Parents' perception of stroller use in young children: a qualitative study

Optimal low-cost cooling strategies for infant strollers during hot weather

The current study aimed to identity the optimal low-cost stroller cooling strategies for use in hot and moderately humid summer weather. A commercially available stroller was instrumented to assess the key parameters of the thermal environment. The cooling efficacy of eight different stroller configurations was examined in a counterbalanced order across 16 hot summer days (air temperature (Ta) = 33.3 ± 4.1 °C; relative humidity = 36.7 ± 15%; black globe temperature = 43.9 ± 4.6 °C). Compared with a standard-practice stroller configuration, combining a moist muslin draping with a battery-operated clip-on fan provided optimal in-stroller cooling, reducing the end-trial air temperature by 4.7 °C and the wet bulb globe temperature (WBGT) by 1.4 °C. In contrast, in-stroller temperatures were substantially increased by draping a dry muslin (Ta = +2.6 °C; WBGT = +0.9 °C) or flannelette (Ta = +3.7 °C; WBGT = +1.4 °C) cloth over the stroller carriage. These findings provide empirical evidence which may inform guidance aimed at protecting infants during hot weather.Practitioner summary: This study examined the efficacy of traditional and novel stroller cooling strategies for use in hot and moderately humid weather. Covering the carriage with a dry muslin cloth substantially increased stroller temperatures and should be avoided. Evaporative cooling methods reduced in-stroller temperatures. A moist muslin cloth draping combined with a fan provided optimal stroller cooling.

Functional mobility in children and young adults with Dravet syndrome

AIM

This cohort study aimed to describe functional mobility in Dravet syndrome, a developmental and epileptic encephalopathy.

METHOD

Functional mobility was assessed in individuals (aged 3-25 years), diagnosed with Dravet syndrome, using the Functional Mobility Scale (FMS), Mobility Questionnaire 28 (MobQues28), and estimated walking distance. Secondary outcome variables were Gait Profile Score (GPS), walking velocity, age at independent walking, intellectual disability, seizure frequency, genetic variant type, and body mass index (BMI).

RESULTS

Forty participants aged 3 years to 24 years 2 months (mean = 12 years 2 months) had a median MobQues28 of 79%, median scores of 5, 5, and 4 for the FMS 5 m, 50 m, and 500 m and a median estimated walking distance of 1 km to 3 km. Most difficulties were seen in walking up and down the stairs, walking over obstacles, kicking a ball, and running. MobQues28 scores showed a significant decrease (-6.6%, p = 0.016) in the age category of young adults (≥18 years). After correcting for age, MobQues28 was correlated to age at independent walking (-0.485, p = 0.002), GPS (-0.460, p = 0.003), and walking velocity (0.334, p = 0.038). Analysis of variance showed a significant effect of intellectual disability and BMI on MobQues28 (p = 0.029, p = 0.049). No effect of seizure frequency or genetic variant was found (p = 0.579, p = 0.337).

INTERPRETATION

Functional mobility limitations were observed mainly in dual tasks and activities requiring stability, with limitations increasing from the age of 18 years. Age at independent walking, gait impairments, intellectual disability, and BMI can impact functional mobility in Dravet syndrome.

WHAT THIS PAPER ADDS

Most limitations were seen in dual task activities and activities that required more stability. Deterioration in functional mobility occurred in young adults. The more gait impairments, the more functional mobility limitations. Age at independent walking, intellectual disability, and body mass index can impact functional mobility.

Interdisciplinary Educational Interventions Improve Knowledge of Eating, Nutrition, and Physical Activity of Elementary Students

This research aimed to evaluate the interdisciplinary educational intervention effects on knowledge of eating, nutrition, and physical activity in elementary-school students. Participants were 368 school children enrolled in public schools. The research was organized in three stages: pre-intervention, intervention and post-intervention. In pre-intervention, children were evaluated regarding their nutritional status. They also answered questionnaires related to eating and nutrition and physical activity. In the intervention stage, educational interventions were carried out on the same topics for a period of five months; in post-intervention, children answered the same questionnaires applied in pre-intervention. Despite most children having normal nutritional status (58.2%), a high number of students were overweight (38%). In the initial phase, it was found that most children had excellent knowledge of eating, nutrition, and good physical activity knowledge (p-value < 0.05). Educational health intervention significantly increased children’s knowledge of eating, nutrition, and physical activity, when evaluated in the post-intervention period. Both boys and girls increased their knowledge of eating, nutrition, and physical activity after the application of interdisciplinary interventions (p-value < 0.05). A similar effect was observed for children with different nutritional status. It is concluded that interdisciplinary educational interventions carried out for children in an elementary-school environment are effective for improving knowledge of eating, nutrition, and in physical activity, promoting healthier habits among children.

Perceptions of physical activity and sedentary behaviour guidelines among end-users and stakeholders: a systematic review

Background

Many of the world’s population, across all age groups and abilities, are not meeting or even aware of internationally recommended physical activity (PA) and sedentary behaviour (SB) guidelines. In order to enhance awareness and uptake, guidelines should be perceived positively by targeted users. The purpose of this study was to review the literature on end-user and stakeholder perceptions of PA and SB guidelines.

Methods

The electronic databases APA PsycInfo, CINAHL, MEDLINE, and SPORTDiscus, using EBSCOhost Research Platform, and Web of Science were searched from inception to June, 2021 with keyword synonyms for “perceptions”, “PA guidelines”, and “SB guidelines”. Studies of any design that collected stakeholder and/or end-user responses to a PA and/or SB guideline were included and assessed for risk of bias. The PA and/or SB guideline could be any type of official form (e.g., national documents, organizational guidelines, expert consensus statements, etc.) from any country, that targets individuals at the regional, provincial/statewide, national, or international level, and includes all types of guidelines (e.g., strength, aerobic, clinical, nonclinical, screen-time, sitting, etc.). Data were extracted and analyzed using thematic synthesis.

Results

After screening 1399 abstracts and applying citation screening, 304 full-texts were retrieved. A total of 31 articles met the inclusion criteria. End-users and stakeholders for PA guidelines across all age groups expressed the need for simplified language with more definitions, relatable examples and imagery, and quantification of PA behaviours. There was concern for the early years and child PA guidelines leading to guilt amongst parents and the SB guidelines, particularly the recommendations to limit screen-time, being unrealistic. General age group PA guidelines were not perceived as usable to populations with differing abilities, clinical conditions, and socioeconomic status. Guidelines that targeted clinical populations, such as persons with multiple sclerosis and persons with spinal cord injury, were well received.

Conclusions

There is a clear need to balance the evidence base with the pragmatic needs of translation and uptake so that the guidelines are not ignored or act as a barrier to actual engagement.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01245-9.

Exploring parents' provision of factors related to the establishment of physical activity between normal weight and overweight infants

PURPOSE

Infancy is a critical time for the prevention of obesity and establishment of healthy behaviors such as physical activity that help to control weight. A limited amount of research has examined if factors related to infant physical activity vary by infant weight status. Therefore, the purpose of this mixed methods triangulation study was to examine differences in motor development, the home environment, and infant-parent play behaviors as well as to explore how parents promote active play opportunities with normal weight infants (NWIs) and overweight infants (OWIs).

DESIGN AND METHODS

We used a mixed methods triangulated approach to combine quantitative and qualitative data strands to examine variables associated with active play in normal weight (n = 16) and overweight (n = 11) infants. Data were analyzed using a two-tailed Mann-Whitney U nonparametric test and a summative content analysis approach.

RESULTS

Although there were no differences in infants' motor development and parent play behaviors based on infant weight, several other differences were found. OWIs had less access to materials that stimulate locomotor movement. Further, parents of OWIs more often reported utilizing cognitive play strategies in comparison to parents of NWIs who more often reported using physical play strategies. Parents felt they were the greatest influence on their child's activity regardless of infant size. Importantly, all parents desired more specific guidelines on how to encourage active play and preferred this information was delivered by their healthcare provider.

PRACTICE IMPLICATIONS

To meet parents' desires and potentially improve infants' developmental outcomes through the establishment of healthy physical activity behaviors, pediatric nurses could provide more specific guidance on providing active opportunities for infants.

Push or Carry? Pragmatic Opportunities for Language Development in Strollers vs. Backpacks

Strollers and backpacks are employed early, frequently and throughout the first year, with parents overwhelmingly using strollers. However, because these transport modalities put infants in different proximities to caregivers, postures, and states of alertness, their use may translate to different opportunities that are of developmental consequence, particularly with regard to language. We used GoPro technology in a within subjects counter-balanced design to measure dyadic vocalizations in strollers and backpacks with 7-to-11-month-old infants. Parent-infant dyads (N=36), who regularly used both transport modes took two 8-minute walks in their own neighborhoods using their own carriers while wearing lightweight head-mounted GoPros. There was significantly more parent speech, infant vocalizations, dyadic conversations and infant-initiated speech in backpacks, as well as more head motion consistent with visual scanning by infants. Backpacks appear to be a practical way to encourage more engaging, language-enriched developmental opportunities in the critical first year.

Barriers and facilitators to young children's physical activity and sedentary behaviour: a systematic review and synthesis of qualitative literature

Positive activity behaviours (i.e. higher physical activity [PA]/lower sedentary behaviour [SB]) are beneficial from infancy, yet evidence suggests that young children (0- to 6-year-olds) are relatively inactive. To better understand the perceived influences on these behaviours and to aid intervention development, this paper systematically synthesizes the extensive qualitative literature regarding perceived barriers and facilitators to PA and SB in young children (0-6 years old). A search of eight electronic databases (July 2016) identified 43 papers for inclusion. Data extraction and evidence synthesis were conducted using thematic content analysis, underpinned by the socio-ecological model (i.e. individual, interpersonal, community, organizational and policy levels). Parents, childcare providers and children perceived seven broad themes to be important for PA and SB, including the child; the home; out-of-home childcare; parent-childcare provider interactions; environmental factors; safety; and weather. Each theme mapped onto between one and five levels of the socio-ecological model; barriers and facilitators at the interpersonal level (e.g. parents, care providers and family) were most frequently cited, reflecting the important (perceived) role adults/peers play in shaping young children's behaviours. We provide an overarching framework to explain PA and SB in early childhood. We also highlight where gaps in the current literature exist (e.g. from male carers; in developing countries; and barriers and facilitators in the environmental and policy domains) and where future quantitative work may focus to provide novel insights about children's activity behaviours (e.g. safety and weather).

Stroller running: Energetic and kinematic changes across pushing methods

OBJECTIVE

Running with a stroller provides an opportunity for parents to exercise near their child and counteract health declines experienced during early parenthood. Understanding biomechanical and physiological changes that occur when stroller running is needed to evaluate its health impact, yet the effects of stroller running have not been clearly presented. Here, three commonly used stroller pushing methods were investigated to detect potential changes in energetic cost and lower-limb kinematics.

METHODS

Sixteen individuals (M/F: 10/6) ran at self-selected speeds for 800m under three stroller conditions (2-Hands, 1-Hand, and Push/Chase) and an independent running control.

RESULTS

A significant decrease in speed (p = 0.001) and stride length (p<0.001) was observed between the control and stroller conditions, however no significant change in energetic cost (p = 0.080) or heart rate (p = 0.393) was observed. Additionally, pushing method had a significant effect on speed (p = 0.001) and stride length (p<0.001).

CONCLUSIONS

These findings suggest that pushing technique influences stroller running speed and kinematics. These findings suggest specific fitness effects may be achieved through the implementation of different pushing methods.

He's just content to sit: a qualitative study of mothers' perceptions of infant obesity and physical activity

Background

Rates of obesity among children ages zero to five are rapidly increasing. Greater efforts are needed to promote healthy behaviors of young children. Mothers are especially important targets for promoting health as mothers’ views play a vital role in helping their children foster healthy habits from an early age. Research has found parents’ views of infants’ weight may influence their feeding practices; however, limited research has explored mothers’ view of infants’ weight in relation to the promotion of physical activity. Therefore, the purpose of this study was to explore the perceptions of mothers of normal weight infants and overweight infants about their infant’s weight and physical activity.

Methods

Semi-structured interviews were conducted with mothers of normal weight (n = 18) and of overweight (n = 11) infants (6.5 ± 0.5 month) in a Midwestern city in the United States. A thematic analysis was used to analyze the data.

Results

A majority of mothers thought infants could be overweight. However, no mothers referenced their own infant as overweight. Mothers most commonly noted infants could be overweight only if they were formula fed and/or were overfed, not if they were breastfed. Mothers views were not negatively influenced by others who mentioned that their child was either “big” or “small” and only one mother had been told her infant was overweight. A majority of mothers thought an infant could be physically active. When discussing infant activity, mothers primarily referred to it in terms of general mobility and a few thought activity level was related to a personality characteristic. Mothers intended to promote physical activity in the future either through outdoor play or specific organized activities such as sports. Despite a majority of mothers stating they were currently physically active themselves, only a few talked about interacting with their infant to promote their infant’s physical activity.

Conclusions

Efforts are needed by healthcare professionals and other public health professionals to inform mothers about the dangers of increased weight during infancy as well as the importance of interacting with infants to promote physical activity.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4503-5) contains supplementary material, which is available to authorized users.