External Publications Using GUI Data

Background
There are few prospective studies of factors that mediate the association between exposure to adverse childhood experiences (ACEs) and obesity in adolescence. Our aim was to address this limitation.

Methods
We used prospective data from the Growing up in Ireland cohort study, with measurements at 9, 13, and 18 years old. The exposures were 14 adverse experiences before age 9. The main outcome was body mass index (BMI) at 18 years. Mediators were daily activity, diet quality, self-image and behavioural difficulties at 13 years.

Results
Among the 4561 adolescents in the final cohort, 77.2% experienced any adversity, 50.5% were female and 26.7% were overweight/obese at 18 years. BMI Z was higher at ages 9 (0.54 vs 0.43, p < 0.05, 95% CI of difference: −0.22, −0.01) and 13 years (0.50 vs 0.35, p < 0.05, 95% CI of difference: −0.25, −0.06), in those exposed to an ACE, compared to those unexposed. Structural equation models revealed that behavioural difficulties (β = 0.01; 95% CI: 0.007–0.018, p < 0.001) and self-concept (β = 0.0027; 95% CI: 0.0004–0.0050, p = 0.026) indirectly mediate the association between exposure to ACEs and BMI at 18 years.

Conclusions
The association between ACEs and BMI in adolescence is mediated by behavioural difficulties and self-concept.

Impact

• In a previous study, we found modest associations between exposure to a range of adverse childhood experiences and weight gain at 13 years of age.
• The strength of the association between adverse childhood experiences and weight gain was lower at 18 years of age compared to the association observed at 13 years and was no longer significant after controlling for confounding and including possible mediators.
• The association between adverse childhood experiences and BMI in adolescence is indirectly mediated by behavioural difficulties and self-concept.

We analyse parental smoking and cessation (quitting) associations with teenager e-cigarette, alcohol, tobacco smoking and other drug use, and explore parental smoking as a mechanism for social reproduction. We use data from Waves 1–3 of Growing Up in Ireland (Cohort ’98). Our analytic sample consisted of n = 6,039 participants reporting in all 3 Waves. Data were collected in Waves 1 and 2 when the children were 9 and 13 years old and in Wave 3 at age 17/18 years. Generalized Estimating Equations (GEE) models were used to analyse teenage substance use at Wave 3. Parental smoking was associated with significantly increased risk of all teenage substance use, adjusted odds ratios were aOR2.13 (ever e-cigarette use); aOR1.92 (ever alcohol use); aOR1.88 (current alcohol use); aOR1.90 (ever use of other drugs); aOR2.10 (ever-smoking); and aOR1.91 (current smoking). Primary caregiver smoking cessation (quitting) was associated with a lower risk for teenager current smoking aOR0.62, ever e-cigarette use aOR 0.65 and other drug use aOR 0.57. Primary caregiver smoking behaviour had greater associations than secondary, and age13 exposure more than age 9. Habitus seems to play a role and wealth was protective for teenage smoking. The findings suggest that prevention interventions should target both caregivers and their children.

Background
Children with a parent who smokes are more likely to become substance users than those who do not have a parent who smokes. In this study, we examined whether childhood or early adolescent exposure to primary parent smoking increased the risk of subsequent teenage alcohol and drug use at ages 17–18 years.

Methods
For this longitudinal observational study, we analysed data from 6039 teenagers and their parents from the waves 1–3 of the Growing up in Ireland Cohort 98’ Study. Parental smoking was assessed at baseline (9 years) and wave 2 (13 years) with responses coded as yes or no. The primary parent was defined as the person who provided most care and who knew most about the Study Child, usually the mother or mother figure for 98% of study participants. Teenage alcohol and drug use assessed at ages 17–18 years (wave 3) was determined by responses to the question “Have you ever consumed alcohol?” (answers yes or no), drug use was assessed by questions on ever trying aerosols/gas, cannabis, and non-prescribed drugs, with those answering yes being classified as other-drug ever users. We did a logistic regression analysis to examine the associations between parents’ smoking on teenage alcohol and drug use, controlling for covariates: gender, education, income, education, region, and household type. Ethics approval for the GUI project was obtained from the Health Research Board.

Findings
Of the 6039 teenagers included in our study, 2968 (49%) were female, 3070 (51%) were male, 5351 (89%) ever used alcohol, 5065 (85%) were current users, and 2098 (35%) used other drugs. Rates of primary parent smoking were 31% (n=1883) in wave 1 and 30% (n=1829) in wave 2. After adjusting for other exposures known to be associated with teenage substance use, primary parent smoking at waves 1 and 2 was associated with higher odds of teenage alcohol ever use (adjusted odds ratios [aORs] 1·89 [95% CI 1·44–-2·46] at wave 1 and 1·53 [1·20–1·98] at wave 2), current alcohol use (1·88 [1·50–2·36] and 1·59 [1·28–1·97]) and other-drug ever use (1·699 [1·45–1·95] and 1·71 [1·47–1·98]).

Interpretation
Teenagers aged 17–18 years exposed at ages 9 and 13 years to parental smoking were more likely to report significantly higher odds of alcohol and drug use at age 17–18 years. The finding that exposure to parent smoking in childhood increases the risk of teenage alcohol and other drug use suggests a need for interventions aimed at parents who smoke Limitations include potential unmeasured or residual confounders and reliance on self-reported teenage substance use behaviours.

Funding
Royal City of Dublin Hospital Trust, Irish Research Council Government of Ireland Postgraduate Scholarship Programme.

Childhood obesity is a growing concern worldwide. The association between childhood obesity and maternal smoking and/or paternal smoking has been reported. However, few studies have explored the association between childhood obesity and exposure to carers’ smoking status. This study aimed to assess the impact of carers’ smoking status on childhood obesity in a cohort of children enrolled in the Growing up in Ireland (GUI) study. Participants from the GUI infant cohort were categorized into four groups based on their exposure status: Neither caregiver smoked (60.4%), only primary caregiver smoked (13.4%), both caregivers smoked (10.9%). Exposure to primary carers’ smoking (98% are biological mothers) was found to be significantly associated with childhood overweight/obesity at age three (Odds Ratio: 1.30, 95% CI: 1.17–1.46) and at age five (OR: 1.31, 95% CI: 1.16–1.49). Exposure to both carers’ smoking status was significantly associated with increased odds of childhood overweight/obesity across both waves. These findings emphasize the health burden of childhood obesity that may be attributable to maternal smoking postnatally and through early childhood in Ireland.

Keywords
growing up in Ireland, childhood obesity, primary carer, secondary carer

Background
Adolescence is a critical transition point for body weight. Personality traits are associated consistently with weight and obesity risk in adulthood. We examined whether personality, particularly Conscientiousness (the tendency to be organized, disciplined, and responsible), is associated with weight outcomes between ages 13 and 17.

Methods
Data are drawn from the Growing Up in Ireland suites of studies. Parents rated their child’s personality at age 13, and trained staff measured weight and height at ages 13 and 17 (N = 4962). Logistic regression was used to predict risk of incident obesity and obesity remission between ages 13 and 17.

Results
Among children who were not in the obesity category at age 13, higher Conscientiousness was associated with lower risk of moving into the obesity category by age 17, and, among children with obesity at age 13, Conscientiousness was associated with greater likelihood of moving to the nonobesity category by age 17. These associations were independent of sociodemographic characteristics, parent body mass index, and were similar across gender. The other five-factor model personality traits were unrelated to weight outcomes.

Conclusions
Conscientiousness is one trait psychological factor implicated in weight transitions across a critical period during adolescence.

Children with disabilities experience significantly poorer socio-emotional outcomes than their peers without disabilities. However, research evidence is scarce about children with both disability and migration background, the group which this study aimed to investigate using data from a national longitudinal study. Secondary data analyses were conducted on a sample of 7290 children (weighted with missing values imputed). Significant differences in socio-emotional outcomes were found in relation to impairment status but not in relation to migration. Having an impairment and activity limitation significantly increased the likelihood of experiencing poorer socio-emotional outcomes over time. Our findings highlight a higher risk of socio-emotional problems among children with disabilities, especially among children from lower income backgrounds and with parents with lower educational attainment. These findings clearly require policy development on two fronts: to raise professional and community awareness on these issues and to strengthen the capacity of health, education and social care systems to support schools, families, and communities.

A small proportion of children experience social-emotional difficulties from early childhood onwards. Longitudinal studies with nationally representative samples are needed to identify the prevalence and the characteristics of children and families persistently experiencing these difficulties. Secondary analysis of data collected on over 7500 Irish children and with the Strengths and Difficulties Questionnaire as the primary indicator, found that 6% of children when they were five year olds and 8% when they were nine-years, had above threshold scores that warranted further investigation. A smaller proportion—2.9% had elevated scores at both ages. Logistic regression analyses found that children with one or more developmental disabilities were up to six times more likely to have sustained difficulties. There were also significant associations with the lower education attainment of primary caregivers and the socio-economic deprivation of families. Primary caregivers and teachers reported higher conflict in their relationships with these children. Although the number of Irish children presenting with continuing social-emotional difficulties is small, they can present an ongoing and future societal cost in terms of the impact on family relations and demands placed on educational, health and social services. This study identified the children and families who are at greatest risk and for whom targeted early intervention services could be provided.

Identifying the clustering and correlates of physical activity (PA) and sedentary behavior (SB) is very important for developing appropriate lifestyle interventions for children and adolescents. This systematic review (Prospero CRD42018094826) aimed to identify PA and SB cluster patterns and their correlates among boys and girls (0-19 years). The search was carried out in five electronic databases. Cluster characteristics were extracted in accordance with authors’ descriptions by two independent reviewers and a third resolved any disagreements. Seventeen studies met the inclusion criteria and the population age ranged from six to 18 years old. Nine, twelve, and ten cluster types were identified for mixed-sex samples, boys, and girls, respectively. While girls were in clusters characterized by “Low PA Low SB” and “Low PA High SB”, the majority of boys were in clusters defined by “High PA High SB” and “High PA Low SB”. Few associations were found between sociodemographic variables and all cluster types. Boys and girls in “High PA High SB” clusters had higher BMI and obesity in most of the tested associations. In contrast, those in the “High PA Low SB” clusters presented lower BMI, waist circumference, and overweight and obesity. Different cluster patterns of PA and SB were observed in boys and girls. However, in both sexes, a better adiposity profile was found among children and adolescents in “High PA Low SB” clusters. Our results suggest that it is not enough to increase PA to manage the adiposity correlates, it is also necessary to reduce SB in this population.

A growing number of international studies document the importance of regular school attendance. There is a consensus among authors that absenteeism has negative implications for academic achievement as well as the social development of the child and may put them at a disadvantage in terms of their position in the education and labour market. Most of the existing studies have focused on school absenteeism among adolescents with studies on poor school attendance among young children relatively rare. This paper addresses this gap in research by exploring factors that are related to school absenteeism in Irish primary schools. Drawing on a nationally representative study of nine-year-olds, it demonstrates the complexity of the issue. The findings indicate that a combination of institutional and individual factors shape patterns of poor school attendance in Irish primary schools. While the data relate to the Irish situation, the paper raises a number of issues of interest to an international audience.

Keywords
school absenteeism, primary schools, national survey, Ireland

Chapter 12 considers the prevalence of anti-social behaviour in the early teenage years in Ireland, the nature of this behaviour and the extent to which anti-social behaviour is associated with socio-economic characteristics of the family, family structure and other factors such as parenting style, the adolescent’s self-esteem and peer influences.

Despite the right of disabled people to full social and economic inclusion, many face multiple day-to-day and systemic challenges. These include but are not limited to additional expenses, access to housing, and everyday accessibility difficulties. Surveys show the general public hold positive attitudes towards policies that seek to enable disabled people to overcome these challenges, but standard survey methods are susceptible to response biases that may overestimate this support. This study aimed to test whether two such biases influence support for disability policy in Ireland: social desirability bias (i.e. the tendency for survey respondents to alter their responses in order to present themselves in a positive light); and inattention to the implications of policy support (e.g. that welfare policies require funding). Together the survey experiments covered a range of policy issues and types of disability, as identified in previous research and in consultation with the disability advisory group for the project.

Objective
The purpose of this study was to examine the relationship between maternal obesity that is calculated 9 months after delivery and sociodemographic variables.

Study Design
A national cohort of mothers was sampled 9 months after delivery as part of the Growing Up in Ireland Study Infant Cohort. Sociodemographic and clinical details were recorded at the interview by trained fieldworkers who used validated questionnaires. Body mass index was calculated based on weight and height measurements at the postpartum interview. The unadjusted and adjusted odds of obesity were calculated for predictor variables with the use of logistic regression analysis.

Results
Of the 10,524 mothers whose cases were studied, the mean age was 31.6 ± 5.5 years, and the mean parity was 1.0 ± 1.1. The mean body mass index after delivery was 25.7 ± 5.4 kg/m2; 16.8% of the women (n = 1768) were obese. Postpartum maternal obesity levels were associated positively on univariable analyses with smoking, lower household income, African nationality, earlier completion of full-time education, gestational weight gain, lower breast-feeding duration, and increasing parity. On multivariable analysis, maternal obesity was associated with increasing parity in lower income households, but not in higher income households.

Conclusion
Public health interventions that are aimed at decreasing obesity levels after childbirth should prioritize women who are disadvantaged socioeconomically.

Keywords
maternal obesity, parity, postpartum weight

The objective of this paper is to quantify and decompose the socioeconomic gradient in childhood obesity in the Republic of Ireland. The analysis is performed using data from the first wave of the Growing Up in Ireland survey, a nationally representative survey of 8568 nine-year-old children conducted in 2007 and 2008. We estimate concentration indices to quantify the extent of the socioeconomic gradient in childhood obesity and undertake a subsequent decomposition analysis to pinpoint the key factors underpinning the observed inequalities. Overall the results confirm a strong socioeconomic gradient in childhood obesity in the Republic of Ireland. Concentration indices of obesity (CI = −0.168) and overweight/obese (CI = −0.057) show that the gradient is more pronounced in obese children, while results from the decomposition analysis suggest that the majority of the inequality in childhood obesity is explained by parental level variables. Our findings suggest that addressing childhood obesity inequalities requires coordinated policy responses at both the child and parental level.

None of the many critical moments in Ireland’s often tumultuous history was more significant or defining than the Easter Rising of 1916. Central to the Rising was the Proclamation of Independence, in which Pádraig Pearse declared the new nation’s resolve to cherish all its children equally. CHERISHING ALL THE CHILDREN EQUALLY? brings together contributions from a range of disciplines to shed light on the processes of child development and to investigate how that development is influenced by a variety of demographic, family and socio-economic factors. Making extensive use of research and data that have emerged over recent years from the Growing Up in Ireland longitudinal study of children, the book considers whether or not all children can participate fully and equitably in contemporary Irish society. It asks whether or not we do, in fact, cherish all our children equally in modern Ireland, regardless of their family circumstances, health or ethnic background.

TABLES OF CONTENTS:

1. Introduction
2. Changing Perceptions and Experiences of Childhood, 1916-2016
3. Children and Families, Then & Now
4. Is Family Structure a Source of Inequality in Children’s Lives?
5. Parental Investment & Child Development
6. Inequalities in Access to Early Care and Education in Ireland
7. Inequalities from the Start? Children’s Integration into Primary School
8. Insights into the Prevalence of Special Educational Needs
9. The Experiences of Migrant Children in Ireland
10. Social Variation in Child Health & Development: A Life-course Approach
11. Child Access to GP Services in Ireland: Do User Fees Matter?
12. Anti-Social Behaviour at Age 13
13. Child Economic Vulnerability Dynamics in the Recession
14. Concluding Observations

In this paper we make use of the first and second waves of the 2008 and 1998 cohorts of the Growing Up in Ireland study, to develop a multidimensional and dynamic approach to understanding the impact on families and children in Ireland of the Great Recession. Economic vulnerability is operationalised as involving a distinctive risk profile in relation to relative income, household joblessness and economic stress. We find that the recession was associated with a significant increase in levels of economic vulnerability and changing risk profiles involving a more prominent role for economic stress for both the 2008 and 1998 cohorts. The factors affecting vulnerability outcomes were broadly similar for both cohorts. Persistent economic vulnerability was significantly associated with lone parenthood, particularly for those with more than one child, lower levels of primary care giver (PCG) education and, to a lesser extent, younger age of PCG at child’s birth, number of children and a parent leaving or dying. Similar factors were associated with transient vulnerability in the first wave but the magnitude of the effects was significantly weaker particularly in relation to lone parenthood and level of education of the PCG. For entry into vulnerability the impact of these factors was again substantially weaker than for persistent and transient vulnerability indicating a significantly greater degree of socioeconomic heterogeneity among the group that became vulnerable during the recession. The findings raise policy and political problems that go beyond those associated with catering for groups that have tended to be characterized by high dependence on social welfare.

In  this  paper  we  make  use  of  the  first  and  second  waves  of  the 2008  and 1998  cohorts  of  the  Growing  Up  in  Ireland  study,  to  develop  a  multidimensional  and  dynamic  approach  to understanding the impact on families and children in Ireland of the Great Recession. Economic vulnerability is operationalised as involving a distinctive risk profile in relation to relative income, household  joblessness  and  economic  stress.  We  find  that  the  recession  was  associated  with  a  significant increase in levels of economic vulnerability and changing risk profiles involving a more prominent  role  for  economic  stress  for  both  the  2008  and  1998  cohorts.  The  factors  affecting  vulnerability outcomes were broadly similar for both cohorts. Persistent economic vulnerability was  significantly  associated  with  lone  parenthood,  particularly  for  those  with  more  than  one  child, lower levels of primary care giver (PCG) education and, to a lesser extent, younger age of PCG  at  child’s  birth,  number  of  children  and  a  parent  leaving  or  dying.  Similar  factors  were  associated  with  transient  vulnerability  in  the  first  wave  but  the  magnitude  of  the  effects  was significantly weaker particularly in relation to lone parenthood and level of education of the PCG. For entry into vulnerability the impact of these factors was again substantially weaker than for persistent and transient vulnerability indicating a significantly greater degree of socioeconomic heterogeneity among the group that became vulnerable during the recession. The findings raise policy and political problems that go beyond those associated with catering for groups that have tended to be characterized by high dependence on social welfare.