A qualitative study of healthy eating, physical activity, and mental health among single mothers in Canada.

Single motherhood is associated with higher demands in home and family responsibilities that may exist in similar sized households with grandparents. These demands can compete with opportunities and resources for maintenance of healthy behaviours. This may have been exacerbated during the COVID-19 pandemic since supports outside the home may have been restricted by public health measures. A qualitative narrative study was conducted to explore these issues with 12 single mothers in Canada. Semi-structured interviews provided an in-depth understanding of the challenges and facilitators to maintaining healthy eating habits, physical activity levels, and mental health. Theory-driven content and structural analysis were applied through a descriptive thematic approach. Challenges to maintaining healthy eating behaviours included stay-at-home orders, limited budget, unhealthy food/cravings, and lack of motivation. In contrast, living with grandparents who provide help or having an understanding of healthy food were factors that facilitated engagement in healthy eating. Challenges to maintaining physical activity levels included lack of willpower, lack of time, and low energy. Whereas time on one's own, weighing scales or outdoor gear, and weather conditions promoted physical activity. Spirituality and gratitude were the main coping mechanisms used to deal with loneliness, unemployment, and depressive symptoms. Further research into the utility of gratitude as a coping mechanism could inform public health interventions that aim to increase levels of well-being among single mothers.

Infant Movement Motivation Questionnaire: development of a measure evaluating infant characteristics relating to motor development in the first year of life.

This paper highlights the development and testing of the Infant Movement Motivation Questionnaire (IMMQ), an instrument designed to evaluate qualities of infant characteristics that relate specifically to early motor development. The measurement development process included three phases: item generation, pilot testing and evaluation of acceptability and feasibility for parents and exploratory factor analysis. The resultant 27-item questionnaire is designed for completion by parents and contains four factors including Activity, Exploration, Motivation and Adaptability. Overall, the internal consistency of the IMMQ is 0.89 (Cronbach's alpha), with test-retest reliability measured at 0.92 (ICC, with 95% CI 0.83-0.96). Further work could be done to strengthen the individual factors; however it is adequate for use in its full form. The IMMQ can be used for clinical or research purposes, as well as an educational tool for parents.

Environmental opportunities questionnaire: development of a measure of the environment supporting early motor development in the first year of life.

PURPOSE: The development and testing of a measure evaluating the quality and variability in the home environment as it relates to the motor development of infants during the first year of life. METHODS: A sample of 112 boys and 95 girls with a mean age of 7.1 months (SD 1.8) and GA of 39.6 weeks (SD 1.5) participated in the study. The measurement development process was divided into three phases: measurement development (item generation or selection of items from existing measurement tools), pilot testing to determine acceptability and feasibility to parents, and exploratory factor analysis to organize items into meaningful concepts. Test-retest reliability and internal consistency were also determined. RESULTS: The environmental opportunities questionnaire (EOQ) is a feasible 21-item measure comprised of three factors including opportunities in the play space, sensory variety and parental encouragement. Overall, test-retest reliability was 0.92 (CI 0.84-0.96) and the internal consistency is 0.79. The EOQ emphasizes quality of the environment and access to equipment and toys that have the potential to facilitate early motor development. CONCLUSION: The preliminary analyses reported here suggest more work could be done on the EOQ to strengthen its use for research or clinical purposes; however, it is adequate for use in its current form. Implications for Rehabilitation New and feasible 21-item questionnaire that enables identification of malleable environmental factors that serve as potential points of intervention for children that are not developing typically. Therapeutic tool for use by therapists to inform and guide discussions with caregivers about potential influences of environmental, social and attitudinal factors in their child's early development.

Perceptions of vulnerability and variations in childrearing practices of parents of infants born preterm.

INTRODUCTION AND PURPOSE: To determine differences in Canadian, Norwegian, and Dutch parents' perceptions of vulnerability of their infants born preterm and their childrearing practices. METHODS: This observational study included 62 infants born preterm (46% boys) and their parents. Parents completed the Beliefs About My Baby Scale and the Daily Activities of Infants Scale when infants were between 4 and 11 months corrected age. One-way analyses of variance were conducted. RESULTS: Parents in the Netherlands perceived their infants as being more vulnerable than parents in the other countries (P < .001). The total Daily Activities of Infants Scale scores did not differ across countries. Parents who received therapy services had greater perceptions of their infants' vulnerability than parents not receiving services (P = .01). CONCLUSIONS: Prematurity stereotyping is not limited to North America. Service providers need to consider therapy for infants born preterm from a strength-based rather than disability perspective.

The prevalence, distribution, and effect of pain among adolescents with cerebral palsy.

PURPOSE: : To describe the prevalence, distribution, and intensity of pain and determine the relationship between pain intensity and effect on daily activities in adolescents with cerebral palsy. METHODS: : A sample of 104 girls and 126 boys, mean ages 14.7 (SD = 1.7) and 14.8 (SD = 1.7) years, were asked "Have you experienced physical pain in the past month?" RESULTS: : Sixty-four percent of girls and 50% of boys reported pain. Pain was most frequent in the feet and ankles, knees, and lower back of girls and boys at Gross Motor Function Classification System levels I to IV. Foot and ankle and knee pain were also frequent at level V. The Spearman rho value between intensity and effect on daily activities was 0.75 (p < 0.01) and 0.82 (p < 0.01) for girls and boys. CONCLUSIONS: : The high prevalence of pain and its effect on daily activities suggests a need for greater focus on health promotion.

Development of the Daily Activities of Infants Scale: a measure supporting early motor development.

We describe the development and preliminary psychometric testing of the Daily Activities of Infants Scale (DAIS), a parent-completed measure of opportunities parents provide infants for development of postural control and movement. First we obtained 1300 photographs of typical activities from 17 families with infants aged 4 to 11 months. Through consensus we established nine dimensions of activities, graded across three levels of opportunity for development. Pilot testing supported content validity of the DAIS. Subsequently, 50 parents of infants born preterm aged 4 to 11 months participated in psychometric testing. There were 25 male and 25 female infant participants with a mean gestational age of 29.4 weeks (SD 3.6) and a mean birthweight of 1266 grams (SD 635). We found that completion of the DAIS over 1 day was representative of data collected over 3 sequential days. Older infants obtained significantly higher DAIS scores than younger infants, providing preliminary evidence for discriminant validity. The DAIS scores demonstrated a part-correlation of 0.20 (p<0.01) with scores on the Alberta Infant Motor Scale obtained concurrently, providing some evidence for convergent validity. The intraclass correlation coefficients reflecting interrater reliability and test-retest reliability of the total DAIS score were 0.76 (95% confidence interval [CI] 0.60-0.86) and 0.77 (95% CI 0.60-0.87) respectively. The DAIS has sufficient reliability and validity for use in clinical practice and research.

A comparison of the International Classification of Functioning, Disability, and Health to the disability tax credit.

BACKGROUND: The Disability Tax Credit (DTC) Certification is an assessment tool used to provide Canadians with disability tax relief The International Classification of Functioning, Disability and Health (ICF) provides a universal framework for defining disability. PURPOSE: The purpose of this study was to evaluate the DTC and familiarize occupational therapists with the process of mapping measures to the ICF classification system. METHOD: Concepts within the DTC were identified and mapped to appropriate ICF codes (Cieza et al., 2005). RESULTS: The DTC was linked to 45 unique ICF codes (16 Body Functions, 19 Activities and Participation, and 8 Environmental Factors). IMPLICATIONS: The DTC encompasses various domains of the ICF; however, there is no consideration of Personal Factors, Body Structures, and key aspects of Activities and Participation. Refining the DTC to address these aspects will provide an opportunity for fair and just determinations for those who experience disability.