Health Behaviors and Health-related Quality of Life among Vulnerable Children in a Community

Suyeon Kim; Jina Choo

doi:10.12799/jkachn.2015.26.3.292

Articles

Page Path: HOME > J Korean Acad Community Health Nurs > Volume 26(3); 2015 > Article

Original Article
Health Behaviors and Health-related Quality of Life among Vulnerable Children in a Community: Suyeon Kim, Jina Choo; Journal of Korean Academy of Community Health Nursing 2015;26(3):292-302.
DOI: https://doi.org/10.12799/jkachn.2015.26.3.292
Published online: September 30, 2015

College of Nursing, Korea University, Seoul, Korea.

• Received: April 27, 2015 • Revised: September 16, 2015 • Accepted: September 23, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

prev next

1,303 Views
8 Download
8 Crossref

Full Article

Download PDF

Abstract

Abstract

Purpose
The purpose of this study was to examine the association between health behaviors and health-related quality of life (HRQOL) among vulnerable children in a community.
Methods
Using data from 'The Obesity Prevention Framework for Vulnerable Children', a secondary analysis was conducted for 165 children (ages 8~12 years) and their parents who were recruited from 16 K-gu Community Child Centers in Seoul. Six types of health behaviors related to eating and activity were assessed. Each behavior was categorized into the non-recommended vs. recommended levels. The scores of the recommended levels of the six health behaviors were summed up for the composite score of health behaviors. HRQOL was measured by KIDSCREEN-52.
Results
The groups with a non-recommended level of fast food intake and sedentary behavior had a significantly lower total score of KIDSCREEN-52 than those with a recommended level. Moreover, the lower composite score of health behaviors was significantly associated with the lower total score of KIDSCREEN-52.
Conclusion
Among the vulnerable children, the six recommended health behaviors and their composite score were in significant positive associations with the HRQOL levels. Therefore, nursing strategies for enhancing the recommended levels of health behaviors are needed for vulnerable children.
Key Words: Vulnerable populations; Child; Health behavior; Quality of life

Figure 1

Percentages of recommended vs. non-recommended health behaviors.

Figure 2

Distribution of the composite scores of health behaviors.

Figure 3

Levels of health-related quality of life as measured by KIDSCREEN-52.

Table 1

Sociodemographic Characteristics among Vulnerable Children and their Parents (N=165)

Variables	Characteristics	Categories	N	n (%)	M±SD
Children's characteristics	Age (year)		165		9.8±1.26
	Girls		165	84 (50.9)
	Family type	Two parents family	165	107 (64.9)
		One parent family		56 (33.9)
		Grandparents family		2 (1.2)
	Perceived economic status	Very low	165	2 (1.2)
		Low		13 (7.9)
		Moderate		97 (58.8)
		High		45 (27.3)
		Very high		8 (4.8)
	Academic achievement	Very low	165	12 (7.3)
		Low		20 (12.1)
		Moderate		82 (49.7)
		High		41 (24.8)
		Very high		10 (6.1)
	Having many friends	Yes	165	132 (80.0)
	Having many friends	No	165	33 (20.0)
	Self-rated health	Poor	165	6 (3.6)
		Fair		12 (7.3)
		Good		88 (53.3)
		Very good		33 (20.0)
		Excellent		26 (15.8)
	Illness	Yes	152	42 (27.6)
	Illness	No	152	110 (72.4)
Parents' characteristics	Mothers' age (year)		140		41.3±5.46
	Mothers' education	Elementary school	140	7 (5.0)
		Middle school		12 (8.5)
		High school		89 (63.6)
		≥College		32 (22.9)
	Fathers' age (year)		144		43.7±5.86
	Fathers' education	Elementary school	146	3 (2.1)
		Middle school		19 (13.0)
		High school		91 (62.3)
		≥College		33 (22.6)
	Marital status	Married	148	85 (57.4)
		Separated		14 (9.5)
		Widowed		4 (2.7)
		Divorced		45 (30.4)
	Monthly household income (10,000 won)	≤100	152	35 (23.0)
		101~200		82 (53.9)
		201~300		21 (13.8)
		301~400		12 (7.9)
		401~500		2 (1.4)
		≥501		0 (0.0)
	Employed	Yes	151	112 (74.2)
	Employed	No	151	39 (25.8)
	Coverage of health insurance	Company health insurance	152	48 (31.6)
		Local health insurance		59 (38.8)
		Medical aid/none		45 (29.6)
	Religion	Yes	152	99 (65.1)
	Religion	No	152	53 (34.9)

Table 2

Associations between Health Behaviors and HRQOL among Vulnerable Children (N=165)

Variables	Eating behaviors				Activity behaviors		Composite scores of health behaviors^†
	Fast food	Sweetened beverage	Fruits & vegetables	Breakfast	Sweated activity	Sedentary behavior	Composite scores of health behaviors^†
	β (SE)	β (SE)	β (SE)	β (SE)	β (SE)	β (SE)	β (SE)
Total	-2.82 (1.31)^*	-2.26 (1.57)	1.25 (1.30)	2.16 (1.35)	3.45 (2.13)	-4.35 (1.47)^*	1.72 (0.49)^*
Physical well-being	-0.48 (1.90)	-2.13 (2.25)	2.10 (1.86)	1.28 (1.93)	14.28 (2.80)^*	-2.77 (2.16)	1.78 (0.71)^*
Psychological well-being	-4.16 (2.07)^*	-3.98 (2.47)	2.51 (2.05)	4.76 (2.12)^*	4.14 (3.38)	-8.30 (2.29)^*	3.16 (0.76)^*
Moods & emotions	-2.19 (2.22)	-2.04 (2.63)	1.48 (2.18)	3.21 (2.25)	1.53 (3.59)	-0.61 (2.55)	1.29 (0.85)
Social support & peers	-2.03 (2.19)	0.17 (2.60)	2.70 (2.14)	2.83 (2.23)	5.17 (3.51)	-7.78 (2.41)^*	2.31 (0.82)^*
Parent relation & home life	-5.87 (1.91)^*	-4.92 (2.31)^*	4.85 (1.89)^*	2.07 (1.99)	1.67 (3.20)	-6.56 (2.19)^*	2.95 (0.70)^*
Self-perception	-5.93 (1.77)^*	-6.68 (2.10)^*	0.67 (1.80)	-0.66 (1.83)	5.02 (2.94)	-2.45 (2.09)	1.88 (0.67)^*
Autonomy	-3.17 (1.91)	-0.99 (2.28)	0.47 (1.89)	1.91 (1.92)	2.26 (3.10)	5.96 (2.11)^*	1.48 (0.72)^*
School environment	-4.68 (2.28)^*	-3.00 (2.73)	0.75 (2.27)	5.54 (2.29)^*	2.79 (3.73)	-6.50 (2.58)^*	2.52 (0.85)^*
Social acceptance (bullying)	-1.78 (2.09)	-0.35 (2.48)	-1.52 (2.05)	1.42 (2.12)	1.17 (3.38)	-0.49 (2.39)	0.41 (0.80)
Financial resources	2.09 (2.07)	1.29 (2.45)	-1.49 (2.03)	-0.79 (2.08)	-3.53 (3.34)	-2.06 (2.37)	-0.55 (0.78)

HRQOL=health-related quality of life; β=unstandardized coefficients; SE=standard error.

All HRQOL variables were adjusted for age, girls, perceived economic status, academic achievement, having many friends, mothers' education levels, monthly household income, parents' employed status, parents' coverage status of health insurance, and parent-reported children's illness.

^*p<.05; ^†Composite scores indicate the sum of recommended levels of six health behaviors[16 17].

This article is based on a part of the first author's master's thesis from Korea University.

This study was supported by the Health Promotion Fund, Ministry of Health & Welfare, Republic of Korea(13-8).

1. The Organization for Economic Co-operation and Development. Doing better for families [Internet] Paris: The Organization for Economic Co-operation and Development; 2011;cited 2015 July 29. Available from: http://dx.doi.org/10.1787/9789264098732-en
2. Statistics Korea. 2013 economic and financial data for Korea [Internet] Seoul: Statistics Korea; 2013;cited 2015 July 3. Available from: http://kostat.go.kr/portal/korea/kor_nw/2/4/4/index.board?bmode=read&bSeq=&aSeq=310209&pageNo=1&rowNum=10&navCount=10&currPg=&sTarget=title&sTxt=
3. Kim HR, Lee SH, Choi JM, Oh YI. Report No.: 2011-07. Children's obesity and underweight among low income families in Korea: Status, implications and policy options. Sejong: Korea Institute for Health and Social Affairs; 2011. 07.
4. Craig LC, McNeill G, Macdiarmid JI, Masson LF, Holmes BA. Dietary patterns of school-age children in Scotland: Association with socioeconomic indicators, physical activity and obesity. Br J Nutr. 2010;103(3):319–334. Article
5. Drenowatz C, Eisenmann JC, Pfeiffer KA, Welk G, Heelan K, Gentile D, et al. Influence of socio-economic status on habitual physical activity and sedentary behavior in 8- to 11-year old children. BMC Public Health. 2010;10(1):214.Article PubMed PMC PDF
6. United States Department of Agriculture. Dietary guidelines for Americans 2010 [Internet] Washington, DC: United States Department of Health and Human Services; 2010;cited 2014 April 14. Available from: http://www.cnpp.usda.gov/dgas2010-policydocument.htm
7. Evans DR. Enhancing quality of life in the population at large. Soc Indic Res. 1994;33(1-3):47–88.Article PDF
8. The KIDSCREEN Group Europe. The KIDSCREEN Questionnaires-quality of life questionnaires for children and adolescents. Lengerich: Pabst Science Publishers; 2006. p. 231.
9. Mansour ME, Kotagal U, Rose B, Ho M, Brewer D, Roy-Chaudhury A, et al. Health-related quality of life in urban elementary schoolchildren. Pediatrics. 2003;111(6):1372–1381.Article PubMed PDF
10. Chen G, Ratcliffe J, Olds T, Magarey A, Jones M, Leslie E. BMI, health behaviors, and quality of life in children and adolescents: A school-based study. Pediatrics. 2014;133(4):e868–e874.Article PubMed PDF
11. Wu XY, Ohinmaa A, Veugelers PJ. Diet quality, physical activity, body weight and health-related quality of life among grade 5 students in Canada. Public Health Nutr. 2012;15(1):75–81.Article PubMed
12. Dalton WT 3rd, Schetzina KE, Pfortmiller DT, Slawson DL, Frye WS. Health behaviors and health-related quality of life among middle school children in Southern Appalachia: data from the winning with wellness project. J Pediatr Psychol. 2011;36(6):677–686.Article PubMed
13. Schlesinger S, Walter J, Hampe J, von Schonfels W, Hinz S, Kuchler T, et al. Lifestyle factors and health-related quality of life in colorectal cancer survivors. Cancer Causes Control. 2014;25(1):99–110.Article PubMed PDF
14. Choo J, Kim HJ, Yang HM, Kim S. Report No.: General 13-8. An obesity prevention framework for vulnerable children based on a methodology of community-based participatory research: Using a strategy of training community lay health advisors. Seoul: Korea Health Promotion Foundation; 2013. 11.
15. Ravens-Sieberer U, Gosch A, Rajmil L, Erhart M, Bruil J, Duer W, et al. KIDSCREEN-52 quality-of-life measure for children and adolescents. Expert Rev Pharmacoecon Outcomes Res. 2005;5(3):353–364.Article PubMed
16. Ministry of Health & Welfare. The Korean dietary guidelines for children [Internet] Sejong: Ministry of Health & Welfare; 2009;cited 2015 January 31. Available from: http://www.mw.go.kr/front_new/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=031603&CONT_SEQ=224044&page=1
17. Kvaavik E, Andersen LF, Klepp KI. The stability of soft drinks intake from adolescence to adult age and the association between long-term consumption of soft drinks and lifestyle factors and body weight. Public Health Nutr. 2005;8(2):149–157.Article PubMed
18. KIDSCREEN. Questionnaires [internet] Hamburg: Germany; 2011;cited 2014 December 23. Available from: http://www.kidscreen.org/
19. Lee BJ, Kwak GJ, Gu IH, Kim MH, Kim SS, Kim JH, et al. Report No.: 11-1351000-000228-01. A nationwide survey: The status of Korean children and adolescents. Seoul National University Report. Sejong: Ministry of Health & Welfare; 2009. 01.
20. Ministry of Education. Results of 2013 school health examination [Internet] Sejong: Ministry of Education; 2013;cited 2015 January 31. Available from: http://www.moe.go.kr/web/45859/ko/board/view.do?bbsId=294&boardSeq=52706
21. Dave JM, Evans AE, Pfeiffer KA, Watkins KW, Saunders RP. Correlates of availability and accessibility of fruits and vegetables in homes of low-income hispanic families. Health Educ Res. 2010;25(1):97–108.Article PubMed
22. Lee HY, Park YG, You SR, Jung SW, Ko JW. Report No.: 12-R09. Report of longitudinal analysis III: Socially disadvantaged children and adolescents. Sejong: National Youth Policy Institute; 2012. 12.
23. Morales PF, Sanchez-Lopez M, Moya-Martinez P, Garcia-Prieto JC, Martinez-Andres M, Garcia NL, et al. Health-related quality of life, obesity, and fitness in schoolchildren: The cuenca study. Qual Life Res. 2013;22(7):1515–1523.Article PubMed PDF
24. Young EM, Fors SW, Hayes DM. Associations between perceived parent behaviors and middle school student fruit and vegetable consumption. J Nutr Educ Behav. 2004;36(1):2–8.Article PubMed
25. Chen X, Sekine M, Hamanishi S, Wang H, Gaina A, Yamagami T, et al. Lifestyles and health-related quality of life in Japanese school children: A cross-sectional study. Prev Med. 2005;40(6):668–678.Article PubMed
26. June KJ, Kim JY, Park SM, Lee JY. Breakfast skipping and related factors in children in poverty. J Korean Acad Community Health Nurs. 2011;22(2):204–211.Article
27. World Health Organization. Global health risks [Internet] Geneva: World Health Organization; 2009;cited 2015 January 31. Available from:http://www.who.int/healthinfo/global_burden_disease/global_health_risks/en/
28. Mathers M, Canterford L, Olds T, Hesketh K, Ridley K, Wake M. Electronic media use and adolescent health and well-being: Cross-sectional community study. Acad Pediatr. 2009;9(5):307–314.Article PubMed
29. Syväoja HJ, Kantomaa MT, Ahonen T, Hakonen H, Kankaanpää A, Tammelin TH. Physical activity, sedentary behavior, and academic performance in Finnish children. Med Sci Sports Exerc. 2013;45(11):2098–2104.Article PubMed
30. Kwon YH, Kim CN. The relationship between computer game addiction and the impulsiveness, aggression, and emotional intelligence of elementary school students. J Korean Community Nurs. 2004;15(3):460–470.

Figure & Data

References

Citations

Citations to this article as recorded by

Effects of Multidisciplinary Health Promotion Program Among Children in Community Childcare Center
Yerin Kim, Gyeong Seob Shin, Jungwon Park, Minji Kang, Kumhee Son, Yoon Myung Kim, Kyung Hee Park, Hyunjung Lim
Clinical Nutrition Research.2024; 13(1): 8. CrossRef
Diet-Related Disparities and Childcare Food Environments for Vulnerable Children in South Korea: A Mixed-Methods Study
Jiyoung Park, Seolhyang Baek, Gahui Hwang, Chongwon Park, Sein Hwang
Nutrients.2023; 15(8): 1940. CrossRef
Development of Forest-based Health Promotion Program forVulnerable School Children
Kyung-Sook Bang, Sungjae Kim, Min Kyung Song, KyungIm Kang, Yeseul Jeong
Perspectives in Nursing Science.2020; 17(1): 1. CrossRef
Factors Affecting Health Behaviors in Late School-aged Children from Multicultural Families
Sangmi Lee
Child Health Nursing Research.2020; 26(1): 23. CrossRef
A Systematic Review of Interventions with Low-Income School-Age Children and Adolescents
Ji-hye Hwang, HyunJee Choi, Hyo Jin Jeong, Chorong Kim, YunJung Woo
Perspectives in Nursing Science.2018; 15(2): 92. CrossRef
The Differences in Obesity Rates According to Status of Co-Residence with Their Parents in Korean Adolescents: The Implication of the Gender of Single Parent Living with Adolescents
Nahee Kim, Young Gyu Cho, Jae-Heon Kang, Hyun Ah Park, Kyoungwoo Kim, Yang-Im Hur, Duho Kwon
Korean Journal of Health Promotion.2018; 18(4): 177. CrossRef
Ecological factors associated with behavioral problems in vulnerable children
Jina Choo, Hye‐Jin Kim, Melanie T. Turk, Eun‐Kyung Kim, Kyung‐Sook Yang
Japan Journal of Nursing Science.2017; 14(3): 205. CrossRef
Ecological predictors of health-related quality of life (HRQoL) among children from low-income families in South Korea
Jiyoung Park, Suyon Baek
Children and Youth Services Review.2017; 81: 238. CrossRef

PubReader
Cite

CITE

export Copy Format

Close

XML Download

Figure

We recommend

Related articles

Health Behaviors and Health-related Quality of Life among Vulnerable Children in a Community

Figure 1 Percentages of recommended vs. non-recommended health behaviors.

Figure 2 Distribution of the composite scores of health behaviors.

Figure 3 Levels of health-related quality of life as measured by KIDSCREEN-52.

Figure 1

Figure 2

Figure 3

Health Behaviors and Health-related Quality of Life among Vulnerable Children in a Community

Variables	Characteristics	Categories	N	n (%)	M±SD
Children's characteristics	Age (year)		165		9.8±1.26
	Girls		165	84 (50.9)
	Family type	Two parents family	165	107 (64.9)
		One parent family		56 (33.9)
		Grandparents family		2 (1.2)
	Perceived economic status	Very low	165	2 (1.2)
		Low		13 (7.9)
		Moderate		97 (58.8)
		High		45 (27.3)
		Very high		8 (4.8)
	Academic achievement	Very low	165	12 (7.3)
		Low		20 (12.1)
		Moderate		82 (49.7)
		High		41 (24.8)
		Very high		10 (6.1)
	Having many friends	Yes	165	132 (80.0)
	Having many friends	No	165	33 (20.0)
	Self-rated health	Poor	165	6 (3.6)
		Fair		12 (7.3)
		Good		88 (53.3)
		Very good		33 (20.0)
		Excellent		26 (15.8)
	Illness	Yes	152	42 (27.6)
	Illness	No	152	110 (72.4)
Parents' characteristics	Mothers' age (year)		140		41.3±5.46
	Mothers' education	Elementary school	140	7 (5.0)
		Middle school		12 (8.5)
		High school		89 (63.6)
		≥College		32 (22.9)
	Fathers' age (year)		144		43.7±5.86
	Fathers' education	Elementary school	146	3 (2.1)
		Middle school		19 (13.0)
		High school		91 (62.3)
		≥College		33 (22.6)
	Marital status	Married	148	85 (57.4)
		Separated		14 (9.5)
		Widowed		4 (2.7)
		Divorced		45 (30.4)
	Monthly household income (10,000 won)	≤100	152	35 (23.0)
		101~200		82 (53.9)
		201~300		21 (13.8)
		301~400		12 (7.9)
		401~500		2 (1.4)
		≥501		0 (0.0)
	Employed	Yes	151	112 (74.2)
	Employed	No	151	39 (25.8)
	Coverage of health insurance	Company health insurance	152	48 (31.6)
		Local health insurance		59 (38.8)
		Medical aid/none		45 (29.6)
	Religion	Yes	152	99 (65.1)
	Religion	No	152	53 (34.9)

Variables	Eating behaviors				Activity behaviors		Composite scores of health behaviors^†
	Fast food	Sweetened beverage	Fruits & vegetables	Breakfast	Sweated activity	Sedentary behavior	Composite scores of health behaviors^†
	β (SE)	β (SE)	β (SE)	β (SE)	β (SE)	β (SE)	β (SE)
Total	-2.82 (1.31)^*	-2.26 (1.57)	1.25 (1.30)	2.16 (1.35)	3.45 (2.13)	-4.35 (1.47)^*	1.72 (0.49)^*
Physical well-being	-0.48 (1.90)	-2.13 (2.25)	2.10 (1.86)	1.28 (1.93)	14.28 (2.80)^*	-2.77 (2.16)	1.78 (0.71)^*
Psychological well-being	-4.16 (2.07)^*	-3.98 (2.47)	2.51 (2.05)	4.76 (2.12)^*	4.14 (3.38)	-8.30 (2.29)^*	3.16 (0.76)^*
Moods & emotions	-2.19 (2.22)	-2.04 (2.63)	1.48 (2.18)	3.21 (2.25)	1.53 (3.59)	-0.61 (2.55)	1.29 (0.85)
Social support & peers	-2.03 (2.19)	0.17 (2.60)	2.70 (2.14)	2.83 (2.23)	5.17 (3.51)	-7.78 (2.41)^*	2.31 (0.82)^*
Parent relation & home life	-5.87 (1.91)^*	-4.92 (2.31)^*	4.85 (1.89)^*	2.07 (1.99)	1.67 (3.20)	-6.56 (2.19)^*	2.95 (0.70)^*
Self-perception	-5.93 (1.77)^*	-6.68 (2.10)^*	0.67 (1.80)	-0.66 (1.83)	5.02 (2.94)	-2.45 (2.09)	1.88 (0.67)^*
Autonomy	-3.17 (1.91)	-0.99 (2.28)	0.47 (1.89)	1.91 (1.92)	2.26 (3.10)	5.96 (2.11)^*	1.48 (0.72)^*
School environment	-4.68 (2.28)^*	-3.00 (2.73)	0.75 (2.27)	5.54 (2.29)^*	2.79 (3.73)	-6.50 (2.58)^*	2.52 (0.85)^*
Social acceptance (bullying)	-1.78 (2.09)	-0.35 (2.48)	-1.52 (2.05)	1.42 (2.12)	1.17 (3.38)	-0.49 (2.39)	0.41 (0.80)
Financial resources	2.09 (2.07)	1.29 (2.45)	-1.49 (2.03)	-0.79 (2.08)	-3.53 (3.34)	-2.06 (2.37)	-0.55 (0.78)

Table 1 Sociodemographic Characteristics among Vulnerable Children and their Parents (N=165)

Table 2 Associations between Health Behaviors and HRQOL among Vulnerable Children (N=165)

HRQOL=health-related quality of life; β=unstandardized coefficients; SE=standard error.

^*p<.05; ^†Composite scores indicate the sum of recommended levels of six health behaviors[1617].