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Preschool and School Age Activities: Comparison of Urban and Suburban Populations

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Title: Preschool and School Age Activities: Comparison of Urban and Suburban Populations


1
Preschool and School Age Activities Comparison
of Urban and Suburban Populations
  • Dorothy Damore, MD
  • Weill Cornell Medical College
  • New York, NY
  • Published in Journal of Community Health
    200227203-211.

2
Objective
  • To compare the activities of urban and suburban
    children in the New York metropolitan area

3
Background
  • Leisure time activities may be related to the
    living environment.
  • Studies have found greater illicit drug use and
    greater smokeless tobacco use in rural children
    and teenagers when compared with their urban
    counterparts.
  • This substance abuse is associated with criminal
    activity.
  • Finke L et al. J Drug Educ 199929279-291.
  • Kuria MW. East Afr Med J 199673339.
  • Olds RS. J Sch Health 198858374-378.
  • Gordon WR et al. Adolescence 199631883-901.

4
Background
  • The average American child watches between 21 and
    27 hours of television a week which accounts for
    more time spent watching television than on any
    other activity except sleep including school and
    homework.
  • AC Nielsen Company, Nielsen Media Research, 1989.

5
Background
  • In certain individuals watching violent
    television programming relates to aggressive
    behavior.
  • Violent television viewing in the third grade has
    been shown to correlate with aggressive behaviors
    10 to 22 years later.
  • Increased television viewing is associated with
    decreased sporting activities, decreased time
    spent outdoors and obesity.
  • Cantor J. J Adolesc Health 200027S30-34.
  • Dietz WH et al. Curr Probl Pediatr 19918-31.
  • Gortmaker SL et al. Arch Pediatr Adolesc Med
    1996150356-362.
  • Tucker LA. Adolescence 198621797-806.
  • Dietz WH et al. Pediatrics 198575807-812.

6
Methods
  • Prospective survey
  • Convenience sample
  • Conducted at one urban and one suburban primary
    care pediatric office
  • Urban office in the Upper East Side of Manhattan
  • Suburban office in Westchester County, just north
    of New York City

7
Methods
  • The primary investigator asked the caretakers of
    preschool and school age children to complete a
    questionnaire about their childs activities.
  • Questionnaire available in Spanish
  • Only one questionnaire per family
  • Exclusion children with physical handicaps

8
Questionnaire
  • Activities included
  • sports
  • time spent outdoors
  • reading
  • library use
  • video or television watching
  • computer use
  • summer camp
  • 34 questions, 5 pages
  • Took most parents 5 minutes to complete

9
Methods
  • Preschool and school age activities were compared
    between urban and suburban populations.
  • Suburban school age activities were compared
    between the school year and summer.
  • Due to time constraints, data collection for the
    urban school age children during the summer was
    not performed.

10
Methods
  • Assuming that 80 of urban children watched TV or
    videos for 3 or more hours a day and that a
    difference of 50 in the suburban children would
    be considered significant, to detect this
    difference with 80 power, a sample size of 45 in
    each group was determined using a chi-square test
    (two-tailed, alpha0.05).

11
Methods
  • Mann-Whitney test was used for numeric or
    quantitative variables.
  • Fishers Exact test was used for categorical
    variables.
  • Informed consent from a legal guardian
  • The Institutional Review Board approval

12
Results
  • Completed Questionnaires
  • 66 urban preschool children
  • 70 suburban preschool children
  • 57 urban school age children
  • 61 suburban school age children
  • 63 suburban school age children during the summer

13
Results
  • Refusal rates from 1 - 12 in the different
    groups
  • Four questionnaires completed in Spanish

14
Preschool Results
  • The preschool groups were similar in
  • mean age
  • gender
  • health insurance
  • parental level of education
  • Urban preschool children had greater ethnic
    diversity (plt.01).

15
Preschool Results
  • Suburban preschool children
  • spent more time outdoors, with 86 of suburban
    children spending 4 or more days outdoors per
    week versus 52 of urban children (plt.01)
  • were read to more frequently, with 97 of
    suburban children being read to 4 or more days
    per week versus 83 of urban children (p.01)
  • visited the library more frequently, with 66 of
    suburban children visiting the library at least 1
    to 3 times per month versus 47 of urban children
    (p.03)
  • and more often attended summer camp (plt.01)

16
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17
School Age Results
  • The school age groups were similar in
  • mean age
  • gender
  • health insurance
  • Urban school age children had greater ethnic
    diversity (plt.01).
  • The parental level of education was greater in
    the suburban group (p.01).

18
School Age Results
  • Suburban school age children
  • spent more time outdoors, with 87 of suburban
    children spending 4 or more days outdoors per
    week compared with 54 of urban children (plt.01)
  • more frequently participated in a community sport
    league, 62 of suburban children vs. 23 of urban
    children (plt.01)
  • and more often attended summer camp (plt.01)
  • Urban school age children
  • watched more TV or videos, with 25 of urban
    children watching more than 3 hours per day vs.
    100 of suburban children watching 3 hours or
    less per day (plt.01)

19
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20
Suburban School Age Children School Year vs.
Summer Results
  • The suburban groups, school year vs. summer, were
    similar in
  • mean age
  • gender
  • ethnicity
  • health insurance
  • parental level of education

21
Suburban School Age Children School Year vs.
Summer Results
  • School year
  • used the library more frequently, with 41
    visiting the library at least 1 to 3 times per
    week during the school year vs. 18 during the
    summer (p.01)
  • Summer
  • spent more time outdoors, with 63 spending 1
    hour or more per day outdoors during the summer
    vs. 23 during the school year (plt.01)

22
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23
Discussion
  • Suburban preschool and school age children spent
    more time outdoors.
  • Suburban school age children tended to spend more
    time playing sports than urban school age
    children.
  • Easier for suburban children to spend time
    outdoors near their homes.
  • Transportation may be easier in suburban settings.

24
Discussion
  • One study found greater physical activity to be
    associated with greater time spent outdoors.
  • In contrast, adults living in urban settings have
    been found to be more active than those living in
    rural settings.
  • Klesges RC et al. Health Psychol 19909435-449.
  • MMWR. 1998471097-1100.

25
Discussion
  • In our school age children, 36 53 played
    sports 4 or more days per week and 51 79
    played sports more than 30 minutes a day.
  • Vigorous activity for 3 days a week or more and
    20 minutes or more at a time is one of the
    objectives of Healthy People 2000.
  • Other studies have found that 60 80 of school
    age children meet this criteria.
  • US Department of Health and Human Services, 1991.
  • Molnar D et al. Eur J Pediatr 2000159S45-55.
  • Andersen RE et al. JAMA 1998279938-942.

26
Discussion
  • Most of our children 75 100 watched TV or
    videos, 3 hours or less per day.
  • However, in the urban school age group, 25
    watched 3 or more hours per day.
  • The American Academy of Pediatrics recommends
    that Pediatricians encourage their parents to
    limit their childs viewing of TV to less than 2
    hours per day.
  • In one study with over 4000 school age children,
    67 watched gt2 hours of TV per day and 26
    watched gt4 hours per day.
  • Andersen RE et al. JAMA 1998279938-942.

27
Limitations
  • Responses depended on parental interpretation of
    sports activities as well as parental estimations
    of the number of days and amount of time their
    children spent outdoors, playing sports, reading,
    using the library or using the computer.
  • Most of the children had private insurance which
    makes the groups similar but may not apply to
    other children with different insurance.

28
Limitations
  • Greater ethnic diversity was seen in the urban
    preschool and school age groups and a greater
    parental level of education in the suburban
    school age group which may account for some of
    the differences seen between the various groups.
  • Since this study was conducted in the New York
    metropolitan area, other urban and suburban areas
    may have different findings.

29
Conclusions
  • Important differences exist between the
    activities of urban and suburban children in two
    practices in the New York metropolitan area.
  • Pediatricians caring for urban children may have
    an important opportunity to promote participation
    in sports and educational activities.
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