The relationship between pets and multiple child health indicators

描述(由申请人提供)：人类与动物的互动对儿童发展、心理和情绪健康有积极影响，如果宠物是狗，还会增加体力活动。我们的长期目标是衡量宠物，特别是狗对儿童的心理健康(情绪和行为问题)和身体健康(减轻肥胖和屏幕时间)的影响。此RO-3应用程序的目标是调整最近开发的访问前筛查工具，以包括宠物相关问题，从而能够对宠物与儿童心理和身体健康指标之间的关系进行横断面分析，同时控制外部变量。这款名为DartScreen的筛查工具是基于网络的，在我们的儿科诊所使用苹果iPad进行访问。对于年度探视，为孩子安排房间的护士会在初始屏幕上输入测量的体重和身高、身体质量指数(BMI)、年龄和性别。然后由父母完成筛查问题，并回答营养、体力活动、总“屏幕”时间(孩子在屏幕前看电视、视频游戏等的总时间)。和安全相关的问题，通常是在探视井下儿童时解决的。DartScreen还包括与曾经被诊断为精神健康障碍、精神健康功能和焦虑有关的详细精神健康筛查问题，并包括儿科症状检查表。我们建议为DartScreen加入并试点测试一个与宠物相关的模块，该模块可以查询宠物的拥有情况，并可以更详细地询问家庭是否有宠物，特别是狗。然后，我们将对500名4至10岁的儿童进行筛查，这些儿童每年都会来诊所就诊。我们将分析筛查结果，以描述自变量(宠物相关)和因变量(心理健康、BMI、屏幕时间)之间的分布和相关性，并建立社会人口协变量如何影响这些关系。对于狗主人，我们将分析孩子与狗的接触(花费的时间、依恋程度等)之间的关系。孩子的体重指数、屏幕时间和心理健康得分。使用线性回归模型，我们将确定与狗有关的暴露变量和这些子指标之间是否存在剂量反应关系。在双变量分析中，将进行多变量分析以控制显著协变量。然后，一项嵌入式定性研究将使用这些结果，结合文献综述，为儿科保健提供者开发一种干预措施，供父母使用，对4至10岁儿童常规饲养宠物的风险和好处进行平衡评估。这项研究的优点是：1)它利用了现实世界的数据收集环境，2)采用了一种先进的数据收集工具，加快了数据分析和 3)能够更全面地分析宠物暴露(重点是狗)和儿童健康之间的关系，同时调整几个协变量。这项研究还将产生一个干预原型，供初级保健提供者使用，以指导父母讨论常规养狗对孩子的风险和好处。

DESCRIPTION (provided by applicant): Human animal interactions have been linked to positive effects on child development, mental and emotional health as well as to increased physical activity if the pet is a dog. Our long-term goal is to measure how pets, particularly dogs affect children's mental health (emotional and behavioral problems) and physical health (mitigation of obesity and screen time). The objective of this RO-3 application is to adapt a recently developed pre-visit screening tool to include pet related questions that will enable a cross sectional analysis of the relationship between pets and child mental and physical health indicators while controlling for extraneous variables. The screening tool, called the DartScreen, is web-based and accessed in our Pediatric clinic using an Apple iPad. For annual visits, the nurse who rooms the child enters measured weight and height, body mass index (BMI), age, sex on the initial screen. Screening questions are then completed by parents and address nutrition, physical activity, total "screen" time (total amount of time the child spends in front o a screen viewing TV, video games, etc.) and safety related issues commonly addressed during well child visits. The DartScreen also includes detailed mental health screening questions that pertain to ever being diagnosed with a mental health disorder, mental health function and anxiety and includes the Pediatric Symptom Checklist. We propose to incorporate and pilot test a pet related module for the DartScreen that inquires about pet ownership and branches to more detailed questions if the family has a pet, specifically a dog. We will then screen 500 children ages 4 to 10 presenting to the clinic for annual visits. We will analyze the screening results in order to describe the distribution and correlation between independent variables (pet related) and dependent variables (mental health, BMI, screen time) and establish how socio-demographic covariates affect these relationships. For dog owners, we will analyze the relationship between the child's exposure to the dog (time spent, attachment level, etc.) with the child's BMI, screen time and mental health scores. Using linear regression modeling, we will determine if a dose response relationship exists between dog-related exposure variables and these child indicators. Multivariate analysis will be performed to control for significant covariats in bivariate analysis. An embedded qualitative study will then use these results, combined with a literature review, to develop an intervention for pediatric health care providers to use with parents that imparts a balanced appraisal of the risks and benefits of routine pet ownership for children ages 4 to 10 years. The strengths of this study are: 1) it utilizes a real world setting fr data collection, 2) adapts a cutting edge tool for data collection that expedites data analysis and 3) enables a more comprehensive analysis of the relationship between pet exposure (focusing on dogs) and child health while adjusting for several covariates. This study will also produce an intervention prototype for primary care providers to use to guide parents in a discussion of the risks and benefits of routine dog ownership for their children.