Parental feeding practices and child eating behavior in different socioeconomic neighborhoods and their association with childhood weight : The STEPS study

Child obesity risk, child eating behavior and parental feeding practices show a graded association with individual level socioeconomic status. However, their associations with neighborhood socioeconomic disadvantage are largely unknown. In this study (n = 682), we investigated how parental feeding practices and child eating behaviors were associated with body mass index and risk of overweight at preschool age in affluent and disadvantaged neighborhoods. We found that high food approach tendency in disadvantaged neighborhoods predicted higher body mass index and increased the risk of overweight at the age of 6 years compared with affluent neighborhoods. Our results suggest that children's eating habits may have stronger impact on overweight risk in disadvantaged than in affluent neighborhoods.Peer reviewe

Diet quality in preschool children and associations with individual eating behavior and neighborhood socioeconomic disadvantage. The STEPS Study

A good quality diet in childhood is important for optimal growth as well as for long-term health. It is not well established how eating behaviors affect overall diet quality in childhood. Moreover, very few studies have considered the association of diet quality and a neighborhood socioeconomic disadvantage in childhood. Our aim was to investigate how diet quality is associated with eating behaviors and neighborhood disadvantage and their interaction in preschool age children in Finland. The participants were from the Steps to Healthy Development Study at age 2 y (n = 780) and 5 y (n = 653). Diet quality was measured with a short questionnaire on habitual food consumption and eating behavior was assessed with the child eating behavior questionnaire to indicate the child's eating style regarding food approach and food avoidance dimensions. Information on neighborhood socioeconomic disadvantage were obtained from the statistics Finland grid database. We found that diet quality was higher at 5 years compared to 2 years of age (p < 0.001). Food approach subscale, enjoyment of food, was positively associated with the diet quality (p < 0.001 for 2 and 5 y) while subscale desire to drink was negatively associated with the diet quality (p = 0.001 for 2 and 5 y). Food avoidance was negatively associated with the diet quality both at 2 and at 5 years of age (p < 0.001). A higher neighborhood disadvantage was negatively associated with the diet quality at the age of 2 years (p = 0.02), but not at the age of 5 years. Eating behavior had similar associations with diet quality both in affluent and deprived neighborhoods. Our results suggest that both the eating behavior and neighborhood disadvantage are, already in the early age, important factors when considering children's diet quality.Peer reviewe

Parental feeding practices and child eating behavior in different socioeconomic neighborhoods and their association with childhood weight. The STEPS study

Child obesity risk, child eating behavior and parental feeding practices show a graded association with individual level socioeconomic status. However, their associations with neighborhood socioeconomic disadvantage are largely unknown. In this study (n = 682), we investigated how parental feeding practices and child eating behaviors were associated with body mass index and risk of overweight at preschool age in affluent and disadvantaged neighborhoods. We found that high food approach tendency in disadvantaged neighborhoods predicted higher body mass index and increased the risk of overweight at the age of 6 years compared with affluent neighborhoods. Our results suggest that children's eating habits may have stronger impact on overweight risk in disadvantaged than in affluent neighborhoods.</p

Diet quality in preschool children and associations with individual eating behavior and neighborhood socioeconomic disadvantage. The STEPS Study

A good quality diet in childhood is important for optimal growth as well as for long-term health. It is not well established how eating behaviors affect overall diet quality in childhood. Moreover, very few studies have considered the association of diet quality and a neighborhood socioeconomic disadvantage in childhood. Our aim was to investigate how diet quality is associated with eating behaviors and neighborhood disadvantage and their interaction in preschool age children in Finland. The participants were from the Steps to Healthy Development Study at age 2 y (n = 780) and 5 y (n = 653). Diet quality was measured with a short questionnaire on habitual food consumption and eating behavior was assessed with the child eating behavior questionnaire to indicate the child's eating style regarding food approach and food avoidance dimensions. Information on neighborhood socioeconomic disadvantage were obtained from the statistics Finland grid database. We found that diet quality was higher at 5 years compared to 2 years of age (p </p

Psychological Distress During the Retirement Transition and the Role of Psychosocial Working Conditions and Social Living Environment

Mental health is determined by social, biological, and cultural factors and is sensitive to life transitions. We examine how psychosocial working conditions, social living environment, and cumulative risk factors are associated with mental health changes during the retirement transition.\nWe use data from the Finnish Retirement and Aging study on public sector employees (n = 3,338) retiring between 2014 and 2019 in Finland. Psychological distress was measured with the General Health Questionnaire annually before and after retirement and psychosocial working conditions, social living environment, and accumulation of risk factors at the study wave prior to retirement.\nPsychological distress decreased during the retirement transition, but the magnitude of the change was dependent on the contexts individuals retire from. Psychological distress was higher among those from poorer psychosocial working conditions (high job demands, low decision authority, job strain), poorer social living environment (low neighborhood social cohesion, small social network), and more cumulative risk factors (work/social/both). During the retirement transition, greatest reductions in psychological distress were observed among those with poorer conditions (work: absolute and relative changes, p [Group × Time interactions] < .05; social living environment and cumulative risk factors: absolute changes, p [Group × Time interactions] < .05).\nPsychosocial work-related stressors lead to quick recovery during the retirement transition but the social and cumulative stressors have longer-term prevailing effects on psychological distress. More studies are urged incorporating exposures across multiple levels or contexts to clarify the determinants of mental health during the retirement transition and more generally at older ages.</p

Neighborhood Disadvantage, Greenness, and Population Density as Predictors of Breastfeeding Practices : A Population Cohort Study from Finland

Background Many environmental factors are known to hinder breastfeeding, yet the role of the family living environment in this regard is still poorly understood. Objectives We used data from a large cohort to identify associations between neighborhood characteristics and breastfeeding behavior. Methods Our observational study included 11,038 children (0-2 years) from the Southwest Finland Birth Cohort. Participant information was obtained from the Medical Birth Register and municipal follow-up clinics. Neighborhood socioeconomic disadvantage, greenness, and population density were measured for a period of 5 years prior to childbirth within the residential neighborhood on a 250 x 250-m grid. Any breastfeeding and breastfeeding at 6 months were the primary outcomes. Binary logistic regression models were adjusted for maternal health and socioeconomic factors. Results Adjusted analyses suggest that mothers living in less populated areas were less likely to display any breastfeeding (OR: 0.46; 95% CI: 0.36, 0.59) and breastfeeding at 6 months (OR: 0.37; 95% CI: 0.34, 0.40). Mothers living in highly disadvantaged neighborhoods were less likely to display any breastfeeding if the neighborhood was less populated (OR: 0.54; 95% CI: 0.30, 0.95) but more likely to breastfeed at 6 months if the neighborhood was highly populated (OR: 3.74; 95% CI: 1.92, 7.29). Low greenness was associated with higher likelihood of any breastfeeding (OR: 3.82; 95% CI: 1.53, 9.55) and breastfeeding at 6 months (OR: 4.41; 95% CI: 3.44, 5). Conclusions Our results suggest that neighborhood characteristics are associated with breastfeeding behavior in Finland. Unravelling breastfeeding decisions linked to the living environment could help identify interventions that will allow the appropriate support for all mothers and infants across different environmental challenges.Peer reviewe

Residential green environments are associated with human milk oligosaccharide diversity and composition

Publisher Copyright: © 2023, The Author(s).Increased exposure to greener environments has been suggested to lead to health benefits in children, but the associated mechanisms in early life, particularly via biological mediators such as altered maternal milk composition, remain largely unexplored. We investigated the associations between properties of the mother’s residential green environment, measured as (1) greenness (Normalized Difference Vegetation index, NDVI), (2) Vegetation Cover Diversity (VCDI) and (3) Naturalness Index (NI), and human milk oligosaccharides (HMOs), known for their immune- and microbiota-related health effects on the infant (N = 795 mothers). We show that HMO diversity increases and concentrations of several individual HMOs and HMO groups change with increased VCDI and NI in residential green environments. This suggests that variation in residential green environments may influence the infant via maternal milk through modified HMO composition. The results emphasize the mediating role of breastfeeding between the residential green environments and health in early life.Peer reviewe

Understanding Different Approaches to ECE Pedagogy through Tensions

The concept of pedagogy is the key to understanding pedagogy in early childhood education (ECE) in the Nordic countries, which are known for their high quality of life and education. However, in ECE, there are several different approaches toward pedagogy and it can be said that pedagogy is a multidimensional and dynamic concept. In this paper, the different approaches to pedagogy are defined and reconceptualized through an integrative literature analysis focusing on scientific papers and research reports of the concept. Five approaches to pedagogy were constructed: pedagogy through interaction, pedagogy through scaffolding, pedagogy through didactics, pedagogy through expertise, and pedagogy through future orientation. The identified tensions and elements within the five approaches are presented. Finally, the shared elements among these pedagogical approaches are presented in a dynamic model.</p

Neighborhood disadvantage, greenness and population density as predictors of breastfeeding practices: a population cohort study from Finland

BackgroundMany environmental factors are known to hinder breastfeeding, yet the role of the family living environment in this regard is still poorly understood.ObjectivesTherefore, we used data from a large cohort to identify associations between neighborhood characteristics and breastfeeding behavior.MethodsOur observational study included 11,038 children (0-2 years) from the Southwest Finland Birth Cohort. Participant information were obtained from the Medical Birth Register and municipal follow-up clinics. Neighborhood socioeconomic disadvantage, greenness and population density were measured for a period of 5 years prior to childbirth within the residential neighborhood on a 250×250m grid. Any breastfeeding and breastfeeding at six months were the primary outcomes. Binary logistic regression models were adjusted for maternal health and socioeconomic factors.ResultsAdjusted analyses suggest that mothers living in less populated areas were less likely to display any breastfeeding (OR: 0.46; 95% CI 0.36, 0.59) and breastfeeding at six months (OR: 0.37; 95% CI: 0.34, 0.40). Mothers living in highly disadvantaged neighborhoods were less likely to display any breastfeeding if the neighborhood was less populated (OR: 0.54, 95% CI: 0.30, 0.95) but more likely to breastfeed at six months if the neighborhood was highly populated (OR: 3.74; 95% CI: 1.92, 7.29). Low greenness was associated with higher likelihood of any breastfeeding (OR: 3.82; 95% CI: 1.53, 9.55) and breastfeeding at six months (OR: 4.41; 95% CI: 3.44, 5).ConclusionsOur results suggest that neighborhood characteristics is associated with breastfeeding behavior in Finland. Unravelling breastfeeding decisions linked to the living environment may help identify interventions that will allow the appropriate support for all mothers and infants across different environmental challenges.</p

An evidence-based approach to the use of telehealth in long-term health conditions: development of an intervention and evaluation through pragmatic randomised controlled trials in patients with depression or raised cardiovascular risk

Background: Health services internationally are exploring the potential of telehealth to support the management of the growing number of people with long-term conditions (LTCs). Aim: To develop, implement and evaluate new care programmes for patients with LTCs, focusing on two common LTCs as exemplars: depression or high cardiovascular disease (CVD) risk. Methods Development: We synthesised quantitative and qualitative evidence on the effectiveness of telehealth for LTCs, conducted a qualitative study based on interviews with patients and staff and undertook a postal survey to explore which patients are interested in different forms of telehealth. Based on these studies we developed a conceptual model [TElehealth in CHronic disease (TECH) model] as a framework for the development and evaluation of the Healthlines Service for patients with LTCs. Implementation: The Healthlines Service consisted of regular telephone calls to participants from health information advisors, supporting them to make behaviour change and to use tailored online resources. Advisors sought to optimise participants’ medication and to improve adherence. Evaluation: The Healthlines Service was evaluated with linked pragmatic randomised controlled trials comparing the Healthlines Service plus usual care with usual care alone, with nested process and economic evaluations. Participants were adults with depression or raised CVD risk recruited from 43 general practices in three areas of England. The primary outcome was response to treatment and the secondary outcomes included anxiety (depression trial), individual risk factors (CVD risk trial), self-management skills, medication adherence, perceptions of support, access to health care and satisfaction with treatment. Trial results Depression trial: In total, 609 participants were randomised and the retention rate was 86%. Response to treatment [Patient Health Questionnaire 9-items (PHQ-9) reduction of ≥ 5 points and score of < 10 after 4 months] was higher in the intervention group (27%, 68/255) than in the control group (19%, 50/270) [odds ratio 1.7, 95% confidence interval (CI) 1.1 to 2.5; p = 0.02]. Anxiety also improved. Intervention participants reported better access to health support, greater satisfaction with treatment and small improvements in self-management, but not improved medication adherence. CVD risk trial: In total, 641 participants were randomised and the retention rate was 91%. Response to treatment (maintenance of/reduction in QRISK®2 score after 12 months) was higher in the intervention group (50%, 148/295) than in the control group (43%, 124/291), which does not exclude a null effect (odds ratio 1.3, 95% CI 1.0 to 1.9; p = 0.08). The intervention was associated with small improvements in blood pressure and weight, but not smoking or cholesterol. Intervention participants were more likely to adhere to medication, reported better access to health support and greater satisfaction with treatment, but few improvements in self-management. The Healthlines Service was likely to be cost-effective for CVD risk, particularly if the benefits are sustained, but not for depression. The intervention was implemented largely as planned, although initial delays and later disruption to delivery because of the closure of NHS Direct may have adversely affected participant engagement. Conclusion: The Healthlines Service, designed using an evidence-based conceptual model, provided modest health benefits and participants valued the better access to care and extra support provided. This service was cost-effective for CVD risk but not depression. These findings of small benefits at extra cost are consistent with previous pragmatic research on the implementation of comprehensive telehealth programmes for LTCs