The relationship between pets and multiple child health indicators

描述（由申请人提供）：如果宠物是狗，人类与动物的互动对儿童发展、心理和情感健康以及增加身体活动都有积极影响。我们的长期目标是衡量宠物，尤其是狗如何影响儿童的心理健康（情绪和行为问题）和身体健康（减轻肥胖和屏幕时间）。这个RO-3应用程序的目的是适应最近开发的访问前筛选工具，包括宠物相关的问题，这将使宠物与儿童心理和身体健康指标之间的关系的横断面分析，同时控制外来变量。这个名为DartScreen的筛查工具是基于网络的，可以在我们的儿科诊所使用苹果iPad访问。对于每年一次的探视，照顾孩子的护士在最初的屏幕上输入测量过的体重和身高、身体质量指数（BMI）、年龄和性别。然后由家长完成筛查问题，包括营养、身体活动、总“屏幕”时间（儿童在屏幕前看电视、视频游戏等的总时间）以及健康儿童访问期间通常涉及的安全相关问题。DartScreen还包括详细的心理健康筛查问题，这些问题与曾经被诊断患有心理健康障碍、心理健康功能和焦虑有关，还包括儿科症状清单。我们建议为DartScreen添加一个与宠物相关的模块，并进行试点测试，该模块可以查询宠物的饲养情况，如果家庭养宠物，特别是养狗，还可以询问更详细的问题。然后我们将筛查每年来诊所就诊的500名4到10岁的儿童。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、筛查时间）之间的分布和相关性，并确定社会人口统计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，依恋水平等）与孩子的BMI，屏幕时间和心理健康评分之间的关系。使用线性回归模型，我们将确定与狗有关的暴露变量与这些儿童指标之间是否存在剂量反应关系。将进行多变量分析以控制双变量分析中的显著协变量。然后，一项嵌入的定性研究将利用这些结果，结合文献综述，为儿科卫生保健提供者制定一项干预措施，供父母使用，对4至10岁儿童常规养宠物的风险和收益进行平衡评估。本研究的优势在于：1)它利用了真实世界的数据收集环境，2)采用了一种尖端的数据收集工具，加速了数据分析和分析

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. PUBLIC HEALTH RELEVANCE: The proposed study focuses on the relationship between human animal interaction and child health indicators for children ages 4 to 10 years being seen for annual visits in a pediatric clinic. This project is applicable to the prevention or early intervention of emotional, behavioral and weight related problems of children. This study will set the stage for future investigations on the effects of HAI in children with emotional and behavioral problems detected in primary care settings.