CABLEChild and Adolescent Behaviors in Long-term Evolution

CABLE Research TeamPI ： Hsing-yi Chang （張新儀）

Lee-Lan Yen ( 李 蘭 ) Szu-Hsien T. Lee ( 李思賢 ) Wen-Chi Wu ( 吳文琪 ) Chi-Chen Wu （吳其臻）

Yi-Chen Chiang （江宜珍）

Outline

Background & Purposes Study Design Work Completed in 2001~2005 Work Will Be Conducted in 2006

Background

Childhood is an important developmental stage.

Early and successful interventions can improve children’s health behaviors and health status and can reduce social cost.

A lifestyle based study following the development of children and their health related behaviors has never previously been conducted in Taiwan.

Datasets of Child Health in Other Countries

HBSCHealth Behavior in School-Aged Children, by WHO, Europe

NLSC National Longitudinal Survey of Children, by Canada ADD National Longitudinal Study of Adolescent Health by North Carolina, Chapel Hill YRBSS Youth Risk Behavior Surveillance System, by US, CDC

Specific Aims

To observe the change of health behavior, health status, mental health and lifestyle of children and adolescents.

To examine the determinants of change. To differentiate the typologies of

developmental trajectories.

Study Design (1)

Cross-sectional Longitudinal Individual Family/Group Community/Society Changeability

Study Design (2)

Grade Elementary School Junior High Senior High

Year 1 2 3 4 5 6 7 8 9 10 11 12 13

Acco

mp

lishe

d

2001 A1 B1

2002 A2 B2

2003 A3 B3

2004 A4 B4

2005 A5 B5

Continuing

2006 A6 B6

2007 A7 B7

2008 A8 B8

2009 A9 B9

2010 A10 B10

A1-A10: The 1st cohort 2001-2010, include metropolitan and rural area;B1-B10: The 2nd cohort of 2001-2010, include metropolitan and rural area.

Study FrameworkCross-Sectional Survey

Intrapersonal Factors

Interpersonal Factors

Organizational Factors

Health Lifestyle

Health Status

Study FrameworkLongitudinal Follow-up

Independent VariableChild & Parental Factors

Family FactorsSchool FactorsOther Factors

Intermediate VariableTime 1 → Time 2 Intrapersonal FactorsInterpersonal Factors

Organizational Factors

Dependent VariableTime 1 → Time 2

Health LifestyleHealth Status

Study Subjects of 2001~2004

2220

27212576 2462

1858

2499 24492172

1604

2075

0

500

1000

1500

2000

2500

3000

2001 2002 2003 2004 4 years

1st Cohort 2nd Cohort

Add new participants

Follow-up rate

Participants in 2001as denominator

Participants in 2001as denominator

Cohort 1 Cohort 2 Cohort 1 Cohort 2

2001 N=2255 N=2075

2002 N=2773 N=2545

2003

2004

Field Survey, 2001-2006

Student name list

Inform consent

Subject name list

School survey--Student--Parent

Check name list

Cohort 1& 22001-2002

Rearrange name list

Mail survey--Student--Parent

Mail survey-Student

Cohort 22004

Cohort 22006

Rearrange name list

Cohort 1& 22001-2006

Rearrange name list

Website survey

--Student

Cohort 22005

Study Instruments &Data Collection

Intrapersonal Factors

Interpersonal Factors

Organizational Factors

Health Lifestyle

Health Status

CABLE Questionnaires

Students+Parents +Teachers

School Health Records

School & Community Profiles

CABEL QuestionnaireStudent Version

For 1st – 3rd graders Animal & Plant Version

For 4th graders and older students Student Version

Contents of Student Version

Previous Achievements (I) Development of Positive Health Behaviors

Sun protecting behavior is the lowest from 2001 to 2004 and decline annually.

For cohort 2, most behaviors have increased before 2003, but decreased at 2004.

Development of Negative Health Behaviors Staying up late, eating before sleeping, and using vulgar

language are increased annually. For cohort 2, destroying public property are increased.

Some Health Behaviors aggregated together.

（邱靜如， 2003 ；吳文琪， 2005 ）

Previous Achievements (II) Correlates of health behaviors

Student’s and parent’s characteristics, family interaction, school’s characteristics, community’s characteristics.

Correlates of suicide ideation living in Taipei, using substance frequently, higher

degree of depression, older mother, being punished frequently, lower family support, and girl with higher social loneliness

Correlates of internal mental health student’s sex, family relationship, family conflict, school

attachment

（怜燕、李蘭、吳文琪、江宜珍， 2002 ；陳如毓， 2002 ；邱靜如， 2003 ；林芳美 2003 ；江宜珍， 2003 ；陳俐婷， 2003 ； 吳其臻， 2003 ； 張弘潔， 2004 ； Szu-Hsien Lee, Lee-Lan Yen, and Li-Ting Chen, 2004 ；高啟賢， 2004 ；傅建泰 2004 ； 吳文琪， 2005 ）

Results Disseminationfrom 2001 to 2004

Annual reports Annual Report 2001 has been published Annual Report 2002 has been published Annual Report 2003-2004 has been published

2002 CABLE conference Reference for parents Application of CABLE questionnaires

Presentations and Publications from 2001 to 2004 (I)

Conference papers 2002 ISHPA (2) 2002 APA (1 paper) 2002 TPA (1 paper) 2002-2004 APHA (8 papers) 2004 First Conference on Statistical Methodology

(1 paper) 2004 TPHA Annual Meeting (3 papers) 2005 Biennial Meeting of SRCD (1 paper)

Paper Writing & Publishing from 2001 to 2004 (II)

Journal Article Yen LL, Chen L, Lee SH, Hsiao C, Pan LY. IUHP

E- Promotion and Education 2002; Suppl. 1: 33- 40.

Lee SH, Yen LL, Cheng LT. J Med Sci 2004; 24(4): 185-190.

江宜珍 , 吳肖琪 , 李蘭 . 台灣衛誌 2005. (printed) 3 papers submitted

Professional Training 2001-2005

Master Doctor

2001

2002

2003

2004

2005

CABLE’s Websitehttp://cable.nhri.org.tw/

Data collection in 2006

Sixth graders (1st cohort) Subjects: Students + Parents Field survey at 19 primary schools in 2 area School health records transcribing

Ninth graders (2nd cohort) Subjects: Students Field survey at 27 junior high schools Mail survey and internet survey for those who

didn’t attend major those junior high schools

Major focus of 2006

Childhood overweight/obesity Mental health Effect of physical punishment Aggressive and addictive behavior Emerging issues

Data analysis in 2006

Cross-sectional and Longitudinal Analysis Multiple linear and logistic regression Multilevel analysis Structure equation model Latent growth curve model

Data Released

A data-releasing guideline was drawn-up at 2003 October.

Data of 2001 & 2002 were released. 1 foreign scholar and 3 domestic researchers

are analyzing the data. The dataset of 2003 will be released in 2006.

CABLE’s Website in 2006

Maintain CABLE website Access the effectiveness of CABLE website

for retrieving participants who didn’t be interviewed in school.

Significance

The findings of CABLE will generate a dataset for observing the development of child and adolescent in Taiwan.

According to the evidence based information from CABLE, related agencies can develop supporting and learning programs to improve child health.