the bigger picture of child health - university of …...12/06/2019 1 uc child well-being research...

12/06/2019

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UC Child Well-being Research Institute | www.canterbury.ac.nz/childwellbeing @UCChildwellbeing @UCCWRI

The bigger picture of child health

Professor Philip Schluter

Ms Hyun (Alice) Kim

Ms Nikita Gregory


We are in the midst of a Data Revolution

• BigData, open source data, structured and unstructured data, geospatial data, …

• It challenges us to rethink data, information and knowledge

• But will big data offer answers to the big questions?

• Data doesn’t just reflect the world, but also changes it


Sudden infant death syndrome (SIDS or cot death) in New Zealand

• In the 1980s, one in every 250 babies died suddenly, unexpectedly and without explanation (≈240 babies per year, in today’s terms)

• Indescribable trauma – many theories, no solutions


Sudden infant death syndrome (SIDS or cot death) in New Zealand• New Zealand Cot Death Study

• 3-year case-control study (1987-1990)

• Multidisciplinary – social determinants of health framework

• Three modifiable risk factors identified, published in 1991 –prevention campaign launched:• prone sleeping position

• maternal smoking

• lack of breastfeeding

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Sudden infant death syndrome (SIDS or cot death) in New Zealand

• prone sleeping position (≈43% to less than 3%)

• maternal smoking (≈34% to ≈10%)

• breastfeeding to 6 weeks (≈85%)

• Over 3,000 New Zealand babies lives saved by 2008

• 25 SIDS death in New Zealand in 2015

• UK fell from 1,500 to 600 per year by the mid 1990s


BigData

• Today’s world is increasingly digitised; the amount of data produced daily is truly mind-boggling. In 2018 it was estimated that 2.5 quintillion bytes of data created each day, and this is rapidly accelerating


BigData

• Today’s world is increasingly digitised; the amount of data produced daily is truly mind-boggling. In 2018 it was estimated that 2.5 quintillion bytes of data created each day, and this is rapidly accelerating

2,500,000,000,000,000,000

• In the last two years alone, 90% of the world’s data were generated

• New Zealand’s Integrated Data Infrastructure (IDI) holds microdata about all New Zealand people and households; it individually links detailed data from health, education, justice, income and work, population, and many other sources


Child population wellbeing

• Conceptually appealing to bring together data from multiple sources

• Will big data offer answers to the big questions?

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• Conceptually appealing to bring together data from multiple sources

• Will big data offer answers to the big questions?

• What we can learn about educational success when multi-disciplinary data are weaved together from a social-determinants framework

• E.g.: Pacific Islands Families (PIF) Study

• But what about the translation to practice

• Stakeholder perceptions of data sharing

• Ethics, Law, Privacy, Consent, Big Brother (surveillance)

• Implementation



Research Motivation

• What does `educational success’ mean?

• Pacific perspective vs. Documented outcome

• Integrated membership within NZ society

• Success in both Pacific and Palagi worlds

• Cultural identity and competence

• English language mastery essential for scholastic achievement in the English-medium schools

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Research Objectives

• Pacific children aged 6 years in NZ (first year in school)

• Perceptions of school work performance: a multi-informant study

• Pacific children

• Mothers

• Teachers

• Prediction model for English receptive vocabulary

• Ethnic-specific analyses of English receptive vocabulary development


Pacific Islands Families (PIF) Study

At 6 – years measurement wave:

• Children (n = 1,001)

• Mothers (n = 1,001)

• Teacher responses (n = 549)

• BPVS (n = 877)


Tobacco Smoking

Alcohol Consumption

Birth-weight

Parity

Maternal Age

Maternal Mental

Health (1yr)

Story Reading (1yr)

Parenting Discipline

(2yr)

Parenting Nurture (2yr)

Development Screening

(2yr)

Development Screening

(4yr)


Early Cultural Environment

• Maternal ethnicity

• Maternal English language fluency

• Mother’s length of stay in NZ

• Maternal acculturation • Integration

• Assimilation

• Separation

• Marginalization

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0

100

200

300

400

500

AN SN N SY AY

Children's evaluations

Co

un

t

0

100

200

300

400

500

VP P A W VW

Mothers' evaluations

Co

un

t

0

50

100

150

200

VP NI S VG E

Teachers' evaluations

Co

un

t

BPVS raw test scores

Fre

qu

en

cy

20 40 60 80 100

0

50

100

150

200

250

300


Multi-Informant Agreement Study

• Joint understanding of learning success

• Common objectives

• Empowerment of Pacific families


Prediction Model

• Classification tree model

• Important factors for strong English RV skills identified

• Performance measured using cross validation


Education

Story Reading

Household Income

Length of Stay (NZ)

Maternal Ethnicity

PBC−Discipline

Early Develop. (4y)

Small Birthweight

Acculturation

●

●

●

●

●

●

●

●

●

10 20 30 40 50

Variable Importance

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Assimilator Separator Integrator Marginalisor

94

96

98

100

10

2104

106

Maternal Acculturation

BP

VS

Sta

nd

ard

ised S

core

s


5 10 15 20

0.0

0.2

0.4

0.6

0.8

1.0

L12:L21

Mis

cla

ssific

ation R

ate

(P

runed

)

False negative

False positive

5 10 15 20

0.0

0.2

0.4

0.6

0.8

1.0

L12:L21

Mis

cla

ssific

ation

Ra

te (

L1

O C

V)

False negative

False positive

Actual PIF Cohort Data ModelMisclassification Errors

Cross ValidationMisclassification Errors


Main Findings and Implications

• Ethnic, cultural and linguistic diversity of Pacific people

• Culturally appropriate language tools

• Integration of health, education and cultural factors

• Cultural and linguistic considerations

• Strength-based teaching and intervention design

• Family and community oriented programmes

Sharing Wellbeing and Success:

Sharing Student Health Information with Teachers

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Phase 3

Phase 2b - Focus Groups

Phase 2a - Questionnaires

Phase 1

Who? Year 0-2 Teachers (n = 7; 78%)

Where? Three Canterbury Schools Decile 1, 6 and 9

How? Questionnaire – Quantitative (n = 26)Focus Groups – Qualitative (n = 7)

Thematic Analysis Focus Groups

Theme 1: The Roles are Changing

• The role of the teacher, the school and the parent are changing

• Needs of the community are changing

• A more holistic focus • Need for more integrative approaches

Thematic Analysis Focus Groups

Theme 2: Holistic Benefits

• For both students and their whanau

• Timely, appropriate, consistent support• Support from day one (or even before!)

• Academic achievement

Thematic AnalysisFocus Groups

Theme 3: Risks

• Misuse of information

• Judgement/ stigma/ disadvantaging students

• Negative experiences with schools and other agencies

• Scared of agency intervention

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Thematic AnalysisFocus Groups

Theme 4: Solution-Focused Implementation

• Partnership: Building relationships and trust• Building meaningful, trusting relationships

• Participation: inclusion of parents in how data is used• Including whānau communication, decision-making

• Protection: always having the child’s and whānau’sbest interests

Implications Where to next?

• Ask parents

• “Principles of data sharing” What is the current legislation?

Is the current legislation working for us?

Where could current legislation be improved?

the bigger picture of child health - university of …...12/06/2019 1 uc child well-being research...

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