The Impact of Psychosocial Well-being on the Health Behaviors of Rural Children I Hope Bilinski RN PhD, College of Nursing, University of Saskatchewan, Canada Louise Humbert, PhD, College of Kinesiology, University of Saskatchewan, Canada Carol Henry, PhD, College of Pharmacy and Nutrition, University of Saskatchewan, Canada ISCI, University of York, July 27-29, 2011

Overview Background Purpose of the Study Research Questions Methodology Findings Implications for Practice & Research

Background Health behaviours of Canadian children: 59% consumed fruits and vegetables < 5 times/day (CCHS, 2004) Children and youth getting an average of 6 hrs/day of screen time (HBSC, 2006) 9% boys and 4% girls meet the guidelines for physical activity (CHMS, 2009) Prevalence of overweight doubled and obesity tripled (Stats Canada, 2006)

Rural Canadian Children Less aerobically fit (Tremblay, 2005) Watched TV more than 2 hrs /day (Bilinski, et al, 2009) Consumed less than the recommended servings of fruits and vegetables (Martz & Wagner, 2008) More likely to be overweight/obese (Brunner et al, 2009)

Qualitative Health means: “Knowing stuff” “Having a working body” “Feeling Happy” Rural Saskatchewan Children Quantitative 34% of children overweight or obese Higher prevalence of overweight/obesity in boys Many (52.6%) children watched 2 or more hrs of TV on a daily basis

Psychosocial well-being and health behaviours in rural preadolescent children Purpose: 1)To determine the relationship between psychosocial health and health behaviours in children 2)To discover, from the children’s perspective, the influence of the rural environment on health behaviours and psychosocial health

Research Questions 1)What are the patterns of weight, health behaviours, and psychosocial health characteristics of the study sample? 2)What is the relationship between the psychosocial characteristics and the health behaviours? 3)What are the children’s perceptions of their rural environment and how this environment contributes to their health?

Methodology Study design Mixed methods approach Target population All students in Grades 4,5, & 6 attending four rural schools Instruments Psychosocial health Piers-Harris 2 Questionnaire Faces Scale Dietary patterns Youth/Adolescent FF Questionnaire Physical Activity Physical Activity Questionnaire Pedometers Perceptions Photovoice

Methodology Weight Status: BMI calculated (wt/ht 2 ) from measured heights and weights Categorized as healthy weight, overweight or obese based on IOTF 6 month cut off points for BMI related to age and sex (Cole et al, 2000)

Findings Sample Response rate 47.2% male; 52.8 % female Mean age: years

Findings For all children: 20.2% were overweight 16.2% were obese

Findings Physical Activity Patterns

Findings Pedometer readings: For all children average steps: 55,000 steps Boys: 50,927 steps/6 days Girls: 57,855 steps/6 days

Findings Dietary Patterns

Findings Psychosocial Characteristics Faces Scale: -88.7% rated their happiness as A, B, C -11.3% rated their happiness as D

Findings Psychosocial Characteristics Piers-Harris 2 ‘The way I feel about myself’ Overall score derived from six domains: 1)Behavioral adjustment 2)Intellectual and school status 3)Physical appearance and attributes 4)Freedom from anxiety 5)Popularity 6)Happiness and satisfaction For all children – mean total score 54.25

Findings Psychosocial health and health behaviours No significant relationships between total Piers-Harris (PH) score and BMI scores or PA Significant but relatively weak relationships: - Vegetable intake and Total PH - Vegetable intake and Happiness - BMI and anxiety

“It’s fun, it’s a lot better than the city” “You know everyone in town” The Rural Context

The Rural Context “it feels good to have a whole bunch of space out there” “I like it, you can walk in the middle of the road because there is no traffic”

The Rural Context “You can take a nap on the road” “You don’t have to worry..like we don’t even lock our door at night ”

Conclusions 36.4% of children overweight or obese Most participated in physical activities 2-3/wk Most consumed Fr & Veg less than 3/wk Most consumed sugary snacks Majority of children reported they were happy or very happy Majority had a positive self concept The rural environment contributed to health

Strengths and Limitations Homogeneous sample of rural children Response/selection bias Generalization Children as participants

Implications for research/practice Replicate study with a larger random sample Early assessment of overweight and obesity Integrate psychosocial components in health promotion or interventions

Thank you!