The association of activity level, parent mental distress, and parental involvement and monitoring with unintentional injury risk in fifth graders

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Abstract

Objective

Extend findings with young children by examining the strength of association of activity level, parent mental distress, and parental involvement and monitoring with fifth graders’ unintentional injuries.

Methods

Ordinal logistic regression models were used to predict unintentional injury frequency among 4745 fifth-graders. Examined predictors included demographics, parent reports of mental distress, temperamental activity level (tendency to be fidgety, restless, and constantly in motion), and parental involvement and monitoring in adolescents’ lives.

Results

Higher levels of both activity level and parent mental distress predicted more frequent injuries.

Conclusions

As has been found with younger children, unintentional injuries in fifth graders are associated with both parent and child characteristics. The result is discussed in the context of adolescent development. Implications include those for injury prevention (multi-dimensional prevention strategies that incorporate environmental modifications as well as training of youth and parents) and future research (study of potential mechanisms behind injury risk behavior via longitudinal and experimental research; study of injury risk during this phase of child development).

Research highlights

▶ Ordinal logistic regressions predicted unintentional injury among 4745 5th graders. ▶ Parent predictors included parent mental distress, parent involvement/monitoring. ▶ Youth predictors included demographics, youth activity level. ▶ Both activity level and parent mental distress positively related to injury. ▶ Unintentional injury in 5th graders associate with parent and child characteristics.

Section snippets

Conceptual background

Contextual theory offers a theoretical perspective from which to consider pediatric injury risk (Barton and Schwebel, 2007). The premise of contextual theory is that an individual does not act or develop in a vacuum, but rather does so in the presence of people, places, and situations that influence how he or she thinks, behaves, and acts (Bronfenbrenner, 1977, Bronfenbrenner, 1986, Bronfenbrenner, 1988). From the perspective of injury risk, a wide range of contextual factors influences the

Study objectives

The present study was designed to examine the relative magnitudes of associations of activity level, parent mental health, and parental involvement and monitoring on injury risk among a sample of fifth graders. From a developmental perspective, we felt it important to examine these three contextual influences simultaneously because fifth grade represents a development stage when youth begin to act with much greater independence from parents. Many of those acts involve individual decisions, made

Data source

Data come from Healthy Passages, a community-based longitudinal study of adolescent health. This report uses baseline data collected in two cohorts from 2004 to 2006, when the sample consisted of 5147 individuals in the fifth grade. Participants in Healthy Passages were sampled from public schools in three geographic areas: (a) 10 contiguous public school districts in and around Birmingham, AL; (b) 25 contiguous public school districts in Los Angeles County, CA; and (c) the largest public

Results

Table 1 lists descriptive data for the sample. As shown, injuries were relatively rare events (M = 0.2, SD = 0.7), with 4097 (86% of the sample) participants reporting no injuries requiring professional medical treatment in the past year. However, 484 (10%) reported one injury, 115 (2%) reported two injuries, and 49 (1%) reported three or more injuries.

Table 2 presents bivariate (first two columns) and multivariate (last two columns) ordinal logistic regression models predicting injury requiring

Discussion

Extending a large body of literature based on younger children, results from ordinal logistic regression models indicate that both activity level and parent mental health distress predict injury among fifth graders, with more active youth and those with more distressed parents experiencing more injuries. These factors appeared to be of roughly equal importance, with similar standardized odds ratios. Moreover, these effects are large and important in magnitude. Being at the 90th percentile in

Conclusions

This manuscript extends findings from the injury literature examining early childhood to a sample of fifth graders, and suggests both youth and parent characteristics are related to pediatric injury risk, even as children develop into early adolescents. The magnitudes of youth and parent contributions to injury risk were similar.

This study has limitations. One limitation stems from the cross-sectional nature of the data. Because injury reports were retrospective, assessment of activity level,

Acknowledgements

The Healthy Passages Study is funded by the Centers for Disease Control and Prevention, Prevention Research Centers (Cooperative Agreements U48DP000046, U48DP000057, and U48DP000056). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Thanks to Patricia Dittus for input on the parental involvement and monitoring literature and to Martha Hovater for data analysis support.

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