RESUMO

Background: Preventing interpersonal violence requires understanding the moral development and determinants of child aggression. Communication about moral values and concerns by parents is theoretically important in this process. We aimed to develop a coding system to measure mothers' communication about morality with young children and test its psychometric properties. Method: The cross-sectional study included a subsample (n = 200) of mothers and their four-year-old children in a population-based Brazilian birth cohort. Mothers and children were filmed while looking at a picture book together, containing events of aggression, taking away without asking, and several prosocial behaviours. Films were transcribed and a coding system, including 17 items, was developed to measure the maternal moral judgements and the explanations communicated to their children. Inter-rater reliability was estimated, and exploratory factor analysis performed. Results: Mothers judged acts of physical aggression as wrong more frequently than taking away material goods without asking; most mothers communicated about the emotional consequences of wrong behaviour with their child. Two latent factors of moral communication were identified, interpersonal moral concern and the expression of material moral concern. There was excellent inter-rater reliability between the two coders. Conclusions: Parent-child book-sharing provides a means to measure maternal communication about morality with their children. The coding system of this study measures both communication about interpersonal moral concern and material moral concern. Further studies with larger samples are suggested to investigate the importance of these dimensions of caregiver moral communication for children's moral development.

Assuntos

RESUMO

Abstract This study aimed to investigate the occurrence of behavior problems in 3750 four years old children from a birth cohort. Children were followed from birth to four years old through home visits, and questionnaires on child health and development and the Child Behavior Checklist 4-18/CBCL were applied. Prevalence rates were high (total problems 35.6%), particularly externalizing problems, which occurred in 44.4 % of children (48.3% girls; 40.6% boys; p < 0.001). Internalizing problems were less prevalent, occurring in 15.5 % of children (19.1% boys; 11.6% girls; p < 0.001). Regardless of sex, there was a higher prevalence of behavioral problems in children with younger siblings, whose mothers had less education and had no partner.

Resumo Este estudo objetivou investigar a ocorrência de problemas de comportamento em 3750 crianças pertencentes a uma coorte de nascimentos. As crianças foram acompanhadas do nascimento aos quatro anos de idade, por meio de visitas domiciliares, tendo sido aplicados instrumentos sobre saúde e desenvolvimento infantil e o Child Behavior Checklist 4-18/CBCL. As prevalências encontradas foram altas (total de problemas de comportamento: 35,6%), com destaque para problemas de externalização, que ocorreram em 44,4% das crianças (48,3% meninas; 40,6% meninos; p < 0,001). Problemas de internalização foram menos prevalentes, ocorrendo em 15,5% das crianças (19,1% meninos; 11,6% meninas; p < 0,001). Independente do sexo, houve maior prevalência de problemas de comportamento em crianças com maior número de irmãos mais novos, cujas mães tinham menor escolaridade e não tinham companheiro.

RESUMO

Parent training programmes have significant potential to improve the quality of children's early environments and thereby their development and life-course outcomes. The aim of this study was to identify and explain the extent to which parents engaged in two group-based training programmes, offered to high-risk families enrolled in a randomized controlled trial study called PIÁ in Southern Brazil. The programmes were: (1) ACT: Raising Safe Kids, a 9-week programme aiming to reduce harsh parenting and maltreatment and improve positive parenting practices; (2) Dialogic book-sharing (DBS), an 8-week programme aiming to promote parental sensitivity and improve child cognitive development and social understanding. Of the 123 mothers randomly allocated to the ACT programme, 64.2% (n = 79) completed the course, and of 124 mothers allocated to DBS, 76.6% (n = 95) completed the course. After the interventions, mothers were very positive about the experience of both programmes but highlighted practical difficulties in attending. In adjusted regression analyses, only two variables significantly predicted ACT course completion (maternal age and distance between the intervention site and household); no significant predictor was found for DBS attendance. We conclude that although high completion rates are possible, there are important challenges to engaging parents of young children in training programmes, and practical difficulties occurring during training courses may be more important for attendance than baseline participant characteristics.

RESUMO

RESUMO Objetivo Este estudo objetivou investigar a associação entre problemas de comportamento e excesso de peso (sobrepeso e obesidade) em pré-escolares de uma coorte de nascimentos do sul do Brasil, acompanhados do nascimento aos 4 anos de idade. Métodos No acompanhamento dos quatro anos foram realizadas entrevistas domiciliares com as mães das crianças, tendo sido coletadas informações sobre a saúde e o desenvolvimento infantil, além de ser aplicado o Child Behavior Checklist 4-18/CBCL. Resultados Cerca de 15% dos meninos e 12% das meninas de 4 anos apresentaram excesso de peso, e a associação entre problemas de comportamento e o excesso de peso nessa idade se deu apenas em problemas de ansiedade-depressão, nas meninas (OR: 3,79 [IC95%: 1,60-8,97]; p = 0,002). Conclusões Meninas em idade pré-escolar com excesso de peso apresentaram mais problemas de ansiedade-depressão do que as com peso adequado da mesma idade. Essa informação é de extrema relevância, visto que os anos pré-escolares são ideais para se investir em prevenção, tanto dos problemas de comportamento, como do excesso de peso, possibilitando introduzir comportamentos/hábitos mais saudáveis e diminuir, assim, as consequências negativas que ambos acarretam à vida das crianças.

ABSTRACT Objective This study aimed to investigate the association between behavior problems and excess of weight (overweight and obesity) in preschool children from a birth cohort in southern Brazil, followed from birth to four years old. Methods In the follow-up of four years, home interviews with mothers were carried out where information on the health and development of children were collected, in addition to application of the Child Behavior Checklist 4-18/CBCL. Results About 15% of boys and 12% of four-year girls were overweight/obese, and the association between behavior problems and excess of weight in this age occurred only with problems of anxiety-depression in girls (OR: 3.79 [95% CI: 1.60 to 8.97]; p = 0.002). Conclusions Preschool girls with excess of weight showed more problems of anxiety and depression than those with adequate weight at the same age. This information is extremely important, as the preschool years are ideal for investing in prevention of both behavioral problems and overweight/obesity, allowing to introduce healthier habits and behaviors and decrease thus the negative consequences both cause to children.

RESUMO

BACKGROUND: Sleep problems in childhood have been found to be associated with memory and learning impairments, irritability, difficulties in mood modulation, attention and behavioral problems, hyperactivity and impulsivity. Short sleep duration has been found to be associated with overweight and obesity in childhood. This paper describes the protocol of a behavioral intervention planned to promote healthier sleep in infants. METHODS: The study is a 1:1 parallel group single-blinded randomized controlled trial enrolling a total of 552 infants at 3 months of age. The main eligibility criterion is maternal report of the infant's sleep lasting on average less than 15 h per 24 h (daytime and nighttime sleep). Following block randomization, trained fieldworkers conduct home visits of the intervention group mothers and provide standardized advice on general practices that promote infant's self-regulated sleep. A booklet with the intervention content to aid the mother in implementing the intervention was developed and is given to the mothers in the intervention arm. In the two days following the home visit the intervention mothers receive daily telephone calls for intervention reinforcement and at day 3 the fieldworkers conduct a reinforcement visit to support mothers' compliance with the intervention. The main outcome assessed is the between group difference in average nighttime self-regulated sleep duration (the maximum amount of time the child stays asleep or awake without awakening the parents), at ages 6, 12 and 24 months, evaluated by means of actigraphy, activity diary records and questionnaires. The secondary outcomes are conditional linear growth between age 3-12 and 12-24 months and neurocognitive development at ages 12 and 24 months. DISCUSSION: The negative impact of inadequate and insufficient sleep on children's physical and mental health are unquestionable, as well as its impact on cognitive function, academic performance and behavior, all of these being factors to which children in low- and middle-income countries are at higher risk. Behavioral interventions targeting mothers and young children that can be delivered inexpensively and not requiring specialized training can help prevent future issues by reducing the risk to which these children are exposed. TRIAL REGISTRATION: ClinicalTrial.gov NCT02788630 registered on 14 June 2016 (retrospectively registered).

Assuntos

RESUMO

A violência urbana afeta a vida dos indivíduos, tornando-se um problema complexo de saúde e segurança pública. Buscando avaliar a situação de violência em uma cidade de médio porte, realizou-se um estudo transversal, de base populacional, investigando a prevalência de vitimização por violência urbana para furtos, roubos, agressões e furto/roubo à residência nos últimos cinco anos e 12 meses; e o perfil das vítimas e a prevalência de notificação à polícia. Foi construído um escore a fim de medir a vitimização por pelo menos um dos tipos de violência em cada período. Na análise bruta, a associação entre a vitimização por cada tipo de violência e as variáveis independentes foi investigada através do teste de Wald para heterogeneidade e para tendência linear, quando aplicável. A Regressão de Poisson foi utilizada na análise multivariável. Foram entrevistados 2.912 indivíduos (idade > 20 anos), sendo que 16,6 por cento destes sofreram violência no último ano e 28 por cento nos últimos cinco anos. As maiores prevalências de vitimização foram de furto/roubo à residência (9,7 por cento) e furto (6,0 por cento). As principais vítimas de violência urbana foram homens e jovens. Mais da metade dos vitimizados não notificou a ocorrência por não confiar na polícia. Os achados confirmam a importância de pesquisas de vitimização além das metrópoles. As discussões sobre o tema mostram a necessidade de incrementar, executar ou criar políticas públicas de segurança e saúde em distintos contextos nacionais, sem desconsiderar cidades do interior.

Urban violence affects individuals' lives, and therefore it is a complex problem of public health and security. To evaluate the occurrence of violence in a medium size city, a population-based cross-sectional study was carried out to investigate: prevalence of urban violence victimization (theft, robbery, aggression, and burglary) in the period of five years and twelve months before the interview; victims' profile and prevalence of crime reporting. A score was constructed to measure global urban violence victimization, which means at least one type of violence in each period. The Wald test for heterogeneity and linear trend was used in crude analysis, to measure violence victimization and independent variables. Poisson Regression was used in multivariate analysis. The sample included 2.912 individuals (> 20 years of age) and 16.6% of them had experienced urban violence in the past year and 28.0% in the past five years. Prevalence of burglary was 9.7% and theft 6.0% in the past year. Most urban violence victims were men and youth. More than half of the victims had not reported the crime, and the reason for that was distrust in the police. These findings sustain the importance of victimization surveys in smaller cities. The debate about urban violence should include the need to develop, execute or create health and security policies in different contexts, without comprising countryside.

Assuntos

RESUMO

OBJETIVOS: Descrever as orientações sobre amamentação fornecidas às gestantes e comparar sua freqüência durante o pré-natal de acordo com o modelo de atenção: Programa de Saúde da Família (PSF) ou Tradicional. MÉTODOS: Integrando a pesquisa de avaliação do PROESF/UFPEL (2005), estudou-se mulheres que tiveram filhos nos dois anos anteriores à entrevista, residentes na área de abrangência de 93 Unidades Básicas de Saúde (UBS) em 17 municípios gaúchos com mais de 100.000 habitantes. Entre março e maio de 2005, 15 entrevistadores selecionados e capacitados coletaram informações em entrevistas domiciliares de 568 mulheres que fizeram o pré-natal na UBS de sua área de abrangência, através de questionários padronizados e pré-codificados. Na análise dos dados, utilizou-se o teste t para a comparação entre as médias e o teste do qui-quadrado para associação entre as proporções, considerando-se significativas as diferenças com valor p inferior a 0,05. Também foram calculadas as razões de prevalência (RP), com intervalos de confiança de 95 por cento. RESULTADOS: Todas as proporções de orientações sobre amamentação foram significativamente mais referidas por moradoras de áreas com PSF do que em moradoras de áreas de UBS tradicionais. Quando as orientações foram analisadas em um escore quantitativo, verificou-se que 18 por cento das mães não receberam nenhuma orientação, 39 por cento receberam pelo menos uma e 43 por cento receberam todas as orientações investigadas e estas proporções foram significativamente diferentes de acordo com o tipo de UBS, em favor do PSF. CONCLUSÕES: Os serviços de atenção primária do PSF mostraram-se mais efetivos no fornecimento de informações sobre amamentação, o que constitui uma vantagem que deve ser incentivada, tanto com a expansão da estratégia, ampliando sua cobertura populacional, quanto recomendando que profissionais vinculados à atenção tradicional possam ser motivados a incluir em seus atendimentos de pré-natal o reforço às orientaç...

Assuntos

RESUMO

O presente estudo investigou a prática de esportes individuais e coletivos e fatores associados em jovens com idade média de 11 anos, pertencentes a uma coorte de nascimentos. Informações dos jovens e de suas mães foram coletadas por meio de questionários. O desfecho foi dividido em prática de esportes individuais e coletivos. Uma análise por meio de regressão de Poisson foi conduzida para estabelecer os fatores associados à prática esportiva, obedecendo a um modelo conceitual de análise com as variáveis independentes hierarquizadas. Um total de 4350 jovens foi estudado. A prática de esportes coletivos foi menor nas meninas - 68,1 por cento (IC95 por cento 66,2 - 70,0) em comparação aos meninos - 82,1 por cento (IC95 por cento 80,5 - 83,7). Nos esportes individuais, a prevalência foi de 12,9 por cento (IC95 por cento 11,6 - 14,4) e 18,9 por cento (IC95 por cento 17,3 - 20,6) em meninas e meninos, respectivamente. Entre as meninas, a prática de esportes individuais relacionou-se diretamente com nível econômico e inversamente com assistir televisão. Nos meninos este desfecho associou-se com estudar em escolas privadas e ter mães fisicamente ativas. Em esportes coletivos, a prática foi menor naqueles que despendem maior tempo assistindo TV. Em ambos os sexos houve uma relação direta entre o uso regular do vídeo-game e a prática de esportes. Políticas públicas devem considerar os diferentes aspectos relacionados à prática esportiva e atender a disparidades socioeconômicas no acesso a diferentes modalidades esportivas. Além disso, o maior acesso a diferentes locais de práticas esportivas, bem como o incentivos de pais, amigos e ambiente escolar devem ser fortalecidos.

The present study investigated individual and collective sports practice and associated factors among adolescents with a mean age of 11 years, belonging to a birth cohort study. Information on the adolescents and on their mothers were obtained through questionnaires. The outcome variable was divided into practice of individual and collective sports. Poisson regression models were used in order to determine the factors associated with sports practice, following a hierarchical framework. A total of 4350 adolescents were interviewed. Practice of collective sports was less frequent among girls - 68.1 percent (95 percentCI 66.2 - 70.0) in comparison to boys- 82.1 percent (95 percentCI 80.5 - 83.7). Regarding individual sports, the prevalence was 12.9 percent (95 percentCI 11.6 - 14.4) and 18.9 percent (95 percentCI 17.3 - 20.6) in girls and boys, respectively. Among girls, individual sports practice was directly associated with socioeconomic level and inversely with television viewing. Among boys, the outcome was associated with studying in private schools and having an active mother. In terms of collective sports, the practice was less frequent among those with high level of television viewing. In both sexes, a direct association was observed between videogame playing and sports practice. Public policies should consider the different aspects related to sports practice and consider socioeconomic inequalities in sports practice.

Assuntos