Impact of the 'Healthy Youngsters, Healthy Dads' program on physical activity and other health behaviours: a randomised controlled trial involving fathers and their preschool-aged children

Influence of physical activity home environment on fundamental movement skills development in Chinese preschoolers: mediating role of moderate-to-vigorous physical activity

Background

Research on how the physical activity home environment affects fundamental movement skills (FMS) in preschool children in China is limited. However, the role of moderate-to-vigorous physical activity (MVPA) in this relationship is still unclear. This study aims to analyze gender differences in FMS, explore associations between the physical activity home environment, MVPA, and FMS, and investigate MVPA's mediating role in these relationships.

Methods

We recruited 169 preschool children (95 boys, 74 girls; mean age 4.9 years) from four kindergartens in Hengyang, China. The Family Environment Scale on Motor Development for Preschool Urban Children (FESMPD) assessed physical activity home environment. Objective measurement of MVPA used ActiGraph wGT3-BT accelerometers. The Test of Gross Motor Development-3 (TGMD-3) evaluated FMS. Statistical analyses were conducted using the PROCESS macro in SPSS, with sociodemographic variables as controls.

Results

Boys exhibited significantly higher levels of MVPA, parenting style, locomotor skills, and object control skills compared to girls (P < 0.05). MVPA, parenting style, and FMS showed positive correlations (R = 0.355-0.568, P < 0.05). Similarly, MVPA was positively correlated with the physical activity home environment (β = 0.237-0.568, P < 0.05). Parenting style emerged as a significant predictor of children's MVPA levels (β = 0.956, P < 0.001), and MVPA was a predictor of the development ofFMS and its subdomains (β = 0.097-0.207, P < 0.05). Furthermore, MVPA partially mediated the relationship between parenting style and the development of FMS in preschool children. The physical environment was also a significant predictor of children's MVPA (β = 0.637, P < 0.05), and in turn, MVPA predicted the development of FMS and its subdomains (β = 0.188-0.343, P < 0.01). Notably, MVPA fully mediated the relationship between the physical environment and the development of FMS.

Conclusion

Overall, this study highlights the important roles of physical activity home environments and individual levels of MVPA in developing FMS in preschool children, noting significant gender differences. Parenting style greatly affects both MVPA and FMS development, while the physical environment fully mediates this relationship. Collaborative efforts among kindergartens, families, and communities are essential to support MVPA and improve FMS development.

Bridging Generations Through Movement: "How and Why" Intergenerational Programs Operate-A Systematic and Narrative Review

Well-being and social interaction are among the primary goals to be achieved for the elderly. Intergenerational physical activity (PA) has gained increasing attention due to its potential to encourage PA and social interaction, providing both social and physical benefits to both younger and older individuals. This review aimed to gain a deeper understanding of the potential roles of PA in facilitating intergenerational interactions and provide practical insights. Methods: Following PRISMA guidelines, the systematic review identified specific keywords to search for articles that met the chosen inclusion and exclusion criteria (n. 5 RCT articles, selected between 2009 and 2024), conducted by three independent reviewers. Scopus, PubMed, EBSCOhost, and Web of Science were consulted to identify relevant articles. Risk of bias was assessed using Cochrane RoB 2. For the narrative dissertation, articles were identified across three key areas of focus: types of PA, age groups, and intended goals. Results: Few studies have specifically implemented PA protocols in intergenerational relationships, and most have planned remote activities without monitoring outcomes. The main advantages of intergenerational PA are oriented towards the social and relational sphere rather than simple PA involvement. Conclusions: For the elderly, these programs may help mitigate age-related deficits, while children and adolescents, when adapting to their older counterparts, experience greater effectiveness when provided with clear guidance during shared activities. Considering the characteristics and needs of individuals of different ages, different activities must be proposed to obtain different results. The organization of workshops and preparatory sessions will help in facilitating relationships and interactions among participants.

The chain mediating role of family health and physical activity in the relationship between life satisfaction and health-promoting lifestyles among young adults in China

Background

Unhealthy lifestyles during adolescence are significant factors leading to chronic diseases in the future. Enhancing health-promoting lifestyles among young adults in China is crucial for preventing and reducing the risk factors of chronic diseases.

Objective

This study aims to explore the relationships between life satisfaction, family health, physical activity, and health-promoting lifestyles among young adults in China. It also seeks to confirm the chain mediation role of family health and physical activity in the influence of life satisfaction on health-promoting lifestyles in this population.

Methods

This study, conducted from August 2023 to November 2023, employed a random sampling method to recruit young adult participants aged 18-40 in the southwestern region of China. Variables were measured using the Satisfaction with Life Scale (SWLS), the Family Health Scale-Short Form (FHS-SF), the Physical Activity Rating Scale-3 (PARS-3), and the Health-Promoting Lifestyle Profile II Revised (HPLP-IIR). Data analysis was performed using SPSS 27.0 and the PROCESS macro version 4.1.

Results

The results indicated that life satisfaction was positively correlated with family health (r = 0.225), physical activity (r = 0.245), and health-promoting lifestyles (r = 0.506). Family health was positively correlated with physical activity (r = 0.320) and health-promoting lifestyles (r = 0.312). Physical activity was positively correlated with health-promoting lifestyles (r = 0.429). Additionally, life satisfaction could influence health-promoting lifestyles directly (effect = 0.369) and through three mediation pathways: (a) family health (effect = 0.033); (b) physical activity (effect = 0.050); (c) family health and physical activity (effect = 0.020).

Conclusion

This study supports the mediating role of family health and physical activity in the influence of life satisfaction on health behaviors among young adults in China. Therefore, we recommend that future public health initiatives place greater emphasis on family health and create conditions that facilitate physical activity for this group. This could be an important direction for further enhancing health-promoting lifestyles among young adults in China.

Multistakeholder Perspectives on the Determinants of Family Fundamental Movement Skills Practice: A Qualitative Systematic Review

BACKGROUND

Childhood obesity is a significant public health crisis that is exposing children to associated morbidities and premature mortality. However, parents can positively influence physical activity trajectories and improve health outcomes by nurturing fundamental movement skills (FMS) in children. This is the first study to explore the determinants of family FMS practice via a systematic synthesis of qualitative evidence.

METHODS

Keyword searches were completed in SPORTDiscus, PubMed, Scopus, Web of Science, and Embase. Studies that offered perspectives relating to influences on the FMS of 2-6-year-old children in the family context via qualitative approaches, including visual methodologies that provided an important voice to children, were included. A thematic analysis was used to establish key themes.

RESULTS

The emergent themes included parent knowledge and beliefs, self-efficacy of parents to teach, and the home environment. Parents often undervalued FMS and lacked the self-efficacy to teach due to poor understanding, conflicting priorities, and multifaceted societal influences. Children preferred autonomous play and socialisation but were negatively influenced by technology and restrictive household rules.

CONCLUSIONS

Greater knowledge exchange between stakeholders is necessary to empower parents and enhance FMS application at home. More community initiatives could facilitate greater access to outdoor spaces, facilities, and equipment, which may improve family engagement with FMS.

Effectiveness of a Social-Media-Based Diet and Physical Activity Programme for Fathers in Japan: A Randomised Controlled Trial

Provision of healthy lifestyle support for fathers can improve the lifestyles and health awareness of not only fathers but also their children and families. Few studies have examined the effectiveness of education targeting healthy fathers provided via social media. Hence, we aimed to clarify the effects of providing fathers with information on healthy lifestyle habits via social media on their awareness and behaviours regarding diet, physical activity, and healthcare, in addition to such a programme's indirect effects on their children. This randomised controlled trial included 73 fathers of primary school children in Japan. The intervention group received information on 'healthy lifestyle', 'lifestyle-related diseases', 'healthy diet', and 'healthy physical activity' via social media six times every 2 weeks. Data were collected before, 3 months after, and 4 months after the intervention. The intervention was effective in improving some awareness regarding diet, physical activity, and healthcare. In addition, the fathers in the intervention group demonstrated significantly improved interest in their child's diet and exercise habits. Social-media-based diet and physical activity programmes for fathers improved their awareness and behaviour. Therefore, social-media-based health education programmes can be an important tool for increasing fathers' interest in their own health and in their children's lifestyles.

"Establishing healthy habits and lifestyles early is very important": parental views of brain health literacy on dementia prevention in preschool and primary school children

Introduction

Parents have the potential to drive healthy lifestyle behaviors through educational initiatives. This study aims to understand the prevalent thoughts and perceptions parents have toward brain health educational programs for preschool and primary school settings, whilst also contributing to a comprehensive understanding of the role parents can play in the broader context of dementia reduction strategies and the cultivation of brain health awareness among children.

Methods

Parents with children aged between 2 and 11 years old were interviewed about their current knowledge of dementia, prior beliefs, current lifestyle factors and opinions on educating their children from a young age on the topic of dementia literacy. Thematic deductive analysis was employed to systematically categorize and interpret the qualitative data obtained from these interviews.

Results

Thirty parents (M age = 38.6, SD = 4.9, Range = 32-48) identified three core themes on nurturing bodies and minds (e.g., conceptualizing the link between intellectual engagement, continuous learning, and the prevention of cognitive decline), brain health literacy (e.g., current knowledge and awareness of brain health, dementia and associated stigma, and provision of age-appropriate health literacy) and parental concerns (i.e., barriers to initiating conversations about dementia with children and strategies to address and alleviate parental concerns). Parents possessing prior knowledge of dementia and its modifiable risk factors exhibited greater propensity to educate their children on the associated risk factors.

Conclusion

Our study highlights the vital influence of parents' experiences, health literacy, and education on the acceptance of brain health education for children. Future interventions should target stigma reduction, enhance awareness, and offer accessible information on modifiable dementia risk factors, enabling a conducive environment for active parental involvement in educating children about brain health and contributing to future well-being.

Replicability, adaptability and long-term impact of the 'Healthy Youngsters, Healthy Dads' program in Newcastle, Australia

'Healthy Youngsters, Healthy Dads' (HYHD) targets fathers to improve the health of their preschool-aged children. In a previous randomized trial, fathers and children experienced meaningful improvements in physical activity and eating behaviours. The next phase is to test the replicability and adaptability of HYHD when delivered in the community by trained facilitators. Fathers/father-figures and children aged 3-5 years were recruited from Newcastle, Australia into a 9-week, non-randomized trial with assessments at baseline, 10 weeks, and 12 months. The primary outcome was achievement of pre-registered targets for recruitment (≥ 96 dyads), attendance (≥ 70%), compliance (completing ≥ 70% of home-based tasks), fidelity (≥ 80% of content delivered as intended) and program satisfaction (≥ 4/5). Secondary outcomes included physical activity, nutrition, screen time and parenting measures. Process targets were surpassed for recruitment (140 fathers, 141 children), attendance (79% for fathers-only workshops, 81% for father-child sessions), compliance (80% of home-tasks completed), fidelity (99% for education, ≥ 97% for practical) and program satisfaction (4.8/5). Mixed effects regression models revealed significant effects in fathers for moderate-to-vigorous physical activity, co-physical activity, dietary intake and parenting practises, which were maintained at 12 months. Significant effects were also established for screen time at 10 weeks only. For children, significant effects were observed for screen time and dietary intake at 10 weeks, while effects on energy-dense, nutrient-poor foods and healthy, nutrient-dense core food intake were maintained at 12 months. Findings demonstrate the replicability and adaptability of HYHD when delivered in the community by local trained facilitators. Further investigation into how to optimally scale-up HYHD is warranted.

Effects of structured and unstructured interventions on fundamental motor skills in preschool children: a meta-analysis

Background

It has been suggested that higher levels of fundamental motor skills (FMS) promote the physical health of preschool-aged children. The impacts of structured and unstructured interventions on FMS in children aged 10-16 years have been widely acknowledged in previous studies. However, there is a lack of relevant studies in preschool-aged children.

Objective

This meta-analysis aimed to compare the effects of structured and unstructured interventions on FMS in preschool-aged children.

Methods

The PubMed, Web of Science, and Google Scholar databases were searched from inception to 1 November 2023 to identify experiments describing structured and unstructured interventions for FMS in preschool-aged children. The Downs and Black Checklist was used to assess the risk of bias. A random effects model was used for the meta-analysis to evaluate the pooled effects of interventions on FMS. Subgroup analyses based on the duration and characteristics of the intervention were conducted to identify sources of heterogeneity.

Results

A total of 23 studies with 4,068 participants were included. There were 12 studies examining structured interventions, 9 studies examining unstructured interventions, and 6 studies comparing structured vs. unstructured interventions. The risk of bias in the included studies was generally low. All interventions significantly improved FMS in preschool-aged children compared to control treatments (p < 0.05). Structured interventions had more significant effects on locomotor skills (LMSs) in preschool-aged children than unstructured interventions (Hedges' g = 0.44, p = 0.04). The effects of structured interventions were strongly influenced by the total intervention duration, such that long-term interventions were more effective (Hedge's g = 1.29, p < 0.001).

Conclusion

Structured interventions play a crucial role in enhancing FMS among young children, especially when considering LMSs. These interventions require consistent and repeated practice over time to reach proficiency.

Systematic review registration

PROSPERO, identifier number CRD42023475088, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023475088.

Designing Child Nutrition Interventions to Engage Fathers: Qualitative Analysis of Interviews and Co-Design Workshops

BACKGROUND

Fathers play a pivotal role in parenting and child feeding, but they remain underrepresented in intervention studies, especially those focused on disadvantaged populations. A better understanding of fathers' experiences and needs regarding support access and child nutrition information in the context of disadvantage can inform future interventions engaging fathers.

OBJECTIVE

This study aims to explore fathers' experiences; perceived enablers; and barriers to accessing support and information related to parenting, child feeding, and nutrition and to co-design principles for tailoring child nutrition interventions to engage fathers.

METHODS

Australian fathers of children aged 6 months to 5 years with lived experience of disadvantage participated in semistructured interviews and co-design workshops, primarily conducted via videoconference. Creative analogies were used to guide the ideation process in the workshops.

RESULTS

A total of 25 interviews and 3 workshops (n=10 participants) were conducted, with data analyzed using reflexive thematic analysis and the Capability, Opportunity, and Motivation-Behavior model. The interview data illuminated factors influencing fathers' initiation in seeking support for parenting, child feeding, and nutrition, including their experiences. It highlighted fathers' diverse information needs and the importance of an inclusive environment and encouragement. Enablers and barriers in accessing support related to parenting and child nutrition were identified at the individual (eg, personal goals and resource constraints), interpersonal (family support and false beliefs about men's caregiving role), organizational (inadequate fathering support), and systemic levels (father-inclusive practice and policy). Digital data collection methods enabled Australia-wide participation, overcoming work and capacity barriers. Videoconferencing technology was effectively used to engage fathers creatively. Key principles for engaging fathers were co-designed from the workshop data. Interventions and resources need to be father specific, child centered, and culturally appropriate; promote empowerment and collaboration; and provide actionable and accessible strategies on the what and how of child feeding. Fathers preferred multiformat implementation, which harnesses technology-based design (eg, websites and mobile apps) and gamification. It should be tailored to the child's age and targeted at fathers using comprehensive promotion strategies.

CONCLUSIONS

Fathers faced barriers to accessing support and information related to parenting and feeding that may not adequately address their needs. Future interventions could integrate the co-designed principles to engage fathers effectively. These findings have implications for health service delivery and policy development, promoting father-inclusive practice.

Interactive Malaysian Childhood Healthy Lifestyle (i-MaCHeL) programme: a single-arm pilot study

BACKGROUND

The growing obesity epidemic in Malaysia presents a public health challenge that requires innovative intervention strategies. In an effort to address this problem, an Interactive Malaysian Childhood Healthy Lifestyle (i-MaCHeL) programme, which is a web-based initiative designed for preschool child-parent dyads offers a novel approach. Nevertheless, the success of such a web-based intervention depends on several interrelated factors. This research aims to examine the feasibility of i-MaCHeL in the Malaysian context, its usability for preschool child-parent dyads, and the acceptability of the programme among these user groups.

METHODS

This was a single-arm pilot study involving 46 child-parent dyads recruited from six government preschools in Terengganu, Malaysia. The preschools were selected using a cluster random sampling technique at the preschool level. The intervention feasibility was determined based on the retention rate of participants in the pilot study. The System Usability Scale (SUS) and intervention process evaluation were used to assess the usability and acceptability of the web-based i-MaCHeL programme.

RESULTS

The retention data demonstrated that 42 out of 46 participants completed the 13-week intervention programme, which showed that the overall retention rate was 91.3%. A mean (SD) SUS score of 84.70 (13.82) was obtained from parents, indicating that the web-based i-MaCHeL had an acceptable usability level. The mean scores of the process evaluation items ranged from 4.52 (0.63) to 4.83 (0.38), demonstrating that the web-based i-MaCHeL was highly accepted by the parents. The acceptability data also indicated that at least 92.9% (39/42) of the parents agreed/strongly agreed that the web content, programme duration, intervention dose, WhatsApp group, and delivery mode were appropriate.

CONCLUSIONS

According to these findings, the i-MaCHeL intervention using a web-based approach was feasible, usable, and acceptable as part of a weight-related behaviour change intervention for preschool child-parent dyads. This pilot study demonstrated that the web-based i-MaCHeL was feasible and promising for delivering weight-related behavioural intervention to child-parent dyads.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04711525 . Registered on January 15, 2021.

Early childhood (1-5 years) obesity prevention: A systematic review of family-based multicomponent behavioral interventions

INTRODUCTION

Globally 38.9 million children under age 5 have overweight or obesity, leading to type 2 diabetes, cardiovascular complications, depression, and poor educational outcomes. Obesity is difficult to reverse and lifestyle behaviors (healthy or unhealthy) can persist from 1.5 years of age. Targeting caregivers to help address modifiable behaviors may offer a viable solution.

OBJECTIVE

Evaluate the impact of multicomponent family interventions on weight-based outcomes in early childhood and explore related secondary behavior outcomes.

METHODS

Four databases were searched (1/2017-6/2022) for randomized controlled trials (RCTs) of obesity-prevention interventions for children (1-5 years). Eligible studies included an objectively measured weight-based outcome, family interventions targeting the caregiver or family, and interventions including at least two behavioral components of nutrition, physical activity, or sleep.

RESULTS

Eleven interventions were identified consisting of four delivery modes: self-guided (n = 3), face-to-face group instruction (n = 3), face-to-face home visits (n = 2), and multiple levels of influence (n = 3). The reviewed studies reported almost no significant effects on child weight-based outcomes. Only two studies (one was an underpowered pilot study) resulted in significant positive child weight-management outcomes. Seven of the interventions significantly improved children's dietary intake.

CONCLUSION

Except for one, the reviewed studies reported that family based interventions had no significant effects on child weight-based outcomes. Future studies of this type should include measurements of age and sex-based body mass index (BMI) and trajectories, and also examine other important benefits to the children and families.

Indian fathers are involved in nurturing healthy behaviours in adolescents: A qualitative inquiry

BACKGROUND

Indian adolescents exhibit unhealthy food behaviours and inactive lifestyles which increase their risk of developing obesity and associated negative health consequences. The family food environment represents a vital setting to nurture healthy lifestyle behaviours in adolescents, with parents influencing their adolescents' dietary and physical activity behaviours. Yet, much of the existing evidence exploring parental influences predominantly focuses on mothers while fathers' engagement in instilling healthy dietary and physical activity behaviours is understudied, more so in the context of developing economies like India. Therefore, this qualitative study was designed to understand Indian fathers' views on instilling healthy behaviours in their children.

METHODS

Convenience sampling along with snowball sampling techniques were employed to recruit fathers of adolescents aged 10-19 years from Kolkata city, India. Informed by the research aim and review of literature, an interview guide was developed and pre-tested. Interviews were carried out either in person or virtually (Zoom/telephone) in English/Hindi/Bengali as per the preference of the participants. All interactions were audio recorded, transcribed verbatim, and translated to English for the purpose of data analysis. The transcripts were analysed thematically using NVivo software program. Themes were identified using both inductive and deductive approaches.

RESULTS

A total 36 fathers participated in the interviews. Seven main themes were identified: (i) Involvement of fathers in adolescent upbringing (i.e. engagement in meal preparation, food shopping, educational activities, physical activity); (ii) Family food environment (i.e. setting food rules, having meals with children, making food available); (iii) Challenges to instilling healthy behaviours in adolescents (i.e. adolescents' sedentary lifestyle and liking for unhealthy foods); (iv) Barriers to routine involvement in adolescent upbringing (i.e. time constraints due to paid employment, poor socio-economic status); (v) Adolescent nutrition education: (vi) Dual burden of malnutrition (i.e. awareness of malnutrition, no knowledge about government-led health programs for adolescents); (vii) Paternal knowledge.

CONCLUSIONS

The emerging themes reveal that Indian fathers played a crucial role in instilling healthy dietary and physical activity behaviour in their adolescents through various parenting practices such as purchasing nutritious food, enforcing food rules, disseminating nutrition-related knowledge, and encouraging adolescents to participate in moderate-to-vigorous intensity outdoor sports. This provides strong support for the inclusion of fathers in sustainable family-focused lifestyle interventions to maximise the nurturing care required by adolescents as well as assist in normalising the representation of fathers in health and welfare policies designed for adolescents.

Effectiveness of utilizing step-monitoring devices to prevent and treat obesity in children and adolescents: A systematic review and meta-analysis

Background

Children and adolescents who are overweight and obese represent a growing public health issue. The use of step-monitoring devices as an intervention tool may be a simple, cost-effective, and easily replicable solution for addressing obesity in children and adolescents. No prior systematic reviews have evaluated the effectiveness of utilizing step-monitoring devices as an intervention method for obesity in children and adolescents.

Methods

Previous studies on using step-monitoring devices to prevent and treat obesity in children and adolescents were identified in the following databases: Web of Science, EMBASE, PubMed, Cochrane Library, SPORTDiscus, and SCOPUS. The search period for each database ranged from the year of their inception to 8 March 2023 (updated in June 2024). Meta-analyses were performed for mean differences (MDs) in body mass index (BMI), BMI z-score (BMI-Z), body fat, waist circumference, and body weight.

Results

From 12,907 relevant records, 23 studies were included in this meta-analysis. The included studies were mainly at low risk of bias, except for blinding. Step-monitoring device-based interventions had significant effects in reducing BMI-Z (MD -0.06; 95% CI -0.10 to -0.02), body fat (MD -0.95%; 95% CI -1.35 to -0.54), and body weight (MD -1.23 kg; 95% CI -2.36 to -0.10). However, there was no significant effect on BMI (MD -0.16 kg/m2; 95% CI -0.55 to 0.22) and waist circumference (MD -0.33 cm; 95% CI -1.23 to 0.58). Subgroup analyses indicated that participants who were overweight or obese showed greater intervention effects on BMI and BMI-Z compared to participants with normal weight. The programs with an intervention duration of ≤6 months presented a greater intervention effect on BMI-Z than those with an intervention duration of more than 6 months. The programs that established goals had a greater intervention effect on body fat than those that did not.

Conclusions

Step-monitoring devices may be an effective and generalizable intervention tool for the prevention and treatment of obesity in children and adolescents. Future studies should further explore how to set step goals and the duration of interventions to achieve better intervention effects.

Direct Parent Engagement to Improve Fundamental Movement Skills in Children: A Systematic Review

Fundamental movement skills (FMS) are basic movements in children that represent the building blocks for more complex motor skill development and act as a prerequisite for enduring sport and physical activity (PA) engagement and positive health-related behaviours. The FMS proficiency is currently inadequate worldwide, and consequently there are alarming levels of inactivity and childhood obesity. However, parents are role models to their children and possess the power to influence their PA behaviour. This review investigated if parent-focused interventions could improve FMS in 2-7-year-old children and evaluated which setting and method of parent engagement was most impactful. Keyword searches were conducted via Scopus, Web of Science, SPORTDiscus, PubMed, Science Direct, and Google Scholar. Only nine articles met the inclusion criteria. No research originated from the United Kingdom, highlighting the urgent need for further FMS interventions involving parents. The FMS improved in all nine studies, with significant changes in seven of the articles (p < 0.05). Parent-child co-activity, the education and empowerment of parents, and the provision of clear FMS guidance, messaging, and structure can positively influence children's FMS. Recently, smartphone apps have increased the feasibility and accessibility of FMS practice at home and may be integral to future interventions. Further research with direct parental involvement is clearly warranted.