Variation in the association between socioeconomic status and breastfeeding practices by immigration status in Taiwan: a population based birth cohort study.

BACKGROUND: The relationship between socioeconomic status (SES) and breastfeeding has been extensively discussed in the literature. However, there is some evidence that this relationship can differ with immigration status. To date the majority of research investigating the relationships among SES, breastfeeding and immigration status has been conducted in Europe and the United States with a lack of similar research from Asia. Therefore, the aim of this study was to describe differences in breastfeeding practices between native-born Taiwanese mothers and immigrant mothers in Taiwan and to investigate any differences in the relationship between SES and breastfeeding practices by immigration status. METHODS: Data analyzed came from the Taiwan Birth Cohort Study, the first longitudinal study of babies in Taiwan with a nationally representative sample born in 2005. In the present study, we included 21,217 mothers or primary caregivers who completed interview surveys when their child was 6 months old. Socioeconomic status was measured by the education level of mothers and fathers, and the couple's monthly income. Data analysis involved multiple logistic regression. Control variables included residential area, mother's employment status, age of the father and mother, and sex of the infant. RESULTS: The proportion of immigrant mothers predominantly breastfeeding for 4 and for 6 months (Mainland Chinese mothers: 18.25 %, 36.29 %; Southeast Asian mothers: 10.71 %, 24.85 %) was significantly higher than that observed in their Taiwan-born counterparts (7.03 %, 16.22 %). Analysis stratified by immigration status showed that a higher level of parental education was associated with a greater likelihood of predominantly breastfeeding in Taiwanese mothers. However, no statistically significant relationship was observed between education and predominantly breastfeeding in immigrant mothers. Higher monthly income was also significantly associated with a greater likelihood of predominantly breastfeeding in Taiwanese mothers. However, there was no significant linear relationship between monthly income and predominantly breastfeeding in immigrant women. CONCLUSION: The relationship between SES and breastfeeding is different in immigrant mothers and native-born Taiwanese mothers. Taiwanese policy should continue to encourage breastfeeding in immigrant mothers. However, greater attention should be placed on Taiwanese mothers from a low SES background.

Mental health of parents having children with physical disabilities.

BACKGROUND: Parents of children with disabilities play an essential role in the successful rehabilitation of their children. However, the high level of care required may affect the mental health of the parents and consequently contribute to an unfavorable rehabilitation outcome in their children. The aims of this study are to investigate the mental health of parents of children with physical disabilities and to elucidate the factors affecting parental mental health. METHOD: This was a cross-sectional study. Ninety-one parents of children with physical disabilities who visited the outpatient rehabilitation clinics of a tertiary hospital were invited to join the study. Data from the parents and children were recorded during face-to-face interviews. Parental- perceived stress was assessed using the simplified Parenting Stress Index (PSI/SF). Parental mental health was evaluated as the main outcome measure using the 12-item version of the Chinese Health Questionnaire (CHQ-12). RESULTS: Forty parents (44%) were categorized as psychiatric cases on the CHQ. Child-related factors that negatively affected parental mental health were poor walking ability (p < 0.05), dependency on others to perform activities of daily life (ADL) (p < 0.01), and younger age (p < 0.05). Parent-related factors that negatively affected parental mental health were low income (p < 0.05), no religious beliefs (p < 0.01), high level of parental distress (p < 0.01), parent-child dysfunctional interaction (p < 0.01), and having difficult child (p < 0.05). The most significant predictor of overall parental mental health in multivariate analysis was found to be parental distress. CONCLUSIONS: Parents of children with physical disabilities were at risk of poor mental health. Perceived parental distress is the most important factor affecting parental mental health. Strategies to reduce parental stress should be developed to prevent deterioration of parental mental health.

Regional survey of assistive devices use by children with physical disabilities in southern Taiwan.

BACKGROUND: Despite increasing use of assistive devices (ADs) by physically disabled (PD) children, the use rate, number, effects and related services have seldom been studied. Understanding AD utilization is helpful in improving the related services. This study describes the usage of ADs by children with physical disabilities (PDs). METHODS: This regional survey enrolled children with PDs. The children's parents or primary caregivers filled out structured questionnaires regarding the children's use of and need for ADs, the benefits and problems associated with the ADs and related services. RESULTS: In total, 224 ADs were used by 124 children (1.79 ADs per child). The most commonly used ADs were orthoses (n = 77, 62.10%), mobility aids (n = 51, 41.13%), and aids for therapy and training (n = 21, 16.94%). The degree of disability, age, gender, diagnosis and rehabilitation training location were not associated with the number of ADs used. Most children (n = 103, 83.06%) benefited from ADs, and 93 (75%) children had been evaluated prior to buying ADs. Eighty three (66.94%) parents paid for the Ads, and 108 (87.10%) parents acquired information from rehabilitation professionals. Forty one (40.20%) parents were satisfied with the services of local suppliers; 119 (95.97%) parents had applied to their local government for financial support; 82 (68.91%) parents were not satisfied with the application procedures or the amount of support they received. CONCLUSION: Although parents of PD children favored the usage of ADs, they needed additional information. We suggest that policies and strategies are needed to reduce barriers to ADs utilization, enhance insurance coverage and improve ease of using the services.

Aggregation of health behaviors among fourth graders in northern Taiwan.

PURPOSE: To investigate the aggregation of health behaviors among fourth graders in northern Taiwan. METHODS: This study conducted an analysis of data collected from the 2001 Child and Adolescent Behaviors in Long-term Evolution (CABLE) project, which included a sample of 2075 fourth grade students. Factor analysis and cluster analysis were used to investigate the aggregation patterns. RESULTS: After factor analysis, we found that the 18 health behaviors could be grouped under five factors. These five factors were named: healthy behavior, rule-breaking behavior, substance use behavior, violent behavior, and pleasure-seeking behavior, according to the characteristics of the various health behaviors grouped under each of them. Each study subject was assigned points for each of these five factors and then cluster analysis was used to divide the subjects into four different clusters. The names of these clusters and the percentage of subjects within them were as follows: healthy group (43.47%), violent group (29.11%), pleasure-seeking group (22.55%), and rebellious group (4.87%). CONCLUSIONS: A total of 56.53% of the study sample were grouped under unhealthy groups (violent group, pleasure-seeking group and rebellious group), which indicates that already more than half of the students had lifestyles that put their health at risk. It was suggested that health and educational organizations need to place importance on behavioral problems in children and adopt early prevention measures.