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

Sex differences in physical activity of US children at age 13 months: child and Mother Physical Activity Study (CAMPAS)

BACKGROUND

Lower physical activity (PA) has been observed in females compared to males among preschool-aged and older children. However, the timing of when the sex gap emerges is unclear. The purpose of this study was to investigate whether females have lower PA levels than males in the early toddler age and to explore whether gross motor competency and PA parenting practices might explain a sex difference in PA.

METHODS

The study design was cross-sectional. Participants were a community-based sample of 137 children aged 10-16 months residing in US Midwest urban/suburban area. Participants' mothers completed a survey that contained a demographic questionnaire, the Ages and Stages Questionnaire gross motor competency subscale, and a PA parenting practices questionnaire. Participating children wore an ActiGraph accelerometer on their hip for 7 days. Accelerometer-measured time spent in moderate- and vigorous intensity PA (MVPA; minutes/day) and in total PA (minutes/day) were calculated. Multivariable linear regression analysis was conducted to predict MVPA and total PA by sex, gross motor competency, PA parenting practices, and socioeconomic status.

RESULTS

Among 137 participants (54.0% female), average age was 13.6 months (SD = 1.7). MVPA was 72 ± 25 and 79 ± 26 min/day for females and males, respectively (p = 0.14). Total PA was 221 ± 48 and 238 ± 47 min/day for females and males, respectively (p = 0.04). Both gross motor competency and PA-encouraging parenting practices were positively associated MVPA (p = 0.01 and p = 0.02, respectively) and total PA (p = 0.02 and p = 0.01, respectively); however, these relationships did not differ by sex (p = 0.11 and p = 0.89, respectively). After accounting for gross motor competency and PA parenting practices, total PA was 15 min/day lower among females than males (p = 0.04).

CONCLUSIONS

This cross-sectional study of US children observed a sex gap in total PA at 10-16 months of age. Gross motor development and PA parenting practices did not differ by child sex nor explain the sex difference in PA. A longitudinal investigation should follow to further narrow down when sex differences in PA emerge and to determine the factors that lead to this difference.

Feasibility and potential efficacy of a family-based intervention on promoting physical activity levels and fundamental movement skills in preschoolers: A cluster randomised controlled trial

Physical activity (PA) is crucial for preschool-aged children's health and development. However, limited evidence exists regarding the feasibility of implementing home-based interventions and how program components influence parent cognitions and practices and child PA. This study evaluated the feasibility and potential efficacy of a family-based PA intervention on objectively measured PA, fundamental movement skills (FMS), parental efficacy, support, goal setting and parent-child co-activity. Guided by social cognitive theory, an 8-week cluster randomised controlled trial was conducted in Hong Kong. The trial included parental workshops, FMS training, PA homework, social media activity sharing and exercise equipment provision. Data were collected at baseline (Time 1; April 2019) and at the end of the intervention period (Time 2; approximately 2 months later) from 108 parent-child pairs in five preschools. The intervention led to increased moderate-to-vigorous PA and FMS in children, along with improved parental self-efficacy, goal setting, supportiveness and co-participation. However, parental PA did not show significant changes. Parents expressed high satisfaction, supporting the need for tailoring interventions to address the unique needs and preferences of young children and their parents. Reinforcing the parental role and providing informative materials and training can promote healthy lifestyles in early childhood.

Using a Human-Centered Design Process to Evaluate and Optimize User Experience of a Website (InPACT at Home) to Promote Youth Physical Activity: Case Study

Background

Web-based physical activity interventions often fail to reach the anticipated public health impact due to insufficient use by the intended audiences.

Objective

The purpose of this study was to use a human-centered design process to optimize the user experience of the Interrupting Prolonged sitting with ACTivity (InPACT) at Home website to promote youth physical activity participation.

Methods

Qualitative interviews were conducted to assess engagement and pain points with the InPACT at Home website. Interview data were used to create affinity maps to identify themes of user responses, conduct a heuristic evaluation according to Nielsen's usability heuristics framework, and complete a competitive analysis to identify the strengths and weaknesses of competitors who offered similar products.

Results

Key themes from end user interviews included liking the website design, finding the website difficult to navigate, and wanting additional features (eg, library of watched videos). The website usability issues identified were lack of labeling and categorization of exercise videos, hidden necessary actions and options hindering users from decision-making, error-prone conditions, and high cognitive load of the website. Competitive analysis results revealed that YouTube received the highest usability ratings followed by the Just Dance and Presidential Youth Fitness Program websites.

Conclusions

Human-centered design approaches are useful for bringing end users and developers together to optimize user experience and impact public health. Future research is needed to examine the effectiveness of the InPACT at Home website redesign to attract new users and retain current users, with the end goal of increasing youth physical activity engagement.

Sex Differences in Physical Activity of US children at age 13 months: Child and Mother Physical Activity Study (CAMPAS)

Background

Lower physical activity (PA) has been observed in females compared to males among preschool-aged and older children. However, the timing of when the sex gap emerges is unclear. The purpose of this study was to investigate whether females have lower PA levels than males in the early toddler age and to explore whether gross motor competency and PA parenting practices might explain a sex difference in PA.

Methods

The study design was cross-sectional. Participants were a community-based sample of 137 children aged 10-16 months residing in US Midwest urban/suburban area. Participants' mothers completed a survey that contained a demographic questionnaire, the Ages and Stages Questionnaire gross motor competency subscale, and a PA parenting practices questionnaire. Participating children wore an ActiGraph accelerometer on their hip for 7 days. Accelerometer-measured time spent in moderate- and vigorous intensity PA (MVPA; minutes/day) and in total PA (minutes/day) were calculated. Multivariable linear regression analysis was conducted to predict MVPA and total PA by sex, gross motor competency, PA parenting practices, and socioeconomic status.

Results

Among 137 participants (54.0% female), average age was 13.6 months (SD = 1.7). MVPA was 72 ± 25 and 79 ± 26 minutes/day for females and males, respectively (p = 0.14). Total PA was 221 ± 48 and 238 ± 47 minutes/day for females and males, respectively (p = 0.04). Both gross motor competency and PA-encouraging parenting practices were positively associated MVPA (p = 0.01 and p = 0.02, respectively) and total PA (p = 0.02 and p = 0.01, respectively); however, these relationships did not differ by sex (p = 0.11 and p = 0.89, respectively). After accounting for gross motor competency and PA parenting practices, total PA was 15 minutes/day lower among females than males (p = 0.04).

Conclusions

This cross-sectional study of US children observed a sex gap in total PA at 10-16 months of age. Gross motor development and PA parenting practices did not differ by child sex nor explain the sex difference in PA. A longitudinal investigation should follow to further narrow down when sex differences in PA emerge and to determine the factors that lead to this difference.

Parenting Practices Are Associated With Out-of-School Physical Activity in US Adolescents in 2014

INTRODUCTION

Lack of physical activity (PA) is associated with obesity, diabetes, hypertension, cardiovascular diseases, and cancer. Parenting practices influence PA in young children. However, there is little evidence available for adolescents. We examined whether parenting practices were associated with out-of-school PA (OSPA) in US adolescents.

METHODS

This cross-sectional 2019 study analyzed data from the 2014 FLASHE study, a web-based, quota-sampled survey of parent-adolescent dyads. Inclusion required survey completion and parents to live with their teen (ages 12-17 y old). Physically limited adolescents were excluded. Dyads were stratified by teen age. Exposures included parental modeling, monitoring, facilitation, restriction, guided choice, and pressure. The outcomes of interest were OSPA Youth Activity Profile scores. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated using adjusted logistic regressions.

RESULTS

A total of 1109 dyads were included. Guided choice increased odds of OSPA for 15- to 17-year-olds (OR = 2.12; 95% CI, 1.17-3.84). Facilitation increased odds of OSPA for 12- to 14-year-olds (OR = 2.21; 95% CI, 1.13-4.33). Monitoring decreased odds of OSPA for 15- to 17-year-olds (OR = 0.34; 95% CI, 0.20-0.57) and 12- to 14-year-olds (OR = 0.45; 95% CI, 0.27-0.74). Friend support increased odds of OSPA in 15- to 17-year-olds (OR = 4.03; 95% CI, 2.29-7.08) and 12- to 14-year-olds (OR = 3.05; 95% CI 1.69-5.51).

CONCLUSION

Future interventions should prioritize (1) shared decision making for older teens, (2) access to PA opportunities for younger adolescents, and (3) promoting peer PA and friend support for everyone.

Patterns of Physical Activity Parenting Practices and Their Association With Children's Physical Activity Behaviors

Background: Little is known about how parents combine multiple physical activity (PA) parenting practices (PAPP) and their relationship with their child's activity level. This study examined patterns of PAPP and their associations with sociodemographic characteristics and children's PA. Methods: Parents of 5- to 12-year-olds (n = 618) completed the 65-items PAPP item-bank assessing their use of structured, autonomy promoting, and controlling PAPP, and reported their child's PA. Latent class analysis was used to uncover similar groups of parents based on their use of nine PAPP. Regression analyses evaluated associations between the latent classes, sociodemographic factors, and children's PA. Results: Four latent classes emerged: (1) Indifferent (30%)-parents who were unlikely to use any of the PAPP examined; (2) Coercive (23%)-parents using primarily controlling PAPP; (3) Involved (19%)-parents using most PAPP examined; and (4) Supportive (28%)-parents using primarily structured and autonomy promoting PAPP. Involved parents were younger than Indifferent and Supportive parents. Supportive parents reported the highest level of children's PA compared with all other groups, whereas Coercive parents reported the lowest level of children's PA. Conclusions: Our findings showed that different latent classes exist among Canadian parents and that the combination of structured and autonomy promoting PAPP, when used without control, was associated with the highest PA level among children. The emergent latent classes are novel, theoretically meaningful, and key to inform family-based PA interventions.

Parental Perceptions of Physical Activity and Risk of Disease Associated with Sedentary Behaviours in Infants and Toddlers

OBJECTIVES

The current study intends to measure parents' perceptions of newborn and toddler physical activity.

METHODS

A Cross-sectional study was conducted at the pediatric clinic at a University Hospital in Riyadh. The parents or guardians of children 0 to 3 years of age, healthy infants, and toddlers who visited the vaccination and pediatric clinic at a University Hospital in Riyadh, were recruited. The Parental Perceptions of Physical Activity Scale (PPPAS) was translated into the Arabic language. The Chi-square test was applied to observe the association between categorical variables. P value < 0.05 was considered to be statistically significant.

RESULTS

A total of 383 parents were recruited. There was a significant association observed between physical activity and income, employment, and education. A significant association was observed between the following perceptions; the child enjoys physical activity, it increases the child's fitness level, the strength of the muscles, flexibility, and life span, improves happiness, keeps the child active, and provides a sense of achievement, and decrease future weight problems.

CONCLUSION FOR PRACTICE

The study determined that parental inclination towards engaging in a physical activity intervention for their infants, as well as identifying any concerns that may impact their children's adherence to physical activity was satisfied.

Family-based physical activity interventions and family functioning: A systematic review

Family physical activity (PA) can confer multiple health benefits, yet whether PA interventions affect general family functioning has not been appraised. The purpose of this review was to evaluate studies that have examined the effect of family PA interventions, where child PA was the focus of the intervention, on constructs of family functioning. Literature searches were concluded on January 11, 2022 using seven common databases. Eligible studies were in English, utilized a family PA intervention, and assessed a measure of family functioning as a study outcome. The initial search yielded 8413 hits, which was reduced to 20 independent PA interventions of mixed quality after screening for eligibility criteria. There was mixed evidence for whether family PA interventions affected overall family functioning; however, analyses of subdomains indicated that family cohesion is improved by PA interventions when children are in the early school years (aged 5-12). High-quality studies also showed an impact of family PA interventions on family organization. Targeted interventions at specific family subsystems (e.g., father-son, mother-daughter), characteristics (low-income, clinical populations, girls), and broad multibehavioral interventions may have the most reliable effects. Overall, the findings show that family PA interventions can promote family cohesion and organization, particularly among families with children in the early school years. Higher quality research, employing randomized trial designs and targeting specific intervention and sample characteristics (e.g., different clinical conditions, specific parent-child dyads), is recommended in order to better ascertain the effectiveness of these approaches.

Level, types and determinants of physical activity in children with type 1 diabetes and their parents: A cross-sectional study

AIM

The aim of the study was to describe the level, types and determinants of leisure time PA and exercise among children with type 1 diabetes and their parents.

METHODS

One hundred twenty children aged 6-18 years with type 1 diabetes and 113 parents (n = 113) participated to this questionnaire-based study at Northern Ostrobothnia District Hospital in Oulu, western Finland. All participants gave informed consent before entering this study.

RESULTS

Twenty-three per cent of the children exercised briskly for at least 7 h a week which corresponds to 60 min per day. The total PA occasions children had with a parent accounted for the children's total number of PA occasions in a week (β = 0.83, 95% CI 0.20-1.47) and total weekly hours of PA (β = 0.90, 95% CI 0.07-1.73). There was a positive association between total weekly hours of brisk PA and HbA1 c (β = 0.65, 95% CI 0.02-0.13), while there was no such association with light PA (β = 0.42, 95% CI -0.04-0.87). Laziness, fear of unexpected glycaemic variability and tiredness were the most frequent barriers to PA in children.

CONCLUSION

Most of the children with type 1 diabetes did not reach generally recommended 60 min of brisk PA a day. Exercising with a parent was positively associated with children's weekly frequency and total hours of PA.

Clustering of Multilevel Factors Among Children and Adolescents: Associations With Health-Related Physical Fitness

BACKGROUND

To identify the clustering characteristics of individual-, family-, and school-level factors, and examine their associations with health-related physical fitness.

METHODS

A total of 145,893 Chinese children and adolescents aged 9-18 years participated in this cross-sectional study. The 2-step cluster analysis was conducted to identify clusters among individual-, family-, and school-level factors. Physical fitness indicator was calculated through sex- and age-specific z scores of forced vital capacity, standing long jump, sit-and-reach flexibility, body muscle strength, endurance running, and body mass index.

RESULTS

Three, 3, and 5 clusters were automatically identified at individual, family, and school levels, respectively. Students with low physical fitness indicator were more likely to be in the "longest sedentary time and skipping breakfast" cluster (odds ratio [OR] = 1.18; 95% confidence interval [CI], 1.12-1.24), and "physical inactivity and insufficient protein consumption" cluster (OR = 1.07; 95% CI, 1.02-1.12) at individual level, the "single children and high parental education level" cluster (OR = 1.15; 95% CI, 1.10-1.21), and "no physical activity support and preference" cluster (OR = 1.30; 95% CI, 1.25-1.36) at family level, and the "physical education occupied" cluster (OR = 1.06; 95% CI, 1.01-1.11), and "insufficient physical education frequency" cluster (OR = 1.16; 95% CI, 1.08-1.24) at school level. Girls were more vulnerable to individual- and school-level clusters, while boys were more susceptible to family clusters; the younger students were more sensitive to school clusters, and the older students were more susceptible to family clusters (P-interaction < .05).

CONCLUSIONS

This study confirmed different clusters at multilevel factors and proved their associations with health-related physical fitness, thus providing new perspective for developing targeted interventions.

"I'm going to change the WIFI password if you don't go outside!": a qualitative examination of changes in parenting practices over the course of the COVID-19 pandemic

Introduction

Parenting practices are an important influence on the movement behaviours of children. Parenting practices are shaped by various contextual factors (e.g., culture, sociodemographic, community) and are susceptible to external pressures, such as health crises like the COVID-19 pandemic. Situated within the revised Family Ecological Model, the purpose of this study was to qualitatively explore changes in parenting practices over time in relation to the evolving nature of this global event.

Methods

One-on-one semi-structured interviews with 40 parents of children (aged 7-11) in three Canadian provinces were conducted in August, 2021. A narrative thematic analysis was conducted to develop themes mapping changes in parenting practices and organize the temporal patterns of these changes into shared case trajectories over time.

Results

Four themes were constructed to highlight changes in parenting practices: (1) Screen time permissiveness, (2) Force and coercion, (3) Agents of unstructured physical activity, and (4) Stepping back from structured physical activity. These themes were organized into three distinct case trajectories that each represent a shared, chronological narrative for how the first 18 months of the pandemic were broadly experienced by parents. The three trajectories were characterized by: (1) Resilience (2) Enduring impact and (3) Adaptive growth.

Discussion

Parenting practices were changed in response to circumstances in both temporary and enduring manners that may continue beyond the pandemic. Further research is needed to longitudinally assess these trajectories in order to support families and enhance understanding of parenting practices in challenging circumstances.

Psychometric properties of the Portuguese version of the physical activity parenting practices questionnaire

BACKGROUND

Adopting a healthy lifestyle, including regular physical activity, is often part of interventions targeting childhood overweight and obesity. However, to properly inform the objectives of the intervention, reliable psychometric measures are needed to better understand children's and their families necessities and characteristics.

OBJECTIVES

To evaluate the psychometric properties of the Physical Activity Parenting Practices questionnaire in a community sample of Portuguese parents of children aged 5-10, assess measurement invariance across children's weight status, and construct validity.

METHODS

Five hundred three parents completed the Portuguese version of the Physical Activity Parenting Practices (PAPP) questionnaire, a sociodemographic questionnaire, the Comprehensive Feeding Practices Questionnaire, and the Lifestyle Behavior Checklist. A subsample (n = 125) completed the PAPP questionnaire 1 month later. Data analyses were performed using R's lavaan (version 0.6-12) and psych (version 2.2.9) packages.

RESULTS

Confirmatory factor analyses revealed good psychometric properties for the PAPP's single-factor Encouragement scale and the three-factor Discouragement scale. Configural, metric, and scalar invariance were found across parents of children with different weight statuses for both scales' factor structures. Internal reliability ranged from α = .64 to α = .89, and test-retest reliability ranged from r = .57 to r = .74.

CONCLUSIONS

The constructs evaluated by PAPP questionnaire revealed adequate validity. The Portuguese version of the PAPP questionnaire is a reliable measure to assess relevant physical activity parenting practices, capable of differentiating the practices of parents with children of different weight statuses, and useful for both research and intervention purposes.

Parents' Thoughts Regarding Their Normal-Weight Children's Food and Physical Activity as Expressed During Health Conversations With the School Nurse: A Qualitative Analysis Informing Health-Promoting Practices

Parents are key to promoting children's healthy growth and development. However, school nurses need knowledge about how to best support parents' health-promoting activities. This study aimed to explore parents' thoughts regarding their normal-weight 6-year-old children's food and physical activity behaviors as expressed during health conversations with the school nurse. Qualitative content analysis of audio-recorded conversations (n = 30) showed that parents think of their children's behaviors in terms of: (a) children's personality in relation to food and physical activity; (b) recognizing children's food and physical activity behaviors; (c) parenting in relation to food and physical activity; (d) interaction with children in situations around food and physical activity; and (e) contextual circumstances to promote children's healthy food and physical activity behaviors. The study contributes with novel knowledge regarding clinical work in health promotion, with suggestions for how school nurses can engage parents in promoting and sustaining healthy food and physical activity behaviors.

Cultural and neighborhood characteristics associated with activity-specific parenting practices in Hispanic/Latino youth: a secondary analysis of the Hispanic Community Children's health study/study of Latino youth

Hispanic/Latino youth are less physically active than non-Hispanic/Latino youth. We assessed whether activity-specific parenting practices relate to moderate-to-vigorous physical activity (MVPA) and sedentary behavior among Hispanic/Latino youth, and whether cultural (acculturation) and neighborhood characteristics (perceived barriers to activity) relate to the use of parenting practice patterns. Using the Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth, n = 976 8-16-year-olds), we modeled linear regression associations between parenting practices and mean daily MVPA and sedentary behavior. Parenting practice patterns were then developed using k-means cluster analysis, and regressed on parental acculturation and neighborhood characteristics. Discipline predicted higher MVPA in females (β 1.89 [95% CI 0.11-3.67]), while Monitoring/Reinforcement predicted higher MVPA in males (β 4.71 [95% CI 0.68-8.74]). Three patterns were then identified: Negative Reinforcement (high Limit Setting and Discipline use), Positive Reinforcement (high Limit Setting and Monitoring/Reinforcement use), and Permissive Parenting (low parenting practice use). Higher acculturation predicted use of Positive Reinforcement. Activity-specific parenting practices are associated with activity in sex-specific ways among Hispanic/Latino youth, and cultural factors predict the use of parenting practices.

Experiences, Perspectives, and Barriers to Physical Activity Parenting Practices for Chinese Early Adolescents

BACKGROUND

Parents play an important role in shaping youth's lifestyle behaviors. This study aimed to investigate physical activity parenting practices (PAPP) for Chinese early adolescents and compare reporting discrepancies between parents and adolescent boys and girls.

METHODS

Fifty-five adolescent-parent dyads participated in 16 paired focus group interviews, and an additional 122 dyads completed questionnaire surveys with open-ended questions. Participants were recruited from 3 public middle schools in Suzhou, China. Qualitative data were analyzed inductively using an open-coding scheme. Frequencies of codes were compared by parent-child role and adolescent gender using chi-square tests.

RESULTS

Eighteen types of PAPP were identified and grouped into 6 categories: goals/control, structure, parental physical activity participation, communication, support, and discipline. These PAPP were viewed as promotive, preventive, or ineffective. Participants had mixed opinions on the effects of 11 PAPP and identified parental, adolescent, and environmental barriers for parents to promote youth physical activity. Compared with parents, adolescents were more likely to value the effects of setting expectation, scheduling, and coparticipation as well as dislike pressuring, restriction, and punishment. Girls were more likely to favor coparticipation and were more sensitive about negative communication than boys. Parents paid more attention to environmental barriers, whereas adolescents, especially girls, focused more on personal issues.

CONCLUSIONS

Future studies need to address both positive and negative PAPP as well as perception discrepancies by child-parent role and adolescent gender to generate more evidence to promote parents as favorable socialization agents of youth physical activity.

Examining the Association Between Parental Factors and Childhood Obesity

PURPOSE

To examine associations between parent's diet and BMI (body mass index) and child's sedentary behavior and physical activity (PA) with child's BMI.

DESIGN

A descriptive design.

METHODS

Study participants were a parent-child dyad in a subsample of families enrolled in Chicago Heights Early Childhood Center.

FINDINGS

Approximately 80% of parents had a BMI classifying as overweight or obese. Associations between children's sedentary behavior, PA, and BMI were insignificant.

CONCLUSIONS

Findings highlight the importance of including parents when developing strategies for promoting healthy behavior of children.

CLINICAL EVIDENCE

Community health nurses are well-positioned to promote healthy behaviors.

Clusters of Activity-Related Social and Physical Home Environmental Factors and Their Association With Children's Home-Based Physical Activity and Sitting

PURPOSE

Understanding which physical activity (PA) and sedentary behavior correlates cluster in children is important, particularly in the home, where children spend significant time. Therefore, this study aimed to assess clustering of physical and social activity-related factors at home, and whether these clusters are related to home-based sitting and PA in children. A secondary aim was to explore whether the clusters were associated with child, parent, and family characteristics.

METHODS

Altogether, 235 children (55% girls, mean age = 10.2 [0.7] y) and their parents took part. Physical (eg, PA and electronic media equipment, house and garden size, layout) and social (eg, activity preferences, priorities, parental rules) home environmental factors were obtained via the HomeSPACE-II audit and self-report, respectively. Principal component analysis was used to identify clusters of physical and social environmental factors. Backward regression analysis and partial correlations were used to examine relationships between clusters, children's device-measured home-based activity behaviors, and background characteristics.

RESULTS

The findings show that physical and social environment activity-related factors at home cluster. The clusters were associated with several background characteristics, with socioeconomic factors appearing to be particularly influential. The clusters were also associated with home-based activity behaviors in the hypothesized directions.

CONCLUSION

Interventions which target clusters of social and physical factors at home, especially among low-socioeconomic status families, are warranted.

Patterns of Movement Performance among Japanese Children and Effects of Parenting Practices: Latent class analysis

Objectives

This study aimed to examine the long-term effects of parenting practice during preschool years on children's movement performance in primary school.

Methods

This three-year longitudinal study included 225 children aged 3-6-years-old. Parents reported baseline parenting practice and evaluated children's movement performance three years later. Latent class analysis was used to explore latent classes of movement performance. A post hoc test was used to identify the characteristics of different patterns. Finally, adjusted multinomial logistic regression models were used to test the influence of parenting practice on identified patterns of movement performance.

Results

Children in this study were grouped into three movement performance patterns, labelled as 'least difficulties' (n = 131, 58.2%), 'low back pain' (n = 68, 30.2%) and 'most difficulties' (n = 26, 11.6%). After controlling for age, gender, having siblings or not, family structure, standardised body mass index, sleep condition and dietary habits, the researchers found that if parents played games with children frequently, the children would have a 0.287 times lower probability of being in the 'low back pain' class (95% confidence interval [CI]: 0.105-0.783). In addition, if parents take children to meet peers of a similar age frequently, children would have a 0.339 times lower probability of being in 'most difficulties' class (95% CI: 0.139-0.825).

Conclusion

Primary healthcare providers should pay careful attention to children with movement difficulties. The study provides longitudinal evidence to support the applicability of positive parenting practice in early childhood to prevent children's movement difficulties.

Process and effect evaluation of the app-based parenting program Samen Happie! on infant zBMI: A randomized controlled trial

Background

Although energy balance-related parenting practices are regarded critical components in the prevention of childhood obesity, most programs targeting parenting practices with respect to a wide range of energy balance-related behaviors were not aimed at high-risk families with a lower socioeconomic position (SEP).

Objective

The Samen Happie! app-based program aimed to stimulate healthy child weight development especially among families with a lower SEP, by encouraging healthy energy balance-related parenting practices.

Methods

A two-armed randomized controlled trial examined the process and effectiveness of the Samen Happie! program on child zBMI outcomes at 6- and 12-months follow-up. In total, 357 Dutch parents with infants aged 5-15 months old at baseline participated. Parents in the app condition (n = 179) received access to the Samen Happie! app and were compared to a waitlist-control condition (n = 178). Changes in zBMI were examined through linear mixed-effects models based on intention-to-treat and exploratory per-protocol principles.

Results

Process data showed low levels of sustained app use and moderate app acceptability. A general increase in child zBMI was observed in both conditions after 6 and 12 months. Intention-to-treat analyses using multiple imputations showed several statistically significant differences between conditions and high-risk subgroups. Specifically, at 6-months follow-up, zBMI increase was least pronounced in the app condition among children of parents with lower educational level. These findings were supported by exploratory per-protocol analyses including only frequent app users. In addition, per-protocol analyses showed benefits of app use at 6-months follow-up for children of parents with higher BMI. However, these effects were reversed at 12-months follow-up in both intention-to-treat and per-protocol analyses, where children of parents in the app condition in general increased the most in zBMI.

Conclusions

This study suggests that the Samen Happie! program might prevent zBMI increases after 6 months among children of parents with lower educational level, and children of parents with higher BMI who more frequently use the app. However, the app did not prevent increases in zBMI after 12 months. Future research should investigate strategies to increase sustained app use and engagement in mHealth parenting programs for childhood obesity as well as options to combine app-based programs with additional support strategies aimed at high-risk families.

Trial registration

Netherlands trial register (ID: NTR6938), https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6938.

Padres Preparados, Jóvenes Saludables: A Randomized Controlled Trial to Test Effects of a Community-Based Intervention on Latino Father's Parenting Practices

Parenting practices have been associated with adolescent lifestyle behaviors and weight status. Evidence is limited regarding the efficacy of interventions to address father influences on adolescent lifestyle behaviors through availability and modeling practices. Therefore, the purpose of this study was to evaluate changes in father parenting practices after Latino families with adolescents participated in the Padres Preparados Jóvenes Saludables (Padres) program. Time-1 (baseline) and Time-2 (post-intervention) data were used from Latino father/adolescent (10-14 years) dyads enrolled in the Padres two-arm (intervention vs. delayed-treatment control group) randomized controlled trial in four community locations. The program had eight weekly, 2.5-h experiential learning sessions on food preparation, parenting practices, nutrition, and physical activity. Two types of parenting practices (role modeling and home food availability) were assessed by father report via questionnaire for each of 7 lifestyle behaviors, for a total of 14 parenting practices. Linear regression mixed models were used to evaluate the intervention effects. A total of 94 father/adolescent dyads completed both Time-1 and Time-2 evaluations. Significant positive intervention effects were found for frequencies of fruit modeling (p = 0.002) and screen time modeling (p = 0.039). Non-significant results were found for the other 12 father parenting practices.

Homes became the "everything space" during COVID-19: impact of changes to the home environment on children's physical activity and sitting

BACKGROUND

During the 2020 UK COVID-19 lockdown restrictions, children spent almost all of their time at home, which had a significant influence on their physical activity (PA) and sedentary behaviour. This study aimed to: 1) determine changes to the social and physical environment at home and children's home-based sitting, PA, standing and sitting breaks as a result of the COVID-19 restrictions; and 2) examine associations between changes at home and children's movement behaviours.

METHODS

One hundred and two children had their PA and sitting, standing and sitting breaks at home objectively measured pre-COVID-19 and during the first COVID-19 lockdown (June-July 2020). Children's parents (n = 101) completed an audit of their home physical environment and a survey on the home social environment at both time points. Changes in the home physical and social environment and behavioural outcomes were assessed using Wilcoxon signed ranked tests, paired t-tests, or chi-square. Repeated linear regression analyses examined associations between changes in homes and changes in the home-based behavioural outcomes.

RESULTS

During COVID-19, households increased the amount of seated furniture and electronic media equipment at home. The number of books and PA equipment decreased and fewer parents enforced a screen-time rule. Children's preference for physical activities and socialising at home decreased. Time at home and sitting at home increased during COVID-19, whilst PA, standing and sitting breaks decreased. Both MVPA and TPA were positively associated with child preference for PA, and negatively associated with attending school. Sitting was negatively associated with child preference for PA and child preference for socialising at home. Media equipment was negatively associated with sitting breaks, whilst PA equipment was positively associated with standing.

CONCLUSION

The COVID-19 restrictions forced children to spend almost all their time at home. Children's PA, standing, and sitting breaks at home declined during the restrictions, while sitting increased. Mostly negative changes occurred in homes, some of which impacted children's behaviours at home. To avoid the changes persisting post-lockdown, interventions are needed to reset and promote children's PA and discourage prolonged sitting time.

Physical Activity and Sedentary Behaviors in Primary School Children in Saudi Arabia during the COVID-19 Pandemic: Association with Parents' Behaviors

During the COVID-19 pandemic, a few studies used accelerometers to assess physical activity (PA) and sedentary behavior in the family context. This study aimed to assess children and parents' moderate and vigorous physical activity (MVPA) and sedentary time, as well as their relationship in MVPA and sedentary time. Data were collected from 30 parent-child dyads during the COVID-pandemic for seven days, using a hip-worn accelerometer. Children and parents engaged in 65.6 and 34.6 min/day in MVPA and 442.2 and 427.9 min/day sedentary, respectively. There was no evidence of gender difference in MVPA and sedentary between boys and girls. Male parent spent more time in MVPA than female parents. A total of 50% of children and 53.3% of parents met the recommended PA. Children's MVPA and sedentary time were both correlated with that of their parents. Adjusted linear regression showed that only child MVPA was negatively associated with their parents' MVPA. There is evidence that multi-level interventions involving parents and children are more effective than interventions focusing on a single group. This study also provides evidence to support the link between MVPA and sedentary time between parents and children. Generalization of the findings is difficult due to the bias of self-selection sample.

Acceptability of a parent-focused program for physical literacy development among parents and children during the COVID-19 pandemic: A qualitative study

Background

A 3-month parent education program was designed and implemented in Hong Kong to improve physical literacy (PL) among primary school children and their parents during the COVID-19 pandemic. This study aims to probe into the acceptability of the intervention from parental perspectives, providing more insights for future implementation.

Methods

Following the 3-month parent-focused PL program, 16 parents (mean age = 43.73 years, 15 mothers) were recruited to participate in semi-structured individual interviews in June 2021. Interviews were analyzed using thematic analysis in NVivo 12. Two coders analyzed interview transcripts deductively based on the interview guide and social cognitive theory (SCT).

Results

Three themes were identified that captured the acceptability of the program: (1) Addressing needs through appropriate delivery enhances acceptability of intervention; (2) Positive behavioral and psychological changes to families; (3) Appropriate support of environmental factors can enhance the sustainability of program effects. The high levels of acceptability were attributable to the fact that parents were able to learn and be a gatekeeper to impact their children positively. Moreover, the design and contents of the program were appropriate for the participating parents because the program provided adequate learning resources and interactive learning support without being overly rigid, and the online learning mode was feasible and convenient. Consequent to their participation in the program, parents expressed that they became more aware of the importance of PL, established physical activity routines with their children, and modified their parenting styles which resulted in improved parent-child relationships.

Conclusions

The current study provided evidence that engaging parents in the intervention was feasible and acceptable approach in supporting both parents and children to establish physically active routines in the family setting. The insights gained regarding the appropriateness and acceptability of the program in this specific context may be used to inform the design, implementation and sustainability of other parent-focused PL programs.

Parent-focused online intervention to promote parents' physical literacy and support children's physical activity: results from a quasi-experimental trial

Background

The development of physical literacy (PL) early in life may influence children's subsequent physical activity (PA) participation and consequent health benefits across the life course. Interventions designed for parents are lacking, but such efforts can potentially enhance the PL of parents and their children’s PA participation. Additionally, there is insufficient evidence to support the feasibility of delivering a PL intervention using an online format. Therefore, the purpose of this study was to examine the feasibility and effectiveness of a parent-focused, theory-driven, online-delivered intervention designed to improve the parents’ PL and children’s PA behaviors.

Methods

A non-randomized trial was conducted to evaluate the effects of the program. 224 Hong Kong families (primary school-aged children and their parents) registered to the program were considered the experimental group and were exposed to an online intervention over three months. Another 220 families in Hong Kong were considered the comparison group and did not receive any intervention. Outcome measures included PA behaviors (daily steps and moderate-to-vigorous PA), parent–child co-activity behaviors, family PA routines, and parent perceived PL. Linear mixed models were used to analyze the differences in terms of changes in measured outcomes between groups over time.

Results

No significant group-by-time effects were found for children’s or parents’ PA behaviors. In terms of the family Co-PA routines, a small positive effect size in favor of the experimental group was found (p = .44, d = 0.2). Group-by-time effects favorable to the experimental group was detected for parent–child co-activity (p < .001, d = 0.7) and parental PL (p < .001, d = 0.9) at post-intervention. The results demonstrated that the intervention was acceptable and that there was potential for scale up.

Conclusions

Findings indicated that the intervention was effective in increasing parent–child co-activity and parent perceived PL. During the pandemic, online intervention delivery was found to be feasible. Using this mode of delivery, the intervention has the potential to reach a wide population in the local context.

Trial registration

The study was prospectively registered at the Chinese Clinical Trial Registry, Registration number: ChiCTR2100041903, Registered 09 January 2021.

Considerations for a Social Media Physical Activity Program: Exploratory Study

BACKGROUND

Social media may be a powerful platform to combat parents' and children's low physical activity levels.

OBJECTIVE

This study surveyed parents' beliefs about physical activity in order to expand the extant literature concerning the interest in and the design of an effective and feasible social media physical activity (SMPA) program.

METHODS

Primary caregivers (n=250; 215 [86%] mothers, 164 [65.6%] White) of children aged 6-12 years completed an online questionnaire. Interest was examined through responses on the questionnaire; beliefs (ie, perceptions, knowledge, and support) about physical activity were examined using Spearman correlations; and to support the SMPA program design, researchers examined a combination of multiple-choice and free-response questions. For the free-response questions, the researchers performed open coding related to perceived benefits, barriers, and motivators.

RESULTS

Parent respondents (n=215, 86%) were interested in a SMPA program tailored for families. Regarding beliefs, parents exhibited a monotonic relationship between 2 questions related to perceptions of physical activity levels in their children (r_s(250)=.310, P<.001), knowledge about physical activity and motor skills (r_s(250)=.328, P<.001), and support of physical activity and motor skills (r_s(250)=.385, P<.001). Parents perceived benefits of a SMPA program, highlighting family time and health. Barriers included time constraints, a lack of motivation, and environmental factors.

CONCLUSIONS

Parents are interested in supporting healthy family behaviors using a SMPA program. An effective program should emphasize motor skill activities, be fun and family oriented, and incorporate incentives, goal setting, and advice and tips. SMPA also needs to address identified barriers, such as those regarding time and environment.

Relationships between Physical Activity Parenting Practices and Children’s Activity Measured by Accelerometry with Children’s Activity Style as a Moderator—A Cross Sectional Study

The objective was to examine the associations between physical activity parenting practices (PAPP) and children’s levels of moderate-to-vigorous physical activity (MVPA), and time spent sedentary (SED) during non-school time in weekdays and weekends when children’s activity style was taken into account. Study participants were 88 children (mean age 6.3 (SD 0.3) years); 51.0% girls) and their parents who took part in A Healthy School Start Plus in Sweden. The independent variables included PAPPs Structure, Neglect/control, and Autonomy promotion and children’s activity style as moderator, assessed through validated parent questionnaires. Dependent variables were the MVPA and SED in minutes, measured by accelerometry. Structural equation modeling was used to examine the associations between PAPPs and children’s MVPA and SED with children’s activity style as a moderator. No significant associations between the PAPPs Structure, Neglect/control, and Autonomy promotion and measures of physical activity were found (p > 0.13). The moderating role of activity style improved the model fit and the final model had a reasonable fit to the data. Our results suggest that in future studies, with the aim to explore the relationship between PAPP and children’s physical activity, the activity style of the children should be included as a moderator.

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.

The Influence of Family Sports Attitude on Children's Sports Participation, Screen Time, and Body Mass Index

Background: Children’s physical health is an important resource for a country’s future construction. However, researchers found that the physical fitness of young children around the world has declined during the two decades, from 1992 to 2012. The decline in the physique of young children has caused widespread concern around the world. Children’s main living places are families and kindergartens, so this research explores the impact of family factors on children’s body mass index (BMI) from the perspective of family attitudes, children’s sports participation, and screen time.

Methods: A cross-sectional study was used to conduct a questionnaire survey of children in China. A total of 600 children were investigated, and 589 valid questionnaires were obtained. SPSS21.0 statistical analysis software was used for descriptive analysis, mean comparison, and correlation analysis of the data. AMOS 21.0 was used to construct a structural equation model and carry out path analysis.

Results: (1) There are significant differences in children’s family sports attitude, sports participation, screen time, and BMI with different family structures, and parents’ education levels. (2) Family sports attitude is significantly positively correlated with parents’ education levels and children’s sports participation, and negatively correlated with children’s screen time and BMI. (3) Children’s sports participation and screen time play a chain-mediating role between family sports attitude and children’s BMI, and the role is a complete mediating role. Therefore, family sports attitudes can affect children’s physical health by affecting children’s sports participation and screen time. To promote children’s physical health, we should pay attention to the intervention of family sports attitude. (4) The mediating effects of exercise participation and screen time are similar in different family structures, so the structure of this study can be applied to different family structures.

Conclusions: Children’s family sports attitude, sports participation, and screen time can affect children’s BMI. Children’s screen time and sports participation play a chain-mediating role in the influence of family sports attitudes on the path of children’s BMI. The results of this study will provide a useful reference for teachers and parents to control children’s physical health.

Associations Between Physical Activity and Gross Motor Skills in Parent–Child Dyads

This study examines the associations of physical activity and gross motor skills in parent–child dyads. Parent–child dyads (N = 61, 84% mothers, children aged 8–11 years) participated in this study. Anthropometrics were self-reported through Qualtrics. Physical activity was assessed using accelerometers. Motor skills were measured through four skills: catch, kick, throw, and jump. These skills were assessed using process (i.e., performance criteria of the Test of Gross Motor Development-3) and product (i.e., catch percentage and jump distance) measures. A complete motor skill score was computed by standardizing both process and product scores and summing them. Correlation coefficients and ordinary least square regressions were computed to examine the associations of physical activity and motor skills. Parents’ and children’s moderate to vigorous physical activity were significantly associated (β = 0.30 ± 0.11; p = .008). Parents’ and children’s motor skills were significantly associated (β = 0.46 ± 0.18; p = .012). Understanding parent determinants can support effective interventions targeting children’s low physical activity levels and improving motor competence. Our results highlight the importance of parents’ physical activity and motor skills, which are significantly associated with those of their children. These parent factors may be a key consideration for effective family-based physical activity interventions.

Examining current physical activity interventions in Black school-age children and parents: A systematic review

Obesity is prevalent in Black children and adults; increasing physical activity (PA) can aid in reducing childhood obesity in both age groups. The purpose of this systematic review is to examine current research on PA interventions in school-age Black children. Adhering to PRISMA guidelines, a systematic search was conducted in six databases for PA interventions in Black children. A total of 13 articles met inclusion criteria (n = 7 randomized controlled trial, n = 5 quasi-experimental, n = 1 cross-sectional). The majority of the articles were on a combination of diet and PA programs (n = 9). Four articles targeted PA and parental role modeling of PA as the outcome showing positive intervention effects. Nine additional studies included PA as an outcome variable along with at least one additional obesity-related predictor. PA interventions for Black school-age children typically use a parent-child dyadic approach (n = 13), are guided by theory (n = 11) and are high quality. However, continued investigation is warranted to draw definitive conclusions and determine how to best involve parents within the PA interventions. Theory-driven higher quality trials that clearly describe the structured PA component and outcomes among Black parent-child dyads are needed.

Needs assessment for physical activity information during COVID-19 among a nationally representative sample of parents and children ages 6-17 in the United States: a cross-sectional study

Background

The COVID-19 pandemic presented novel barriers to youth physical activity engagement. Identifying what resources parents and children are interested in receiving can support efforts to mitigate the negative impact of the pandemic on youth physical activity behavior. This study aimed to identify physical activity-related information needs during the COVID-19 pandemic among a nationally representative sample of American parents of children 6–10 years-old and parent-child dyads of children 11–17 years-old.

Methods

A cross-sectional survey was conducted by a market research company in October–November 2020. Parents and children were asked about their interest in specific types of information about helping their family and themselves, respectively, be active (Yes/No). Weighted percentages were calculated for reported information needs and compared using two-sample test of proportions.

Results

Final analytic sample was 1000 parents (55.4% female; 74.7% White; 74.0% non-Hispanic); 500 children 11–17 years-old (52.1% male; 77.6% White). Over 40% of participants were interested in information about being active during COVID-19. Parents were more likely to be interested in information if they always (versus never) worked from home [53.3% (95% CI: 43.3–63.0%) versus 22.0% (95% CI: 14.9–31.3%), p < 0.001]; had children attending school remotely versus in-person [47.3% (95% CI:40.2–54.5%) versus 27.5% (95% CI: 19.6–37.1%), p < 0.001]; and lived in a big city versus a rural area [66.5% (95% CI:54.5–76.7%) versus 34.1% (95% CI: 22.8–47.6%), p < 0.001]. Children most interested were those who did not have resources for online activity engagement and those worried about their safety or getting infected with COVID-19. Children were also more likely to be interested if their parents worked full-time versus not working [48.6% (95% CI:41.7–55.6%) versus 31.5% (95% CI: 24.1–39.9%), p < 0.001], and lived in a big city versus a rural area [57.2% (95% CI:45.3–68.3%) versus 27.8% (95% CI:17.8–40.7%), p < 0.001].

Conclusions

Families are interested in physical activity resources, particularly those whose daily routines and opportunities for physical activity may have been most significantly impacted by the pandemic. This includes parents who always worked from home or whose children attended school remotely. Identifying felt needs is an important step in developing tailored interventions that aim to effectively and sustainably support families in promoting physical activity.

Parental influence on urban adolescents' physical activity experience

As important socializing agents of adolescents, parents may substantially influence adolescents' physical activity but their roles in adolescents' physical activity experience have not been sufficiently studied. Furthermore, there is a dearth of research on potential mechanisms through which parents may promote adolescents' positive physical activity experience. Using a longitudinal sample of 464 urban and primarily Hispanic and African American adolescents, this study examined the impact of parental support on adolescents' physical activity experience. Results of structural equation modeling showed that after controlling for adolescents' gender, body mass index, and perceived overall health, parental support positively affected adolescents' restructuring ability (i.e., ability to construct meaningful and satisfying activities during unpleasant experiences) and intrinsic motivation (i.e., activity participation driven by inherent interest and enjoyment) in physical activity, which in turn positively affected adolescents' physical activity experience. No significant gender differences were found in these relationships. Theoretical and practical implications are discussed.

Moving Together: Understanding Parent Perceptions Related to Physical Activity and Motor Skill Development in Preschool Children

Background: Establishing physical activity (PA) and motor behaviors in early childhood are important for developing healthy activity behaviors. Parents play a central role in shaping young children’s PA and fundamental motor skills (FMS). This qualitative study explored parents’ attributes, values, perceptions, and practices related to PA and FMS. Methods: Thirty-one parents (26 mothers) of preschool-aged children participated in semi-structured in-person interviews. Interviews were audio-recorded, transcribed verbatim, coded and analyzed using an iterative approach. Results: Four themes related to PA and FMS emerged: (1) parent attributes; (2) parent–child interactions; (3) parent perception of children’s attributes; and (4) parenting practices. Although most parents enjoyed playing with their child, some did not realize the importance of engaging in PA with their child and even believed that FMS are naturally developed. Parents indicated that children’s temperament may influence their preference for practicing motor skills. Conclusions: Social support and positive parenting practices, including encouragement, monitoring, logistical support, co-participation, and facilitation, are important for the development of PA and FMS. The findings add emphasis to the importance of parents’ role in the development of young children’s PA and FMS, and they inform future strategies aiming to promote young children’s activity behaviors.

Variations in perceptions of parenting role related to children's physical activity and sedentary behaviours - a qualitative study in a Northern European context

Background

The aim of the study was to increase understanding of the variation in parental perceptions of their roles and responsibilities in relation to children’s physical activity and sedentary behaviours.

Methods

This qualitative study was based on data from the Healthy School Start intervention study II, in the form of recorded motivational interviewing (MI) sessions with mothers and fathers participating in the intervention. Forty-one MI sessions where parents discussed physical activity and/or sedentary behaviour were selected for analysis. Data analysis was performed using a phenomenographic approach.

Results

Three categories describing a structural relationship of parents’ different views on their own role in relation to their child’s habits were identified: 1) The parent decides – Child physical activity according to my beliefs and views as a parent and where I, as a parent, decide, 2) Parent-child interaction – child physical activity is formed in interaction between me as a parent and my child or 3) The child/someone else decides – The child or someone other than me as a parent decides or has the responsibility for my child’s physical activity. All three categories included four subcategories of specific activities: organised activity, activity in everyday life, being active together and screen time, describing practical approaches used in each of the three categories.

Conclusions

This study found variation in mothers’ and fathers’ perceptions of their roles and responsibilities for their child’s physical activity and sedentary behaviours related to specific types of activities. The results indicate areas where parents need support in how to guide their children and how parental responsibility can have a positive influence on children’s physical activity and sedentary habits.

Scoping Review on Interventions for Physical Activity and Physical Literacy Components in Brazilian School-Aged Children and Adolescents

This scoping review mapped the existing evidence on interventions to promote physical activity (PA) and/or components of physical literacy (PL) in Brazilian school-aged children and adolescents. Nine electronic databases and gray literature were consulted in May 2020, with no limit on year or language. School-based intervention studies (6 to 18 years old, primarily) that assessed PA or PL components (PA-related factors or attributes) were eligible. The studies were stratified by children (<12 years of age) and adolescents (≥12 years of age). A total of 63 documents were included, which refer to 42 different intervention studies. Twenty-five interventions focused on adolescents and 17 on children. The most-used strategies in the interventions were changes in physical and environmental education classes, extracurricular PA sessions, and health education. No study has analyzed all components of PL or evaluated PL using specific protocols or instruments. PA attributes were the most studied components (30 studies). This review identified the need to conduct interventions with strategies that target all components of PL, representing important elements for a research agenda that underlies school interventions that contribute to an active lifestyle.

Patterns of physical activity parenting practices among parent-adolescent dyads who participated in a cross-sectional internet-based study

Background

While research exploring relationships between individual parenting practices and child physical activity (PA) exists, little is known about simultaneous use of practices. Hence, study objectives were to determine patterns of PA parenting practices and their associations with demographic, anthropometric, and PA measures in a large sample of parents and their adolescent children (12–17 years).

Methods

Dyadic survey data from Family Life, Activity, Sun, Health, and Eating (FLASHE), a cross-sectional, internet-based study, conducted in 2014 were analyzed using latent class analysis on 5 PA parenting practices – pressuring, guided choice, expectations, facilitation, and modeling. Self-report model covariates included adolescent age and parent and adolescent sex, body mass index category (based on height and weight), legitimacy of parental authority regarding PA (PA-LPA), and moderate-to-vigorous PA (MVPA).

Results

Based on 1166 parent-adolescent dyads, four latent classes were identified representing a continuum of practice use (high to low) – Complete Influencers (26%), Facilitating-Modeling Influencers (23%), Pressuring-Expecting Influencers (25%), and Indifferent Influencers (27%). Compared to dyads with parent underweight/healthy weight, dyads with parent overweight/obesity had 84% higher odds of belonging to Indifferent Influencers. Compared to dyads with adolescent underweight/healthy weight, dyads with adolescent overweight/obesity had 50 and 46% lower odds of belonging to Facilitating-Modeling and Indifferent Influencers. Odds of belonging to Pressuring-Expecting and Indifferent Influencers were less than 1% lower for every 1 min/day increase in parent MVPA and 2 and 4% lower for every 1 min/day increase in adolescent MVPA. Compared to dyads with high parental and adolescent agreement with PA-LPA, dyads with low agreement had between 3 and 21 times the odds of belonging to Facilitating-Modeling, Pressuring-Expecting, or Indifferent Influencers.

Conclusions

Findings suggest that parents utilize distinct patterns of PA practices ranging from use of many, use of some, to low use of any practice and these patterns are differentially associated with parent and adolescent PA. When planning PA interventions, a counseling or intervening approach with parents to use combinations of practices, like facilitation and modeling, to positively influence their adolescents’ and possibly their own participation in PA may prove more efficacious than parental pressuring or lack of practice use.

Parental Factors Related to Physical Activity among Adolescent Men Living in Built and Natural Environment: A Population-Based MOPO Study

Introduction

Physical inactivity is a global concern, especially among adolescent men. Little research has been done on the association between parental factors and young adults' physical activity in the context of residential environment. We aimed to reveal what parental factors are associated with physical activity among adolescent men living in built and natural environments.

Methods

A population-based sample of 1,904 men (mean age = 17.9, SD = 0.7 years) completed a questionnaire regarding physical activity, parental factors, and lifestyle in Northern Finland in 2012 and 2013. Geographical information system methods and dominant land-use type were used to define the residential environment in a 1-kilometer radius buffer zone surrounding each participant's home address. If the residential area included more artificial surfaces, it was defined as a built environment, and areas including more nature were defined as natural environments.

Results

According to multivariable analyses, a mother's physical activity (OR = 1.9; 95% CI: 1.3-2.8) was positively associated with the physical activity of adolescent men living in built environments, and the father's physical activity was positively associated with the physical activity of adolescent men living in natural environments (2.8; 1.7-4.8). Self-rated health (built 5.9 [4.0-8.7]; natural 5.2 [3.0-9.0]) was positively associated with physical activity level. Those with symptoms of depression were more likely to be physically inactive (built 0.5 [0.3-0.8]; natural 0.3 [0.1-0.6]). Adolescent men were equally physically active regardless of the living environment.

Conclusions

The level of physical activity of parents, self-rated health, and depressive symptoms should be considered when designing physical activity promotions for adolescent men according to their residential environments.

An App-Based Parenting Program to Promote Healthy Energy Balance-Related Parenting Practices to Prevent Childhood Obesity: Protocol Using the Intervention Mapping Framework

BACKGROUND

The family environment plays an important role in the development of children's energy balance-related behaviors. As a result, parents' energy balance-related parenting practices are important targets of preventive childhood obesity programs. Families with a lower socioeconomic position (SEP) may benefit from participating in such programs but are generally less well reached than families with a higher SEP.

OBJECTIVE

This paper describes the application of the Intervention Mapping Protocol (IMP) for the development of an app-based preventive intervention program to promote healthy energy balance-related parenting practices among parents of children (aged 0-4 years) with a lower SEP.

METHODS

The 6 steps of the IMP were used as a theory- and evidence-based framework to guide the development of an app-based preventive intervention program.

RESULTS

In step 1, behavioral outcomes for the app-based program (ie, children have a healthy dietary intake, sufficient sleep, and restricted screen time and sufficient physical activity) and sociocognitive (ie, knowledge, attitudes, and self-efficacy) and automatic (ie, habitual behaviors) determinants of energy balance-related parenting were identified through a needs assessment. In step 2, the behavioral outcomes were translated into performance objectives. To influence these objectives, in step 3, theory-based intervention methods were selected for each of the determinants. In step 4, the knowledge derived from the previous steps allowed for the development of the app-based program Samen Happie! through a process of continuous cocreation with parents and health professionals. In step 5, community health services were identified as potential adopters for the app. Finally, in step 6, 2 randomized controlled trials were designed to evaluate the process and effects of the app among Dutch parents of infants (trial 1) and preschoolers (trial 2). These trials were completed in November 2019 (trial 1) and February 2020 (trial 2).

CONCLUSIONS

The IMP allowed for the effective development of the app-based parenting program Samen Happie! to promote healthy energy balance-related parenting practices among parents of infants and preschoolers. Through the integration of theory, empirical evidence, and data from the target population, as well as the process of continued cocreation, the program specifically addresses parents with a lower SEP. This increases the potential of the program to prevent the development of obesity in early childhood among families with a lower SEP.

TRIAL REGISTRATION

Netherlands Trial Register NL6727, https://www.trialregister.nl/trial/6727; Netherlands Trial Register NL7371, https://www.trialregister.nl/trial/7371.

Physical Activity and Enjoyment in Parent-Child Dyads During Shared Physical Activity

Purpose: The purpose of this study was to compare objectively-measured physical activity (PA) and enjoyment of five shared PAs in parent-child dyads. Method: Thirty-one parent-child dyads (mean±SD; age, parents: 38.0 ± 6.6 years, children: 5.9 ± 1.7 years) completed separate PA sessions, which included five standardized PAs (brisk walking, jumping games, dancing, body-weight exercises, and tag games) in random order for each dyad. Parent and child moderate-to-vigorous PA (MVPA) and accelerometer counts per minute (CPM) were measured using Actigraph GT9X activity monitors. The Visual Analog Scale was used to assess enjoyment of children and parents. Repeated measures ANOVAs and paired t-tests determined differences in PA within and between children and parents for the activities, respectively. Friedman Tests with post hoc Wilcoxon signed-rank tests determined significant differences in enjoyment across the activities for children and parents and Wilcoxon signed-rank tests compared enjoyment between children and parents for each PA. Results: Jumping games resulted in the highest proportion of time spent in MVPA and highest overall CPM for children and parents (p < .05). Compared to parents, children spent proportionally more time in MVPA during jumping games, body-weight exercises, and tag games (all, p < .05). Tag games were the most enjoyable PA for children and parents (p < .05). Children enjoyed body-weight exercises more than parents (p < .05). Conclusions: Future indoor PA programs and research interventions that include parent-child dyads should consider implementing jumping games, body-weight exercises, and tag games during shared PA, which resulted in higher MVPA and enjoyment by both children and parents when compared to walking and dancing.

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.

Do parenting practices moderate the association between the physical neighbourhood environment and changes in children's time spent at various physical activity levels? An exploratory longitudinal study

BACKGROUND

As many children do not meet the recommended daily physical activity (PA) levels, more research is needed towards environmental determinants of children's PA levels. The aims of this longitudinal study were to investigate whether the physical environment and parenting practices have an impact on changes in children's weekday time spent at various PA levels and whether associations between physical neighbourhood environment and changes in children's PA are moderated by parenting practices.

METHODS

We performed a secondary data analysis of longitudinal data collected at three timepoints (baseline, 6, and 18 months) from 10 control schools of the Active Living study, a quasi-experimental study, which took place in South Limburg, the Netherlands. In total, 240 children aged 8-12 years were included in the analyses. PA levels were measured using accelerometry (ActiGraph GT3X+). The physical environment was assessed at baseline through neighbourhood audits of the school environment, and PA parenting practices were measured at baseline via validated parental questionnaires. Multivariate multilevel regression analyses were conducted to determine the main effects of the physical environment and parenting practices on changes in children's time spent in sedentary behaviour (SB), light PA and moderate-to-vigorous PA (MVPA) over 18 months. Additionally, moderation of the association between the physical environment and children's PA levels by parenting practices was examined by adding interacting terms to the regression equations.

RESULTS

Walkability of the physical environmental was associated with a decrease in SB at 18 months (B = -5.45, p < .05). In addition, the parenting practice logistic support was associated with an increase in MVPA (at all time points, B = .68, B = .73 and B = 1.02, respectively, all p < .05) and a decrease in SB (at 18 months, B = -1.71, p < .05). Stratified analyses (based on significant interaction terms) showed that the effect of specific physical environmental features (e.g., sports facilities) on children's improvements in PA levels were strengthened by favourable parenting practices.

DISCUSSION

Besides the main effects of walkability and logistic support, there were indications that several parenting practices moderate the association between the physical environment and changes in children's time in various PA levels. The current findings are exploratory, and need to be confirmed in further research.

Parents' and Teachers' Perceptions of Physical Activity in Schools: A Meta-Ethnography

The aim of this meta-ethnographic study was to analyze parents' and teachers' perceptions of barriers and facilitators to physical activity in children. Facilitators were the benefits of physical activity, modeling, participation, children's preferences, and factors supporting active transport. Barriers were quantifying the physical activity, parents' lack of time, the cost of activities, bad weather, traffic, long distances, and the lack of facilities and safety. The level of physical activity does not depend exclusively on individual factors related to the child; rather, barriers and facilitators are influenced by the social and school context and the physical and built environment. It is important that school nurses understand these contextual factors, so that they can take these into consideration when designing their intervention programs.

The physical activity parenting practices (PAPP) item Bank: a psychometrically validated tool for improving the measurement of physical activity parenting practices of parents of 5-12-year-old children

BACKGROUND

Many tools have been developed to measure physical activity parenting practices (PAPP). Currently, there is little standardization on how PAPP constructs are operationalized for 5-12 year-old children. Given this lack of consistency our team have started the process of standardizing the measurement of PAPP by developing an item bank which was conceptually informed by 24 experts from 6 countries.

PURPOSE

The purpose of this paper is to present the psychometric properties of the PAPP item bank using the expert-informed PAPP conceptual framework.

METHODS

A sample (N = 626) of Canadian parents completed the PAPP item bank (100 items measuring 12 constructs). Confirmatory Factor Analyses (CFA), confirmatory bi-factor item analyses, and Item Response Modeling (IRM) were used to assess the structural validity of scores derived from the PAPP item bank. Differential Item Functioning (DIF) and Differential Response Functioning (DRF) were used to determine whether the PAPP items are invariant by parent sex, ethnicity of parent, and household income. Finally, Computerized Adaptive Testing (CAT) simulations were used to determine the efficiency of the item bank - this involved ascertaining whether each construct can be assessed with fewer items.

RESULTS

The PAPP expert-informed conceptual framework was mainly supported by the CFA analyses. Notable changes included: a) collapsing smaller constructs into one general construct (modeling, co-participation, and monitoring constructs were collapsed into a construct assessing nondirective support); or b) splitting a construct into two smaller constructs (restrict for safety reason construct was split into indoor physical activity restriction and allowance for unsupervised outside physical activity). While the CFA analyses supported the structural validity of 11 constructs, the bi-factor item analyses and IRM analyses supported collapsing correlated constructs into more general constructs. These analyses further reduced the number of constructs measured by the PAPP item bank to nine constructs (65 items - reliability ranging from .79 to .94). As seven of the PAPP constructs had reliability greater than .80, CAT simulations further reduced the number of items to 31 items.

CONCLUSION

Overall, the PAPP item bank has excellent psychometric properties and provides an efficient way to assess PAPP.

Effects of the “MAMI Deporte®” Family Sports Program on Parents’ Motivation towards Sport Participation: A Randomized Controlled Intervention

As most parents do not meet physical activity (PA) recommendations, new PA promotion strategies need to be developed considering the role of motivation as an essential underlying factor of PA behavior. Recreational sports programs practiced in the family would represent an effective strategy to promote PA for the entire family in general, and for parents in particular. Building upon self-determination theory, the purpose of this study was to examine the effect of the Active Methodology for Improving Sports Initiation (MAMI Deporte®) program on parents’ behavioral regulation. The participants were 58 parents (50% men) and 78 children (48.71% boys), who were randomized into a control group (29 parents and 39 children), which followed its habitual sports activity over 8 months, and an experimental group (29 parents and 39 children), which completed the MAMI Deporte® program. Specifically, the MAMI Deporte® program focused on simultaneous participation between parents and children in multisports activities, including 32 lessons distributed into 2 h/week for 8 months. Pre-and-post-intervention measures were collected. The results showed significant differences in the parents’ level of intrinsic motivation, integrated regulation, identified regulation and introjected regulation in favor of the experimental group. Nonsignificant effects were found for gender. These results were discussed, highlighting the internalization process of the value of sport in the family experienced by parents after the MAMI Deporte® family-based sports program.

Parental Perspectives and Experiences in Relation to Lifestyle-Related Practices in the First Two Years of a Child's Life: A Qualitative Study in a Disadvantaged Neighborhood in The Netherlands

The first two years of a child's life are a critical period in preventing several lifestyle-related health problems. A qualitative study was conducted to explore parental experiences and perspectives in relation to lifestyle-related child-rearing practices in order to minimize risk factors at an early stage. Data were collected through interviews (n = 25) and focus groups (n = 4) with parents of children aged 0-2 years, in a disadvantaged neighborhood in Amsterdam, the Netherlands. Results showed that parents were often uncertain about a number of lifestyle-related practices. Ambiguity also appeared regarding the parents' intentions to engage in certain practices and what they were able to achieve in everyday life. In addition, parents experienced strong sociocultural influences from their family, which interfered with their ability to make their own decisions on lifestyle-related practices. Parents also expressed a need for peer-support and confirmation of their practices. Future studies should focus on supporting parents in their parental practices during the first two years of their child's life. Any such study should take into account the specific sociocultural context accompanying lifestyle-related parental practices.

It's about being the good parent: exploring attitudes and beliefs towards active school transportation

In recent decades, there has been a decline in active school transportation (AST). Parents play an important role as the key decision-makers of children’s AST, and there is a need of more knowledge about the decision-making process and parents’ beliefs towards AST. The overall aim of this study was to explore parents’ attitudes and beliefs towards AST in the northern part of Sweden. Twenty parents participated in semi-structured interviews, which was based on the theory of planned behaviour. Qualitative content analysis was used to analyse the interviews. The analysis yielded one main theme, “Parenting and active school transportation – making route choices in a changed landscape” and four subthemes, “Knowing that it is beneficial while struggling with daily life”, “Considering barriers and solutions to enable AST”, “Parenting is challenging and about balancing”, and “Reflecting and contemplating about what we and others do”. Winter conditions affect parents’ decisions, and this needs to be considered when facilitating AST in these regions. Overall better health, increased physical activity, time spent outdoors, and free play were revealed as positive outcomes of AST. Decisions were also influenced by social norms and how the idea of parenting has changed through generations. The findings of this study are likely to be important when promoting AST.

Parent-Child Physical Activity Association in Families With 4-to 16-Year-Old Children

Background: The main aim of this study was to quantify the associations between parents’ and children’s physical activity by age, gender, and the day of the week on the basis of a pedometer-measured step count (SC). Methods: The sample comprised data from 4-to 16-year-old children and their parents from the Czech Republic (1102 mother-child dyads and 693 father-child dyads). The parents and their children wore the Yamax SW200 pedometer during seven days of monitoring. Results: The strongest SC association was found between mothers and daughters aged 4–7.9 years on weekdays (r_p = 0.402; p < 0.01) and at weekends (r_p = 0.577; p < 0.01). In children aged 8–16, the parent-child association is gender-specific, with the father-son relationship being dominant, especially at weekends (weekend SC: fathers-sons_{8–11.9 y} r_p = 0.416, p < 0.01; fathers-sons_{12–16 y} r_p = 0.443, p < 0.01). An increase of 1000 steps in the fathers (mothers) is associated with an increase of more than 400 (200) steps in their sons (daughters). Conclusions: This study confirms a strong parent-child SC relationship in children younger than eight years of age. In older children, the parent-child SC association is gender-specific and dominated by the father-son relationship, particularly on weekends. The SC associations that are revealed can be used for the development of physical activity programs for adolescents.

Association between parent and child physical activity: a systematic review

Background

Childhood represents an important life stage for establishment of physical activity (PA) habits. Parents are assumed to play an important role in influencing children’s PA. Earlier reviews have mainly focused on parental modelling, encouragement, and support for PA, rather than the actual PA levels of parents. Therefore, the purpose of this review was to systematically summarize the evidence on the relationship between parent and child PA.

Methods

Papers were identified using electronic databases and manual searches of reference lists. Papers reporting on associations between objectively measured child PA and at least one measure of parental PA were included. The quality of the papers was assessed using a modified version of the ROBINS-I tool. For interpretation of the results across studies, we produced albatross plots for all studies combined and by age-groups, sex of the parents, sex of the child, methodology of assessment of parental PA, and type of PA.

Results

Thirty-nine papers were included with sample size of parent-child dyads ranging from 15 to 1267 (mean = 319 dyads, median = 227 dyads). The majority of studies were published from 2008 to 2018 and used accelerometry to assess PA. Most of the studies were classified as having moderate, serious, or critical risk of bias. The albatross plot for all studies combined showed that the clear majority of studies observed a positive relationship between parent and child PA. The plot suggested an average magnitude of correlation across studies to be around 0.13, and the overall impression was that this was fairly similar across child age-groups and gender of parent-child dyads. Studies using objective assessment of parental PA showed stronger relationship between parent and child PA compared with studies using self-report (average magnitude of correlation around 0.16 vs 0.04 respectively). No clear evidence was found for the strength of relationship being dependent on type of PA measure of parent and child (total PA, moderate-to-vigorous PA, steps), however, the relationship for light PA appeared weaker.

Conclusion

This systematic review showed that the clear majority of studies observed a weak positive relationship between parent and child PA regardless of age of the child, the gender of the parent-child dyad, and type of PA.

Trial registration

Registration in PROSPERO: CRD42019093462.

Latino adolescent-father discrepancies in reporting activity parenting practices and associations with adolescents' physical activity and screen time

Background

Latino fathers may play important roles in adolescents’ physical activity and screen time. However, informant discrepancies regarding paternal activity parenting practices may challenge studies supporting evidence-based applications. This study examined Latino adolescent-father discrepancies in reporting paternal activity parenting practices, types of discrepancies by participant characteristics, and associations between discrepancy types and adolescents’ physical activity and screen time.

Methods

The sample for this cross-sectional study included Latino early adolescents and their fathers (n = 138 dyads) from baseline data collected for a family-centered, healthy lifestyle intervention in a metropolitan area. In parallel measures, Latino adolescents and fathers reported paternal activity parenting practices related to expectation or allowance, behavioral modeling, and providing opportunities for physical activity or screen time. Level of agreement and discrepancies were examined using the percentage of agreement, weighted kappa statistics, Pearson correlation coefficients, and paired-sample t-tests. Undesirable discrepancy types included adolescents reporting lower scores for paternal physical activity parenting practices or higher scores for paternal screen time parenting practices than fathers. Participants’ sociodemographic characteristics and weight status were compared by discrepancy type using between-group t-tests or Chi-square tests. Associations between discrepancy type and adolescents’ physical activity and screen time were examined using multivariate regression analyses.

Results

The study sample was low-income with a high prevalence of overweight and obesity. Adolescent and paternal reports of activity parenting practices had poor agreement (percentages of agreement: 22.2–34.3%, weighted kappa statistics: < 0.2, and correlation coefficients: 0.06–0.25). An undesirable discrepancy type for certain parenting practices was more likely to be observed among fathers without full-time employment, girls, older adolescents, and adolescents and fathers within overweight or obese BMI categories. Discrepancies in paternal expectation regarding physical activity and allowance of screen time had adverse associations with adolescents’ physical activity (β = − 0.18, p = 0.008) and screen time (β = 0.51, p <  0.001).

Conclusion and implications

Discrepancies in reporting activity parenting practices were evident between Latino adolescents and their fathers, especially among certain sociodemographic and weight status groups. Adolescents’ perceptions on paternal parenting practices tended to be better indicators of their activity levels than fathers’ reports.