Search Results (272)

Background: Early childhood caries (ECC) remains a critical public health challenge, yet recent prevalence data and risk factors are scarce in rapidly urbanizing regions like Shenzhen City, China. Objectives: This study aimed to assess ECC prevalence and identify risk factors among 5-year-old children in Shenzhen City. Methods: This cross-sectional survey was conducted in Shenzhen City in 2024, recruiting 5-year-old children through multistage sampling from kindergartens. Self-administered parental questionnaires were distributed to collect data such as demographic characteristics, socioeconomic background and oral health-related behaviors. One trained dentist conducted the oral examination in kindergartens using ball-ended community periodontal index probes and disposable dental mirrors with an intra-oral light-emitting diode light attached. Dental caries was assessed using diagnosis criteria recommended by World Health Organization. The decayed, missing, and filled primary teeth (dmft) were recorded. Zero-inflated negative binomial regression was applied to identify associations between risk factors and ECC. Results: Among 1462 participants (86% response rate), ECC prevalence was 58% (mean dmft: 2.5 ± 3.4), with untreated decay (dt) accounting for 92% of cases. Socioeconomic factors, including low family income (p < 0.001), non-local residency (p < 0.001), and low caregiver education level (p = 0.012), were significantly associated with higher dmft scores. Behavioral factors such as frequent sugary drink consumption (p = 0.005), lack of parental brushing assistance (p = 0.027), and non-fluoride toothpaste use (p = 0.008) also contributed to the risk of ECC. Conclusions: Over half of Shenzhen City’s 5-year-olds suffered from ECC, predominantly untreated, driven by socioeconomic disparities and modifiable behavioral factors. Public health strategies must prioritize parental education, fluoride use and early preventive practices to reduce the burden of ECC. Full article

Despite notable progress in reducing childhood morbidity and mortality, achieving Sustainable Development Goal 3 remains a challenge in sub-Saharan Africa, where many children under five die before accessing formal healthcare services. This study explored the roles of the community in the implementation of the Integrated Management of Childhood Illness (IMCI) programme from the perspectives of caregivers and professional nurses. Using an interpretative phenomenological analysis design, 18 participants were purposively selected from four primary healthcare facilities. Data was collected through audio-recorded interviews, transcribed verbatim and analysed using the IPA framework. The findings underscore the critical role of community health workers (CHWs) within the Integrated Management of Childhood Illness (IMCI) framework, particularly in health promotion, child assessments and follow-up home visits. Support from early childhood development educators and community leaders further enhances these efforts. Nurses highlighted mobile health teams as vital for delivering integrated services, though challenges such as limited transport and inadequate training hinder CHWs’ effectiveness. Community-based care offers a cost-effective, accessible model in low-resource settings by leveraging local structures. Strengthening the connection between communities and formal health systems is essential. To sustain IMCI, investment in CHW-led initiatives, including training and logistical support, is recommended to improve service delivery and child health outcomes. Full article

Background: Digital devices (DDs) are increasingly present in early childhood, with screen exposure beginning as early as infancy. Despite international and national guidelines discouraging digital media use before age two, many children are exposed to screens far earlier, often mediated by parents and caregivers. Excessive or unregulated screen use has been linked to adverse neurodevelopmental, emotional, and physical outcomes. Objective: This study aims to assess the knowledge, attitudes, and educational needs of primary care pediatricians (PCPs) regarding digital education (DE) and DD use in preschool-aged children (0–6 years) in two provinces of Northern Italy. Methods: A cross-sectional survey was distributed to all 165 PCPs in the Modena and Reggio Emilia provinces between December 2024 and January 2025. The 17-item questionnaire explored PCPs’ knowledge of guidelines, awareness of DD-related risks, current counseling practices, and training needs. Results: Of the 165 contacted PCPs, 93 (56%) completed the survey. While 77% were aware of Italian Pediatric Society recommendations, only 56% correctly identified age two as the threshold for total screen avoidance. 87% of PCPs recognized the risks of excessive DD use, particularly its cognitive, behavioral, and physical consequences. Nearly all participants (95%) reported discussing DE during clinical visits, and 96% expressed a desire for further training. Conclusions: PCPs show strong engagement in promoting healthy digital habits but lack specific knowledge of current recommendations. Structured tools such as digital health check-ups and targeted training programs are needed to strengthen pediatricians’ roles in digital health education and support parental guidance. Full article

This study aims to identify the most significant characteristics of non-university teaching staff within the general system in Spain who participate in non-traditional tasks outside the school and the classroom within the educational field. An exploratory study was conducted on a sample of 6512 teachers in Spain, using a 13-item Likert-scale questionnaire structured into three scopes (Technical–Political, Scientific–Academic, and Teacher Training). The results identify three distinct profiles of teachers who participate in tasks away from the classroom and the educational institution, according to the educational level at which they work. In the case of Early Childhood Education teachers who participate most in such tasks, the most significant variables are gender, holding a management position, type of school, and Continuous Teacher Training (CTT). For Primary Education teachers, the most important variables are teaching experience, holding a management position, and CTT. Finally, for Secondary Education teachers who participate most in these tasks, the most significant variables across all three scopes are teaching experience, holding a management position, and CTT. Although the proportion of teachers who report dedicating time to tasks outside the classroom and the school is small, a deeper understanding of the characteristics of those who do such activities for the consideration and design of strategies, plans, and policies, targeted by educational level, in order to increase or improve the degree of teacher participation in the three scopes under investigation. Full article

(1) Background/Objectives: Obstructive Sleep Apnea (OSA) in childhood is a significant health concern with potential adverse effects on daytime function, behavior, education, and overall development. Early intervention is crucial to ease these consequences. Myofunctional therapy (MT) has emerged as a treatment modality, particularly in young children, to address OSA. This highlights the importance of early detection and intervention by pediatric dentists and other healthcare providers who frequently interact with the pediatric oral and facial structures. This study aimed to investigate the knowledge, attitudes, and practices of Lebanese pediatric dentists regarding pediatric OSA and MT. (2) Methods: A cross-sectional survey was distributed to 103 Lebanese Pediatric dentists registered with the Lebanese Society of Pediatric Dentistry (LSPD). The survey assessed familiarity with OSA, diagnostic practices, treatment approaches, and utilization of MT. (3) Results: Out of 103 pediatric dentists, 62 responded (60.2%). Most respondents were familiar with OSA (86.8%). However, the number of diagnostic symptoms used varied. MT was not pediatric dentists’ primary choice in treating OSA. (4) Conclusions: Lebanese pediatric dentists demonstrate a good understanding of OSA, but there is potential for improvement in diagnostic comprehensiveness and exploration of MT as a treatment option. Full article

High-quality early care and education (ECE) programs, characterized by safe environments, emotionally supportive communication, proactive behavior supports, and teacher self-care practices, play a pivotal role in healthy child development. Early Childhood Mental Health Consultation (ECMHC) is an evidence-based approach designed to strengthen these environments and support young children’s social–emotional outcomes. However, the long-term impacts of ECMHC models remain understudied. Grounded in ECMHC, the purpose of this study is to evaluate the effectiveness of Jump Start Plus COVID Support (JS+CS) in supporting child psychosocial outcomes (prosocial behaviors and reduced externalizing/internalizing behaviors) over two school years. In a cluster-randomized trial, 12 ECE centers received the 14-week JS+CS intervention, and 12 attention control centers received a 14-week obesity prevention program. Children were followed over two school years to determine long-term impacts on behavior, measured by the Devereux Early Childhood Assessment (DECA) and the Strengths and Difficulties Questionnaire (SDQ). Over two school years, significant time-by-group interactions emerged for primary child outcomes. The JS+CS group showed greater improvements in DECA Initiative and Self-Regulation (p = 0.01 and p = 0.02, respectively) compared to controls. JS+CS significantly enhanced child psychosocial functioning, supporting its potential as an effective model for a scalable mental health consultation in ECE settings. Full article

To ensure the success of early childhood education and further studies and to formulate interventions, the early diagnosis of childhood socioemotional and behavioral problems is essential. In this study, we analyzed socioemotional and behavioral difficulties in a sample of 501 Hungarian minority children (primary school children from Grades 1, 2, 3, and 4) residing in five administrative regions of Slovakia. Teachers’ and parents’ ratings on the Strengths and Difficulties Questionnaire (SDQ) were used for the assessment, and teacher–parent agreement (ICCs) from a total of 501 parents and 107 teachers were calculated to validate cross-informant convergence. The SDQ assessment tool includes a total of 25 items, which are divided into five subscales: emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial behavior. Hyperactivity was the problem most frequently reported by teachers, showing abnormal scores, while emotional symptoms were most frequently reported by parents. Demographic information, such as school grade, GPA (grade point average), and maternal education, was significantly related to the children’s SDQ scores. GPA showed a significant negative correlation with difficulties and a positive correlation with prosocial behavior. Significant differences in socioemotional and behavioral problems were also found across different grades. Inter-rater reliability analysis using intraclass correlation coefficients (ICCs) revealed fair-to-good agreement between teachers and parents (ICC range: 0.45–0.61). These findings reveal the importance of incorporating multiple informants in behavioral assessments, highlighting the need for early diagnosis and family-informed interventions to address socioemotional and behavioral problems within culturally diverse educational settings. Full article

Background: Childhood obesity is a growing public health challenge in Poland and worldwide, associated with serious long-term health consequences. Effective prevention requires family-centered, evidence-based interventions that actively engage both children and their caregivers. This study presents the Finnish Smart Family practice—an evidence-based lifestyle counseling method developed by the Finnish Heart Association—and describes its adaptation and implementation in Poland as part of the EU Health4EUkids project. The study emphasizes the method’s practical utility for professionals working with families of children with obesity. Methods: The Smart Family approach is a structured lifestyle counseling method based on findings from the Special Turku Coronary Risk Factor Intervention Project (STRIP) that is grounded in health psychology and strength-based counseling principles. Unlike traditional counseling, which focuses mainly on information transfer, Smart Family promotes motivation, families’ active participation, and recognition of their strengths in areas such as nutrition, physical activity, sleep, and oral hygiene. The method uses practical tools including the Smart Family card, other supporting materials, and dedicated online platforms for both families and healthcare providers. These tools enable families to self-assess their lifestyle, select discussion topics during visits, and set achievable goals while supporting professionals in initiating non-judgmental, collaborative conversations. In Poland, the program was adapted using culturally appropriate materials and professional training, followed by pilot implementation in primary healthcare and educational settings that included pre-implementation planning, practical training sessions, the application of intervention tools, and outcome evaluation. Results: Pilot implementation demonstrated high usability and effectiveness. The approach enabled non-judgmental, supportive engagement with families, facilitated active participation in setting health goals, and promoted sustainable lifestyle changes in nutrition, physical activity, sleep, and other health behaviors. Evaluation highlighted the importance of supporting program objectives at the national level, standardizing child healthcare practices, and engaging media and local authorities to create a supportive ecosystem. Conclusions: The Polish experience confirms that Smart Family is an evidence-based intervention that strengthens professional competence, provides practical tools for family-centered care, and supports the long-term prevention of child-hood obesity and related non-communicable diseases. Its integration into healthcare and educational settings offers a promising strategy for improving public health outcomes. Full article

Outdoor learning offers dynamic, real-world educational opportunities that extend beyond traditional classrooms and foster sustainability awareness. This quantitative study endeavors to assess teachers’ competency in facilitating outdoor learning, aiming for a more engaging and impactful introduction. Employing a relational survey design in the form of a multi-survey model, the research engaged 586 teachers representing diverse academic disciplines across public and private elementary and secondary schools. Central to the investigation was the utilization of the “Outdoor Learning Regulation Scale [OLRS]” as the primary data collection instrument. The evaluation of teachers’ aptitude in regulating outdoor learning encompassed various variables, including gender, subject specialization, prior online or in-person training in outdoor learning, use of non-school environments for teaching, childhood environment, and teaching location. To analyze the collected data, a nuanced approach to statistical analysis was undertaken, aiming to provide a clearer and more specific explanation of the data analysis methods employed. The findings of the study unveiled no significant disparities in teachers’ outdoor learning regulation capabilities based on gender, subject specialization, childhood environment, or teaching location. However, discernible differences surfaced in their proficiency in outdoor learning regulation concerning previous online or in-person training in outdoor learning and their utilization of outdoor environments for teaching, thus providing deeper insights into the factors shaping teachers’ efficacy in facilitating outdoor learning experiences. Additionally, the study emphasizes the link between outdoor learning and sustainability education. By equipping teachers with the skills to regulate outdoor learning, this research supports the integration of sustainability into educational practices, promoting students’ ecological awareness and sustainable thinking. These results highlight the importance of professional development and targeted training in outdoor education, with direct implications for strengthening sustainability-oriented teaching practices. Full article

Background/Objectives: This study examines the associations between household socioeconomic status (SES), child nutrition, and developmental status among children aged 24–59 months in the Mont Ngafula health zone in Kinshasa. The primary research question focuses on how SES and stunting affect developmental outcomes in early childhood. Methods: A cross-sectional analysis was conducted involving 348 children, assessing developmental outcomes using the Early Childhood Development Index (ECDI2030). Results: The study found that 70.4% of children were classified as on track, with ONTRACK prevalence increasing across SES tertiles. Children who attended preschool education had higher odds of being on track. The rich tertile had higher odds of being on track than those in the poor tertile, while the middle tertile showed a weaker association. Child age categories and stunting were inversely associated with being developmentally on track. The results are consistent with multiple imputation sensitivity analyses. Conclusions: The study concludes that preschool attendance and a higher household socioeconomic position are strongly associated with better early developmental outcomes, while an age of 48–59 months and stunting are associated with a markedly lower likelihood of being developmentally on track. Integrated policies that reduce household poverty, promote early education, and prevent/treat early faltering growth could improve early childhood developmental trajectories. Full article

Background/Objectives: Childhood obesity rates in Jordan have reached alarming levels, with 28% of school-age children classified as overweight or obese. School-based gardening interventions show promise for promoting healthy eating behaviors, yet limited research exists in Middle Eastern contexts. This study evaluated the effectiveness of a five-month school-based vegetable gardening and nutrition education intervention on anthropometric measures, dietary intake, and knowledge, attitudes, and practices (KAP) regarding vegetable consumption among Jordanian primary school children. Methods: A quasi-experimental controlled trial was conducted with 216 students (ages 10–12 years) from two demographically matched schools in Amman, Jordan. The intervention group (n = 121) participated in weekly one-hour gardening sessions combined with nutrition education and vegetable tasting activities over five months, while the control group (n = 95) continued the standard curriculum. Outcomes measured at baseline and post-intervention included anthropometric assessments, dietary intake via 24 h recalls, and vegetable-related KAP using a validated questionnaire. Data were analyzed using paired t-tests and repeated measures ANCOVA. Results: The intervention group demonstrated significant improvements in body composition, including reductions in BMI (−1.57 kg/m²), weight (−1.88 kg), and BMI z-score (−0.37), while controls showed minimal increases. Vegetable intake showed significant time × group interaction (p-value = 0.003), with a non-significant increase in the intervention group (2.7 to 2.9 times/day) and a non-significant decrease in the controls (2.5 to 2.4 times/day). Dietary quality improved, including increased fiber intake (+2.36 g/day) and reduced saturated fat consumption (−9.24 g/day). Nutrition knowledge scores increased substantially in the intervention group (+22.31 points) compared to controls (+1.75 points; p-value ≤ 0.001). However, attitudes and practices toward vegetable consumption showed no significant changes. Conclusions: This intervention effectively improved body composition, dietary quality, and nutrition knowledge among Jordanian primary school children. These findings provide evidence for implementing culturally adapted school gardening programs as childhood obesity prevention interventions in Middle Eastern settings, though future programs should incorporate family engagement strategies to enhance behavioral sustainability. Full article

Mathematical performance in early education is influenced by a complex interplay of cognitive and affective factors, including language skills, working memory, and anxiety. This study investigated whether working memory and math anxiety, in both explicit numerical situations (ENS) and general classroom situations (GCS), mediate the relationship between general and math-specific vocabulary and math performance in a sample of 467 second-grade students in Chile. Structural equation modelling was employed to test a dual-pathway model in which both working memory and math anxiety served as mediators between vocabulary knowledge and math performance. Results indicated that both general and math-specific vocabulary positively predicted working memory and negatively predicted math anxiety in ENS. In turn, working memory and ENS significantly predicted math outcomes, whereas GCS was not a significant predictor. Indirect effects supported a dual mediation structure, with vocabulary influencing math performance through both cognitive and affective mechanisms. Math-specific vocabulary exerted a slightly stronger total effect than general vocabulary, consistent with its closer alignment to the semantic demands of mathematical tasks. These findings suggest that vocabulary supports early mathematical learning not only by enhancing cognitive processing capacity but also by reducing anxiety in task-specific contexts. Full article

Background/Objectives: Health insurance coverage is critical for children’s health, yet underinsurance remains a significant issue in the United States. This study aims to estimate the prevalence and correlates of childhood underinsurance in southwestern Ohio during a portion of the COVID-19 pandemic. Methods: This is a cross-sectional study of a convenience sample of children, ages 6 months to <18 years, seen in primary care pediatric practices. Recruitment of children’s primary caregivers (PCGs) occurred in practice waiting rooms from June 2021 to April 2023. Respondents completed the Medical Expenses of Children Survey (MEoCS). Index children were considered underinsured if their PCG responded “yes” to any of six questions regarding the inability to pay for a child health clinician’s recommendation despite the child having health insurance. Chi-squared tests and logistic regression were employed in data analysis. Results: 1252 PCGs completed the MEoCS with a response rate of about 90%. 11.3% of index children were underinsured. 41.5% of PCGs raising underinsured children found it harder to access care for their child compared to 3 years ago, while only 9.5% of PCGs raising adequately insured children reported it was harder (p < 0.001). PCGs of underinsured children were more likely to report that COVID-19 had a negative effect on their household income (49.2%) and their child’s school performance (52.0%) and mental health (47.7%) compared to adequately insured children (27.0%, 27.0%, 25.0%; p < 0.001). Conclusions: About 1 in 9 index children were underinsured. Lower parental education and private health insurance were associated with underinsurance across several study cohorts, documenting the stability of these drivers of underinsurance. Full article

Background/Objectives: Childhood trauma significantly hinders the developmental and academic outcomes of learners, particularly in under-resourced schools such as those in Limpopo province, South Africa. Teachers in these settings often face challenges in supporting trauma-exposed learners due to a lack of knowledge, training, and appropriate resources. Addressing this gap requires the development of structured, trauma-informed educational support systems. Methods: This study forms the final phase of a multi-phase research project aimed at developing a trauma-informed curriculum for primary school teachers. A multi-phase mixed method design was adopted across four phases: (1) a global scoping review to identify effective trauma-informed interventions; (2) empirical interviews with primary school teachers, trauma center managers, clinical psychologists, and social workers to understand local needs and experiences; (3) development of a conceptual framework grounded in theoretical and empirical findings; and (4) curriculum development guided by El Sawi’s curriculum design model. The curriculum was validated using structured questionnaires with a panel of stakeholders including educators, mental health professionals, and curriculum experts. Results: The study identified critical issues, including teachers’ limited understanding of childhood trauma, lack of standardized training, and inadequate classroom strategies. Key curriculum components were developed to address these gaps, including modules on the nature of trauma, early identification of symptoms, trauma-informed teaching practices, and collaboration with mental health professionals. Validation results indicated strong agreement on the curriculum’s clarity, relevance, and potential impact. Conclusions: The developed trauma-informed curriculum provides primary school teachers in Limpopo with the knowledge, tools, and confidence to support trauma-exposed learners. It emphasizes early identification, responsive classroom strategies, and inter-professional collaboration. This curriculum has the potential to enhance learning environments and promote better educational and psychosocial outcomes for trauma-affected learners. Full article

Background/Objectives: Poor dietary habits remain a significant public health concern, highlighting the need to promote healthy and sustainable eating patterns, especially in childhood and adolescence. This study assessed the eating habits of primary school children in the Tagus Lezíria region, focusing on adherence to the Mediterranean Diet (MD), recognized for its health and environmental benefits. Methods: The KIDMED index (Mediterranean Diet Quality Index for children and adolescents) was applied to 435 children, the vast majority (97.7%) aged 6–10 years. Results: The data showed that 64.6% of participants exhibited high adherence to the MD, 32.0% medium, and 3.5% low adherence. Despite these encouraging levels, several gaps were identified: 80% of the children did not meet the recommendation for regular nut consumption (≥2–3 times/week), 44% consumed legumes less than once a week, and 43% failed to eat vegetables more than once a day. Regarding demographic factors, no significant differences were observed in overall adherence categories; however, differences emerged in specific eating behaviours. For example, girls consumed more vegetables and cereals than boys, and children in rural areas consumed less dairy than those living in urban settings. Conclusions: These findings emphasize the importance of reinforcing targeted school-based educational interventions to promote healthier dietary behaviours, particularly increased consumption of fruits, vegetables, fish, pulses, and nuts. Strengthening children’s adherence to the MD from an early age may contribute to improving their health and fostering sustainable eating practices. Full article