External Publications Using GUI Data

While the role parents play in supporting young people is well established, support from other caring adults also becomes important during adolescence, particularly when young people are facing problems in their lives. The goal of this paper is to reflect on youth support seeking when facing problems, exploring differences between youth who seek support from parents only and those who seek support from parents and other non-parental adults. This paper outlines the findings of a secondary analysis of data from the third wave of the Growing up in Ireland child cohort at 17/18 years, collected from primary caregivers and youth. From 6126 young people in the national sample, 91.3% answered the selective question about the type of adult support they seek. Of this cohort, 36% of young people seek support from a parent and 48% go to a parent and another adult. Comparing these groups, there are significant differences found in both their individual and contextual characteristics, with better outcomes for youth with additional non-parental adult support, including using active coping strategies, better self-esteem, and identity resolution. While the findings indicate that non-parental adults have a positive influence in different areas of youth well-being, further research is required to better understand the ways in which support from non-parental adults helps young people in their transition to adulthood.

Keywords
Supportive adults, natural mentors, youth, transition to adulthood, parenting

Large-scale international migration continues apace. From a health-care services perspective, it is important to understand the influence of migrant heritage on utilization, to allocate resources appropriately and facilitate equity. However, the differences in utilization across different migrant groups remain poorly understood, particularly so for paediatric populations. This paper contributes to filling this gap in knowledge, examining the health-care contact of children for whom their primary caregiver is foreign-born, using longitudinal data from two nationally representative surveys. The study setting is Ireland, which provides an interesting case as a small, open European country, which for the first-time experienced net inward migration in the past two decades. For both cohorts, panel regression models, adjusting for socioeconomic and health indicators, demonstrated lower utilization of general practitioner (GP) services for children of caregivers from ‘less-advanced, non-Anglosphere, non-European Union (EU)’ nations, relative to native-born counterparts. Relatively lower attendances at Emergency Departments and hospital nights were also observed for this group, as well as for children born to EU (non-UK) caregivers. The insights provided are instructive for policymakers for which immigration is a substantial phenomenon in current and future population demographics.

Background
Energy poverty, typified by cold homes and/or an inability to afford energy bills, presents risks to the mental health of occupants. Parents of young children may be especially susceptible to a mental health toll from energy poverty since they have a significant care obligation and spend much of their day at home.

Methods
Data from the Growing Up in Ireland study inform this longitudinal analysis.

Results
A 1.64 greater odds of maternal depression were estimated for households containing young children characterized by energy poverty [P = 0.000; 95% confidence interval (CI): 1.31–2.05]. For energy poor households with older children (9 years and above), the odds of maternal depression were also higher [odds ratio (OR) 1.74, P = 0.001; 95% CI: 1.27–2.39]. Fathers of young children had greater odds of depression in energy poor households (OR 1.59, P = 0.002; 95% CI: 1.19–2.12), though the deleterious effect on mental health was not statistically significant for fathers of older children.

Conclusions
Energy poverty increases the likelihood of depression in parents. These findings merit policy attention since a mental health burden is in itself important, and more widely, parental well-being can influence child development and outcomes.

Children, particularly those of preschool ages (below 3 years), spend the majority of time indoors in the family home. Home conditions can impact upon occupant’s health, with energy poverty identified as a public health concern in Europe and internationally. Children growing up in energy poor homes may be especially vulnerable to health impacts, though the area is relatively understudied. This study addresses a gap in understanding, examining the effect of household energy poverty on the health of resident children using longitudinal data from two cohorts – an Infant Cohort (aged 9 months to 5 years) and a Child Cohort (aged 9 years to 17–18 years), growing up in Ireland.

Panel logistic regression models adjust for a range of covariates including socioeconomic and household information as well as smoking in the household. For the Infant Cohort, household energy poverty was associated with a 1.41 times higher odds of child respiratory illness (p = 0.003; 95% Confidence Interval (CI) 1.12–1.77), and 1.47 times the odds of child wheezing (p < 0.001; 95% CI 1.25–1.74). The odds of a young child being rated as very healthy was lower (point estimate: 0.85, p = 0.011; 95% CI 0.75–0.96). For older children, the relationships were not statistically significant. The risk that energy poverty presents for the health of young children merits continued policy attention.

The internet provides opportunities for social interactions which first occur in an online environment that can lead to meeting up in real life. However, growing concerns around safety and privacy warrant greater study of this modern-day phenomenon. Using a longitudinal dataset of approximately 4,300 20-year-olds in Ireland, this study finds one-in-three report meeting someone from online. Multiple regression reveals that females are less likely to engage in such behaviour, while the trait of ‘openness’, spending more time on the internet, being non-heterosexual, using dating apps, and being sexually active at 17 years are positively associated. Early exposure to information and communication technologies, as indicated by mobile phone ownership at 9 years, is also associated with online-to-offline encounters. A range of policy considerations are discussed, including the continued need for education in e-safety and cyber safety awareness from a young age through young adulthood, particularly for groups such as LGBT communities.

Technological advancement has seen a rise in computer-based and online gaming, and the online space has facilitated a proliferation in gambling options that increasingly adopt game-like features. There is a concern that gaming in childhood could predispose subsequent engagement with gambling behaviors, which has drawn the attention of parents, researchers, governments, and the European Union. To inform policy and legislation aimed at mitigating gambling-related harms, this research uses three waves of longitudinal data from Ireland to examine whether computer game engagement at 9-years-old (collected in 2007/8), and online gaming at 17 and 20, is associated with gambling participation in young adulthood. Multiple regression models, adjusting for a range of socio-economic and health characteristics, revealed that online gaming at 17 was associated with 1.4 higher odds of more frequent online gambling at 20 years (p = 0.011), while online gaming at 20 was associated with a 1.7 higher odds (p < 0.001). However, no association between early computer-based gaming at 9 years and subsequent gambling behaviors at 20 was uncovered for this cohort (born in 1998). Given more recent introductions of loot boxes and social casino games, continuous research is needed for future cohorts which may be greater affected by such developments.

Co-payments for prescription drugs are a common feature of many healthcare systems, although often with exemptions for vulnerable population groups. International evidence demonstrates that cost-sharing for medicines may delay necessary care, increase use of other forms of healthcare and result in poorer health outcomes. Existing studies concentrate on adults and older people, particularly in the US, with relatively less attention afforded to paediatric and European populations. In Ireland, prescription drug co-payments were introduced for the first time for medical cardholders (i.e. those with public health insurance) in October 2010, initially at a cost of €0.50 per item, rising to €1.50 in January 2013, and further increasing to €2.50 in December 2013. Using data from the Growing Up in Ireland longitudinal study of children, and a difference-in-difference research design, we estimate the impact of the introduction (and increase) of these co-payments on health, healthcare utilisation and household financial wellbeing. The introduction of modest co-payments on prescription items was not estimated to impinge on the health of children and parents from low-income families. For the younger Infant Cohort, difference-in-difference estimates indicated that the introduction (and increase) in co-payments was associated with a decrease in GP visits and hospital nights, and a decrease in the proportion of households reporting ‘difficulties with making ends meet’. In contrast, for the older cohort of children (the Child Cohort), co-payments were associated with an increase in GP visiting, and an increase in household deprivation. While the parallel trends assumption for difference-in-difference analysis appeared to be satisfied, further investigation revealed that there were other time-varying observable factors (such as exposure to the economic recession over the period) that affected the treatment and control groups, as well as the two cohorts of children differentially, that may partly explain these divergent results. For example, while the analysis suggests that the introduction of the €0.50 co-payment in 2010 was associated with an increase in the probability of treated families in the Child Cohort being deprived by 9.4 percentage points, the proportion of treated families experiencing unemployment and reductions in household income also increased significantly around the time of the co-payment introduction. This highlights the difficulty in identifying the effect of the co-payment policy in an environment in which assignment to the treatment (i.e. medical cardholder status) was not randomly assigned.

Background
Research has demonstrated positive associations between adverse childhood experiences (ACEs) and substance use behaviours in young adults. However, many of these are based on cross-sectional data. The pathway between ACEs and substance misuse among emerging adults is also not fully understood and few studies have investigated potential mediating factors.

Methods
We analysed data from the Child Cohort of the Growing Up in Ireland study, a nationally representative longitudinal sample of children recruited at 9 years of age (n = 4,729). Logistic regression was used to examine individual and cumulative ACE exposure relationships with substance use at age 20 years. Mediation analyses were used to assess whether parental and peer relationships and school engagement mediate ACE history associations with substance use behaviours.

Results
ACE exposure relationships with current cannabis use, other illicit drug use and problematic drug use were observed. In particular, young adults who had experienced 2 ACEs or 3 + ACEs had an approximate two-fold (OR=1.80, 95 % CI: 1.29, 2.51) and approximate three-fold (OR=2.94, 95 % CI: 2.06, 4.19) increased odds of problematic drug use, respectively, when compared to participants who had experienced no ACEs during the study period. Mediation analyses suggested that parent and peer attachment and liking school partially mediate relationships between ACEs and substance use behaviours.

Conclusions
Children who have experienced ACEs are at higher risk of future substance use and problematic drug use. In supporting these children, identified mediators such as interpersonal relationships and school engagement may help guide selection of prevention interventions.

Importance As young people’s mental health difficulties increase, understanding risk and resilience factors under challenging circumstances becomes critical.

Objective To explore the outcomes of the COVID-19 pandemic on secondary school students’ mental health difficulties, as well as the associations with individual, family, friendship, and school characteristics.

Design, Setting, and Participants For this cohort study, follow-up data from the My Resilience in Adolescence (MYRIAD) cluster randomized clinical trial were collected across 2 representative UK cohorts. Mainstream UK secondary schools with a strategy and structure to deliver social-emotional learning, with an appointed head teacher, and that were not rated “inadequate” in their latest official inspection were recruited. A total of 5663 schools were approached, 532 showed interest, and 84 consented. Cohort 1 included 12 schools and 864 students, and cohort 2 included 72 schools and 6386 students. COVID-19 was declared a pandemic after cohort 1 had completed all assessments (September 2018 to January 2020), but cohort 2 had not (September 2019 to June 2021).

Exposures Cohort 2 was exposed to the COVID-19 pandemic, including 3 national lockdowns. Associations of individual, family, friendship, and school characteristics with students’ mental health were explored.

Main Outcomes and Measures Changes in students’ risk for depression (Center for Epidemiological Studies-Depression scale); social, emotional, and behavioral difficulties (Strengths and Difficulties Questionnaire); and mental well-being (Warwick-Edinburgh Mental Well-Being Scale).

Results Of the 7250 participants included, the mean (SD) age was 13.7 (0.6) years, 3947 (55.4%) identified as female, and 5378 (73.1%) self-reported their race as White. Twelve schools and 769 of the 864 students (89.0%) in cohort 1 and 54 schools and 2958 of the 6386 students (46.3%) in cohort 2 provided data and were analyzed. Mental health difficulties increased in both cohorts but to a greater extent among students exposed to the pandemic, including for risk of depression (adjusted mean difference [AMD], 1.91; 95% CI, 1.07-2.76); social, emotional, and behavioral difficulties (AMD, 0.76; 95% CI, 0.33-1.18); and mental well-being (AMD, −2.08; 95% CI, −2.80 to −1.36). Positive school climate, high home connectedness, and having a friend during lockdown were protective factors during the pandemic. Female gender and initial low risk for mental health difficulties were associated with greater mental health deteriorations. Partial school attendance during lockdown was associated with better adjustment than no attendance when returning to school.

Conclusions and Relevance This cohort study of secondary school students demonstrated that to promote mental health and adjustment, policy interventions should foster home connectedness, peer friendship, and school climate; avoid full school closures; and consider individual differences.

Background
Bullying has a profound and enduring impact on academic achievement. However, there is a lack of clarity surrounding the specific mechanisms of this relationship.

Aims
This study examined the link between bullying at age 9 and Numeracy/Literacy achievement at age 15 to determine if this relationship is partially or fully explained by psychological difficulties at age 13.

Sample
Secondary data analysis was completed on waves 1, 2 and 3 of child cohort (Cohort’98) of the Growing Up in Ireland (GUI) study, respectively, at 9 years (N = 8568), 13 years (N = 7527) and 15 years of age (N = 6216).

Results
Longitudinal path mediation model was conducted with bullying at age 9 as the predictor, total (emotional and behavioural) difficulties at age 13 as the mediator and Numeracy/Literacy scores at age 15 as outcomes revealing significant indirect effects of bullying on achievement, via psychological difficulties.

Conclusions
We discuss the impact of bullying on the student’s psychological well-being, the relationship between bullying and academic attainment and how this may be tackled to avoid consequences throughout education and later in life.

Educational Impact and Implications
This study emphasizes the need for schools to address the emotional and behavioural difficulties occurring as a result of bullying in order to improve the overall educational experience of a child. Existing interventions can be built upon by focusing on the continuous remediation of such psychological difficulties.

Background
Ireland has one of the lowest BF rates in the world. This study investigates the association between breastfeeding and infant health in Ireland.

Methods
A cross-sectional, secondary analysis of data collected from Growing Up in Ireland (GUI): the National Longitudinal Study of Children was conducted. The average morbidity for 2212.

infants exclusively breastfed for at least 90 days (EBF90days) was compared to data for 3987 infants in the non-breastfed (Non-BF) group. Data were weighted using entropy balancing to ensure the comparability of groups. Sensitivity analyses considered alternative definitions of the breastfeeding group.

Results
Infants who were EBF90days were significantly less likely to be admitted to hospital (CI: − 0.06 to − 0.03), spent less nights in hospital (CI: − 0.37 to − 0.11), and were less likely to develop respiratory diseases including asthma (CI: − 0.03 to − 0.01), chest infections (CI: − 0.12 to − 0.08), snuffles/common colds (CI: − 0.07 to − 0.02), ear infections (CI: − 0.08 to − 0.04), eczema (CI: − 0.08 to − 0.04), skin problems (CI: − 0.04 to − 0.00), wheezing or asthma (CI: − 0.06 to − 0.03), vomiting (CI: − 0.03 to − 0.00), and colic (CI: − 0.04 to − 0.01). Further outcomes such as current health of the infant at time of interview (CI: − 0.04 to − 0.00), feeding problems (CI: − 0.04 to − 0.02) and sleeping problems (CI: − 0.02 to − 0.00) indicated a protective effect of EBF90days versus Non-BF. However, these infants were also more likely to fail to gain weight (CI: 0.01 to 0.02) and were at a slightly higher risk of developing nappy rash (CI: 0.00 to 0.02).

Conclusion
Exclusive breastfeeding for 90+ days is associated with protection against childhood morbidity. Given the protective effect of breastfeeding on adverse health effects in infants, policy makers should prioritise policies that support, promote and protect exclusive breastfeeding.

The Growing Up in Ireland Infant Cohort dataset (n = 11,134) includes information on fertility treatments for over 400 infants. IVF (28.1 %) and IVF-related treatments (17.8 %) were the most frequent, but there was also a high percentage following clomiphene citrate alone (31.5 %). Infants born following fertility treatment were much more likely to be in higher income families, and this relationship was not accounted for by older mothers in wealthier families. Analysis of fertility-treatment pregnancies among Irish infants, controlling for income and maternal age, shows a greater risk of multiple birth and low birth-weight, although the latter appears to be largely related to the former especially for IVF-type treatments.

Parenting style has been highlighted as an important factor in child and adolescent outcomes for a range of indicators including health and educational achievement. The fostering of a positive self-concept and closer parental monitoring of school involvement are two of the suggested mechanisms by which parenting style may affect educational achievement. In recent years, much research has tended to focus on adolescents and there is considerably less information for middle childhood. This paper looks at the role of maternal parenting style (based on child-reports) on academic achievement for a large sample of 9-year-old children who took part in the Growing Up in Ireland study. It shows that an authoritative parenting style was associated with higher scores on measures of reading and maths relative to neglectful or uninvolved styles, however the expected advantage over an authoritarian parenting style did not emerge (and tended to reverse post-adjustment for mediators), and other socio-demographic characteristics such as maternal education were stronger predictors. Adjustments for possible mediating variables had a complex effect on the earlier models and suggest that authoritative parenting may have an indirect effect through both parental monitoring and the promotion of positive self-concept, especially the latter.

Keywords
parenting style, academic achievement, middle childhood, self-concept

This study uses a nationally representative sample of 9-month-old infants and their families from the Growing Up in Ireland (GUI) study to investigate if reading to infants is associated with higher scores on contemporaneous indicators of cognitive development independently of other language-based interactions between parent and infant, such as showing them pictures or talking to them. Reading to infants had an independent positive effect on scores for both the problem-solving and communication subscales of the Ages and Stages Questionnaire (ASQ), while the positive effect of showing pictures was independent only for communication scores. The effects of both of these activities were, however, less substantial than the positive effect observed for the more informal activity of frequently talking to the infant while doing other things; and this was observed for both communication and problem-solving. The analyses were robust to adjustment for several other factors including maternal education, gestational age, non-parental care, breastfeeding, attachment and presence of siblings. The findings highlight the potential of reading and talking to infants, not just for language and literacy development but also for other aspects of cognitive development.

Chapter 6 provides a detailed discussion of the history of childcare provision in Ireland throughout the 20th century before investigating trends in non-parental childcare for infants in the first few years of life. The role of the Free Pre-school Year, a major policy shift in the Irish context, is also discussed.

The objective was to identify determinants of uptake and maintenance of active school travel (AST) over 4 years in children aged 9 at baseline. Data from wave 1 (n=8502) and 2 (n=7479) of the Growing Up in Ireland study were analysed. At 9- and 13-years 25% and 20% engaged in AST. Children were more likely to maintain or take-up AST if they lived in an urban area. Change in distance to school influenced both maintenance and adoption of AST, with a negative impact seen for increased distance between 9 and 13 years and a positive impact seen for decreased distance. Some factors which predict uptake and maintenance of AST are modifiable and can inform intervention development.