Agreement between parent and child report on parental practices regarding dietary, physical activity and sedentary behaviours: the ENERGY cross-sectional survey

Patterns and trajectories of inequality in physical activity from childhood to adolescence in Kazakhstan

Objective

Sociodemographic differences in physical activity (PA) levels during the transition from childhood to adolescence, particularly in Central Asian countries, is lacking. In this study, we examine individual, family and environmental sociodemographic variables associated with PA among children and young adolescents in Kazakhstan.

Study design

Secondary data analyses of two nationally representative cross-sectional studies administered by parents of children (aged 7-9 y) and by self-report surveys (adolescents aged, 11-15 y) .

Methods

The 2020 Childhood Obesity Surveillance Initiative (COSI) and 2018 Health Behaviour in School-aged Children (HSBC) studies were used. Predictors of daily PA by individual (gender, grade, weight status), family (family composition, family employment, family wealth), and environment (school location) factors were analysed through binary logistic regressions after adjusting for screen time.

Results

Among both children and adolescents, males were more physically active than females. Daily PA among children was positively associated with high family employment (OR = 1.23, CI = 1.03-1.48) or living in an urban location (OR = 0.58, CI = 0.49-0.70). Daily PA was associated with low family wealth, two-parent families (OR = 1.25 CI = 1.08-1.44) or living in a rural location (OR = 1.18 CI = 1.04-1.34) among adolescents.

Conclusion

In Kazakhstan, the trajectory of children's and adolescent's PA levels, differed according to individual, family and environmental characteristics , suggesting a need for age-specific, targeted interventions to promote PA, appropriate policies that promote programs in schools, communities, and development of infrastructure for physically active lifestyles.

Dietary patterns and internalizing symptoms in children and adolescents: A meta-analysis

CONTEXT

Studies of child and adolescent internalizing symptoms and dietary pattern have produced mixed results.

OBJECTIVES

To quantify the association between dietary patterns and internalizing symptoms, including depression, in children and adolescents.

DATA SOURCES

Embase, PsycINFO, MEDLINE, Web of Science and Cochrane up to March 2021.

STUDY SELECTION

Observational studies and randomized controlled trials with mean age ⩽ 18 years, reporting associations between diet patterns and internalizing symptoms.

DATA EXTRACTION

Mean effect sizes and 95% confidence intervals were determined under a random-effects model.

RESULTS

Twenty-six studies were cross-sectional, 12 were prospective, and 1 used a case-control design. The total number of participants enrolled ranged from 73,726 to 116,546. Healthy dietary patterns were negatively associated with internalizing (r = -0.07, p < 0.001, 95% confidence interval [-0.12, 0.06]) and depressive symptoms (r = -0.10, p < 0.001, 95% confidence interval [-0.18, -0.08]). Effect sizes were larger for studies of healthy dietary patterns and internalizing and depressive symptoms using self-report versus parent-report measures, as well as in cross-sectional studies of healthy dietary patterns and depression compared to prospective studies. Unhealthy dietary patterns were positively associated with internalizing (r = 0.09, p < 0.001, 95% confidence interval [0.06, 0.14]) and depressive symptoms (r = 0.10, p < 0.01, 95% CI [0.05, 0.17]). Larger effect sizes were observed for studies of unhealthy dietary patterns and internalizing and depressive symptoms using self-report versus parent-report measures.

LIMITATIONS

A lack of studies including clinical samples and/or physician diagnosis, and a paucity of studies in which anxiety symptoms were the primary mental health outcome.

CONCLUSION

Greater depression and internalizing symptoms are associated with greater unhealthy dietary patterns and with lower healthy dietary intake among children and adolescents.

Validity and Reliability of the International FItness Scale (IFIS) in preschool children

OBJECTIVES

Examine the validity and reliability of parent-reported International FItness Scale (IFIS) in preschool-age children.

METHOD

A cross-sectional study of 3051 Spanish preschoolers (3-5 years). Fitness was measured by PREFIT fitness test battery and reported by parents using an adapted version of the IFIS. Waist circumference was evaluated, and the waist-to-height ratio (WHtR) was calculated. Seventy-six parents of randomly selected schoolchildren completed the IFIS twice (two weeks apart) for a reliability assessment.

RESULTS

ANCOVA, adjusted for sex, age and WHtR, showed that preschoolers who were scored by their parents as having average-to-very good fitness had better levels of measured physical fitness than those preschoolers who were classified as having "very poor/poor" fitness levels (18.1laps to 22.1laps vs 15.6laps for cardiorespiratory fitness; 6.6 kg to 7.5 kg vs 5.3 kg for muscular fitness-handgrip-; 71.7 cm to 76.4 cm vs 62.0 cm for muscular fitness-standing long jump-; 17.2s to 16.2s vs 18.2s for speed/agility; and 11.2s to 15.6s vs 8.7s for balance; p < 0.001). The weighted kappa for concordance between parent-reported fitness levels and objective assessment was poor (κ ≤0.18 for all fitness measures). Overall, the mean values of the abdominal adiposity indicators were significantly lower in high-level fitness categories reported by parents than in low-level fitness categories (p < 0.05). The test-retest reliability of IFIS items ranged from 0.46 to 0.62.

CONCLUSIONS

The reliability of the parent-reported IFIS are acceptable, but the concordance between parents reported and objectively measures fitness levels is poor, suggesting that parents' responses may not be able to correctly classify preschoolers according to their fitness level.

Development and preliminary validation of the Adolescent Food Parenting Questionnaire: Parent and adolescent version

Suitable instruments for measuring Food Parenting Practices (FPP) among adolescents and their parents that also measure the perception of adolescents about their parent's FPP are rare. The current study describes the development and preliminary testing of a short 16-item Adolescent Food Parenting Questionnaire (AFPQ) for parents (AFPQ-p) and adolescents (AFPQ-a) that may enable future large-scale research on potentially eminent parent-child FPP discrepancy. Participants included 381 parents (73.8 % mothers; M_age 45.9, 26.2% fathers; M_age 49.1) and their adolescent children (aged 12-16) who participated in the Dutch "G(F)OOD together" study. Most parents finished higher professional education (mothers: 44.3 %; fathers: 34.4 %) and performed a paid job of 32 h per week or more (mothers: 22.1 %; fathers: 60.0 %). The theoretical framework of Vaughn (2016) was leading in the development of the AFPQ. Exploratory factor analysis (EFA) was performed on a random split sample of parent-adolescent dyads and confirmatory factor analysis (CFA) was performed on the other half. The EFA in both parent and adolescent samples resulted in a clear 5 factor solution explaining 61.6 % (AFPQ-p) and 64.2 % (AFPQ-a) of the variance respectively, representing the factors Autonomy Support (α = 0.79/.82), Coercive Control (α = 0.85/.83), Snack Structure (α = 0.79/75), Healthy Structure (α = 0.78/74) and Modelling (α = 0.69/85). CFA confirmed good model fit for the AFPQ-p and the AFPQ-a. Associations with adolescent self-reported food intake were in the expected direction, confirming the preliminary convergent validity of the instrument among a moderate to highly educated group of parent-adolescent dyads. Although the AFPQ provides a promising short instrument, future research in more diverse samples is needed to build evidence on the instrument's psychometric characteristics in other groups.

Can Flu-Like Absenteeism in Kindergartens Be Reduced Through Hand Hygiene Training for Both Parents and Their Kindergarteners?

Background: Hand hygiene has been found as an effective method to prevent the spread of infectious diseases. Parents, however, were found to have inadequate knowledge, reporting skills, and parenting practices related to seasonal influenza. The aim of our study was to investigate if there was any correlation between the flu infection among parents and their kindergarteners and ascertain the effectiveness of using hand hygiene interventions in kindergartens to lower kindergarteners’ absenteeism attributable to seasonal flu. Methods: This study was a quasi-experimental study with a pretest-posttest design. Fifteen kindergartens were randomly selected from the kindergarten lists in different districts displayed on the Hong Kong government website. From these 15 kindergartens, parents and their kindergarteners were then randomly selected to participate in our hand hygiene program. To support the validity of the program, the WHO hand hygiene checklist was used to ensure sufficient coverage of the objectives. All kindergarteners attended 45-minute session for 4 weeks, while their parents attended a separate session lasting 1 hour. Parents monitored their kindergartners on a daily basis for any flu symptoms and kindergartens monitored their school attendance. Results: The study results showed that kindergarteners with strong parenting and proper hand hygiene compliance had fewer recorded signs and symptoms of flu-like illnesses. Our findings also showed that the kindergarteners’ absence rates in all participating kindergartens owing to flu decreased from 21.5% to 12% of the study period in 3 months. Conclusion: It was found that the flu infection rates of the parents and their kindergarteners were significantly correlated with P = .005. The awareness and personal hygiene skills of the parents and kindergarteners were both raised after the program. The findings in this study supported that positive parenting on hand hygiene can help reduce kindergarteners’ flu-like absenteeism.

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.

Development of a Survey to Assess Latino Fathers’ Parenting Practices Regarding Energy Balance–Related Behaviors of Early Adolescents

Latino adolescents face challenges to performing energy balance–related behaviors (EBRBs) to prevent childhood obesity, including healthy dietary intake, adequate physical activity, and limited screen time. Fathers are underrepresented in family-based obesity interventions but could be influential in shaping the EBRBs of Latino children. Three types of parenting practices (setting expectations/limits, role modeling, managing availability and accessibility) have shown relatively consistent positive relationships with children’s EBRBs in studies that have mostly involved mothers. The purpose of this study was to develop measures to assess Latino fathers’ parenting practices based on existing measurement instruments, focus groups and cognitive testing. Criterion validity of the measures (40 items) was examined with Latino fathers and their early adolescents (10-14 years old, n = 96 dyads) who were predominantly from low-income, two-parent households. Criterion validity was indicated by significantly higher intakes of fruit and vegetables; lower intakes of sugar-sweetened beverages, sweets/salty snacks and fast foods; more weekly physical activity hours; and fewer daily screen time hours among adolescents who reported high versus low levels/frequencies of supportive parenting practices. In addition, nearly all scales of adolescent-reported paternal behavioral modeling and availability/accessibility practices were significantly correlated with adolescents’ corresponding EBRBs (r = 0.22 to 0.54). However, poor validity and agreement with early adolescents’ reports were found for most father-reported parenting practices. Overall, this study indicated that the measures were acceptable for assessing adolescents’ report of Latino fathers’ parenting practices around EBRBs. The findings also indicate the importance of including early adolescents’ reports in measuring paternal parenting practices.

Feasibility and Acceptability of a Self-Report Activity Diary in Families of Children With and Without Special Needs

This study was conducted to examine the feasibility and acceptability of a self-report activity diary completed by parents and older children to assess the child's daily activity in children with and without special needs. The study included 36 child/parent dyads stratified by child age and diagnosis. Parents (n = 36) and children ≥13 years (n = 12) were asked to report on the child's daily activity using an activity diary. Feasibility was determined based on successfully returned diaries and acceptability via post-study interview. Activity diaries were submitted by 94% of the parents and 100% of the children, with 83% and 80%, respectively, successfully completed. Comments provided post-study regarding the diaries were primarily on the format and were generally negative. The activity diary was feasible to use, but not well accepted within our sample of children with and without special needs or their parents. Further research is needed to create valid physical activity assessment measures that are population specific for individuals with special needs.

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.

The Mediating Role of Anxiety Sensitivity in Uncontrolled Drinking: A Look at Gender-Specific Parental Influences

BACKGROUND

Anxiety sensitivity (AS) reflects an individual's belief that experiencing anxiety will cause illness or embarrassment, and may be a reason individuals self-medicate with alcohol. Harsh or indulgent parenting could contribute to the development of AS. We examined the direct and indirect associations between parenting styles and alcohol-related variables through AS and impaired control over drinking (IC; i.e., perceived failure to adhere to limits on alcohol consumption in the future).

METHODS

A multiple-group structural equation model with 614 university students (344 men; 270 women) was examined. Structural invariance tests were conducted to evaluate moderation by gender. We used a bias corrected bootstrap technique to obtain the mediated effects.

RESULTS

Father authoritarianism and mother permissiveness were directly linked to AS among women, whereas father permissiveness was directly linked to AS among men. This suggests unique parental influences based on gender regarding AS. While AS was directly linked to alcohol-related problems for both men and women, several gender-specific associations were found. AS was directly linked to IC for men but not for women. For men, father permissiveness was directly related to AS, and AS mediated the indirect link between father permissiveness and IC along both the heavy episodic drinking and alcohol-related problems pathways. Similar to other internalizing constructs (e.g., neuroticism and depression), higher AS was directly associated with less heavy episodic drinking but more alcohol-related problems.

CONCLUSIONS

Our findings highlight the dangers of AS for men as an important correlate of under-controlled drinking behaviors. Additionally, permissive parenting of the same-gender parent was associated with AS, which is consistent with the gender-matching hypothesis. Together, these results underscore the importance of measuring the independent influence of both parents.

A systematic review of methods to measure family co-participation in physical activity

The family environment is key in influencing children's health behaviours. Encouraging family co-participation in physical activity may therefore be an effective approach to increasing children's physical activity levels. Yet, little is known about how to best assess family co-participation in physical activity. This review summarizes methods to measure family co-participation in physical activity, which was defined as joint physical activities including at least one healthy child (0-18 years) and one other family member. Methods were identified through a systematic literature search, cross-referencing pre-selected reviews and contacting research groups. Thirty-seven measurement methods were included. Questionnaires were the most common method used, with the majority assessing frequency of co-participation and few also assessing duration and type. Reliability and internal consistency of scales were often reported, but rarely specified for the item(s) relevant to co-participation. Other methods of measuring co-participation included diaries, event history calendars, direct observations and accelerometry combined with diary, ecological momentary assessment or global positioning systems (GPS). Whilst a large number of measurement methods of family co-participation in physical activity exist, few are comprehensive and/or report acceptable psychometric properties. Future work should focus on reaching consensus in defining family co-participation in physical activity, and subsequently developing reliable and valid measures.

Home Food Rules in Relation to Youth Eating Behaviors, Body Mass Index, Waist Circumference, and Percent Body Fat

PURPOSE

To investigate agreement and associations between parent and youth acknowledgment of home food rules, youth eating behaviors, and measures of body composition and excess weight.

METHODS

Parent-youth dyads (N = 413) completed the "rules for eating at home" scale (Active Where Survey) and reported dietary intake. Trained research staff obtained anthropometric data. Linear regression analyses separately evaluated relationships between youth and parent acknowledgment of rules and youth-reported eating behaviors and anthropometric outcomes. Food rules were evaluated as a 12-item scale and individually.

RESULTS

Score on the food rule scale was positively associated with fruit and vegetable servings by youth acknowledgment only (β = .09, p = .006), and not with anthropometric outcomes. The rule "no desserts except fruit" was positively associated with fruit and vegetable servings by youth (β = .72, p = .002) and parent (β = .53, p = .03) acknowledgment. The rules "no second helpings at meals" and "limited fast food" were positively associated with body mass index z-score by youth (β = .38, p = .002; β = .32, p = .02, respectively) and parent (β = .74, p < .001; β = .41, p = .006, respectively) acknowledgment, with similar results for waist circumference z-score and percent body fat.

CONCLUSIONS

Inverse associations between specific food rules and healthful eating behaviors but positive associations with anthropometric outcomes suggest potentially bidirectional relationships between food rule implementation and youth weight. Future studies should disentangle how food rules guide youth behavior in the context of youth weight status.

Perceived Bonding by Parents Living with HIV and Their Adolescent Children

This study examined the associations between parent and adolescent reports of bonding within families and the relationships among reported parental bonding, family conflict and adolescent stress. A total of 118 families from Anhui, China, were recruited for this study. Two family-level bonding scores were constructed: the average of and difference between parent and adolescent bonding scores. Study results indicated that the difference between parent and adolescent bonding reports was associated with higher levels of adolescent daily stress. A negative association was observed between average family-level bonding and the level of parent-reported conflict. Our findings highlight the importance of combining data from both parents and adolescents when studying issues related to family wellbeing.

Context matters! The relationship between mother-reported family nutrition climate, general parenting, food parenting practices and children's BMI

Background

Efforts to explain children’s nutrition behavior or weight often involve investigating the parent-child relationship, typically studying the associations between food parenting practices (FPPs) and child outcomes. However, these behaviors are embedded in a broader system: general parenting (GP, the general emotional climate at home), and the family health climate (an aspect of the broader family system in the context of health). In the current study, we combined the parent-child measures of parenting (FPPs and GP) and the nutritional dimension of the family health climate (family nutrition climate, FNC) to get a broader view of how these concepts are interrelated. The current study had two aims: predicting FPPs using GP and FNC as predictor variables, and investigating the relationship between FPPs and children’s weight in different groups of parents, based on low and high GP and FNC scores.

Methods

We collected cross-sectional data via an online survey panel. Mothers of 267 children aged 5–12 years filled out a questionnaire assessing demographics (e.g., children’s weight and height), GP, FPPs, and FNC. Bivariate correlation coefficients were calculated between all constructs. Structural equation modeling was performed to test the hypothesized relationships between GP, FNC and FPPs. Hereafter, different groups of parents were identified, using median split, based on a low or high score on GP or a low or high score on FNC. Bivariate correlation coefficients were calculated between FPPs and children’s BMI z-score for these different groups.

Results

GP and FNC were consistently positively correlated (all r’s ≥.177), and both concepts were positively associated with healthy FPPs (all r’s ≥.214). In families with a positive context (i.e. scoring high on GP and on FNC), healthy FPPs were associated with lower BMI z-scores of the children (r -.229). This association was not found for children with a more negative family context.

Conclusions

FNC and GP are valuable additional concepts to investigate relationships between FPPs and child outcomes. We recommend that more studies, next to investigating the parent-child system, include a measure of the broader family system, in order to get a broader view of the mechanisms explaining child health behaviors and weight status.

The Empowering Role of Mobile Apps in Behavior Change Interventions: The Gray Matters Randomized Controlled Trial

Background

Health education and behavior change programs targeting specific risk factors have demonstrated their effectiveness in reducing the development of future diseases. Alzheimer disease (AD) shares many of the same risk factors, most of which can be addressed via behavior change. It is therefore theorized that a behavior change intervention targeting these risk factors would likely result in favorable rates of AD prevention.

Objective

The objective of this study was to reduce the future risk of developing AD, while in the short term promoting vascular health, through behavior change.

Methods

The study was an interventional randomized controlled trial consisting of subjects who were randomly assigned into either treatment (n=102) or control group (n=42). Outcome measures included various blood-based biomarkers, anthropometric measures, and behaviors related to AD risk. The treatment group was provided with a bespoke “Gray Matters” mobile phone app designed to encourage and facilitate behavior change. The app presented evidence-based educational material relating to AD risk and prevention strategies, facilitated self-reporting of behaviors across 6 behavioral domains, and presented feedback on the user’s performance, calculated from reported behaviors against recommended guidelines.

Results

This paper explores the rationale for a mobile phone–led intervention and details the app’s effect on behavior change and subsequent clinical outcomes. Via the app, the average participant submitted 7.3 (SD 3.2) behavioral logs/day (n=122,719). Analysis of these logs against primary outcome measures revealed that participants who improved their high-density lipoprotein cholesterol levels during the study duration answered a statistically significant higher number of questions per day (mean 8.30, SD 2.29) than those with no improvement (mean 6.52, SD 3.612), t_97.74=−3.051, P=.003. Participants who decreased their body mass index (BMI) performed significantly better in attaining their recommended daily goals (mean 56.21 SD 30.4%) than those who increased their BMI (mean 40.12 SD 29.1%), t₈₀ = −2.449, P=.017. In total, 69.2% (n=18) of those who achieved a mean performance percentage of 60% or higher, across all domains, reduced their BMI during the study, whereas 60.7% (n=34) who did not, increased their BMI. One-way analysis of variance of systolic blood pressure category changes showed a significant correlation between reported efforts to reduce stress and category change as a whole, P=.035. An exit survey highlighted that respondents (n=83) reported that the app motivated them to perform physical activity (85.4%) and make healthier food choices (87.5%).

Conclusions

In this study, the ubiquitous nature of the mobile phone excelled as a delivery platform for the intervention, enabling the dissemination of educational intervention material while simultaneously monitoring and encouraging positive behavior change, resulting in desirable clinical effects. Sustained effort to maintain the achieved behaviors is expected to mitigate future AD risk.

Trial Registration

ClinicalTrails.gov NCT02290912; https://clinicaltrials.gov/ct2/show/NCT02290912 (Archived by WebCite at http://www.webcitation.org/6ictUEwnm)

Relationship between Czech Parent and Child Pedometer-assessed Weekday and Weekend Physical Activity and Screen Time

AIM

Uncovering the influences of parents' behaviour on their children's physical activity provides an insight into the lifestyle of families and development of effective family-based interventions. The aim of this study was to determine the relationship between parents' behaviour (step count (SC) and screen time (ST)) and children's SC on weekdays and at weekends.

METHODS

The participants (388 parents aged 35-45 and their 485 children aged 9-12) were randomly recruited from 21 Czech government funded primary schools. The participants recorded SC and ST duration for seven consecutive days (≥ 10 h/day) during April-May and September-October 2013. The associations between parents' behaviour (SC and ST) and children's SC were estimated using general linear regression separately for weekdays and weekends. Each 1,000 SC increase in mothers' (fathers') SC/weekday was associated with an extra 261 SC/day in their daughters and 413 (244) SC/day in their sons.

RESULTS

Each 1,000 SC increase in mothers' (fathers') SC/weekend day was associated with an extra 523 (386) SC/day in their daughters and 508 (435) SC/day in their sons. A reduction in mothers' ST by 30 minutes per weekend day was associated with an extra 494 SC/day in their daughters and 467 SC/day in their sons.

CONCLUSIONS

This study reveals a quantifiable relationship between parent-child SC/day and mothers' ST and children's SC at weekends. Weekend days are more suitable for the implementation of family-based interventions.

Associations between parental rules, style of communication and children's screen time

BACKGROUND

Research suggests an inverse association between parental rules and screen time in pre-adolescents, and that parents' style of communication with their children is related to the children's time spent watching TV. The aims of this study were to examine associations of parental rules and parental style of communication with children's screen time and perceived excessive screen time in five European countries.

METHODS

UP4FUN was a multi-centre, cluster randomised controlled trial with pre- and post-test measurements in each of five countries; Belgium, Germany, Greece, Hungary and Norway. Questionnaires were completed by the children at school and the parent questionnaire was brought home. Three structural equation models were tested based on measures of screen time and parental style of communication from the pre-test questionnaires.

DISCUSSION

Of the 152 schools invited, 62 (41 %) schools agreed to participate. In total 3325 children (average age 11.2 years and 51 % girls) and 3038 parents (81 % mothers) completed the pre-test questionnaire. The average TV/DVD times across the countries were between 1.5 and 1.8 h/day, while less time was used for computer/games console (0.9-1.4 h/day). The children's perceived parental style of communication was quite consistent for TV/DVD and computer/games console. The presence of rules was significantly associated with less time watching TV/DVD and use of computer/games console time. Moreover, the use of an autonomy-supportive style was negatively related to both time watching TV/DVD and use of computer/games console time. The use of a controlling style was related positively to perceived excessive time used on TV/DVD and excessive time used on computer/games console. With a few exceptions, results were similar across the five countries.

CONCLUSIONS

This study suggests that an autonomy-supportive style of communicating rules for TV/DVD or computer/ games console use is negatively related to children's time watching TV/DVD and use of computer/games console time. In contrast, a controlling style is associated with more screen time and with more perceived excessive screen time in particular. Longitudinal research is needed to further examine effects of parental style of communication on children's screen time as well as possible reciprocal effects.

TRIAL REGISTRATION

International Standard Randomized Controlled Trial Number Register, registration number: ISRCTN34562078 . Date applied29/07/2011, Date assigned11/10/2011.