Parenting Intervention and the Prevention of Serious Mental Health Problems in Children

The reduction of coercive or inadequate parenting is essential if the mental health status of Australian children and adolescents is to be improved. Of the available approaches that address parenting practices, behavioural family interventions have the strongest empirical support and are effective in reducing parenting practices that contribute to the development of behavioural and emotional problems in children. However, only a small proportion of parents access such interventions. A comprehensive multilevel, evidence-based parenting and family support strategy needs to be implemented on a wide scale to reduce the prevalence of mental health problems in children and youth. The Triple P – Positive Parenting Program is an example of a population-level strategy that can be used to improve the mental health status of children and their parents

Risk Factors of Hypertension in High School Students: Multilevel Evidence of The Contextual Effect of School

Background: In 2025, it is projected that 29% of the world's citizens will suffer from hyper­tension. Hypertension does not only occur in adults but in adolescents. The prevalence of Indonesian hypertension is relatively high at 34.1%. Hypertension if not treated immediately can cause death. This study aimed to analyze risk factors of hypertension in high school students.Subjects and Method: This was a cross sectional study conducted in Bantul, Yogyakarta, from April to May 2019. A sample of 200 adolescents aged 15-19 years was selected by probability sampling. The dependent variable was hypertension. The independent variables were gender, genetic history, obesity, dietary pattern, sleep duration, stress, and money pocket. The data on hypertension were collected using sphygmomanometer. BMI was measured by microtoise and weight scale. Data on stress were measured by perceived stress scale (PSS). The other variables were collected by questionnaire. The data were analyzed by multilevel logistic regression.Results: The risk of hypertension increased with male gender (b= 1.87; 95% CI= 0.38 to 3.36; p= 0.014), genetic history (b= 1.93; 95% CI= 0.48 to 3.39; p= 0.009), obesity (b= 2.15; 95% CI= 0.76 to 3.55; p= 0.002), poor dietary pattern (b= 1.54 CI 95% = 0.97 to 2.99; p= 0.036), sleep duration <8 hours/day (b= 2.28; 95% CI= 0.63 to 3.93; p= 0.007), high stress (b= 3.52; 95% CI= 1.64 to 5.39; p<0.001), and high money pocket (b= 2.00; 95% CI= 0.45 to 3.56; p= 0.011). School had contextual effect on hypertension with ICC= 22.47%.Conclusions: The risk of hypertension increased with male gender, genetic history, obesity, poor dietary pattern, sleep duration <8 hours/day, high stress, and high money pocket. School has contextual effect on hypertension.Keywords: hypertension, adolescence, diet, stress, duration of sleep, socio-economicCorrespondence: Mayasari Kurnianingsih. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +628­5729990090.Journal of Epidemiology and Public Health (2019), 4(4): 259-269https://doi.org/10.26911/jepublichealth.2019.04.04.0

Do Primary Schools Have Contextual Influence on Health Behavior? A Multilevel Evidence from Nganjuk, East Java

Background: Health problems among primary school age children caused by poor personal hygiene can be prevented by good clean and healthy life behavior. Clean and healthy life behavior is affected by perceived susceptibility, perceived seriousness, perceived benefit, perceived barrier, cues to action, and self-efficacy. This study aimed to analyze the contextual effect of primary school on clean and healthy life behavior in primary school age children in Nganjuk, East Java.Subjects and Method: This was cross sectional study conducted at 25 primary schools in Nganjuk, East Java, from August to December 2019. There were 200 primary school  age children aged 6-12 years involved as the sample of this study. The study used stratified random sampling. The dependent variable was clean and healthy life behavior. The independent variables were pe­rceived susceptibility, perceived seriousness, perceived benefit, perceived barrier, cues to action, and self-efficacy. This study used questionnaires to collect the data. This study used multilevel multiple logistic regression with Stata 13 to analyze the data.Results: Clean and healthy life behavior in the primary school age children increased with high perceived susceptibility (b=1.06; 95%CI=0.31 to 1.80; p=0.005), high perceived seriousness (b= 0.92; 95%CI=0.16 to 1.68; p=0.018 ), strong perceived benefit (b=0.76; 95%CI=0.05 to 1.47; p= 0.036), strong cues to action (b=0.97; 95%CI=0.26 to 1.68; p=0.007), and strong self-efficacy (b= 1.16; 95%CI=0.43 to 1.89; p=0.002). Clean and healthy life behavior in the primary school  age children decreased with strong perceived barrier, but the result was statistically non-significant (b= -0.27; 95%CI=-1.02 to 0.33; p=0.484). Primary school had a contextual effect on clean and healthy life behavior (ICC 17.33%).Conclusion: Clean and healthy life behavior in primary school  age children is affected by per­ceived susceptibility, perceived seriousness, perceived benefit, perceived barrier, cues to action, and self-efficacy. Primary school has a contextual effect on clean and healthy life behavior.Keywords: clean and healthy life behavior, Health Belief Model, contextual of primary schoolCorrespondence:Frida Indriani, Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir.Sutami 36A, Surakarta, Central Java, Indonesia. Email: [email protected]. Mobile: 082226327646Journal of Health Promotion and Behavior (2019), 4(3): 235-245https://doi.org/10.26911/thejhpb.2019.04.03.0

Desigualdades no uso do parque público de bairro para a atividade física de crianças : evidências multiníveis de Córdoba, Argentina

Introduction: The complexity of urbanization processes across Latin American societies encourages investigating its implications in health conditions, especially during childhood. One of the possible links between them is recreation, a component of the daily life of children and, therefore, essential to produce health and life itself. The objective of this study was to examine the associations between neighborhood context and active public park use among school-aged children in Cordoba, Argentina. Methods: A cross-sectional study was conducted with 1466 children, aged 9 to 11, attending 19 schools and living in 110 neighborhoods. Multilevel models with Poisson distribution were used for the analyses, stratified by gender. Socio-demographic, behavioral, and physical covariates were included at the individual level, and socioeconomic neighborhood conditions at second level. Results: Girls residing in neighborhoods with a worse socioeconomic context were less likely to report frequent public park use for physical activity, while those from neighborhoods with better socioeconomic conditions were more likely to, regardless of individual characteristics. Conclusion: This study suggests that socioeconomic conditions of neighborhoods are associated with public park use for physical activity in school-aged girls, demonstrating gender inequality in the use and appropriation of public spaces.Introdução: O processo de urbanização das sociedades latino-americanas estimula investigar suas consequências nas condições de saúde. Um dos elos possíveis é a recreação, componente do cotidiano das crianças essencial para a produção da saúde e da própria vida. O objetivo foi examinar as relações entre o contexto do bairro e o uso ativo do parque público entre as crianças em idade escolar em Córdoba, Argentina. Métodos: Foi realizado um estudo transversal com 1466 crianças que frequentam 19 escolas e moram em 110 bairros. Modelos multinível com distribuição de Poisson foram utilizados para as análises, estratificados por sexo. Covariáveis sociodemográficas, comportamentais e físicas foram incluídas no nível individual e as condições socioeconômicas do bairro, no segundo nível. Resultados: As meninas que residem em bairros com pior contexto socioeconômico foram menos prováveis a relatar o uso frequente de parques públicos para atividades físicas, enquanto aquelas provenientes de bairros com melhores condições eram mais prováveis, independentemente das características individuais. Conclusões: Este estudo sugere que as condições socioeconômicas dos bairros estão associadas ao uso de parques públicos para atividade física em meninas unicamente, demonstrando uma desigualdade de gênero.Fil: Lavin Fueyo, Julieta. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad. Universidad Nacional de Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; ArgentinaFil: Berra, Silvina del Valle. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad. Universidad Nacional de Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; Argentin

Social capital and burnout among mental healthcare providers

Background: Provider burnout is a critical problem in mental health services. Contributing factors have been explicated across three domains: personal, job and organizational characteristics. Of these, organizational characteristics, including workplace environment, appear to be particularly important given that most interventions addressing burnout via the other domains (e.g. bolstering personal coping skills) have been modestly effective at best. Aims: This study builds on previous research by using social capital as a framework for the experience of work social milieu, and aims to provide a richer understanding of how workplace social environment might impact burnout and help create more effective ways to reduce burnout. Methods: Providers (n = 40) taking part in a larger burnout intervention study were randomly selected to take part in interviews regarding their workplace environment and burnout. Participant responses were analyzed thematically. Results: Workplace social milieu revolved around two primary themes: workplace social capital in provider burnout and the protective qualities of social capital in cohesive work teams that appear to mitigate burnout. Conclusions: These results imply that work environments where managers support collaboration and social interaction among work teams may reduce burnout

Does the Integrated Health Post have Contextual Effect on Exclusive Breastfeeding? A Multilevel Evidence from Karanganyar, Central Java

Background: Breastfeeding provides amazing benefits for the health of the child and the mother. WHO and UNICEF suggest a mother should be able to practice and maintain exclusive breast­feeding during the first six months of her baby's life. This study aimed to analyze contextal effect of integrated health post on exclusive breastfeeding.Subjects and Method: This was cross sectional study conducted in 25 integrated health posts (posyandu) in Karanganyar, Central Java, from August to September 2019. A sample of 200 nursing lactating mothers who had children aged 7 to 12 months was selected by stratified random sampling. The dependent variable was exclusive breastfeeding. The independent variables were maternal age, education, occupation, type of birth delivery, knowledge, attitude, family support, and so­cial capital. The data were collected by questionnaire. The data were analysis by multilevel mul­ti­ple logistic regression with Stata 13.Results: Exclusive breastfeeding increased with maternal age 20 to 34 years (b= 2.38; 95% CI= 0.62 to 4.15; p= 0.008), maternal education ≥Senior high school (b= 1.64; 95% CI= 0.01 to 3.23; p= 0.049), good knowledge (b= 2.13; 95% CI= 0.41 to 3.86; p= 0.015), positive attitude (b= 1.67; 95% CI= 0.10 to 3.23; p= 0.036), strong family support (b= 1.58; 95% CI= 0.10 to 3.07; p= 0.036), and strong social capital (b= 1.64; 95% CI= 0.01 to 3.27; p= 0.049). Exclusive breast­fee­ding decreased with mother working outside the house (b= -3.54; 95% CI= -5.50 to -1.58; p<0.001) and sectio caesarea (b= -1.88; 95% CI= -3.58 to -3.58 to -0.19; p= 0.029). Integrated health post had strong contextual effect on exclusive breastfeeding with intra-class correlation (ICC)= 29.3%.Conclusion: Exclusive breastfeeding increases with maternal age 20 to 34 years, high maternal education, good knowledge, positive attitude, strong family support, and strong social capital. Exclusive breast­fee­ding decreases with mother working outside the house and sectio caesarea. Integrated health post has strong contextual effect on exclusive breastfeeding.Keywords: exclusive breastfeeding, multilevel analysis, posyanduCorrespondence: Lathifah ‘Arub, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta, Central Java 57126. Email: [email protected]. Mobile: 085789212539Journal of Maternal and Child Health (2020), 5(1): 100-110https://doi.org/10.26911/thejmch.2020.05.01.11

Does between-School Variation Influence Safe Sexual Behavior among Female Adolescents? A New Multilevel Evidence from Karanganyar, Central Java

Background: World Health Organization (WHO) reported that unsafe sex is ranked second among the top ten risk factors to health in terms of the burden of disease they cause. HIV/AIDS is the reason unsafe sex ranks so high. Studies have also shown that the number of adolescents who have premarital sex is increasing. Unsafe sex can increase the risk of sexual transmitted disease, unwanted pregnancy, and suicide in adolescents. The study aimed to determine the associations between attitude, subjective norm, perceived behavior control, equal gender relation, and media exposure, on safe sexual behavior among female adolescents in Karanganyar, Central Java, using Theory Planned Behavior. Subjects and Method: This was a cross-sectional study conducted in 25 senior high schools in Karanganyar, Central Java, from December 2017 to January 2018. The 25 schools were selected by stratified random sampling, composing of urban and rural schools. A total sample of 200 female adolescents was chosen from by stratified random sampling, resulting in 8 female adolescents from each of the 25 senior high schools. The dependent variable was safe sexual behavior. The independent variables were attitude, subjective norm, perceived behavior control, equal gender relation, and media exposure on safe sexual behavior. The data was collected using questionnaire and analyzed by multilevel analysis. The contextual effect of school, which distinguished rural and urban schools, on safe sex behavior was measured by intra-class correlation (ICC). Results: Safe sex behavior in female adolescents increased with positive attitude (b= 0.41; 95% CI= 0.14 to 0.69; p= 0.004), positive subjective norm (b=0.23; 95% Cl= 0.21 to 0.43; p= 0.031), strong perceived behavior control (b= 0.69; 95% Cl= 0.44 to 0.96 ; p<0.001), equal gender relation (b= 0.41; 95% Cl= 0.18 to 0.63; p<0.001), and exposure to media on safe sex behavior (b= 0.17; 95% Cl= -0.02 to 0.36; p= 0.085). The intra-class correlation (ICC)= 5.55%, indicating negligible contextual effect of schools. Conclusion: Safe sex behavior in female adolescents increases with positive attitude, positive subjective norm, strong perceived behavior control, equal gender relation, and exposure to media on safe sex behavior. The contextual effect of schools is negligible. Keywords: safe sexual behavior, female adolescents, urban-rural, school, multilevel analysi

Does Secondary Smoking and Posyandu Affect the Risk of Hypertension in Pregnancy? Multilevel Evidence from Magelang, Central Java

Background: Pregnancy hypertension was a complication of pregnancy which became one of the causes of maternal and perinatal morbidity and mortality in the world. This study aimed to determine the effect of individual and contextual factors of integrated health post (posyandu) on hypertension in pregnancy.Subjects and Method: A case control study was conducted in 5 posyandus in Magelang, Central Java, from April to May 2019. A sample of 210 women was selected by simple random sampling. The dependent variable was hypertension in pregnancy. The independent variables were age, parity, nutritional status, family history of hypertension, history of hypertension before pregnancy, history of hormonal contraceptive, and exposure to cigarette smoke. The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression.Results: Hypertension in pregnancy increased with age 35 years old (b= 2.10; 95% CI= 0.16 to 4.04; p= 0.033), parity (b= -3.81; 95% CI = - 6.31 to -1.32; p = 0.003), nutritional status (b= 3.35; 95% CI= 1.36 to 5.33; p= 0.001), family hypertension history (b= 3.35; 95% CI= 1.33 to 5.37; p= 0.001), hypertension history before pregnancy (b= 2.46; 95% CI= 1.1 to 3.81; p 35 years old, parity, nutritional status, family hypertension history, hypertension history before pregnancy, hormonal contraceptive history, and cigarette smoke exposure. Posyandu has negligible contextual effect on hypertension in pregnancy.Keywords: Hypertension, pregnancy, cigarette smoke, multilevel analysisCorrespondence: Erin Rizkiana, Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085729883106Journal of Epidemiology and Public Health (2019), 4(3): 247-258https://doi.org/10.26911/jepublichealth.2019.04.03.12