Mental health profiles and academic achievement in Australian school students.

This study explored mental health profiles in Australian school students using indicators of well-being (i.e., optimism, life satisfaction, and happiness) and psychological distress (i.e., sadness and worries). The sample included 75,757 students (ages 8-18 years) who completed the 2019 South Australian Wellbeing and Engagement Collection. Latent profile analysis identified five mental health profiles consisting of (a) complete mental health (23%), (b) good mental health (33%), (c) moderate mental health (27%), (d) symptomatic but content (9%), and (e) troubled (8%). Findings provide partial support for the dual-factor model of mental health. Distal outcomes analysis on a sub-set of students (n = 24,466) found students with a symptomatic but content, moderate mental health, or troubled profile had poorer academic achievement than students with complete mental health. Implications for schools and education systems are discussed, including the need to pair clinical supports for students with psychological distress with population-level preventative health approaches to build psychological well-being.

Prevalence of breakfast skipping among children and adolescents: a cross-sectional population level study.

BACKGROUND: Interventions to promote breakfast consumption are a popular strategy to address early life inequalities. It is important to understand the epidemiology of children and adolescents who skip breakfast so that interventions and policy can be appropriately considered. This study investigated the prevalence of breakfast skipping among a contemporary, population-wide sample of children and adolescents in Australia. METHODS: Participants were grade 4-12 students (n = 71,390, 8-18 years) in South Australian government (public) schools who took part in the 2019 Wellbeing and Engagement Collection. The prevalence of breakfast skipping (never, sometimes, often, or always) was calculated for the overall sample and stratified by gender, school grade, socioeconomic status and geographical remoteness. Multinomial logistic regression analyses were conducted to determine the relative risk ratio of sometimes, often, and always skippers compared with never skippers, according to demographic characteristics. RESULTS: Overall, 55.0% of students reported never skipping breakfast, 17.4% reported sometimes skipping, 18.0% reported often skipping, and 9.5% reported always skipping breakfast. Skipping breakfast was more prevalent among females, students in senior grades, and those living in socioeconomically disadvantaged and regional and remote areas. Analyses disaggregated by gender revealed that grade level gradients in breakfast skipping were more marked among females compared to males. CONCLUSIONS: Breakfast skipping among children and adolescents appears considerably more prevalent than previous research suggests. Drivers of breakfast skipping across population sub-groups need to be explored to better inform strategies to promote breakfast consumption.

Prevalence of electronic device use before bed among Australian children and adolescents: a cross-sectional population level study.

OBJECTIVE: To understand the prevalence of children and adolescents' electronic device use (EDU) in the hour before bed and identify sociodemographic groups that are at increased risk of problematic use. METHOD: A contemporary population wide sample of South Australian school students aged 8-18 years (n = 70,936) was utilised to present descriptive statistics of EDU before bed across sociodemographic groups. Data was collected from the 2019 Wellbeing and Engagement Collection, an annual self-report census of students' health, wellbeing and school engagement. RESULTS: 90% of children used an electronic device in the hour before bed at least one night a week, with 51% using a device every night. Older adolescent females in grades 10-12 were most frequent users and children from the most socioeconomically disadvantaged communities were also more likely to use electronic devices in the hour before bed. CONCLUSION: EDU before bed is highly prevalent among Australian children and adolescents and given the negative health and educational impacts, it requires immediate and widespread action from policy makers to ensure the health of Australia's next generation. IMPLICATIONS FOR PUBLIC HEALTH: The scale of the problem has now been identified; next steps rely on a public health approach to address this issue. This might include awareness raising campaigns and targeted interventions towards at-risk groups.

Breakfast skipping and cognitive and emotional engagement at school: a cross-sectional population-level study.

OBJECTIVE: Research on the consequences of breakfast skipping among students tends to focus on academic outcomes, rather than student well-being or engagement at school. This study investigated the association between breakfast skipping and cognitive and emotional aspects of school engagement. DESIGN: Cross-sectional study using data from a population-level survey of children and adolescents' well-being and engagement at school. Linear regression with adjustment for confounders was used to estimate the effect of breakfast skipping on school engagement. SETTING: Government schools (i.e. public schools) in South Australia. PARTICIPANTS: The participants were students, Grades 4-12, who completed the Wellbeing and Engagement Collection in 2019. The analysis sample included 61 825 students. RESULTS: Approximately 9·6 % of students reported always skipping breakfast, with 35·4 % sometimes skipping and 55·0 % never skipping. In the adjusted linear regression models, children and adolescents who always skipped breakfast reported lower levels of cognitive engagement (ß = -0·26 (95 % CI -0·29, -0·25)), engagement with teachers (ß = -0·17 (95 % CI -0·18, -0·15)) and school climate (ß = -0·17 (95 % CI -0·19, -0·15)) compared with those who never skipped breakfast, after controlling for age, gender, health, sleep, sadness and worries, parental education, socio-economic status and geographical remoteness. CONCLUSION: Consistent with our hypothesis, skipping breakfast was associated with lower cognitive and emotional engagement, which could be due to mechanisms such as short-term energy supply and long-term health impacts. Therefore, decreasing the prevalence of breakfast skipping could have a positive impact on school engagement.

Basic epidemiology of wellbeing among children and adolescents: A cross-sectional population level study.

Wellbeing and mental health are fundamental rights of children and adolescents essential for sustainable development. Understanding the epidemiology of child and adolescent wellbeing is essential to informing population health approaches to improving wellbeing and preventing mental illness. The present study estimated the prevalence of wellbeing and how wellbeing indicators were distributed across social and economic groups. This study used data from the 2019 Wellbeing and Engagement Collection; an annual census conducted in South Australian schools that measures self-reported wellbeing in students aged 8-18 years (n = 75,966). We estimated the prevalence (n, %) of low, medium and high wellbeing across five outcomes: life satisfaction, optimism, sadness, worries and happiness, overall and stratified by gender, age, language background, socio-economic position and geographical remoteness. The prevalence of low wellbeing on each indicator was: happiness 13%, optimism 16%, life satisfaction 22%, sadness 16% and worries 25%. The prevalence of low wellbeing increased with age, particularly for females. For example, 22.5% of females aged 8-10 years had high levels of worries compared to 43.6% of 15 to 18-year old females. Socioeconomic inequality in wellbeing was evident on all indicators, with 19.5% of children in the most disadvantaged communities having high levels of sadness compared to 12.5% of children in the most advantaged communities. Many children and adolescents experience low wellbeing on one or more indicators (40.7%). The scale of this problem warrants a population-level preventative health response, in addition to a clinical, individual-level responses to acute mental health needs. Universal school-based programs that support social and emotional wellbeing have a role to play in this response but need to be supported by universal and targeted responses from outside of the education system.

Measuring early child development in low and middle income countries: Investigating the validity of the early Human Capability Index.

Inclusion of early child development in the United Nations Sustainable Development Agenda raises issues of how this goal should be monitored, particularly in low resource settings. The aim of this paper was to explore the validity of the early Human Capability Index (eHCI); a population measure designed to capture the holistic development of children aged 3-5 years. Convergent, divergent, discriminant and concurrent validity were examined by exploring the associations between eHCI domains and child (sex, age, stunting status, preschool attendance) and family (maternal education, home learning environment) characteristics. Analyses were repeated using data from seven low and middle income countries: Brazil (n = 1810), China (n = 11421), Kiribati (n = 8339), Lao PDR (n = 7493), Samoa (n = 12191), Tonga (n = 6214), and Tuvalu (n = 549). Correlations and linear regressions provide evidence that within these country samples, the tool is capturing the aspects of early child development that it was designed to measure. Although the tool was intended to measure development of children aged 3-5 years, results suggest it can be validly applied to children aged 2-6 years. The eHCI is free, requires minimal implementation resources, captures development across domains and abilities, and is designed to allow cultural and contextual concepts to be included. The eHCI appears psychometrically robust in diverse country contexts and could enable evaluation of early years policies and programs, as well as monitoring of children's development to track progress towards the Sustainable Development Agenda.

Measuring early childhood development in multiple contexts: the internal factor structure and reliability of the early Human Capability Index in seven low and middle income countries.

BACKGROUND: The fourth year of the Sustainable Development Agenda era calls for countries to continue to invest not only in interventions and policies that will promote global equity and sustainability, but also in the monitoring systems required to track progress against these targets. A more pragmatic solution to measuring children's early development in low and middle income countries in particular, is required. This study explores the psychometric properties of the early Human Capability Index (eHCI), a population measure of holistic development for children aged 3-5 years, designed with the vision of being flexible and feasible for use in low resource and capacity settings. METHODS: Utilizing data from seven low and middle income countries: Brazil (n = 1810), China (n = 11,421), Kiribati (n = 8339), Lao People's Democratic Republic (n = 7493), Samoa (n = 12,191), Tonga (n = 6214), and Tuvalu (n = 549), analyses explored the internal factor structure and reliability of scores produced by the tool within each country. RESULTS: Confirmatory factor analyses and internal consistency coefficients demonstrated that after local adaptation, translation, and different implementation methods across countries, the eHCI maintained the same factor structure of nine theoretically-based developmental domains: Physical Health, Verbal Communication, Cultural Knowledge, Social and Emotional Skills, Perseverance, Approaches to Learning, Numeracy, Reading, and Writing. CONCLUSIONS: Findings support the aims of the eHCI in being adaptable and applicable for use within a range of low and middle income countries to facilitate measurement and monitoring of children's early development, as is required for the tracking of progress towards the Sustainable Development Agenda.