Factors associated with health service utilization in Ulaanbaatar, Mongolia: a population-based survey.

BACKGROUND: Understanding patterns of health service utilization can improve health care and increase use of health services. We examined patterns of health service utilization among residents of Ulaanbaatar, Mongolia. METHODS: A total of 500 adults were surveyed using paper-based questionnaires. The χ(2) test and multiple logistic regression were used to identify associations between factors. RESULTS: 44.1% of respondents had visited a physician during the previous 12 months. After controlling for determinants, the significant predictors of utilization of health service were attention to health examinations (OR = 3.6, CI: 1.93-6.76), being married (OR = 2.7, CI: 1.50-4.72), being satisfied with the overall cleanliness of the hospital (OR = 2.4, CI: 1.12-5.19), being a nonsmoker (OR = 2.2, CI: 1.21-3.98), having periodic physical examinations (OR = 2.2, CI: 1.25-3.71), not being a hospital patient during the previous 3 years (OR = 2.1, CI: 1.22-3.73), having proper documentation (OR = 1.9, CI: 1.10-3.43), having medical insurance (OR = 1.9, CI: 1.96-3.28), not wanting to receive information on food and nutrition (OR = 0.6, CI: 0.36-0.96), having more than 5 household members (OR = 0.5, CI: 0.50-0.85), low income (OR = 0.5, CI: 0.30-0.85), lack of concern for food and nutrition (OR = 0.5, CI: 0.28-0.84), self-medication during the past 12 months (OR = 0.4, CI: 0.24-0.69), and desire for treatment abroad (OR = 0.4, CI: 0.20-0.60). CONCLUSIONS: A number of health-related behaviors and sociodemographic factors were important predictors of health service utilization.

Implications of social competence among thirty-month-old toddlers: a theory of mind perspective.

BACKGROUND: The purpose of this study was to examine the relations between children's social competence and initial index of theory of mind at 30 months of age. METHODS: The participants of the study were 322 toddlers and parents/caregivers who were registered with the Japan Science and Technology Agency (JST) project. They completed a five-minute interaction session, which was coded using the Interaction Rating Scale (IRS) as an evidence-based practical index of children's social competence. In addition, the children were asked to complete a diverse-desire task as a ToM (theory of mind) index. RESULTS: The results showed that the ToM index was related to the total score and subscales of the IRS, such as Empathy and Emotional regulation. CONCLUSIONS: These findings show that the IRS score was related to ToM task performance at 30 months of age.

The trajectory patterns of parenting and the social competence of toddlers: a longitudinal perspective.

BACKGROUND: Many studies have suggested that the daily emotional interactions between a child and his/her caregiver play a significant role in his/her development. The purpose of this study was to determine whether the trajectory patterns of parenting patterns of caregivers raising toddlers affect the social competence of the toddlers. METHODS: The study participants were 246 dyads of 18-month-old children (baseline) and their caregivers, which was conducted as part of a Japan Science and Technology Agency (JST) project. We used the Interaction Rating Scale (IRS) to evaluate the children's social competence. We assessed the child rearing environments by analyzing the caregivers' responses to the Index of Child Care Environment (ICCE). RESULTS: Multiple logistic regression analysis showed that the children's total score on the IRS was significantly related to how frequently they sang songs together with their caregivers. Their score was also significantly related to how closely their caregiver worked with his/her partner in raising the child. These relationships did not change according to demographic information. CONCLUSIONS: The results confirm previous findings on the relationship between parenting patterns and children's social competence. In particular, the study shows that varied and continual parenting significantly affects a child's social competence.

Interaction Rating Scale (IRS) as an evidence-based practical index of children's social skills and parenting.

BACKGROUND: The purpose of this paper is to describe the features of the Interaction Rating Scale (IRS) as an evidence-based practical index of children's social skills and parenting. METHODS: The participants in our study, which was conducted as part of a Japan Science and Technology Agency (JST) project, were 370 dyads of children (aged 18, 30, and 42 month) and 81 dyads of 7-year-old children with their caregivers. The participants completed the five minute interaction session and were observed using the IRS. RESULTS: The results indicated that the IRS can measure children's social skill development and parenting with high validity. Along with the discriminate validity for pervasive development disorder (PDD), attention-deficit/hyperactivity disorder (ADHD), abuse and maltreatment, a high correlation with the SDQ (Strength and Difficulties Questionnaire), and high reliability, the IRS is effective in describing features of social skill development. CONCLUSIONS: The IRS provides further evidence of the fact that in order to study children's social skill development, it is important to evaluate various features of the caregiver-child interaction as a predictor of social skills.