RESUMEN
OBJECTIVES: To explore how the use of, and trust in, different sources of advice and information on COVID-19 differed across the four UK nations and between different sociodemographic groups and their associations with COVID-19 vaccination status. METHODS: We used a UK-wide representative survey conducted in July 2021, which included data on uptake of COVID-19 vaccination, trust in information sources, use of sources and geographical and sociodemographic variables. We used multivariate logistic regression to identify factors associated with completed or planned COVID-19 vaccination. RESULTS: Trust in the NHS, followed by trust in scientists, were the strongest predictors of vaccination intention. NHS websites were the most used (56% across the UK); only the Scottish government website had a higher level of reported use (58%). Using either source was associated with a positive vaccination status as were use of the GP and television as sources of advice. Use of social media, family and friends, and 'none' of the sources enquired about, were all linked to a lower likelihood of being or intending to get vaccinated. Compared to those in England, respondents in other UK nations were less likely to trust the central UK government for advice on COVID-19. There was considerable variation by age in trust and use of some, but not all, sources of advice, with predicted probabilities ranging from 35% among the youngest age group to 62% among those aged 65 years or older. There were also significant differences by annual household income and by occupational class for trust in government, with higher incomes correlating with greater likelihood of trust. CONCLUSIONS: This study demonstrates high levels of trust in the key sources of public health advice and there was a positive association between using official sources of advice and vaccination intentions, even in the context of overall high vaccination rates. Our findings highlight the need for the UK and devolved governments to value the importance of public trust in the health system and take appropriate measures to avoid undermining such trust.
Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Confianza , Humanos , Reino Unido , COVID-19/prevención & control , COVID-19/epidemiología , Masculino , Persona de Mediana Edad , Femenino , Adulto , Vacunas contra la COVID-19/administración & dosificación , Anciano , Factores Socioeconómicos , Adulto Joven , Adolescente , Encuestas y Cuestionarios , Vacunación/estadística & datos numéricos , Medicina Estatal , SARS-CoV-2 , Fuentes de InformaciónRESUMEN
BACKGROUND: Little is known about the causal pathways through which domestic violence affects children's internalising, externalising and prosocial behaviours over time, and the role that risk and protective factors play in mediating and moderating direct effects. OBJECTIVE: We explored how different risk and protective factors affect children's psychopathology in the context of domestic violence. We focused on the mother and child bond and explored if this moderates or mediates the effect of domestic violence on children's internalising, externalising and prosocial behaviours. PARTICIPANTS AND SETTING: A prospective longitudinal nationally representative study of children in Scotland aged 6 to 13 years (N:2554). METHODS: Multivariate logit models, moderation and mediation analysis. RESULTS: Domestic violence exposure predicted higher internalising and externalising behaviours and lower prosocial skills (e.g. OR2.17, 95%CI 1.15-4.08 for externalising symptoms). Children with a strong mother-child bond had lower odds of internalising and externalising symptoms, and were more likely to manifest prosocial skills (OR4.14, 95%CI 3.09-5.55). We found evidence that the mother-child relationship both moderated and mediated the effect that domestic violence exposure had on children's internalising, externalising and prosocial scores. The mediation effect was strongest for prosocial behaviours, and strongest in cases where the abuse was less intense. CONCLUSIONS: We show how domestic violence directly and indirectly affects children, via the mother-child relationship. We propose a model which could explain how the mother-child bond both mediates and moderates the effect of domestic violence on children's psychopathology. Our findings suggest mothers need support to in turn support children in the context of domestic violence.
Asunto(s)
Trastornos de la Conducta Infantil , Violencia Doméstica , Femenino , Niño , Humanos , Estudios Prospectivos , Factores Protectores , Estudios LongitudinalesRESUMEN
BACKGROUND: Research on child maltreatment in the context of intimate partner violence (IPV) rarely draws on nationally representative samples, and rarely accounts for maternal, paternal and child reports of parental aggression towards children separately. OBJECTIVE: We explore if living with IPV makes children more likely to be smacked or slapped by their parents. PARTICIPANTS AND SETTING: A prospective longitudinal and nationally representative child cohort study for Scotland (starting sample N:5217). METHODS: Questions for children at ages 2-7 include: maternal and paternal reports of aggression towards children; children's reports of being 'smacked' by parents; maternal reports of IPV. Multivariate logit models explore how maternal IPV is associated with child maltreatment, controlling for socio-economic confounders. RESULTS: In homes with a long-term abusive partner, children are more likely to have been smacked/slapped by the father (OR1.91, p ≤ 0.05), mother (OR1.84 p ≤ 0.05), and both parents (OR2.31, p ≤ 0.05). Maternal IPV frequency and intensity was incrementally associated with children's odds of being smacked/slapped (OR range 1.47-1.70, p ≤ 0.05). Ethnic minority boys were more likely (predicted probability of 42 % p ≤ 0.05) to have been smacked/slapped by their mother frequently compared to other children (predicted probability range: 19-27 %). CONCLUSIONS: When mothers report IPV, the extent and severity of the abuse is incrementally associated with children's experiences of parental aggression, and ethnic minority boys are far more at risk. Parental aggression should be understood within the context of the stresses associated with living with an abusive partner. We discuss the fragmented picture which surveys of children provide when interviewing mainly the mother.
Asunto(s)
Maltrato a los Niños , Violencia de Pareja , Niño , Preescolar , Estudios de Cohortes , Etnicidad , Femenino , Humanos , Estudios Longitudinales , Masculino , Grupos Minoritarios , Estudios ProspectivosRESUMEN
Domestic abuse is a pernicious societal issue that has both short- and long-term consequences for those who are victimized. Research points to motherhood being linked to women's victimization, with pregnancy being a particular point of risk. Across UK jurisdictions, new legislation aims to extend the criminalization of domestic abuse to include coercive control. Less clear is the relationship between mothers' victimization of different "types" of abuse and other factors such as age, socioeconomic status, and level of education. The article makes an original contribution to knowledge by addressing these limitations of the existing literature. Using nationally representative data from a Scottish longitudinal survey (N = 3,633) into children's development this article investigates the social stratification of mothers' exposure to different types of abuse, including coercive control, physical abuse, and threats. Overall, 14% of mothers report experiencing any type of domestic abuse since the birth of the study child (age 6), of which 7% experienced physical abuse. Compared to mothers in the highest income households, mothers in the lowest income quintile were far more likely to experience any form of abuse (Logistic Regression, OR = 3.55), more likely to have experienced more types of abuse and to have experienced these more often (OR = 5.54). Age had a protective effect, with mothers aged 20 or younger at most risk of abuse (OR = 2.60 compared to mothers aged 40+). Interaction effects between age and income suggested that an intersectional lens may help explain the cumulative layers of difficulty which young mothers on low incomes may find themselves in when it comes to abusive partners. The pattern of social stratification remained the same when comparing different types of abuse. Mothers of boys were more likely to experience abuse, and to experience more types of abuse, more often. We reflect on how these findings could inform existing policy interventions.
Asunto(s)
Maltrato a los Niños , Víctimas de Crimen , Niño , Preescolar , Femenino , Humanos , Masculino , Madres , Embarazo , Prevalencia , Factores SocioeconómicosRESUMEN
INTRODUCTION: Obesity is a global pandemic that affects all socioeconomic strata, however, the highest figures have been observed in the most disadvantaged social groups. Evidence from the USA and Canada showed that specific urban settings encourage obesogenic behaviour in the population living and/or working there. We aim to examine the evidence on the association between local food environments and obesity in the UK, Ireland, Australia and New Zealand. METHODS: Six databases from 1990 to 2017 will be searched: MEDLINE (Ovid), Embase (Ovid), Scopus, The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Applied Social Sciences Index and Abstracts (ASSIA) and Web of Science. Grey literature will also be sought by searching Opengrey Europe, The Grey Literature Report and relevant government websites. Additional studies will be retrieved from the reference lists of the selected articles. It will include cohort, longitudinal, case study and cross-sectional studies that have assessed the relationship between local food environments and obesity in the UK, Ireland, Australia and New Zealand regardless of sex, age and ethnicity of the population. Two researchers will independently select the studies and extract the data. Data items will incorporate: author names, title, study design, year of study, year exposure data collected, country, city, urban/rural, age range, study exclusions, special characteristics of study populations, aims, working definitions of food environments and food outlets, exposure and methods of data collection, outcomes and key findings. A narrative synthesis and a summary of the results will be produced separately for children and adults, according to the type of food exposure-outcome. All the selected studies will be assessed using The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. ETHICS AND DISSEMINATION: This study will be based on published literature, and therefore ethical approval has not been sought. Our findings will be presented at relevant national and international scientific conferences and published in a peer-reviewed journal.
Asunto(s)
Comportamiento del Consumidor/economía , Dieta Saludable/economía , Abastecimiento de Alimentos/economía , Obesidad/epidemiología , Australia/epidemiología , Composición Familiar , Preferencias Alimentarias , Calidad de los Alimentos , Humanos , Irlanda/epidemiología , Nueva Zelanda/epidemiología , Obesidad/economía , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Reino Unido/epidemiologíaRESUMEN
BACKGROUND: Substantial investments in promoting breastfeeding have taken place in the past 10 years in Scotland. This study assesses whether there were significant changes in breastfeeding initiation and mixed breastfeeding duration between 2004-2005 and 2010-2011. METHODS: This study uses data from two nationally representative cohorts of babies in Scotland born between June 2004-May 2005 (N = 5030) and March 2010-February 2011 (N = 5838). Multivariate logistic regression for breastfeeding initiation and multivariate survival analysis for breastfeeding duration using cross-sectional data based on maternal recall were performed. RESULTS: An increase in breastfeeding initiation from 60 to 63% was not significant (P = 0.125), and controlling for covariates, there was no significant cohort effect when comparing breastfeeding initiation between cohorts [odds ratio (OR) 1.02, 95% confidence interval (CI) 0.91-1.13]. For breastfeeding duration of up to 1 month, the 2010-11 cohort was more likely to give up breastfeeding sooner (HR 1.23, 95%CI 1.12-1.34). However, for breastfeeding durations of >1-6 months, or ≥6 months, the 2010-11 cohort was significantly less likely to give up breastfeeding sooner (HR 0.79, 95%CI 0.70-0.88 and HR 0.79, 95%CI 0.68-0.92, respectively). Breastfeeding duration increased the most among mothers with fewer educational qualifications, and mothers with no qualifications in 2010-11 were far less likely to stop breastfeeding early compared with their counterparts in 2004-05 (HR 0.32, 95%CI 0.17-0.58). CONCLUSION: After the 1 month mark, babies born in 2010-11 were more likely to be breastfed for longer compared with those born in 2004-05, and this effect was particularly pronounced among more disadvantaged families. The potential causal role of health policy is discussed.
Asunto(s)
Lactancia Materna/estadística & datos numéricos , Política de Salud , Promoción de la Salud , Adulto , Estudios de Cohortes , Demografía , Femenino , Humanos , Recién Nacido , Escocia , Factores SocioeconómicosRESUMEN
BACKGROUND: While an association has been established between low income and poor diet using cross-sectional data, such analysis cannot account for confounding by unobserved characteristics correlated with income and diet, and changes in income and diet cannot be tracked over time. This paper, using longitudinal panel data, explores whether falls in objective and subjective family income predict deterioration in children's diets over time. METHODS: This paper uses panel data from the nationally representative birth cohort study Growing Up in Scotland. 3279 families have valid data on all dependent, independent and control variables for both time points. Dietary data were collected using maternal recall at sweeps 2 and 5 when the children were aged 22 and 58 months, respectively. Mothers reported on children's variety of consumption of vegetables, fruit and on the frequency of consumption of crisps, sweets and sugary drinks. The dietary variables were ordinal and were analysed using multivariate fixed effects ordinal logistic regression models. RESULTS: Controlling for time-varying confounders (children's food fussiness, maternal social class, maternal education, family composition, maternal employment) and for family and child time-invariant characteristics, moving from the highest to the lowest income band was linked to a smaller chance of increased fruit variety from 22 to 58 months (OR=0.42, 95% CI 0.21 to 0.82). Mothers who transitioned from 'living very comfortably' to 'finding it very difficult' to cope on current income had children who consumed fewer fruit varieties over time (OR=0.40, 95% CI 0.19 to 0.85), and who increased their frequency of consumption of crisps (OR=2.03, 95% CI 1.05 to 3.94) and sweets (OR=2.23, 95% CI 1.18 to 4.20). CONCLUSIONS: The diets of young children in Scotland deteriorated between the ages of 2 and 5 years across the entire socioeconomic spectrum. Additionally, deterioration in subjective income predicted less healthy diets for children.
Asunto(s)
Dieta/economía , Composición Familiar , Conducta Alimentaria/clasificación , Renta/clasificación , Distribución por Edad , Preescolar , Estudios Transversales , Dieta/psicología , Dieta/normas , Sacarosa en la Dieta , Conducta Alimentaria/psicología , Femenino , Frutas , Humanos , Renta/estadística & datos numéricos , Modelos Logísticos , Estudios Longitudinales , Masculino , Madres , Trastornos Fóbicos , Escocia , Bocadillos , Clase Social , VerdurasRESUMEN
OBJECTIVES: To examine how transnational tobacco companies (TTCs) tried to penetrate the Bulgarian cigarette market and influence tobacco excise tax policy after the fall of communism and during Bulgaria's accession to the European Union (EU). DESIGN: Analysis of internal tobacco industry documents supplemented by analysis of press coverage, tobacco industry journals, market reports and key informant interviews. RESULTS: TTCs have been involved in cigarette smuggling to and through Bulgaria since at least 1975 and used smuggling as a market-entry strategy. National tobacco company Bulgartabac appears to have been involved in smuggling its own cigarettes from and reimporting them to Bulgaria. Since Bulgaria's accession to the EU opened the market to the TTCs, TTCs have exaggerated the scale of the illicit trade to successfully convince politicians and public health experts that tax increases lead to cigarette smuggling. Yet, sources point to TTCs' continued complicity in cigarette smuggling to and through Bulgaria between 2000 and 2010. TTCs aimed to influence the Bulgarian tobacco excise tax regime, import duties and pricing mechanism, but appear to have been less successful than in other former communist countries in part due to the co-existence of a state-owned tobacco company. Undisclosed meetings between the tobacco industry and government ministers and officials are ongoing despite Bulgaria being a party to the Framework Convention on Tobacco Control (FCTC). CONCLUSIONS: The TTCs continued involvement in smuggling suggests that deals in 2004, 2007 and 2010 which the European Commission has reached with TTCs to address cigarette smuggling are inadequate. The TTCs' continued access to policymakers suggests that the FCTC is not being properly implemented.
Asunto(s)
Comercio/legislación & jurisprudencia , Impuestos/economía , Industria del Tabaco/organización & administración , Productos de Tabaco/economía , Bulgaria , Comercio/economía , Costos y Análisis de Costo/economía , Costos y Análisis de Costo/legislación & jurisprudencia , Crimen/economía , Humanos , Cooperación Internacional , Maniobras Políticas , Industria del Tabaco/economía , Productos de Tabaco/provisión & distribuciónRESUMEN
The general consensus in the research to date is that family meals are linked to healthier eating habits in children, compared to not eating with the family. Yet, few studies explore what it is about commensality which leads to better food choices among children. Using a representative Scottish sample of five-year-old children, this research explores the extent to which family meal occurrence, meal patterns regarding where, when and with whom children eat and perceived meal enjoyment predict the quality of children's diets after controlling for indicators of maternal capital that influence both meal rituals and taste preferences. Eating the same food as parents is the aspect of family meals most strongly linked to better diets in children, highlighting the detrimental effect in the rise of 'children's food'. Although theoretical and empirical work pointed to the important health advantage in children eating together with parents, the results suggested that eating together was a far less important aspect of family meals. In evaluating the importance of the family meal, this article redirects attention away from issues of form and function towards issues of food choice. Policy implications and the importance for public health to recognise the way eating habits are defined by and reproduce social and cultural capital are discussed.
Asunto(s)
Fenómenos Fisiológicos Nutricionales Infantiles , Relaciones Familiares , Preferencias Alimentarias/psicología , Conocimientos, Actitudes y Práctica en Salud , Comidas/psicología , Adulto , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Entrevistas como Asunto , Estudios Longitudinales , Masculino , Madres/psicología , Análisis Multivariante , Encuestas Nutricionales , Escocia , Clase Social , Adulto JovenRESUMEN
In 2005, Scotland became the first nation to make breastfeeding in public a legal right, but current breastfeeding targets and maternity leave allowance do not acknowledge the conflicting demands women face when juggling employment and motherhood. This paper explores how employment and maternity leave relate to breastfeeding duration among mothers in Scotland. The Growing Up in Scotland national longitudinal cohort study of 5,217 babies born in 2004-2005 was used. Multivariate proportional hazards regression models were specified using one cross-sectional wave of data to predict breastfeeding duration. Mothers working as employees, full-time (Hazard Ratio 1.6) or part-time (HR1.3), had a higher risk of earlier breastfeeding cessation than non-working mothers. However, self-employed mothers did not differ significantly from non-working mothers in their breastfeeding patterns. Mothers who took longer maternity leave breastfed for longer. The relationships between employment, maternity leave and breastfeeding duration were significant when controlling for known predictors of breastfeeding. Younger mothers, those with less formal education, single mothers, those of white ethnic background, and first-time mothers were more likely to stop breastfeeding sooner, as has been noted in previous research. Employment and early return to work are both factors associated with a shorter duration of breastfeeding. More flexible working conditions and more generous employment leave could help to prolong breastfeeding among working mothers. Current health and employment policy in Scotland and the UK could be better coordinated so that working mothers have the adequate support to meet the conflicting demands of employment and motherhood.
Asunto(s)
Lactancia Materna/psicología , Empleo , Madres/psicología , Permiso Parental , Mujeres Trabajadoras/psicología , Adolescente , Adulto , Lactancia Materna/estadística & datos numéricos , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Lactante , Edad Materna , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Escocia , Factores Socioeconómicos , Análisis de Supervivencia , Factores de Tiempo , Adulto JovenRESUMEN
OBJECTIVE: To examine changes in breast-feeding take-up rates among young children in Scotland and to assess whether maternal education or occupation-based social class is a stronger and better predictor of breast-feeding take-up. DESIGN: Binary logistic regression models were developed from the first sweep of the Growing Up in Scotland longitudinal survey, for the two cohorts of children. SETTING: A national representative survey for Scotland. SUBJECTS: A baby cohort of 5012 singletons born over a 12-month period between June 2004 and May 2005, and a toddler cohort of 2732 singletons born over a 12-month period between June 2002 and May 2003. RESULTS: Mothers from more privileged social classes and those with more educational qualifications resulted as more likely to breast-feed. However, maternal education was a better and more robust predictor of breast-feeding take-up compared with social class. There were no significant differences in breast-feeding take-up between the two cohorts and only minor differences between mothers aged 20-29 years and those who stated an intention to bottle-feed prior to birth. CONCLUSIONS: The study suggests that the importance of maternal education in influencing breast-feeding has been somewhat overlooked in research based in more developed countries. The results indicate that, compared with occupation-related social class, maternal education is a more informative, accurate and useful lens through which to understand and explain patterns of breast-feeding take-up.