TEACHERS BELIEFS OF BOGOTA BILINGUAL PROGRAM”

D1: General health status of respondent Rationale

Parental ill-health has implications for the health and well-being of children, particularly if it compromises the ability of the parent to care for the child (see questions D2 – D5 below).

Measure

Item D1 was derived from the Short Form 12 Health Survey which measured generic health concepts and health related quality of life. The item tapped the general health status of the parent on a 5-point rating scale ranging from ‘excellent’ through ‘poor’ and there is good evidence summarised in Blaxter (1989) that such measures are close analogues of clinically assessed health status.

D2 – D5: Chronic physical or mental health problem, illness or disability Rationale

Armistead et al (1995) have proposed a number of pathways through which the experience of parental chronic illness can impact on child functioning. Thus, parental illness may disrupt aspects of parenting (e.g. support, reinforcement, discipline) by reducing capacity to provide care, or indirectly through the emotional distress of parents (e.g. depression). However, the

extent to which the experience of parental illness impacts upon child outcomes remains an under-researched phenomenon relative to the extensive literature which addresses families’ adjustment to child illness (Pedersen & Revenson, 2005). These questions were also included in the questionnaires completed by the Primary and Secondary Caregiver at 9 months and 3 years of age. The association of parental chronic health problems with child outcomes at 5 years may therefore be investigated in terms of its persistence (or otherwise) over the child’s life.

Measure

Questions D2 – D5 were derived from the European Community Household Panel survey (ECHP – also known as the Living in Ireland survey 1994-2001) and explored the nature, duration and impact of the illness/disability on the respondent. These questions were also asked of the Secondary Caregiver, where appropriate.

D6 – D8: Healthcare Insurance Rationale

Children are some of the heaviest users of both primary and hospital health care services and UK data have shown that more than 25 per cent of a GP’s workload arises from consultations with children (Saxena, Majeed, & Jones, 1999). A parsimonious explanation for variations in children’s health care usage would be that a child’s health status and level of need determines their use of medical care services (Janicke & Finney, 2000). However, the extent of fee paying in the Irish system means that many children who require medical attention may not receive this, or may do so much later than they would have done had their parents not had to pay directly. Those on low incomes without medical card cover may be particularly vulnerable as GP visitation is likely to consume a large proportion of discretionary income. Determining variations in childhood access to medical care is clearly a major policy issue, especially since there is reason to suspect that a delay in seeking medical care is associated with more complications from, and sequelae to illness (Starfield & Budetti, 1985). This information will also be valuable in looking at changes in health care cover status through the public and private systems over the three waves of the study, and whether or not these changes have any impact on health outcomes for the child or on healthcare utilization rates – for example, as a child goes from private to public cover or vice versa. This is particularly important in Ireland when fieldwork for the 5-year-olds took place in 2013, a few years into the deep recession which started in 2008. One of the implications of the recession was an increase in the proportion of children covered for medical care by the medical card scheme – with a lower

level of cover under private health insurance scheme (Department of Health, 2015, Section 4).33

Measure

Questions D6–D8 recorded information in respect of the family’s medical insurance cover, including the provision of private healthcare insurance, as well as asking specifically whether the child is covered by health insurance. These will provide information on access to, and utilisation of health services, as well as variation in health status.

D9 – D10: Chronic physical or mental health problem, illness or disability of anyone living in the house with the child

Rationale

As with parental ill-health, having another person in the household with a chronic illness may also impact on parents’ ability to care for the child, and may have implications for the health and wellbeing of children.

Measure

Questions D9 – D10 asked if anyone in the household currently has a chronic illness, disability or special need which adversely affects the study child in any way or the care that the caregivers are able to give to the child. If the respondent answers yes to this question, they are asked what the relationship of that person is to the study child, i.e., parent, sibling, other relative, or a non-relative.

D11: Parent’s physical activity Rationale

It is widely believed that exercise habits established in early childhood persist into adulthood (e.g. Rimal, 2003) and research has demonstrated that physical exercise serves an important function in preventing the development of cardiac disease and other related vascular disorder in later life. Possible mechanisms for the relationship between parents' and child's activity levels include the parents' serving as role models, sharing of activities by family members, enhancement and support by active parents of their child's participation in physical activity, and genetically transmitted factors that predispose the child to increased levels of physical activity (Moore et al., 1991).

Measure

Question D11 asked the respondent to rate themselves as: Very physically active, Fairly physically active, Not very physically active, Not at all physically active.

D12: Parent’s perception of their own weight and frequency of dieting Rationale

Children model themselves on their parents’ eating behaviours, lifestyles, eating-related attitudes, and dissatisfaction regarding body image. Informed and motivated parents can become a model for children by offering a healthy diet and promoting self-regulation from the first years of life. Accordingly, it is instructive to compare the relationship between parental perceptions of their weight status and their measured weight status on the one hand, and how both relate to the child’s weight status on the other.

Measure

Questions D12-D13 asked the respondent to rate themselves as: Very underweight, Moderately underweight, Slightly underweight, About the right weight, Slightly overweight, Moderately overweight, or Very overweight. This was followed by question D13 which asked about frequency of dieting with answer categories Very often, Often, Sometimes, Rarely, Never.