Remote Monitoring of Patient- and Family-Generated Health Data in Pediatrics.

In this article, we provide an overview of remote monitoring of pediatric PGHD and family-generated health data, including its current uses, future opportunities, and implementation resources.

INFANT MORTALITY AND FAMILY HEALTH STRATEGY IN THE 3RD HEALTH REGIONAL OF PARANÁ, FROM 2005 TO 2016.

OBJECTIVE: To analyze the temporal trend in infant mortality and in populational coverage by the Family Health Strategy and associated factors with infant mortality in the municipalities of the 3rd Health Regional of Paraná, Southern Brazil. METHODS: Ecological time series study, with data from the Mortality Information System (Sistema de Informação Sobre Mortalidade - SIM), the Live Birth Information System (Sistema de Informação Sobre Nascidos Vivos - SINASC) and the Support Room for Strategic Management (Sala de Apoio à Gestão Estratégica - SAGE), from 2005 to 2016. Trends were calculated using polynomial regression. The associated factors with infant mortality were maternal, perinatal and obstetric variables. The significance level adopted was 5%. RESULTS: Between 2005 and 2016, there were 115,796 births and 1,575 deaths of children under 1 year of age. Considering the municipalities together, the populational coverage by the Family Health Strategy went from 43.8% in 2005 to 66.4% in 2016 and the infant mortality from 17.1/1,000 live births in 2005 to 10.7/1,000 live births in 2016. The trend over time of populational coverage by the Family Health Strategy was crescent and of infant mortality was decrescent, for most municipalities. The factors associated with greater chances of death in children under 1 year of age were preterm gestational age (Odds Ratio - OR=15.05; 95% confidence interval - 95CI% 13.54-16.72), low birth weight (OR=15.14; 95%CI 13.61-16.84), multiple gestation (OR=4.51; 95%CI 3.74-5.45) and mother with up to 7 years of study (OR=1.93; 95%CI 1.74-2.14). CONCLUSIONS: Crescent trend in coverage by the Family Health Strategy was accompanied by a decrescent trend in infant mortality. The results can be a source of information for the strengthening of mother-child health actions, considering local and regional specificities.

Reducing the Impact of Anti-Vaccine Propaganda on Family Health.

Emeritus Professor Alan Glasper from the University of Southampton discusses strategies to enhance Covid-19 and other vaccine uptake among some families and groups in society who are adversely influenced by so called anti-vaxxers.

Socioeconomic inequalities in the quality of primary care under Brazil's national pay-for-performance programme: a longitudinal study of family health teams.

BACKGROUND: Many governments have introduced pay-for-performance programmes to incentivise health providers to improve quality of care. Evidence on whether these programmes reduce or exacerbate disparities in health care is scarce. In this study, we aimed to assess socioeconomic inequalities in the performance of family health teams under Brazil's National Programme for Improving Primary Care Access and Quality (PMAQ). METHODS: For this longitudinal study, we analysed data on the quality of care delivered by family health teams participating in PMAQ over three rounds of implementation: round 1 (November, 2011, to March, 2013), round 2 (April, 2013, to September, 2015), and round 3 (October, 2015, to December, 2019). The primary outcome was the percentage of the maximum performance score obtainable by family health teams (the PMAQ score), based on several hundred (ranging from 598 to 914) indicators of health-care delivery. Using census data on household income of local areas, we examined the PMAQ score by income ventile. We used ordinary least squares regressions to examine the association between PMAQ scores and the income of each local area across implementation rounds, and we did an analysis of variance to assess geographical variation in PMAQ score. FINDINGS: Of the 40 361 family health teams that were registered as ever participating in PMAQ, we included 13 934 teams that participated in the three rounds of PMAQ in our analysis. These teams were located in 11 472 census areas and served approximately 48 million people. The mean PMAQ score was 61·0% (median 61·8, IQR 55·3-67·9) in round 1, 55·3% (median 56·0, IQR 47·6-63·4) in round 2, and 61·6% (median 62·7, IQR 54·4-69·9) in round 3. In round 1, we observed a positive socioeconomic gradient, with the mean PMAQ score ranging from 56·6% in the poorest group to 64·1% in the richest group. Between rounds 1 and 3, mean PMAQ performance increased by 7·1 percentage points for the poorest group and decreased by 0·8 percentage points for the richest group (p<0·0001), with the gap between richest and poorest narrowing from 7·5 percentage points (95% CI 6·5 to 8·5) to -0·4 percentage points over the same period (-1·6 to 0·8). INTERPRETATION: Existing income inequalities in the delivery of primary health care were eliminated during the three rounds of PMAQ, plausibly due to a design feature of PMAQ that adjusted financial payments for socioeconomic inequalities. However, there remains an important policy agenda in Brazil to address the large inequities in health. FUNDING: UK Medical Research Council, Newton Fund, and CONFAP (Conselho Nacional das Fundações Estaduais de Amparo à Pesquisa).

Engaging the Family in the Care of Young Adults With Substance Use Disorders.

Efforts to engage young adults with substance use disorders in treatment often focus on the individual and do not consider the role that the family can play in the recovery process. In summarizing the proceedings of a longitudinal meeting on substance use among young adults, this special article outlines three key principles concerning the engagement of broader family units in substance use treatment: (1) care should involve family members (biological, extended, or chosen); (2) these family members should receive counseling on evidence-based approaches that can enhance their loved one's engagement in care; and (3) family members should receive counseling on evidence-based strategies that can improve their own health. For each principle, we provide an explanation of our guidance to practitioners, supportive evidence, and additional practice considerations.

Family-centeredness of services for young children with Down syndrome: an observational study from Turkey

Background/aim: Physicians require information on the family centeredness of services for children with Down syndrome, one of the most frequently encountered disabilities in childhood. We aimed to determine the family-centeredness of services for young children with Down syndrome and using a bioecological theory framework we hypothesized that child, family and service-related factors would be associated with such services. Materials and methods: In a crosssectional design, children with Down syndrome seen at Ankara University Developmental Pediatrics Division (AUDPD) between February 2020 and June 2020 were included if they had received services in the community for at least 12 months. Mothers responded to the measure of process of care-20 (MPOC-20) used to measure family centeredness. Results: All 65 eligible children were included; 57% were boys and median age was 25.0 (IQR: 18.5­38.0) months. The MPOC-20 subscale scores were highest for the "respectful and supportive care (RSC)" (median 6.0; IQR: 4.8­6.8) and lowest for the "providing specific information" (median 3.0; IQR: 4.4­6.5) subscales. On univariate analyses, maternal education

Factors Associated with Choice of Career in Family Medicine Among Junior Doctors in Oman.

OBJECTIVES: The number of family physicians in Oman is far below that recommended by the World Health Organization. This study aimed to determine factors influencing junior doctors' choice of a career in family medicine. METHODS: This cross-sectional study was conducted between March and June 2018 and targeted applicants to Oman Medical Specialty Board residency programmes during the 2018-2019 academic year. Applicants were grouped according to their choice of either family medicine (n = 64) or other specialities (n = 81). A self-administered questionnaire was utilised to compare the applicants' sociodemographic characteristics, factors influencing their choice of career and their Myers-Briggs Type Indicator® (MBTI) personality traits. RESULTS: A total of 52 family medicine and 43 other residency applicants participated in the study (response rates: 81.3% and 53.1%, respectively). Most family medicine applicants were female (86.5%), married (65.4%) and resided in rural areas (73.1%); moreover, 19.2% were ≥30 years of age. Overall, emphasis on continuity of care, opportunity to deal with a variety of medical problems, the ability to use a wide range of skills and knowledge, early exposure to the discipline, opportunity to teach and perform research and the influence of family or friends were important factors in determining choice of a career in family medicine. Moreover, the MBTI analysis revealed that family medicine applicants were commonly extroverted-sensing-thinking-judging personality types. CONCLUSION: Knowledge of the factors influencing career choice among junior doctors may be useful in determining future admission policies in order to increase the number of family physicians in Oman.

Mechanisms underlying familial aggregation of exceptional health and survival: A three-generation cohort study.

The familial resemblance in length of adult life is very modest. Studies of parent-offspring and twins suggest that exceptional health and survival have a stronger genetic component than lifespan generally. To shed light on the underlying mechanisms, we collected information on Danish long-lived siblings (born 1886-1938) from 659 families, their 5379 offspring (born 1917-1982), and 10,398 grandchildren (born 1950-2010) and matched background population controls through the Danish 1916 Census, the Civil Registration System, the National Patient Register, and the Register of Causes of Death. Comparison with the background, population revealed consistently lower occurrence of almost all disease groups and causes of death in the offspring and the grandchildren. The expected incidence of hospitalization for mental and behavioral disorders was reduced by half in the offspring (hazard ratio 0.53, 95% confidence interval 0.45-0.62) and by one-third in the grandchildren (0.69, 0.61-0.78), while the numbers for tobacco-related cancer were 0.60 (0.51-0.70) and 0.71 (0.48-1.05), respectively. Within-family analyses showed a general, as opposed to specific, lowering of disease risk. Early parenthood and divorce were markedly less frequent in the longevity-enriched families, while economic and educational differences were small to moderate. The longevity-enriched families in this study have a general health advantage spanning three generations. The particularly low occurrence of mental and behavioral disorders and tobacco-related cancers together with indicators of family stability and only modest socioeconomic advantage implicate behavior as a key mechanism underlying familial aggregation of exceptional health and survival.

Knowledge and health promotion practice of Family Health Strategy nurses.

OBJECTIVES: to analyze the knowledge and health promotion practice carried out by Family Health Strategy nurses. METHODS: a descriptive study and qualitative approach. The study was conducted with 18 Family Health Strategy nurses from the city of São Carlos. Data were collected through semi-structured interviews and analyzed through thematic analysis. The study was approved by the Research Ethics Committee. RESULTS: the data revealed that nurses had difficulties to conceptualize health promotion, and it is common to describe the definition of disease prevention. Nurses also reported developing group activities for health promotion; however, individual actions and consultations were still predominant. Final Considerations: it is necessary to develop sustainable strategies for collective health-promoting activities, in addition to strengthening multidisciplinary work and Continuing Education actions.

Setting the baseline: a description of cannabis poisonings at a Canadian pediatric hospital prior to the legalization of recreational cannabis. / Établissement d'une base de référence : description des intoxications au cannabis dans un hôpital pédiatrique canadien avant la légalisation de la consommation de cannabis à des fins récréatives.

INTRODUCTION: This study describes the events and circumstances preceding children aged 16 years or younger being treated for cannabis poisoining in the emergency department (ED) of a Canadian pediatric hospital. METHODS: We extracted cannabis poisoning treated in the ED at British Columbia Children's Hospital (BCCH) between 1 January, 2016 and 31 December, 2018, from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database. The poisonings were distinguished by the inadvertent or intentional ingestion of cannabis. We reviewed the hospital's electronic health information system and the patients' health records to obtain additional information on the context, including spatial and temporal characteristics. RESULTS: Of the 911 poisonings treated at BCCH, 114 were related to intentional cannabis use (12.5%). Fewer than 10 poisonings resulted from inadvertent ingestions by children and the median age for these was 3 years. All inadvertent ingestion occurred at home and involved cannabis belonging to the patient's family. The vast majority of poisonings resulted from the intentional use of cannabis only (28.9%) or cannabis use with other psychoactive substances (co-ingestions; 71.1%). The median patient age was 15 years. Most patients reported consuming cannabis through inhalation with peers. Cannabis and co-ingestion poisonings were more often reported on weekdays than weekends. The consumption of cannabis leading to poisoning more often occurred in private residences. Patients with cannabis poisoning more often sought medical treatment themselves or were helped by their family. CONCLUSION: The characteristics of cannabis poisonings among children are described for the three-year period prior to recreational cannabis legalization in Canada in order to set a baseline for future comparisons. Implications for improving injury prevention initiatives and policies are discussed.

Family-Centered Health Promotion: Perspectives for Engaging Families and Achieving Better Health Outcomes.

Communities and populations are comprised of individuals and families who together affect the health of the community. The family unit is an unparalleled player for maintaining health and preventing disease for public health because members may support and nurture one another through life stages. Preliminary research confirms that family-oriented health promotion and disease prevention are promising strategies because the family unit is both a resource and a priority group needing preventative and curative services across the life course. Although there are growing numbers of successful efforts, family health systems are generally underutilized in health promotion practice. This lack of utilization in policy and practice have hampered the collection of robust evidence for family health. This paper purports that families are important actors in public health. Yet, since no one pattern for healthy families is known, public health practitioners can consider six principle-based approaches to legitimately and respectfully advance the families' innate potential for health promotion and disease prevention. Each perspective aims to foster higher capacity for family health systems to function appropriately in public health practice. Health promotion practitioners and researchers can explore family health perspectives with the potential for systems policy and practice adjustments in public health.

Health and Safety in a Family Child Care Network: An Analysis of Violation Data of Routine, Full Unannounced Inspections.

OBJECTIVE: To analyze how engagement with a staffed family child network is associated with compliance on health and safety regulations among family day care (FDC) homes. METHODS: Publically available data on health and safety inspection violations on FDC homes were merged with engagement data from a staffed family child network. Descriptive analysis, logistic regression, and latent class analysis were used. RESULTS: Network FDC homes, compared to non-network FDC homes, were less likely to have health and safety violations in the areas of Child/Family/Staff Documentation (43.1% vs. 53.6%, p = 0.001) and Indoor Safety (36.0% vs. 42.6%, p = .041). Controlling for area median income and for decades since obtaining license, network FDC homes had fewer violations, fewer violation categories, and less variety of violation categories. Additionally, FDC homes which were not engaged with the staffed family child network but were in the city or town in which the network offered services, performed better compared to FDC homes in cities or towns without network resources. CONCLUSIONS FOR PRACTICE: The better compliance among network FDC homes and among FDC homes in cities and towns where the network offers services, suggests that the network is having positive effects on health and safety quality in FDC homes. A staffed child care network may be a means to improve child care quality and may be a means of improving educational and health outcomes for children.

Child mental health care in the context of the Family Health Strategy: an evaluative study.

OBJECTIVE: To evaluate child's mental health care in the context of the Family Health Strategy, from the professionals' perspective. METHODS: A qualitative case study type, using the Fourth Generation Assessment as a methodological reference. Fourteen professionals from two teams of the Family Health Strategy of Porto Alegre/RS were the participants. Data collection extended from May to August 2018, and consisted of observations and interviews through the dialectical hermeneutic circle, and of analysis through the Constant Comparative Method. RESULTS: The analytical category emerged of Mental Health Care for Children related to home visit, care network, advice, team meeting and space in the medical agenda. CONCLUSIONS: The results show that the FHS is an important psychosocial care space and that, at the same time, presents weaknesses in cross-sectorial work and needs support from the mental health services network to accompanying children and families.

Effects of a family diabetes self-management education intervention on the patients' supporters.

INTRODUCTION: Diabetes self-management education (DSME) programs that engage the families of patients with diabetes have shown to be effective in improving diabetes-related outcomes of the patients. The health effects of these "family models" of DSME on participating family members are rarely studied. Opportunity exists for the participating family members to benefit from the healthy lifestyle recommendations offered through such programs. METHOD: Using data from a randomized controlled trial to assess the effect of family DSME compared to standard DSME among Marshallese adults with Type 2 diabetes, this study examined baseline to 12-month changes in A1c, body mass index (BMI), food consumption, and physical activity among participating family members, comparing outcomes of family members based on attended at least 1 (n = 98) versus attended no (n = 44) DSME sessions. RESULTS: Overall, family member attendance was low. There were no differences in the level of change from baseline to 12 months for A1c, BMI, food consumption, and physical activity between groups. After controlling for attendance and sociodemographic measures, lowering of BMI was the only significant predictor of not having an A1c level indicative of diabetes at 12 months. DISCUSSION: Future research on family DSME should consider ways to improve family member attendance; have them set their own health improvement goals; and integrate healthy lifestyle education, such as healthy eating and being physically active, along with the DSME core content to create an added benefit of diabetes prevention for participating family members. The limitations of this study and recommendations for future research are provided. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Influences of the early family environment and long-term vocabulary development on the structure of white matter pathways: A longitudinal investigation.

In the present longitudinal study, we investigated the joint effect of early family factors and long-term vocabulary development on the structure of reading-related white matter pathways in adolescents. Seventy-nine children participated in this study. Family environment was measured via parental questionnaire between age 1 and age 3. From age 4 to age 10, children's vocabulary skills were tested annually. At age 14, diffusion tensor imaging data of the children were collected. Using individual-based tractography, 10 reading-related tracts of the two hemispheres were delineated. Different family factors were found to be correlated with different pathways: Age of literacy exposure was correlated with fractional anisotropy of the direct segment of the left arcuate fasciculus, while an association trend was found between early family socioeconomic status and fractional anisotropy of the left inferior frontal occipital fasciculus. Further regression analyses showed that the age of literacy exposure modulated the relationships between vocabulary development and the structure of the left arcuate fasciculus. Specifically, in the earlier literacy exposure group, no association was found between vocabulary development and the strength of the arcuate fasciculus, whereas in the later literacy exposure group, significant associations were found between vocabulary development and the strength of the arcuate fasciculus.

Child mental health care in the context of the Family Health Strategy: an evaluative study / Cuidado en salud mental infantil en el contexto de la Estrategia de Salud de la Familia: estudio evaluativo / Cuidado em saúde mental infantil no contexto da Estratégia da Saúde da Família: estudo avaliativo

ABSTRACT Objective: To evaluate child's mental health care in the context of the Family Health Strategy, from the professionals' perspective. Methods: A qualitative case study type, using the Fourth Generation Assessment as a methodological reference. Fourteen professionals from two teams of the Family Health Strategy of Porto Alegre/RS were the participants. Data collection extended from May to August 2018, and consisted of observations and interviews through the dialectical hermeneutic circle, and of analysis through the Constant Comparative Method. Results: The analytical category emerged of Mental Health Care for Children related to home visit, care network, advice, team meeting and space in the medical agenda. Conclusions: The results show that the FHS is an important psychosocial care space and that, at the same time, presents weaknesses in cross-sectorial work and needs support from the mental health services network to accompanying children and families.

RESUMEN Objetivo: Evaluar la atención de salud mental a niños en el contexto de la Estrategia de Salud de la Familia (ESF), desde la perspectiva de los profesionales. Métodos: Estudio cualitativo, del tipo estudio de casos, en el que se utilizó la Evaluación de Cuarta Generación como referencial metodológico. Catorce profesionales de dos equipos de la Estrategia de Salud de la Familia de Porto Alegre/RS participaron en el estudio. La recolección de datos se registró entre mayo y agosto de 2018, consistió en observaciones y entrevistas a través del círculo hermenéutico dialéctico, y en análisis a través del Método Comparativo Constante. Resultados: Surgió la categoría analítica de Atención de salud mental a niños en relación con: visita domiciliaria, red de atención, asesoramiento, reunión de equipo y espacio en la agenda médica. Conclusiones: Los resultados demuestran que la ESF es un importante espacio de atención psicosocial, al mismo tiempo que presenta debilidades en el trabajo intersectorial y necesita el apoyo de la red de servicios de salud mental para acompañar a los niños y a las familias.

RESUMO Objetivo: Avaliar o cuidado em saúde mental à criança no contexto da Estratégia de Saúde da Família - ESF, a partir da perspectiva dos profissionais. Métodos: Estudo qualitativo, tipo estudo de caso, utilizou-se a Avaliação de Quarta Geração como referencial metodológico. Participaram 14 profissionais de duas equipes da Estratégia de Saúde da Família do município de Porto Alegre/RS. A coleta de dados ocorreu entre maio e agosto de 2018, consistiu em observação e entrevista através do círculo hermenêutico dialético, e análise através do Método Comparativo Constante. Resultados: Emergiu a categoria analítica Cuidado de Saúde Mental destinado à Criança relacionada visita domiciliar, rede de cuidados, matriciamento, reunião de equipe e espaço na agenda médica. Conclusões: Os resultados demonstram que a ESF se constitui em um importante espaço de cuidado psicossocial, ao mesmo tempo encontra fragilidades no trabalho intersetorial e necessita de apoio da rede de serviços de saúde mental para o acompanhamento de crianças e famílias.

Knowledge and health promotion practice of Family Health Strategy nurses / Conocimiento y práctica de promoción de la salud de las enfermeras de la Estrategia de Salud Familiar / Conhecimento e prática de promoção da saúde de enfermeiros da Estratégia Saúde da Família

ABSTRACT Objectives: to analyze the knowledge and health promotion practice carried out by Family Health Strategy nurses. Methods: a descriptive study and qualitative approach. The study was conducted with 18 Family Health Strategy nurses from the city of São Carlos. Data were collected through semi-structured interviews and analyzed through thematic analysis. The study was approved by the Research Ethics Committee. Results: the data revealed that nurses had difficulties to conceptualize health promotion, and it is common to describe the definition of disease prevention. Nurses also reported developing group activities for health promotion; however, individual actions and consultations were still predominant. Final Considerations: it is necessary to develop sustainable strategies for collective health-promoting activities, in addition to strengthening multidisciplinary work and Continuing Education actions.

RESUMEN Objetivos: analizar el conocimiento y la práctica de la promoción de la salud llevada a cabo por enfermeras de Estrategias de Salud Familiar. Métodos: estudio descriptivo y enfoque cualitativo. El estudio se realizó con 18 enfermeras de Estrategias de Salud Familiar de la ciudad de São Carlos. Los datos fueron recolectados a través de entrevistas semiestructuradas y analizados a través de análisis temáticos. El estudio fue aprobado por el Comité de Ética en Investigación. Resultados: los datos revelaron que las enfermeras tenían dificultades para conceptualizar la promoción de la salud, y es común describir la definición de prevención de enfermedades. Las enfermeras también informaron el desarrollo de actividades grupales para la promoción de la salud; sin embargo, las acciones y consultas individuales seguían predominando. Consideraciones Finales: es necesario desarrollar estrategias sostenibles para las actividades colectivas de promoción de la salud, además de fortalecer el trabajo multidisciplinario y las acciones de Educación Continua.

RESUMO Objetivos: analisar o conhecimento e a prática de promoção de saúde realizada por enfermeiros de Estratégias Saúde da Família. Métodos: estudo descritivo e de abordagem qualitativa. O estudo foi realizado com 18 enfermeiros de Estratégias Saúde da Família do município de São Carlos. Os dados foram coletados por meio de entrevista semiestruturada e analisados por meio da análise temática. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultados: os dados revelaram que os enfermeiros apresentaram dificuldades para conceituar a promoção de saúde, sendo comum descrever a definição de prevenção de doenças. Os enfermeiros também relataram desenvolver atividades grupais para a promoção de saúde; porém, as ações de caráter individual e em forma de consultas ainda eram predominantes. Considerações Finais: torna-se necessário o desenvolvimento de estratégias sustentáveis para a realização de atividades coletivas de promoção em saúde, além do fortalecimento do trabalho multidisciplinar e das ações de Educação Permanente.

[Development of a tool to conduct family studies in primary health care]. / Estudio de familia en Atención Primaria: construcción y validación de una herramienta para la valoración familiar.

BACKGROUND: The Family and Community Health Model (MAIS) establishes the continuity of care as an essential principle. The Family Study, as a clinical strategy, allows to have sufficient and timely information and knowledge about users of health care services, facilitates their accompaniment and is a source of information to improve the quality of care and the management of health centers. AIM: To develop a tool to conduct family studies, devised by experts in Primary Health Care. MATERIAL AND METHODS: Using a qualitative method, an electronic Delphi was conducted on 24 experts on primary health care. Afterwards, the content validation was carried out with the participation of judges. RESULTS: The resulting tool considers two levels of family assessment. It allows to distinguish those families that would benefit from interventions of greater complexity than those derived from the usual care of health centers. CONCLUSIONS: The tool to perform family studies responds to the informational and continuity component of Continuity of Patient Care principle. It may be a proposal for the continuous improvement of Chilean primary care.

Quality matters: A meta-analysis on components of healthy family meals.

OBJECTIVE: A greater frequency of family meals is associated with better diet quality and lower body mass index (BMI) in children. However, the effect sizes are small, and it remains unclear which qualitative components of family meals contribute to these positive health outcomes. This meta-analysis synthesizes studies on social, environmental, and behavioral attributes of family meals and identifies components of family meals that are related to better nutritional health in children. METHOD: A systematic literature search (50 studies; 49,137 participants; 61 reported effect sizes) identified 6 different components of healthy family mealtimes. Separate meta-analyses examined the association between each component and children's nutritional health. Age (children vs. adolescents), outcome type (BMI vs. diet quality), and socioeconomic status (SES; controlled vs. not controlled for SES) were examined as potential moderators. RESULTS: Positive associations consistently emerged between 5 components and children's nutritional health: turning the TV off during meals (r = .09), parental modeling of healthy eating (r = .12), higher food quality (r = .12), positive atmosphere (r = .13), children's involvement in meal preparation (r = .08), and longer meal duration (r = .20). No moderating effects were found. CONCLUSIONS: How a family eats together shows significant associations with nutritional health in children. Randomized control trials are needed to further verify these findings. The generalizability of the identified mealtime components to other contexts of social eating is also discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).