A mixed methods study examining neighborhood disadvantage and childhood behavior problems in Montevideo, Uruguay

Seth Frndak; Yanina Gallo; Elena I Queirolo; Gabriel Barg; Nelly Mañay; Katarzyna Kordas

doi:10.1016/j.ijheh.2021.113753

A mixed methods study examining neighborhood disadvantage and childhood behavior problems in Montevideo, Uruguay

Int J Hyg Environ Health. 2021 Jun:235:113753. doi: 10.1016/j.ijheh.2021.113753. Epub 2021 Apr 26.

Authors

Seth Frndak¹, Yanina Gallo², Elena I Queirolo², Gabriel Barg², Nelly Mañay³, Katarzyna Kordas⁴

Affiliations

¹ Department of Epidemiology and Environmental Health: University at Buffalo, The State University of New York, United States. Electronic address: sethfrnd@buffalo.edu.
² Department of Neurocognition, Catholic University of Uruguay, Montevideo, Uruguay.
³ Faculty of Chemistry, University of the Republic of Uruguay (UDELAR), Montevideo, Uruguay.
⁴ Department of Epidemiology and Environmental Health: University at Buffalo, The State University of New York, United States.

Abstract

Background: Neighborhood disadvantage (ND) is a risk factor for child behavior problems (CBPs), but is understudied outside the United States and Europe. Our mixed methods study aims to (1) create a culturally meaningful measure of ND, (2) test cross-sectional associations between ND and CBPs and (3) qualitatively explore life in the neighborhoods of families participating in the Salud Ambiental Montevideo (SAM) study.

Methods: The quantitative study (Study 1) comprised 272, ~7-year-old children with geolocation and complete data on twelve behavioral outcomes (Conner's Teachers Rating Scale - Revised Short Form: CTRS-R:S and Behavioral Rating Inventory of Executive Functioning: BRIEF). A ND factor was created at the census segment level (1,055 segments) with 19 potential indicators of ND downloaded from the Municipality of Montevideo Geographic Services. Children were assigned ND scores based on the location of their household within a census segment. Multilevel models tested associations between ND and all CBP scales, controlling for confounders at the individual level. The qualitative study (Study 2) comprised 10 SAM caregivers. Photovoice alongside semi-structured interviews in Spanish were used to foster conversations about neighborhood quality, activities, and raising children. Thematic analysis with inductive coding was used to summarize qualitative study findings.

Results: The ND factor consisted of 12 census-based indicators related to education, employment, ethnicity, housing quality, and age characteristics, but unrelated to home ownership and some ethnicity variables. In multivariable models, ND was associated with greater conduct problems (β = 1.37, p < .05), poor shifting (β = 1.56, p < .01) and emotional control problems (β = 2.36, p < .001). Photovoice and semi-structured interviews yielded four themes: physical disorder, recreation, safety and crime, and community resources. Residents discussed improving waste management and transportation, updating playgrounds, and ensuring neighborhood safety.

Conclusions: ND in Montevideo comprised a unique set of census indicators. ND was primarily related to behavioral regulation problems. Hypothesized pathways whereby ND affects CBPs are discussed.

Keywords: Child behavior; Construct validity; Global south; Mixed methodology; Multilevel modeling; Neighborhood disadvantage.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Child
Cross-Sectional Studies
Ethnicity
Humans
Problem Behavior*
Residence Characteristics*
United States
Uruguay

Abstract

Publication types

MeSH terms

Grants and funding