Neighbourhood environment as a predictor of television watching among girls

Parental Perception of the Social and Physical Environment Contributes to Gender Inequalities in Children's Screen Time

BACKGROUND

This cross-sectional study aimed to explore how parental perceptions of the social and physical environment of the neighborhood was associated with 3- to 10-year-old children's use of traditional and modern screen devices.

METHODS

Participants were recruited under the scope of the project ObesInCrisis, conducted in 2016-2017 in the cities of Porto, Coimbra, and Lisbon (Portugal). Data from 6347 children aged 3-10 years were analyzed (3169 boys [49.9%]). A parental questionnaire was used to collect data on children's screen time (dependent variable) and parents' perceived social and physical environment (from the Environmental Module of the International Physical Activity Prevalence Study questionnaire; independent variable), parental education, and urbanization (used as covariates).

RESULTS

Neighborhood features were more correlated with girls' screen time, than with boys', particularly among younger children. Also, more social than physical characteristics of the neighborhood were positively associated with children's use of television and mobile devices (ie, tablet and smartphone).

CONCLUSIONS

Community-based approaches should improve the social environment and implement supervised after-school programs to encourage and support children to be outdoors and spend less time in sedentary pursuits.

Exposure to electronic media between 6 and 24 months of age: An exploratory study

This study explores the associations between electronic media exposure, age, and socioeconomic status (SES) in a longitudinal sample of 24 infants from English-speaking families. Leveraging Language ENvironment Analysis (LENA) technology, the study seeks to characterize the relation between electronic media exposure and parental and child vocal activity. We analyzed ecologically valid, daylong audio recordings collected in infants' homes when they were 6, 10, 14, 18, and 24 months old. SES was measured with the Hollingshead Index, and exposure to electronic media and adult and infant vocal activity were measured automatically with LENA. On average, the children in the sample were exposed to 58 min of electronic media daily. We found that electronic media exposure was negatively associated with SES and decreased with child age, but only amongst high-SES families. We also found that electronic media exposure negatively impacted concurrent adult and child vocal activity, irrespective of SES and infant age. The present findings are an important step forward in examining the role of demographic factors in exposure to electronic media and enhance our understanding of the mechanisms through which exposure to electronic media may impact linguistic development in infancy and beyond.

Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth

BACKGROUND

Children and youth who meet the physical activity, sedentary, and sleep behaviour recommendations in the Canadian 24-Hour Movement Guidelines are more likely to have desirable physical and psychosocial health outcomes. Yet, few children and youth actually meet the recommendations. The family is a key source of influence that can affect lifestyle behaviours. The purpose of this paper is to describe the process used to develop the Consensus Statement on the Role of the Family in the Physical Activity, Sedentary, and Sleep Behaviours of Children and Youth (0-17 years) and present, explain, substantiate, and discuss the final Consensus Statement.

METHODS

The development of the Consensus Statement included the establishment of a multidisciplinary Expert Panel, completion of six reviews (three literature, two scoping, one systematic review of reviews), custom data analyses of Statistics Canada's Canadian Health Measures Survey, integration of related research identified by Expert Panel members, a stakeholder consultation, establishment of consensus, and the development of a media, public relations, communications and launch plan.

RESULTS

Evidence from the literature reviews provided substantial support for the importance of family on children's movement behaviours and highlighted the importance of inclusion of the entire family system as a source of influence and promotion of healthy child and youth movement behaviours. The Expert Panel incorporated the collective evidence from all reviews, the custom analyses, other related research identified, and stakeholder survey feedback, to develop a conceptual model and arrive at the Consensus Statement: Families can support children and youth in achieving healthy physical activity, sedentary and sleep behaviours by encouraging, facilitating, modelling, setting expectations and engaging in healthy movement behaviours with them. Other sources of influence are important (e.g., child care, school, health care, community, governments) and can support families in this pursuit.

CONCLUSION

Family is important for the support and promotion of healthy movement behaviours of children and youth. This Consensus Statement serves as a comprehensive, credible, and current synopsis of related evidence, recommendations, and resources for multiple stakeholders.

Perception of neighborhood safety and screen time in adolescents from Curitiba, Brazil

OBJECTIVE

To analyze the association between perceptions of neighborhood safety (PNS) and screen time among adolescents and to assess the moderating effects of sex, age and socioeconomic status.

METHODS

A cross-sectional study with school survey was conducted in Curitiba, Brazil. First, six schools (three public and three private) were intentionally selected. Next, one class within each educational level (from the sixth year of elementary school to the third year of high school) was randomly selected. PNS was assessed using a NEWS-Y scale, and daily screen time was defined as the time spent watching TV/videos/DVDs, playing video games and using the Internet. Multinomial logistic regression models were used to test the association between PNS and screen time, adjusting for the confounding variables.

RESULTS

The sample included 776 adolescents (boys and girls), aged between 11 and 18 years old. Perceived crime was associated with time playing video games among older teenagers (p < 0.05). Pedestrian and traffic safety was inversely associated with time playing video games among adolescents with high socioeconomic status (p < 0.05).

CONCLUSION

The association between PNS and screen time is complex among adolescents and varies according to sociodemographic variables and the screen time outcome (TV/videos/DVDs, video games and the Internet).

The Influence of Weather Variation, Urban Design and Built Environment on Objectively Measured Sedentary Behaviour in Children

With emerging evidence indicating that independent of physical activity, sedentary behaviour (SB) can be detrimental to health, researchers are increasingly aiming to understand the influence of multiple contexts such as urban design and built environment on SB. However, weather variation, a factor that continuously interacts with all other environmental variables, has been consistently underexplored. This study investigated the influence of diverse environmental exposures (including weather variation, urban design and built environment) on SB in children. This cross-sectional observational study is part of an active living research initiative set in the Canadian prairie city of Saskatoon. Saskatoon's neighbourhoods were classified based on urban street design into grid-pattern, fractured grid-pattern and curvilinear types of neighbourhoods. Diverse environmental exposures were measured including, neighbourhood built environment, and neighbourhood and household socioeconomic environment. Actical accelerometers were deployed between April and June 2010 (spring-summer) to derive SB of 331 10–14 year old children in 25 one week cycles. Each cycle of accelerometry was conducted on a different cohort of children within the total sample. Accelerometer data were matched with localized weather patterns derived from Environment Canada weather data. Multilevel modeling using Hierarchical Linear and Non-linear Modeling software was conducted by factoring in weather variation to depict the influence of diverse environmental exposures on SB. Both weather variation and urban design played a significant role in SB. After factoring in weather variation, it was observed that children living in grid-pattern neighbourhoods closer to the city centre (with higher diversity of destinations) were less likely to be sedentary. This study demonstrates a methodology that could be replicated to integrate geography-specific weather patterns with existing cross-sectional accelerometry data to understand the influence of urban design and built environment on SB in children.

Associations of Neighborhood and School Socioeconomic and Social Contexts With Body Mass Index Among Urban Preadolescent Students

OBJECTIVES

We examined independent and synergistic effects of school and neighborhood environments on preadolescent body mass index (BMI) to determine why obesity rates nearly double during preadolescence.

METHODS

Physical measures and health surveys from fifth and sixth graders in 12 randomly selected schools in New Haven, Connecticut, in 2009 were matched to student sociodemographics and school- and residential census tract-level data, for a total of 811 urban preadolescents. Key independent variables included school connectedness, neighborhood social ties, and school and neighborhood socioeconomic status. We estimated cross-classified random-effects hierarchical linear models to examine associations between key school and neighborhood characteristics with student BMI.

RESULTS

Greater average connectedness felt by students to their school was significantly associated with lower BMI. This association was stronger among students living in neighborhoods with higher concentrations of affluent neighbors.

CONCLUSIONS

How schools engage and support students may affect obesity rates preferentially in higher-income neighborhoods. Further research should explore the associations between multiple environments to which children are exposed and obesity-related behaviors and outcomes. This understanding of the multiple social-spatial contexts that children occupy has potential to inform comprehensive and sustainable child obesity prevention efforts.

Capturing the Interrelationship between Objectively Measured Physical Activity and Sedentary Behaviour in Children in the Context of Diverse Environmental Exposures

Even though physical activity and sedentary behaviour are two distinct behaviours, their interdependent relationship needs to be studied in the same environment. This study examines the influence of urban design, neighbourhood built and social environment, and household and individual factors on the interdependent relationship between objectively measured physical activity and sedentary behaviour in children in the Canadian city of Saskatoon. Saskatoon’s built environment was assessed by two validated observation tools. Neighbourhood socioeconomic variables were derived from 2006 Statistics Canada Census and 2010 G5 Census projections. A questionnaire was administered to 10–14 year old children to collect individual and household data, followed by accelerometry to collect physical activity and sedentary behaviour data. Multilevel logistic regression models were developed to understand the interrelationship between physical activity and sedentary behaviour in the context of diverse environmental exposures. A complex set of factors including denser built environment, positive peer relationships and consistent parental support influenced the interrelationship between physical activity and sedentary behaviour. In developing interventions to facilitate active living, it is not only imperative to delineate pathways through which diverse environmental exposures influence physical activity and sedentary behaviour, but also to account for the interrelationship between physical activity and sedentary behaviour.

The Interaction Between an Individual's Acculturation and Community Factors on Physical Inactivity and Obesity: A Multilevel Analysis

OBJECTIVES

We examined whether the interactions between primarily speaking English at home and community-level measures (median household income and immigrant composition) are associated with physical inactivity and obesity.

METHODS

We pooled the 2005 and 2007 Los Angeles County Health Survey data to construct a multilevel data set, with community-level median household income and immigrant density as predictors at the community level. After controlling for individual-level demographic variables, we included the respondent's perceived community safety as a covariate to test the hypothesis that perceived public safety mediates the association between acculturation and health outcomes.

RESULTS

The interaction between community median household income and primarily speaking English at home was associated with lower likelihoods of physical inactivity (odds ratio [OR] = 0.644; 95% confidence interval [CI] = 0.502, 0.825) and obesity (OR = 0.674; 95% CI = 0.514, 0.882). These odds remained significant after we controlled for perceived community safety.

CONCLUSIONS

Resources in higher-income areas may be beneficial only to residents fully integrated into the community. Future research could focus on understanding how linguistic isolation affects community-level social learning and access to resources and whether this differs by family-level acculturation.

Why the Canadian sedentary behaviour guidelines should reflect sex and gender

The world's first evidence-based sedentary behaviour guidelines were released in Canada in 2011. Based on evidence that time spent in sedentary pursuits poses important health risks, the guidelines recommend limits on the time that children and youth are sedentary throughout the day. Although the guidelines reflect differences in age, they do not include recommendations for adults, nor engage with other important determinants of health such as sex and gender, despite research suggesting that girls and boys, women and men, engage in different sedentary behaviours. For example, it has been suggested that girls spend considerable time in communication-based sedentary behaviours such as talking on the phone, texting and instant messaging, while boys are more likely to watch television and videos, or play computer games. There is also evidence suggesting that the health outcomes associated with sedentary behaviour differ for females and males, and there are gendered social and economic barriers that may influence sedentary behaviour. It is therefore time to consider sex and gender in research and policy on sedentary behaviour in order to effectively reduce time spent sedentary and to improve the health of women and men in Canada.

Disentangling neighborhood contextual associations with child body mass index, diet, and physical activity: the role of built, socioeconomic, and social environments

Obesity prevalence among US children and adolescents has tripled in the past three decades. Consequently, dramatic increases in chronic disease incidence are expected, particularly among populations already experiencing health disparities. Recent evidence identifies characteristics of "obesogenic" neighborhood environments that affect weight and weight-related behaviors. This study aimed to examine associations between built, socioeconomic, and social characteristics of a child's residential environment on body mass index (BMI), diet, and physical activity. We focused on pre-adolescent children living in New Haven, Connecticut to better understand neighborhood environments' contribution to persistent health disparities. Participants were 1048 fifth and sixth grade students who completed school-based health surveys and physical measures in fall 2009. Student data were linked to US Census, parks, retailer, and crime data. Analyses were conducted using multilevel modeling. Property crimes and living further from a grocery store were associated with higher BMI. Students living within a 5-min walk of a fast food outlet had higher BMI, and those living in a tract with higher density of fast food outlets reported less frequent healthy eating and more frequent unhealthy eating. Students' reported perceptions of access to parks, playgrounds, and gyms were associated with more frequent healthy eating and exercise. Students living in more affluent neighborhoods reported more frequent healthy eating, less unhealthy eating, and less screen time. Neighborhood social ties were positively associated with frequency of exercise. In conclusion, distinct domains of neighborhood environment characteristics were independently related to children's BMI and health behaviors. Findings link healthy behaviors with built, social, and socioeconomic environment assets (access to parks, social ties, affluence), and unhealthy behaviors with built environment inhibitors (access to fast food outlets), suggesting neighborhood environments are an important level at which to intervene to prevent childhood obesity and its adverse consequences.

Factors associated with screen time among school-age children in Korea

The purpose of this study was to investigate the association of sociodemographic, psychosocial, and behavioral characteristics with screen time among school-age children in Korea. This study employed a nonexperimental, cross-sectional study design. A total of 370 children attending four elementary schools participated in the study. Self-report method was used, and instruments included screen time (time spent on TV/video/computer/video games), sleep duration, eating behavior, pros and cons of exercise, and exercise self-efficacy. According to the results, 45.7% of the children had screen time of 1-2.9 hr/day and 8.9% had 3 or more hr/day. Increased screen time showed an association with gender (boy), higher body mass index, fast food consumption, higher cons of exercise, having a working mother, and attendance at a school in an inner city area (p < .05). Understanding the factors associated with screen time may provide useful information in the development of health promotion programs aimed at decreasing sedentary behaviors.

Adolescent sedentary behaviors: correlates differ for television viewing and computer use

PURPOSE

Sedentary behavior is associated with obesity in youth. Understanding correlates of specific sedentary behaviors can inform the development of interventions to reduce sedentary time. The current research examines correlates of leisure computer use and television viewing among adolescents in California.

METHODS

Using data from the 2005 California Health Interview Survey, we examined individual, family, and environmental correlates of two sedentary behaviors among 4,029 adolescents: leisure computer use and television watching.

RESULTS

Linear regression analyses adjusted for a range of factors indicated several differences in the correlates of television watching and computer use. Correlates of additional time spent watching television included male sex, American Indian and African American race, lower household income, lower levels of physical activity, lower parent educational attainment, and additional hours worked by parents. Correlates of a greater amount of time spent using the computer for fun included older age, Asian race, higher household income, lower levels of physical activity, less parental knowledge of free-time activities, and living in neighborhoods with higher proportions of nonwhite residents and higher proportions of low-income residents. Only physical activity was associated similarly with both watching television and computer use.

CONCLUSIONS

These results suggest that correlates of time spent on television watching and leisure computer use are different. Reducing screen time is a potentially successful strategy in combating childhood obesity, and understanding differences in the correlates of different screen time behaviors can inform the development of more effective interventions to reduce sedentary time.

A review of family and environmental correlates of health behaviors in high-risk youth

Disparities in the prevalence of obesity in youth place minority and low socioeconomic status youth at increased risk for the development of chronic disease, such as metabolic syndrome and type 2 diabetes. Contributing factors to the increases in obesity include a decline in positive health behaviors, such as making healthy dietary choices, engaging in physical activity, and limiting sedentary behaviors. Family and physical environmental contextual factors related to health behaviors are increasingly the focus of health behavior interventions in line with the bioecological model that encourages a system-focused perspective on understanding health behavior influences. Physical environmental characteristics, such as home and neighborhood characteristics and resources, provide the tangible means to support health behaviors and are important contextual variables to consider that may increase intervention effectiveness. Therefore, the current review seeks to highlight the importance of investigating influences of behavior beyond individual characteristics in understanding factors related to the risk of developing metabolic syndrome and type 2 diabetes in youth at high risk for developing chronic disease. The current study reviews the non-intervention literature on family and physical environmental factors related to health behaviors (i.e., diet, physical activity, and sedentary behavior) in youth who are considered to be at-risk for developing metabolic syndrome and type 2 diabetes. Results on 38 published articles of diet, physical activity, and sedentary behaviors showed support for the role of parenting and physical environmental factors, particularly parental monitoring and neighborhood context, such as social cohesion, as they relate to health behaviors in high-risk youth. Implications and recommendations for future research are discussed.

The association between community stressors and asthma prevalence of school children in Winnipeg, Canada

It is generally surmised that community stressors have an incubating effect for a variety of diagnoses on maternal and child health. This is of public health significance, as children of mothers facing long-term distress were found to have a 60% higher risk for asthma diagnosis at age 7 in Manitoba, Canada. Our objective was to determine the association of community stressors with childhood asthma prevalence in Winnipeg, Canada from participants who completed the Study of Asthma, Genes and the Environment (SAGE) survey administered in 2002–2003 to a birth cohort from 1995. Measures of community socioeconomic makeup and community disorder with rank ordinalized by quintile at the census tract level were obtained from the 1996 Canada Census. Crime data (annual incidence per 10,000 persons) by neighbourhood profile for 2001 was provided by the Winnipeg Police Service. Dichotomous caregiver report of child asthma along with other indicators from the geocoded SAGE survey allowed linkage to 23 neighbourhood profiles. Multilevel logistic regression analyses were performed to estimate the effect of community stressors on childhood asthma prevalence for birth and non-birth home children (N = 1472) and children resident of birth homes at age 7 or 8 (N = 698). After adjusting for individual risk factors, children resident of birth homes in a high thefts over $5,000 neighbourhood profile were twice as likely (Adjusted OR, 2.05; 95% CI, 1.11–3.81) to have report of asthma compared to children in a lower thefts over $5,000 profile, with community thefts over $5,000 explaining over half of the observed neighbourhood variation in asthma.

The effect of perceived and structural neighborhood conditions on adolescents' physical activity and sedentary behaviors

OBJECTIVE

To test whether physical activity and sedentary behaviors are associated with perceived and structural neighborhood conditions.

DESIGN

Secondary analysis of data from wave I (1994-1995) of the National Longitudinal Study of Adolescent Health in the United States.

SETTING

In-home interviews of adolescents and their parents.

PARTICIPANTS

Thirteen thousand six hundred sixty-eight adolescents (6794 adolescent boys and 6874 adolescent girls; grades 7-12).

MAIN EXPOSURES

Perceived neighborhood conditions (public nuisance, acquaintanceship, and informal control measured at both individual and census tract levels) and structural neighborhood characteristics (concentrated poverty, immigrant concentration, and residential stability at the census tract level).

OUTCOME MEASURES

Failure to meet moderate to vigorous physical activity (MVPA) guidelines (<5 bouts of MVPA per week) and excessive screen time (>2 hours per day).

RESULTS

Individual-level perception of intermediate (adjusted odds ratio [OR], 0.76; 95% confidence interval [CI], 0.68-0.84) or high (OR, 0.56; 95% CI, 0.50-0.61) acquaintanceship and high informal control (OR, 0.90; 95% CI, 0.82-0.99) in the neighborhood were negatively associated with failure to meet the MVPA guidelines compared with lower levels. At the census tract level, high informal control (OR, 1.16; 95% CI, 1.04-1.29) and intermediate (OR, 1.13; 95% CI, 1.01-1.26) and high (OR, 1.22; 95% CI, 1.06-1.40) concentrated poverty compared with lower levels were also associated with failing to meet the MVPA guidelines (when adjusted for sociodemographic characteristics). Compared with the lowest levels, high public nuisance (OR, 1.19; 95% CI, 1.04-1.36) and immigrant concentration (OR, 1.18; 95% CI, 1.01-1.38) at the census tract level were associated with excessive screen time.

CONCLUSION

These findings suggest that both perceptual and structural neighborhood factors should be considered to understand adolescents' physical activity and sedentary behaviors.

Association between neighborhood socioeconomic status and screen time among pre-school children: a cross-sectional study

BACKGROUND

Sedentary behavior is considered a separate construct from physical activity and engaging in sedentary behaviors results in health effects independent of physical activity levels. A major source of sedentary behavior in children is time spent viewing TV or movies, playing video games, and using computers. To date no study has examined the impact of neighborhood socioeconomic status (SES) on pre-school children's screen time behavior.

METHODS

Proxy reports of weekday and weekend screen time (TV/movies, video games, and computer use) were completed by 1633 parents on their 4-5 year-old children in Edmonton, Alberta between November, 2005 and August, 2007. Postal codes were used to classified neighborhoods into low, medium or high SES. Multiple linear and logistic regression models were conducted to examine relationships between screen time and neighborhood SES.

RESULTS

Girls living in low SES neighborhoods engaged in significantly more weekly overall screen time and TV/movie minutes compared to girls living in high SES neighborhoods. The same relationship was not observed in boys. Children living in low SES neighborhoods were significantly more likely to be video game users and less likely to be computer users compared to children living in high SES neighborhoods. Also, children living in medium SES neighborhoods were significantly less likely to be computer users compared to children living in high SES neighborhoods.

CONCLUSIONS

Some consideration should be given to providing alternative activity opportunities for children, especially girls who live in lower SES neighborhoods. Also, future research should continue to investigate the independent effects of neighborhood SES on screen time as well as the potential mediating variables for this relationship.