Screening for behavioural problems in children aged 3 to 5 years.

OBJECTIVE: We aim to investigate the association between undergoing behavioural screening and having a diagnosis of behavioural problems and to explore factors associated with receiving treatment with counselling versus medication in children 3 to 5 years old. METHODS: This cross-sectional data analysis consisted of children 3-5 years old from the US National Study of Children's Health, 2017-2018. Pearson's χ2 test was used to assess the association between formal and informal screening and having a behavioural problem. Prevalence of behavioural screening, behavioural problems, and covariates were calculated. Survey binomial logistic regression was used to evaluate the association between formal and informal screening and treatment with counselling versus medication in children with behavioural problems. RESULTS: A total of 7837 children 3-5 years old were included in the analysis. Combined formal and informal screening for behavioural problems was 18.1%, 12.3% of children had informal screening only, and 10.8% had formal screening, as reported by parents. Five percent of children had a diagnosis of behavioural problem, for which 6.8% had formal screening only, 16.5% had informal screening only, and 58% had both. Children who had both types of screening were about 10 times as likely to have behavioural problems, and about 4 times as likely if they only had informal screening. Children with behavioural problems who had both types of screening were about 5 times as likely to be treated with medication. CONCLUSION: Formal behavioural screening was low in children 3 to 5 years old but, when done in conjunction with informal screening such as addressing parental concerns, was associated with a diagnosis of behavioural problems and receipt of treatment with medication.

Psychometric validity of the parent's outcome expectations for children's television viewing (POETV) scale.

BACKGROUND: TV and other screen use are common among elementary school aged children with both potential benefits and harms. It is not clear why some parents restrict their children's screen use and others do not. Parent's outcome expectations for allowing their child to watch TV and other screen media, i.e. the perceived 'costs' and 'benefits,' may be influential. Our objective was to develop a measure of Parent's Outcome Expectations for Children's TV Viewing (POETV) and test the psychometrics of the resulting instrument among parents with children 6-12 years old. METHODS: An ethnically diverse sample (n = 311) of parents from Harris County, Texas completed measures for POETV, demographics, and parent and child TV viewing and other screen media use via an internet survey. The sample was randomly split and an exploratory factor analysis (EFA) was conducted among the first half of the sample separately for Positive and Negative POETV. A confirmatory factor analysis (CFA) assessed the fit of the resulting factors with the data in the second half of the sample. Internal reliabilities and Spearman partial correlations (controlling for confounders) of children's TV and other screen use with the resulting POETV factors were calculated for the full sample. RESULTS: EFA identified two factors for Positive POETV (Parent Centered; Child Centered) and two factors for Negative POETV (TV & Content Exposure; Prevent Other Activities). Follow up CFA confirmed moderate to good psychometric properties for both factor structures with the addition of four correlated errors in the Positive POETV model. Internal reliabilities were appropriate (Cronbach's alpha >0.7). Parent Centered Positive POETV and Child Centered Positive POETV were correlated with children's TV viewing on weekdays (0.14, p < 0.05) and weekends (0.17, p < 0.01) respectively. Both also correlated with other screen media use on weekends (0.20 and 0.21, p < 0.001). Prevent Other Activities Negative POETV was negatively correlated with children's TV viewing on weekdays (-0.16, p < 0.01), weekends (-0.14, p < 0.05) and other screen media on weekends (-0.14, p < 0.05). CONCLUSIONS: The Positive and Negative POETV scales offer a new tool to better define predictors of screen media parenting practices and child screen media use behaviors.

Hispanic parents of overweight and obese children and their outcome expectations for children's television viewing: a qualitative study.

OBJECTIVE: Explore parental outcome expectations (OE) regarding children's television (TV) viewing among parents of overweight or obese children. METHODS: Qualitative study using semi-structured interviews with 20 parents of 5- to 8-year-old overweight or obese children. RESULTS: Parent's positive OE for allowing TV viewing were the convenience of using TV for entertainment or as a babysitter. Hispanic parents would limit children's TV viewing to improve their children's health, restrict content, and promote other activities. Negative OE such as children misbehavior and the loss of positive OE for allowing TV emerged as reasons parents may not limit TV. CONCLUSIONS AND IMPLICATIONS: Although Hispanic parents expected to improve their child's health by limiting TV, the negative OE may prevent them from doing so. Interventions targeting children's TV viewing, as a strategy to fight childhood obesity, may be more effective if they promote parent's positive OE and address parent's negative OE for children's TV viewing.