Associations between parent and child physical activity and eating behaviours in a diverse sample: an ecological momentary assessment study

A Scoping Review of Household Factors Contributing to Dietary Quality and Food Security in Low-Income Households with School-Age Children in the United States

Low-income and food-insecure households are at risk of poor dietary quality and even more severe food insecurity. Especially in childhood, consuming a nutritionally adequate diet is an essential driver of health, growth, and development. Household-level factors can present challenges to support the nutritional needs of low-income and food-insecure household members. The aim of this scoping review is to identify the contributing household factors to dietary quality and food security in US households of school-aged children 5 to 19 years and synthesize the evidence around emergent themes for application to future interventions. The scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Extension for Scoping Reviews using search terms addressing food insecurity, low income, and dietary behaviors in the database PubMed. Screening by 3 independent reviewers of the title, abstract, and full study phases identified 44 studies. The 5 themes around which the studies grouped were: parental behaviors, child/adolescent behaviors, food procurement behaviors, food preparation behaviors, and household environment factors. Most studies were cross-sectional (n = 41, 93%) and focused on parental behaviors (n = 31, 70%), followed by food preparation and procurement behaviors. The themes identified were interrelated and suggest that incorporating education on parent and child behaviors that influence food procurement and preparation, along with strengthening organization and planning in the household environment, may hold promise to improve dietary quality and food security among food-insecure and low-income households. The findings can be used to inform future nutrition education interventions aimed at improving dietary quality and food security in households with school-aged children.

Associations of Maternal and Paternal Parenting Practices With Children's Fruit and Vegetable Intake and Physical Activity: Preliminary Findings From an Ecological Momentary Study

BACKGROUND

Childhood obesity prevention interventions routinely focus on changing maternal parenting practices. Failure to assess how fathers' weight-related (ie, diet and physical activity) parenting practices contribute to children's energy balance behaviors limits the understanding of their paternal role within the family. Examining the independent and interacting effects of fathers' and mothers' weight-related parenting practices on children's diet and physical activity addresses this important research gap.

OBJECTIVE

This study used ecological momentary assessment (EMA) to investigate the within-subject and between-subject independent and interactive effects of maternal and paternal encouragement to eat and preparation of fruits and vegetables (F/V) and encouragement of and taking their child to be physically active on their child's self-reported F/V intake and physical activity engagement.

METHODS

Participants included mother-father-child triads (n=22 triads, n=205-213 prompts/occasions) in the Mothers and Their Children's Health Study and the University of Southern California Fathers Study. Simultaneously, mothers and fathers (ages_mean 44.2 years, SD 5.6, and 45.2 years, SD 8.1, respectively), and their children (age_mean 12.0 years, SD 0.7) completed up to 8 randomly prompted EMA surveys per day on separate smartphones for 7 days. At each prompt, mothers and fathers each reported whether they did the following in the past 2 hours: (1) encouraged their child to eat F/V, (2) prepared F/V for their child, (3) encouraged their child to be physically active, or (4) took their child to be physically active. Children self-reported whether they consumed F/V or were physically active in the past 2 hours.

RESULTS

Results from Bayesian multilevel logistic models (all in log-odd units) indicated that at the within-subject level, greater maternal encouragement (β=2.28, 95% CI 0.08 to 5.68) of eating F/V was associated with greater child report of eating F/V, but paternal encouragement (β=1.50, 95% CI -0.83 to 4.52) showed no effects above and beyond maternal encouragement. Additionally, greater than usual paternal encouragement (β=2.28, 95% CI 0.08 to 5.54) and maternal encouragement (β=2.94, 95% CI 0.36 to 6.69) of physical activity had significant independent effects and were associated with greater child report of physical activity. No other within-subject or between-subject associations nor interactive effects were significant.

CONCLUSIONS

Findings from this study suggest that fathers play a role in supporting their children's physical activity but not their intake of F/V. Future EMA studies should recruit larger samples to evaluate the independent and interacting roles of mothers' and fathers' weight-related parenting practices on child's obesogenic behaviors.

Examining the Relationship Between Parental Stress and Girls' and Boys' Physical Activity Among Racially/Ethnically Diverse and Immigrant/Refugee Populations

Given the high prevalence of overweight/obesity and the low prevalence of engaging in physical activity in children, it is important to identify barriers that impede child physical activity. One potential barrier is parental stress. The current study examined the association between parental stress levels and girls' and boys' moderate to vigorous physical activity. Children aged 5-7 years and their families (n = 150) from 6 racial/ethnic groups (n = 25 each Black, Hispanic, Hmong, Native American, Somali, and White families) were recruited for the Family Matters mixed-methods study in 2015 through primary care clinics in Minneapolis and St Paul, MN. Two in-home visits were carried out with families 10 days apart for data collection, with an 8-day observational period in between when children wore accelerometers. Higher parental stress levels were associated with fewer minutes of moderate to vigorous physical activity in girls (P < .05) compared with boys. On average, girls with a parent reporting a stress rating of 10 engaged in 24 minutes less of physical activity per day than girls with a parent with a stress rating of 1. The results suggest that parental stress may reduce girls' engagement in physical activity. The implications of these results include targeting parental stress and coping skills in future physical activity interventions. In addition, when addressing child physical activity in health care visits with parents and daughters, providers may want to focus their anticipatory guidance on parental stress and coping skills in addition to providing resources to help parents manage stress.