Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
Faculty of Social Work and Education, The Hague University of Applied Science, The Hague, Netherlands.
Front Public Health. 2021 Dec 9;9:747725. doi: 10.3389/fpubh.2021.747725. eCollection 2021.
Prevention programs often are directed at either parents or children separately, thereby ignoring the intergenerational aspect of health and well-being. Engaging the family is likely to improve both the uptake and long-term impact of health behavior change. We integrated an intergenerational approach into a frequently used shared assessment tool for children's care needs. The current study's aim was 2-fold: to monitor this family-engagement tool's effects on both children and their parents' health behaviors and well-being, and to examine the different dynamics of health behavioral change within a family. We followed 12 children ages 10-14 years and their parents for 12 weeks using an explanatory mixed-methods design comprising interviews, questionnaires, and an n-of-1 study. During home visits at the beginning and end of the study, we interviewed children and their parents about their expectations and experiences, and measured their height and weight. Furthermore, we collected secondary data, such as notes from phone and email conversations with parents, as well as evaluation forms from professionals. In the n-of-1 study, families were prompted three times a week to describe their day and report on their vegetable intake, minutes of exercise, health behavior goals, and psychosomatic well-being. The interviews, notes, and evaluation forms were analyzed using qualitative content analyses. For the n-of-1 study, we performed multi-level time-series analyses across all families to assess changes in outcomes after consulting the family-engagement tool. Using regression analyses with autocorrelation correction, we examined changes within individual families. Five child-mother dyads and three child-mother-father triads provided sufficient pre- and post-data. The mean minutes of children's physical activity significantly increased, and mothers felt more energetic, but other outcomes did not change. In consultations related to overweight, the family-engagement tool often was used without setting specific or family goals. The family-engagement approach elicited positive effects on some families' health and well-being. For multifaceted health problems, such as obesity, family-engagement approaches should focus on setting specific goals and strategies in different life domains, and for different family members.
预防方案通常针对父母或儿童个体分别开展，从而忽略了健康和福祉的代际方面。让家庭参与进来可能会提高健康行为改变的接受程度和长期影响。我们将代际方法纳入儿童护理需求的常用共享评估工具中。本研究的目的有两个：监测这种家庭参与工具对儿童及其父母健康行为和福祉的影响，以及研究家庭内健康行为改变的不同动态。我们使用解释性混合方法设计，对 12 名 10-14 岁的儿童及其父母进行了为期 12 周的随访，该设计包括访谈、问卷调查和 n-of-1 研究。在研究开始和结束时，我们通过家访的方式，对儿童及其父母进行了访谈，了解他们的期望和经验，并测量了他们的身高和体重。此外，我们收集了二级数据，例如父母的电话和电子邮件对话记录，以及专业人员的评估表。在 n-of-1 研究中，每周三次提示家庭描述他们的一天，并报告他们的蔬菜摄入量、运动分钟数、健康行为目标和身心幸福感。使用定性内容分析对访谈、记录和评估表进行了分析。对于 n-of-1 研究，我们对所有家庭进行了多层次时间序列分析，以评估在咨询家庭参与工具后结果的变化。使用带有自相关校正的回归分析，我们检查了每个家庭内的变化。5 个儿童-母亲对子和 3 个儿童-母亲-父亲三人组提供了足够的前后数据。儿童的体育活动分钟数显著增加，母亲感到更有活力，但其他结果没有变化。在与超重相关的咨询中，家庭参与工具通常在没有设定具体或家庭目标的情况下使用。家庭参与方法对一些家庭的健康和福祉产生了积极影响。对于肥胖等多方面的健康问题，家庭参与方法应侧重于在不同生活领域为不同的家庭成员设定具体目标和策略。
