Goldfeld Sharon, Kvalsvig Amanda, Incledon Emily, O'Connor Meredith
Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.
Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
J Epidemiol Community Health. 2017 Mar;71(3):225-231. doi: 10.1136/jech-2015-207061. Epub 2016 Sep 9.
Until now, child mental health promotion efforts have focused primarily on reducing the prevalence and severity of problems; yet the absence of mental health problems does not necessarily imply the presence of healthy psychosocial functioning. We aimed to investigate the epidemiology of child mental health competence in a full national population of school entrants.
The data source was the 2012 Australian Early Development Index, a national census of early childhood development completed for school entrants by teachers across Australia (n=275 800). The mental health competence outcome measure was derived from constructs that focused on children's social and emotional strengths. Children with mental health competence scores in the top quintile were compared with the standard population across individual and community characteristics.
Average age at assessment was 5 years 7 months. Higher odds of mental health competence were observed for children who lived in more advantaged areas (OR 1.62; 99% CI 1.49 to 1.75), had attended preschool (1.38; 1.25 to 1.51) and demonstrated effective oral communication skills in the classroom (19.01; 15.62 to 23.13). Indigenous children had lower odds compared with non-Indigenous children (0.59; 0.54 to 0.64). Children in disadvantaged areas who attended preschool did not 'catch up' with their more advantaged peers.
Mental health competence is unequally distributed across the Australian child population at school entry and is strongly predicted by measures and correlates of disadvantage. Effective oral communication and attendance at preschool warrant further investigation as potentially modifiable factors that may support mental health competence in new school entrants.
到目前为止，促进儿童心理健康的努力主要集中在降低问题的发生率和严重程度；然而，没有心理健康问题并不一定意味着存在健康的心理社会功能。我们旨在调查全国所有入学儿童的心理健康能力的流行病学情况。
数据来源是2012年澳大利亚早期发展指数，这是一项由澳大利亚各地教师为入学儿童完成的全国幼儿发展普查（n = 275800）。心理健康能力结果测量源自关注儿童社会和情感优势的结构。将心理健康能力得分处于最高五分位数的儿童与标准人群在个人和社区特征方面进行比较。
评估时的平均年龄为5岁7个月。生活在更具优势地区的儿童（比值比1.62；99%置信区间1.49至1.75）、上过学前班的儿童（1.38；1.25至1.51）以及在课堂上表现出有效口头沟通能力的儿童（19.01；15.62至23.13），心理健康能力的几率更高。与非原住民儿童相比，原住民儿童的几率较低（0.59；0.54至0.64）。处于弱势地区且上过学前班的儿童并未“赶上”他们更具优势的同龄人。
心理健康能力在澳大利亚入学儿童中分布不均，并且受到劣势的衡量指标和相关因素的强烈预测。有效的口头沟通和上幼儿园作为可能支持新入学儿童心理健康能力的潜在可改变因素，值得进一步研究。
