Guthridge Steven, Li Lin, Silburn Sven, Li Shu Qin, McKenzie John, Lynch John
Health Gains Planning, Department of Health, Darwin, Northern Territory, Australia.
Centre for Child Development and Education, Menzies School of Health Research, Darwin, Northern Territory, Australia.
J Paediatr Child Health. 2015 Aug;51(8):778-86. doi: 10.1111/jpc.12852. Epub 2015 Mar 9.
This study investigated the association between early-life risk factors and school education outcomes.
This is an historical cohort study of 7601 children (61% were Indigenous) born in the Northern Territory between 1999 and 2004. Information was linked, for each child on: perinatal health, student enrolment and National Assessment Program - Literacy and Numeracy (NAPLAN) Year 3 results. Logistic regression was used to estimate the association between selected risk factors and a NAPLAN result 'below' the national minimum standard (NMS) in reading and numeracy.
Indigenous children had much higher odds, than non-Indigenous children, of a result below the NMS for both reading (odds ratio (OR): 8.58, 95% confidence interval (CI): 7.55-9.74) ) and numeracy (OR: 11.52, 95% CI: 9.94-13.35). When adjusted for all other variables, the increased odds were attenuated for both reading (OR: 2.89, 95% CI: 2.46-3.40) and numeracy (OR: 3.19, 95% CI: 2.65-3.84). Common risk factors for Indigenous and non-Indigenous children included higher birth order, maternal smoking in pregnancy and being a boy. There were gradients of decreasing risk with increasing education level of primary care giver and increasing maternal age. Among Indigenous children only, risks increased when living in remote areas, with younger age (<8 years) and low birthweight.
The study highlights that many of the risk factors associated with poor education outcomes among Indigenous children are shared with the general population. The results inform a targeted, cross-agency response to address modifiable early-life risk factors for educational disadvantage. Data linkage, using existing administrative datasets, provides a useful addition to methods that identify priority areas for prevention and early intervention.
本研究调查了早期生活风险因素与学校教育成果之间的关联。
这是一项对1999年至2004年在北领地出生的7601名儿童(61%为原住民)进行的历史性队列研究。针对每个儿童,将围产期健康、学生入学情况以及国家评估计划——读写和算术能力(NAPLAN)三年级成绩等信息进行了关联。采用逻辑回归来估计所选风险因素与NAPLAN读写和算术成绩“低于”国家最低标准(NMS)之间的关联。
原住民儿童读写成绩低于NMS的几率(优势比(OR):8.58,95%置信区间(CI):7.55 - 9.74)和算术成绩低于NMS的几率(OR:11.52,95% CI:9.94 - 13.35)均远高于非原住民儿童。在对所有其他变量进行调整后,读写(OR:2.89,95% CI:2.46 - 3.40)和算术(OR:3.19,95% CI:2.65 - 3.84)成绩低于NMS的增加几率均有所减弱。原住民和非原住民儿童的常见风险因素包括出生顺序较高、母亲孕期吸烟以及为男孩。随着主要照顾者教育水平的提高和母亲年龄的增加,风险呈递减梯度。仅在原住民儿童中,生活在偏远地区、年龄较小(<8岁)和低出生体重时风险会增加。
该研究强调,原住民儿童中与教育成果不佳相关的许多风险因素与普通人群相同。研究结果为有针对性的跨部门应对措施提供了依据,以解决可改变的早期生活风险因素导致的教育劣势问题。利用现有行政数据集进行数据关联,为确定预防和早期干预的优先领域的方法提供了有益补充。