Objective: Economic hardship (EH) may link to poorer child diet, however whether this association is due to resource limitations or effects on family functioning is unknown. This study examines whether parenting stress mediates the association between EH and child consumption of foods high in saturated fats and added sugars (SFAS).Design: Data were collected from the Fragile Families and Child Wellbeing study. EH was assessed using eight items collected when children were between 1–9 years old. Mothers reported parenting stress and frequency of child consumption of high SFAS foods when children were 9 years old. Latent growth curve modelling (LGCM) and structural equation modelling tested direct associations between the starting level/rate of change in EH and high SFAS food consumption, and parenting stress as a mediator of the association.Setting: Twenty US cities.Participants: Mothers/children (n3846) followed birth through age 9 years, oversampled ‘high-risk’, unmarried mothers.Results: LGCM indicated a curvilinear trend in EH from ages 1–9, with steeper increases from ages 3–9 years. EH did not directly predict the frequency of high SFAS foods. Average EH at 3 and 5 years and change in EH from ages 1–9 predicted higher parenting stress, which in turn predicted more frequent consumption of high SFAS foods.Conclusions: Findings suggest it may be important to consider parenting stress in early prevention efforts given potential lasting effects of early life EH on child consumption of high SFAS foods. Future research should explore how supports and resources may buffer effects of EH-related stress on parents and children.
24 February 2022 in International Journal of Migration, Health and Social Care
Purpose: There is an urgent need to upscale accessible mental health (MH) interventions that address barriers to care among Syrian refugee adolescents. The Happy Helping Hand (HH) is an innovative, cognitive behavioral digital game designed to improve MH for adolescents across digital divides. This study aims to examine the impact of HH implemented among Syrian refugees who varied according to group size and face-to-face (F2F) versus digital contact. Design/methodology/approach: This mixed-methods study took place in Central Beqaa, Lebanon, from September 2020 to February 2021. Nine groups of Syrian displaced adolescents (n = 125) aged 13–17 years (Mage = 13.6 years) were recruited from an education center, two orphanages and one informal settlement to participate in the ten-session HH program. The WHO-Five-Well-being Index (WHO5) is a validated measure used to evaluate HH impact on MH at baseline and directly postintervention. Findings: Significant improvements were seen in WHO5 scores in F2F and digital settings from baseline to follow-up. At baseline, 28% reported normal well-being, which increased to 99% after HH participation. WHO5 scores changed from M = 59.4 at baseline, indicating depression, to M = 77.3 at follow-up, indicating normal well-being. Smaller groups with more F2F contact reported greater improvements in mean WHO5 than larger groups with less F2F contact. The greatest aggregate change in well-being was achieved when HH was implemented digitally in bigger groups. Originality/value: Study results indicate that the HH game can improve well-being and MH for Syrian refugees. Importantly, results build on the base of evidence on digital MH interventions as promising tools on the way to ensure healthy lives and well-being for all.
1 September 2019 in Journal of Nutrition Education and Behavior