The influence of routine and leisure family activities on the ability of young Asian Americans to maintain a healthy lifestyle: findings from a nationwide survey

Family is uniquely influential in the health of young Asian Americans (AAs), yet little is known on the impact of specific shared family activities. This study explores different types and frequencies of AA young adult shared family activities on perceived familial influence on the ability to maintain a healthy lifestyle (diet, physical activity, sleep, social relationships, stress, and risky substances). A nationwide sample of 18-35-year-old AAs was surveyed in March 2021 on a list of 30 shared family activities with mothers, fathers, siblings, or extended family. Overall, 984 unique family relationships reported by 616 young AAs were analyzed. Confirmatory factor analysis synthesized a reliable two-factor (routine, leisure activities) 10-item Shared Activities with Family (SAF) scale. Mothers were most influential (mean 3.25, SD = 1.14), although shared activities among South Asians or with extended family were most associated with changes in perceived influence. Routine shared activities were more strongly associated with perceived influence on sleep, diet, and risky substances, while leisure shared activities were more associated with influence on developing healthy social relationships. Family-based, dyadic interventions for young AAs may incorporate shared activities (both routine and leisure) to promote healthy behaviors, although further research to explore mechanisms and directionality of influence is needed to inform action.

Cultivation and Enabling Effects of Social Support and Self-Efficacy in Parent-Child Dyads

Background

There are two alternative mechanisms, elucidating the reciprocal relationship between self-efficacy and social support when explaining health outcomes: self-efficacy beliefs may operate as the establisher of social support (the cultivation model) or social support may enable the formation of self-efficacy beliefs (the enabling model).

Purpose

In line with the cultivation hypothesis, it was tested if self-efficacy (measured in parents and children) would indirectly predict parental and child moderate-to-vigorous physical activity (MVPA), via the mediator, social support (parent-provided, child-received). In line with the enabling hypothesis, it was tested if social support would predict MVPA indirectly, via the mediator, self-efficacy.

Methods

A total of 879 parent–child dyads (1758 individuals; 52.4% girls, aged 5–11 years old, 83.2% mothers) provided self-reports at the baseline (T1) and the 7- to 8-month follow-up (T2). Body weight and height were measured objectively. Manifest path analyses were performed, controlling for the baseline levels of the mediator and dependent variables.

Results

A similar number of significant simple indirect effects was found for the cultivation and the enabling model. Across the models, the indirect effects followed similar patterns: (a) within-individual indirect effects in children; (b) across-individual indirect effects, with the independent variable measured in children and the mediator/dependent variables measured in parents (e.g., child self-efficacy predicted parental support provision and, indirectly, parental MVPA); (c) across-individual indirect effects, accounting for self-efficacy and MVPA measured in children, combined with parental reports of social support.

Conclusions

The findings provide support for both cultivation and enabling models in the context of MVPA among parent–child dyads.

A Dyadic Analysis on Source Discrepancy and a Mediation Analysis via Self-Efficacy in the Parental Support and Physical Activity Relationship among Black Girls

BACKGROUND

Physical activity (PA) declines in adolescence among black girls. This study assesses how moderate/vigorous physical activity (MVPA) relates to caregiver- vs. adolescent-reported parental support and whether the relationship is mediated by self-efficacy.

METHODS

MVPA was assessed through accelerometry. Parental support and encouragement on adolescents' PA were reported by caregivers and adolescents with a 10-item Social Support and Exercise Survey. Adolescent-reported self-efficacy related to PA was assessed with an 8-item scale. Structural equation modeling assessed source variation (caregiver vs. adolescent report) in the relationship between parental support and MVPA and mediation through adolescent self-efficacy.

RESULTS

The sample includes black adolescent girls (n = 272), with mean age of 11.6 years (standard deviation = 0.7), and average MVPA/day of 40.6 minutes. Caregiver/adolescent agreement on parental support was low (weighted Kappa <0.20). There was significant source variation in the parental support-MVPA relationship (Wald χ² = 4.18, df = 1, p = 0.041); adolescent-reported support was related to MVPA (b = 0.40, standard error = 0.14, p = 0.003) and mediated through self-efficacy (95% bootstrapped confidence interval: 0.05-0.29). Caregiver-reported support or BMI z-score was not related to MVPA.

CONCLUSIONS

The association between MVPA and adolescent-reported parental support among black adolescent girls is explained by positive self-efficacy. Findings suggest that effective adolescent/caregiver communication around parental support on PA relates to high adolescent self-efficacy and supports objectively measured PA. Additional research is merited to examine longitudinal patterns. Furthermore, although 51.5% of girls in the sample were overweight or obese, the lack of association between MVPA and body composition minimizes its implication for mitigating obesity among overweight/obese black adolescent girls.

Psychosocial predictors of changes in adolescent girls' physical activity and dietary behaviors over the course of the Go Girls! group-based mentoring program

Changes in social cognitions targeted within a group-based mentoring program for adolescent girls were examined as predictors of changes in physical activity (PA) and dietary behavior (in two separate models) over the course of the 7-week program. Data were collected from 310 participants who participated in the program. Multilevel path models were used to assess changes in psychosocial variables predicting changes in behavioral outcomes from pre- to post-program. Analyses revealed that 24.4 and 12.3% of the variance in increases in PA and dietary behavior, respectively, was explained by increases in affective and instrumental attitudes, self-regulatory efficacy (SRE), and intentions. Increases in intentions partially mediated the effects of increases in SRE and affective attitudes on increases in PA behavior. In relation to improvements in dietary behavior, increases in intentions and SRE directly predicted improvements in dietary behavior. These findings suggest potential psychological mechanisms through which a group-based mentoring program may lead to changes in adolescent girls' health-enhancing PA and dietary behaviors.

Persuading Others to Avoid Persuasion: Inoculation Theory and Resistant Health Attitudes

Inoculation theory, a theory of conferring resistance to persuasive influence, has established efficacy as a messaging strategy in the health domain. In fact, the earliest research on the theory in the 1960s involved health issues to build empirical support for tenets in the inoculation framework. Over the ensuing decades, scholars have further examined the effectiveness of inoculation-based messages at creating robust positive health attitudes. We overview these efforts, highlight the structure of typical inoculation-based health messages, and describe the similarities and differences between this method of counter-persuasion and other preparatory techniques commonly employed by health researchers and practitioners. Finally, we consider contexts in which inoculation-oriented health messages could be most useful, and describe how the health domain could offer a useful scaffold to study conceptual issues of the theory.

"Go Girls!": psychological and behavioral outcomes associated with a group-based healthy lifestyle program for adolescent girls

The objective of this study was to assess changes in adolescent girls' health-enhancing cognitions and behaviors targeted by the Go Girls! group-based mentorship lifestyle program. Three hundred and ten adolescent girls (nested within 40 Go Girls! groups) completed questionnaires that assessed cognitions (attitudes, self-regulatory efficacy, and intentions) and behaviors (physical activity and dietary) at four time points (two pre-program, one at the end of the program, and one at 7-week follow-up). Hierarchical linear modeling was used to examine changes in the outcome variables among Go Girls! participants (M age = 11.68 years, SD = 0.80). No significant changes occurred in the outcome variables during the baseline comparison period (Time 1-2). When compared to the average of the baseline assessments, 7 weeks after completing the program, girls reported significant improvements in physical activity (M Baseline PAtotal = 3.82, SD = 3.49; M T4 PAtotal = 4.38, SD = 3.75) and healthy eating (M Baseline = 10.71, SD = 1.13; M T4 = 11.35, SD = 1.05) behavior and related cognitions (d values ≥0.65). Findings provide preliminary support for programs that foster belongingness and target health behaviors through mentorship models.

Physical activity and social support in adolescents: a systematic review

The objective of this review was to systematically synthesize the results of original studies on the association between physical activity and social support in adolescents, published until April 2011. Searches were carried out in Adolec, Eric, Lilacs, Medline, SciELO, Scopus, SportsDiscus and Web of Science electronic databases and the reference lists of selected articles. Searches for articles, data extraction and assessment of methodological quality were conducted independently by two reviewers. In total, 75 articles met inclusion criteria and were analyzed. Most studies were published over the past 6 years (2006-11), conducted in high-income countries, with a cross-sectional design, using subjective measures of physical activity (e.g. questionnaires and recall) and exhibited medium to high methodological quality level. Social support was positive and consistently associated with the physical activity level of adolescents in cross-sectional and longitudinal studies. Those who received more overall social support as well as support from both parents, friends and family showed higher levels of physical activity. It is concluded that social support is an important factor associated with physical activity level in adolescents and should be targeted in intervention programs that aim to increase physical activity levels in this population group.

Perceived environmental characteristics and psychosocial factors associated with physical activity levels in adolescents from Northeast Brazil: structural equation modelling analysis

This study aimed to investigate the direct and indirect associations between perceived environmental characteristics and psychosocial factors and physical activity levels in adolescents from Northeast Brazil. The sample was composed of 2,361 adolescents aged 14-19 years (56.6% female). Physical activity was measured using a questionnaire and environmental (perceived environmental characteristics) and psychosocial (self-efficacy, social support from parents and friends for physical activity) factors with previously validated scales. Perceived environmental characteristics were not directly associated with the levels of physical activity, but exhibited significant indirect associations, mediated by self-efficacy in males. Self-efficacy and social support were positively and directly associated with physical activity levels, and part of the associations between social support and physical activity was mediated by self-efficacy. Perception of self-efficacy and social support, important factors associated with physical activity levels in adolescents, should be the target of interventions aimed at increasing physical activity. Favorable environments for physical activity also need to be considered, since they have a positive influence on the self-efficacy of adolescents.

Physical activity in adolescents: analysis of the social influence of parents and friends

OBJECTIVE

To analyze the association between physical activity and social support from parents and friends on the physical activity level among adolescents.

METHODS

Data from 2,361 adolescents (56.6% females; mean age 16.4; SD = 1.2), from public and private high schools were analyzed. The physical activity level of the adolescents, parents, and friends were measured through a questionnaire. Parents' and friends' support and self-efficacy were measured using two previously tested scales. Data analysis was performed using the structural equation modeling in IBM® SPSS® Amos™ 20.0.

RESULTS

Physical activity of friends was directly associated with physical activity level of adolescents. Physical activity of the father was associated with that of their sons, and the physical activity of mother was associated with that of their daughters. An indirect association was identified between the physical activity of parents and friends with physical activity level of the adolescents, mediated by social support. Social support was directly associated with physical activity in adolescents of both genders and indirectly mediated by self-efficacy.

CONCLUSIONS

Parents and friends have a social influence on adolescents' level of physical activity through the mechanism of behavior modeling or through social support, mediated by self-efficacy.

Implementing family-based childhood obesity interventions

Family-based interventions have been effective in managing childhood obesity, and pediatric nurse practitioners (PNPs) are positioned to provide obesity interventions in both patient and family primary care settings. The purpose of this article is to guide the PNP in implementing family-based childhood obesity interventions, including identification, diagnostic evaluation, and management.

Impact of physical activity intervention programs on self-efficacy in youths: a systematic review

Lack of physical activity has contributed to the nation's childhood obesity crisis, but the impact of physical activity on self-efficacy as a mediator of behavior change has not been examined. This systematic review (SR) describes the published evidence related to the impact of physical activity intervention programs on self-efficacy among youths. From January 2000 to June 2011, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to identify publications from PubMed, PsychInfo, Web of Knowledge, and the Cochran Database of Systematic Reviews. The Cochrane Population, Intervention, Control, Outcome, Study Design (PICOS) approach guided this SR articles selection and evaluation process. Of the 102 publications screened, 10 original studies matched the SR inclusion criteria. The types of physical activity interventions and self-efficacy assessments for these 10 studies were diverse. Of the 10 included articles, 6 articles identified an improvement in post-self-efficacy assessments compared to baseline and 4 showed no effect. In conclusion, physical activity intervention programs may improve self-efficacy in youths. A standardized approach to classify and measure self-efficacy is required. Further research is needed to quantify the association of self-efficacy ratings after completing physical activity interventions with objective health improvements, such as weight loss.

Direct and indirect associations between the family physical activity environment and sports participation among 10-12 year-old European children: testing the EnRG framework in the ENERGY project

Background

Sport participation makes an important contribution to children’s overall physical activity. Understanding influences on sports participation is important and the family environment is considered key, however few studies have explored the mechanisms by which the family environment influences children’s sport participation. The purpose of this study was to examine whether attitude, perceived behavioural control, health belief and enjoyment mediate associations between the family environment and 10–12 year-old children’s sports participation.

Methods

Children aged 10–12 years ( = 7234) and one of their parents (n = 6002) were recruited from 175 schools in seven European countries in 2010. Children self-reported their weekly duration of sports participation, physical activity equipment items at home and the four potential mediator variables. Parents responded to items on financial, logistic and emotional support, reinforcement, modelling and co-participation in physical activity. Cross-sectional single and multiple mediation analyses were performed for 4952 children with complete data using multi-level regression analyses.

Results

Availability of equipment (OR = 1.16), financial (OR = 1.53), logistic (OR = 1.47) and emotional (OR = 1.51) support, and parental modelling (OR = 1.07) were positively associated with participation in ≥ 30mins/wk of sport. Attitude, beliefs, perceived behavioural control and enjoyment mediated and explained between 21-34% of these associations. Perceived behavioural control contributed the most to the mediated effect for each aspect of the family environment.

Conclusions

Both direct (unmediated) and indirect (mediated) associations were found between most family environment variables and children’s sports participation. Thus, family-based physical activity interventions that focus on enhancing the family environment to support children’s sport participation are warranted.

Social influence and adolescent health-related physical activity in structured and unstructured settings: role of channel and type

BACKGROUND

Social influence channels (e.g., parents) and types (e.g., compliance) have each been related to physical activity independently, but little is known about how these two categories of influence may operate in combination.

PURPOSE

This study examined the relationships between various combinations of social influence and physical activity among youth across structured and unstructured settings.

METHODS

Adolescents (N=304), classified as high or low active, reported the social influence combinations they received for being active.

RESULTS

Participants identified three channels and three types of influence associated with being active. For structured activity, compliance with peers and significant others predicted membership in the high active group (values of p< .001). In the unstructured setting, peer compliance (p= .009) and conformity (p= .019) were associated with active group membership.

CONCLUSIONS

These findings reinforce considering both setting, as well as the channel/type combinations of social influence, when examining health-related physical activity.

The association of self-efficacy and parent social support on physical activity in male and female adolescents

OBJECTIVE

Previous research has shown that cognitive factors may account for the relationship between interpersonal factors and health behaviors. Given these findings, the current study sought to further explore the direct and indirect relationship between parental social support and adolescent physical activity (PA).

METHOD

Data were collected from 1,421 sixth graders (73% Black, 54% females, 71% on free or reduced lunch) in South Carolina. Measures for emotional social support, instrumental social support, and adolescent self-efficacy (SE) were assessed and PA was assessed via accelerometry.

RESULTS

Parent instrumental social support was directly related to girls' PA and parent emotional social support was inversely related to girls' PA. Parent instrumental social support was indirectly related to boys' PA through boys' SE. The covaried association of SE with PA was significant for boys and marginal for girls.

CONCLUSIONS

SE for overcoming barriers may be an important construct for understanding the relationship between parent instrumental social support and boys' PA in underserved populations. The mechanisms for engaging in PA may be different for adolescent girls and boys.

Cognitive influences as mediators of family and peer support for pediatric cancer survivors' physical activity

OBJECTIVE

The objective of this study was to determine the extent to which self-efficacy mediates the relations between social support and childhood cancer survivors' physical activity (PA).

METHODS

A structured telephone survey was conducted with 105 childhood cancer survivors aged 8-16 years. Participants completed measures assessing their PA as well as proposed predictors of PA including various demographic, medical, cognitive, and social influences. Multiple mediation analyses were utilized to evaluate the relations between social support, cognitive influences, and survivor PA.

RESULTS

Cognitive influences, including perceived benefits, barriers, and self-efficacy for PA, partially mediated the influence of family and peer support on survivor PA. Self-efficacy emerged as a significant unique mediator, indicating that higher levels of family and peer support are associated with higher levels of survivor PA via increases in survivor self-efficacy.

CONCLUSIONS

Social support has both direct and indirect influences on survivor PA. Indirectly, social support influences PA via survivor self-efficacy. Interventions should target family and peer support as well as self-efficacy to increase survivor PA.

Parental Influences on Physical Activity Behavior in Children and Adolescents: A Brief Review

Understanding the social and environmental factors that influence physical activity is important in the development of effective interventions to increase physical activity behavior in children and adolescents. One factor that has received considerable research attention is the influence of parenting practices and behaviors on child physical activity. This review evaluated 103 studies that examined the influence of parental physical activity, parental support for child physical activity, parenting style, and family cohesion on child and adolescent activity behavior. Results showed that parental support was consistently positively and significantly associated with child activity. With respect to the association between parent and child physical activity, there was little evidence of association. Although the evidence linking parenting style and family cohesion with child physical activity was nonsupportive, too few studies have examined these relationships to draw firm conclusions. Priorities for future research and implications for health care professionals are discussed.

Perceptions of Exercise Among School-Aged Children With Asthma

This grounded theory–driven study explored the predominant categories and concepts involved with perceptions of exercise among school-aged children with asthma. Data came from 13 in-depth interviews with 10 children. Five boys and 5 girls, ages 8 to 12 years, with varying asthma disease severity, participated. In addition, 9 parents completed a health history questionnaire. The process of creating perceptions of exercise was the grounded theory that emerged from the data. The ongoing creation of perceptions of exercise was influenced by 4 predominant categories: perceived benefits, striving for normalcy, exercise influences, and asthma’s influence. Because process is an ongoing occurrence, the 4 predominant categories may influence the creation of exercise perceptions simultaneously, or at different times and in various ways dependent upon the characteristics of the child and his or her unique situations and experiences. Perceived benefits, striving for normalcy, exercise influences, and asthma’s influence were identified categories involved with the interactions, actions, and consequences interwoven throughout the creation of perceptions of exercise process. These categories help explain how exercise perceptions are developed from the participants’ perspective. The process of creating perceptions of exercise is a continuous, circular happening with the consequences leading to the development of exercise perceptions. The context may change but the overall process retains applicability to creating perceptions of exercise. The subjective insight gained through the development of this theory gives light to numerous areas for future nursing research and implications for practice to improve the overall quality of life among school-aged children with asthma.

The confidence to get going: the moderating effects of depressive symptoms on the self-efficacy-activity relationship among youth and adolescents

The purpose of this study was to examine whether the relationship between self-efficacy and physical activity was moderated by the presence of depressive symptoms in a sample of youth and adolescents. Participants (N = 688) from grades 7-12 completed measures of self-efficacy and depressive symptoms at baseline and self-report measures of physical activity 1 month later. Hierarchical regression analyses indicated a moderating effect of depressive symptoms on the self-efficacy-physical activity relationship, with this relationship being even more pronounced among those reporting depressive symptoms. These findings have important implications for the promotion of physical activity among youth and adolescents especially those suffering from depressive symptoms.

Relationships of Social Context and Identity to Problem Behavior among High-Risk Hispanic Adolescents

The present study was designed to examine the extent to which (a) family and school functioning and (b) personal and ethnic identity is associated with conduct problems, drug use, and sexual risk taking in a sample of 227 high-risk Hispanic adolescents. Adolescents participated in the study with their primary parents, who were mostly mothers. Adolescents completed measures of family and school functioning, personal and ethnic identity, conduct problems, and drug use. Parents completed measures of family functioning and adolescent conduct problems. Results indicated that school functioning and personal identity confusion were related to alcohol use, illicit drug use, and sexual risk taking indirectly through adolescent reports of conduct problems. Adolescent reports of family functioning were related to alcohol use, illicit drug use, and sexual risk taking through school functioning and conduct problems. Results are discussed in terms of the problem behavior syndrome and in terms of the finding of relative independence of contextual and identity variables vis-à-vis conduct problems, substance use, and sexual risk taking.