@techreport{HoffmannWachtlerSanderetal., author = {Hoffmann, Stephanie and Wachtler, Benjamin and Sander, Lydia and Blume, Miriam and Hilger-Kolb, Jennifer and Herke, Max and Matos Fialho, Paula Mayara and Pischke, Claudia R. and Novelli, Anna and Lampert, Thomas and Spallek, Jacob}, title = {Health inequalities among infants and pre-school children: Protocol for a scoping review examining the moderating and mediating role of contextual and compositional family characteristics}, publisher = {Open Science Framework}, doi = {10.17605/OSF.IO/3U4ST}, abstract = {Background: Although early childhood is a life period of overall good health, research shows that families' socioeconomic position (SEP) is affecting children's health from pregnancy on, ultimately leading to health inequalities. Little is currently known about the pathways by which family SEP is influencing child health and health-related behaviour, and which role family characteristics play. The scoping review therefore aims to screen the international literature on the mediating and moderating effects of contextual and compositional family characteristics on socioeconomic health risks of pre-school children in developed countries. Methods: Following the PRISMA guidelines for scoping reviews, three online databases (Pubmed, PsycINFO, and Scopus) will be searched for literature in English or German published after year 2000. The two-step data screening approach and the subsequent data extraction will be conducted independently by two researchers in consideration of specific criteria and a previously tested standardized data extraction form. Due to the broad research question at hand, various study designs (e.g. cross-sectional, intervention, cohort studies, and qualitative studies), SEP measures (e.g. education, income) and compositional (e.g. family size, migration) or contextual (e.g. parenting, housing) family characteristics influencing children's health will be included. Since diverse definitions and reporting formats of subjective health, health behaviour, well-being, and diseases will be considered, a substantial heterogeneity in outcome measures focusing on the age group of 0-6 years is expected. Thus, a narrative synthesis of the findings will be performed according to the Centre for Reviews and Dissemination framework. Ethics and dissemination: Because no primary data will be collected, ethical clearance will not be required. Dissemination will include peer-reviewed publications and conferences.}, language = {en} } @misc{HoffmannSanderBlumeetal., author = {Hoffmann, Stephanie and Sander, Lydia and Blume, Miriam and Schneider, Sven and Herke, Max and Matos Fialho, Paula Mayara and Pischke, Claudia R. and Sch{\"u}ttig, Wiebke and Lampert, Thomas and Spallek, Jacob}, title = {Do families have moderating or mediating effects on early health inequalities? A scoping review}, series = {European Journal of Public Health}, volume = {31}, journal = {European Journal of Public Health}, number = {Supplement_3}, publisher = {Oxford University Press}, doi = {10.1093/eurpub/ckab165.506}, abstract = {Background During early childhood, families have a crucial impact on children's health behaviour, health, and development (bhd). However, a family's socioeconomic position (SEP) determines both the parental behaviour, living conditions, and child health. To understand how family characteristics may influence the development of health inequalities, this scoping review synthesised research on their mediating and moderating effects. Methods The review followed the guidelines of the PRISMA Extension for Scoping Reviews. The search included German and English peer-reviewed articles published between January 1st, 2000 and December 19th, 2019. The search in PubMed, PsycINFO, and Scopus used both free text terms in the title/abstract and index terms within linked keyword blocks: (1) family characteristics, (2) inequalities, (3) income, education, occupation, (4) bhd, (5) newborn, infant, toddler, preschooler. Two researchers independently examined eligibility for inclusion in two rounds (title/abstract; full-text). Results Of 7,089 articles identified, ten sources were included that studied family characteristics and health inequalities among 0-6 years olds. Parental rules, stress, and screentime, and TV in bedroom showed mediating effects on inequalities in behaviour problems or children's screentime. Families' negativity, single parenthood, and the number of children in the household moderated differences in impairment, health, behaviour problems, development or breastfeeding initiation. Conclusions The effect of family characteristics on early health inequalities has been sparsely investigated. The evidence supported models of family stress and investment. Further research is needed to comprehensively understand this association. Key messages Family characteristics contribute to health inequalities. Taking families' stress and investment into account could improve targeted prevention efforts aimed at reducing health inequalities.}, language = {en} } @misc{HoffmannSanderWachtleretal., author = {Hoffmann, Stephanie and Sander, Lydia and Wachtler, Benjamin and Blume, Miriam and Schneider, Sven and Herke, Max and Pischke, Claudia R. and Matos Fialho, Paula Mayara and Schuettig, Wiebke and Tallarek, Marie and Lampert, Thomas and Spallek, Jacob}, title = {Moderating or mediating effects of family characteristics on socioeconomic inequalities in child health in high‑income countries - a scoping review}, series = {BMC Public Health}, volume = {22}, journal = {BMC Public Health}, issn = {1471-2458}, doi = {10.1186/s12889-022-12603-4}, pages = {1 -- 14}, abstract = {Background: By explaining the development of health inequalities, eco-social theories highlight the importance of social environments that children are embedded in. The most important environment during early childhood is the family, as it profoundly influences children's health through various characteristics. These include family processes, family structure/size, and living conditions, and are closely linked to the socioeconomic position (SEP) of the family. Although it is known that the SEP contributes to health inequalities in early childhood, the effects of family characteristics on health inequalities remain unclear. The objective of this scoping review is to synthesise existing research on the mediating and moderating effects of family characteristics on socioeconomic health inequalities (HI) during early childhood in high-income countries. Methods: This review followed the methodology of "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews". To identify German and English scientific peer-reviewed literature published from January 1st, 2000, to December 19th, 2019, the following search term blocks were linked with the logical operator "AND": (1) family structure/size, processes, living conditions, (2) inequalities, disparities, diversities, (3) income, education, occupation, (4) health and (5) young children. The search covered the electronic databases PubMed, PsycINFO, and Scopus. Results: The search yielded 7,089 records. After title/abstract and full-text screening, only ten peer-reviewed articles were included in the synthesis, which analysed the effects of family characteristics on HI in early childhood. Family processes (i.e., rules /descriptive norms, stress, parental screen time, parent-child conflicts) are identified to have mediating or moderating effects. While families' living conditions (i.e., TVs in children's bedrooms) are suggested as mediating factors, family structure/size (i.e., single parenthood, number of children in the household) appear to moderate health inequalities. Conclusion: Family characteristics contribute to health inequalities in early childhood. The results provide overall support of models of family stress and family investment. However, knowledge gaps remain regarding the role of family health literacy, regarding a wide range of children's health outcomes (e.g., oral health, inflammation parameters, weight, and height), and the development of health inequalities over the life course starting at birth.}, language = {en} } @misc{RattayBlumeWachtleretal., author = {Rattay, Petra and Blume, Miriam and Wachtler, Benjamin and Wollgast, Lina and Spallek, Jacob and Hoffmann, Stephanie and Sander, Lydia and Herr, Raphael and Herke, Max and Reuter, Marvin and Novelli, Anna and H{\"o}vener, Claudia}, title = {Socioeconomic position and self-rated health among female and male adolescents: The role of familial determinants in explaining health inequalities. Results of the German KiGGS study}, series = {PloS one}, volume = {17}, journal = {PloS one}, number = {4}, issn = {1932-6203}, doi = {10.1371/journal.pone.0266463}, abstract = {Objective Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining the association between the family's socioeconomic position and adolescents' self-rated health. The current study aimed to explore whether the association between socioeconomic position and self-rated health was mediated by familial determinants. Methods Using data from wave 2 of the"German Health Interview and Examination Survey for Children and Adolescents" (KiGGS) (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of income, education, occupational status, socioeconomic position index and adolescents' subjective social status on self-rated health into direct effects and indirect effects through familial determinants (family cohesion, parental well-being, parental stress, parenting styles, parental obesity, smoking and sporting activity). Results A significant total effect of all socioeconomic position indicators on self-rated health was found, except for income in male adolescents. In female adolescents, more than 70\% of the total effects of each socioeconomic position indicator were explained by familial mediators, whereas no significant direct effects remained. The most important mediator was parental well-being, followed by family cohesion, parental smoking and sporting activity. In male adolescents, the associations between income, parental education, the socioeconomic position index and subjective social status were also mediated by familial determinants (family cohesion, parental smoking, obesity and living in a single-mother family). However, a significant direct effect of subjective social status remained. Conclusion The analysis revealed how a family's position of socioeconomic disadvantage can lead to poorer health in adolescents through different family practices. The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions (macro-level), community-based strategies (meso-level) and programs to improve parenting and family functioning (micro-level).}, language = {en} } @misc{RattayBlumeSpalleketal., author = {Rattay, Petra and Blume, Miriam and Spallek, Jacob and Hoffmann, Stephanie and Sander, Lydia and Herr, Raphael and Herke, Max and Reuter, Marvin and Novelli, Anna and H{\"o}vener, Claudia}, title = {Socioeconomic position and self-rated health among adolescents: the mediating role of the family}, series = {European Journal of Public Health}, volume = {32}, journal = {European Journal of Public Health}, number = {Supplement_3}, issn = {1101-1262}, doi = {10.1093/eurpub/ckac129.580}, pages = {1}, abstract = {Background Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining adolescents' health inequalities. The study aimed to explore whether the association between socioeconomic position and self-rated health (SRH) was mediated by familial determinants. Methods Using data from wave 2 of the KiGGS study (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of parents' education, occupation, income, socioeconomic position index, and adolescents' subjective social status on SRH into direct effects and indirect effects through familial determinants (family cohesion, parenting styles, parental well-being, stress, obesity, smoking and sporting activity). Results A significant total effect of all socioeconomic position indicators on SRH was found, except for income in male adolescents. In female adolescents, more than 70\% of the total effects of each socioeconomic position indicator were explained by familial mediators, whereas no significant direct effects remained. The most important mediator was parental well-being, followed by family cohesion, parental smoking and sporting activity. In male adolescents, the associations of parental education, the socioeconomic position index and subjective social status with SRH were also mediated by familial determinants (family cohesion, parental smoking and obesity). However, a significant direct effect of subjective social status remained. Conclusions The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions, community-based strategies, as well as programs to improve parenting and family functioning.}, language = {en} }