1. CABLE Child and Adolescent Behaviors in Long-Term Evolution: A School-Based Healthy Lifestyle Study PI ： Lee-Lan Yen ( 李 蘭 ) Szu-Hsien T. Lee ( 李思賢 ) Likwang Chen ( 陳麗光 ) Chuhsing K. Hsiao ( 蕭朱杏 ) Ling-Yen Pan ( 潘怜燕 ) CABLE Research Team

3. OUTLINE §CABLE as a Five-Year Prospective Project §Previous Work Accomplished l CABLE 2001 l CABLE 2002 §Follow-Up (CABLE 2003) l Specific Aims l Methods §Anticipated Results

4. CABLE ： A FIVE-YEAR PROSPECTIVE PROJECT

5. BACKGROUND §Childhood experiences have long-term influences on physical and psychological health and social behavior in later life. §Early and successful interventions improve children’s health behaviors, health status and cognitive ability, and reduce their anti-social behavior. §There have been a few long-term studies investigating child development relevant to his/her health behaviors.

6. SPECIFIC AIMS §To understand the status and types of healthy lifestyle among the selected metropolitan and rural students in Taiwan §To investigate their developments and changes of healthy lifestyle over time §To explore the factors on determinants of student’s healthy/unhealthy lifestyle §To analyze the relationship between healthy lifestyle and health status among the selected students

7. M25 C25M15 C15 2005 M24 C24M14 C14 2004 M23 C23M13 C13 2003 M22 C22M12 C12 2002 M21 C21M11 C11 2001 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

8. SAMPLING DESIGN Students and their parents are also our study participants

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

10. PROGRESS (Year 2001) §CABLE 2001 survey completed l 18 schools had been selected. l The questionnaires were developed. l A pilot study was conducted to test the validity and reliability of questionnaires. l Data were collected during October and December, 2001. l Data was keyed in and cleaned between December, 2001 and January, 2002. l Four datasets were checked, corrected, and strung for analyses.

11. PROGRESS (Year 2002) §Collected students’ school records §Plan the second wave of data collection l The descriptive analysis of wave 1(year 2001) had been done. l Questionnaires were revised. l Pilot test had been done in June, 2002. l Data will be collected during September and November, 2002. l Datasets will be ready by December, 2002.

12. PROGRESS (Year 2002) §The conference on CABLE 2001 is held in Taipei City on August 14. §Schools’ principals, teachers, representatives of parents, scholars, and government officers are invited. §Five original papers will be presented. (cont.)

13. PROGRESS (Year 2002) §Publications l Conference abstracts l Master thesis One thesis has been done 「國小四年級學童及父母危害健康行為的關係」 four thesis are undergoing l Annual report will be published l Several manuscripts are undergoing (cont.)

14. CABLE 2003 [Following Years]

15. SPECIFIC AIMS OF CABLE 2003 (1) To investigate trends in healthy lifestyle and health status among the primary school children. (2) To determine the factors influencing the changes in healthy lifestyle and health status among the primary school children.

16. SPECIFIC AIMS OF CABLE 2003 (cont.) (3) To identify the health behaviors with significant changes among the primary school children in order to conduct in-depth qualitative research in 2004.

17. STUDY METHODS §Conceptual framework §a follow-up data collection will be implemented among the same cohort (third graders and sixth graders then) with their parents. §Using the same instruments (with some modification) to facilitate the comparisons of measures. §Student’s health examination records will be linked. §Analytical models, including time-dependent techniques (such as ANCOVA and GEE) and multilevel analysis, will be used.

18. ANTICIPATED RESULTS (1) To establish a model for long-term study in the field of health behavioral sciences; (2) To help the development of theories related to health behaviors; (3) To systematically describe the patterns of behavioral developments and changes in childhood and adolescence; (4) To identify the factors influencing children’s and adolescents’ lifestyles;

19. ANTICIPATED RESULTS (5) To provide our government the research results as references for making health policies for children and adolescents; (6) To provide the students and research assistants various learning opportunities for becoming a researcher in future; (7) To establish a cooperative relationship between the universities and the NHRI. (cont.)

20. ~Thank You~

21. Procedure of Data Collection Collect students’ name list Collect inform consents Interviewer training Field Survey -- Children -- Parents Rearrange name list

22. Study Subjects in 2001 Student: Population (n) 33652707240764 35242686442106 Sampling (n) 195016343584 184217703612 Completed (n) 12979212218 10899862075 Student’s father Stuednt’s mother 1 st graders4 th graders Taipei City Hsinchu County Total Taipei City Hsinchu County Total Complete rate (%) 66.556.461.9 59.155.757.4 Completed (n) 9917361727 8678371704 Completed (n)11677961963 10078811888

23. Instruments Development (2001.3-8) §Preliminary studies ： referring to several well- developed questionnaires of HBSC 、 PSID 、 YRBSS 、 HRBS.etc. §Weekly meeting is held §Content Validity (2001.7) §Standardization and verification of questionnaires （ 2001.7.15 ） §Pilot Study (2001.7-8) §Finalization of questionnaires

24. Core of questionnaires §Four versions of questionnaire l Pupil versions for 1st and 4th grade l Parental versions for mother and father §The core of questionnaires l CABLE intra-personal questionnaire l CABLE interpersonal questionnaire l CABLE health behavior questionnaire

25. 學童健康生活型態研討會 §CABLE 計畫的研究目的與設計 §CABLE2001 調查之初步結果 § 父母與學童之健康行為的關聯性 § 國小四年級學童的內外控與社交孤寂 § 家庭互動與學童心理健康

26. Conference Abstracts §Four abstracts have been accepted by the Annual Meeting of APHA §Poster l Child and Adolescent Behaviors in Long-term Evolution (CABLE):A School-based Health Lifestyle Study l Locus of control and social loneliness in school children §Oral l Formation of Habitual Health Behaviors --- with a Focus on Parental Demonstration Effects l Family Interaction and Children’s Mental Health – results from CABLE study, 2001

27. 進行中碩士論文 § 國小四年級學童自殺意念相關因素之探 討 § 夫妻間健康行為的一致性與學童健康 § 兒童知覺的家庭衝突與其因應策略、社 交孤寂、社交焦慮之關係

28. Annual Report ~ Tentative article titles §Child and adolescent behaviors in long-term evolution [CABLE Study]: Design, Instruments, Implementation and Preliminary findings §Children’s clusters of health behaviors §The relationships between community level variables and children’s health behaviors §The relationship of mental states and health risk behaviors in children §Locus of control and social loneliness in forth graders

29. Annual Report ~ Tentative Article titles (cont.) §Family interaction and children’s mental health §Formation of habitual health behaviors – with a focus of parental demonstration effects §The association between parents’ and school children’s health behaviors § 家長與子女對家庭互動之評量結果與兒童心理 健康的關係 § 國小四年級學童及父母危害健康行為的關係 §Sampling design of CABLE Study

31. Official Propaganda