Patterns of parent screen use, child screen time, and child socioemotional problems at 5 years

Background: Digital media screens have become an essential part of our family life. While most studies focus on children’s screen use, we know less about parental screen use patterns and how these affect children’s socio-emotional development.Method: 867 Canadian parents of 5-year old children from the TARGet Kids! Cohort (73.1% mothers, mean age=38.88±4.45 years) participated from 2014 to 2020. Parents reported parental and child time on TV and handheld devices and completed the Strengths and Difficulties Questionnaire (SDQ). Latent profile analysis (LPA) was used to identify groups of parents with similar patterns of screen use and link these profiles with child screen time and SDQ.Results: We identified six latent profiles of parent screen use: low users (P1, reference; n=323), more TV than handheld (P2; n=261), equal TV and handheld (P3; n=177), more handheld than TV (P4; n=57), high TV and handheld (P5; n=38) and extremely high TV and handheld (P6; n=11). P6 were more likely to be living in single parent households compared to P1 (estimate=-1.49(0.70), p=0.03). P2 (estimate=-0.67(0.32), p=0.04) and P4 (estimate=-1.42(0.40), p<0.001) were more likely to have lower household income compared to P1. P4 (χ2=12.32, p<0.001) and P5 (χ2=9.54, p=0.002) have higher total child screen time compared to P1. P6 (χ2=6.82, p=0.009) had higher total SDQ compared to P1.Discussion: Patterns of parent screen use were associated with child screen use and child socioemotional problems. The link between parental screen use profiles and child behaviours suggests a need for guidelines on parental screen time.

Sociodemographic characteristics determine download and use of a Corona contact tracing app in Germany—Results of the COSMO surveys

During the SARS-CoV-2 pandemic mobile health applications indicating risks emerging from close contacts to infected persons have a large potential to interrupt transmission chains by automating contact tracing. Since its dispatch in Germany in June 2020 the Corona Warn App has been downloaded on 25.7 Mio smartphones by February 2021. To understand barriers to download and user fidelity in different sociodemographic groups we analysed data from five consecutive cross-sectional waves of the COVID-19 Snapshot Monitoring survey from June to August 2020. Questions on the Corona Warn App included information on download, use, functionality, usability, and consequences of the app. Of the 4,960 participants (mean age 45.9 years, standard deviation 16.0, 50.4% female), 36.5% had downloaded the Corona Warn App. Adjusted analysis found that those who had downloaded the app were less likely to be female (Adjusted Odds Ratio for men 1.16 95% Confidence Interval [1.02;1.33]), less likely to be younger (Adjusted Odds Ratio for age 18 to 39 0.47 [0.32;0.59] Adjusted Odds Ratio for age 40 to 64 0.57 [0.46;0.69]), less likely to have a lower household income (AOR 0.55 [0.43;0.69]), and more likely to live in one of the Western federal states including Berlin (AOR 2.31 [1.90;2.82]). Willingness to disclose a positive test result and trust in data protection compliance of the Corona Warn App was significantly higher in older adults. Willingness to disclose also increased with higher educational degrees and income. This study supports the hypothesis of a digital divide that separates users and non-users of the Corona Warn App along a well-known health gap of education, income, and region.

Suicide ideation in Canada during the COVID-19 pandemic

Introduction Many Canadians report decreased mental health during the COVID-19 pandemic, and concerns have been raised about possible increases in suicide. This study investigates the pandemic’s potential impact on adults’ suicide ideation. Methods We compared self-reported suicide ideation in 2020 versus 2019 by analyzing data from the Survey on COVID-19 and Mental Health (11 September to 4 December 2020) and the 2019 Canadian Community Health Survey. Logistic regression was conducted to determine which populations were at higher risk of suicide ideation during the pandemic. Results The percentage of adults reporting suicide ideation since the pandemic began (2.44%) was not significantly different from the percentage reporting suicide ideation in the past 12 months in 2019 (2.73%). Significant differences in the prevalence of recent suicide ideation in 2020 versus 2019 also tended to be absent in the numerous sociodemographic groups we examined. Risk factors of reporting suicide ideation during the pandemic included being under 65 years, Canadian-born or a frontline worker; reporting pandemic-related income/job loss or loneliness/isolation; experiencing a lifetime highly stressful/traumatic event; and having lower household income and educational attainment. Conclusion Evidence of changes in suicide ideation due to the pandemic were generally not observed in this research. Continued surveillance of suicide and risk/protective factors is needed to inform suicide prevention efforts.

Vasectomy interest and awareness among patients and their partners in prenatal clinics in the United States

ObjectiveAlthough vasectomy is safer, more effective and less expensive than tubal ligation, rates of permanent contraception are consistently higher in women than in men. We sought to explore vasectomy interest and awareness in patients and their partners during prenatal visits, a time when contraceptive counselling is typically performed.MethodsAnonymous surveys were distributed between January and July 2019 to a cross-sectional, convenience sample of pregnant women and their partners, if available, presenting for outpatient prenatal care at two hospitals (one public, one private) serving different patient populations in Chicago, Illinois, USA. Survey questions gauged participant awareness and interest in vasectomies.ResultsSurveys were completed by 436 individuals (78% female, 24% male). Seventy percent of respondents indicated interest in vasectomy after achieving optimal family size, but most respondents had never discussed it with their healthcare provider. Factors associated with vasectomy interest included being partnered, having a lower household income, and knowing someone who has had a vasectomy. Almost 50% of respondents would be interested in obtaining information about vasectomies from their obstetrician or prenatal care provider.ConclusionsMany patients and their male partners in the prenatal clinic setting were interested in vasectomy as a method for permanent contraception, but most respondents had never received counselling. Since comprehensive prenatal care includes contraceptive planning, obstetric providers are uniquely positioned to educate individuals on vasectomy.

Optimization and Application of the Wine Neophobia Scale

Wine consumers’ willingness (wine neophilia) or reluctance (wine neophobia) to try new wines represent, respectively, an opportunity or barrier for product innovation and market development in the wine industry. Here, we first sought to validate and optimize the Wine Neophobia Scale (WNS) in a large sample of 1269 Canadian wine consumers. Both exploratory and confirmatory factor analyses showed that a seven-item scale was optimal. This modified WNS (mWNS) was then used to investigate demographic and behavioral correlates of wine neophobia. Using lower and upper quartile values, 316 neophiles and 326 neophobes were identified. Wine neophiles and neophobes did not differ with respect to gender or age; however, neophobes had lower household income, education, and wine involvement, and reported consuming fewer wine styles than neophiles. Interestingly, while neophiles drank wine considerably more frequently than neophobes—a finding that is mediated by wine involvement—total annual wine intake did not differ between the groups. Importantly, the price typically paid per bottle of wine also varied with wine neophobia. We recommend adoption of the modified mWNS as a useful tool for more fully understanding the drivers of wine behavior and providing guidance to wine marketers.

Association of Mercury Exposure and Maternal Sociodemographics on Birth Outcomes of Indigenous and Tribal Women in Suriname

Information regarding adverse birth outcomes (ABO) of Indigenous and Tribal women living in the remote tropical rainforest of Suriname, where mercury (Hg) use is abundant in artisanal gold mining, is not available. In the context of a health system analysis, we examined the association between Hg exposure, maternal sociodemographics on the ABO of Indigenous and Tribal women living in Suriname’s interior and its capital, Paramaribo. ABO were determined in pregnant women enrolled from December 2016 to July 2019 in the Caribbean Consortium for Environmental and Occupational Health prospective environmental epidemiologic cohort study. Associations were explored using Pearson’s χ2-test and the Mann–Whitney U-test. Among 351 singleton participants, 32% were Indigenous, residing mainly in the interior (86.8%), and 23.1% had ABO. Indigenous participants had higher rates of ABO (29.8% vs. 19.8%) and preterm birth (PTB) (21.2% vs. 12.4%), higher Hg levels, delivered at a younger age, were less educated, and had lower household income compared to Tribal participants. Multivariate logistic regression models revealed that Indigenous participants had higher odds of ABO (OR = 3.60; 95% CI 1.70–7.63) and PTB (OR = 3.43; 95% CI 1.48–7.96) compared with Tribal participants, independent of Hg exposure and age at delivery. These results highlight the importance of effective risk reduction measures in support of Indigenous mothers, families, and communities.

Exposure to Second-Hand Smoke in Public Places and Barriers to the Implementation of Smoke-Free Regulations in The Gambia: A Population-Based Survey

Introduction: Second-hand smoke is associated with more than 1.2 million deaths per year among non-smokers. Smoking in public places is prohibited in The Gambia but there is no information on the level of exposure to second-hand smoke among adolescents and adults 15–64 years. The aim of this study was to assess the level and predictors of exposure to second-hand smoke in public places and compliance with smoke-free regulations in The Gambia. Methods: A population-based survey was conducted in an established Health and Demographic Surveillance System (HDSS). A total of 4547 participants (15–64 years) from households within the Farafenni HDSS were interviewed at their homes but only 3343 were included in our analysis. Factors associated with exposure to second-hand smoke in public places were assessed by three different multivariable regression models. Results: Exposure to tobacco smoke in public places was high (66.1%), and higher in men (79.9%) than women (58.7%). Besides being male, less education, lower household income, urban residence and not aware of smoke-free regulations were strongly associated with exposure to second-hand smoke. Conclusion: Despite existing smoke-free regulations, reported exposure to second-hand smoke remains high in public places in The Gambia. The Ministry of Health should continue to strengthen their advocacy and sensitization programs to ensure smoke-free regulations are fully implemented. Some population subgroups are at a higher risk of exposure and could be targeted by interventions; and settings where these subgroups are exposed should be targeted by enforcement efforts.

Changes in Consumption of Foods and Beverages With Added Sugars During the COVID-19 Pandemic Among US Adults

Objectives To examine changes in intake of foods and beverages with added sugars during the COVID-19 pandemic among US adults to understand groups at risk for decreasing dietary quality. Methods We used SummerStyles data collected in June 2020 (3,916 US adults, ≥18 y). The outcome was the reported frequency of 1) consuming more unhealthy snacks and desserts including chips, cookies, and ice cream and 2) drinking more sugary drinks like regular soda, fruit drinks, sports/energy drinks, sweetened coffee/teas during the COVID-19 pandemic. Responses were categorized as Never/Rarely, Sometimes, or Often/Always. Exposure variables were sociodemographics, currently having children (<18 y), weight status, and Census regions. Multinomial regressions were used to estimate adjusted odds ratios (OR) for Sometimes or Often/Always consuming more unhealthy snacks/desserts (vs. Never/Rarely); and Sometimes or Often/Always more sugary drinks (vs. Never/Rarely). Results 36% of adults reported Sometimes consuming more unhealthy snacks/desserts; 16% did so Often/Always. 22% of adults reported Sometimes drinking more sugary drinks; 10% did so Often/Always. Factors significantly associated with higher odds of reporting Often/Always consuming more unhealthy snacks/desserts were younger adults (OR range = 1.51–2.86 vs. adults ≥65 y), females (OR = 1.58), non-Hispanic (NH) Black (OR = 1.89 vs. NH White), lower household income (OR = 2.01 for < $35K vs. ≥$100K), and obesity (OR = 1.56 vs. underweight/healthy weight). Factors significantly associated with odds of Often/Always drinking more sugary drinks were being younger (OR range = 2.26–4.39 vs. adults ≥65 y), NH Black (OR = 3.25), Hispanic (OR = 1.75), NH other (OR = 2.41 vs. NH White), lower education (OR = 2.03 for ≤high school; OR = 1.80 for some college vs. college graduate), lower household income (OR range = 1.64–3.15 vs. ≥$100k), and obesity (OR = 1.61 vs. underweight/healthy weight). Conclusions Consuming more foods and beverages with added sugars during the pandemic was higher in younger adults, racial/ethnic minority groups, lower-income adults, and adults with obesity. Dietary changes such as these may impact metabolic health if continued long-term. Implementing strategies to ensure these dietary changes are not permanent may benefit future health. Funding Sources Solely for author's time from their institutions.

713 Sleep of infants and toddlers during 12 months of the COVID-19 pandemic

Introduction SARS-CoV-2 changed the lives of children and their parents in 2020. To our knowledge, no studies have examined infant and toddler sleep during this pandemic. We sought to compare parent-reported sleep characteristics of infants and toddlers over successive quarters of the past year. Methods Parents of children aged 0–36 months were surveyed primarily in the Midwestern USA between 01/17/2020 and 12/07/2020. Each parent responded only once. Age was categorized as: <6 months, 6–12 months, 12–24 months, and 24–36 months. Income was categorized as: <$50,000, $50-100,000, $100-150,000, and >$150,000. The year was divided into quarters. Multivariable linear regression included Total Sleep Time (TST), Sleep Onset Latency (SOL) and parental frustration with sleep (any frustration, scale of 1–5) as dependent variables and year quarter, child’s age, prematurity, child’s comorbidities, maternal age (during their child’s birth), parenting experience, household income, and room sharing as independent variables. Logistic regression included nap consistency (napping at the same time daily) as the dependent variable, and year quarter, child’s age, prematurity, comorbidity, maternal age, parenting experience, household income, and room sharing as independent variables. Results Of 594 children, mean age was 18.5±9.7 months and 52% were female. Prematurity and comorbidities were reported for 8% and 15%, respectively. Mean maternal age was 31.8±4.5 years. Neither TST (β=-0.488; p= 0.16) nor SOL (β= 0.029; p=0.23) were associated with year quarter. SOL was 3 minutes less for each increase in income category (β =-0.051; p= 0.003). TST (β = -0.994; p<0.001) and SOL (β =0.092; p<0.0001) were most associated with child’s age. Parental frustration was associated with child’s age (β=0.12; p= 0.04), comorbidity (β=0.30; p=0.05) and room sharing (β= -0.38; p=0.006), but not year quarter. Nap consistency was associated with increased child age category (OR 1.47; 95% CI 1.13, 1.94) and lack of room sharing (OR=2.09; 1.10, 3.97), but not year quarter. Conclusion Parent-estimated TST, nap consistency and sleep-related frustration did not differ significantly over the first 12 months of the pandemic. Yet, our results underscore that special attention should be given to the sleep of infants and toddlers with comorbidities, who share a room, and who have a lower household income. Support (if any) 2T32HL110952-06

Income-related inequalities in informal care: Evidence from the Longitudinal Healthy Longevity Survey in China

Objectives This report seeks to examine income-related inequalities in informal care among older people with functional limitations in China. Methods Data are drawn from the 2005, 2008, 2011 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Erreygers Concentration Index, Concentration Index, and Horizontal Inequity Index are used to examine inequalities in informal care. Random effects model is then used to investigate the relationship between household income and informal care. Results There is no significant association between household income and the probability of receiving informal care. However, we observe a significantly positive association between household income and hours of informal care received, indicating that those with higher household income receive more hours of informal care compared to those with lower household income. The degree of this inequality increases as number of functional limitations increases. Discussion Lower household income is associated with lower intensity of informal care received, particularly for older people with more functional limitations. Policies are required to support low-income older people with more functional limitations.