Parent-child Relationship Among Low-income Families in Hong Kong
Condition: Child Development; Parent-Child Relations
Study type: Observational

Summary: 
      This is a prospective cohort study building upon the existing cohort study on the
      effectiveness of the Trekkers Family Enhancement Scheme. This study will sample 200
      low-income parent-child pairs and follow them up for 24 months with yearly assessment on
      parental stress and child health using both subjective measures and objective physiological
      parameters. Additional data on parenting style, neighbourhood cohesion, child physical
      assault and neglect potential, parental mental health and HRQOL and family disharmony will
      also be collected at each assessment time point for testing mediating and moderating
      mechanisms between parental stress and child health. The baseline assessment will be carried
      out in 2016-17 with three repeated assessments after 6 months, 12 months, and 24 months.
    

Detailed description: 
      Study aims

        -  To examine the relationship between parental stress and child health.

        -  To evaluate the stress of parents as indicated by their subjective perception of mental
           health, quality of life and allostatic load on the body.

        -  To evaluate the health of children as indicated by their well-being, behaviors, body
           mass index (BMI) z-score and telomere length.

        -  To examine the correlation between changes in parental stress and changes in child
           health over time.

        -  To identify the moderators and mediators of the relationship between parental stress and
           child health.

      Eligible participants in the main cohort study will be approached by call or during
      face-to-face sessions. Parents who express interest in participation will be provided with an
      information sheet about the research and asked to sign the consent form for themselves and
      for their children. After providing consent, the parent of each parent-child pair will
      complete a set of structured questionnaires on parental mental health and HRQOL, parenting
      style, neighborhood cohesion, and their children's well-being and behaviors. Physical
      examination including blood pressure, heart rate, weight, height, and waist-to-hip ratio will
      also be carried out on both parents and children. A swab of buccal cells will be taken from
      each child. Venous blood will be sampled from each parent.

      This study will have four assessment waves: Baseline, T2 follow up (6 months), T3 follow up
      (12 months), and T4 follow up (24 months). Physical health data and biological samples will
      be collected by research nurses and research assistants during health assessment session held
      in community centers. Questionnaire data will be collected by trained interviewers during
      telephone survey. To minimize attrition, a package of questionnaires and a sheet of
      instructions and equipment (i.e. brushes) for swab-taking at home may also be sent to parents
      upon request.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Participants from low-income families will be recruited from the existing cohort study
        (main cohort study) on the effectiveness of the Trekkers Family Enhancement Scheme funded
        by a philanthropic foundation in Hong Kong (Kerry Group Kuok Foundation (Hong Kong)
        Limited).
      
Biospecimen description: 
      DNA will be extracted from buccal epithelial cells. Telomere length will be measured by the
      method adapted from that originally published by Cawthon. For each sample, the telomere
      length will be represented by the relative ratio of the telomere repeat copy number (T) to
      the single copy gene 36BA copy number (S). The T/S ratio will be determined by quantitative
      polymerase chain reaction (qPcR) using a 7900HT Thermocycler (Applied Biosystems).