Examining the relationship between child holiday club attendance and parental mental wellbeing.

Objectives: This paper reports results of an evaluation of 17 holiday clubs located throughout North East England that ran during the summer of 2017, designed to reduced summertime food insecurity. Study design: Questionnaire administed to parents/caregivers of children who attended a holiday club.
Methods: Ordinary Least Squares regression models were used to predict Warwick-Edinburg Mental Wellbeing scale scores measuring parental mental wellbeing.
Results: We find that after a summer of attending a holiday club, the most important factor associated with higher parental wellbeing scores is the reduction in social isolation and increased relationships that the parent and their children build while children attend holiday clubs. Conclusions: Our results suggest that reducing social isolation for parents and families during summertime is a likely a latent function of holiday clubs. These are important findings in that the benefits of holiday club appear to extend beyond access to food and reductions in household food insecurity.

Introduction

Holiday hunger, seasonal household food insecurity during the summer school holiday, is a substantial and growing problem in the UK [[1], [2], [3]]. Recent estimates suggest that approximately one million students in the UK receive free school meals (FSM) and another two million students who do not qualify for FSM are also living in food insecure households [3]. In short, when FSM are not available, already high levels of child and household food insecurity become higher. “Holiday clubs” have become the predominate response to holiday hunger in the UK. Holiday clubs are organizations that are primarily funded and administered by the central government, local authorities and charities and provide breakfast and/or lunch to children in the local area during the summer school holidays. Many holiday clubs also offer other services and activities for the children such as nutrition education, cooking lessons, field trips, among others. Previous qualitative research suggests that these other services are important and helpful for the children and their parents/caregivers [4]. Furthermore, the reduction in social isolation that accompanied holiday club attendance was welcomed by numerous respondents in the same study [4].

Previous research has examined whether holiday club attendance reduced household food insecurity [2], whether holiday clubs are located in areas of need [5], and related work on educational learning loss over the summer [6,7]. The question of whether child attendance at holiday club is associated with parental mental wellbeing is currently unaddressed. Therefore, as this study is primarily exploratory, we include a new set of measures designed to capture the different types of benefits of holiday club. These measures have been constructed based off of the literature on holiday clubs and parenting. Mental wellbeing, measured in this study by the validated Warwick-Edinburgh Wellbeing Questionnaire, is the positive aspect of mental health. In this paper, we report results from an evaluation of 17 holiday clubs in North East England in the summer of 2017. Specifically, using questionnaire data gathered from 133 parents of children who attended one of the 17 holiday clubs, we examine, what aspects of holiday club are associated with higher levels of parental mental wellbeing?

A recent study of the benefits of holiday clubs [4] highlighted a number of benefits to children and households that can be grouped into four main categories, 1) expanding access to food (e.g., serving nutritious meals), 2) reducing social isolation and building relationships (e.g., increased child-to-child interaction, increased parent-to-parent interaction), 3) promoting improved child behavior and structure, and 4) promoting childhood activities and engagement (e.g., child engages in a wider variety of activities than they would without holiday club) [4]. Therefore, in our empirical analyses we follow these findings and design measures of these four general benefits of holiday clubs.

Previous research in various fields of social science and public health suggest that all four of these potential benefits of holiday clubs may be associated with higher levels of parental mental wellbeing. For example, expanding access to food (i.e. reducing food insecurity) may be associated with higher levels of mental wellbeing, as research has shown that increases in food insecurity have been related to poor mental health outcomes [[8], [9], [10], [11]]. Social isolation, which has been associated with poverty [[12], [13], [14], [15]], has been linked with poor mental health and wellbeing outcomes [[15], [16], [17], [18], [19]]. Improvements in a child’s structure and routine has been linked to better behavior and wellbeing [20,21], while research has shown that child behavioral problems are associated with parental and caregiver mental health problems [[22], [23], [24], [25]]. Finally, having a more engaged and happy child [26,27] should be associated with increased parental mental wellbeing. In this paper, we examine how these four categories of the impacts of holiday club are associated with higher parental mental wellbeing.

Methods

The current study is part of a larger evaluation of 17 holiday clubs in the North East of England. The portion of the evaluation that is reported in this paper focuses on the relationship between child holiday club attendance and mental wellbeing of their parents. While other aspects of holiday clubs have been studied in the past, this is the first study, to our knowledge, to focus on holiday club’s impacts of parental wellbeing. Therefore, this is an exploratory study in which in addition to addressing the main research question in the paper, we are also testing a new suite of questions used to measure the benefits of holiday clubs.

The Children North East charity was awarded funding from the UK Big Lottery program to both fund and evaluate the effectiveness of the holiday clubs in the summer of 2017. The holiday clubs were required to spend the money received from the grant to purchase food for the clubs and fund activities for the children (and sometimes parents) who attended the club. The clubs were required to meet School Standards in terms of nutritional guidelines and be open for at least four weeks during the summer school holiday for four days a week and 4 ​h a day.

All 17 clubs were free for children to attend. Table 1 contains information each club. The clubs were open between four and six weeks over the summer holiday, were held mostly in community centres (three were held in schools), median attendance ranged from four to 26 children, and the ages of the children ranged from four to 14. Clubs were staffed by volunteers and seasonal employees.

Table 1

Description of holiday club in the study.

Club	Weeks club open	Club location	Median number of child attending	Age range of children attending
1	5	Community centre	24	5–12
2	4	Community centre	7	7–14
3	4	School	4	11–12
4	6	School	9	4–10
5	4	Community centre	20	5–12
6	4	Community centre	24	5–11
7	4	Community centre	8	7–11
8	4	Community centre	17	7–12
9	5	Community centre	26	6–13
10	6	Community centre	12	4–11
11	5	Community centre	9	9–12
12	5	Community centre	10	7–12
13	4	Community centre	24	7–10
14	4	Community centre	21	5–11
15	4	Community centre	19	4–12
16	4	Community centre	23	5–12
17	4	School	9	5–8

Parents and caregivers who dropped off and sometimes attended holiday club were asked by the holiday club staff or the research team to complete a questionnaire that asked questions about, 1) the specific holiday club they attended, 2) their mental wellbeing last summer (when their child did not attend holiday club) and this summer (after their child had been attending holiday club), 3) the impact of holiday club on themselves, their child and their household, 4) their child’s behavior after attending holiday club, and 5) demographic information. Some of the parents were recruited at the holiday club on the day to complete the survey, whilst others had a prearranged interview with a member of the research team in which they also completed the questionnaire. A total of 133 parents and caregivers completed the questionnaire. In the analyses, parent’s gender was coded female ​= ​1, male ​= ​0, race/ethnicity was coded 1 ​= ​minority, 0 ​= ​white British and age was measured on a scale with the following categories: less than 18 years, 18–25 years, 26–35 years, 36–45 years, 46–55 years, 55–70 years, over 70 years. The sample of parents was predominately female (86.7%), white British (92.4%) and the median age range of respondents was 26–35 years old.

Table 2 contains descriptive statistics for the questions about the impact of holiday club on children, parents and households. As noted above, these questions were based off previous qualitative research on the benefits of holiday clubs [4] which found four main categories of benefits. These questions are grouped into those four areas, 1) expanding access to food, 2) reducing social isolation and building relationships, 3) promoting improved child behavior and structure, and 4) promoting childhood activities and engagement. The individual questions were measured on a five-point scale (1 ​= ​Disagree a lot to 5 ​= ​Agree a lot). In subsequent analyses these four groups of questions were combined into additive scales. The Cronbach’s α levels for each scale are reported in Table 1 (ranging from 0.60 to 0.86) indicating acceptable levels of internal scale consistency. These Cronbach’s α levels are high enough to suggest that our benefits of holiday club measures are valid measures for the purposes of this exploratory study of parental wellbeing.

Table 2

Descriptive Statistics for Holiday Club Parent Survey “How much do you agree with the following statements about Holiday Club?” Questions (1 ​= ​Disagree a lot, 5 ​= ​Agree a lot).

Statement	n	Mean	St. Deviation	Min.	Max
Expanding Access to Food (α ​= ​.600)
Serves healthy food	122	4.68	0.70	1	5
Serves a wide variety of foods	128	4.49	0.74	1	5
Serves food that my child enjoys	129	4.35	0.93	1	5
Serves food that my child doesn’t have at home	127	3.41	1.42	1	5
Reducing Social Isolation and Building Relationships (α ​= ​.733)
Has allowed my child to make new friends	130	4.72	0.66	1	5
Has allowed me to make new friends	125	4.00	1.20	1	5
Has allowed me to spend time with people I wouldn’t usually spend time with	130	3.75	1.28	1	5
Has allowed my child to spend time with school friends that they wouldn’t usually see during the school holidays	130	4.11	1.18	1	5
Has given me more hours to socialise with friends	129	3.69	1.27	1	5
Promoting Improved Child Behaviour and Structure (α ​= ​.703)
Has led to an improvement in my child’s behaviour at home	128	3.89	1.01	1	5
Has given my child more of a structured routine than they usually have during the summer holidays	130	4.63	0.74	1	5
Will make it easier for my child to get back into a structured school routine after the summer holidays	130	4.57	0.70	1	5
Promoting Childhood Activities and Engagement (α ​= ​.855)
Is enjoyable for my child	130	4.82	0.58	1	5
Has made my child feel less bored than they usually are during the summerHolidays	130	4.76	0.62	1	5
Has given my child more activities to do than they usually have during the summer holidays	130	4.72	0.64	1	5

We measured parental wellbeing with the Warwick-Edinburgh Wellbeing Questionnaire (W-E). The W-E consists of a series of 14 statements about a person’s thoughts and feelings. Each statement is scored on a five-point scale ranging from 1 ​= ​none of the time, to 5 ​= ​all of the time. The W-E scale has been validated and used as a measure of mental wellbeing in many studies, including those that investigate the relationship between aspects of poverty and mental wellbeing [28] as this study does. We asked each parent to recall their mental wellbeing (using the W-E) the previous summer when their child did not attend a holiday club (“last summer”) and the current summer in which their child attended holiday club (“this summer”). Table 3 reports each W-E statement, the mean of parents wellbeing on each W-E statement, and the p-value of a paired t-test examining the change in parental wellbeing from last summer to this summer. The mean of each W-E statement increased from last summer and this summer and the change was statistically significant in all cases (p ​< ​0.001).

Table 3

Comparison of Parent Warwick-Edinburgh Mental Wellbeing Scale Means between Last Summer when Child did not Attend Holiday Club and this Summer Holiday when Child has Attended Holiday Club (N ​= ​133).

Scale Item	Last SummerMean	This SummerMean	p-value for Differencea
Optimistic about the future	3.4	4.0	.000
Useful	3.5	4.1	.000
Relaxed	3.1	4.1	.000
Interested in other people	3.3	4.0	.000
Energy to spare	3.1	4.0	.000
Dealing with problems well	3.5	4.0	.000
Thinking clearly	3.4	4.1	.000
Good about myself	3.2	3.9	.000
Close to other people	3.3	3.9	.000
Confident	3.4	4.0	.000
Make up my own mind about things	3.8	4.1	.000
Loved	3.7	4.1	.000
Interested in new things	3.4	4.1	.000
Cheerful	3.5	4.1	.000

Note: two-tailed p-values from paired sample t-tests.

To answer our research question: what aspects of holiday club are associated with higher levels of parental mental wellbeing, we estimate two Ordinary Least Squares (OLS) regression equations as the dependent variable is continuous. The dependent variable in the regression models is an additive scale of the 14 ​W-E statements for the current summer during which the child attended holiday club (Range ​= ​19–70, Mean ​= ​56.18, Cronbach’s α ​= ​0.968). The first model includes the four aspects of holiday club predictors and the second model adds in gender, race/ethnicity and age as control variables. The Variance Inflation Factor (VIF) values were all under two in both models suggesting that multicollinearity has not affected the estimates [29].

Results

Table 4 contains the results of the two OLS models predicting parental W-E scale scores for the summer that their child attended holiday club. In Model 1, reducing social isolation and building relationships was positively related to parental W-E scale scores (b ​= ​1.00, p ​< ​0.001). Specifically, a one-unit increase in the reducing social isolation and building relationships scale was associated with a one-unit increase in the parental W-E scale. The other three aspects of holiday club were not associated with parental W-E scale scores in Model 1. Model 2, which contains the demographic control variables, is similar to Model 1. Reducing social isolation and building relationships was positively associated with parental W-E scale scores and the size of the unstandardized regression coefficient (b ​= ​0.97, p ​< ​0.001) is very similar to the coefficient in Model 1. The remaining three aspects of holiday club remain unassociated with parental W-E scale scores. Race/ethnicity is positively related to parental W-E scale scores in Model 2, suggesting that minority parents reported higher wellbeing scores after their child attended holiday club compared to white British parents. Specifically, minority parents averaged 7.96 ​W-E scale score points higher than white British parents. This results should be interpreted with caution however, as the number of minority parents in the sample was small (n=10). In a model not shown here, the interaction between reducing social isolation and building relationships and ethnicity was added to Model 2 but was found to be unrelated to the dependent variable.

Table 4

OLS unstandardized regression coefficients (b) and standard errors (SE) for determinants of parent Warwick-Edinburgh mental wellbeing after attending holiday club scale scores.

	Model 1		Model 2
	b	SE	b	SE
Expanding access to food	−0.02	0.43	−0.01	0.44
Reducing social isolation and building relationships	1.00∗∗∗	0.26	0.97∗∗∗	0.26
Promoting improved child behavior and structure	0.32	0.56	0.14	0.57
Promoting childhood activities and engagement	−0.52	0.65	−0.40	0.86
Gender (female ​= ​1)	–	–	−0.90	2.66
Age	–	–	0.49	0.99
Ethnicity (minority ​= ​1)	–	–	7.96∗	3.50
Constant	40.15∗∗∗	7.51	39.85∗∗	11.28
N	110		108
F	6.07∗∗∗		4.18∗∗∗
Adjusted R2	0.16		0.17

Note: ∗∗∗p ​< ​0.001, ∗∗p<0.01, ∗p ​< ​0.05 (two-tailed).

Discussion and conclusion

In this paper we addressed the following research question: what aspects of holiday club attendance are associated with higher parental mental wellbeing. Using results from a questionnaire completed by a sample of holiday club parents, we found that reducing social isolation and building relationships was positively related with parental mental wellbeing. As this was an exploratory study, employing a new suite of questions to measure the benefits of holiday clubs, our findings need to be explored further in future research. We do believe that our findings are important as they demonstrates how social isolation, which is disproportionately experienced by those living in poverty, may contribute to poor mental health. Conversely, reducing that social isolation, starting friendships and creating relationships with other parents may increase the mental wellbeing of parents whose children attend holiday club. While expanding access to food, promoting improved child behavior and structure, and promoting childhood activities and engagement failed to show an association with parental mental wellbeing, this does not mean that these are not important aspects of holiday clubs for the children who attend. Interestingly, racial/ethnic minority parents reported higher parental mental wellbeing scores compared with white British respondents. However, these results should be interpreted with caution as the overall number of racial/ethnic minorities in the sample is low (n ​= ​10). This possible relationship between ethnicity and parental wellbeing, within the context of holiday clubs, would be furtile ground for both further quantitative and qualitative research. We also need to acknowledge the limitations in the ability to generalize from the results due to the non-random manner in which the sample was collected. A related limitation of the study methodology was that it is a pre-post test design that uses only a few controls in the fully saturared statistical model. Given the relative consistency in our results however, we are confident in our results. We would also recommend that further validation be done on the benefits of holiday club questions that we designed based off of previous qualitative research and literature.

We believe the ultimate goal of holiday clubs should be to reduce the myriad impacts of living in poverty on children and their parents and caregivers. In addition to reducing child and household food insecurity, other potential positive impacts of holiday clubs on children and parents need to be evaluated and highlighted. In this case we find that reducing social isolation and building relationships is associated with higher parental mental wellbeing. Our findings suggest that future holiday clubs should encourage increased attendance and involvement of parents and interaction between parents.

Ethical approval

Ethical approval was obtained from the Ethics Committee of Northumbria University prior to the data being collected.

Funding

Funding was obtained from the .

Declaration of Competing Interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.