Predicting Changes Across 12 Months in Three Types of Parental Support Behaviors and Mothers' Perceptions of Child Physical Activity

Physical activity maintenance and increase in Chinese children and adolescents: the role of intrinsic motivation and parental support

Objective

This longitudinal study aimed to examine the association of intrinsic motivation, parental physical activity, and parental support with physical activity maintenance and increase among children and adolescents.

Methods

A sample of 2,424 children and adolescents in Shanghai, China participated in the two-wave survey before and during the COVID-19 pandemic. The questionnaire measured children and adolescents' physical activity and intrinsic motivation, as well as their parental physical activity and support (concern for their child and co-activity with their child). Multivariable logistic regressions were performed by groups to examine the associations between these factors and physical activity change.

Results

Most children and adolescents exhibited a decline in physical activity participation during the pandemic, as indicated by a mere 15.0 and 8.0% of individuals maintaining and increasing their pre-pandemic levels, respectively. Among the initially active participants, perceived self-choice [OR = 1.341 (95%CI: 1.173-1.533)] and parental concern [OR = 1.922 (95%CI: 1.204-3.068)] predicted maintained physical activity. Increased physical activity was predicted by perceived enjoyment [OR = 1.193 (95%CI: 1.046-1.362)] and parental co-activity (OR = 1.995 [95%CI: 1.095-3.633]).

Conclusion

This study provides longitudinal evidence that intrinsic motivation and parental support can have a positive impact when physical activity levels change significantly. Effective interventions targeting multilevel factors are needed to maintain or increase children and adolescents' physical activity.

Feasibility of the Mothers and Daughters Moving Together Physical Activity Intervention

PURPOSE

Preschool-aged children, especially girls, have low levels of physical activity that may be influenced through parent role modeling. Evidence for mother-daughter interventions that include preschool-aged children is sparse. The primary purpose of this study was to examine the feasibility of recruitment procedures, protocol compliance, and participant retention for the Mothers and Daughters Moving Together intervention. The secondary aim was to provide initial estimates of the intervention effect on mother-daughter and family physical activity co-participation, moderate to vigorous physical activity, and maternal physical activity enjoyment and support.

METHOD

This nonrandomized feasibility study included mother-daughter (2-5 y) dyads who self-selected into the intervention (n = 21 dyads) or comparison (n = 10 dyads) group.

RESULTS

The recruitment rate was 41.9% (31 enrolled/74 interested). Intervention group mother-daughter dyads attended 57% of intervention sessions. Among the whole sample, 70% to 80% of participants (mothers and daughters) had at least 4 valid days of accelerometer data at preintervention and postintervention. The retention rate was 90% (28/31 dyads completed the study). Initial estimates of intervention effect indicated small, positive changes for mother-daughter physical activity co-participation, and maternal physical activity support and enjoyment.

CONCLUSIONS

This study provides valuable information that should be confirmed using an adequately powered and randomized study design.

Developing and Disseminating Physical Activity Messages Targeting Parents: A Systematic Scoping Review

BACKGROUND

Physical activity (PA) messages have demonstrated success in targeting parent support for PA. However, little research exists to inform the development and dissemination of optimally effective PA messages targeting parents. A synthesis of existing literature is necessary to inform message development and dissemination strategies. Unique considerations for parents of children with disabilities (CWD) should be identified given a need for inclusive PA messaging that consider the needs of CWD and their families.

METHODS

Systematic scoping methodologies included a peer-reviewed literature search and expert consultation to identify literature regarding PA messages targeting parents, and considerations for parents of CWD.

RESULTS

Thirty-four articles that met eligibility criteria were included for examination. Twenty-eight studies were identified regarding the PA messages targeting parents; six themes and 12 subthemes emerged from these articles. Six studies were identified regarding unique considerations for parents of CWD; three themes and four subthemes emerged from these articles.

CONCLUSIONS

Through knowledge synthesis, this research can contribute to a knowledge translation process to inform practice guidelines for the development and dissemination of PA messages targeting parents, while also providing unique considerations for PA messages targeting parents of CWD.

Leading by Example: Association Between Mother and Child Objectively Measured Physical Activity and Sedentary Behavior

PURPOSE

The authors examined the relationship between mother and child activity.

METHODS

The authors compared moderate-vigorous physical activity (MVPA) and sedentary time of low-income mothers with obesity and their 6- to 12-year-old children on week (WD) and weekend (WE) days. A total of 196 mother-child pairs wore accelerometers simultaneously for a week. Mothers completed questionnaires. Spearman correlation and multivariate regression were used.

RESULTS

WE MVPA (accelerometry) was significantly correlated between mothers with children aged 6-7 (rs = .35) and daughters (rs = .27). Self-reported maternal PA time spent with one of their children was significantly correlated with the WE MVPA of all children (rs = .21) and children aged 8-10 (rs = .22) and with the WD MVPA of all children (rs = .15), children aged 8-10 (rs = .23), aged 11-12 (rs = .52), and daughters (rs = .37), and inversely correlated to the WD sedentary time of all children (rs = -.21), children aged 8-10 (rs = -.30), aged 11-12 (rs = -.34), daughters (rs = -.26), and sons (rs = -.22). In multivariate regression, significant associations were identified between reported child-mother PA time together and child MVPA and sedentary time (accelerometry).

CONCLUSIONS

Mothers may influence the PA levels of their children with the strongest associations found in children aged 6-7 and daughters. Mother-child coparticipation in PA may lead to increased child MVPA and decreased sedentary behavior.

Predicting Family and Child Physical Activity across Six-Months of a Family-Based Intervention: An Application of Theory of Planned Behaviour, Planning and Habit

Family-based physical activity (PA) interventions have proven effective in modifying PA; yet, the underlying mechanisms are currently unclear. In this study, we follow-up upon prior trial data that showed changes to child moderate-to-vigorous PA (MVPA) as a result of a family education+planning intervention compared to an education-only condition. We examined parents' perceived family PA frequency, family PA social cognitions, and family PA habit over 26 weeks between the two conditions. One hundred and two parents (of children aged 6 to 12 yrs), were recruited through advertisements and randomized to either the planning + education condition (n = 52) or an education-only condition (n = 50). Self-reported family PA, and measures of theory of planned behaviour, planning intention, and habit were completed by the contact parent at baseline, six-week, 13-week, and 26-week time-periods. The education+planning intervention increased planning intention (p <.01) and family PA (p =.06) compared to the© education-only group. The effect of condition on the putative mediators did not explain these changes (all 95% CIs crossed 0), and family PA was associated with child MVPA only at 13 weeks (p <.01). Intervention 20 assignment had a small indirect effect on family PA (favouring©the education+planning group) via Habit. Perceived behavioural©control and habit were consistent predictors of family PA (p <.05), but not PA intention or planning intention (p >.05). The planning+education intervention showed improved family PA and planning intention, yet null mediation results suggest that other variables from the family system (e.g., child motivation, other parent's motivation and plans) are likely needed to fully understand the intervention effects. The promotion of perceived behavioural control and habit to assist in family PA is recommended for future research in this population.

Correlates of children's physical activity during the COVID-19 confinement in Portugal

OBJECTIVES

The aim of the study was to understand the role of household variables on the percentage of physical activity (%PA) during the coronavirus disease 2019 (COVID-19) confinement in Portugal.

STUDY DESIGN

A cross-sectional study design using an anonymous online survey was launched to assess how Portuguese families with children aged younger than 13 years adjusted their daily routines to the confinement.

METHODS

Separate analyses of variance were performed to investigate how factors such as the number of children, age, sex, the housing characteristics, and the adults' job situation can affect the percentage of time for PA (%PA).

RESULTS

Findings, based on data from 2159 children, indicate that (1) boys and girls did not differ in the %PA on any of the age-groups; (2) children with an outdoor space and who had other children in the household were significantly more active (P < .001); (3) children from families with all adults working from home showed lower levels of %PA; and (4) being younger, having a big outdoor space, having other children in the household, and having at least one adult free from working from home were significant positive predictors of children's %PA, explaining 21% of the overall variance.

CONCLUSION

Time allocated for PA during this period is reduced compared with what is usually reported on normal days. It is necessary to find strategies to increase children's PA, especially in families in which both parents are working and have no outdoor space.

Parents and children active together: a randomized trial protocol examining motivational, regulatory, and habitual intervention approaches

BACKGROUND

Regular physical activity (PA) is associated with many health benefits during childhood, and tracks into desirable PA patterns and health profiles in adulthood. Interventions designed to support these behaviours among young children are critical. Family-based interventions focusing on parent-child activities together (i.e., co-activity) among preschool-aged children are warranted. Targeting parental support practices can increase the frequency of co-activity, however interventions must move beyond merely building intention and planning skills for successful maintenance. Interventions designed to increase co-activity habit strength may facilitate the sustainability and thus impact child PA. The purpose of this study is to compare the effects of three intervention conditions designed to increase child PA through co-activity: a standard education condition (information about benefits), a planning (action planning, coping planning) + education condition and a habit (context-dependent repetition from prompts and cues) + planning +education condition.

METHODS/DESIGN

A longitudinal three-arm parallel design randomized trial will compare three conditions over six months. Families are eligible if they have at least one child between 3y and 5y that is not meeting 60mins/day of moderate to vigorous physical activity (MVPA). The primary outcome (child MVPA) is assessed via accelerometry at baseline, six weeks, three months and six months (primary endpoint). Intervention materials targeting co-activity are delivered post baseline assessment, with booster sessions at six weeks and three months. Parental co-activity habit, parent-child co-activity and other behavioural constructs are also assessed via questionnaire at all measurement occasions. As tertiary outcomes, parental PA is measured via accelerometry and co-activity is measured via a Bluetooth-enabled proximity feature. A total of 106 families have been recruited thus far from the Greater Victoria region. The study is ongoing with a minimum target of 150 families and an anticipated recruitment completion date of August 2022.

DISCUSSION

This protocol describes the implementation of a randomized trial evaluating the effectiveness of a habit formation group compared with a planning group and an education only group to increase child PA through targeting parent-child co-activity. This information could prove useful in informing public health initiatives to promote PA among families with preschool-aged children.

TRIAL REGISTRATION

This trial was prospectively registered on clinicaltrials.gov in February 2016, identifier NCT03055871 .

Family-based habit intervention to promote parent support for child physical activity in Canada: protocol for a randomised trial

INTRODUCTION

Regular physical activity (PA) participation has many important physical and psychological health benefits, managing and preventing over 25 chronic conditions. Being more physically active as a child is associated with being more active as an adult, but less than 10% of Canadian children are achieving the recommended PA guidelines of 60 minutes per day of moderate to vigorous PA. Parental support is a predictor of child PA, but parent intention to support child PA does not always predict enacted support. Targeting factors that assist in the sustainability of parent support behaviour of child PA may have an impact on child PA. The purpose of this study is to evaluate an intervention designed to promote habit formation of parental support (HABIT, independent variable) on child PA (dependant variable) compared with a planning and education group (PLANNING) and an education only group (EDUCATION).

METHODS AND ANALYSIS

The three conditions will be compared using a 6-month longitudinal randomised trial. Eligible families have at least one child aged 6-12 years who is not meeting the 2011 Canadian PA Guidelines. Intervention materials are delivered at baseline, with check-in sessions at 6 weeks and 3 months. Child's moderate-to-vigorous PA, measured by accelerometry, is assessed at baseline, 6 weeks, 3 months and 6 months as the primary outcome. At baseline and 6 months, children perform fitness testing. Parents and children complete questionnaires at all timepoints. So far, 123 families have been recruited from the Greater Victoria and surrounding area. Recruitment will be continuing through 2020 with a target of 240 families.

ETHICS AND DISSEMINATION

This protocol has been approved by the University of Victoria Human Research Ethics Board (Victoria, Canada). Results will be shared at conferences as presentations and as published manuscripts. Study findings will be made available to interested participants.

TRIAL REGISTRATION NUMBER

NCT03145688; Pre-results.

Diet and physical activity changes among low-income families: perspectives of mothers and their children

Purpose: The current study explored how mothers and their children influence each other's diet and physical activity. Methods: We conducted semi-structured interviews with women with diabetes and their children (N = 18) from eight low-income families. Results: Two approaches to changes emerged: collaborative and non-collaborative. Families using collaborative approaches believed they could sustain positive changes through accepting family changes, encouragement, abstaining from buying certain foods, modelling and compromise. Within families using non-collaborative approaches, some challenges included using more individualistic approaches and poor communication. Lack of information and resource constraints challenged all families. Conclusion: Interventions should reinforce family collaborative approaches and teach skills for families to work together towards a healthier lifestyle.

Parental support of the Canadian 24-hour movement guidelines for children and youth: prevalence and correlates

BACKGROUND

To explore the prevalence of parental support for meeting the Canadian 24-Hour Movement Guidelines for Children and Youth, identify key interactive support profiles among the four movement behaviors, and investigate subsequent sociodemographic and social cognitive correlates of these profiles.

METHODS

A sample of Canadian parents (N = 1208) with children aged 5 to 17 years completed measures of the theory of planned behavior (TPB), and support of the four child movement behaviors via questionnaire. Differences in the proportion of parents supporting these four health behaviors were explored and demographic and social cognitive (attitude and perceived control) correlates of combinations of parental support for the four health behaviors were evaluated.

RESULTS

Child and youth sleep behavior had the highest parental support (73%) and moderate to vigorous physical activity support had the lowest prevalence (23%). Interactive profiles of the four movement behaviors yielded six primary clusters and comprised wide variation from parents who supported none of these behaviors (19%), to parents who supported all four behaviors (14%). These profiles could be distinguished by the age of the child (younger children had higher support) and the gender of the parent (mothers provided more support), as well as constructs of the TPB, but TPB cognitions were more specific predictors of each health behavior rather than general predictors of aggregate health behavior clusters.

CONCLUSIONS

Teenagers and fathers may represent key targets for parental support intervention of the 24-Hour Movement Guidelines. Intervention content may need to comprise the underlying foundations of attitude and perceived behavioral control to change parental support while considering the unique features of each health behavior to maximize related intervention effectiveness.

Correlates of physical activity parenting: The Skilled Kids study

We examined the relationship between physical activity parenting (PAP) and child, family, and environmental factors in families. The participants were 840 families with young children (n = 993; 5.40 ± 1.14 years) and parents (n = 993; 35.8 ± 5.29 years). Parents' self-reported PAP (co-participation, (in)direct support, and encouragement), child-specific (sex, age, temperament, outdoor time, organized physical activity or sports, sedentary time, media time, PA enjoyment, motor skills compared to peers, PA, and sport facility use), family-specific (respondent's sex, age, education, exercise frequency, family income, family status, number of children in the family, child's birth order and partner's PAP, and exercise frequency), and environment-specific (residential density, access to sport and outdoor facilities, type of house, and access to electronic devices) factors were collected. Children's motor skills and anthropometrics were measured. After adjusting for the family cluster effect, child, family, and environmental factors were entered into a linear mixed-effects model, with PAP as the response variable. The final model consisted of statistically significant factors, and parental education, which was forced into the model. Nine child- and family-related factors explained 15% of parenting variance between the children and 52% between the families. Partner's PAP (B = 0.68, P < 0.001) had the strongest association, whereas the child's temperament (B = 0.08, P < 0.001) and birth order (B = -0.10, P < 0.001) had smaller but novel associations with the respondent's PAP. Partner's PAP and a range of child- and family-related factors should be considered when promoting parental support for child PA.

Can The Moblees™ Move Canadian Children? Investigating the Impact of a Television Program on Children's Physical Activity

Background: The effects of messaging about physical activity and sedentary behavior purposefully integrated into children's TV programming on children's behavior is unknown. The Moblees is a Canadian childrens' show that explicitly promotes physical activity. Two studies were conducted to (1) examine whether children were more physically active when watching a Moblees episode, and (2) explore parental perceptions of the show. Methods: Study 1 was an experimental study with 21 families randomized to watch an episode of The Moblees vs. a control condition. Movement was assessed through accelerometry and observation. A Chi-square test was used to compare the direct observation proportions of children sitting between intervention and control conditions. Independent t-tests were performed to examine the differences in total vector magnitude counts between the experimental and control groups. Study 2 was an online cross-sectional study with 104 parent/child dyads that included viewing an episode of The Moblees. To identify correlates and predictors of parent-reported child PA during viewing The Moblees compared to other TV programs, Pearson's correlations and a linear regression were calculated, respectively. Results: In study 1 there was a significant association between condition and whether or not children remained sitting χ² = 55.96, p < 0.001. There was a significant difference in counts between the two conditions, t_{(13, 61)} = 2.29, p < 0.05. Children randomized to the experimental group (i.e., Moblees) moved more compared to control. In study 2 the majority (76%) of parents reported that their child engaged in some physical activity during viewing. Parent encouragement during viewing was the strongest predictor of child physical activity while viewing (β = 0.30, p < 0.01). Conclusion: Television content that includes messaging about physical activity and sedentary behavior, and positive portrayals of physical activity may influence the physical activity of young children. Although the benefits of such modest movement are not clear without further evidence of accumulation over time and/or transfer to other settings, television programming might provide a far reaching medium for knowledge translation.

Increasing Physical Activity Through Principles of Habit Formation in New Gym Members: a Randomized Controlled Trial

BACKGROUND

The promotion of physical activity (PA) is paramount to public health, yet interventions in the social cognitive tradition have yielded negligible improvements. The limited progression may be due to an overreliance on intention as the proximal determinant of behavior and a lack of consideration of implicit/automatic processes. The purpose of this study was to examine the impact of a habit formation intervention on PA over 8 weeks in a two-arm parallel design, randomized controlled trial.

METHODS

Participants (n = 94) were new gym members with the intention to engage in PA but below international PA guidelines at baseline, who were randomized into a control or habit experimental group. The experimental group attended a workshop (at baseline) and received a follow-up booster phone call at week 4. The primary outcome of the study was minutes of moderate-vigorous intensity PA (MVPA) at week 8. The secondary outcome was a manipulation check to determine if the experimental group effectively incorporated habit-building constructs (cues and practice consistency).

RESULTS

The experimental group showed a significant increase in MVPA after 8 weeks in both accelerometry (d = 0.39, p = .04) and self-report (d = 0.53, p = .01) compared with the control group. The experimental group also showed an increase in use of cues (d = 0.56, p < .001) and practice consistency (d = 0.40, p = .01) at week 8.

CONCLUSION

The results contribute to the initial validity of increasing PA through a focus on preparation cues and practice consistency. Future research should replicate these findings and extend the duration of assessment to evaluate whether PA changes are sustained. Registered Trial Number NCT02785107.

Awareness of ParticipACTION among Canadian adults: a seven-year cross-sectional follow-up

INTRODUCTION

In this cross-sectional follow-up study, we explored Canadian's awareness of ParticipACTION and their levels of physical activity (PA) after seven years of campaigns.

METHODS

A population-based survey was conducted with 7282 adults over a period of 14 months from February 2014 to May 2015. The survey consisted of questions on the 2014-2015 Physical Activity Monitor relating to awareness and knowledge of ParticipACTION. Weighted logistic models were constructed to examine whether awareness was associated with PA-related beliefs, intentions, and leisure time physical activity (LTPA).

RESULTS

Approximately 20% of Canadians reported unprompted awareness of ParticipACTION and 82% reported prompted awareness. Education, income, and having children were significant correlates of awareness among Canadians. The adjusted odds of people being aware of ParticipACTION (prompted and unprompted) were greater if they were more educated (OR = 1.57, 95% CI: 1.04-2.39; OR = 2.00, 95% CI: 1.24-3.24), reported higher income (OR = 3.92, 95% CI: 2.35-6.53; OR = 2.29, 95% CI: 1.44-3.62), and had children (OR = 1.93, 95% CI: 1.40-2.66; OR = 1.70, 95% CI: 1.26-2.30). Furthermore, awareness of ParticipACTION was positively associated with outcome expectations and self-efficacy, and negatively associated with LTPA status.

CONCLUSION

Levels of unprompted awareness of ParticipACTION are higher than previously reported and, in comparison to active Canadians, inactive Canadians are more likely to be aware of the organization. Given that it had primarily targeted parents of inactive children over the past seven years, it appears the organization has been partially effective in achieving its communication goals.

Motivating parent support for physical activity: the role of framed persuasive messages

Parent support for physical activity (PA) is a behavior unto itself that requires motivation. Persuasive messages may be one method for motivating parent support for their children's PA. Message framing is one strategy for optimizing the impact of messages. The current study examined the relative effectiveness of gain- versus loss-framed messages for encouraging parent support for children's PA. Regardless of message frame, parents had an increase in social cognitive antecedents (e.g. perceived behavioral control, intentions) and support for children's PA following message exposure.

Parenting Practices and Children's Physical Activity: An Integrative Review

The purpose of this integrative review was to analyze the state of science concerning the influence of parenting practices on children's physical activity (PA) levels. A total of 38 studies met the inclusion criteria after full-text review. The body of research is limited in experimental designs with only three studies measuring the influence of the intervention on parenting practices. Seven of the 30 quantitative studies (23.3%) found significant associations between parental role modeling of PA and children's PA levels. Seven of the eight (87.5%) qualitative studies identified parental role modeling of PA as important in promoting children's PA. Sixteen of the 30 (53.3%) quantitative studies found that parental support of PA was significantly associated with children's PA. Five of the eight (62.5%) qualitative studies identified logistic support as supporting PA in children. The science could be expanded by the development of randomized controlled trials aimed at this area.

Promoting Parent and Child Physical Activity Together: Elicitation of Potential Intervention Targets and Preferences

Promoting physical activities that involve both parents and their children would be very useful to the improved health and well-being of families, yet coactivity interventions have been particularly unsuccessful in past research. The purpose of this study was to elicit the salient parental beliefs about coactivity framed through theory of planned behavior in order to inform future intervention content. A representative sample of Canadian parents ( N = 483) with children aged 6 to 14 years completed belief elicitation measures of theory of planned behavior, as well as coactivity and program preferences. Analyses included content theming by physical activity belief and preference through tallies of the percentages of parents endorsing each belief. Exploratory analyses of differences in endorsed themes were conducted by parent (mother, father), age of child (6-10 years, 11-14 years), and sex of the child. The results showed that behavioral beliefs about health, interpersonal and educational/learning opportunities and control beliefs about lack of time, various incompatible parent/child factors, parental health, and bad weather were dominant themes. Most of these themes did not vary in endorsement by parent and child characteristics. By contrast, preferences for various activities varied by parent and child characteristics, yet parents overwhelmingly desired the activities to be outdoors, close to home, after work, and originally delivered from community health professionals via Internet or face-to face means. Overall, the findings provide several considerations for specific targets to improve future physical activity intervention approaches among parents and their children.