Vaezghasemi Masoud, Vogt Thomas, Lindkvist Marie, Pulkki-Brännström Anni-Maria, Richter Sundberg Linda, Lundahl Lisbeth, Silfverdal Sven-Arne, Feldman Inna, Ivarsson Anneli
Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden.
Department of Applied Educational Science, Umeå University, 901 87, Umeå, Sweden.
SSM Popul Health. 2023 Jan 21;21:101345. doi: 10.1016/j.ssmph.2023.101345. eCollection 2023 Mar.
Social-emotional problems occurring early in life can place children at future risk of adverse health, social and economic outcomes. Determinants of social-emotional problems are multi-layered and originate from different contexts surrounding children, though few studies consider them simultaneously. We adopted a holistic approach by using Bronfenbrenner's process-person-context-time model as a structuring device. We aimed to assess what characteristics of families and children from pregnancy, over birth, and up to 3 years of age are associated with social-emotional problems in boys and girls. This study used regional data from the Salut Programme, a universal health promotion programme implemented in Antenatal and Child Health Care, and data from national Swedish registers. The study population included 6033 3-year-olds and their parents during the period 2010-2018. Distinct logistic regression models for boys and girls were used to assess associations between the family social context, parents' lifestyle, parent's mental health, children's birth characteristics, and indicators of proximal processes (the independent variables); and children's social-emotional problems as measured by the parent-completed Ages and Stages Questionnaire: Social-Emotional between 33 and 41 months of age (the outcome). Overall, a less favourable family social context, detrimental lifestyle of the parents during pregnancy, and parents' mental illness from pregnancy onwards were associated with higher odds of social-emotional problems in 3-year-olds. Higher screentime and infrequent shared book-reading were associated with higher odds of social-emotional problems. The multifaceted determinants of children's social-emotional problems imply that many diverse targets for intervention exist. Additionally, this study suggests that Bronfenbrenner's process-person-context-time theoretical framework could be relevant for public health research and policy.
儿童早期出现的社会情感问题会使他们未来面临健康、社会和经济方面不良后果的风险。社会情感问题的决定因素是多层次的,源自儿童周围的不同环境,不过很少有研究同时考虑这些因素。我们采用了一种整体方法,将布朗芬布伦纳的过程-人-环境-时间模型作为一种构建工具。我们旨在评估从孕期到出生再到3岁的家庭和儿童的哪些特征与男孩和女孩的社会情感问题相关。本研究使用了来自“健康计划”的区域数据,该计划是在产前和儿童保健中实施的一项全民健康促进计划,以及瑞典国家登记处的数据。研究人群包括2010年至2018年期间的6033名3岁儿童及其父母。我们使用针对男孩和女孩的不同逻辑回归模型,来评估家庭社会环境、父母生活方式、父母心理健康、儿童出生特征以及近端过程指标(自变量)之间的关联;以及由父母填写的《年龄与阶段问卷:33至41个月的社会情感》所衡量的儿童社会情感问题(结果)。总体而言,不太有利的家庭社会环境、父母在孕期有害的生活方式以及从孕期开始父母的精神疾病,都与3岁儿童出现社会情感问题的较高几率相关。较长的屏幕使用时间和不经常共同阅读书籍与社会情感问题的较高几率相关。儿童社会情感问题的多方面决定因素意味着存在许多不同的干预目标。此外,本研究表明布朗芬布伦纳的过程-人-环境-时间理论框架可能与公共卫生研究和政策相关。