Journal
INTERNATIONAL JOURNAL OF HYGIENE AND ENVIRONMENTAL HEALTH
Volume 235, Issue -, Pages -Publisher
ELSEVIER GMBH
DOI: 10.1016/j.ijheh.2021.113753
Keywords
Neighborhood disadvantage; Child behavior; Global south; Mixed methodology; Multilevel modeling; Construct validity
Funding
- U.S. National Institute of Environmental Health Sciences (NIEHS) [R21ES019949]
- Fogarty International (FI) Institute [R21ES16523]
- Community of Excellence in Global Health Equity (CGHE) at the University at Buffalo -State University of New York
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This study examines the impact of neighborhood disadvantage (ND) on child behavior problems (CBPs) through quantitative and qualitative methods. ND was found to be primarily related to behavioral regulation problems, and residents also made suggestions for improving environmental quality and community resources.
Background: Neighborhood disadvantage (ND) is a risk factor for child behavior problems (CBPs), but is understudied outside the United States and Europe. Our mixed methods study aims to (1) create a culturally meaningful measure of ND, (2) test cross-sectional associations between ND and CBPs and (3) qualitatively explore life in the neighborhoods of families participating in the Salud Ambiental Montevideo (SAM) study. Methods: The quantitative study (Study 1) comprised 272, similar to 7-year-old children with geolocation and complete data on twelve behavioral outcomes (Conner's Teachers Rating Scale - Revised Short Form: CTRS-R:S and Behavioral Rating Inventory of Executive Functioning: BRIEF). A ND factor was created at the census segment level (1,055 segments) with 19 potential indicators of ND downloaded from the Municipality of Montevideo Geographic Services. Children were assigned ND scores based on the location of their household within a census segment. Multilevel models tested associations between ND and all CBP scales, controlling for confounders at the individual level. The qualitative study (Study 2) comprised 10 SAM caregivers. Photovoice alongside semistructured interviews in Spanish were used to foster conversations about neighborhood quality, activities, and raising children. Thematic analysis with inductive coding was used to summarize qualitative study findings. Results: The ND factor consisted of 12 census-based indicators related to education, employment, ethnicity, housing quality, and age characteristics, but unrelated to home ownership and some ethnicity variables. In multivariable models, ND was associated with greater conduct problems (beta = 1.37, p < .05), poor shifting (beta = 1.56, p < .01) and emotional control problems (beta = 2.36, p < .001). Photovoice and semi-structured interviews yielded four themes: physical disorder, recreation, safety and crime, and community resources. Residents discussed improving waste management and transportation, updating playgrounds, and ensuring neighborhood safety. Conclusions: ND in Montevideo comprised a unique set of census indicators. ND was primarily related to behavioral regulation problems. Hypothesized pathways whereby ND affects CBPs are discussed.
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