Child and Adolescent Health: Challenges and Perspectives

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "School Health".

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 77141

Special Issue Editors


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Guest Editor
National Centre for Disease Prevention and Health Promotion, National Institute of Health, 00161 Rome, Italy
Interests: public health; epidemiology; surveillance; cancer and cancer registries; child and adolescent health; women’s health

E-Mail Website
Guest Editor
National Centre for Disease Prevention and Health Promotion, National Institute of Health, 00161 Rome, Italy
Interests: public health; epidemiology; child and adolescent health; life style behaviour; health promotion

E-Mail Website
Guest Editor
National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
Interests: public health; epidemiology; child and adolescent health; life style behaviour; health promotion
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The ‘life course’ concept recognizes the opportunity to prevent and control possible diseases at key stages of life from preconception through pregnancy, infancy, childhood, and adolescence to adulthood. Indeed, unhealthy behaviours adopted from preconception (e.g., no intake of folic acid, tobacco and alcohol use during pregnancy, etc.) to adolescence (e.g., eating habits, physical activity, sedentary behaviors, etc.) can influence health outcomes during early development and in adult life as well. Alcohol and tobacco use, obesity, and overweight are the main risk factors that could be modified during the first phases of life to prevent chronic diseases in later life.

Public health surveillance is essential to collecting health indicators and promoting the planning, implementation, and evaluation of public health interventions.

Health care workers, family, and school are the main actors that support healthy lifestyles and change unhealthy habits among young people and pregnant women.

This Special Issue will focus on: 1) preconception, prenatal, and newborn prevention and care; 2) life styles and risk behaviours in childhood; and 3) life styles and risk behaviors in adolescence as predictors of a healthy adulthood. Papers on physical activity, eating and dieting, family, mental health, and sexual habits as well as studies describing differences and inequalities in women’s and young people’s health (also during a pandemic period) are welcome. We also encourage the submission of interdisciplinary work and multi-country collaborative research.

Dr. Daniela Pierannunzio
Dr. Silvia Ciardullo
Dr. Paola Nardone
Guest Editors

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Keywords

  • Child/adolescent health
  • women’s health
  • life styles
  • risk behaviors
  • well-being
  • overweight/obesity
  • surveillance systems
  • Covid-19
  • health inequalities.

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Published Papers (22 papers)

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10 pages, 1170 KiB  
Article
Educational Intervention in the Postural Hygiene of School-Age Children
by María José Menor-Rodríguez, Raquel Rodríguez-Blanque, María Montiel-Troya, Jonathan Cortés-Martín, María José Aguilar-Cordero and Juan Carlos Sánchez-García
Healthcare 2022, 10(5), 864; https://doi.org/10.3390/healthcare10050864 - 6 May 2022
Cited by 3 | Viewed by 2531
Abstract
Introduction: Healthy lifestyle habits formed in childhood provide the foundation for a healthy adult life; therefore, it is important to encourage healthy habits and to correct poor habits from an early age. Aim: In this study, we aim to evaluate the influence of [...] Read more.
Introduction: Healthy lifestyle habits formed in childhood provide the foundation for a healthy adult life; therefore, it is important to encourage healthy habits and to correct poor habits from an early age. Aim: In this study, we aim to evaluate the influence of educational intervention in order to modify postural hygiene habits in school-age children. Materials and methods: We randomly selected three public primary education schools in the Galician provinces of Orense and Pontevedra based on stratified multistage sampling. A sample of 479 students was obtained, representing 2% of all 6- to 12-year-old children registered during the 2015/2016 academic year in those provinces. Results: Following the intervention, the students’ postural hygiene improved. We found statistically significant differences regarding a reduction in the number of hours spent watching television (0.531 h/day); the way school books and supplies were carried, with an increase in the use of backpacks with wheels (from 58.5% to 64.1%); and an improvement in postural hygiene when watching television, with an increase from 63.7% to 80.8% of those surveyed opting to watch television whilst seated on a chair instead of lying down. Conclusions: Educational intervention by inculcating healthy postural hygiene habits in children at an early age can improve and correct unhealthy behaviours. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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18 pages, 619 KiB  
Article
Finding the Link between Cyberbullying and Suicidal Behaviour among Adolescents in Peninsular Malaysia
by Siti Aisyah Mohd Fadhli, Jasy Liew Suet Yan, Ahmad Shahril Ab Halim, Asrenee Ab Razak and Azriani Ab Rahman
Healthcare 2022, 10(5), 856; https://doi.org/10.3390/healthcare10050856 - 6 May 2022
Cited by 16 | Viewed by 7633
Abstract
Social media engagement has contributed to the rise of cyberbullying, which has recently triggered tragic suicides among adolescents. The objective of this cross-sectional study is to determine the prevalence of cyberbullying, suicidal behaviour, and their association among adolescents in Peninsular Malaysia. The study [...] Read more.
Social media engagement has contributed to the rise of cyberbullying, which has recently triggered tragic suicides among adolescents. The objective of this cross-sectional study is to determine the prevalence of cyberbullying, suicidal behaviour, and their association among adolescents in Peninsular Malaysia. The study was conducted among 1290 secondary school adolescents aged between 13 and 17 years old in Peninsular Malaysia using a self-administered and anonymous online questionnaire. Our findings reveal that the prevalence of cyberbullying victimization and perpetrator is 13.7% and 3.8%, respectively. The prevalence of suicidal behaviour among adolescents is 17.1%, in which 11.9% had suicidal thoughts, 10.2% had a suicide plan, and 8.4% had made a suicide attempt. Multiple logistic regression shows that adolescents experiencing cyberbullying victimization is a significant risk factor (p < 0.001) for suicidal behaviour after adjusting for other confounders. An alarming number of adolescents in Peninsular Malaysia found to be involved in cyberbullying and its significant association with suicidal behaviour warrant the need to strengthen current interventions. Since the study was conducted during the COVID-19 pandemic, our findings make an important contribution in reporting current trends in cyberbullying and suicide among adolescents, especially when they are becoming ever-more present in cyberspaces. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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9 pages, 257 KiB  
Article
Physical Activity, Eating Habits and Mental Health during COVID-19 Lockdown Period in Serbian Adolescents
by Višnja Đorđić, Milan Cvetković, Boris Popović, Danilo Radanović, Milica Lazić, Biljana Cvetković, Slobodan Andrašić, Svetlana Buišić and Miroslav Marković
Healthcare 2022, 10(5), 834; https://doi.org/10.3390/healthcare10050834 - 30 Apr 2022
Cited by 6 | Viewed by 2547
Abstract
The COVID-19 pandemic has impacted almost every aspect of life, especially daily physical activity and healthy eating habits but also mental health. Our study aimed to examine the relationship between the physical activity level, eating habits and mental health of Serbian adolescents during [...] Read more.
The COVID-19 pandemic has impacted almost every aspect of life, especially daily physical activity and healthy eating habits but also mental health. Our study aimed to examine the relationship between the physical activity level, eating habits and mental health of Serbian adolescents during the COVID-19 pandemic. A total of 3506 students from the territory of the Republic of Serbia participated in this study. IPAQ-short version and HBSC-FFQ were used to assess physical activity level and eating habits, along with self-rated health. Moderate correlations were identified between physical activity, eating habits and mental health, along with average physical activity, very high life satisfaction (β = 0.177, p < 0.01) and very low emotional distress (β = −0.150, p < 0.01). A significant predictor of mental health was the frequency of breakfast on weekdays (β = 0.167, p < 0.01 for life satisfaction and β = −0.153, p < 0.01 for emotional distress), but not on weekends. Since the pandemic’s course is uncertain, the focus should be on maintaining good physical activity, nutrition and well-being. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
10 pages, 252 KiB  
Article
The Association between Physical Activity and Smartphone Addiction in Korean Adolescents: The 16th Korea Youth Risk Behavior Web-Based Survey, 2020
by Jooyoung Kim and Kihyuk Lee
Healthcare 2022, 10(4), 702; https://doi.org/10.3390/healthcare10040702 - 9 Apr 2022
Cited by 17 | Viewed by 3950
Abstract
Many side effects of smartphone addiction have been reported, such as a lack of sleep, obesity, and poor concentration. However, the relationship between physical activity (PA) and smartphone addiction has not been fully elucidated. This study aimed to analyze the relationship between physical [...] Read more.
Many side effects of smartphone addiction have been reported, such as a lack of sleep, obesity, and poor concentration. However, the relationship between physical activity (PA) and smartphone addiction has not been fully elucidated. This study aimed to analyze the relationship between physical activity and smartphone addiction among 53,534 Korean adolescents using raw data from the 16th (2020) Korea Youth Risk Behavior Web-based Survey (KYRBS). The dependent variables were the general user group, potential risk user group, and high-risk user group for smartphone addiction. The independent variables were moderate PA (over 5 days per week), vigorous PA (over 3 days per week), and strength exercise (over 3 days per week). Sex, body mass index (BMI), school grade, academic achievement, sleep satisfaction, depression, loneliness, and stress were selected as confounding variables. A complex sample logistic regression analysis was performed. Potential smartphone addiction risk users showed statistically significant odds ratios of 1.423 (p < 0.001), 1.379 (p < 0.001), and 1.383 (p < 0.001) based on general users participating in moderate PA, vigorous PA, and strength exercise, respectively. High-risk users showed statistically significant odds ratios of 1.475 (p < 0.001), 1.484 (p < 0.001), and 1.619 (p < 0.001), respectively. In conclusion, to prevent smartphone addiction among Korean adolescents, participation in moderate PA for more than five days a week, vigorous PA for more than three days a week, or strength exercise for more than three days a week is considered effective. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
10 pages, 741 KiB  
Article
Value of Adding Bioelectrical Impedance Analysis to Anthropometric Indices in the Diagnosis of Metabolic Syndrome in 10–16 Years Old Schoolgirls
by Rawan G. Muhanna, Ghadeer S. Aljuraiban, Najwa K. Almadani, Mohammed Alquraishi, Mohamed S. El-Sharkawy and Mahmoud M. A. Abulmeaty
Healthcare 2022, 10(3), 419; https://doi.org/10.3390/healthcare10030419 - 23 Feb 2022
Cited by 5 | Viewed by 2015
Abstract
The use of bioelectrical impedance analysis (BIA) in clinical settings is common. However, the value of BIA-based parameters in diagnosing metabolic syndrome (MetS) in children is under-investigated. Herein, we aimed to study the usefulness of BIA-indices in the diagnoses of MetS in 6–10-year-old [...] Read more.
The use of bioelectrical impedance analysis (BIA) in clinical settings is common. However, the value of BIA-based parameters in diagnosing metabolic syndrome (MetS) in children is under-investigated. Herein, we aimed to study the usefulness of BIA-indices in the diagnoses of MetS in 6–10-year-old girls. Therefore, a diagnostic accuracy case-control study was conducted, which included 75 girls aged 10–16 years, divided into three age-matched groups (normal, None-MetS, and MetS). Anthropometric indices, BIA parameters (including fat-free mass (FFM), body fat percent (BFP), and total body water (TBW)), blood pressure (BP), and blood samples were collected. Our main findings show that for girls in None-MetS and MetS groups, the waist circumference (WC) correlated positively with waist-hip ratio and mid-arm circumference (r = 0.58, 0.47, respectively), but not with BFP based on skinfold thickness (SFT), or mid-arm muscle area. WC was positively correlated with FFM and TBW, while high-density lipoprotein was inversely correlated with FFM. However, fasting blood glucose, triglycerides and BP showed no association with anthropometric measurements and BIA components. WC was the best indicator of MetS (AUC = 0.88, cut-off = 81.5 cm), followed by BMI (AUC = 0.84, cut-off = 26.9 kg/m2), while BFP based on SFT was the least sensitive (62.5%). In conclusion, apart from the FM index, anthropometric parameters such as WC are more valuable in diagnosing MetS in young adolescent girls. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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17 pages, 1215 KiB  
Article
Contextual Factors Influencing Young Athletes’ Decision to Do Physical Activity and Choose a Sports’ Club: The Case of Portugal
by Gonçalo Santinha, Rafaela Oliveira and Luís Jorge Gonçalves
Healthcare 2022, 10(2), 347; https://doi.org/10.3390/healthcare10020347 - 11 Feb 2022
Cited by 1 | Viewed by 2655
Abstract
Physical activity and sports are a central part of individuals’ lives throughout the life cycle. During adolescence, its regular practice may contribute to the development of healthy adult lifestyles, decreasing chronic disease incidence. Therefore, the reasons that drive adolescents to start practicing sports [...] Read more.
Physical activity and sports are a central part of individuals’ lives throughout the life cycle. During adolescence, its regular practice may contribute to the development of healthy adult lifestyles, decreasing chronic disease incidence. Therefore, the reasons that drive adolescents to start practicing sports in a certain club may be multiple and understanding such causes can be important to design and implement public policies to promote active lifestyles for everyone. In this article, we report the core findings of a research on why young athletes do sports, how they choose their team-training club and how COVID-19 has had an impact on their routines. From a methodological viewpoint, a questionnaire was developed and sent to sport clubs located in NUTS2 Centro Region, Portugal, and results were analyzed through the use of geographic information systems and statistical analysis, namely association tests (Chi-square test), difference tests (Mann–Whitney test and Kruskal–Wallis test), logistic regression and descriptive analysis. Findings show that family, age group, friends, proximity to sports facilities, teammates, and club conditions are the factors that influence adolescents the most. In short, external factors have a significant preponderance to practice physical activity and choose a sports’ club. These findings can provide useful insights for clubs, coaches and policy-makers to become more aware of the relationship between sports practice and accessibility to sports halls, as well as the athletes’ behavior and their connection with the club and basketball practice. As such, these findings can motivate the design of initiatives and strategies to boost sports practice and to find ways for clubs to attract more adolescents. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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13 pages, 1126 KiB  
Article
Identifying Cardiovascular Risk Profiles Clusters among Mediterranean Adolescents across Seven Countries
by Riki Tesler, Sharon Barak, Orna Reges, Concepción Moreno-Maldonado, Rotem Maor, Tânia Gaspar, Oya Ercan, Yael Sela, Gizell Green, Avi Zigdon, Adilson Marques, Kwok Ng and Yossi Harel-Fisch
Healthcare 2022, 10(2), 268; https://doi.org/10.3390/healthcare10020268 - 29 Jan 2022
Cited by 6 | Viewed by 3558
Abstract
Cardiovascular diseases (CVDs) are the number one cause of death globally and are partially due to the inability to control modifiable lifestyle risk factors. The aim of this study was to analyze the profiles of adolescents from seven Mediterranean countries (Greece, Israel, Italy, [...] Read more.
Cardiovascular diseases (CVDs) are the number one cause of death globally and are partially due to the inability to control modifiable lifestyle risk factors. The aim of this study was to analyze the profiles of adolescents from seven Mediterranean countries (Greece, Israel, Italy, Macedonia, Malta, Portugal, Spain) according to their modifiable lifestyle risk factors for CVD (overweight/obesity, physical activity, smoking, alcohol consumption). The sample consisted of 26,110 adolescents (52.3% girls) aged 11, 13, and 15 years who participated in the Health Behavior in School-aged Children (HBSC) survey in 2018 across the seven countries. Sociodemographic characteristics (sex, age, country of residence, socioeconomic status) and CVD modifiable lifestyle risk factors (overweight/obesity, physical activity, smoking, alcohol consumption) were recorded. A two-step cluster analysis, one-way analysis of variance, and chi-square test were performed. Four different cluster groups were identified: two low-risk groups (64.46%), with risk among those with low physical activity levels; moderate-risk group (14.83%), with two risk factors (unhealthy weight and low physical activity level); and a high-risk group (20.7%), which presented risk in all modifiable lifestyle risk factors. Older adolescents reported a higher likelihood of being in the high-risk group. Given that the adolescence period constitutes an important time for interventions aimed at CVD prevention, identifying profiles of moderate- and high-risk adolescents is crucial. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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10 pages, 232 KiB  
Article
Electronic Cigarette Use and Other Factors Associated with Cigarette Smoking among Thai Undergraduate Students
by Phantara Chulasai, Surarong Chinwong, Purida Vientong, John J. Hall and Dujrudee Chinwong
Healthcare 2022, 10(2), 240; https://doi.org/10.3390/healthcare10020240 - 26 Jan 2022
Cited by 3 | Viewed by 3109
Abstract
The prevalence of smoking among young adults in Thailand has gradually increased. Therefore, this study aimed to identify factors associated with cigarette smoking among undergraduate students. This cross-sectional study used a self-administered, anonymous online questionnaire to gather data from undergraduate students across four [...] Read more.
The prevalence of smoking among young adults in Thailand has gradually increased. Therefore, this study aimed to identify factors associated with cigarette smoking among undergraduate students. This cross-sectional study used a self-administered, anonymous online questionnaire to gather data from undergraduate students across four universities in Chiang Mai Province, Thailand. All 1126 participants were an average age of 21.30 years old (SD 1.48). The findings revealed seven factors significantly associated with cigarette smoking (p < 0.05), including male sex, having no medical conditions, consuming alcohol daily and consuming alcohol in the past, having brothers or sisters who smoked cigarettes, having a father or mother who smoked cigarettes, having parents who considered smoking acceptable and having parents who had uncertain concerns about smoking, and had or have used electronic cigarettes (e-cigarettes). These associated factors could be useful in implementing appropriate tobacco-control programs to prevent cigarette smoking among undergraduate students. Relevant organizations, universities and healthcare professionals should communicate correct and appropriate information about the illness and diseases caused by using tobacco products to strengthen the correct perceptions of the harms of cigarette smoking and e-cigarette use among undergraduate students. Furthermore, smoke-free policies should be monitored and strictly enforced, particularly in university areas. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
16 pages, 340 KiB  
Article
The Need for Health Education and Vaccination—Importance of Teacher Training and Family Involvement
by Eduardo García-Toledano, Emilio López-Parra, Antonio Cebrián-Martínez and Ascensión Palomares-Ruiz
Healthcare 2022, 10(1), 110; https://doi.org/10.3390/healthcare10010110 - 6 Jan 2022
Cited by 8 | Viewed by 2815
Abstract
The health emergency due to COVID-19 has highlighted the importance of vaccination and its impact on social welfare. Inequalities have surfaced that affect the most vulnerable and those millions of children do not receive the necessary vaccines. Health education becomes a fundamental resource [...] Read more.
The health emergency due to COVID-19 has highlighted the importance of vaccination and its impact on social welfare. Inequalities have surfaced that affect the most vulnerable and those millions of children do not receive the necessary vaccines. Health education becomes a fundamental resource for citizens to access universal rights. One thousand people from 76 countries on five continents participated in this research in 2019–2020, from the health, education, and economic sectors. A descriptive cross-sectional study with a quantitative design was used. The instrument used was a correctly validated questionnaire: VACUNASEDUCA. The objectives were to reflect on the adequacy of teacher training and their awareness for the proper use of vaccines and to analyze the knowledge of parents about the consequences of vaccination. The results demonstrate the importance of teacher training and health education, with positive involvement of the family. The most favorable group is female, under 30 years, from the European continent, with a very high Human Development Index (HDI), and from the education sector. In conclusion, it is noted that, within the framework of the fourth industrial revolution, education must be configured with innovative approaches and tools, making it necessary to intervene in the context considering their cultural characteristics and promoting healthy lifestyle habits. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
10 pages, 825 KiB  
Article
Smartphone Addiction and Depression among Low-Income Boys since COVID-19: The Moderating Effect of Being an Only Child
by Jaewon Lee, Hyejung Lim, Jennifer Allen, Gyuhyun Choi and Jiyu Jung
Healthcare 2021, 9(10), 1350; https://doi.org/10.3390/healthcare9101350 - 11 Oct 2021
Cited by 13 | Viewed by 3150
Abstract
Even though boys’ depression has become important, and their smartphone use has increased since COVID-19, little is known about low-income middle and high school boys’ depression in the context of whether they have siblings. Thus, this study investigates the relationship between smartphone addiction [...] Read more.
Even though boys’ depression has become important, and their smartphone use has increased since COVID-19, little is known about low-income middle and high school boys’ depression in the context of whether they have siblings. Thus, this study investigates the relationship between smartphone addiction and depression as well as the moderating effect of being an only child on the relationship. Participants were limited to middle and high school students whose families were regarded as having a low-income. A total of 129 low-income boys were selected for the final sample. The PROCESS macro 3.4 for Statistical Product and Service Solutions was used to identify the moderating effect. Smartphone addiction was positively related to depression among low-income male students. Being an only child significantly moderated the relationship between smartphone addiction and depression. This study contributes to understanding the importance of examining mental health problems among middle school boys since COVID-19, particularly among low-income boys. It is necessary to provide tailored mental health services for middle school boys in low-income families. Alternative activities and social programs should be provided for adolescent boys who are only children to safely socialize with friends and peers without a smartphone. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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11 pages, 735 KiB  
Article
A School-Based Progressive Muscle Relaxation Program for Female Adolescents: Development and the Effectiveness on Physiological and Psychological Evidence
by Mei-Li Tsai, Tsan-Hwang Cheng, Yen-Kuang Yang and Chi-Jane Wang
Healthcare 2021, 9(10), 1319; https://doi.org/10.3390/healthcare9101319 - 3 Oct 2021
Cited by 1 | Viewed by 3095
Abstract
(1) Background: A variety of stressors may be potentially harmful to adolescents’ health and well-being. Relaxation techniques have been recognized as a valid method for stress release, but the challenge is to apply them practically in schools to produce the desired effects. (2) [...] Read more.
(1) Background: A variety of stressors may be potentially harmful to adolescents’ health and well-being. Relaxation techniques have been recognized as a valid method for stress release, but the challenge is to apply them practically in schools to produce the desired effects. (2) Methods: This feasibility study used the Perceived Stress Scale (PSS) and hair cortisol concentration (HCC) to test the effects of an abbreviated progressive muscle relaxation (APMR) program on female adolescents. The participants were recruited from a high school and assigned by class cluster to either the experimental group (EG, n = 40) or the control group (CG, n = 35). Both received 4 weeks of stress-related lessons. The EG received 60 additional sessions of APMR over 12 weeks. (3) Results: The program dropout rate of the participants was 1.3%. The EG’s program adhesion rate was 99.1%, and nearly half felt satisfied with the program. After adjusting for the BMI and the pretest in the ANCOVA, it was found that the CG had a greater change in HCC between the pre- and post-tests than the EG, while the PSS did not change significantly in either group. (4) Conclusion: APMR is a valid practice for physiological homeostasis of HCC for female adolescents, but it has no significant effect on perceived stress. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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16 pages, 536 KiB  
Article
A Retrospective Study on the Factors Associated with Long-Stay Hospitalization in a Child Neuropsychiatry Unit
by Silvia Zanato, Marina Miscioscia, Annalisa Traverso, Miriam Gatto, Mikael Poli, Alessia Raffagnato and Michela Gatta
Healthcare 2021, 9(9), 1241; https://doi.org/10.3390/healthcare9091241 - 21 Sep 2021
Cited by 5 | Viewed by 2315
Abstract
The past twenty years have seen a rapid increase in acute psychiatric symptoms in children and adolescents, with a subsequent rise in the number of psychiatric hospitalizations. This paper aims to: (a) describe the epidemiology of hospitalizations and some of the clinical and [...] Read more.
The past twenty years have seen a rapid increase in acute psychiatric symptoms in children and adolescents, with a subsequent rise in the number of psychiatric hospitalizations. This paper aims to: (a) describe the epidemiology of hospitalizations and some of the clinical and sociodemographic characteristics of pediatric patients admitted to a regional referral Complex Operative Child Neuropsychiatry Hospital Unit in Northeast Italy and (b) identify potential factors correlated with the length of hospital stay. Methods: 318 (M = 12.8 years; SD = 3.11; 72% Female) patients hospitalized for mental health disorders from 2013 to 2019. Results: Around 60% of hospital admissions occurred via the emergency room, mostly due to suicidal ideation and/or suicide attempts (24%). Affective disorders were the most frequent discharge diagnosis (40%). As for factors correlated with length of hospital stay, we found significant links with chronological age, way of hospital admission, cause of admission, discharge diagnosis, presence of psychiatric comorbidity, family conflict, and psychiatric family history. Conclusions: These results provide information about global characteristics associated with the length of psychiatric hospital stays in pediatric patients and provide a basis on which specific precautions can be hypothesized with the aim of developing more focused treatments. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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12 pages, 2929 KiB  
Article
A Longitudinal Study on the Relationship between Physical Education and Social Health
by Hanguk Cheon and Seijun Lim
Healthcare 2021, 9(9), 1134; https://doi.org/10.3390/healthcare9091134 - 31 Aug 2021
Cited by 1 | Viewed by 1945
Abstract
This study aimed to examine whether school physical education (PE) promotes students’ social health using a longitudinal design. To this end, data from 1979 students from a 4th grade cohort, established by the Korean Children and Youth Panel Survey with data collected from [...] Read more.
This study aimed to examine whether school physical education (PE) promotes students’ social health using a longitudinal design. To this end, data from 1979 students from a 4th grade cohort, established by the Korean Children and Youth Panel Survey with data collected from 2010 to 2016, who participated in all of the 7th grade (2013), 8th grade (2014), and 9th grade (2015) surveys were analyzed. We used autoregressive cross-lagged structural equation modeling conducted with AMOS 23.0 to examine the longitudinal causality among the factors. The following results were obtained. First, there was reciprocal causation between PE and social health (PE→SR, β = 0.099, β = 0.100; SR→PE; β = 0.207, β = 0.226). Second, PE did not influence sense of community, whereas the latter had a negative effect on PE (β = −0.078, β = −0.077). Third, social relationships influenced the sense of community (β = 0.248, β = 0.266). Based on these findings, we suggest the need for a system that enables students to frequently monitor their performance. This includes implementing a program to improve social relationships to enhance the quality of PE participation, designing programs that foster a sense of community in PE in Korean middle schools, and structuring PE programs that consider the hierarchy between social relationships and a sense of community. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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13 pages, 245 KiB  
Article
The Development and Psychometric Properties of an Education Well-Being Scale among Elementary School Students
by Po-Lin Chen
Healthcare 2021, 9(8), 1045; https://doi.org/10.3390/healthcare9081045 - 13 Aug 2021
Viewed by 1718
Abstract
The purpose of this study is to develop a tool that can measure the educational well-being of elementary school students and to analyze the fit of the developed instrument. The measurement tool was based on four levels which include: (1) parents’ support, (2) [...] Read more.
The purpose of this study is to develop a tool that can measure the educational well-being of elementary school students and to analyze the fit of the developed instrument. The measurement tool was based on four levels which include: (1) parents’ support, (2) teachers’ care, (3) students’ care in school, and (4) peer cooperation. It also had eight facets which include: (1) basic need, (2) family companionship, (3) happy learning, (4) teacher-student interaction, (5) safety protection, (6) school rules, (7) peer learning, and (8) peer interaction. The participants of this study were grades 5 and 6 students in Taiwan. Pre-testing with 197 grade 6 students was done to assess the validity and reliability of the developed scale. For the formal study, a total of 960 grade 6 students and 834 grades 5 and 6 students were recruited to join. The data collected underwent item analysis, reliability estimation, and confirmatory factor analysis. The results of the analyses were as follows: (1) the confirmatory factor analysis supported the four latent factors of the educational well-being scale; (2) the Cronbach’s alpha ranged from 0.73 to 0.89 for the elementary school students; (3) the cross-validation analysis with split-half samples implies that the study had a well-constructed stability model and that the scale had construct validity; and (4) the average scores of grade 5 students on the 8 facets and their overall score on educational well-being were all significantly higher than that of grade 6 students. Finally, several suggestions were proposed for future studies based on the results obtained. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
14 pages, 303 KiB  
Article
Sedentary Behavior among 6–14-Year-Old Children during the COVID-19 Lockdown and Its Relation to Physical and Mental Health
by Rima Breidokienė, Roma Jusienė, Vaidotas Urbonas, Rūta Praninskienė and Sigita Girdzijauskienė
Healthcare 2021, 9(6), 756; https://doi.org/10.3390/healthcare9060756 - 18 Jun 2021
Cited by 19 | Viewed by 4085
Abstract
As a result of the outbreak of SARS-CoV-2 and consequent restrictions in spring 2020, children in many countries might be engaged in more sedentary behavior and have limited possibilities to access the necessary level of physical activity to maintain their physical and mental [...] Read more.
As a result of the outbreak of SARS-CoV-2 and consequent restrictions in spring 2020, children in many countries might be engaged in more sedentary behavior and have limited possibilities to access the necessary level of physical activity to maintain their physical and mental health. The aim of this study was to explore the relationships between child sedentary behavior, physical activity, mental and physical health, and parental distress in a sample of Lithuanian children aged 6–14 years during the COVID-19 pandemic lockdown in March–June 2020. Parents of 306 children (52.9% female) completed an online survey in May–June 2020 and reported on their children’s screen time for educational and recreational (leisure) purposes, the level of physical activity and time outdoors, somatic symptoms, and emotional well-being and behavior. Parents also reported on stressful life events in the family and personal distress. The results revealed that 57.5% of children exceeded the recommended maximum of 2 h of recreational screen time per day, and 33.6% of the children did not meet the recommended guidelines of 60 min of physical activity per day. Longer screen time for educational purposes and parental distress significantly predicted a higher prevalence of somatic symptoms in children and parental distress also served as a significant predictor of children’s decreased emotional well-being and behavior. These results highlight the importance of psychosocial support interventions for parents who experience distress when raising children at a stressful time, such as during a pandemic. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
13 pages, 1022 KiB  
Article
Influence of the Perception of Barriers in Practice of PA in Adolescents: Explanatory Model
by Iago Portela-Pino, Myriam Alvariñas-Villaverde, Javier Martínez-Torres and Margarita Pino-Juste
Healthcare 2021, 9(4), 380; https://doi.org/10.3390/healthcare9040380 - 1 Apr 2021
Cited by 2 | Viewed by 2191
Abstract
Background: Sedentarism is an important risk factor for non-communicable diseases. To avoid it, it is necessary to establish the barriers which influence a low level of practice of Physical Activity. Methods: This study, conducted with 833 students, aims to describe a model to [...] Read more.
Background: Sedentarism is an important risk factor for non-communicable diseases. To avoid it, it is necessary to establish the barriers which influence a low level of practice of Physical Activity. Methods: This study, conducted with 833 students, aims to describe a model to explain the barriers determining the level of practice of Physical Activity in adolescents according to age, school year, BMI and gender. The inclusion of the analyzed barriers followed the tetra-factorial model: Body image/physical and social anxiety; Tiredness/laziness; Responsibilities/lack of time and Environment/facilities. Results: The barriers to Physical Activity in adolescents are fatigue and sloth, and temporary obligations. The barrier that least influences the practice of Physical Activity is the environment and body image. It is determined that the subjects with the lowest Physical Activity index were those with a high fatigue and laziness score and higher age. The level of physical activity of this population is medium (95% CI, 2.8274–2.9418). Conclusions: It is necessary to overcome tiredness or apathy towards the practice of Physical Activity, especially in those under 16 years of age. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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7 pages, 225 KiB  
Article
Close Association between Awareness of Teeth-Alignment Disorder and Systemic Disorders in Late Adolescence
by Masanobu Abe, Akihisa Mitani, Atsushi Yao, Chun-Dong Zhang, Kazuto Hoshi and Shintaro Yanagimoto
Healthcare 2021, 9(4), 370; https://doi.org/10.3390/healthcare9040370 - 26 Mar 2021
Cited by 5 | Viewed by 2123
Abstract
Background: Oral diseases are associated with various systemic disorders. Our previous research revealed new insights into the close relationship between occlusal disorder (functional disorder) and systemic disorders (allergic rhinitis, asthma, and arrhythmia) in late adolescence. Here, we investigated whether there was an association [...] Read more.
Background: Oral diseases are associated with various systemic disorders. Our previous research revealed new insights into the close relationship between occlusal disorder (functional disorder) and systemic disorders (allergic rhinitis, asthma, and arrhythmia) in late adolescence. Here, we investigated whether there was an association between the awareness of teeth-alignment disorder (morphological disorder) and common systemic disorders. Subjects and Methods: We retrospectively reviewed the data of the mandatory medical questionnaire that is required for the freshman medical checkup in Japan. We collected the data of all students who completed the questionnaire between April 2017 and April 2019. The data were analyzed using the χ2 test, and a multivariate analysis was performed with a binomial logistic regression model. Results: The subjects were 8903 students aged 17–19 who had no awareness of occlusal disorder. The rate of awareness of teeth-alignment disorder was 20.43% (1819 of 8903 eligible subjects), and the aware students had significantly greater rates of gum bleeding (p < 0.001), pollinosis (n = 0.007), and atopic dermatitis (n = 0.042). The multivariate analysis revealed significant rates of gum bleeding (odds ratio (OR) 1.540, 95% confidence interval (CI): 1.386–1.711, p < 0.001), pollinosis (OR 1.197, 95% CI: 1.040–1.378, p = 0.012), and female gender (OR 1.141, 95% CI: 1.002–1.299, p = 0.046) among the students with awareness of teeth-alignment disorder. Conclusion: We identified close associations between the awareness of teeth-alignment disorder and both gum bleeding and pollinosis in a late-adolescent population. The systemic disorders that are targeted by teeth-alignment disorder were found to be different from those targeted by occlusal disorder. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
9 pages, 243 KiB  
Article
Mozambican Adolescents and Youths during the COVID-19 Pandemic: Knowledge and Awareness Gaps in the Provinces of Sofala and Tete
by Claudia Marotta, Ussene Nacareia, Alba Sardon Estevez, Francesca Tognon, Giselle Daiana Genna, Giovanna De Meneghi, Edoardo Occa, Lucy Ramirez, Marzia Lazzari, Francesco Di Gennaro and Giovanni Putoto
Healthcare 2021, 9(3), 321; https://doi.org/10.3390/healthcare9030321 - 13 Mar 2021
Cited by 11 | Viewed by 2783
Abstract
(1) Background: Mozambique has an average population age of 17 years and adolescents and youths have a pivotal role in SARS-CoV-2 pandemic control. (2) Methods: We conducted a cross-sectional study in order to assess the awareness and information needs with regard to COVID-19 [...] Read more.
(1) Background: Mozambique has an average population age of 17 years and adolescents and youths have a pivotal role in SARS-CoV-2 pandemic control. (2) Methods: We conducted a cross-sectional study in order to assess the awareness and information needs with regard to COVID-19 among a sample of adolescents and youths from two different Mozambican provinces. (3) Results: Only 25% of adolescents and youths had a high level of awareness and only 543/2170 participants reported a high level of knowledge regarding COVID-19. In our multivariate model, significant predictors of reporting a high level of knowledge about COVID-19 include female sex (O.R. = 1.47; 95% confidence interval (CI) 1.23–2.89), having a house without a thatched roof (O.R. = 1.85; 95% CI 1.02–2.95) and HIV-positive status (O.R. = 1.56; 95% CI 1.36–2.87). (4) Conclusions: Our study highlights an important and relevant knowledge gap in adolescents and youths with respect to the COVID-19 pandemic. Involving young people and adolescents in the fight against SARS-CoV-2 is an essential strategy, especially in countries where the national average age is young, such as Mozambique, and where this epidemic can aggravate an already fragile health system. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
8 pages, 1479 KiB  
Article
Prevalence of Low Back Pain among Primary School Students from the City of Valencia (Spain)
by Vicente Miñana-Signes, Manuel Monfort-Pañego, Antonio Hans Bosh-Bivià and Matias Noll
Healthcare 2021, 9(3), 270; https://doi.org/10.3390/healthcare9030270 - 3 Mar 2021
Cited by 12 | Viewed by 4113
Abstract
It is well-known that low back pain (LBP) prevalence is high among school-age children. However, literature concerning the initial onset of back pain between the ages of three and eleven years is scarce. The present study aims to analyze the prevalence of LBP [...] Read more.
It is well-known that low back pain (LBP) prevalence is high among school-age children. However, literature concerning the initial onset of back pain between the ages of three and eleven years is scarce. The present study aims to analyze the prevalence of LBP in kindergarten and primary school students. A total of 278 (9.9 ± 2.1 years old; 52.2% girls) students from two public kindergartens and primary schools in Valencia (Spain) participated in this cross-sectional study. The Nordic questionnaire on LBP was used to assess the onset and duration of LBP symptoms. The lifetime prevalence of LBP was 47.5% (n = 132), the last year’s prevalence was 44.2% (n = 123), and last week’s prevalence was 18.8% (n = 50). Boys and girls reported a lifetime prevalence of 52.3% (n = 64) and 47.7% (n = 63) (p = 0.186, Fisher’s exact test, 2-sided), respectively. By age group, lifetime episodes of LBP became more prevalent with increasing age (p < 0.001, Fisher’s exact test, 2-sided). In summary, our findings show that LBP increases with age and further strengthens the evidence that LBP onset could start as young as 10 years of age. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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Review

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20 pages, 655 KiB  
Review
Barriers and Facilitators of Physical Activity Participation among Children and Adolescents with Intellectual Disabilities: A Scoping Review
by Siyi Yu, Taijin Wang, Tianwei Zhong, Yingtao Qian and Jing Qi
Healthcare 2022, 10(2), 233; https://doi.org/10.3390/healthcare10020233 - 26 Jan 2022
Cited by 19 | Viewed by 7306
Abstract
Background: Children and adolescents with intellectual disabilities (ID) have low levels of physical activity (PA). Understanding factors influencing the PA participation of this population is essential to the design of effective interventions. The purposes of this study were to identify and map the [...] Read more.
Background: Children and adolescents with intellectual disabilities (ID) have low levels of physical activity (PA). Understanding factors influencing the PA participation of this population is essential to the design of effective interventions. The purposes of this study were to identify and map the barriers and facilitators of PA participation among children and adolescents with ID. Methods: A scoping review was conducted in accordance with established methodology. Articles were evaluated for relevance using predetermined inclusion criteria in eight databases. Extracted barriers and facilitators were classified using the social ecological model as individual, interpersonal, or environmental factors. Results: Thirty-two studies published between 1992 and 2020 were included (24 quantitative, 6 qualitative, and 2 mixed-method). Thirty-four factors were identified. The most commonly reported barriers included disability-specific factors, low self-efficacy, lack of parental support, inadequate or inaccessible facilities, and lack of appropriate programs. The most commonly reported facilitators included high self-efficacy, enjoyment of PA, sufficient parental support, social interaction with peers, attending school physical education (PE) classes, and adapted PA programs. Conclusions: Continued exploration of factors influencing PA participation is required among children and adolescents with ID. Future interventions should involve families, schools, and wider support network in promoting their PA participation together. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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19 pages, 23199 KiB  
Review
Recent Trends in Sedentary Time: A Systematic Literature Review
by Hui Fang, Yuan Jing, Jie Chen, Yanqi Wu and Yuehua Wan
Healthcare 2021, 9(8), 969; https://doi.org/10.3390/healthcare9080969 - 30 Jul 2021
Cited by 16 | Viewed by 6497
Abstract
This paper systematically reviews and synthesizes the relevant literature on sedentary time research. A bibliometric analysis was conducted to evaluate the publications from 2010 to 2020 in the Web of Science (WoS) core collection database. Derwent Data Analyzer software was used for the [...] Read more.
This paper systematically reviews and synthesizes the relevant literature on sedentary time research. A bibliometric analysis was conducted to evaluate the publications from 2010 to 2020 in the Web of Science (WoS) core collection database. Derwent Data Analyzer software was used for the cleaning, mining, and visualization of the data. Historical trends of the topics, main contributors, leading countries, leading institutions, leading research areas, and journals were explored. A total of 3020 publications were studied. The United States, the United Kingdom, and Australia are the three most productive countries. The Australian institution Baker Heart and Diabetes Institute led the list of productive institutions, and Ekelund U published the most papers. Sedentary time raised the concerns of scholars from 106 research areas, and public health was the dominant field. Physical activity, accelerometer, children, and obesity were the most frequently used keywords. The findings suggest that sedentary time is rapidly emerging as a global issue that has detrimental effects on public health. The hotspots shifted in the past 10 years, and COVID-19 was the most popular topic of sedentary time research. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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16 pages, 635 KiB  
Review
Relationship of Physical Activity and Sedentary Time with Metabolic Health in Children and Adolescents Measured by Accelerometer: A Narrative Review
by Jungjun Lim, Joon-Sik Kim, Soyoung Park, On Lee and Wi-Young So
Healthcare 2021, 9(6), 709; https://doi.org/10.3390/healthcare9060709 - 10 Jun 2021
Cited by 8 | Viewed by 2643
Abstract
The purpose of this study was to summarize the associations of physical activity (PA) and sedentary time (SED) with metabolic health and examine the effects of time reallocation on metabolic health in adolescents using accelerometer data. A literature search was conducted using PubMed, [...] Read more.
The purpose of this study was to summarize the associations of physical activity (PA) and sedentary time (SED) with metabolic health and examine the effects of time reallocation on metabolic health in adolescents using accelerometer data. A literature search was conducted using PubMed, ScienceDirect, Web of Science, Cochran Library, and Google Scholar, and 27 articles were reviewed. Recent research generally confirms the associations of PA and SED with metabolic health. High PA levels and low SED levels had a positive relationship with metabolic health. Moreover, reallocating 10 min of daily SED to PA was associated with better metabolic health indicators. These results were stronger for moderate-to-vigorous physical activity than for light intensity PA. Thus, efforts to convert SED into PA of at least moderate intensity appear to be an effective strategy to prevent metabolic disease development in children and adolescents. However, some of the associations between PA and metabolic health indicators were inconsistent, depending on age, obesity degree, and PA intensity. Additionally, various accelerometer data collection and processing criteria impact the interpretation of the results. Therefore, consistent accelerometer data collection and analysis methods are needed in future studies. Further, intervention studies are required to verify the causality and effectiveness of the isotemporal substitution model. Full article
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
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