CABLE
Child and Adolescent Behaviors
in Long-term Evolution:
A School-Based Health Lifestyle Study
PI：Lee-Lan Yen (李 蘭)
Szu-Hsien T. Lee (李思賢)
Chuhsing K. Hsiao (蕭朱杏)
Ling-Yen Pan (潘怜燕)
Wen-Chi Wu (吳文琪)
CABLE Research Team
Outline
Background
Study Design
Work Completed in 2004
Work Will Be Conducted in 2005
Background
Childhood is an important developmental
stage.
Early and successful interventions can
improve children’s health behaviors and
health status.
A lifestyle based study following the
development of children and their health
related behaviors has never previously
been conducted in Taiwan.
Specific Aims
To understand the status and types of
health lifestyle among children.
To investigate the developments and
changes of children’s health lifestyle over
time.
To explore the determinants of children’s
health lifestyle.
To analyze the correlation between
children’s health lifestyle and health
status.
Study Design (1)
Cross-sectional
Longitudinal
Individual
Family/Group
Community/Society
Changeability
Study Design (2)
Observational Follow-up
-- Yearly Survey
2001
2005
2010
Study Design (3)
Year Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9
2001
2002
2003
2004
2005
2006
A1 B1
C1 D1
A2 B2
C2 D2
A3 B3
C3 D3
A4 B4
C4 D4
A5 B5
C5 D5
A6 B6
A1-A6: The 1st cohort of Taipei from 2001-2006
B1-B6: The 1st cohort of Hsinchu from 2001-2006
C1-C6: The 2nd cohort of Taipei from 2001-2006
D1-D6: The 2nd cohort of Hsinchu from 2001-2006
C6 D6
Study Framework
~ Cross-Sectional Survey ~
Intrapersonal
Factors
Interpersonal
Factors
Organizational
Factors
Health
Lifestyle
Health
Status
Study Framework
~ Longitudinal Follow-up ~
Independent Variables
1.Children & Parental Factors (demographics, health history,
personal characteristics, etc.)
2.Family Factors (family structure, SES, etc.)
3.School & Community Factors (size, resources, etc.)
4.Other Factors (survey time, study area, etc.)
Intermediate Variables
Dependent Variables
Intrapersonal Factors
Health Lifestyle
Time 1
Time i
Time 1
Time i
Interpersonal Factors
Time 1
Time i
Health Status
Time 1
Organizational Factors
Time 1
Time i
Time i
Study Subjects of Cohort 1
person
2001 participants
3000
2002 new participants
2730
2500
94.0%
2000
-6.0%
2576
645
93.0% 637
-7.0%
1500
1000
2218
2085
1939
2001
2002
2003
1st grade
2nd grade
3rd grade
500
0
year
Study Subjects of Cohort 2
person
2001 participants
3000
2510
2500
90.4%
2000
2449
634
-9.6%
1500
1000
2002 new participants
96.6%
637
-3.4%
2075
1876
1812
2001
2002
2003
4th grade
5th grade
6th grade
500
0
year
Study Instruments
Questionnaires
student
parent
teacher
Documents
student health record
school profile
community profile
Data Collection
CABLE
Questionnaires
Intrapersonal
Factors
Interpersonal
Factors
Health
Lifestyle
Health
Status
Organizational
Factors
School & Community
Profiles
School Health Records
Field Survey, 2001-2003
2001 & 2002
Student name list
2003
Subject name list
Informed consent
Interviewer
training
Subject
name
list
Field Survey
-- Children
-- Parents
Interviewer
training
Check
name list
Field Survey
-- Children
-- Parents
Field Survey, 2004 & 2005
Cohort 1
(Grade 4 & 5)
Subject name list
Interviewer
training
Check
name list
Field Survey
-- Children
-- Parents
Cohort 2
(Grade 7 & 8)
Subject name list
Interviewer
training
Field Survey
-- Children
-- Parents
Rearrange
name list
Mail Survey
-- Children
-- Parents
Data Management
Coding, key in, and checking data
Creating different data files
Statistical analysis for specific
purposes
Work Completed
in 2004
Data collection & management
Paper writing & publishing
Results dissemination
Professional training
Data collection
teacher survey
school profile
community profile
focus groups
field & mail surveys
Data management
data files
statistical
analyses
Paper Writing & Publishing in 2004
Conference papers
2004 TPHA Annual Meeting (4 papers)
132th APHA Annual Meeting (3 papers)
2005 Biennial Meeting of SRCD (1 paper)
First Conference on Statistical Methodology
(1 paper)
Journal articles
1 paper published in Journal of Medical Science
4 papers submitted to domestic and international
journals
Results Dissemination in 2004
Annual reports
Annual Report 2002 has been published
Annual Report 2003 is under preparation
Reference for parents
Application of CABLE questionnaires
Professional Training
Master
2001
2002
2003
2004
Doctor
Work Will Be
Conducted
in 2005
Data Collection in 2005
Fifth graders (1st cohort) :
Subjects: students + parents
Field survey at 19 primary schools in 2 areas
Eighth graders (2nd cohort):
Subjects: students + parents
Field Survey at 27 junior high schools
+ mail survey
Data Analysis in 2005
Cross-sectional data analyses
Multiple / logistic regression
Multilevel analysis
Structural equation model, etc.
Longitudinal data analyses
Time series analysis
Growth mixture model, etc.
Growth Mixture Model (GMM)
(Muthen, 2004)
Use both continuous and categorical
latent variables to represent
individual differences in development.
Will be able to establish developmental
typology of trajectories for child health
lifestyle and also behavior problems.
The CABLE Project Website
CABLE s Homepage Sitemap
Overview
Methods
Publications
News
Links
Introduction
Study Design
Journal Articles
Latest News
Memorandum of Events
Sampling
Conference Papers
Major Findings
Logo
Data Collection
Annual Reports
Journals
Data
Theses Abstracts
Conferences
Discussion
Research Team
Field surveys
Contact Us
Student profiles
Health records
School profiles
Question naires
Student
Female caregiver
Male caregiver
Teacher
School
Longitudinal
Members
Programs
Submit / Login
Member s Rights
Data Release
Purpose: to maximize the contribution of
the valuable CABLE datasets.
A data-releasing guideline has been drawnup in October, 2003.
Three domestic researchers are working
closely with CABLE research team
currently.
Connection with foreign scholars is
building up.
2nd CABLE Conference
Will be held in early spring of 2005
Target audiences:
Principles and teachers from study
schools
Officers from health and education
departments
Researchers and graduate students
from academic institutes
CABLE Research Team
Division of Health Policy Research,
National Health Research Institutes
Institute of Health Policy and Management,
College of Public Health, National Taiwan University
Department of Humanities and Social Sciences,
National Defense Medical Center, National Defense University
~Thank You~
(1) Changes in HealthRelated Behaviors Between
2001 and 2002 Among Two
Child Cohorts of the
CABLE Study
Lee-Lan Yen, Ling-Yen Pan, Likwang Chen,
Szu-Hsien Lee, Chuhsing Hsiao,
Major Findings
Most of the positive health behaviors showed
similar or increased rates over the two years.
Decreased rates were only found in “wearing a
motorcycle helmet” and “brushing teeth before
sleeping”.
The prevalence rates of performing negative
health behaviors and the rates of children who
changed to good or bad behaviors over the two
years varied depending on the behavioral item,
cohort, and area.
Using vulgar language, drinking alcohol, and
suicidal ideas are three problem behaviors with
great potential in increase among children.
(2) The Influence of Family
Interaction on the Initiation
of Smoking Among
Elementary Students in
Taiwan
Ling-Yen Pan, Lee-Lan Yen
Major Findings
There were 3,961 students who completed
the questionnaires both in 2001 and 2002.
Regarding the initiation of cigarette
smoking :
New triers : 2.89%
Continuous triers : 7.74%
After controlling the children’s and
family’s characteristics, those children
with less family support and those
receiving more punishment were more
likely to be new triers.
Research Topics
of Annual Report 2003
Lee-Lan Yen (李蘭): Change patterns of health
behaviors from 2001 to 2003.
Tony Szu-Hsien Lee (李思賢): Test-retest the validity and
reliability of psychological instruments for CABLE study.
Ling-Yen Pan (潘怜燕): Family interaction, parental
psychological state and children’s suicidal ideation: Results
from CABLE cohort study.
Wen-Chi Wu (吳文琪): Effects of school and class factors
on the 6th graders’ health behaviors in northern Taiwan:
Results of CABLE study, 2003.
Master Theses
Hung-Chieh Chang (張弘潔): Social Capital of Family and
School – Its Relationship with Children’s Internalized
Behavioral Problems.
Jian-Tai Fu (傅健泰): The Impact of Leisure Activities on Sleep
Deprivation and Negative Behaviors among Sixth-Graders：
Playing Computer Games as An Example.
Chi-Hsien Kao (高啟賢): The Relationship between Children’s
Depression and Family Interaction Types.
Hsin-I Liu (劉欣怡): The Relationship Between Parent’s Working
Time and Children’s Overweight and Obesity Among The Fifth
Graders.
Social Capital of Family and School ─
Its Relationship with Children’s Internalized
Behavioral Problems
Master: Hung-Chieh Chang Advisor: Lee-Lan Yen
Major Finding：
Those who are in lack of family social capital (low
family interaction and high family conflict) and
school social capital (low school identification)
have more internalized behavioral problems.
Besides, social capital might have more influence
on girls than on boys.
The Impact of Leisure Activities on Sleep
Deprivation and Negative Behaviors among
Sixth-Graders：Playing Computer Games as
An Example
Master:Jian-Tai Fu
Advisor:Lee-Lan Yen
Major Finding：
The rates of children who playing
PC games frequently and everyday
are 21% and 9% respectively.
Playing PC games was found to be
associated with children’s sleep
deprivation and negative behaviors.
The Relationship between Children’s Depression
and Family Interaction Types
Master: Chi-Hsien Kao
Advisor: Lee-Lan Yen
Major Findings：
Children were more likely to be depressed when their
mothers have had psychological problems or fathers have
performed violent behaviors.
Four types of family interaction: disciplinary, authoritative,
supportive, and conflictive.
Children from authoritative or conflictive families were more
likely to be depressed.
The Relationship between Parent’s Working Time
and Children’s Overweight and Obesity Among
Fifth Graders
Master: Hsin-I Liu
Advisor; Lee-Lan Yen
Likwang Chen
Major Findings：
Overweight: 11.8%(male); 10.5%(female)
Obesity: 4.0%(male); 2.8%(female).
Maternal working time (over 50 hrs/wk)
was found to be associated with children’s
overweight.