

The rates of performing negative behaviors

among children in Taipei city, 2001 & 2002

Taipei City Boy Girl Total Behavior

a b c d χ 2 a b c d χ 2 a b c d χ 2 Staying up late 47.7 17.8 24.9 9.6 ** 45.4 20.5 19.4 14.7 -- 46.6 19.1 22.2 12.1 -- Eating late at night 43.5 17.6 21.5 17.4 -- 35.0 22.4 20.2 22.4 -- 39.4 19.9 20.8 19.9 -- Eating fast food 44.8 22.3 17.0 15.9 * 33.7 25.9 17.4 23.0 ** 39.4 24.1 17.2 19.3 ** Playing computer games >2hrs 19.7 30.2 14.7 35.4 *** 7.2 23.5 11.7 57.6 *** 13.6 26.9 13.2 46.3 *** Watching TV >2hrs 35.4 26.8 15.1 22.7 *** 26.1 24.6 14.4 34.9 *** 30.8 25.7 14.8 28.7 *** Using vulgar language 23.6 13.9 20.9 41.6 ** 11.4 11.4 16.4 60.8 * 17.7 12.7 18.7 50.9 ** Breaking things when angry 8.1 17.8 13.4 60.7 -- 4.0 10.0 9.6 76.4 -- 6.1 14.0 11.5 68.4 -- Getting into fights 21.0 19.6 19.4 40.0 -- 11.9 13.3 11.0 63.8 -- 16.6 16.5 15.3 51.6 -- Causing damage public property 2.1 6.4 6.1 85.4 -- 0.2 3.2 2.9 93.7 -- 1.2 4.9 4.5 89.4 -- Stealing 1.5 11.7 7.4 79.4 * 0.9 11.1 3.8 84.3 *** 1.2 11.4 5.6 81.8 *** Smoking 2.3 4.8 3.1 89.8 -- 0.7 4.4 1.2 93.7 ** 1.5 4.6 2.2 91.7 ** Drinking alcohol 19.8 11.4 17.4 51.4 ** 11.4 9.3 12.6 66.7 -- 15.7 10.4 15.0 58.9 ** Suicidal ideation 6.8 7.9 12.9 72.4 ** 3.7 4.1 12.4 79.8 *** 5.3 6.0 12.7 76.0 ***

a: high performance in 2001→high performance in 2002 b: high performance in 2001→low performance in 2002c: low performance in 2001→high performance in 2002d: low performance in 2001→low performance in 2002

The rates of performing negative behaviors among children in Hsinchu country, 2001 & 2002

Hsinchu County Boy Girl Total Behavior

a b c d χ2 a b c d χ

2 a b c d χ2

Staying up late 42.5 21.8 21.4 14.3 -- 38.4 28.2 17.3 16.1 ** 40.5 24.9 19.4 15.2 *

Eating late at night 35.8 23.1 24.1 17.0 -- 33.3 19.1 22.2 25.4 -- 34.6 21.2 23.1 21.1 --

Eating fast food Playing computer games >2hrs

33.6 28.4 18.2 19.8 ** 24.6 28.7 17.0 29.7 *** 29.2 28.6 17.6 24.6 ***

Playing computer games >2hrs games >2hrs 26.4 31.6 15.6 26.4 *** 10.1 27.7 8.8 53.4 *** 18.5 29.7 12.3 39.5 ***

Watching TV >2hrs 41.3 23.3 19.2 16.2 -- 33.1 30.5 15.6 20.8 *** 37.3 26.7 17.5 18.5 ***

Using vulgar language 16.6 14.7 20.2 48.5 -- 9.1 12.3 18.1 60.5 * 13.0 13.5 19.2 54.3 **

Breaking things when angry 6.6 12.6 16.2 64.6 -- 3.1 10.9 9.7 76.3 -- 4.9 11.8 13.0 70.3 --

Getting into fights 18.0 14.1 23.5 44.4 ** 11.5 12.5 18.7 57.3 * 14.8 13.3 21.2 50.7 ***

Causing damage public property 3.2 7.0 9.4 80.4 -- 0.5 5.7 3.6 90.2 -- 1.9 6.4 6.6 85.1 --

Stealing 2.5 9.9 8.1 79.5 -- 1.7 9.8 4.8 83.7 ** 2.1 9.9 6.5 81.5 *

Smoking 6.8 9.3 6.5 77.4 -- 0.0 5.5 2.6 91.9 * 3.5 7.4 4.7 84.4 *

Drinking alcohol 24.3 13.7 17.6 44.4 -- 12.0 11.7 11.0 65.3 -- 18.3 12.8 14.4 54.5 --

Suicidal ideation 4.5 8.5 8.3 78.7 -- 3.4 6.9 6.5 83.2 -- 3.9 7.8 7.4 80.9 --

a: high performance in 2001→high performance in 2002 b: high performance in 2001→low performance in 2002c: low performance in 2001→high performance in 2002d: low performance in 2001→low performance in 2002

Incidence rates of children (the 1st graders in 2001)

who performed positive behaviors in 2002

Taipei City Hsinchu County Behavior

Boy Girl Sub- total

Boy Girl Sub- total

Total

Walking carefully 7.73 5.47 6.62 10.96 9.69 10.37 8.01

Wearing a seatbelt 8.81 6.32 7.73 4.79 6.76 5.71 6.81

Wearing a motorcycle helmet 6.14 7.85 6.84 10.19 13.52 11.90 9.34

Washing hands before eating 7.66 4.80 6.42 8.60 4.69 6.63 6.52

Brushing teeth before sleeping 5.16 3.03 4.13 8.78 7.01 7.86 5.54

Eating breakfast 3.59 2.70 3.19 8.36 4.74 6.51 4.46

Eating fruit and vegetables 5.38 4.46 5.01 11.39 6.43 8.93 6.49

Drinking water 5.13 3.23 4.25 6.45 5.20 5.81 4.79

Doing exercise 12.92 11.45 12.12 18.08 13.22 15.64 13.51

Incidence rates of children (the 1st graders in 2001)

who performed negative behaviors in 2002Taipei City Hsinchu County

Behavior Boy Girl

Sub- total

Boy Girl Sub- total

Total

Staying up late 23.94 19.02 21.79 21.02 18.02 19.52 20.53

Eating late at night 20.59 21.23 20.73 24.28 22.53 23.42 21.66

Eating fast food 16.43 17.32 16.62 18.58 17.11 17.89 16.98

Playing computer games > 2hrs 14.19 10.97 12.62 15.93 9.52 12.78 12.39

Watching TV >2hrs 15.48 13.53 14.56 18.77 16.09 17.43 15.60

Using vulgar language 20.76 17.33 19.13 21.28 17.61 19.34 18.86

Breaking things when angry 12.68 9.18 10.99 16.45 9.63 13.08 11.75

Getting into fights 19.34 10.42 15.09 24.18 18.65 21.32 17.51

Causing damage public property 6.22 2.76 4.53 10.21 3.97 7.09 5.47

Stealing 7.50 2.79 5.33 8.48 4.52 6.46 5.72

Smoking 3.03 1.31 2.19 6.40 2.71 4.54 3.14

Drinking alcohol 17.31 12.87 15.11 16.49 10.14 13.35 14.52

Suicidal ideation 12.59 11.91 12.17 9.29 5.91 7.53 10.20

Research Topics Going On~

Lee-Lan Yen: A comparison of health behavioral performance between 2001 and 2002.Likwang Chen: Parents’ and children’s health behaviors – Exploration of parental influences over elementary school children’s developmental stages. Tony Szu-Hsien Lee: Locus of control, social anxiety and social loneliness in forth grade children .Ling-Yen Pan: Family interaction and children’s deviant behaviors. Wen-Chi Wu: Comparison of characteristics between follow-up and new participants in a longitudinal study – Are they different?

Master Theses

Ju-Yu Chen （陳如毓）： The Relationship between Children’s Unhealthy Behaviors and Parents’ Unhealthy Behaviors.

Yi-Chen Chiang （江宜珍）： Factors related to suicide ideation among elementary school students.

Chi-Chen Wu （吳其臻）： The Association of Family Conflict, Interpersonal Coping, and Psychosocial Distress among Children .

Fang-Mei Lin （林芳美）： The Relationship between Children's Eating Behaviors and Parental Eating Paterns.

Ching-Ju Chiu （邱靜如）： A Typology of the 4th Graders’ Health Behaviors.

Li-Ting Chen （陳俐婷）： The Relationship between Parental Conflict, Parenting Behaviors, and Children Internalizing Behaviors.

(M1) The Relationship of Unhealthy Behaviors in Grade Four Children and

their Parents

(M1) The Relationship of Unhealthy Behaviors in Grade Four Children and

their Parents

Master: Ju-Yu ChenMaster: Ju-Yu ChenAdvisor: Lee-Lan YenAdvisor: Lee-Lan Yen

Major FindingsThe most prevalent health-risk behaviors of children are staying up late, eating in the late night, and eating fast food. 　 The prevalence rates are 82.8%, 69.2% and 64.6%, respectively.

Health-risk behaviors can be categorized into four factors: unhealthy lifestyle, antisocial behaviors, substance use, and intake of high calorie food.

(M2) Factors Related to Suicide Ideation among

Elementary School Students

(M2) Factors Related to Suicide Ideation among

Elementary School Students

Master: Yi-Chen Chiang Master: Yi-Chen Chiang Advisor: Shiao-Chi WuAdvisor: Shiao-Chi Wu

Lee-Lan YenLee-Lan Yen

Major FindingsThe prevalence rates of “having suicide ideation in the past” and “having had suicide ideation over the past month” among fourth graders were 19.77% and 8.39%, respectively.

Findings from the structure equation model showed that the factors which increase the likelihood of “having suicide ideation in the past” through the function of depression or social loneliness were “girls”, “ using substance”, “often punished by parents”, “having older mother,” and “having less family support.”

Factors that were indirectly related to the emergence of suicide ideation over the past month through the function of depression or social loneliness were “residence in Taipei City,” “using substance,” “violence-oriented,” and “having less family support.”

(M3) The Association of Family Conflict,

Interpersonal Coping and Psychosocial Distress

among Children

(M3) The Association of Family Conflict,

Interpersonal Coping and Psychosocial Distress

among Children

Master: Chi-Chen WuMaster: Chi-Chen WuAdvisor: Tony Szu-Hsien LeeAdvisor: Tony Szu-Hsien Lee

Lee-Lan YenLee-Lan Yen

Major FindingsFamily conflict, gender, parental support, discipline, number of friends, and peer relationship were significant predictors of social anxiety and social loneliness.

With respect to social loneliness, there were direct and indirect influences of family conflict and coping. Only direct effects of family conflict were found in terms of children’s social anxiety.

(M4) The Relationship between The Relationship between Children's Eating Behaviors and Children's Eating Behaviors and

Parental Eating PatternsParental Eating Patterns

(M4) The Relationship between The Relationship between Children's Eating Behaviors and Children's Eating Behaviors and

Parental Eating PatternsParental Eating Patterns

Master: Fang-Mei LinMaster: Fang-Mei LinAdvisor: Lee-Lan YenAdvisor: Lee-Lan Yen

Major FindingsThe most frequent matching type of eating behaviors in eating breakfast and eating fruit and vegetables is “father high vs. mother high”. The most frequent matching type in eating in late night and eating fast food is “father low vs. mother low”.

The relationship between school children’s eating behaviors and matching types of their parental eating behaviors is significant in eating breakfast, eating in late night, and eating fast food.

(M5) A Typology of the 4th Graders’ Health

Behaviors

(M5) A Typology of the 4th Graders’ Health

Behaviors

Master: Ching-Ju ChiuMaster: Ching-Ju ChiuAdvisor: Lee-Lan YenAdvisor: Lee-Lan Yen

Major FindingsThe children’s health behaviors can be categorized into five factors, which were named “positive health behavior”, ”deviant health behavior”, “substance use behavior”, “violent inclination behavior”, and “health indulgent behavior”.

Based on the factor scores, the subjects were clustered into four groups, and they were named as “healthy type”(48%), “indulgent type”(32.9%), “violent type”(17.8%), and “ deviant type”(1.3%).

(M6) The Relationship between Parental Conflict, Parenting Behaviors and

Children Internalizing Behaviors

(M6) The Relationship between Parental Conflict, Parenting Behaviors and

Children Internalizing Behaviors

Master: Li-Ting ChenMaster: Li-Ting ChenAdvisor: Ruey-Ling ChuAdvisor: Ruey-Ling Chu

Tony Szu-Hsien LeeTony Szu-Hsien Lee

Major FindingsIn general parental conflict group:

Parental conflict has indirect effect on child internalizing behaviors through severe punishment.Parental conflict has no influence on supportive parenting behavior, but supportive parenting behaviors and severe punishment have protective effect on parental conflict and child internalizing behaviors.

In severe parental conflict group:Parental conflict affect child internalizing behaviors directly and strongly. Parental conflict affect supportive parenting behaviors, but supportive parenting behaviors have no protecting effect on parental conflict and severe punishment.