www.usask.ca the impact of psychosocial well-being on the health behaviors of rural children i hope...
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The Impact of Psychosocial Well-being on the Health Behaviors of Rural Children IHope Bilinski RN PhD, College of Nursing, University of Saskatchewan, Canada
Louise Humbert, PhD, College of Kinesiology, University of Saskatchewan, CanadaCarol Henry, PhD, College of Pharmacy and Nutrition, University of Saskatchewan, Canada
ISCI, University of York, July 27-29, 2011
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Overview• Background• Purpose of the Study• Research Questions• Methodology• Findings• Implications for Practice & Research
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BackgroundHealth behaviours of Canadian children:• 59% consumed fruits and vegetables < 5 times/day
(CCHS, 2004)
• Children and youth getting an average of 6 hrs/day of screen time (HBSC, 2006)
• 9% boys and 4% girls meet the guidelines for physical activity (CHMS, 2009)
• Prevalence of overweight doubled and obesity tripled • (Stats Canada, 2006)
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Rural Canadian Children
• Less aerobically fit (Tremblay, 2005)
• Watched TV more than 2 hrs /day (Bilinski, et al, 2009)
• Consumed less than the recommended servings of fruits and vegetables (Martz & Wagner, 2008)
• More likely to be overweight/obese (Brunner et al, 2009)
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QualitativeHealth means: “Knowing stuff” “Having a working body” “Feeling Happy”
Rural Saskatchewan ChildrenQuantitative
• 34% of children overweight or obese
• Higher prevalence of overweight/obesity in boys
• Many (52.6%) children watched 2 or more hrs of TV on a daily basis
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Psychosocial well-being and health behavioursin rural preadolescent children
Purpose: 1) To determine the relationship between psychosocial
health and health behaviours in children2) To discover, from the children’s perspective, the
influence of the rural environment on health behaviours and psychosocial health
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Research Questions
1) What are the patterns of weight, health behaviours, and psychosocial health characteristics of the study sample?
2) What is the relationship between the psychosocial characteristics and the health behaviours?
3) What are the children’s perceptions of their rural environment and how this environment contributes to their health?
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MethodologyStudy design Mixed methods approachTarget population All students in Grades 4,5, & 6 attending
four rural schoolsInstruments Psychosocial health Piers-Harris 2 Questionnaire Faces ScaleDietary patterns Youth/Adolescent FF QuestionnairePhysical Activity Physical Activity Questionnaire PedometersPerceptions Photovoice
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MethodologyWeight Status:• BMI calculated (wt/ht2) from measured heights and
weights• Categorized as healthy weight, overweight or obese based
on IOTF 6 month cut off points for BMI related to age and sex (Cole et al, 2000)
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FindingsSample• Response rate• 47.2% male; 52.8 % female• Mean age: 10.26 years
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FindingsFor all children: 20.2% were overweight 16.2% were obese
OW Obese0
5
10
15
20
25
BoysGirls
Weight status
%
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FindingsPhysical Activity Patterns
PE Recess Noon hr After school
Evening Free time
01020304050607080
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FindingsPedometer readings:
For all children average steps: 55,000 stepsBoys: 50,927 steps/6 daysGirls: 57,855 steps/6 days
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FindingsDietary Patterns
Fruits Veg Salt snacks Sweets0
10
20
30
40
50
60
70
80
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FindingsPsychosocial CharacteristicsFaces Scale:
- 88.7% rated their happiness as A, B, C- 11.3% rated their happiness as D
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FindingsPsychosocial Characteristics
Piers-Harris 2 ‘The way I feel about myself’Overall score derived from six domains:
1) Behavioral adjustment2) Intellectual and school status3) Physical appearance and attributes4) Freedom from anxiety5) Popularity6) Happiness and satisfaction
40 - 55
For all children – mean total score 54.25
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FindingsPsychosocial health and health behaviours
• No significant relationships between total Piers-Harris (PH) score and BMI scores or PA
• Significant but relatively weak relationships: - Vegetable intake and Total PH
- Vegetable intake and Happiness - BMI and anxiety
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“It’s fun, it’s a lot better than the city”
Satisfaction
“You know everyone in town”
The Rural Context
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The Rural Context
“it feels good to have a whole bunch of space out there”
“I like it, you can walk in the middle of the road because there is no traffic”
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The Rural Context
“You can take a nap on the road”
“You don’t have to worry..like we don’t even lock our door at night”
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Conclusions• 36.4% of children overweight or obese• Most participated in physical activities 2-3/wk• Most consumed Fr & Veg less than 3/wk• Most consumed sugary snacks • Majority of children reported they were happy
or very happy• Majority had a positive self concept• The rural environment contributed to health
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Strengths and Limitations
• Homogeneous sample of rural children• Response/selection bias• Generalization• Children as participants
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Implications for research/practice
• Replicate study with a larger random sample• Early assessment of overweight and obesity• Integrate psychosocial components in health
promotion or interventions
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Thank you!