CABLE Child and Adolescent Behaviors in Long-term Evolution: A School-based Healthy Lifestyle Study PI Lee-Lan Yen ( ) Szu-Hsien T. Lee ( ) Likwang Chen ( ) Chuhsing K. Hsiao ( ) Ling-Yen Pan ( )

WHY NAMED CABLE §Cross-sectional §Longitudinal §Individual §Family/Group §School/Society §Changeability

BACKGROUND §Childhood experiences associated with health and social behavior in later life. §Early and successful interventions can improve childrens health and reduce risk. §Few long-term studies on childs health behaviors.

AIMS §To understand the status and types of health lifestyle §To investigate childrens developments and changes of health lifestyle over time §To explore the determinants of participants healthy/unhealthy lifestyle §To describe childrens mental health

AIMS (continued) §To describe the relationship between health lifestyle and physical health among the selected students §To cultivate outstanding researchers

M25 C25M15 C M24 C24M14 C M23 C23M13 C M22 C22M12 C M21 C21M11 C Grade8Grade7Grade6Grade5Grade4Grade3Grade2Grade1Year RESEARCH DESIGN M1: The 1st cohort in metropolitan area M2: The 2nd cohort in metropolitan area C1: The 1st cohort in countryside area C2: The 2nd cohort in countryside area

CABLE PROJECT of YEAR 2002 §Sub-project 1: Developments and Changes in the Health Behaviors among the Primary School Children §Sub-project 2: Psychosocial Changes and Health-Related Behaviors among the Primary School Children.

Independent Variables 1.Intrapersonal Factors Demographic var Health history Personal traits 2.Family Factors Demographic var Family structure Family SES 3.School Size Personnel Facilities Health services and policies 4.Controlled Factors Area Grade Survey time Intermediate Variables Intrapersonal Factors Time 1 Health belief School performance Behavioral capability Time 2 Health belief School performance Behavioral capability Family Factors Time 1 Parents marital status Parents health belief Parents health behaviors Time 2 Parents marital Status Parents health belief Parents health behaviors Interpersonal Factors Time 1 Family support Family interaction Relationship with others Time 2 Family support Family interaction Relationship with others Health Lifestyle Time 1 Health risk behaviors Health protecting behaviors Health promoting behaviors Time 2 Health risk behaviors Health protecting behaviors Health promoting behaviors Health Status Time 1 Physical health Psychosocial health Time 2 Physical health Psychosocial health Figure 1. The Framework of CABLE

Sub-project 1 Health Lifestyle Time1Time2 Health Status Time1Time2 Time1Time2 Independent Variables Intermediate Variables Intrapersonal Factors Family Factors Interpersonal Factors Time1Time2 Time1Time2

Sub-project 2 Health Lifestyle Time 1 Health risk behavior Health protecting behavior Health promoting behavior Time 2 Health risk behavior Health protecting behavior Health promoting behavior Health Status Time 1 Psychosocial Health Time 2 Psychosocial Health

METHODS SAMPLING §Stratified Sampling §School size l Large( 400 ) Medium( ) Small( ) §Number of qualified school l Hsing-Chu :79( 50 students per grade) l Taipei City :152 ( 50 students per grade) §Participants Recruitment Criteria

Study Participants* * Numbers are for a certain urbanization level. Both Taipei City and Hsing-Chu County have the same sampling scheme.

List of randomly selected schools

STUDY FRAMEWORK Intrapersonal Factors Interpersonal Factors Organizational Factors Health Lifestyle Health Status

PROGRESS §sampling §instrument development §pilot study §data collection l

CONTENT of INSTRUMENT §CABLE school profile §CABLE student profile §CABLE questionnaires l Version 1 st grade 4 th grade parents(include fathers and mothers) l Scales in each version CABLE health lifestyle scale CABLE family interaction scale CABLE social anxiety scale etc..

STATISTICAL ANALYSIS §Consider l longitudinal observations l effects from various levels individual, school, area §Use multilevel model for analysis

Level 1

Level 2

Level 3 and 4

ANTICIPATED RESULTS and CONTRIBUTIONS §To describe the health lifestyle of children over time §To determine the factors associated with the changes of health lifestyle §To uncover the plausible pathways of health behavior development

ANTICIPATED RESULTS and CONTRIBUTIONS §To investigate the factors correlated to healthy behavioral developments §To provide policy-related evidence for policy makers §To promote academic research performance through publishing papers in professional journals

~Thank You~

Sampling process §School selection( ) l Visit of sample schools in Hsing-Chu and the arrangement of research cooperation(2001.5)

Brochure

Process of Instrument development §Preliminary studies l referring to several well-developed questionnaires of HBSC NLSY YRBSS HRBS.etc. §Weekly meeting §Validity and reliability §Standardization and verification of questionnaires l seven parents, six 1 st graders, three 4 th graders §Finalization of questionnaires

List of Experts for Questionnaire Validity

Pilot study §Participants ascertainment of pilot study §Data collection of pilot study §Data analysis and discussion of pilot study

Data collection §Interviewer recruitment §Editing interviewer handbook §Printing questionnaires §Data analysis of pilot study §Interviewers training §Data collection §Data management §Editing code book