text:
Associations between socioeconomic status, home food availability, parental role-modeling, and children’s fruit and vegetable consumption: a mediation analysis
BMC Public Health volume 23, Article number: 1037 (2023)
Recent literature has suggested that associations and interactions between family socioeconomic status (SES) and home food environment influence children’s diet, but little is known about the mediation roles of parental role-modeling and food availability in the socioeconomic inequalities of children’s diet. This study aimed to determine the associations between family SES and children’s fruit and vegetable (FV) consumption and to assess the mediation roles of parental role-modeling and food availability in the above associations.
Cross-sectional data of 574 Finnish children (aged 3 to 6) were analyzed. Parents completed an FFQ assessing their children’s FV consumption frequency and a questionnaire assessing SES and home food environment. Two exposure variables: parental educational level (“low”, “middle”, and “high”) and the relative family income tertiles of the family were used. The frequencies of parental role-modeling of FV and sugary food and drink (SFD) consumption, and the availability of FV and SFD at home were calculated. Single- and multiple-mediator models were created using IBM SPSS 27.0.
The positive association between high parental educational level and children’s FV consumption (direct effect coefficient: 2.76, 95% CI: 0.51–4.86) was partially mediated by more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.89, 95% CI: 0.10–1.76), higher availability of FV (indirect effect coefficient: 1.00, 95% CI: 0.35–1.77), and lower availability of SFD (indirect effect coefficient: -0.30, 95% CI: -0.72 – -0.01). The relative family income was not directly associated with the outcome. However, the higher relative family income level indirectly predicted the Children’s FV consumption (full mediation) through more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.91, 95% CI: 0.06–1.83) and higher availability of FV (indirect effect coefficient: 0.98, 95% CI: 0.40–1.67). Parental role-modeling on SFD consumption did not mediate any of the above associations.
Parental educational level showed more associations with children’s FV consumption than relative family income. Our findings suggest that reducing the availability of SFD is as important as increasing the availability of FV to enhance children’s FV consumption. Future interventions to improve children’s dietary behaviors should pay greater attention to the lower SES segments of society. Longitudinal studies and intervention studies supporting these findings are needed for making meaningful recommendations for health promotion.
Adequate consumption of fruits and vegetables (FV) is considered a key component of a healthy diet . The positive influence of higher family socioeconomic status (SES) on children’s FV consumption is well-documented [2,3,4,5]. Educational level and income are two major indicators of SES . Previous studies conducted in high-income countries have revealed associations between high SES levels and healthy dietary intake among children [7,8,9]. Understanding how SES is linked to children’s diets is important for tackling such SES inequalities. The home food environment, which can be defined as any opportunity to obtain food at home , including social aspects such as parental role-modeling, and physical aspects such as food availability  may be important links between SES and children’s diets. Available evidence suggests that parental educational level may influence home food environment via nutritional knowledge and food-related parenting practices. . Low-income households are less likely to purchase healthy food that are comparatively rich in fiber and low in salt, added sugar, and saturated fats [13,14,15] leading to a home food environment, which does not support healthy eating habits.
A role model is a significant figure or character that influences motivation and goals and inspires the behaviors of another individual . Parents are identified as strong role models for children . Recent studies show a clear dietary resemblance between parents and children [18, 19]. According to the available evidence, parents who consume the daily recommended amount of FV are more likely to have children who also consume the recommended daily amount of FV [20, 21]. Furthermore, the inability of parents to meet nutritional recommendations can impede healthy dietary behaviors among their children . Home food availability, which refers to the presence of food at home , plays an important role in children’s diets [24,25,26]. Home availability of FV has usually been positively associated with children’s consumption of FV [27,28,29,30]. In addition, reducing the availability of unhealthy food including sugary food and drinks (SFD) at home has been effective in improving children’s diet quality  and healthy food consumption, including FV .
The concept of “mediation” can simply be defined as the transference of the effect of an independent/ predictor variable on a dependent/ outcome variable through a third variable called a mediator variable . Mediation analysis can be used to study intermediate variables, such as social or physical home food environments, which may act between the independent (SES) and outcome (diet) variables . Previous mediation studies of children’s diets have largely focused on psychosocial variables, such as parents’ self-efficacy, attitudes, and knowledge  and a limited number of studies have assessed the mediation roles of the home food environment. In addition, most previous mediation studies have focused on older children. A recent systematic review has identified home food availability and parental role-modeling of food consumption as mediators of the socioeconomic inequalities of diets among youth in European countries . However, little is known about the above-mentioned mediation roles in the diets of younger children. Children of preschool age spend more time at home and are more exposed to the home food environment than older children . Moreover, the dietary behaviors that are continued throughout life are developed during early childhood . Therefore, knowledge of the influencing factors of diet at preschool age is important for health promotion and intervention planning. The aim of this study was to reduce the above-mentioned knowledge gap by finding evidence on possible pathways by which the aspects of the home food environment influence the diet of preschool-aged children.
In this study, we hypothesized that the parental educational level and the relative family income are positively associated with children’s consumption of FV. We also hypothesized that the above associations are mediated by home food availability (FV and SFD) and parental role-modeling of FV and SFD consumption, as illustrated in Fig. 1. To the best of our knowledge, this is the first study to include both the social and physical aspects of the home food environment with regard to preschool children’s diet simultaneously in a mediation model.
Study design and participants
The DAGIS (Increased Health and Wellbeing in Preschools) project (www.dagis.fi) was aimed to promote healthy energy balance-related behaviors among preschool children in Finland. This study utilized cross-sectional data from the baseline assessment of the DAGIS intervention, a randomized controlled trial conducted in 2017–2018 . Participants were recruited in two municipalities in Southern Finland: Salo and Riihimäki. All the public preschools in Salo (n = 29) and three public preschools in Riihimäki agreed to participate. Altogether, 1702 eligible children in the 3–6-year age group from 32 preschools and their families were invited to take part in the study, and 802 (47% of invitees) consented. Baseline data were collected from September to October 2017. During the data collection, the parents of 728 children completed the parental questionnaire. The University of Helsinki Ethical Review Board of the Humanities and Social and Behavioral Sciences approved the DAGIS intervention study as ethically acceptable in May 2017 (22/2017).
Measurements and variables
Exposure variables: parental educational level and relative family income
Two SES indicators: education and income, were used as the exposures of this study. The parental questionnaire had six response categories for the educational level of the parents: (1) comprehensive school, (2) vocational school, (3) high school, (4) bachelor’s degree or polytechnic degree, (5) master’s degree, and (6) licentiate/doctorate. When applicable, the parent who filled in the questionnaire reported the highest educational level for both themselves and the other parent living in the same household. The answers were classified into three educational levels: “low” (Categories 1, 2, and 3), “middle” (Category 4), and “high” (Categories 5 and 6).
The parent reported the average net income of the entire household per month using 10 predefined answer options (1 = Less than EUR 500; 2 = EUR 500–999; 3 = EUR 1000–1499; 4 = EUR 1500–1999; 5 = EUR 2000–2499; 6 = EUR 2500–2999; 7 = EUR 3000–4999; 8 = EUR 5000–7499; 9 = EUR 7500–10 000; 10 = over EUR 10 000). All regular income, such as capital gains, pensions, and other social benefits, including child benefits, were considered household income. The answers were restructured by assigning an exact value as 1 = EUR 500, 2 = EUR 750, 3 = EUR 1250, 4 = EUR 1750, 5 = EUR 2250, 6 = EUR 2750, 7 = EUR 4000, 8 = EUR 6250, 9 = EUR 8750, and 10 = EUR 10 000. A standard equivalence scale  was used to weigh the net income of the household by the number of family members and to calculate the relative family income . This scale weighted the household’s net income as the first adult in the household = 1.0, the second adult in the household = 0.5, and each child under 18 years = 0.3. The relative family income variable was then categorized into tertiles. The relative family income in the “low”, “middle”, and “high” levels was less than EUR 1668, EUR 1668–1905, and more than EUR 1905, respectively.
Outcome variable: children’s FV consumption
A Food Frequency Questionnaire (FFQ) consisting of 51 items was used to assess children’s FV and SFD consumption outside preschool hours during the preceding week. The parents reported the number of times during the preceding week that their child had consumed each food or drink item outside preschool. An electronic version of the FFQ was emailed to the parent. Upon request, printed copies of the FFQ were provided and collected in sealed envelopes. Three response options were given for each food item in the FFQ: “not at all”, “times per day”, and “times per week”. Parents were instructed to tick the “not at all” column or write the number in one of the other columns. Four food items (fresh fruits, fresh berries, fresh vegetables, and cooked or canned vegetables) were extracted from the FFQ for this study. The consumption frequencies were summed up to compute the outcome variable. Two outcome variables were also computed by summing up the consumption frequencies of fruits and vegetables separately. However, we only report the findings for the combined outcome of FV consumption because splitting up fruit and vegetable consumption in the outcome did not change the results (data not shown). The FFQ was a modified version of a 47-item paper version of the same FFQ that has shown fairly good validity in ranking FV consumption compared to food record data . The FV items have also shown moderate reproducibility .
A previously developed and published tool for assessing food availability[25, 42] was modified and used to collect food availability data . Modifications were made by adding commonly consumed food and drink items and removing the food items considered unnecessary in the Finnish context . The questionnaire had four food items under the FV group and fourteen food and drink items under the SFD group (see Table 1). The parents who answered the questionnaire reported the availability of food/drink items at home as never, rarely, sometimes, often, and always. Values from 1 to 5 were allocated to each answer (1 = never, 5 = always). The values for food items in each food group were summed up and averaged to compute the mediator variables; availability of FV and availability of SFD.
The questions assessing parental role-modeling were adapted from a previously validated tool . The question, “During the past week, how often did you consume (food group) when your child was around?” was repeated for all five food groups: vegetables, fruits, sugary everyday foods, sugary treats, and sugary drinks (see Table 1). Six response options were allocated for each question: 1 = not once, 2 = 1–2 times, 3 = 3–4 times, 4 = 5–6 times, 5 = daily, and 6 = more than once a day. The above responses were converted into 0, 1.5, 3.5, 5.5, 7, and 10.5 respectively. The values for food items in each food group (see Table 1) were summed up to compute the two mediator variables: parental role-modeling of FV consumption (times/week) and parental role-modeling of SFD consumption (times/week).
The children’s age and gender were included in the mediation analysis as covariates. The parents reported their children’s gender and birth date. Age was calculated according to the date of birth and was used as a continuous variable.
The Statistical Package for Social Sciences (SPSS) version 27.0  was used for the descriptive and statistical analysis. The FV consumption variable was assessed for normal distribution, and outliers of at least three standard deviations from the mean (3SD) were removed from the dataset (N = 15). Outcome and mediator variables were checked for multicollinearity using linear regression. As the variance inflation factors for all the combinations among the outcomes and mediators were below 5, we assumed that no multicollinearity was present in the model . We assessed the correlations among the variables using the Spearman correlation test.
The mediation analysis of this study was conducted in two stages. Firstly, in the single-mediator model, we checked the individual mediation effects of the four potential mediators (availability of FV, availability of SFD, parental role-modeling of FV, and parental role-modeling of SFD) on the association between the exposures (parental educational level and relative family income) and the outcome (children’s FV consumption). The significance of the total effect, direct effect, a-path and b-path effects (see Fig. 1) were determined on the basis of the p-value. The indirect effect (a*b), which was the mediational effect in which the exposure influenced the outcome through a certain mediator, was considered statistically significant if its confidence interval did not contain zero. Secondly, in the multiple-mediator model, the significant mediators identified from the single-mediator model were tested simultaneously. We also checked the independent mediation effect of each mediator and the total effect of the model. Mediation analyses were conducted using the PROCESS Version 3 Macro for SPSS . The “low” educational group and “low” relative family income group were treated as the reference categories.
In addition to the above-mentioned analysis, we split our original outcome (FV) into two variables: fruit consumption and vegetable consumption and conducted the analysis again separately for the two outcomes (data not shown). As we observed no notable differences between the results before and after splitting the outcome variable, we only present and discuss the results for one outcome: children’s FV consumption.
Of the 698 parents who filled out the parental questionnaire, 91% were mothers. The children from whom we had data on at least one of the exposures, one of the mediators, and the outcome were eligible for the analysis (N = 574). The children’s mean FV consumption frequency was 21 times per week (Table 2). Parents reported role-modeling of FV and SFD consumption a mean of nine (ranging from 2 to 12) and five (ranging from 3 to 14) times per week in front of the child, respectively, outside preschool time.
Higher parental educational level was weakly associated with children’s increased FV consumption (r = 0.13), availability of FV (r = 0.13) and parental role-modeling of FV (r = 0.08). Higher relative family income was weakly associated with increased availability of FV (r = 0.16), increased availability of SFD (r = 0.12), and more frequent parental role-modeling of FV (r = 0.10). Table 3 shows the correlations between all the variables.
Parental educational level showed a direct effect on the children’s FV consumption under all four potential mediators. According to the a-path coefficients, higher parental educational level was positively associated with three potential mediators: availability of FV (b: 0.96, 95% CI: 0.38–1.54), availability of SFD (b: 1.13, 95% CI: 0.54), and parental role-modeling of FV (b: 1.40, 95% CI: 0.18–2.62) (Table 4). Further, higher availability of FV (b: 1.43, 95% CI: 1.10–1.75), greater parental role-modeling of FV (b: 0.83, 95% CI: 0.68–0.98), and lower availability of SFD (b: -0.21, 95% CI: -0.38 – -0.05) were positively associated with the children’s FV consumption (b-path). Availability of FV (b: 1.37, 95% CI: 0.51–2.30), availability of SFD (b: -0.24, 95% CI: -0.61 – -0.001), and parental role-modeling of FV (b: 0.80, 95% CI: 0.30–1.30) had indirect effects (a*b) on the association between parental educational level and children’s FV consumption. Parents with “middle” and “high” educational levels role-modeled FV consumption more frequently, which was associated with more frequent children’s FV consumption than among the “low” educational level. The households of parents in the “middle” and “high” educational levels had higher availability of FV, which in turn was associated with more frequent children’s FV consumption. Higher availability of SFD in the households of parents with “middle” educational level was associated with less frequent children’s FV consumption.
Relative family income showed a direct effect on children’s FV consumption under two potential mediators: availability of SFD (b: 2.57, 95% CI: 0.16–4.98) and parental role-modeling of SFD consumption (b: 2.45, 95% CI: 0.05–4.84). The associations between relative family income and potential mediators (a-path) showed that a higher relative family income was associated with higher availability of FV (b: 1.05, 95% CI: 0.49–1.61), more frequent parental role-modeling of FV consumption (b: 1.31, 95% CI: 0.12–2.50), higher availability of SFD (b: 1.57, 95% CI: 0.39–2.75), and less frequent parental role-modeling of SFD consumption (b: -0.78, 95% CI: -1.48 – -0.07). Higher availability of FV (b: 1.41, 95% CI: 1.06–1.76), more frequent parental role-modeling of FV consumption (b: 0.85, 95% CI: 0.70–1.01) and lower availability of SFD (b: -0.19, 95% CI: -0.36 – -0.01) were positively associated with children’s FV consumption (b-path). “Middle” (b: 0.83, 95% CI: 0.04–1.68) and “high” (b: 0.1.49, 95% CI: 0.66–2.43) relative family income levels were associated with more frequent children’s FV consumption through higher availability of FV. In addition, “high” (b: 1.13, 95% CI: 0.10–2.18) relative family income level was positively associated with children’s FV consumption through more frequent parental role-modeling of FV consumption.
Table 5 displays the simultaneous and independent mediation roles of all the significant single mediators in the multiple-mediator model. The association between parental educational level and children’s FV consumption was partially mediated by the availability of FV, parental role-modeling of FV, and availability of SFD. The association between relative family income and children’s FV consumption was fully mediated by the availability of FV and parental role-modeling of FV consumption.
The present study had two aims: The first was to determine the associations between both parental educational level and relative family income and the FV consumption of preschool children in Finland. The second was to explore the mediation roles of the availability and parental role-modeling of FV and SFD. In line with our hypotheses, parental educational level was positively associated with children’s FV consumption. However, relative family income did not show a direct association with the outcome. Availability of FV, parental role-modeling of FV, and availability of SFD partially mediated the association between parental educational level and children’s FV consumption. The association between relative family income and children’s FV consumption was fully mediated by the availability of FV and parental role-modeling of FV consumption.
The positive association between parental educational level and children’s FV consumption found in this study is in line with the findings of previous studies conducted in Finland [47, 48] and in other countries of similar development levels [7, 8, 49,50,51]. According to a recent study, a healthy dietary pattern was more prevalent among children (aged 9 to 14) of higher-educated parents in Finland . In addition, a similar analysis in Finland that used data of the same age group as this study revealed that lower parental educational level was associated with less frequent children’s FV consumption.
In the present study, relative family income was not directly associated with children’s FV consumption. Cross-sectional analyses with similar or compatible variables conducted in Finland , Australia [52,53,54], and the United Kingdom have shown findings that are in line with ours. In addition, two cohort studies in France and South Korea have also made similar findings. Finland is a country with less income disparities in society, despite the different educational levels of the population . This can be one reason why family income did not predict children’s consumption of FV like parental educational level did.
Our findings imply that parental educational level is a stronger predictor of children’s FV consumption than relative family income in Finland. Previous studies have assessed the associations between individual SES indicators and children’s FV consumption, but the abilities of different SES indicators to predict FV consumption have rarely been discussed. Several studies focusing on adults have identified education as a stronger SES indicator predicting food behaviors, including FV consumption, than other SES indicators such as income and profession [58,59,60,61]. High-educated people are generally considered more knowledgeable than less-educated people . Therefore, knowledge of a healthy diet may be more important for increased FV consumption than income. Income does not always reflect expenditure on food. Even families with higher incomes might struggle to prioritize a healthy diet and adequate nutrition due to other expenditures. In such situations, people may not have the resources to persuade their children to taste new fruits and vegetables, and just serve the food the children prefer. As the results of our study might have been influenced by the method we used to categorize the relative family income, future studies should use more distinctive categorization methods to assess the associations of relative family income.
Parental role-modeling of FV consumption appeared to be a mediator of the associations between the two exposures (parental educational level and relative family income) and FV consumption in different stages of childhood. Cross-sectional analyses of nine-month-olds , of adolescents and of eight-year-olds and 11-year-olds have identified parental role-modeling as a mediator of the association between parental educational level and children’s FV consumption. In addition, a systematic review has concluded that parental role-modeling is a consistent mediator of socioeconomic inequalities in children’s food consumption during youth . However, none of the above-mentioned studies focused solely on preschool-aged children. Therefore, our findings provide evidence to support the consistency of the mediation role of parental role-modeling throughout childhood. A recent systematic review has identified maternal FV consumption as a mediator of the socio-economic inequalities in 2.5- to 7-year-old children’s FV consumption, though the review did not compare maternal and paternal FV consumption . A previous study by our research group showed moderate dietary resemblance in both father-child and mother-child dyads, suggesting that both parents are important role models for the child . Our study did not assess the mediation effects of mothers’ and fathers’ FV consumption separately. However, 91% of the respondents to the parental questionnaire of our sample were mothers.
Parental role-modeling can be a challenging variable due to the use of different measurement methods and potential biases. Previous studies have measured parental role-modeling using questionnaires filled out by parents about eating together with their child [64, 65], FFQs  or 24-hour diet recall of parents  to determine general parental food intake. Interestingly, many of the studies mentioned above have observed parental role-modeling plays a mediation role on the association between parental educational level and children’s food consumption, regardless of the measurement method used. Self-reported dietary data are highly susceptible to social desirability bias . The questions we used to assess parental role-modeling asked about parental dietary intake in the presence of the child. Reporting food consumption in the presence of the child might be similarly or even more prone to social desirability bias than a general FFQ. Therefore, FV consumption might have been over-reported and SFD consumption under-reported.
This study identified the availability of FV as a mediator of the associations between SES indicators and FV consumption. A previous cross-sectional study using data on children aged 11 in 10 European countries including Finland has identified the availability of FV as a strong mediator of the association between parental educational level and school-aged children’s consumption of FV . In addition, several studies of adolescents  and 11-year-old children  with similar or compatible variables conducted in similar contexts have also found comparable evidence. Moreover, a systematic review concluded that FV availability has a consistent mediation role in the socioeconomic inequalities of FV consumption during youth .
Availability of SFD showed a negative mediation effect on the association between parental educational level and children’s FV consumption. A recent study has revealed a negative association between the availability of SFD and preschool children’s consumption of FV in Finland  but, except for our findings, no other evidence is available on the mediation role of the availability of SFD on the socioeconomic inequalities in children’s FV consumption in Finland. Previous studies have identified strong mediation roles of the availability of SFD in socioeconomic inequalities of children’s SFD consumption [70,71,72], but only a few studies have assessed the mediation role of SFD availability on socioeconomic inequalities in FV consumption [53, 73] the findings are not consistent. However, a very recent multivariate analysis concluded that reducing the availability of unhealthy food at home, including SFD, more effectively improves healthy dietary behaviors among school-aged children than increasing the availability of FV . A possible explanation for this could be that higher availability of SFD leads to a higher intake of SFD during and in between main meals, replacing the amount of FV consumed during main meals. On the other hand, low availability of SFD could simply be a better indicator of a greater preference for FV consumption.
Similar to other Western societies, in the Finnish food culture, fruits and vegetables are not consumed in a similar manner. Vegetables are often served during main meals whereas fruits might be consumed as snacks between main meals. To obtain a deeper understanding of the associations and mediation effects, we split our original outcome into two variables: fruit consumption and vegetable consumption, and reran the analysis for new outcomes. Nevertheless, the results from before and after splitting up the FV consumption variable were similar, suggesting that regardless of their different roles in Finnish food culture, the associations between SES and fruit and vegetable consumption and the possible mediators do not differ greatly.
This study had several strengths. Using an FFQ of known validity and reliability [40, 41] which was specifically designed and developed for the DAGIS project, preschool age group, and the Finnish context is among the main strengths. We included both healthy (FV) and unhealthy (SFD) food groups and both the social (role-modeling) and physical (food availability) aspects of the home food environment in our mediation models. Instead of using a composite score for SES, we studied the individual associations of two SES indicators. The results showed that the two SES indicators predicted FV consumption in different ways. Understanding the individual behaviors of SES indicators may be highly valuable in planning interventions to minimize socioeconomic inequalities in children’s diets. We recommend that future research studies the different SES indicators and their associations with children’s diet more comprehensively, as this may reveal crucial knowledge for intervention planning.
We should also discuss the limitations of this study. The analysis of cross-sectional data does not reveal how the associations change when children grow up. The educational level of our study sample was higher than the Finnish average . Accurate data on income may be more difficult to obtain than data on education level because people are often reluctant to answer questions about income . We received 728 completed parental questionnaires, which included questions on income and education. Of these questionnaires, the number with missing data on educational level and household income was 17 (3% of the study sample) and 90 (16% of the study sample), respectively. These missing values and unanswered questions might have affected and attenuated the observed associations. Respondents who do not want to reveal their income are more likely to belong to the lower SES society with less education and less income  making the study sample seem more educated and with higher incomes than it actually was. We still found associations when the data were selective, and we can assume that these associations would have been stronger with more complete income data. Reverse causality between the mediators and the outcome is possible, and this may have influenced our findings. For example, the higher availability of FV and more frequent parental role-modeling of FV could have been caused by the children’s higher preference of eating FV. Despite the acceptable reproducibility and validity, the FFQ was filled by parents and proxy-reported dietary data may be susceptible to over-reporting and under-reporting. The accuracy level of children’s dietary data may differ according to the respondent (mother or father), and the age and gender of the respondent who answered the questionnaire . Consumption frequencies do not reveal the actual quantities of food eaten, and the quantities may vary significantly from child to child. Lastly, though the children were recruited to the study from 32 preschools, the analysis was not adjusted for clustering at the preschool level. This might have affected the results. However, we only considered the variables related to home food environment and food consumption outside the preschool hours. Therefore, the effect of not adjusting for clustering at preschool level may be fairly weak.
Findings of our study are relevant for the planning of health promotion interventions in Finland and in other counties with similar contexts. To reduce the socioeconomic inequalities in food consumption and home food environment, it is important to identify the factors and mediators, which might predispose children from low SES families to poor diet and other health behaviours leading to adverse health effects later in life. Failing to identify these factors may reduce the effectiveness of the interventions and may further enhance the existing gap between low and high SES level. Our analysis revealed mediators that are less often established in low SES families and therefore, can be effectively used in future for planning of health promotion interventions. We noticed that a direct effect remained between parental educational level and children’s FV consumption after the mediator variables were accounted for. Other aspects of the home food environment which we did not study may also act as mediators and may explain the remaining direct effect. Therefore, future studies should focus on other potential mediators of socioeconomic inequalities in children’s diets found in previous studies, such as food accessibility, rules about food consumption, individual preferences , using food as a reward, parental influence , verbal rewarding , permissiveness , and maternal feeding stress . Further, the potential difference between maternal and paternal role-modeling should be assessed. Children’s diets are not limited to FV. Further analyses should be conducted on the associations with other food groups. Previous studies with similar aims have largely focused on older children. We need more studies on younger children to understand the consistency of the mediation roles of the home food environment throughout childhood. In addition, future interventions should focus on getting parents to reflect on their own behaviors that may influence the eating habits of children. Preschools and child health clinics have a high reach to the parents of young children in Finland and therefore may be important channels to improving home food environment through educating parents.
Compared to relative family income, parental educational level had more associations with the FV consumption of preschool children. Higher availability of FV, more frequent parental role-modeling of FV consumption, and lower availability of SFD partially mediated the association between parental educational level and children’s FV consumption. Furthermore, the higher availability of FV and more frequent parental role-modeling of FV consumption fully mediated the association between relative family income and children’s FV consumption. Future interventions and health promotion in early childhood should aim to upgrade the home food environment by increasing FV availability, decreasing SFD availability, and supporting good parental role-modeling behaviors. Further, when considering all SES levels, greater attention should be paid to the home food environment in families with lower SES levels.
The data and materials of the present study are available from the corresponding author on reasonable request.
Fruit and vegetables
Sugary food and drinks
Food frequency questionnaire
World Health Organization. Report of the commission on ending childhood obesity. Implementation plan: executive summary 2017. https://apps.who.int/iris/handle/10665/259349. Accessed 24 Apr 2021.
Rashid V, Engberink MF, van Eijsden M, Nicolaou M, Dekker LH, Verhoeff AP, et al. Ethnicity and socioeconomic status are related to dietary patterns at age 5 in the Amsterdam born children and their development (ABCD) cohort. BMC Public Health. 2018;18(1):1–10.
Tarasuk V, Fitzpatrick S, Ward H. Nutrition inequities in Canada. Applied Physiology. Nutr Metabolism. 2010;35(2):172–9.
Boelens M, Raat H, Wijtzes AI, Schouten GM, Windhorst DA, Jansen W. Associations of socioeconomic status indicators and migrant status with risk of a low vegetable and fruit consumption in children. SSM Popul Health. 2022;17:2352–8273.
Quezada-Sánchez AD, Shamah-Levy T, Mundo-Rosas V. Socioeconomic characteristics of mothers and their relationship with dietary diversity and food group consumption of their children. Nutr Dietetics. 2020;77(4):467–76.
American Psychological Association. Measuring Socioeconomic Status and Subjective Social Status. (2015). Available from: https://www.apa.org/pi/ses/resources/class/measuring-status. Accessed 17 Oct 2022.
Gutiérrez-Camacho C, Méndez-Sánchez L, Klünder-Klünder M, Clark P, Denova-Gutiérrez E. Association between Sociodemographic factors and dietary patterns in children under 24 months of age: a systematic review. Nutrients. 2019;11(9).
Hinnig P, de Monteiro F, de Assis JS, Levy MAA, Peres RB, Perazi MA. FM, Dietary patterns of children and adolescents from high, medium and low human development countries and associated socioeconomic factors: a systematic review. Nutrients. 2018;10(4).
Sotero AM, Cabral PC, da Silva GAP. Socioeconomic, cultural and demographic maternal factors associated with dietary patterns of infants. Revista Paulista de Pediatria (English Edition). 2015;33(4):445–52.
Townshend T, Lake AA. Obesogenic urban form: theory, policy and practice. Health Place. 2009;15(4):909–16.
Watts AW, Barr SI, Hanning RM, Lovato CY, Mâsse LC. The home food environment and associations with dietary intake among adolescents presenting for a lifestyle modification intervention. BMC Nutr. 2018;4(1):1–9.
Rosenkranz RR, Dzewaltowski DA. Model of the home food environment pertaining to childhood obesity. Nutr Rev. 2008;66(3):123–40.
French SA, Tangney CC, Crane MM, Wang Y, Appelhans BM. Nutrition quality of food purchases varies by household income: the SHoPPER study. BMC Public Health. 2019;19(1):1–7.
Appelhans BM, Milliron BJ, Woolf K, Johnson TJ, Pagoto SL, Schneider KL, et al. Socioeconomic status, energy cost, and nutrient content of supermarket food purchases. Am J Prev Med. 2012;42(4):398–402.
Turrell G, Kavanagh AM. Socio-economic pathways to diet: modelling the association between socio-economic position and food purchasing behaviour. Public Health Nutr. 2006;9(3):375–83.
Morgenroth T, Ryan MK, Peters K. The motivational theory of role modeling: how Role Models influence role aspirants’ goals. Rev Gen Psychol. 2015;19(4):465–83.
Stephens K, Parents Are Powerful Role Models for Children. 2007. Available from: https://www.easternflorida.edu/community-resources/child-development-centers/parent-resource-library/documents/parents-powerful-role-models.pdf. Accessed 30 Nov 2020.
Vepsäläinen H, Nevalainen J, Fogelholm M, Korkalo L, Roos E, Ray C et al. Like parent, like child? Dietary resemblance in families. Int J Behav Nutr Phys Activity. 2018;15(1).
Haines J, Haycraft E, Lytle L, Nicklaus S, Kok FJ, Merdji M, et al. Nurturing children’s healthy eating: position statement. Appetite. 2019;137:124–33.
Coto J, Pulgaron ER, Graziano PA, Bagner DM, Villa M, Malik JA, et al. Parents as Role Models: Associations between parent and young children’s weight, Dietary Intake, and physical activity in a minority sample. Matern Child Health J. 2019;23(7):943–50.
Draxten M, Fulkerson JA, Friend S, Flattum CF, Schow R. Parental role modeling of fruits and vegetables at meals and snacks is associated with children’s adequate consumption. Appetite. 2014;78:1–7.
Brewis A, Gartin M, Gartin M. Biocultural construction of obesogenic ecologies of childhood: parent-feeding versus child-eating strategies. Am J Hum Biology. 2006;18(2):203–13.
Pajulahti R, Salmela-Aro K, Lehto R, Vepsäläinen H, Lehto E, Nissinen K, et al. Does temperament make children differently susceptible to their home physical food environment? A cross-sectional DAGIS study on 3–6 year old finnish children’s food consumption. Appetite. 2021. https://doi.org/10.1061/j.appet.2021.105140.
Wang L, Dalton WT, Schetzina KE, Fulton-Robinson H, Holt N, Ho AL, et al. Home food environment, dietary intake, and weight among overweight and obese children in southern appalachia. South Med J. 2013;106(10):550–7.
Couch SC, Glanz K, Zhou C, Sallis JF, Saelens BE. Home food environment in relation to children’s dietquality and weight status. J Acad Nutr Dietetics. 2014;114(10).
Santiago-Torres M, Adams AK, Carrel AL, Larowe TL, Schoeller DA. Home food availability, parental dietary intake, and familial eating habits influence the diet quality of urban hispanic children. Child Obes. 2014;10(5):408–15.
Vepsäläinen H, Korkalo L, Mikkilä V, Lehto R, Ray C, Nissinen K, et al. Dietary patterns and their associations with home food availability among finnish pre-school children: a cross-sectional study. Public Health Nutr. 2018;21(7):1232–42.
Ong JX, Ullah S, Magarey A, Miller J, Leslie E. Relationship between the home environment and fruit and vegetable consumption in children aged 6–12 years: a systematic review. Public Health Nutr. 2017;20(3):464–80.
Cullen KW, Baranowski T, Owens E, Marsh T, Rittenberry L, de Moor C. Availability, accessibility, and preferences for fruit, 100% fruit juice, and vegetables influence children’s dietary behavior. Health Education and Behavior. 200;30(5):615–26.
Boles RE, Johnson SL, Burdell A, Davies PL, Gavin WJ, Bellows LL. Home food availability and child intake among rural families identified to be at-risk for health disparities. Appetite. 2019;134:135–41.
Robson SM, Ziegler ML, McCullough MB, Stough CO, Zion C, Simon SL, et al. Changes in diet quality and home food environment in preschool children following weight management. Int J Behav Nutr Phys Activity. 2019;16(1):16.
Pereira B, Silva C, Núñez JC, Rosário P, Magalhães P. More than buying Extra Fruits and Veggies, please hide the Fats and Sugars”: children’s Diet Latent Profiles and Family-Related factors. Nutrients. 2021;13(7):2403.
Baron RM, Kenny DA. The moderator-mediator variable distinction in Social Psychological Research: conceptual, Strategic, and statistical considerations. J Personal Soc Psychol. 1986;51(6):1173–82.
Gunzler D, Chen T, Wu P, Zhang H. Introduction to mediation analysis with structural equation modeling. Shanghai Arch Psychiatry. 2013;25(6):390–4.
Wyse R, Wolfenden L, Bisquera A. Characteristics of the home food environment that mediate immediate and sustained increases in child fruit and vegetable consumption: mediation analysis from the healthy Habits cluster randomised controlled trial. Int J Behav Nutr Phys Activity. 2015;12(1):1–9.
Mekonnen T, Havdal HH, Lien N, O’Halloran SA, Arah OA, Papadopoulou E et al. Mediators of socioeconomic inequalities in dietary behaviours among youth: a systematic review. Obes Rev. 2020;21(7).
Ray C, Kaukonen R, Lehto E, Vepsäläinen H, Sajaniemi N, Erkkola M et al. Development of the DAGIS intervention study: a preschool-based family-involving study promoting preschoolers’ energy balance-related behaviours and self-regulation skills. BMC Public Health. 2019;19(1670).
Official Statistics of Finland (OSF). Total statistics on income distribution [e-publication]. 2016. https://www.stat.fi/til/tjkt/index_en.html. Accessed 31 Aug 2022.
Määttä S, Konttinen H, Haukkala A, Erkkola M, Roos E. Preschool children’s context-specific sedentary behaviours and parental socioeconomic status in Finland: a cross-sectional study. BMJ Open. 2017;7(11):e016690.
Korkalo L, Vepsäläinen H, Ray C, Skaffari E, Lehto R, Hauta-alus HH, et al. Parents’ reports of Preschoolers’ diets: relative validity of a food frequency questionnaire and dietary patterns. Nutrients. 2019;11(1):159.
Määttä S, Vepsäläinen H, Lehto R, Erkkola M, Roos E, Ray C. Reproducibility of Preschool Personnel and Guardian reports on Energy Balance-Related behaviors and their Correlates in Finnish Preschool Children. Children. 2018;5(11):144.
Ding D, Sallis JF, Norman GJ, Saelens BE, Harris SK, Kerr J et al. Community Food Environment, Home Food Environment, and Fruit and Vegetable Intake of Children and Adolescents. Journal of Nutrition Education and Behavior. 2012 Nov 1;44(6):634–8.
Pinard CA, Yaroch AL, Hart MH, Serrano EL, McFerren MM, Estabrooks PA. The validity and reliability of the Comprehensive Home Environment Survey (CHES). Health Promot Pract. 2014;15(1):109–17.
IBM Corp. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp; 2020.
Akinwande MO, Dikko HG, Samson A. Variance inflation factor: as a Condition for the inclusion of suppressor variable(s) in regression analysis. Open J Stat. 2015;05(07):754–67.
Hayes AF. Mediation analysis. Introduction to Mediation, Moderation, and conditional process analysis, Second Edition: a regression-based Approach. 2nd ed. New York: Guilford Publications; 2017. 77–216.
de Oliveira Figueiredo RA, Viljakainen J, Viljakainen H, Roos E, Rounge TB, Weiderpass E. Identifying eating habits in finnish children: a cross-sectional study. BMC Public Health. 2019;19(1):1–11.
Lehto E, Ray C, Vepsäläinen H, Korkalo L, Lehto R, Kaukonen R, et al. Increased health and wellbeing in Preschools (DAGIS) Study—Differences in children’s Energy Balance-Related behaviors (EBRBs) and in long-term stress by parental Educational Level. Int J Environ Res Public Health. 2018;15(10):2313.
Pinket AS, de Craemer M, Huybrechts I, de Bourdeaudhuij I, Deforche B, Cardon G, et al. Diet quality in european pre-schoolers: evaluation based on diet quality indices and association with gender, socio-economic status and overweight, the ToyBox-study. Public Health Nutr. 2016;19(13):2441–50.
Finger JD, Varnaccia G, Tylleskär T, Lampert T, Mensink GBM. Dietary behaviour and parental socioeconomic position among adolescents: the german health interview and examination survey for children and adolescents 2003–2006 (KiGGS). BMC Public Health. 2015;15(1):1–13.
Fernández-Alvira JM, Mouratidou T, Bammann K, Hebestreit A, Barba G, Sieri S, et al. Parental education and frequency of food consumption in european children: the IDEFICS study. Public Health Nutr. 2013;16(3):487–98.
Manyanga T, Tremblay MS, Chaput JP, Katzmarzyk PT, Fogelholm M, Hu G, et al. Socioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development? BMC Public Health. 2017;17:457.
McNaughton SA, Ball K, Mishra GD, Crawford DA. Dietary patterns of adolescents and risk of obesity and hypertension. J Nutr. 2008;138(2):364–70.
Ambrosini GL, Oddy WH, Robinson M, O’Sullivan TA, Hands BP, de Klerk NH, et al. Adolescent dietary patterns are associated with lifestyle and family psycho-social factors. Public Health Nutr. 2009;12(10):1807–15.
Camara S, de Lauzon-Guillain B, Heude B, Charles MA, Botton J, Plancoulaine S, et al. Multidimensionality of the relationship between social status and dietary patterns in early childhood: longitudinal results from the french EDEN mother-child cohort. Int J Behav Nutr Phys Activity. 2015;12(1):1–10.
Lee HA, Hwang HJ, Oh SY, Park EA, Cho SJ, Kim HS, et al. Which Diet-Related Behaviors in Childhood Influence a healthier Dietary Pattern? From the Ewha Birth and Growth Cohort. Nutrients. 2016;9(1):4.
Fina S, Heider B, Mattila M, Rautiainen P, Sihvola MW, Vatanen K. Unequal Finland: Regional socio-economic disparities in Finland. Friedrich-Elbert-Stiftung; 2021. Available from: https://fes.de/unequal-finland. Accessed 24 Sep 2021.
Roos E, Prattala R, Lahelma E, Kleemola P, Pietinen P. Modern and healthy? Socioeconomic differences in the quality of diet. Eur J Clin Nutr. 1996;50(11):753–60.
de Irala-Estévez J, Groth M, Johansson L, Oltersdorf U, Prättälä R, Martínez-González MA. A systematic review of socio-economic differences in food habits in Europe: consumption of fruit and vegetables. Eur J Clin Nutr. 2000;54(9):706–14.
Groth M, Fagt S, Brøndsted L. Social determinants of dietary habits in Denmark. Eur J Clin Nutr. 2001;55(11):959–66.
Roos E, Talala K, Laaksonen M, Helakorpi S, Rahkonen O, Uutela A, et al. Trends of socioeconomic differences in daily vegetable consumption, 1979–2002. Eur J Clin Nutr. 2007;62(7):823–33.
Parmenter K, Waller J, Wardle J. Demographic variation in nutrition knowledge in England. Health Educ Res. 2000;15(2):163–74.
Lioret S, Cameron AJ, Mcnaughton SA, Crawford D, Spence AC, Hesketh K, et al. Association between maternal education and diet of children at 9 months is partially explained by mothers’ diet. Maternal and Child Nutrition. 2015;11(4):936–47.
Bere E, van Lenthe F, Klepp KI, Brug J. Why do parents’ education level and income affect the amount of fruits and vegetables adolescents eat? Eur J Pub Health. 2008;18(6):611–5.
Rodenburg G, Oenema A, Kremers SPJ, van de Mheen D. Parental and child fruit consumption in the context of general parenting, parental education and ethnic background. Appetite. 2012;58(1):364–72.
van Ansem WJC, Schrijvers CTM, Rodenburg G, van de Mheen D. Maternal educational level and children’s healthy eating behaviour: role of the home food environment (cross-sectional results from the INPACT study). Int J Behav Nutr Phys Activity. 2014;11(1):1–12.
Miller TM, Abdel-Maksoud MF, Crane LA, Marcus AC, Byers TE. Effects of social approval bias on self-reported fruit and vegetable consumption: a randomized controlled trial. Nutr J. 2008;7(1):1–7.
Lehto E, Ray C, te Velde S, Petrova S, Duleva V, Krawinkel M, et al. Mediation of parental educational level on fruit and vegetable intake among schoolchildren in ten european countries. Public Health Nutr. 2015;18(1):89–99.
Ball K, MacFarlane A, Crawford D, Savige G, Andrianopoulos N, Worsley A. Can social cognitive theory constructs explain socio-economic variations in adolescent eating behaviours? A mediation analysis. Health Educ Res. 2009;24(3):496–506.
de Coen V, Vansteelandt S, Maes L, Huybrechts I, de Bourdeaudhuij I, Vereecken C. Parental socioeconomic status and soft drink consumption of the child. The mediating proportion of parenting practices. Appetite. 2012;59(1):76–80.
Pinket AS, de Craemer M, de Bourdeaudhuij I, Deforche B, Cardon G, Androutsos O, et al. Can Parenting Practices explain the differences in Beverage Intake according to Socio-Economic Status: the Toybox-Study. Nutrients. 2016;8(10):591.
van Ansem WJC, van Lenthe FJ, Schrijvers CTM, Rodenburg G, van de Mheen D. Socio-economic inequalities in children’s snack consumption and sugar-sweetened beverage consumption: the contribution of home environmental factors. Br J Nutr. 2014;112(3):467–76.
Michels N, Vynckier L, Moreno LA, Beghin L. de la o A, Forsner M, Mediation of psychosocial determinants in the relation between socio-economic status and adolescents’ diet quality. European Journal of Nutrition. 2017;57(3):951–63.
Official Statistics of Finland (OSF): Educational structure of population [e-publication]. Helsinki. ; 2022. https://www.stat.fi/til/vkour/index_en.html. Accessed 13 Nov 2022.
Galobardes B, Shaw M, Lawlor DA, Lynch JW, Smith GD. Indicators of socioeconomic position (part 1). J Epidemiol Commun Health. 2006;60(1):7–12.
Kim S, Egerter S, Cubbin C, Takahashi ER, Braveman P. Potential implications of missing Income Data in Population-Based surveys: an Example from a Postpartum Survey in California. Public Health Rep. 2007;122(6):753.
Vereecken CA, Keukelier E, Maes L. Influence of mother’s educational level on food parenting practices and food habits of young children. Appetite. 2004;43(1):93–103.
Mosli RH, Kaaki HM, Fallatah KM, Badreiq LY, Eid NM. Maternal feeding stress during mealtimes as a mediator between child food fussiness and maladaptive feeding behaviors among mothers of preschoolers. Appetite. 2021. https://doi.org/10.1016/j.appet.2021:105322.
We thank all the early childhood education and care centers and families for participating in the study.
This study was financially supported by the Juho Vainio Foundation, The Academy of Finland (Grant: 315816), the Päivikki and Sakari Sohlberg Foundation, Folkhälsan Research Center, and University of Helsinki. The funding bodies were not involved and did not interfere with the study at any stage.
Ethics approval and consent to participate
The DAGIS intervention study was performed in accordance with the guidelines of the Finnish National Board on Research Integrity and the regulations of the Helsinki Declaration. The study was reviewed by the Research Ethics Committee in the Humanities and Social and Behavioural Sciences of the University of Helsinki (22/2017; 16 May 2017) and was found ethically acceptable. Informed written consents were received from the guardians of the participating children.
Consent to publication
The authors declare no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Serasinghe, N., Vepsäläinen, H., Lehto, R. et al. Associations between socioeconomic status, home food availability, parental role-modeling, and children’s fruit and vegetable consumption: a mediation analysis. BMC Public Health 23, 1037 (2023). https://doi.org/10.1186/s12889-023-15879-2
- Socioeconomic position
- Home food environment
- Physical food environment
- Social food environment
- Dietary quality
- Healthy diet


Actresses Ava Gardner (left) and Halle Berry (below right) are challenging Angelina Jolie (bottom right) for the title of the world's most beautiful woman.
That's the showdown set up by readers participating in two “In Your Face” surveys.
In the first one, 37 percent of readers said “Yes” to the question, “Is Angelina Jolie the world's most beautiful woman?” while 63 percent said “No.”
In a follow-up survey, Halle Berry was the top vote-getter, closely followed by Ava Gardner. The survey question was “If not Angelina Jolie, who is the most beautiful woman?”
Here's the final survey in the series:
In that second "If not Angelina" survey, Halle Berry has so far received 18 percent of the votes, while Ava Gardner won 15 percent. Grace Kelly earned 10 percent, but no one else reached double digits.
Other stars who ranked high included these nine women, in this order:
- Jennifer Connelly
- Penelope Cruz
- Kate Winslet
- Elisabeth Taylor
- Audrey Hepburn
- Megan Fox
- Heddy Lamarr
- Ingrid Bergman
- Marilyn Monroe
- Angelina is the star plastic surgery patients want to look like
- Angelina's cheeks could be yours, cosmetic docs say
- 16 pictures of Angelina Jolie at Cannes
- Top 3 techniques to keep skin young, from grand master of skin research
- New ideal — baby fat for middle-aged women. Really?
- The Emmy goes to … plastic-surgery abstainers
- The world's most powerful Botoxed celebrities
For more on celebrities and cosmetic medicine, see links on the right side of this blog.
- Donald Trump rouses cheering crowd in Costa Mesa: 'Build that wall'
- Donald Trump in O.C.: Tensions mount as police in riot gear separate protesters, supporte
- Fullerton standoff suspect surrenders, hostage safe
- Donald Trump in Orange County: Large crowd gathers hours before rally in Costa Mesa
- Subway or Starbucks? Sandwich chain's cafe concept seeks coffee lovers in Orange


Remove unsightly dirt and stains from your carpet the professional way with this effective dry cleaning powder. Manufactured in the UK to the same formula used by floor cleaning companies in hotels and airports, it produces excellent results without any risk of damaging your carpets. Suitable for use on both natural and manmade carpets, simply sprinkle the powder onto the affected area, gently brush in and watch as marks and grime disappear almost instantly. There’s no wetting, so no drying time, no shrinkage, and you can walk on it immediately after application.
- Made in the UK
- Suitable for all natural and manmade fibres
- Can be used on damp areas
- Each 600g bottle covers approx 10-20sq.m
- Choose from Lemon, Lavender or Cotton Fresh fragrance
- 600g bottles


text:
Tactac is a Colorado-based technology company on a mission to radically change the way we shop. It is time to reclaim our confidence and cut back on returned purchases. At tactac, we believe that friends provide the best advice for shopping. Why sift through anonymous reviews? Why not listen to those we trust?
Tactac was founded by parents who care about the products we buy for our children. While shopping for families is a major focus, everyone needs help when it comes to shopping. Let’s face it, nobody knows it all. In an ever-changing world, our network can help us keep up with the latest and greatest as well as what to avoid. Friends make shopping easier.
We're parents living in Colorado. We Believe Outfitting our families shouldn’t be so hard. Through experience, we know friends makes shopping easier. That's why we created tactac - to make everyone’s lives easier.

domain: sociology


text:
Justin Vernon’s third Bon Iver album is a weird and wonderful thing
Shaun Escoffery : Space Rider
New Britsoul hopeful kinda fucks up his chances with boring debut single...
Anyway, enough about Kelis, here's Britsoul wannabe Shaun Escoffery flogging the old interstellar R&B cliche that Jamiroquai killed with 'Space Cowboy' years ago, only more boring. He's signed to the same label that's promoting Omar, which kinda tells you all you need to know: this is UK soul still stuck in a bland, shiny groove that never pulls together into a tune, just like the good ol' Brand New Heavies used to make. Only more boring.
With their bigger and better second album, London-based indie/dance band Boxed In have earned their breakout moment
Islamic mythology meets the horror of war in this claustrophobic, low-budget spine-tingler
California’s coolest lift their usual murk on a free-spirited, adventurous third album at odds with its ‘mature’ description
The New York new wave reprobates’ debut delivers instant gratification via boisterous choruses and loveable melodies

domain: artistic


text:
Recently the government released the Taskforce report about the current state of mental health services across England, I would encourage you to download it and have a read yourself.
Some of the key findings and recommendations were how the NHS needs to have a more proactive approach looking at prevention. This is something that we are extremely passionate about. Phase is delivering projects aimed at giving young people the skills and tools to better equip them to deal with the complexities of been young in todays world, along with this, we are developing key programmes that build the preventative foundation blocks.
1 in 10 children aged 5-16 have a diagnosable mental health problem
Prevention matters - it’s the only way that lasting change can be achieved. Helping people lead ful lled, productive lives is not the remit of the NHS alone. It involves good parenting and school support during the early years
Throughout the report it talks about community organisations being involved in improving the provision and support for people's mental health. This is exciting for Phase, as we want to see this awareness grow and have been working in this area for some time.
As with all things it will take time, money and lots of hard work. If you would like to know how you can help Phase make a difference, then checkout our giving page and become a Phase partner.


Windows 7 and Windows Server 2008 R2 reduce the number of UAC prompts that local administrators and standard users must respond to:
• File operation prompts are merged.
• Internet Explorer prompts for running application installers are merged.
• Internet Explorer prompts for installing ActiveX controls are merged.
The default UAC setting allows a standard user to perform the following tasks without receiving a UAC prompt:
• Install updates from Windows Update.
• Install drivers that are downloaded from Windows Update or included with the operating system.
• View Windows settings. Changing settings still requires a UAC prompt.
• Pair Bluetooth devices to the computer.
• Reset the network adapter and perform other network diagnostic and repair tasks.
Additionally, the default UAC setting allows administrators to perform administrative tasks using operating system features without a UAC prompt. For example, an administrator can change the system time or restart a service without receiving a UAC prompt. However, administrators will still receive a UAC prompt if an application requires administrative privileges.
Windows Vista offers two levels of UAC protection to the user: on or off. Additionally, an administrator can change a Group Policy setting to prevent the screen from being dimmed (a feature known as the secure desktop) when prompting the user for consent.
Windows 7 and Windows Server 2008 R2 introduce two additional UAC prompt levels. If you are logged on as a local administrator, you can enable or disable UAC prompts, or you can choose when to be notified about changes to the computer. Administrators can choose from three levels of notification, with an additional option to disable the secure desktop:
• Always Notify Me Users are notified when they make changes to Windows settings and when programs attempt to make changes to the computer. This is the default setting for standard users.
• Notify Me Only When Programs Try To Make Changes To My Computer Users are not notified when they make changes to Windows settings, but they do receive notification when a program attempts to make changes to the computer. This is the default setting for administrators.
• Never Notify Me Users are not notified of any changes made to Windows settings or when software is installed.
Source of Information : Windows 7 Resource Kit 2009 Microsoft Press
One of the misconceptions about cloud storage is that it is only useful for storing files. This assumption comes from the popularity of file...
On today’s Internet, IPv4 has the following disadvantages: • Limited address space. The most visible and urgent problem with using IPv4 on ...
The following are the advantages of WAP: ● Implementation near to the Internet model; ● Most modern mobile telephone devices support WAP; ...
Many of the virus, adware, security, and crash problems with Windows occu when someone installs a driver of dubious origin. The driver suppo...


text:
INSPIRATION: Praise for "The Renaissance Man"
Information provided by Puran Dang (Class of 1959 IIT-KGP, RP Hall)
**On Sunday, May 8th, 2022, from 10:00am-12:00pm EDT/ 7:30pm-9:30pm IST, The Boston Pledge will be holding a discussion and reflection on India Towards 100: A call for Reset! Need a Missionary Zeal. You can learn more about and register for the event, by clicking here.**
Also, we will be adding a link, when available, to a recording for the talk by Partha on "Europe Crisis=Global Crisis: Deficit of Leadership Exposed", which was held in March 2022.
Reflections by Puran:
My dear friend, Prof. Partha Ghosh (Class of 1971 IIT-KGP), has launched two great books that I strongly suggest all KGPians read. (India Towards 100: A Call for Reset? Need a Missionary Zeal! A Collection of Thoughts on the Arts and Crafts of Nation Building and India at 75: In The Realm of Possibility-Reflections-Inspirations!)
This "Renaissance Man" has delivered some 200 Keynote addresses all over the world and is a Founder of the Humanitarian Organization: The Boston Pledge to help the poor people in India.
These two monumental Books are a collection of his speeches and articles. They are full of knowledge and should be on the desk of each IITian. The wisdom of these books can put their Entreprises and any other endeavor on the top.
The “Readers Digest” for everybody to appreciate his thoughts and speeches at hundreds of International Forums.
On Economics, Strategy, Socioeconomic Issues, Humanitarian Causes embracing the wisdom of our old civilization and astute philosophy of Swami Vivekananda, Gurudev Rabindranath Tagore, Mahatma Gandhi and mathematician who discovered Zero and genius of Ramanujam. Our Vedanta Philosophy can be a cure for many ills we are suffering from.
This Renaissance Man needs to be read and heard to create a benevolent society of the world which is at an Inflection Point. It is the right time to embrace the wisdom of Dr Partha Ghosh. Not only that, Prof. Ghosh has a deep devotion and sense of the great civilization of India and its glorious past and heritage.
As a very distinguished alumnus of KGP IIT-Kgp graduate 1971 and Member of Board Of Trustees, IIT Kgp USA Foundation, he is a brilliant man and a professor.
Additionally, he donated to Kgp for the creation of the "Partha Ghosh Academy of Leadership" on the Campus.
It was recently inaugurated and will create leaders of the world. I am deeply involved with the Academy and Partha and I work closely to promote the Academy.
Partha is a great thinker and writer and my dear friend, like a brother.
You can read more about Partha by clicking here.

domain: library


text:
The Manchester United fans inside Old Trafford went berserk when Robin van Persie scored in stoppage time to rescue a point against Chelsea, writes Paul Pycroft in the Manchester Evening News.
And with good reason. The Reds looked like they were heading for an undeserved defeat before the Dutch striker scored in the final minute of the game.
Van Persie finally got the better of Chelsea keeper Thibaut Courtois, the Belgian keeper named Man of the Match, who had denied the United man twice in one-vv-one situations.
The result means United will take some momentum into next weekend's Manchester derby at the Etihad Stadium.
Check out the video above, and the best pictures from the game, below.
In pictures - Manchester United 1-1 Chelsea:

domain: news


SANTA CRUZ - A preliminary hearing for the San Francisco man accused of stabbing Shannon Collins to death in the Lower Ocean neighborhood will be set on June 18.
Charles Anthony Edwards III, 43, appeared in court briefly Monday morning for receipt of records in the case.
Edwards is charged with first-degree murder and several special allegations of use of a deadly weapon, having prior felony convictions and prior prison commitments. Collins, a Santa Cruz business owner, was stabbed multiple times on May 7 on the 300 block of Broadway as she walked to a hair appointment. Prosecutor Celia Rowland has said the two did not know each other and no motive has been released.
Edwards was quiet as he sat in court in an orange-and-white-striped jumpsuit. A handful of his family members sat in the benches, waiting for updates from Edwards' attorney, public defender Anthony Robinson.
The family is "obviously distraught," Robinson said.
Edwards is being held in a special unit of the County Jail reserved for those with mental health issues.
Edwards has a history of mental illness that includes multiple terms of commitment in prison mental institutions that began in 1991, according to court records. Prison medical staff found him to be schizophrenic and bipolar, according to records. He also has a long history of substance abuse, including use of cocaine, crack, marijuana and alcohol.
His criminal history began at the age of 13 when he was arrested for robbery and includes commitments to California Youth Authority. As an adult, Edwards' criminal history includes a number of assaults, one against an 89-year-old man and a handful committed against his mother. In 2000, he was convicted of making criminal threats against his mother and two young nieces in San Francisco County.
He's also committed a number of parole violations, mostly involving violent behavior and substance abuse, and was convicted of hitting a corrections officer while in custody in San Diego County in 2006.
Edwards was released from parole in December. He spent four nights at the Homeless Services Center in Santa Cruz before Collins' death. Officials there described him as being docile and cooperative. Authorities have not said why he was in Santa Cruz County.
Follow Sentinel reporter Jessica M. Pasko on Twitter: @jmpasko96


text:
Reel Life Starring Us
by Lisa Greenwald
Rockwood Hills Junior High is known for the close-knit cliques that rule the school. When arty new girl Dina gets the opportunity to do a video project with queen bee Chelsea, she thinks this is her ticket to a great new social life. But Chelsea has bigger problems than Dina can imagine: her father has lost his job, and her family is teetering on the brink. Without knowing it, Dina might just get caught in Chelsea's free fall.
Filled with honest truths about status and self-confidence, as well as the bubbly, infectious voice Lisa Greenwald mastered in her breakout, My Life in Pink & Green, this book is sure to charm tween readers everywhere.
Lisa Greenwald is the author of Sweet Treats & Secret Crushes and My Life in Pink & Green, which earned a starred review from Kirkus. She works in the library at the Birch Wathen Lenox School in Manhattan and is a graduate of the New School's MFA program in writing for children. She lives in Brooklyn. Visit her online at LisaGreenwald.com.
"This funny, nuanced tale offers keen observations on middle-school life." - Kirkus Reviews


text:
Hi, I’m back for Day 2!
I want to thank you guys for the support on Day 1, it’s been encouraging for me and I feel glad that I picked this challenge up. Now I can proudly embrace my shoujo side of my anime spectrum.
If you missed my Day 1 and wanna read that first, click here!
So Day 2, All Time Favourite Shoujo Anime. This one is kind of hard, but my choice was clear since the start.
All Time Favourite Shoujo Anime: Soredemo Sekai wa Utsukushii
The review can be found here!
I really love this show, I was glad I finished this show in one sitting and I’m still chasing the manga.
The age and generation gap felt kind of weird. But slowly as you get used to the concept, the romance can be rather sweet and it’s nice to watch as the couple slowly have feelings with one another.
I rewatched it dozen of times and I never got sick of it. It was a lot of rewatch value. The original ending felt nicely wrapped too. But it’s kind of sealed the fate of any future anime series.
The soundtrack is great, Maeda Rena’s singing voice is just incredible.
If you haven’t watch it, I recommend you to watch it, it’s sweet without being sticky, it’s straightforward and doesn’t take you a lot of time. It’s only 12 episodes, you will most probably be glued to your seat and finish up the show in one sitting.
I have watched a lot of other Shoujos after this and nothing really comes as close as this.
Before watching this, my favourite Shoujo was Kaichou wa Maid-Sama, Sugar Sugar Rune, the first Pretty Cure. My taste and requirements changes over time and I guess it has matured over the years.
That’s all for Day 2. Day 3 will be interesting, as a guy, picking a favourite guy is kind of weird and hard. But I think I have an idea who it is. When will it be out? If I can get it done by tomorrow, sure, I will post it tomorrow. If not, Friday.
I hope you enjoyed this challenge so far and I will see you guys then!

domain: entertainment


text:
The next stop after beauty pageants is Bollywood for all winners in India. The same will be the case of Miss world 2017 Manushi Chhillar. She gave away her title of Miss World in June this year and is speculated to be making her debut in Bollywood soon. But Manushi Chhillar is not just going to be an actress. She was studying medicine at her college in Haryana’s Sonipat district. She’s a talented and gifted poet, painter and Kuchipudi dancer.
Her Bollywood Debut
She actually wants to be a cardiac surgeon and is associated with a menstrual hygiene project.She plans to take it up after her Miss World commitments get over. But apart from that, it seems she will also be taking up the responsibilities of an actor after her Bollywood debut. Although still in speculation with no confirmation of sorts, the news is that she’s going to debut with Karan Johar.
Who she is debuting under
Karan Johar has been a key in the industry when it comes to debuting fresh faces. He’s one of the renowned filmmakers of the industry and has launched many faces and celebrity children recently. The likes of Janhvi Kapoor, Alia Bhatt have all debuted under him and if the reports are true next in line is Manushi Chhillar. The director and producer are apparently very keen to have her debuted under him, and the project may go on till 2019. It’s also rumored that Manushi has done some screens tests and auditions for Dharma Productions already. She’s said it many times herself that she is interested in making a career in Bollywood. She’s also said that the industry is new to her and that’s she didn’t even watch many movies growing up. She has a lot to learn,but was recently in a commercial with Ranveer Singh.
How she may have landed a role
Karan Johar has met Manushi Chhillar in a Miss India event earlier this year. The duo also crossed paths at the Filmfare Glamour and style awards 2017. Manushi is beauty and brains to be reckoned with, and it seems had Karan Johar floored with her persona. The announcement of Student Of TheYear 2 came with a backlash of nepotism for Karan Johar when he announced the all celebrity kids cast. But it seems that he’s been wanting to rope in Manushi for the part of the second heroine in the film. The film is going to star two heroines and a hero instead of two heroes and one heroine like the first part. The cast up till now have only confirmed as Tiger Shroff and Ananya Pandey but it seems that Manushi is in for the second heroine’s part.
Feature in Celebrity Photographers Calendar
The young beauty has already started making her mark in Bollywood. She’s doing all the right things and recently appeared in Celebrity Photographer Dabboo Ratnagiri’s Calendar.The calendar also stared Alia Bhatt, Aishwarya Rai Bachchan, Shraddha Kapoor, Parineeti Chopra, and Sonakshi Sinha. It was a glamorous debut, so it seems Manushi is kind of a part of Bollywood already.

domain: celebrity