Do parents’ support behaviours predict whether or not their children get sufficient sleep? A cross-sectional study

Abstract Background Sleep is an essential component of healthy cognitive and physical development. Lack of sleep may put children at risk for a variety of mental and physical health outcomes, including overweight, obesity and related chronic diseases. Given that children’s sleep duration has decreased in recent decades, there is a need to understand the determinants of child sleep, including the role of parental support behaviours. This study aims to determine the relative contribution of different types of parental support behaviours for predicting the likelihood that children meet recently established Canadian sleep guidelines. Methods Data were collected using Computer Assisted Telephone Interviews (CATI) of parents or guardians with at least one child under the age of 18 living in Ontario, Canada. To align with sleep guidelines, parents included in this analysis had at least one child between 5 and 17 years of age (n = 1622). Two multivariable logistic regression models were built to predict whether or not parents reported their child was meeting sleep guidelines – one for weekday sleep and another for sleep on weekends. Independent variables included parent and child age and gender, motivational and regulatory parental support behaviours, and socio-demographic characteristics. Results On weekdays, enforcing rules about child bedtime was a significant positive predictor of children meeting sleep guidelines (OR: 1.59; 95% CI: 1.03–2.44); while encouraging the child to go to bed at a specific time was a significant negative predictor of child meeting sleep guidelines (OR: 0.29; 95% CI: 0.13–0.65). On weekends, none of the parental support behaviours contributed significantly to the predictions of child sleep. For both weekdays and weekends, the child’s age group was an important predictor of children meeting sleep guidelines. Conclusions The contribution of parental support behaviours to predictions of children meeting sleep guidelines varied with the type of support provided, and weekend versus weekday sleep. While only enforcing bedtime rules on weekdays contributed to children meeting sleep guidelines, the importance of children getting a good night’s sleep, and the capacity of parents to help them do so, should be emphasized in public health efforts promoting healthy child development

The impact of different types of parental support behaviours on child physical activity, healthy eating, and screen time: a cross-sectional study

Abstract Background In Canada, 31.5 % of children are overweight or obese, putting them at an increased risk of chronic co-morbidities and premature mortality. Physical activity, healthy eating, and screen time are important behavioural determinants of childhood overweight and obesity that are influenced by the family environment, and particularly parents’ support behaviours. However, there is currently a limited understanding of which types of these support behaviours have the greatest positive impact on healthy child behaviours. This study aims to determine the relative contribution of different types of parental support behaviours for predicting the likelihood that children meet established guidelines for daily physical activity, daily fruit and vegetable consumption, and recreational screen time. Methods A Computer Assisted Telephone Interview survey was used to collect data from a random sample of parents or guardians with at least one child under the age of 18 in Ontario (n = 3,206). Three multivariable logistic regression models were built to predict whether or not parents reported their child was meeting guidelines. Independent variables included parent and child age and gender, multiple indicators of parental support behaviours, and socio-demographic characteristics. Parental support behaviours were categorized post-hoc as motivational, instrumental, regulatory, and conditional based on an adapted framework. Results Controlling for all other factors in the model, several parental support behaviours were found to be significant predictors of children meeting established health guidelines. For example, conditional support behaviours including taking the child to places where they can be active (OR: 2.06; 95 % CI: 1.32-3.21), and eating meals as a family away from the TV (95 % CI: 1.15-2.41) were significant positive predictors of children meeting physical activity and fruit and vegetable guidelines, respectively. Conclusions Health promotion efforts aimed at improving particular parent support behaviours could be effective levers for mitigating the burden of excess body weight in childhood. As such, the influence of support behaviours should be fully considered in any comprehensive approach to prevention and reduction of childhood overweight and obesity

The impact of different types of parental support behaviours on child physical activity, healthy eating, and screen time: a cross-sectional study

Abstract Background In Canada, 31.5 % of children are overweight or obese, putting them at an increased risk of chronic co-morbidities and premature mortality. Physical activity, healthy eating, and screen time are important behavioural determinants of childhood overweight and obesity that are influenced by the family environment, and particularly parents’ support behaviours. However, there is currently a limited understanding of which types of these support behaviours have the greatest positive impact on healthy child behaviours. This study aims to determine the relative contribution of different types of parental support behaviours for predicting the likelihood that children meet established guidelines for daily physical activity, daily fruit and vegetable consumption, and recreational screen time. Methods A Computer Assisted Telephone Interview survey was used to collect data from a random sample of parents or guardians with at least one child under the age of 18 in Ontario (n = 3,206). Three multivariable logistic regression models were built to predict whether or not parents reported their child was meeting guidelines. Independent variables included parent and child age and gender, multiple indicators of parental support behaviours, and socio-demographic characteristics. Parental support behaviours were categorized post-hoc as motivational, instrumental, regulatory, and conditional based on an adapted framework. Results Controlling for all other factors in the model, several parental support behaviours were found to be significant predictors of children meeting established health guidelines. For example, conditional support behaviours including taking the child to places where they can be active (OR: 2.06; 95 % CI: 1.32-3.21), and eating meals as a family away from the TV (95 % CI: 1.15-2.41) were significant positive predictors of children meeting physical activity and fruit and vegetable guidelines, respectively. Conclusions Health promotion efforts aimed at improving particular parent support behaviours could be effective levers for mitigating the burden of excess body weight in childhood. As such, the influence of support behaviours should be fully considered in any comprehensive approach to prevention and reduction of childhood overweight and obesity

Digital Health Technology for Real-World Clinical Outcome Measurement using Patient-Generated Data: Systematic Scoping Review (Preprint)

BACKGROUND Digital health technologies (DHT) have an ever-expanding role in health care management and delivery. Beyond their use as interventions, DHTs also serve as a vehicle for real-world data collection to characterize patients, their care journeys, and responses to other clinical interventions. There is a need to comprehensively map the evidence—across all conditions and technology types—on DHT use for measuring patient outcomes in the real world. OBJECTIVE To investigate the use of DHT for measuring real-world clinical outcomes using patient-generated data. METHODS We conducted this systematic scoping review in accordance with Joanna Briggs Institute methodology. Detailed eligibility criteria documented in a pre-registered protocol informed a search strategy for the included databases: MEDLINE (Ovid), CINAHL, Cochrane (CENTRAL), Embase, PsycINFO, ClinicalTrials.gov, and the EU Clinical Trials Register. We considered studies in which digital health data were collected, passively and/or actively, from patients with any specified health condition outside of clinical visits. Categories for key concepts, such as DHT type and analytic applications, were established where needed. Following screening and full-text review, data were extracted and analyzed using predefined fields, and findings were reported in accordance with the PRISMA-ScR. RESULTS The search strategy identified a total of 11,015 publications, with 7,308 records once duplicates and reviews were removed. After screening and full text review, 510 studies were included for extraction. These studies encompassed 169 different diseases and conditions over 20 therapeutic areas and 44 countries. DHTs used for mental health and addictions research (n = 111) were most prevalent. The most common type of DHT, smartphone/mobile apps, were reflected in approximately half of all studies (n = 250). Most studies used only one DHT (n = 346); however, the majority of digital technologies used were able to collect more than one type of data, with the most common being physiological (n = 189), clinical symptoms (n = 188), and behavioural (n = 171). Overall, there has been real growth in the depth and breadth of evidence, number of DHT types, and use of artificial intelligence and advanced analytics over time. CONCLUSIONS This scoping review offers a comprehensive view of the variety of types of technology, data, collection methods, analytic approaches, and therapeutic applications within this growing body of evidence. To unlock the full potential of DHT for measuring health outcomes and capturing of digital biomarkers, there is a need for more rigorous research that goes beyond technology validation to demonstrate whether robust real-world data can be reliably captured from patients in their daily life, and whether its capture improves patient outcomes. The present study provides a valuable repository of DHT studies to inform subsequent research by health care providers, policymakers, and the life sciences industry. </sec

A Scoping Review of Patient Support Program Services Across Diverse Settings and Disease Areas Described from a People-Centered Perspective

Abstract BackgroundGovernments, private industries and not-for-profit organizations are increasingly investing resources in support programs for patients. These programs may provide self-management strategies enabling patients to manage their disease and medication regimen and/or access to medications, therapies and health services, with the goal to improve health outcomes. The objectives of this scoping review were to: (i) describe the characteristics of patient support programs (PSPs), for patients on medication regimens, (ii) identify subthemes that describe PSP services, and (iii) to classify the service subthemes, using an integrated people-centered (IP-C) perspective. MethodsPRISMA-ScR methodology and Covidence software were used to facilitate the review of 479 articles, and the selection and screening of 70 original research articles that described PSP services and their impact on clinical, humanistic and/or economic outcomes. A search of PubMed, Embase, CINAHL, Academic Search Ultimate, and Web of Science was conducted covering a 10 year period, from 2010 to 2020. The PSPs identified were organized into subthemes identified as part of an inductive process. The thematic areas were grouped into one of three people-centered categories that reflect the WHO vision for IPC health care. ResultsThe 70 articles reviewed, describe PSPs covering more than nine disease categories. The majority of the articles were published in North America, predominantly in the United States (26) and Canada (11), and also in Germany (6), the United Kingdom (6), China (4) and other countries (18). PSPs were funded and delivered by private drug or device manufacturers, government organizations, specialty pharmacies and also non-governmental groups (e.g., not-for-profit organizations), private hospitals, private payers (e.g., insurance companies) and various partnership types among these organizations. Fifty-six unique PSPs were identified that offered a range of services. Twenty-five PSP service subthemes were identified and these were each placed into one of three over-arching patient-centered categories: (i) access and equity services; (ii) quality and health services, and (iii) patient and caregiver empowerment and self-management services.ConclusionsPSPs offer various services that can be optimized and synergized to facilitate equitable, accessible, quality health services that support patient empowerment for the self-management of disease for improved health outcomes.</jats:p

Unlocking First Nations health information through data linkage

Introduction The importance of Indigenous data sovereignty and Indigenous-led research processes is increasingly being recognized in Canada and internationally. For First Nations in Ontario, Canada, access to routinely-collected demographic and health systems data is critical to planning and measuring health status and outcomes in their populations. Linkage of this data with the Indian Register (IR), under First Nations data governance, has unlocked data for use by First Nations organizations and communities. Objectives To describe the linkage of the IR database to the Ontario Registered Persons Database (RPDB) within the context of Indigenous data sovereignty principles.  Methods Deterministic and probabilistic record linkage methods were used to link the IR to the RPDB. There is no established population of First Nations people living in Ontario with which we could establish a linkage rate. Accordingly, several approaches were taken to determine a denominator that would represent the total population of First Nations we would hope to link to the RPDB.  Results Overall, 201,678 individuals in the national IR database matched to Ontario health records by way of the RPDB, of which 98,562 were female and 103,116 were male. Of those First Nations individuals linked to the RPDB, 90.2% (n=181,915) lived in Ontario when they first registered with IR, or were affiliated with an Ontario First Nation Community. The proportion of registered First Nations people linking to the RPDB improved across time, from 62.8% in the 1960s to 94.5% in 2012. Conclusions This linkage of the IR and RPDB has resulted in the creation of the largest First Nations health research study cohort in Canada. The linked data are being used by First Nations communities to answer questions that ultimately promote wellbeing, effective policy, and healing