Preschool children's physical activity in the home, childcare and neighbourhood environment: A latent profile analysis using device-based measures.

Based on the socioecological conceptual model, the physical environment within the home, childcare and neighbourhood domains are key factors that influence preschool children's physical activity; however, the relative importance of each of these domains for preschool children's physical activity is unclear. We explored the physical environment characteristics within three latent profiles of 115 preschool children aged 2-5 years based on where they accumulated moderate-to-vigorous physical activity (MVPA) across five GPS-derived environmental domains. The three profiles were "Active at home" (n = 41), "Active except close to home" (n = 61), and "Active except in local neighbourhood" (n = 13). Compared to other profiles, "Active at home" had fewer parks and playgrounds within their 500-1600 m neighbourhood. Findings suggest preschool children's MVPA profiles are reflections of their physical environmental opportunities.

Home environment factors associated with child BMI changes during COVID-19 pandemic.

BACKGROUND: The influence of home obesogenic environments, as assessed by the validated Family Nutrition and Physical Activity (FNPA) tool, and child obesity during the COVID pandemic were evaluated using electronic health records in this retrospective cohort study. METHODS: Historical data on BMI and the FNPA screening tool were obtained from annual well-child visits within the Geisinger Health System. The study examined youth ages 2-17 that had a BMI record and an FNPA assessment prior to the pandemic (BMI 3/1/19-2/29/20), 1 BMI record 3 months into the pandemic (6/1/20-12/31/20) and 1 BMI in the second year of the pandemic (1/1/21-12/31/21). Tertiles of obesity risk by FNPA score were examined. Mixed-effects linear regression was used to examine change in BMI slope (kg/m2 per month) pre-pandemic to pandemic using FNPA summary and subscales scores as predictors and adjusting for confounding factors. RESULTS: The analyses included 6,746 children (males: 51.7%, non-Hispanic white: 86.6%, overweight:14.8%, obesity:10.3%, severe obesity: 3.9%; mean(SD) age: 5.7(2.8) years). The rate of BMI change in BMI was greatest from early pandemic compared to pre-pandemic for children in lowest versus highest tertiles of FNPA summary score (0.079 vs. 0.044 kg/m2), FNPA-Eating (0.068 vs. 0.049 kg/m2), and FNPA-Activity (0.078 vs. 0.052 kg/m2). FNPA summary score was significantly associated with change in BMI from the pre-pandemic to early pandemic period (p = 0.014), but not associated with change in BMI during the later pandemic period. CONCLUSIONS: This study provides additional insight into the changes in the rate of BMI change observed among children and adolescents in the United States during the COVID-19 pandemic. The FNPA provides ample opportunity to continue our exploration of the negative impact of the COVID-19 pandemic on the longitudinal growth patterns among children and adolescents.

Associations between eating alone, its transition and depressive symptoms among Chinese middle-aged and older adults: evidence from two national cohorts.

BACKGROUND: Few studies have explored the longitudinal association between eating alone and depressive symptoms, and have focused on the effect of eating alone transition. This study aims to explore the longitudinal association between eating alone, its transition and depressive symptoms among two national surveys using a cohort study design. METHODS: The participants aged ≥ 45 years were recruited for the 2016 to 2018 waves China Family Panel Data (CFPS) and 2015 to 2018 waves China Health and Retirement Longitudinal Study (CHARLS). Eating alone was assessed by self-reported. Depressive symptoms were evaluated by Center for Epidemiologic Studies Depression Scale. Cox hazard regression was used to explore the associations between eating alone, its transition and depressive symptoms after adjusting for covariates. RESULTS: A total of 21,476 participants were included in this study. The Cox model showed that compared with commensality, eating alone was associated with a higher risk of depressive symptoms, both in the CFPS, CHARLS and pooled analysis. In addition, compared with commensality consistently, the transition from commensality to alone and eating alone consistently were associated with a higher risk of depressive symptoms. The sensitivity analyses showed that the association remained robust. CONCLUSIONS: Eating alone and a change from commensality to eating alone were associated with higher risks of depressive symptoms among Chinese middle-aged and older adults in two cohorts. This study suggested that providing eating partners may be an effective intervention method to prevent depressive symptoms in middle-aged and older adults.

Improving home-like environments in long-term care units: an exploratory mixed-method study.

Although the number of older adults requiring care is rapidly increasing, nursing homes have long faced issues such as the absence of a home-like environment. This exploratory mixed-method study investigated how residents (n = 15) in a long-term care unit in South Korea perceive home-like features and privacy in their living spaces. The results indicated that most participants were satisfied with the homeliness and privacy of their environment, but some were unhappy with the level of privacy. Most participants had low scores on the Geriatric Depression Scale and the Pittsburgh Sleep Quality Index, indicating low levels of depression and sleep disorders. Sleep quality was affected by factors such as sensory environment, staff visits, and room temperature. Although participants appreciated social support and private rooms, they expressed a desire for larger rooms. Overall, this study provides preliminary insights into older adults' views on their living spaces in long-term care with implications for improving their quality of life.

Home Through Their Eyes: A Qualitative Exploration of the Meaning of Home for Persons With Dementia and Impact of Physical Environment During Meaning-Making.

OBJECTIVES: This study aimed to examine the meaning of home for persons with dementia and the role of the physical environment during their meaning-making process. In response to a growing number of persons with dementia, there has been a strong advocacy for prioritizing the development of dementia-friendly environments within design practice and research agendas, for which "home" has become one of the important loci. However, of the limited studies on the meaning of home from the perspective of those individuals who continue to live in their own homes after developing dementia, even fewer addressed this issue within the Chinese context. METHODS: Five dyads, persons with dementia and their family caregivers, participated in the qualitative phenomenology study. Ten home visits-2 visits per dyad-were conducted, during which interview data, photographs, and field notes were collected. Phenomenological analysis was applied within and across the data sets. RESULTS: Three key themes emerged-"Three Dimensions of Home" revealed that "home" goes beyond physical residence and immediate family connections, including meaningful objects and places, enduring relationships, self-identity, and lived experiences.; "The Impact of Physical Environment" and "The Impact of Cognitive Impairment" showed the complex interactions between the environment, cognitive impairment, and meaning-making. DISCUSSION: An exploration of the essence of meaning of home within the Chinese context, in person-environment relationships with dementia progression, and implications for future research and practice on dementia-related environments and care were further discussed. This study contributes insights into enhancing the well-being of persons with dementia and benefiting their caregivers.

Autistic traits and eating behaviors in Chinese preschoolers: Role of sensory profiles and home environment.

OBJECTIVE: This study aims to 1) explore the association between autistic traits and eating behaviors in Chinese preschoolers; 2) explore the mediating role of sensory processing patterns on the relation of autistic traits and eating-related behaviors; and 3) examine home nurturing environment as a moderator between autistic traits and eating-related behaviors. We hypothesize that there is a significant association between autistic traits and eating behaviors, which is mediated by sensory processing patterns and moderated by the home nurturing environment. METHOD: 509 children aged 3-4 years participated in this cross-sectional research. They were assessed using the Social Responsiveness Scale-Second Edition (SRS-2) for autistic traits, the Chinese Preschoolers' Eating Behavior Questionnaire (CPEBQ) for eating-related behaviors, the Short Sensory Profile-Second Edition (SSP-2) for sensory processing patterns, and the Children Home Nurture Environment Questionnaire (CHNEQ) for home nurturing environment. Mediation regression analyses were used to examine the role of sensory processing patterns, while moderation analyses to examine the role of home nurturing environment. RESULTS: We observed a positive association between autistic traits and eating behavior problems among typically developed children. Sensory processing patterns significantly mediated the impact of autistic traits on children's eating-related behaviors and home nurturing environment also moderated this relationship. DISCUSSION: Our research suggests that Chinese preschoolers with higher autistic traits may face more eating challenges when they possess more heightened sensory processing patterns, while living in supportive home environments helps to improve their eating behaviors. These findings contribute to the understanding of how and to what extent eating problems are influenced by autistic traits, and they offer insight into the alleviation of eating problems from the perspectives of sensory patterns and family nurturing environments.

The influence of residential Environment and residential experience on psychological depression in older adults: Evidence from China and Europe.

This cross-national study examined the influence of residential environment and experience on depression in older adults in China and Europe to address existing research gaps. Using data from the China Health and Retirement Longitudinal Study (CHARLS) and Survey of Health, Ageing, and Retirement in Europe (SHARE) and employing ridge regression, it was found that residential environment and experience have a significant influence on older adults' depression. The influence of residential experience aligns with the sensitivity period hypothesis. The environment in which older adults live during specific age periods leaves an imprint on their psyche. This imprint is activated when specific environments are encountered in old age, thereby influencing the level of depression. This study examined how their influence on depression contributes to understanding older adults' housing preferences and can guide housing-related policies.

Food parenting at-home vs. in restaurants among African American parents of 3-to-8-year-old children.

Feeding style refers to the approach that parents use to feed their child and the emotional climate during eating. Indulgent styles, characterized by low structure and high responsiveness, have been linked to childhood weight gain. Few studies have examined feeding styles within out-of-home contexts (e.g., restaurants), which are common eating environments for many families. This study sought to examine feeding styles at-home and in restaurants among African American parents. 52 African American parents with a 3-to-8-year-old child (M = 35.6 years, 86% mothers, 57% annual household income <$50,000, 57% Associate's degree or higher) who regularly dined at restaurants completed an online survey in winter 2022-2023. Parents reported on demographics, anthropometrics, and their feeding styles at home and in restaurants via The Caregiver's Feeding Style Questionnaire. Findings indicated that the indulgent style was the most common overall. Indulgent styles were more prevalent in restaurants (χ2 = 7.4, p = 0.007) than home, and authoritarian styles more prevalent at home (χ2 = 4.5, p = 0.03). Child weight status differed by feeding style in both contexts (p ≤ 0.04); indulgent styles in restaurants were linked to higher BMI z-scores, while authoritarian styles at home were linked to lower BMI z-scores. Higher parent BMI was linked to increased likelihood of having an indulgent style at home (OR = 1.13, p = 0.03), while lower parent BMI was linked to increased likelihood of the uninvolved style at home (OR = 0.76, p = 0.049). Overall, indulgent styles were common and more prevalent in restaurants, where they were linked to higher child weight status. Findings may inform future health promotion efforts in out-of-home eating contexts.

Household Environments and Functional Decline Among Middle-Aged and Older Adults in China: Variations by Gender, Age, and Residence.

This study examined the associations between household social, economic, and physical environments and the trajectory of functional limitations over time among middle-aged and older adults in China, and how this relationship differs by gender, age, and residence. Linear growth curve models were applied to a sample of 13,564 respondents aged 45 years and older from four waves of the China Health and Retirement Longitudinal Study (CHARLS 2011-2018). Living alone, particularly for rural, female, and older respondents, was associated with a faster functional decline when compared to living with a spouse and without children. Improved housing quality was associated with a slower functional decline. Living with young descendants and without adult children for urban residents and a lower expenditure per capita for younger respondents were associated with a faster functional decline. These findings suggest that policies aimed at enhancing living conditions have the potential to improve physical functioning of older adults.

The crossroads of work and home: linkages between smoke-free policies at work and household environments.

BACKGROUND: Tobacco use causes over eight million global deaths annually, with seven million directly attributed to tobacco use and 1.2 million to second hand smoke (SHS). Smoke-free environments are crucial to counter SHS. Although India banned smoking in public places in 2008, SHS exposure remains high. Studies have noted that limiting smoking in workplaces, restaurants, etc., helps to reduce overall smoking and reduce SHS exposure. Under this background, the study explores the linkages between smoke-free workplaces and living in smoke-free homes in India. METHODS: The two rounds of the GATS India (2009-10 and 2016-17) have been used for the study. The study focuses on male tobacco smokers working indoors or outdoors or both indoors and outdoors. The sample for the study was 2,969 for GATS 1 and 2,801 for GATS 2. Dependent variables include living in a smoke-free home, while the independent variables were adherence to a smoke-free office policy and socio-demographic variables. The two rounds of the GATS data were pooled for analysis. Statistical analysis involves bivariate and multivariate analysis. RESULTS: Findings reveal that 41% of respondents worked in smoke-free workplaces in GATS 2. Nationally, smoke-free homes increased from 35% in 2009-2010 to 44% in 2016-17. Individuals with smoke-free workplaces were more likely to have smoke-free homes. The Southern region consistently exhibited the highest proportion of smoke-free homes. Urban areas and higher education correlated with increased smoke-free homes. Logistic regression analysis confirmed that workplace smoke-free status is a significant predictor of smoke-free homes. In GATS 2, respondents aged 30 years and above were less likely to have smoke-free homes, while education and Southern region residence positively influenced smoke-free homes. CONCLUSIONS: The correlation between smoke-free workplaces and smoke-free homes is linked to stringent workplace no-smoking policies, potentially deterring individuals from smoking at home. Opportunities exist for the expansion and stringent implementation of the smoke-free policies among Indian working adults, leveraging the workplace as a key setting for evidence-based tobacco control. The study highlights positive trends in India's smoke-free homes, crediting workplace policies. Effective policies, education, and regional strategies can advance smoke-free homes, stressing the pivotal role of workplace policies and advocating broader implementation.

A home environment-moderated model of the influence of ergonomics on individual work performance among Filipino nurse educators working from home during the COVID-19 pandemic: An interaction moderation analysis using structural equation model.

AIM: To determine the influence of ergonomics on individual work performance of nurse educators working at home during the COVID-19 pandemic and to develop a model of the moderating effect of home environment. DESIGN: Cross-sectional, predictive-correlational design. METHODS: Utilizing interaction moderation and structural equation modeling, 214 consecutively-selected educators from nursing schools in the Greater Manila Area, Philippines completed a four-part online survey. RESULTS: Physical, cognitive, and organizational ergonomics positively influenced individual work performance. Home environment had a linear, positive moderation on the effects of physical and cognitive ergonomics on individual work performance but had a negative moderating effect with organizational ergonomics. CONCLUSION: The moderated model underscored the positive effects of ergonomics and the moderating effect of home environment on the individual work performance of nurse educators working at home during the COVID-19 pandemic, and this knowledge can be used in developing appropriate programs, strategies, and policies. IMPACT: The moderated model highlights the need for policies and programs, training and education, and organizational evaluation geared towards promoting healthy workplace and work-life balance among nurse educators transitioning to remote work and online teaching. PATIENT OR PUBLIC CONTRIBUTION: Eligible participants contributed in the data collection with the survey responses.

Analysis of health risk factors for older adults living alone in China and establishment and evaluation of a nomogram prediction model.

Objective: To understand the health status of older adults living alone in China and analyze the influencing factors, so as to provide reference for improving the health status of older adults living alone. Methods: Based on CGSS data from China General Social Survey (2017), the influencing factors of health status of older adults living alone were analyzed by unconditional Logistic regression, and the R software was used to develop a nomogram for predicting the risk of self-assessed unhealthy adverse outcomes. Results: Gender, annual income, mandarin listening level and participation in medical insurance were the influencing factors of self-rated health of older adults living alone. Age and annual income are the influencing factors of physiological health. Annual income and Internet use were influential factors for mental health. C-Statistic of nomogram prediction model was 0.645. The calibration curve showed that goodness of fit test (χ2 = 58.09, p < 0.001), and the overall prediction ability of the model was good. Conclusion: The health status of older adults living alone in the home-based older adults care is worrying, and it is affected by various factors. We should pay more attention to older adults living alone, improve the ability of listening and distinguishing mandarin and the use of health information platforms for older adults living alone, and further implement medical insurance policies and health services. Announcing the solution to promote healthy home-based care for older adults living alone.

Social isolation, regardless of living alone, is associated with mortality: the Otassha study.

Introduction: Social isolation has been recognized as a contributing factor to negative health outcomes. Although living alone is associated with health-related outcomes, existing findings are inconsistent. It is not the act of living alone that may predict poor health, but rather social isolation that can lead to increased mortality risk. This study investigated the combined associations of social isolation and living alone with mortality among community-dwelling older adults. Methods: We included older adults from Itabashi ward, Tokyo, who participated in comprehensive health checkups. Participants were categorized into four groups based on their social isolation status and living alone. The primary outcome was all-cause mortality, analyzed using Cox proportional hazards models. Results: Of the 1,106 participants (mean age 73, 42% male), 4.5% experienced both social isolation and living alone. This combination was associated with a worse prognosis regarding all-cause mortality (hazard ratio (HR): 2.08 [95% confidence interval (CI), 1.08-4. 00]). Those who were socially isolated but not living alone also showed a trend towards higher mortality risk (HR: 1.41 [95% CI, 0.90-2.20]). Contrastingly, those who were not socially isolated and lived alone did not show an increased mortality risk (HR: 0.81 [95% CI, 0.44-1.49]). Discussion and conclusion: Living alone is not inherently associated with a poor prognosis in older adults; however, social isolation was associated with a higher mortality risk. Healthcare providers should focus on enhancing social interactions and support for older adults because of their effects on health rather than solely addressing living arrangements to prevent adverse health events.

Home participation and personal and environmental factors in children and adolescents with Down syndrome.

AIM: To describe current home participation (frequency, involvement) and caregiver's desire for change in home participation of children and adolescents with Down syndrome, as well as home environmental factors, and to explore the associations of personal and environmental factors with current participation and caregiver's desire for change. METHOD: Eighty-two caregivers (mean age = 45 years 10 months) of children and adolescents with Down syndrome (mean age = 10 years 7 months) were surveyed about the child's home participation and environmental factors using the Participation and Environment Measure-Children and Youth. Furthermore, children's personal and environmental factors were collected. Results are reported using descriptive analysis and correlations (Spearman's rank correlation coefficients and Mann-Whitney U test) to describe the relationship between current participation and caregiver's desire for change, with personal and environmental factors as ordinal and nominal variables respectively (p < 0.05). RESULTS: Children's participation was highest with regard to personal care management and lowest with regard to school-related activities. Most caregivers desired change in homework and household chores. Greater frequency was associated with male sex, caregiver less rigorous social distancing due to the COVID-19 pandemic, and children receiving therapies. Greater involvement was associated with younger age in children and higher environmental support. Older age in children was associated with caregiver's greater desire for change. INTERPRETATION: Personal and environmental factors correlated with participation in specific ways. Creative strategies to promote participation that consider caregiver's wishes should be undertaken.

The influence of hospital and home environments on physical activity and sedentary behaviour: Perceptions of people recovering from fractures.

BACKGROUND: A lack of evidence exists contrasting the factors that influence physical activity and sedentary behaviour in both hospital and home settings before and after discharge from acute hospitalisation for fractures. OBJECTIVE: To describe and compare perceptions of environmental influences on physical activity in hospital and home settings in people recovering from fractures. METHOD: Semi-structured interviews were conducted with patients hospitalised following fractures (hip fracture or multi-trauma), exploring the barriers and enablers to physical activity within hospital and home settings. Interviews were conducted within two weeks of hospital discharge, audio recorded and transcribed prior to thematic analysis via a framework approach. RESULTS: Between December 2022 and May 2023, 12 semi-structured interviews were undertaken with an equal number of participants who sustained an isolated hip fracture or multi-trauma. The median (IQR) age of participants was 60 (52-68) years, with half being male, and the majority sustaining their injuries via transport crashes. Three main themes that influenced physical activity behaviours in hospital and home settings were: having the opportunity, having a reason, and having support and assistance to be active. CONCLUSION: During the period of reduced physical capability following fracture, patients need to be provided with opportunities and motivation to be active, particularly within the hospital setting. Findings from this study will assist clinicians to better support people recovering from fractures via greater engagement in physical activity within hospital and home settings.

The timescapes of older adults living alone and receiving home care: An interview study.

In this study, we drew on Barbara Adam's (1998) timescape perspective and applied a timescape lens to our analysis of how nine older adults who live alone, receive home care and are considered by home care professionals to be frail, experience living (in) time. Over a period of eight months, we conducted three interviews with each of the nine participants. We analysed the data using reflexive thematic analysis and drew on timescapes to further interpret our preliminary analysis. Our results show that situated everyday time, place across time, and large-scale time interact in the framing and shaping of older adults' everyday lives. Older adults' embodied experiences of being of advanced age, living alone and receiving home care influenced their timescapes. We propose that paying attention to older adults' timescapes can enable home care professionals and other supporters to consider older adults' health, well-being, vulnerabilities and strengths from a broader perspective than the 'here and now' and thereby enhance the provision of person-centred care.

Loneliness, Living Alone, and Risk of Cardiovascular Disease Among Older Adults in China.

BACKGROUND: Older adults are prone to live alone and feel lonely. The main objective of this study was to assess the associations of loneliness and living alone with cardiovascular disease (CVD) among community-dwelling older individuals in China. METHODS: We conducted a longitudinal analysis on 3 661 participants aged older than 65 years from the latest 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. Cox proportional hazards models were used to assess the associations of loneliness and living alone with CVD risk, with adjustment for confounding factors. RESULTS: A total of 616 incident CVD cases were identified during follow-up. Participants who reported feeling lonely experienced a 28% increased risk of developing CVD after adjustment for sociodemographic characteristics, lifestyle factors, and baseline health status (adjusted hazard ratio [HR]: 1.28, 95% confidence interval [CI]: 1.01-1.62; ptrend = .046). In contrast, no significant association was observed between living alone and CVD risk. Subgroup analyses showed that among those individuals who lived alone, often feeling lonely doubled the risk of CVD compared to never being lonely (HR: 2.17, 95% CI: 1.20-3.93; ptrend = .007). CONCLUSIONS: Loneliness was an independent risk factor for CVD among Chinese older adults. Our findings underscore the importance of addressing loneliness in the prevention of CVD among older individuals, especially those who live alone.

Effects of tai chi, ba duan jin, and walking on the mental health status of urban older people living alone: the mediating role of social participation and the moderating role of the exercise environment.

With the global trend of aging, lacking of interpersonal communication and spiritual support and companionship have had a great impact on the mental health of older people living alone. This study examines the multifaceted impacts of engaging in tai chi, ba duan jin, and walking on the mental wellbeing of older people residing alone in urban areas. Additionally, this research aims to explore the association between tai chi, ba duan jin, and walking, and the mental health status of urban older people living alone, by considering the mediating influence of social participation and the moderating influence of the exercise environment. To do so, 1,027 older people living alone in six Chinese cities were investigated using the Physical Activity Rating Scale (PARS-3), the Geriatric Health Questionnaire (GHQ-12), the Social Participation Indicator System Scale, and the Exercise Environment Scale. SPSS 25.0 was utilized for conducting mathematical statistical analysis, specifically for doing linear regression analysis. Additionally, AMOS was employed to develop the study model. We found that a significant negative correlation between tai chi, ba duan jin, and walking and mental health status; among these, tai chi had the greatest impact on the mental health status of urban older people living alone. Social participation mediated the relationship between tai chi, ba duan jin, walking, and mental health status, and the exercise environment had a moderating effect on this relationship. The findings of this study indicate that tai chi, ba duan jin, and walking have a positive impact on the mental health of urban older people living alone, which can be influenced by the mediating efficacy of social participation and the moderating effect of the exercise environment.

Subjective evaluation of home environment and levels of self-reported depression in middle to old age: Results from the HCHS study.

OBJECTIVES: The immediate living environment might, like other lifestyle factors, be significantly related to mental well-being. The current study addresses the question whether five relevant subjective home environment variables (i.e., protection from disturbing nightlight, daylight entering the home, safety at home, quality of window views, and noise disturbance) are associated with levels of self-reported depression over and above well-known sociodemographic and common lifestyle variables. METHODS: Data from the Hamburg City Health Study (HCHS) were analyzed. In N = 8757 with available PHQ-9 depression data, multiple linear regression models were computed, with demographic data, lifestyle variables, and variables describing the subjective evaluation of the home environment. RESULTS: The model explained 15% of variance in depression levels, with ratings for the subjective evaluation of home environment accounting for 6%. Better protection from disturbing light at night, more daylight entering the home, feeling safer, and perceived quality of the window views, were all significantly associated with lower, while more annoyance by noise was associated with higher levels of self-reported depression. Results did not differ if examining a sample of the youngest (middle-aged participants: 46-50 years) versus oldest (70-78 years) participants within HCHS. CONCLUSION: Beyond studying the role of lifestyle factors related to self-reported depression, people's homes may be important for subclinical levels of depression in middle and older age, albeit the direction of effects or causality cannot be inferred from the present study. The development of a consensus and tools for a standardized home environment assessment is needed.