Association of Father Involvement and Neighborhood Quality with Kindergartners' Physical Activity: A Multilevel Structural Equation Model

Do maternal and paternal education protect against developmental delays?

BACKGROUND

Parental education is linked to child development and wellbeing, but unique and combined contributions of maternal and paternal education have rarely been studied.

AIMS

This study assessed the individual and joint associations of maternal and paternal education on children's odds of a probable developmental delay.

METHODS AND PROCEDURES

Mothers (N = 3566) from the Upstate KIDS cohort study reported on theirs and the father's highest level of education and completed the Ages and Stages Questionnaires up to 7 times when the child was 4- to 36-months-old. A nonparametric constrained inference technique assessed the association between education and probable developmental delays.

OUTCOMES AND RESULTS

Higher levels of maternal and paternal education were protective against child probable developmental delays in years 2 (18, 24 months; p-trends<.001) and 3 (30, 36 months; p-trends<.001), but not year 1 (4, 8, 12 months; p-trend=.486-.832). Trends held adjusting for parental age and race. When adjusting for the other parent's education, only maternal education had unique associations with delays. Among parents with the same or similar education levels, when both parents had one level higher education it was also protective.

CONCLUSIONS AND IMPLICATIONS

Both maternal and paternal education may protect against children's developmental delays in toddlerhood, but maternal education may be particularly important.

Bridging the Built and Social Environments: A Systematic Review of Studies Investigating Influences on Physical Activity

BACKGROUND

The purpose of this review was to examine articles assessing aspects of the built and social environment simultaneously, and how these environments influence physical activity (PA). A thorough review of studies is needed to identify patterns across studies and gaps for future research and practice.

METHODS

To be included, articles needed to contain: (1) self-report or objective measure of PA; (2) a measure of the built environment; (3) a measure of the social environment; and (4) an analysis between built environment, social environment, and PA. A systematic literature search of 4358 articles resulted in 87 articles.

RESULTS

Several populations were present within the sample including various age groups and different countries. As previously established, the built environment and social environment were consistently associated with PA; however, mediating factors between these 2 layers were less clear. Further, there was a lack of longitudinal and experimental study designs.

CONCLUSIONS

Results suggest a need for longitudinal and experimental designs with validated and granular measures. As communities recover from the COVID-19 pandemic, a thorough understanding of how built environment factors enhance or detract from social connectedness and how this reciprocal relationship impacts PA behavior is needed for future policy, environment, and systematic change.

Birth intentions among US fathers with disabilities

BACKGROUND

Men's birth intention is an indicator of their sexual health and plays an important role for their child's health and development; however, birth intendedness in fathers with disabilities has been unknown.

OBJECTIVE

This study examines disparities in birth intendedness among fathers with and without disabilities and explores whether the differences vary by marital status or race/ethnicity.

METHODS

Data from the 2011-2017 National Survey of Family Growth (NSFG) were used to examine pregnancy intendedness for fathers with (n = 380) and without disabilities (n = 1,324) about their last birth in the five years preceding the interview. Multinomial regression models estimated the odds ratios of fathers' disability status on birth intention controlling for covariates. Interaction effects of disability status by marital status or race/ethnicity were also tested.

RESULTS

Fathers with disabilities were 1.89 (95% CI = 1.21, 2.95) times as likely to report their last birth as unwanted versus intended compared to those without disabilities after adjusting for covariates. Although married fathers without disabilities were less likely to report unintended birth than their unmarried counterparts, the protective effect of marriage was not evident among fathers with disabilities.

CONCLUSIONS

Disabled fathers are at a higher risk of unintended birth compared to nondisabled fathers. These findings highlight the need to increase access to family planning services for disabled men. Further research is needed to better understand the risk factors that contribute to disabled fathers' unintended birth and how these are linked to their child and family well-being.

Associations among Early Exposure to Neighborhood Disorder, Fathers' Early Involvement, and Children's Internalizing and Externalizing Problems

PURPOSE

This study aimed to examine (1) the effects of early exposure to neighborhood disorder and fathers' early involvement on children's long-term internalizing and externalizing problems, and (2) whether fathers' early involvement buffered effects of early exposure to neighborhood disorder on children's internalizing and externalizing problems.

METHOD

We used five waves of Fragile Family and Child Wellbeing study data and conducted multi-level longitudinal mixed-effects models to examine relationships among early exposure to neighborhood disorder, fathers' early involvement, and children's internalizing and externalizing problems.

RESULTS

Results indicated that early exposure to neighborhood disorder was associated with increased children's internalizing and externalizing problems, while fathers' early involvement was associated with decreased children's internalizing and externalizing problems. However, fathers' early involvement did not buffer the negative effects of early exposure to neighborhood disorder on children's internalizing and externalizing problems.

DISCUSSION

The findings suggest the importance of neighborhood order and fathers' early involvement in decreasing children's internalizing and externalizing problems. Developing neighborhood-level interventions and improving fathers' involvement in early childhood are potential strategies to prevent children's behavioral problems in the long term.

Predictors of Latinx Youth Health and Emotional Well-being: Social Determinants of Health Perspective

Latinx youth disproportionately experience numerous negative social determinants of health (SDOH) that can have deleterious impacts on health outcomes. Yet, limited research is available on the role of SDOH on the well-being of Latinx adolescents. Utilizing data from the Fragile Families and Child Wellbeing Study, this study examined the association between variables representing five discrete domains of SDOH and health and emotional well-being outcomes among youth of Latinx mothers (N = 745). The study included 15-year-old youth of Latina mothers who were retained in the most recent wave of data collection (wave 6). Using Mplus8, we performed structural equation modeling to determine whether exogenous indicators of five domains of SDOH (economic stability, education, neighborhood and built environment, social and community context, and health care access) predicted adolescent health status and emotional well-being. SDOH specific to social, educational, and neighborhood factors emerged as significant predictors of health and well-being. Yet, variation existed in regard to which SDOH were most important for each outcome variable. Findings suggest that several SDOH, including economic stability, education, neighborhood and built environment, and social and community context, are particularly important for Latinx adolescent well-being. Implications for social work practice and policy are presented. Future studies should examine the longitudinal impact of SDOH and should examine Latinx youth by nativity.

Assessing Maternal Support for Physical Activity in Latina Adolescents

Objectives: We developed a comprehensive measure to evaluate 11 domains of maternal social support for physical activity (PA) among Latina adolescents. Methods: The 26-item questionnaire included a version for mothers to rate how often they engaged in behaviors supporting their daughters' PA, and a version for daughters to rate how often their mothers engaged in the same behaviors. Bivariate correlations examined associations between mother-daughter perceived support for daughter's moderate-to-vigorous PA (MVPA), and associations between daughter's perceived support for PA and current MVPA. Results: Twenty-one Latina adolescents, which included 20 adolescent-mother dyads, enrolled in the study. Mother-daughter ratings of support showed significant positive correlations for reminders (r = .573, p = .01), watching daughters' sports (r = .566, p = .01), limit-setting (r = .564, p = .01), encouragement (r = .561, p = .01), transportation (r = .544, p = .02). We found statistically significant associations between MVPA and daughters' ratings of their mothers valuing (r = .544, p = .02) and facilitating PA (r = .48, p = .05). Conclusions: Mothers accurately perceive several supportive behaviors for PA given to daughters, but only daughters' perception of received support predicts their MVPA.

The neighborhood social environment and physical activity: a systematic scoping review

BACKGROUND

Investigating the association of the neighborhood social environment on physical activity is complex. A systematic scoping review was performed to (1) provide an inventory of studies assessing the influence of the neighborhood social environment on physical activity since 2006; (2) describe methodologies employed; and (3) formulate recommendations for the field.

METHODS

Two databases were searched using terms related to 'physical activity,' 'neighborhood,' and 'social environment' in January 2017. Eligibility criteria included: 1) physical activity as an outcome; 2) neighborhood social environment as a predictor; 3) healthy population (without diagnosed clinical condition or special population); 4) observational or experimental design. Of 1352 studies identified, 181 were included. Textual data relevant to the social environment measurement and analysis were extracted from each article into qualitative software (MAXQDA) and coded to identify social environmental constructs, measurement methods, level of measurement (individual vs. aggregated to neighborhood), and whether authors explicitly recognized the construct as the social environment. The following measures were generated for each construct: number of unique measurements; % of times measured at an aggregate level; % of times authors referred to the construct as the social environment. Social environmental constructs were then grouped into larger descriptive dimensions.

RESULTS/FINDINGS

Fifty-nine social environmental constructs were identified and grouped into 9 dimensions: Crime & Safety (n = 133 studies; included in 73% of studies); Economic & Social Disadvantage (n = 55, 33%); Social Cohesion & Capital (n = 47, 26%); Social Relationships (n = 22, 12%); Social Environment (n = 16, 9%); Disorder & Incivilities (n = 15, 8%); Sense of Place/Belonging (n = 8, 4%); Discrimination/Segregation (n = 3, 2%); Civic Participation & Engagement (n = 2, 1%). Across all articles, the social environment was measured using 176 different methods, was measured at an aggregate-level 38% of the time, and referred to as the social environment 23% of the time.

CONCLUSIONS

Inconsistent terminology, definitions, and measurement of the social environment and the lack of explicit language identifying constructs as the social environment make it challenging to compare results across studies and draw conclusions. Improvements are needed to increase our understanding of social environmental correlates and/or determinants of physical activity and facilitate cross-disciplinary conversations necessary to effectively intervene to promote physical activity.

TRIAL REGISTRATION

PROSPERO CRD42017059580.

Do physical activity and screen time mediate the association between European fathers' and their children's weight status? Cross-sectional data from the Feel4Diabetes-study

BACKGROUND

Most research on parenting and childhood obesity and obesity-related behaviours has focused on mothers while fathers have been underrepresented. Yet, recent literature has suggested that fathers uniquely influence their children's lifestyle behaviours, and hence could also affect their weight status, but this has not yet been scientifically proven. Therefore, the present study aimed to determine whether the association between fathers' weight status and their children's weight status is mediated by fathers' and children's movement behaviours (i.e. physical activity (PA) and screen time (ST)).

METHODS

Cross-sectional data of 899 European fathers and their children were analyzed. Fathers/male caregivers (mean age = 43.79 ± 5.92 years, mean BMI = 27.08 ± 3.95) completed a questionnaire assessing their own and their children's (mean age = 8.19 ± 0.99 years, 50.90% boys, mean BMIzscore = 0.44 ± 1.07) movement behaviours. Body Mass Index (BMI, in kg/m2) was calculated based on self-reported (fathers) and objectively measured (children) height and weight. For children, BMI z-scores (SD scores) were calculated to obtain an optimal measure for their weight status. Serial mediation analyses were performed using IBM SPSS 25.0 Statistics for Windows to test whether the association between fathers' BMI and children's BMI is mediated by fathers' PA and children's PA (model 1) and fathers' ST and children's ST (model 2), respectively.

RESULTS

The present study showed a (partial) mediation effect of fathers' PA and children's PA (but not father's ST and children's ST) on the association between fathers' BMI and children's BMI (model for PA; coefficient: 0.001, 95% CI: [0.0001, 0.002]; model for ST; coefficient: 0.001, 95% CI: [0.000, 0.002]). Furthermore, fathers' movement behaviours (PA and ST) were positively associated with their children's movement behaviours (PA and ST) (model for PA, coefficient: 0.281, SE: 0.023, p < 0.001; model for ST, coefficient: 0.345, SE: 0.025, p < 0.001).

CONCLUSIONS

These findings indicate that the influence of fathers on their children's weight status partially occurs through the association between fathers' PA and children's PA (but not their ST). As such, intervening by focusing on PA of fathers but preferably of both members of the father-child dyad (e.g. engaging fathers and their children in co-PA) might be a novel and potentially effective strategy for interventions aiming to prevent childhood overweight and obesity. Longitudinal studies or intervention studies confirming these findings are however warranted to make meaningful recommendations for health intervention and policy.

TRIAL REGISTRATION

The Feel4Diabetes-study is registered with the clinical trials registry http://clinicaltrials.gov , ID: 643708 .

Exploring the Effect of Perceptions on Children's Physical Activity in Varying Geographic Contexts: Using a Structural Equation Modelling Approach to Examine a Cross-Sectional Dataset

Most Canadian children are not meeting the recommended 60 min of moderate-to-vigorous physical activity per day. Research suggests that children’s perceptions of their environment have an influence on their physical activity behaviours, but there is a lack of generalizability among previous work. The purpose of this study was to assess the mediating effect of children’s perceptions of barriers to physical activity on the relationship between their environments and their level of moderate-to-vigorous physical activity (measured with accelerometers). Structural equation modelling stratified by gender was used to assess the research objective in a sample of 546 participants aged 8–14 years old from Northwestern and Southwestern Ontario, Canada. In both models stratified by gender, perceptions of barriers did not significantly mediate the relationship between urbanicity and physical activity. Independent of all other factors, there was no significant relationship between urbanicity and physical activity in girls, but there was in boys. These results offer insight into potential processes by which perceptions impact physical activity and provide initial information to further our understanding of the behavioural aspects of physical activity through multiple levels of analysis. Researchers must continue to improve efforts for quantifying the experience of children’s daily activity contexts.

Context Matters: Examining children's perceived barriers to physical activity across varying Canadian environments

Children's perceptions of their environment have been associated with their physical activity (PA) levels, however a better understanding of the formation of perceptions within different contexts is needed. This will help to inform decision making related to physical inactivity trends in Canadian children. We examined socio-ecological factors influencing children's perceptions of barriers to PA in Ontario, Canada. Binary logistic regression models measured the relationship between perceptions of barriers and PA for 892 children in Ontario. At the intrapersonal level, girls reported the most barriers to PA. Interpersonally, children whose mother was employed reported the most barriers. At the physical environment level, children in urban and suburban neighbourhoods of large cities, and rural areas reported the most barriers, differing relative to population size. The major contribution of this paper is a new perspective of environmental influences on children's perceptions of PA, using an urbanicity spectrum, and highlighting place specific needs of Canadian children.

Neighbourhoods and obesity: A prospective study of characteristics of the built environment and their association with adiposity outcomes in children in Montreal, Canada

This paper examined prospective associations between built environment features assessed at baseline using direct audits and adiposity outcomes two years later in Montreal, Canada. Data stem from the Quebec Adipose and Lifestyle Investigation in Youth study of 630 children aged 8-10 years with a parental history of obesity. Baseline measurements took place between 2005 and 2008. Follow-up took place between 2008 and 2011. Built environment features were assessed at baseline in up to 10 contiguous street segments around participants' residential addresses using on-site audits. Analyses were restricted to participants who reported the same address both at baseline and follow-up. Prospective associations between adiposity outcomes at follow-up (BMI z-score and waist-height ratio) and built environment features at baseline (traffic-calming features, pedestrian aids, disorder, physical activity facilities, convenience stores, and fast-food restaurants) were examined using multivariable regression models. 391 children were included in the analyses. In fully-adjusted models, children living in residential areas with presence of pedestrian aids had lower BMI z-score, and lower waist-height ratio. Also, children residing in residential areas with at least one convenience store had lower BMI z-score, and lower waist-height ratio at follow-up. Findings provide evidence of the potential role of street-level urban design features in shaping childhood adiposity. To better inform policy and intervention, future research should explore the possibility of reducing obesogenic neighbourhoods by enhancing street-level design features.

Accelerometer-Measured Patterns of Shared Physical Activity Among Mother-Young Child Dyads

BACKGROUND

Many mothers and young children are not meeting physical activity guidelines. Parent-child coparticipation in physical activity (ie, shared physical activity) provides opportunities for social modeling and might be associated with child physical activity. There is very little information about shared physical activity using objective measures.

METHODS

Participants (N = 17 mother-young child dyads) completed a demographic survey and height/weight measurements, and wore a Bluetooth^® accelerometer for 1 week. Accelerometers were initialized using the proximity function to yield both individual and proximity [a minute-by-minute log of whether the 2 accelerometers were in- or out-of-range (∼50 m or less)] data. Shared physical activity was calculated in MATLAB by overlaying individual and proximity accelerometer data.

RESULTS

Mother-child dyads spent approximately 2 hours per day in shared time that was mostly shared sedentary activities. Less than 1% of shared minutes per day were spent in shared moderate to vigorous physical activity.

CONCLUSIONS

Mothers and young children spent a small portion of their day in shared activities. Most mother-child shared time was spent in sedentary or light activities rather than moderate to vigorous physical activity. This method for objectively measuring shared physical activity provides novel information about the context in which physical activity occurs and could be used to understand patterns of physical activity among other dyads.

The Influence of Fathers on Children's Physical Activity and Dietary Behaviors: Insights, Recommendations and Future Directions

PURPOSE OF REVIEW

Although fathers have an important influence on their children's well-being, their unique influence on child lifestyle behaviors has been largely overlooked in the literature. To inform and encourage future research, this paper provides an overview of existing studies that have examined the influence of fathers on the physical activity and dietary behaviors of their children.

RECENT FINDINGS

While the available data indicate that fathers' behaviors and parenting practices likely play an important role in promoting healthy behaviors in children, the evidence base is limited by a reliance on observational designs and small, ungeneralizable samples. This paper also provides a summary of the methods, research findings, and experiential insights we have gained while conducting the "Healthy Dads, Healthy Kids" randomized controlled trials, which tested the efficacy and effectiveness of a socio-culturally targeted program that engages fathers to improve their own health and the health of their children. The paper concludes with a series of recommendations for recruiting and engaging fathers and a summary of directions for future research.

Associations between the physical activity levels of fathers and their children at 20 months, 3.5 and five years of age

Background

Early childhood (under five years of age) is a critical developmental period when children’s physical activity behaviours are shaped and when physical activity patterns begin to emerge. Physical activity levels track from early childhood through to adolescence with low levels of physical activity associated with poorer health. The aims of this study were to examine cross-sectional and longitudinal associations between the physical activity levels of fathers and their children at the ages of 20 months, 3.5 and 5 years, and to investigate whether these associations differed based on paternal body mass index (BMI) and education.

Methods

The Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program was a cluster randomized-controlled trial delivered to pre-existing first-time parent groups. Physical activity levels of fathers and their first-born children were assessed using the Active Australia Survey and ActiGraph accelerometers respectively. Cross-sectional associations between father and child physical activity behaviours were assessed at each time point. Longitudinal associations between father and child physical activity were also investigated from child age 20 months to both 3.5 and 5 years. Additional stratified analyses were conducted based on paternal BMI and paternal education as a proxy for socioeconomic position (SEP). Data from the control and interventions groups were pooled and all analyses adjusted for intervention status, clustering by first-time parent group and accelerometer wear time.

Results

Physical activity levels of fathers and their children at child age 20 months were not associated cross-sectionally or longitudinally at child age 3.5 and 5 years. Positive associations were observed between light physical activity of healthy weight fathers and children at age 3.5 years. Inverse associations were observed for moderate/vigorous physical activity between fathers and children at age 5 years, including between overweight/obese fathers and their children at this age in stratified analyses.

Conclusions

There were no clear associations between the physical activity of fathers and children. Future research should include the use of more robust measures of physical activity among fathers to allow in-depth assessment of their physical activity behaviours. Investigation of well-defined correlates of physical activity in young children is warranted to confirm these findings and further progress research in this field.

Maternal-child co-participation in physical activity-related behaviours: prevalence and cross-sectional associations with mothers and children's objectively assessed physical activity levels

BACKGROUND

Co-participation in physical activity may be a useful strategy for increasing physical activity in mothers and their young children, yet little empirical evidence exists on this topic for young families. This study aimed to identify the prevalence of mother-child co-participation in physical activity and examine the association between co-participatory behaviours and objectively-assessed physical activity in young children and their mothers.

METHODS

One-hundred twenty-three 4-6 year-old children and their mothers were recruited from preschools in Belgium between November 2010 and January 2011. Mothers completed a questionnaire assessing the frequency of co-participation in five activities. Both mothers and children wore ActiGraph GT1M accelerometers concurrently for 7 days to assess the time spent in moderate-to vigorous-intensity physical activity (MVPA) and light- to vigorous-intensity physical activity (LMVPA). Descriptive statistics (means, frequencies) were used to determine the prevalence of co-participation. Separate multiple linear regression analyses examined the association between co-participation and mothers' and children's physical activity on weekdays and weekends.

RESULTS

Most mothers reported infrequent co-participation in physical activities with their children. On weekdays, walking or cycling for short trips was positively associated with children's MVPA while attending a park or similar more than once per week was negatively associated with children's MVPA and LMVPA. Going to an indoor play centre together once or more per week was negatively associated with mother's LMVPA. On weekends, walking or cycling with their child in their free time was positively associated with both children's and mothers' MVPA and childrens' LMVPA. Going to an indoor play centre together 1-3 times/month was negatively associated with children's weekend MVPA.

CONCLUSIONS

Reported rates of co-participation in mothers and their preschool children were low. The association with maternal and child physical activity may be dependent on the co-participatory behaviour assessed and may differ between weekday and weekends. Promoting walking and cycling together during leisure time may be an effective strategy to increase both preschool children's and mothers' MVPA.

An Initiative to Facilitate Park Usage, Discovery, and Physical Activity Among Children and Adolescents in Greenville County, South Carolina, 2014

INTRODUCTION

Parks are important settings for increasing population-level physical activity (PA). The objective of this study was to evaluate Park Hop, an incentivized scavenger-hunt-style intervention designed to influence park usage, discovery, park-based PA, and perceptions of parks among children and adolescents in Greenville County, South Carolina.

METHODS

We used 2 data collection methods: matched preintervention and postintervention parent-completed surveys and in-park observations during 4 days near the midpoint of the intervention. We used paired-samples t tests and logistic regression to analyze changes in park visitation, perceptions, and PA.

RESULTS

Children and adolescents visited an average of 12.1 (of 19) Park Hop parks, and discovered an average of 4.6 venues. In a subset of participants, from preintervention to postintervention, the mean number of park visits increased from 5.0 visits to 6.1 visits, the proportion of time engaged in PA during the most recent park visit increased from 77% to 87%, and parents reported more positive perceptions of the quality of park amenities. We observed more children and adolescents (n = 586) in the 2 intervention parks than in the 2 matched control parks (n = 305). However, the likelihood of children and adolescents engaging in moderate-to-vigorous PA was significantly greater in the control parks (74.3%) than in Park Hop parks (64.2%).

CONCLUSION

Park Hop facilitated community-collaboration between park agencies and positively influenced park usage, park discovery, time engaged in PA during park visits, and perceptions of parks. This low-cost, replicable, and scalable model can be implemented across communities to facilitate youth and family-focused PA through parks.

Physical Activity During the Early Years: A Systematic Review of Correlates and Determinants

CONTEXT

Being physically active during the early years (age 0-6 years) is vital for healthy development. Identifying correlates and determinants of physical activity (PA) is crucial to guide effective interventions. This systematic review synthesized studies investigating potential correlates and determinants of PA during the early years, accounting for different types of PA assessment.

EVIDENCE ACQUISITION

Nine electronic databases were searched from inception year (1900) until September 2014; data were analyzed/interpreted in April 2015. The following inclusion criteria were used: written in English, published in peer-reviewed journals, participants not in statutory/school education, and an observational design investigating associations between an exposure/variable, and a quantitative measure of PA. Correlates/determinants of total, moderate to vigorous, and light PA were reported using an ecologic model.

EVIDENCE SYNTHESIS

Of 22,045 identified studies, 130 were included. All took place in high-income countries and few (6%) were of high quality. Correlates of total PA were sex (male, ++); parental PA (+); parental support (+); and time outdoors (+). Determinants of total PA were sex (+) and time spent playing with parents (+). The only correlate of moderate to vigorous PA was sex (male, ++). No determinants of moderate to vigorous or light PA were found. PA correlates/determinants were relatively consistent between objective and subjective PA measures.

CONCLUSIONS

Numerous studies investigated potential correlates and determinants of PA, but overall quality was low. A small number of demographic/biological and social/cultural factors were associated with PA. There is a need for high-quality studies exploring correlates/determinants across all domains of the ecologic model.

Write, draw, show, and tell: a child-centred dual methodology to explore perceptions of out-of-school physical activity

BACKGROUND

Research to increase children's physical activity and inform intervention design has, to date, largely underrepresented children's voices. Further, research has been limited to singular qualitative methods that overlook children's varied linguistic ability and interaction preference. The aim of this study was to use a novel combination of qualitative techniques to explore children's current views, experiences and perceptions of out-of-school physical activity as well as offering formative opinion about future intervention design.

METHODS

Write, draw, show and tell (WDST) groups were conducted with 35 children aged 10-11 years from 7 primary schools. Data were analysed through a deductive and inductive process, firstly using the Youth Physical Activity Promotion Model as a thematic framework, and then inductively to enable emergent themes to be further explored. Pen profiles were constructed representing key emergent themes.

RESULTS

The WDST combination of qualitative techniques generated complimentary interconnected data which both confirmed and uncovered new insights into factors relevant to children's out-of-school physical activity. Physical activity was most frequently associated with organised sports. Fun, enjoyment, competence, and physical activity provision were all important predictors of children's out-of-school physical activity. Paradoxically, parents served as both significant enablers (i.e. encouragement) and barriers (i.e. restricting participation) to physical activity participation. Some of these key findings would have otherwise remained hidden when compared to more traditional singular methods based approaches.

CONCLUSIONS

Parents are in a unique position to promote health promoting behaviours serving as role models, physical activity gatekeepers and choice architects. Given the strong socialising effect parents have on children's physical activity, family-based physical activity intervention may offer a promising alternative compared to traditional school-based approaches. Parents' qualitative input is important to supplement children's voices and inform future family-based intervention design. The WDST method developed here is an inclusive, interactive and child-centred methodology which facilitates the exploration of a wide range of topics and enhances data credibility.

Relationships of physical activity and sedentary time in obese parent-child dyads: a cross-sectional study

BACKGROUND

Research suggests physical activity is linked to obesity. Further, the physical activity of healthy parents and their children is associated with each other. However, this relationship has not been examined in obese parents and their obese children.

METHODS

The purpose of this study was to compare the physical activity and sedentary time of obese, low-income, ethnic minority parents and their children on weekdays and weekend days using accelerometry. Data were obtained from eight rural sites in the middle and eastern part of North Carolina (N.C.), United States (U.S.) from 2007-2010 using a rolling enrollment. One hundred and ninety-nine obese parents (94 % female) and their obese children (54 % female) wore accelerometers simultaneously for three weekdays and one weekend day. Total physical activity, moderate-to-vigorous physical activity (MVPA) and sedentary time and proportions were determined.

RESULTS

Parents' and children's total physical activity and MVPA levels were lower on weekend days than weekdays. Total counts per minute for children on weekdays and weekend days were greater than for parents (p < 0.001). Total counts per minute were more highly correlated on weekend days than weekdays (r = 0.352, p < 0.0002 versus r = 0.165, p < 0.025). Parents' performed MVPA for 14 (SD = ±25) and 9 (SD = ±16) minutes/day on weekdays and weekend days, respectively; children performed MVPA for 37 (SD = ±25) and 31(SD = ±38) minutes/day for weekdays and weekend days, respectively. Correlations between parents and children for MVPA were higher on weekend days versus weekdays (r = 0.253 and 0.177, respectively; p < 0.015). Associations for sedentary time followed a similar trend, with r = 0.33 (p < 0.0002) for weekend days and r = 0.016 (p < 0.026) for weekdays. Associations between obese parent-child dyads on sedentary time were stronger for girls, while associations between dyads on MVPA were stronger for boys. However, formal interaction analyses were not significant (p > 0.13).

DISCUSSION

Since physical activity levels of obese parents and their obese child are somewhat related, especially on weekend days, combined parent-child obesity programs focused on reducing sedentary time could be beneficial, particularly for the child.

CONCLUSION

In conclusion, this study of the physical activity levels of obese parents and their obese children found some relationships between the parents' and children's physical activity and sedentary behavior patterns, especially on weekend days.

TRIAL REGISTRATION

NCT01378806 .

Urban Neighborhood Features and Longitudinal Weight Development in Girls

INTRODUCTION

The literature on environment and obesity is characterized by studies that are often cross-sectional and lack racial diversity. This study examined associations between neighborhood features and BMI development over 6 years in an urban sample of 2,295 girls (56% African American; mean age at baseline, 11.2 years) in 2004. Analyses were conducted in 2011-2015.

METHODS

Girls, caregivers, and study staff completed annual neighborhood questionnaires. Linear mixed-effects modeling examined annual changes in neighborhood features and BMI and assessed whether baseline neighborhood features modified BMI growth over time.

RESULTS

At baseline, 40% of participants were overweight/obese. Participants' neighborhoods had few neighborhood problems, moderate levels of safety issues and inconvenient features, low levels of neighborhood disorder, few cases of loitering youth, and substantial traffic volume. Adverse neighborhood features were more common for African American than white participants. Neighborhood features were relatively stable over the follow-up period. African American girls with helpful neighbors had lower annual BMI growth (-0.09 kg/m(2)) than others. For white girls, BMI increased more for girls with helpful neighbors (+0.09 kg/m(2) annually). Regardless of race, living in a U.S. Census tract with low levels of educational achievement was linked with higher BMI growth (an additional 0.07 kg/m(2) annually). Girls living in Census tracts with high (versus low) levels of poverty gained an additional 0.08 kg/m(2) gain annually.

CONCLUSIONS

Social environment features are associated with BMI change in white and African American urban girls and may be helpful for identifying girls at risk for early adolescent weight gain.

Associations of parental influences with physical activity and screen time among young children: a systematic review

Parents play a critical role in developing and shaping their children's physical activity (PA) and sedentary behaviours, particularly in the early years of life. The aim of this systematic review is to identify current literature investigating associations of parental influences with both PA and screen time in young children. This systematic review was conducted in November 2013 using 6 electronic databases covering research literature from January 1998 to November 2013. Thirty articles that met inclusion criteria were identified. These studies covered five important aspects of parenting: (1) parenting practices; (2) parents' role modelling; (3) parental perceptions of children's PA and screen viewing behaviours; (4) parental self-efficacy; and (5) general parenting style. Findings suggest that parents' encouragement and support can increase children's PA, and reducing parents' own screen time can lead to decreased child screen time. Improving parenting practices, parental self-efficacy or changing parenting style may also be promising approaches to increasing PA time and decreasing screen time of young children.

Neighborhood food environment and obesity in community-dwelling older adults: individual and neighborhood effects

OBJECTIVES

We tested hypotheses about the relationship between neighborhood-level food sources and obesity, controlling for individual-level characteristics.

METHODS

Data (collected November 2006-April 2008) derived from a random-digit-dial sample of 5688 community-dwelling adults aged 50 to 74 years residing in 1644 census tracts in New Jersey. Using multilevel structural equation models, we created latent constructs representing density of fast-food establishments and storefronts (convenience stores, bars and pubs, grocery stores) and an observed indicator for supermarkets at the neighborhood level, simultaneously modeling obesity and demographic characteristics (age, gender, race, education, household income) at the individual level.

RESULTS

When we controlled for individual-level age, gender, race, education, and household income, densities of fast-food establishments and storefronts were positively associated with obesity. Supermarkets were not associated with obesity.

CONCLUSIONS

Because people living in neighborhoods with a higher density of fast food and storefronts are more likely to be obese, these neighborhoods may be optimal sites for interventions.

Active commuting to elementary school and adiposity: an observational study

BACKGROUND

Active commuting to school (ACS; walking or cycling to school) appears promising for decreasing children's obesity risk, although long-term studies are sparse. The aim was to examine whether kindergarten ACS was associated with fifth-grade adiposity.

METHODS

This study was a secondary analysis of the Early Childhood Longitudinal Study, Kindergarten (n=7938). Enrollment in kindergarten (1998-1999) was nationally representative of the United States and follow-up occurred in 2004. Kindergarten ACS was the main exposure variable and fifth-grade BMI z-score was the main outcome measure. Covariates included (1) neighborhood safety and BMI z-score in kindergarten and (2) demographics (i.e., age, gender, race/ethnicity, socioeconomic status, single- vs. two-parent households, region of country, and urbanicity in fifth grade). Three interactions were included: school travel*neighborhood safety; school travel*BMI z-score (kindergarten); and school travel*socioeconomic status. Analysis of covariance accounted for the complex sampling design.

RESULTS

Kindergarten ACS was associated with lower BMI z-score in fifth grade. The interaction of school travel*neighborhood safety indicated that children from less-safe neighborhoods who did ACS in kindergarten had a lower fifth-grade BMI z-score (p<0.05) than their peers who did not do ACS in kindergarten (i.e., in terms of BMI, this difference was -0.49 kg/m(2) for children of average height in less-safe neighborhoods).

CONCLUSION

Among children from less-safe neighborhoods, kindergarten ACS independently predicted lower BMI z-score in fifth grade among a national US cohort. Interventions and policies to increase ACS among young children, especially from unsafe neighborhoods, are warranted and should address parents' safety concerns.

Multi-level modelling of physical activity in nuclear families

BACKGROUND

Few studies focus on the different dyadic relations among family members to study physical activity (PA) levels.

AIM

The aim was to investigate predictors and sources of variance of PA levels in nuclear families using multi-level modelling.

SUBJECTS AND METHODS

The sample consisted of 2661 Portuguese four-member nuclear families (10 644 subjects). PA was measured using a questionnaire and socioeconomic status (SES) was assessed by parental occupation. Height and weight were measured in children, while parents self-reported their values.

RESULTS

The results showed that intra-generational similarities were higher than inter-generational, with correlation values of 0.26 and 0.10, respectively. SES was unrelated to any family members' PA level. Being male (β = 0.26, t = 21.77), being older (β = -0.36, t = -4.73) and greater BMI for mothers (β = 0.02, t = 2.55) had effects on individuals' PA.

CONCLUSION

These results suggest a strong dyadic resemblance in PA, showed different effects of gender, age and BMI on individuals' PA and demonstrated that multi-level modelling is a useful strategy to study PA in families.

Associations among social capital, parenting for active lifestyles, and youth physical activity in rural families living in upstate New York

While emerging research supports a positive relationship between social capital and youth physical activity (PA), few studies have examined possible mechanisms explaining this relationship and no studies have focused on rural youth. In this study, we examined parents' support of children's PA as an intermediary factor linking social capital and youth PA in a largely rural cross sectional sample of American children aged 6- to 19-years and their parents/guardians (N=767 families) living in upstate New York. Parents completed a self-administered survey assessing demographic factors, perceived social capital, support for children's PA, and children's PA including time spent outdoors and days per week of sufficient PA. Structural equation modeling was used to test the hypothesis that higher social capital is linked with higher parental support for PA and, in turn, higher PA in children. Analyses were conducted separately for younger (6-12 years) and older (13-19 years) children and controlled for demographic factors (child age, household education, participation in a food assistance program) and perceived neighborhood safety. Anticipated relationships among social capital, parents' activity-related support, and children's PA were identified for older, but not younger children. Findings suggest that parent support for children's PA is one possible mechanism linking social capital and youth PA and the parents of adolescents may rely more heavily on cues from their social environment to shape their approaches to supporting their children's PA than parents of younger children.

Parental Involvement, Child Temperament, and Parents' Work Hours: Differential Relations for Mothers and Fathers

This study examined how child temperament was related to parents' time spent accessible to and interacting with their 2-year-olds. Bivariate analyses indicated that both fathers and mothers spent more time with temperamentally challenging children than easier children on workdays, but fathers spent less time with challenging children than easier children on non-workdays. After accounting for work hours, some associations between temperament and fathers' workday involvement dropped to non-significance. For fathers, work hours also moderated the relation between irregular temperament and workday play. For mothers, work hours moderated the relation between both difficult and irregular temperament and workday interaction. Mothers also spent more time with girls (but not boys) who were temperamentally irregular. Results speak to the influence of child temperament on parenting behavior, and the differential construction of parenting roles as a function of child characteristics and patterns of work.

Neighborhood environment and physical activity among youth a review

CONTEXT

Research examining the association between environmental attributes and physical activity among youth is growing. An updated review of literature is needed to summarize the current evidence base, and to inform policies and environmental interventions to promote active lifestyles among young people.

EVIDENCE ACQUISITION

A literature search was conducted using the Active Living Research (ALR) literature database, an online database that codes study characteristics and results of published papers on built/social environment and physical activity/obesity/sedentary behavior. Papers in the ALR database were identified through PubMed, Web of Science, and SPORTDiscus using systematically developed and expert-validated search protocols. For the current review, additional inclusion criteria were used to select observational, quantitative studies among youth aged 3-18 years.

EVIDENCE SYNTHESIS

Papers were categorized by design features, sample characteristics, and measurement mode. Relevant results were summarized, stratified by age (children or adolescents) and mode of measurement (objective or perceived) for environmental attributes and physical activity. Percentage of significant results was calculated.

CONCLUSIONS

Mode of measurement greatly influenced the consistency of associations between environmental attributes and youth physical activity. For both children and adolescents, the most consistent associations involved objectively measured environmental attributes and reported physical activity. The most supported correlates for children were walkability, traffic speed/volume, access/proximity to recreation facilities, land-use mix, and residential density. The most supported correlates for adolescents were land-use mix and residential density. These findings support several recommendations for policy and environmental change from such groups as the IOM and National Physical Activity Plan.

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.

Parental social support and the physical activity-related behaviors of youth: a review

Social support from parents serves as one of the primary influences of youth physical activity-related behaviors. A systematic review was conducted on the relationship of parental social support to the physical activity-related behaviors of youth. Four categories of social support were identified, falling under two distinct mechanisms-tangible and intangible. Tangible social support is divided into two categories: instrumental-purchasing equipment/payment of fees and transportation-and conditional-doing activity with and watching/supervision. Intangible social support is divided into the two categories of motivational- encouragement and praise-and informational-discussing benefits of. The majority of studies demonstrated positive associations among selected measures of parental tangible and intangible social support and youth activity. Overall, parental social support demonstrated positive effects. Many studies, however, combine social support categories and/or respondents into composite measures, making it difficult to disentangle the specific effects of parents and the type of support provided.

Systematic review of correlates of screen-viewing among young children

OBJECTIVE

The aims of this review were to: (I) synthesise current research on the correlates of screen-viewing among young children (< or = 7 years old); and (II) identify gaps in the study of these correlates.

METHODS

71 English-language studies published between 1980 and February 2009 were extracted from computerized literature searches and bibliographies of primary studies.

RESULTS

Variables positively associated with screen-viewing were age, ethnicity, family TV viewing, family factors (maternal depressive symptoms and parental body mass) and media access. Variables negatively associated were socioeconomic indicators, parental rules and safety. Mother's age, mother's employment and presence of a TV set in a child's bedroom were found to be unclearly associated with screen-viewing behaviour. Gender, marital status, father's age and number of TVs were not associated with screen-viewing behaviour.

CONCLUSIONS

Few modifiable variables for future research implications were identified. Findings suggest that research on correlates of screen-viewing among young children is limited. However, there are some clear correlates on which future interventions could be tailored (age, ethnicity, some socioeconomic indicators, family TV viewing, some family factors, parental rules and safety). Subsequent research is needed both to further test some of the correlates and to review the correlates for strength of associations.

Childhood obesity and the built environment

PURPOSE OF REVIEW

Neighborhood factors are increasingly examined for their role in the childhood obesity epidemic. Whereas studies on the impacts of neighborhood factors on adult obesity are relatively common, studies examining these same factors on childhood obesity are far fewer.

RECENT FINDINGS

Using the Ecological Systems Theory (EST) as a model, we sought to examine the strength of the literature with respect to neighborhood factors as outlined in EST. This includes factors related to the family and the school, which are embedded in larger social contexts of the community and society. These factors are often referred to in the literature as the 'built environment' which encompasses the entire range of structural elements in a residential setting including, for example, housing mix, transportation networks, public resources, and presence of sidewalks or trails.

SUMMARY

Whereas progress has been made with respect to the body of evidence supporting the role of neighborhood factors on childhood obesity and obesity-related behaviors, much work remains to be done to enhance our understanding of neighborhood level factors. As the body of evidence grows, these studies will inform multilevel interventions which are urgently needed to tackle the growing epidemic of childhood obesity in the US.

Walking trips to parks: exploring demographic, environmental factors, and preferences for adults with children in the household

OBJECTIVES

(1) To understand demographic and environmental factors influencing walking trips to parks for adults with children living at home; and (2) To determine if preferences for walking environments may influence walking trips and why.

METHODS

Neighborhoods with varying levels of canopy coverage and access to destinations were selected within the city of Seattle, Washington and surrounding suburbs. Walking trip frequency, preferences for walking environments, and demographic information were measured through a postal survey in fall 2006 (21% response rate, N=617; 41% adults with children living in the household, n=250). Analysis of variance and multiple linear regressions were used to test the associations between variables. Chi-square and qualitative content analysis were used to understand preferences for walking environments.

RESULTS

Adult respondents with children living at home walked most frequently to parks compared to other destinations. Owning a dog, living within close proximity to a variety of destinations, perceptions of ample neighborhood vegetation, and preference for natural-looking environments were factors positively associated with these walking trips.

CONCLUSIONS

Demographic and environmental factors influence walking trips, particularly perceived level of neighborhood vegetation and individual preferences. However, highly vegetated walking environments also elicited concerns about safety for some respondents.

Engaging parents to increase youth physical activity a systematic review

BACKGROUND

Parents are often involved in interventions to engage youth in physical activity, but it is not clear which methods for involving parents are effective.

PURPOSE

A systematic review was conducted of interventions with physical activity and parental components among healthy youth to identify how best to involve parents in physical activity interventions for children.

EVIDENCE ACQUISITION

Identified intervention studies were reviewed in 2008 for study design, description of family components, and physical activity outcomes. The quality of reporting was assessed using the CONSORT checklist for reporting on trials of nonpharmacologic treatments.

EVIDENCE SYNTHESIS

The literature search identified 1227 articles, 35 of which met review criteria. Five of the 14 RCTs met > or =70% of CONSORT checklist items. Five general procedures for involving parents were identified: (1) face-to-face educational programs or parent training, (2) family participatory exercise programs, (3) telephone communication, (4) organized activities, and (5) educational materials sent home. Lack of uniformity in reporting trials, multiple pilot studies, and varied measurements of physical activity outcomes prohibited systematic conclusions. Interventions with educational or training programs during family visits or via telephone communication with parents appear to offer some promise.

CONCLUSIONS

There is little evidence for effectiveness of family involvement methods in programs for promoting physical activity in children, because of the heterogeneity of study design, study quality, and outcome measures used. There is a need to build an evidence base of more-predictive models of child physical activity that include parent and child mediating variables and procedures that can effect changes in these variables for future family-based physical activity interventions.