Understanding the Accuracy of Parental Perceptions of Child Physical Activity: A Mixed Methods Analysis

'You just eyeball it': Parent and nursery staff perceptions and influences on child portion size: A reflexive thematic analysis

Background: Childhood obesity is one of the most serious public health epidemics of the 21st century. Observational studies report that increases in portion size (PS) have occurred in parallel with levels of obesity. Increased PSs of high-energy-dense foods can promote overeating, and without compensatory behaviours, can contribute to childhood obesity. Caregivers make decisions about PSs for children in the home and nursery environment, thus are gatekeepers to child food intake. Understanding caregiver PS decisions can aid in the best practice of PS provision to young children. The aim of this study was to explore parent and nursery staff influences on child PS selection and their suggestions for useful tools/strategies in PS decisions. Methods: A qualitative design was employed using focus group discussions (FGDs) with parents and nursery staff of children aged 3-5 years. FGDs were employed given their ability to generate rich data, as well as permit the exploration of collective perceptions, attitudes, behaviours and experiences. Data were analysed using an inductive, semantic approach to reflexive thematic analysis. Results: Four FGDs were conducted: two with parents (n = 13), two with nursery staff (n = 17). Four overarching themes were derived: (i) awareness of PS guidelines; (ii) control over PS; (iii) social influences on children's eating behaviours; (iv) child-specific, social and external factors influencing parent and nursery staff PS decisions. Additionally, participants discussed tools/strategies they believe would be useful in PS decisions. Conclusion: Data from the themes suggest that caregiver control, social, child-specific and external factors are more influential than PS guidelines in both parent and nursery staff PS decisions for young children aged 3-5 years. These findings can inform future childhood obesity prevention initiatives focussed on improving parent and nursery staff provision/use of age-appropriate PSs.

Direct Parent Engagement to Improve Fundamental Movement Skills in Children: A Systematic Review

Fundamental movement skills (FMS) are basic movements in children that represent the building blocks for more complex motor skill development and act as a prerequisite for enduring sport and physical activity (PA) engagement and positive health-related behaviours. The FMS proficiency is currently inadequate worldwide, and consequently there are alarming levels of inactivity and childhood obesity. However, parents are role models to their children and possess the power to influence their PA behaviour. This review investigated if parent-focused interventions could improve FMS in 2-7-year-old children and evaluated which setting and method of parent engagement was most impactful. Keyword searches were conducted via Scopus, Web of Science, SPORTDiscus, PubMed, Science Direct, and Google Scholar. Only nine articles met the inclusion criteria. No research originated from the United Kingdom, highlighting the urgent need for further FMS interventions involving parents. The FMS improved in all nine studies, with significant changes in seven of the articles (p < 0.05). Parent-child co-activity, the education and empowerment of parents, and the provision of clear FMS guidance, messaging, and structure can positively influence children's FMS. Recently, smartphone apps have increased the feasibility and accessibility of FMS practice at home and may be integral to future interventions. Further research with direct parental involvement is clearly warranted.

Ability or luck: A systematic review of interpersonal attributions of success

The role of luck in success has a relatively minor, albeit consistent history in academic discourse, with a striking lack of literature engaging with notions of luck within occupational environments. Elucidating why people attribute their own success to luck over ability has predominated in the literature, with interpersonal attributions receiving less attention. Here, we center on systematically summarizing the evidence on interpersonal attributions of success as a function of ability or luck, with a particular focus on whether these differs by gender and race. The perception of the success of others from different sociodemographic groups, and how it is attributed, is a crucial leverage point for inclusion and diversity. Particularly as women and ethnic groups continue to be systematically disadvantaged in the workforce. Ignoring the role of luck conceals and augments privilege, even if not deliberately or consciously invoked. Using the Prisma protocol, this review offers evidence from experiments, published between 1970 and 2020, derived from five electronic bibliographic databases; Business Source Complete; PsychINFO; Scopus; Web of Science; and Google Scholar. There were a limited number of studies on gender that found an effect, but with few exceptions, the papers that pertain to race converged on the understanding that interpersonal attributions of success were predicated on this immutable factor. Such that black individuals were more often viewed as lucky in their success and less able, which translates to lesser opportunity and reward. Decades of research have pointed to individuals making systematic attribution errors in success by gender and race; this review only partially substantiates this consensus and provides narrow support for the view that those believed to be the most talented in society may merely be the luckiest. We add to evidence that context matters.

Introduction of a conversation starter tool to improve health habits in young children

BACKGROUND

Childhood overweight and obesity rates in the United States continue to climb. Providers must identify feasible interventions to improve health habits to prevent and treat obesity in children.

METHODS

Parents (n = 91) of four-to eight-year-old children were recruited and surveyed regarding their child's current health habits and perception of their child's weight status. A conversation starter tool was developed and utilized to improve health habits in children ages four-to-eight over a period of four-to-six weeks.

FINDINGS

Health habits in children improved in the comparison and intervention groups. There was a 42% improvement in health habits in the intervention group who chose a specific goal to work on compared to 30% improvement in the comparison group. There was no statistically significant relationship between health habit adherence and the assigned group when assessing the health habits individually.

DISCUSSION

Overall, 42% of the selected goals were met, according to parent report at the follow-up survey; however, use of the conversation starter tool did not demonstrate statistically significant improvement in health habits. Parental perception of children's weight status remained unchanged. Health habits in children improved in the comparison and intervention groups. Further studies should enroll a larger sample to assess differences between these two groups.

APPLICATION TO PRACTICE

The conversation starter tool was designed to be implemented into practice without the need for any specific training. The tool can be used on all children to promote improved health habits.

Neighborhood and Family Characteristics Associated with Adiposity and Physical Activity Engagement among Preschoolers in a Small Rural Community

The purpose of this study was to evaluate family and home/neighborhood characteristics associated with physical activity (PA) and adiposity among young children living in a small rural community.

METHODS

Participants were 30 parents and their youngest child aged 2-5 years. Children wore accelerometers for 7 days. Parents completed questionnaires about family lifestyle behaviors, parenting practices, and home/neighborhood characteristics.

RESULTS

None of the family lifestyle behaviors were associated with child BMI percentile. Backyard size was inversely associated with moderate to vigorous physical activity on weekday afternoons (rho = -0.488, p = 0.006), as was perception of neighborhood dangers (rho = -0.388, p = 0.034). Perceived neighborhood safety (rho = 0.453, p = 0.012), the presence of sidewalks (rho = 0.499, p = 0.012), and public playground use (rho = 0.406, p = 0.026) were each associated with higher weekday afternoon MVPA.

CONCLUSIONS

Findings suggest neighborhood safety, sidewalks, and use of public playgrounds are positively associated with MVPA among preschoolers, while backyard size and access to play equipment at home are not. These findings have implications for rural communities where space is plentiful but access to community space and sidewalks may be limited.

The Feasibility and Challenges of Conducting Online Research to Examine Movement Behavior in Parents and Children During the COVID-19 Pandemic

The global pandemic of COVID-19 shifted the methodology of this research project. The purpose of this perspective article is to discuss the feasibility and challenges of converting an in-person mixed methods study that examined associations among and beliefs about physical activity, motor competence, and perceived competence to an online format with parents and children during the COVID-19 pandemic. Recruitment was conducted through a University research registry, social media, and public listservs. All correspondence with participants was through email and secure platforms. Physical activity was assessed with accelerometers mailed to participants. Motor competence was assessed through participant-filmed trials of motor skills. Perceived competence was assessed with the Self-Perception Profile for Adults and Children delivered on Qualtrics. Semi- structured interviews to examine beliefs were conducted over Zoom. Approximately 200 families expressed interest in the study, 76 parent-child dyads consented and assented, and 61 parent-child dyads completed at least one component of the study. It is feasible to conduct online research that contributes to scientific knowledge and has potential advantages. However, various challenges need to be considered regarding the application of online research. These challenges included recruitment, the data collection process, and data quality. Future research needs to address these challenges by utilizing wide-reaching and diverse recruitment methods, easing participants' burden with technology, and developing motor competence and perceived competence assessments that can be administered online. The way research was conducted changed due to COVID-19 and adapting to and/or integrating online methods is both necessary and feasible, but modifications must be taken into consideration.

Influence of Parental Physical Activity and Sedentary Behavior on Young Children: Considering Time Together

Purpose: Parents are key role models for their young child's physical activity (PA) and sedentary behavior. This study examined the relationship between parents and their young child's PA and sedentary behavior considering whether the parent and child were together (present) or apart. Methods: Parent and child dyads (N = 26) wore accelerometers for 10 days and recorded times when they were present or absent from their young children (parental presence) in an online daily diary. Hourly data for PA and sedentary behavior of both the parent and young child were coded for parental presence. Multilevel modeling was used to predict child behavior (sedentary, light PA, and moderate to vigorous PA) using the respective parent behavior, the presence of the parent, and the interaction between parent behavior and presence. Results: The interaction between presence and parent behavior predicted the respective child behavior (p < .05). Parents' behavior was positively related to their young child's behavior when they were together, but the relationship was not present (moderate to vigorous PA) or weaker (sedentary behavior, light PA) when apart. Conclusions: Being active alone was not sufficient for a parent's PA to relate to their young child's PA, but rather being active in the presence of their child was important for young child's PA.

Parents accurately perceive problematic eating behaviors but overestimate physical activity levels in preschool children

PURPOSE

The aim of this study is to examine the associations between parents' perceptions of their child's physical activity and eating behaviors to actual physical activity, body mass index percentage (BMI%), and body fat percentage (BF%). A secondary aim is to examine additional parental determinants to child's physical activity.

METHODS

Participants were preschool children (N = 114, 59 females, M_age= 4.06) from three University-sponsored centers and parents (N = 114, 107 mothers). Parents self-reported physical activity, perceptions of child's physical activity, and completed "The Child Eating Behavior Questionnaire". Children physical activity was collected with accelerometers.

RESULTS

Whereas 97% of the 68 parents with children meeting physical activity guidelines accurately identified their child as active, 93% of the 14 parents with children not meeting physical activity guidelines inaccurately identified their child as active (X²(1, N = 82) = 0.58, p = 0.446)). Regarding eating behaviors, child BMI% was moderately correlated with parent's perceptions of their child's Emotional Overeating (r(74) = 0.416, p < 0.001) and Food Responsiveness (r(74) = 0.543, p < 0.001). Parent's engagement in vigorous physical activity demonstrated a positive relationship to child's physical activity (r(78) = 0.297, p = 0.008).

CONCLUSION

Parents of inactive children have inaccurate perceptions of their child's physical activity. The association between children's BMI% and eating behaviors indicates parents can accurately perceive problematic eating behaviors. Parents, who accurately perceive their child's behaviors, may be in a better position to identify deficiency and seek early intervention. Additionally, parent's physical activity may have implications to children's physical activity.

LEVEL OF EVIDENCE

Level V: Descriptive cross-sectional study.

"In my day…"- Parents' Views on Children's Physical Activity and Screen Viewing in Relation to Their Own Childhood

Physical activity and screen viewing are associated with cardio-metabolic risk factors, psychological wellbeing, and academic performance among children. Across the last generation, children’s physical activity and screen viewing behaviours have changed, coinciding with changes to the home and neighbourhood environment. This study aimed to qualitatively explore parents’ views on their 8–9-year-old child’s childhood and how this compares to experiences from their own childhood, with a specific focus on physical activity and screen viewing behaviours. Semi-structured telephone interviews were conducted with 51 parents (mean age = 41.2 years, range 31.5 to 51.5 years), between July and October 2016. Inductive and deductive content analyses were used to explore parents’ perceptions of their child’s physical activity and screen viewing behaviours in comparison to their own childhood behaviours. Interview data revealed that compared to the relative freedom they recalled as children, parents restrict their children’s independent mobility and outdoor play due to concerns about safety. Despite their children having greater access to structured activities than they did as children, parents feel their children are “missing out,” and perceived their own childhood as better with regards to maximising independent and outdoor play and limiting screen viewing. Innovative strategies are needed to change the social norms surrounding children’s independent mobility and outdoor play.

"My Tummy Tells Me" Cognitions, Barriers and Supports of Parents and School-Age Children for Appropriate Portion Sizes

Larger portion sizes have increased in tandem with the rise in obesity. Elucidation of the cognitions of children and parents related to portion size is needed to inform the development of effective obesity prevention programs. This study examined cognitions of parents (n = 36) and their school-age children (6 to 11 years; n = 35) related to portion sizes via focus group discussions. Parents and children believed controlling portion sizes promoted health and weight control. Some parents felt controlling portions was unnecessary, particularly if kids were a healthy weight because kids can self-regulate intake. Barriers to serving appropriate portions identified by parents focused largely on kids getting enough, rather than too much, to eat. Parents also identified lack of knowledge of age-appropriate portions as a barrier. Facilitators of portion control cited by parents included purchasing pre-portioned products and using small containers to serve food. Children relied on cues from parents (e.g., amount of food parent served them) and internal hunger/satiety cues to regulate intake but found it difficult to avoid overeating highly palatable foods, at restaurants, and when others were overeating. Results suggest obesity prevention interventions should aim to improve portion sizes cognitions, barrier management, and use of facilitators, in families with school-age children.

Examining the challenges posed to parents by the contemporary screen environments of children: a qualitative investigation

BACKGROUND

The ubiquity of technology in modern society has led to the American Academy of Pediatrics adapting their screen-viewing (SV) recommendations for children. The revised guidelines encourage families to identify an appropriate balance between SV and other activities. The aims of this study were to explore parents' views of their child's SV time and how important it is for families to achieve a 'digital balance'.

METHODS

Semi-structured telephone interviews were conducted with 51 parents of 8-9-year-old children, between July and October 2016. Inductive and deductive content analyses were used to explore parents' perceptions of their child's level of SV (low, medium, high), how parents feel about child SV, and the importance placed on achieving a digital balance. Parent report of child SV behaviours on weekdays and weekend days were assessed via questionnaire.

RESULTS

Interview data revealed that because SV is considered the 'norm', parents struggle to limit it, partly because they want their children to be equipped for the modern technological world. While most parents believe SV to have negative effects on children, parents also report advantages to SV. Many parents feel that not all SV is equal, with tablets considered worse than television because of the isolated nature of activities, and educational SV considered more beneficial than non-educational SV. Most parents feel it is important for their family to achieve a digital balance, primarily to spend more quality family time together. Large variation was observed in parents' descriptions of child SV time on weekdays and weekend days.

CONCLUSIONS

Parents recognise the importance of digital balance but want their children to fit into the ever-advancing digital world. Parents do not treat all SV equally. Watching television and engaging in educational SV may be encouraged, while 'playing' on tablets is discouraged. These findings highlight the challenge faced by researchers and policy makers to help families achieve a digital balance, and strategies are needed to support parents to plan child SV time.

Roles of mothers and fathers in supporting child physical activity: a cross-sectional mixed-methods study

OBJECTIVES

Examine the extent that parent gender is associated with supporting children's physical activity.

DESIGN

Cross-sectional mixed-methods study.

SETTING

47 primary schools located in Bristol (UK).

PARTICIPANTS

944 children aged 8-9 years and one of their parents provided quantitative data; 51 parents (20 fathers) were interviewed.

METHODS

Children wore an accelerometer, and mean minutes of moderate-to-vigorous physical activity (MVPA) per day, counts per minute (CPM) and achievement of national MVPA guidelines were derived. Parents reported who leads in supporting child activity during the week and weekend. Linear and logistic regression examined the association between gender of parent who supports child activity and child physical activity. For the semistructured telephone interviews, inductive and deductive content analyses were used to explore the role of gender in how parents support child activity.

RESULTS

Parents appeared to have a stronger role in supporting boys to be more active, than girls, and the strongest associations were when they reported that both parents had equal roles in supporting their child. For example, compared with the reference of female/mother support, equal contribution from both parents during the week was associated with boys doing 5.9 (95% CI 1.2 to 10.6) more minutes of MVPA per day and more CPM when both parents support on weekday and weekends (55.1 (14.3 to 95.9) and 52.8 (1.8 to 103.7), respectively). Associations in girls were weaker and sometimes in the opposite direction, but there was no strong statistical evidence for gender interactions. Themes emerged from the qualitative data, specifically; parents proactively supporting physical activity equally, mothers supporting during the week, families getting together at weekends, families doing activities separately due to preferences and parents using activities to bond one-to-one with children.

CONCLUSIONS

Mothers primarily support child activity during the week. Children, possibly more so boys, are more active if both parents share the supporting role.

How parents perceive screen viewing in their 5-6 year old child within the context of their own screen viewing time: a mixed-methods study

BACKGROUND

Few studies have examined parental perceptions of their child's screen-viewing (SV) within the context of parental SV time. This study qualitatively examined parents' perceptions of their 5-6-year-old child's SV within the context of their own quantitatively measured SV.

METHODS

A mixed-methods design employed semi-structured telephone interviews, demographic and SV questionnaires, objectively-measured physical activity and sedentary time. Deductive content analysis was used to explore parents' perceptions of, and concerns about, their child's SV, and management of their child's SV. Comparisons were made between parent-child dyads reporting low (<2-h per day) versus high SV time.

RESULTS

Fifty-three parents were interviewed (94.3% mothers), with 52 interviews analysed. Fifteen parent-child dyads (28.8%) exceeded the 2-h SV threshold on both weekdays and weekend days; 5 parent-child dyads (9.6%) did not exceed this threshold. The remaining 32 dyads reported a combination of parent or child exceeding/not exceeding the SV threshold on either weekdays or weekend days. Three main themes distinguished the 15 parent-child dyads exceeding the SV threshold from the 5 dyads that did not: 1) parents' personal SV-related views and behaviours; 2) the family SV environment; and 3) setting SV rules and limits. Parents in the dyads not exceeding the SV threshold prioritized and engaged with their children in non-SV behaviours for relaxation, set limits around their own and their child's SV-related behaviours, and described an environment supportive of physical activity. Parents in the dyads exceeding the SV threshold were more likely to prioritise SV as a shared family activity, and described a less structured SV environment with minimal rule setting, influenced their child's need for relaxation time.

CONCLUSIONS

The majority of parents in this study who exceeded the SV threshold expressed minimal concern and a relaxed approach to managing SV for themselves and their child(ren), suggesting a need to raise awareness amongst these parents about the time they spend engaging in SV. Parents may understand their SV-related parenting practices more clearly if they are encouraged to examine their own SV behaviours. Designing interventions aimed to create environments that are less supportive of SV, with more structured approaches to SV parenting strategies are warranted.

Mothers' perceptions of the UK physical activity and sedentary behaviour guidelines for the early years (Start Active, Stay Active): a qualitative study

OBJECTIVES

Higher levels of physical activity (PA) during early childhood have been associated with improved health outcomes, whereas sedentary behaviour (SB) has been associated with poorer health outcomes in children. In 2011, the UK produced guidelines for PA and SB in children under 5 years. Mothers have been identified as key influences in young children's PA and SB. The aim of this study was to use in-depth interviews with mothers of preschool children to examine attitudes to the guidance.

DESIGN

Qualitative study using one-to-one, semistructured interviews; Data were analysed thematically using a framework approach.

SETTING

Mothers were recruited from preschools, nurseries, and mother and toddler groups located in four areas of varying socioeconomic status within Bristol, UK.

PARTICIPANTS

24 mothers who were considered the main or joint carer for a preschool child who was at least 2 years of age but had not yet started formal schooling.

RESULTS

Mothers are not aware of the UK PA and SB guidelines for the early years. They believe that their child achieves the guideline targets for PA and SB and therefore, they do not believe these quidelines are relevant to them. Mothers feel that an increase in PA and reduction in SB (especially screen-viewing) would cause stress for mothers. Mothers found defining and quantifying PA and SB in their preschool child problematic.

CONCLUSIONS

As mothers do not identify with the need to increase PA or reduce SB in their child, awareness of the guidelines alone is unlikely to initiate behaviour change. Information on how mothers can make a more accurate assessment of their preschool child's PA and SB levels, and information about the benefits of increased PA and reduced SB should be provided alongside the guideline targets. Clear messages need to be developed that reframe the guidelines into pragmatic and usable targets.