Evaluating a model of youth physical activity

Enjoyment of Physical Activity among Children and Adolescents: A Concept Analysis

Although enjoyment has been linked to participation in physical activity (PA), a thorough analysis of the concept is lacking. Health-related behavior research emphasizes the necessity of focusing on individual psychological requirements, such as enjoyment in PA, to boost children and adolescents' motivation for PA. The current paper is a report on a conceptual analysis of the enjoyment of PA among children and adolescents. We adopted the concept analysis procedure by Walker and Avant. Several databases (PubMed, CINAHL, ERIC, PsychInfo, and Sport Discus) were searched and used to extract relevant articles about the enjoyment of PA. The review process yielded a final set of 72 papers. A refined definition of enjoyment in PA, attributes, cases, antecedents, and consequences of enjoyment in PA were presented. A conceptual understanding of enjoyment in PA can enable nurses to plan interventions that help children and adolescents get appropriate PA and improve their health habits.

Autonomous motivation, social support, and physical activity in school children: moderating effects of school-based rope skipping sports participation

Purpose

Recent studies have shown that physical activity (PA) levels are low among children and adolescents globally. In order to reverse this trend, PA interventions are increasingly favoured. The school setting is the ideal place to address the issues that many children face. The purpose of this study was to (a) The primary focus of this study is to delve into the mediating role played by school-based rope skipping sports participation (SRSP) in the connection between social support and moderate to high-intensity physical activity (MVPA) among school children. (b) Additionally, this research aims to examine the moderating effect of within this pathway.

Methods

We conducted a survey involving 721 adolescents residing in Changsha City. The participants' ages ranged from 8 to 12 years, with an average age of 9.84 ± 1.535 years. Out of these participants, 406 were boys, and 315 were girls. To assess variables such as social support and autonomous motivation, we employed standardized measurement scales. Subsequently, we analyzed the collected data using various statistical methods, including independent s-amples t-tests, bivariate correlation analysis, descriptive statistical analysis, structural equation modeling (SEM), and the Johnson-Neyman method.

Results

An independent samples t-test revealed a statistically significant difference in MVPA between genders (p = 0.003 < 0.05), with boys exhibiting a higher level of engagement in MVPA compared to girls, Correlation analysis revealed significant positive associations among several key variables. Specifically, social support demonstrated a noteworthy positive correlation with autonomous motivation (r = 0.331, p < 0.01) as well as school children's engagement in MVPA (r = 0.308, p < 0.01). Moreover, autonomous motivation displayed a significant positive correlation with school children's involvement in MVPA (r = 0.459, p < 0.01). The moderating analysis revealed a significant influence of the interaction between increased participation in and social support on school children's engagement in MVPA.

Conclusion

Social support and autonomy support have been proven effective in enhancing school children's engagement in MVPA. They exert their influence indirectly by fostering autonomous motivation. Notably, robust social support can significantly benefit MVPA school children with high activity requirements, particularly those regularly engaged in MVPA during the school day.

A meta-analysis of the relationship between social support and physical activity in adolescents: the mediating role of self-efficacy

Introduction

Social support influences physical activity (PA) in adolescents. However, whether mediating and moderating effects impact the relationship between them or the underlying mechanism remains unclear. This study aimed to investigate the mediating effects of self-efficacy as well as a series of moderating influences using a meta-analytic approach.

Methods

A total of 56 studies published between January 2001 and May 2023 were obtained from the Web of Science, EBSCO, Taylor and Francis, Scopus, Wiley, ProQuest, and CNKI (core) databases, comprising 65 independent samples (total sample size = 47,196).

Results and discussion

The mean weighted correlation coefficients between social, family, peer, and school support and adolescent PA were 0.298, 0.226, 0.256, and 0.142, respectively, which were significant, except for school support. Family support and teenage PA were related, although the connection was moderated by gender and socioeconomic characteristics. While social, family, and peer support had a direct influence on adolescent PA, school support did not. Self-efficacy mediated the relationship between social support and its subtypes and adolescent PA.

Self-reported physical activity behaviors of childhood cancer survivors: comparison to a general adolescent population in Korea

PURPOSE

Adequate physical activity (PA) can significantly contribute to the prevention of undesirable health outcomes in childhood cancer survivors (CCS). This study aimed to identify the patterns of PA and related factors in Korean CCS.

METHODS

Study subjects were 184 adolescents selected from an ongoing cohort study of Korean CCS and 1,840 sex- and school grade-matched controls randomly selected from the participants of the 2019 Korea Youth Risk Behavior Web-based Survey. Information on PA and sedentary behaviors was collected by self-administered questionnaire. We estimated body mass index (BMI)-adjusted odds ratio (OR) and 95% confidence interval (CI) for the advisable healthy behaviors of CCS compared with healthy controls using conditional logistic regression analysis. In addition, the associations of advisable healthy behaviors of CCS with sociodemographic and clinical factors were estimated using multiple logistic regression analysis.

RESULTS

CCS were less likely to be physically active than controls, but this finding was evident only in males. The ORs (95% CIs) for regular exercise, moderate intensity PA, vigorous intensity PA, and walking were 0.42 (0.27-0.65), 0.39 (0.24-0.63), 0.53 (0.33-0.84), and 0.64 (0.42-0.98), respectively, in male CCS compared with same-sex controls. Compared with same-sex controls, male CCS were 4.60 times and female survivors were 15.19 times more likely to sleep longer than 8 h a day. Among CCS, males were 2.92 times and 3.07 times more likely to perform moderate intensity PA and muscle-strengthening exercise, respectively, than female. Higher BMI (OR: 1.16), highest family income (OR: 3.98), and a caregiver who performed regular exercise (OR: 2.08) were positively associated with vigorous intensity PA of CCS. With increasing time after treatment completion, the probability of engaging in sedentary activity for less than 6 h per day decreased (OR = 0.89, 95% CI 0.79-1.00).

CONCLUSION

Korean adolescent CCS were physically inactive compared with control adolescents. Several sociodemographic factors such as sex, family income, caregiver PA, and obesity level were associated with PA behaviors of CCS.

IMPLICATIONS

Strategic effort would be needed to increase physical activity of childhood cancer survivors in adolescent period with consideration of various sociodemographic factors found in this study.

Childhood cancer survivors' and their parents' experiences with participation in a physical and social intervention during cancer treatment: A RESPECT study

AIMS

This study explores experiences of childhood cancer survivors and their parents with a combined physical and social activity intervention during treatment, including how the survivors and their parents perceive physical activity post-treatment.

DESIGN

A process evaluation using semi-structured interviews.

METHODS

Using a criterion-sampling strategy, 18 Danish childhood cancer survivors (aged 11-18 years) and their parents were interviewed from September 2019 through May 2020. Data analysis used an inductive thematic approach focused on meaning.

RESULTS

Three themes emerged: (1) being physically active during hospitalization; (2) peers as motivators and (3) physical activity post-treatment. During hospitalization, daily motivation to do physical activity was dependent on the daily well-being, that is, presence of the side effects from the child's treatment. Healthy classmates provided distraction, reduced loneliness and promoted normality for those hospitalized. For most of the survivors, their healthy peers provided motivation for being physically active during treatment. When surplus energy was lacking, some survivors preferred doing physical activity alone with a professional. Those who were physically active in the hospital sustained being physically active post-treatment while their parents continued seeking advice about appropriate activity levels.

CONCLUSION

Childhood cancer survivors and their parents benefited from the intervention which also provided guidance to remaining physically active post-treatment. This was particularly true for the participants with leukaemia.

IMPACT

Healthcare professionals should support children with cancer to be physically active during hospitalization. Including social and physical components in their care plan and being aware of individual preferences is pivotal to improving the survivors' level of physical and social well-being during and post-treatment.

PATIENT OR PUBLIC CONTRIBUTION

The participants were involved in designing the interview guides to ensure that the interview guides were understandable for the participants to provide rich descriptions of their experiences with a physical and social activity intervention during hospitalization.

The Role of Parental Support and the Students' Opinions in Active Finnish Physical Education Homework

Prior research indicates that adolescent boys are often more active than girls, implying a need for special attention to increase the physical activity levels of adolescent girls. Adolescents are at an age where they are especially susceptible to environmental and social influences but still have a limited amount of autonomy over their own behaviors. The effective physical activity programs implemented at this age may benefit health into adulthood. The fact that adolescents' physical activity is influenced by many factors indicates that to achieve any behavioral change, interventions must target several levels across the socio-ecological model. During childhood, the family is the primary factor in socializing and shaping engagement in physical activity. This study is part of the Physical Education (PE) Homework Study project which was implemented in a midsized secondary school in the middle of Finland from 2016 to 2020. The goal was to develop one easily approachable way to prevent the decreasing physical activity of adolescent girls. This was done by increasing physical activity times of adolescent girls outside of the school by giving them active PE assignments. The aim was also to explore students' and their parents' perceptions of physically active physical education homework. In this part of the study, there were 43 interviews: 38 student interviews and 5 interviews with parents. The analysis process followed the qualitative content analysis (QCA) strategy by Schreirer. In this study, we combined the views of students and parents, and obtained a broad picture of the PE homework assignments given at school but completed at home. According to students and parents, PE homework assignments should be diverse, interesting, and challenging, they should also be provided at flexible schedules outside of school hours with family support. Physical education homework could be a potential approach to influence the physical activity of the student population by involving school curriculum and families.

Clustering of longitudinal physical activity trajectories among young females with selection of associated factors

We examined multi-level factors related to the longitudinal physical activity trajectories of adolescent girls to determine the important predictors for physical activity. The Trial of Activity in Adolescent Girls (TAAG) Maryland site recruited participants at age 14 (n = 566) and followed up with these girls at age 17 (n = 553) and age 23 (n = 442). Individual, social factors and perceived environmental factors were assessed by questionnaire; body mass index was measured at age 14 and age 17, and self-reported at age 23. Neighborhood factors were assessed by geographic information systems. The outcome, moderate-to-vigorous physical activity (MVPA) minutes in a day, was assessed from accelerometers. A mixture of linear mixed-effects models with double penalization on fixed effects and random effects was used to identify the intrinsic grouping of participants with similar physical activity trajectory patterns and the most relevant predictors within the groups simultaneously. Three clusters of participants were identified. Two hundred and forty participants were clustered as “maintainers” and had consistently low MVPA over time; 289 participants were clustered as “decreasers” who had decreasing MVPA over time; 39 participants were grouped as “increasers” and had increasing MVPA over time. Each of the three clusters has its own cluster-specific factors identified using the clustering method, indicating that each cluster has unique characteristics.

Are Family Physical Activity Habits Passed on to Their Children?

Studies of the familial association of physical activity (PA) and sedentary behavior (SB) have increased in recent years. However, there is a lack of studies that have objectively examined the correlates between parents, grandparents, and childrens' PA. Therefore, the purpose of this study was to measure PA using accelerometers to determine the extent to which PA and SB correlate among parents, grandparents, and children. A sample of 169 children between 11 and 14 years (77 boys and 97 girls), 225 parents (98 males and 127 females), and 52 grandparents (16 males and 36 females) were recruited for the current study. Accelerometers RM42 (UKK Terveyspalvelut Oy, Tampere, Finland) were used to determine PA levels of children, parents, and grandparents. Epoch length was 6 s. Mothers' moderate-to-vigorous PA (MVPA) was associated with children's MVPA (p < 0.05). After adjusting for age, BMI (child), and educational status, the results remain the same. Results of linear regression analyses for boys' sedentary time showed that fathers' sedentary time was significantly associated with boys (p < 0.01), but not with girls. The association of grandmothers' and grandfathers' MVPA activity with that of children showed that grandparents' MVPA, when adjusted for age, BMI, and educational status, was not a significant predictor (p > 0.05) of children's MVPA (total sample). In contrast, grandfathers' sedentary behavior was a significant predictor (β = 0.269; p < 0.05) of children's sedentary behavior (total sample). The results of the current study suggest that parental involvement in PA, particularly by mothers, is important for children's PA and, accordingly, healthy outcomes.

Leading by Example: Association Between Mother and Child Objectively Measured Physical Activity and Sedentary Behavior

PURPOSE

The authors examined the relationship between mother and child activity.

METHODS

The authors compared moderate-vigorous physical activity (MVPA) and sedentary time of low-income mothers with obesity and their 6- to 12-year-old children on week (WD) and weekend (WE) days. A total of 196 mother-child pairs wore accelerometers simultaneously for a week. Mothers completed questionnaires. Spearman correlation and multivariate regression were used.

RESULTS

WE MVPA (accelerometry) was significantly correlated between mothers with children aged 6-7 (rs = .35) and daughters (rs = .27). Self-reported maternal PA time spent with one of their children was significantly correlated with the WE MVPA of all children (rs = .21) and children aged 8-10 (rs = .22) and with the WD MVPA of all children (rs = .15), children aged 8-10 (rs = .23), aged 11-12 (rs = .52), and daughters (rs = .37), and inversely correlated to the WD sedentary time of all children (rs = -.21), children aged 8-10 (rs = -.30), aged 11-12 (rs = -.34), daughters (rs = -.26), and sons (rs = -.22). In multivariate regression, significant associations were identified between reported child-mother PA time together and child MVPA and sedentary time (accelerometry).

CONCLUSIONS

Mothers may influence the PA levels of their children with the strongest associations found in children aged 6-7 and daughters. Mother-child coparticipation in PA may lead to increased child MVPA and decreased sedentary behavior.

The Role of Dopamine Receptor D2 in Bridging the Intention-Behavior Gap in Sport Participation

Previous studies have identified that a behavior can occur through the strongest predictor intention, but there is a gap between intention and behavior. Dopamine receptor D2 (DRD2) is known to account for a variance in sporting behaviors in human and animal subjects. However, the relationship between DRD2 and sport participation has been poorly studied, and the limited available reports are inconsistent. The present study was performed to examine the impact of DRD2 on sport participation among Korean university students based on the integrated behavioral model (IBM). Data were collected from enrolled university students in Seoul (N = 45). Participants answered survey questions first, and then they gave investigators their hair to provide DNA information (i.e., the A1 allele of DRD2). DRD2 had a significant effect on sport participation, but only in male students. Male students who carried the A1 allele of DRD2 significantly participated in 105.10 min more sporting activities than male students who did not. Moreover, the effect of intention on sport participation was significantly decreased when considering DRD2. Despite the small sample size, the results of this study could be a preliminary case for a larger study and indicate the direction of future research. Our results suggest that DRD2 may have played an important role as the “actual skill” shown in the IBM.

Resemblance in accelerometer-assessed physical activity in families with children: the Lolland-Falster Health Study

Background

Evidence of intra-family resemblance in physical activity (PA) is lacking. The association between parent and child PA appears weak, the influence of age and gender on this association is uncertain, and no studies have investigated the degree of resemblance in family members’ PA behaviours such as walking, sitting/lying, and biking. Thus, the aims of the study were to examine the degree of resemblance in PA within families, specifically between parents and children, and to explore the size of resemblance across age of children, gender of parents and children, and intensity and type of PA.

Method

The study is a cross-sectional analysis of a subsample (902 parents and 935 children nested within 605 families) of the Danish population study Lolland-Falster Health Study. PA was measured using a dual-accelerometer system (Axivity AX3) with subsequent processing of time spent in light PA (LPA), moderate-to-vigorous PA (MVPA), and vigorous PA and classification of PA behaviour types. Families with at least one son/daughter aged 0–22 years and one parent providing minimum 4 days of valid accelerometer data were included in the analysis. A linear mixed model regression analysis was used to determine the intraclass correlation coefficient (ICC) of clustering among family members for PA intensities and PA behaviours, adjusted for sex, age, parental education, and the interaction between sex and age.

Results

In the analysis of within-family variation in PA, the ICCs across PA intensities and PA behaviours ranged from 0.06 to 0.34. We found stronger clustering in family members’ PA for LPA and behaviours requiring low energy expenditure (LPA: ICC 0.22 (95% confidence interval (CI) 0.17; 0.28), sitting/lying: ICC 0.34 (95% CI 0.28; 0.40)), and walking: ICC 0.24 (95% CI 0.19; 0.30) than for higher intensities (e.g. MVPA: ICC 0.07 (95% CI 0.03; 0.14)). The ICC for biking was 0.23 (95% CI 0.18; 0.29). Analyses on parent-child dyads gave similar results. No interaction effects for gender and age (except for biking) were found.

Conclusion

Parents and children’s time spent in PA behaviours requiring low energy expenditure had moderate resemblance within families, whereas engagement in PA with higher intensities showed small or close-to-zero resemblance.

Exercise with Nutrition Education to Improve Quality of Life of Adolescent and Young Adult Cancer Survivors: A Pilot Study

Purpose: Most evidence for the relationship between physical activity, nutrition education, and late effects from cancer treatment come from cross-sectional studies. The purpose of this pilot study was to determine if 8 weeks of exercise and nutrition education in adolescent and young adult (AYA) survivors positively affects fatigue, quality of life, health-related fitness, and dietary intake. Methods: The exercise program targeted improvement in multiple areas of health-related fitness. A Registered Dietitian conducted nutrition education sessions with goal setting. To encourage activity, social engagement, and support, participants connected to a study-specific group. Fatigue and QoL (FACIT, PedsQL Teen, and Young Adult), health-related fitness (cardiovascular endurance, flexibility, muscular strength and endurance, anthropometrics), nutrition knowledge, and dietary intake assessments were conducted at weeks 1 and 10. Participant perceptions of strengths and weaknesses within the program were assessed after program completion. Results: Twenty four (16.6 ± 2.8 years) AYA cancer survivors began and completed the program. Problems with fatigue (PedsQL Teen and Young Adult) significantly improved along with decreased perceived barriers to exercise. Participants significantly improved cardiovascular endurance, flexibility, and muscular strength and endurance. Trying to make healthy nutrition choices, understanding how to read nutrition labels, and identifying a saturated fat significantly improved without a significant change in dietary intake. Participants' favorite program components related to exercise and social support. Conclusion: In view of the short- and long-term impacts of cancer diagnosis, treatment, and survivorship, as well as the benefits of physical activity on these factors, exercise programs with social support should be considered adjuvant therapy among AYA cancer survivors.

Association between parent and child physical activity: a systematic review

Background

Childhood represents an important life stage for establishment of physical activity (PA) habits. Parents are assumed to play an important role in influencing children’s PA. Earlier reviews have mainly focused on parental modelling, encouragement, and support for PA, rather than the actual PA levels of parents. Therefore, the purpose of this review was to systematically summarize the evidence on the relationship between parent and child PA.

Methods

Papers were identified using electronic databases and manual searches of reference lists. Papers reporting on associations between objectively measured child PA and at least one measure of parental PA were included. The quality of the papers was assessed using a modified version of the ROBINS-I tool. For interpretation of the results across studies, we produced albatross plots for all studies combined and by age-groups, sex of the parents, sex of the child, methodology of assessment of parental PA, and type of PA.

Results

Thirty-nine papers were included with sample size of parent-child dyads ranging from 15 to 1267 (mean = 319 dyads, median = 227 dyads). The majority of studies were published from 2008 to 2018 and used accelerometry to assess PA. Most of the studies were classified as having moderate, serious, or critical risk of bias. The albatross plot for all studies combined showed that the clear majority of studies observed a positive relationship between parent and child PA. The plot suggested an average magnitude of correlation across studies to be around 0.13, and the overall impression was that this was fairly similar across child age-groups and gender of parent-child dyads. Studies using objective assessment of parental PA showed stronger relationship between parent and child PA compared with studies using self-report (average magnitude of correlation around 0.16 vs 0.04 respectively). No clear evidence was found for the strength of relationship being dependent on type of PA measure of parent and child (total PA, moderate-to-vigorous PA, steps), however, the relationship for light PA appeared weaker.

Conclusion

This systematic review showed that the clear majority of studies observed a weak positive relationship between parent and child PA regardless of age of the child, the gender of the parent-child dyad, and type of PA.

Trial registration

Registration in PROSPERO: CRD42019093462.

Using Virtual Agents and Activity Monitors to Autonomously Track and Assess Self-Determined Physical Activity Among Young Children: A 6-Week Feasibility Field Study

The majority of youth fail to get the recommended amount of physical activity (PA), and there is a precipitous decline in PA among children as they get older. Guided by self-determination theory and social cognitive theory, we designed an interactive, mixed reality PA intervention for 6-10-year-old children. Capitalizing on the features of consumer-grade interactive communication technologies, the intervention features a kiosk-based system that houses a virtual agent programmed to encourage children to set self-determined PA goals. This intervention aims to resolve many practical challenges in designing and administering a personalized, intrinsically motivated PA intervention for this age group. We pilot tested the feasibility of this kiosk across 6 weeks with n = 42 child/parent dyads. The kiosk tracked and logged children's daily PA and engagement with the intervention without having to rely on human reporting, provided tailored evaluation and feedback whenever children requested it, informed parents about their child's PA progress, and employed a virtual agent (a dog) to offer social support to children. The virtual agent prompted users to set PA goals, and as children met these goals over time, their personalized dog became happier, more fit, and better at tricks. Each time a child engaged with the kiosk the system automatically sent a text message to his/her parent with details about the child's PA progress. The current study demonstrated the kiosk's feasibility in the field over 6 weeks, illustrating the potential of using interactive technologies as tools for disseminating self-sufficient, and truly self-determined health interventions for children at scale.

Relationship of Friend/Parent Exercise Participation Levels and Adolescents' Exercise Intention/Behavior as Moderated by Action Control

This study investigated the role of action control in the relationship between friend and parent exercise participation levels with adolescents’ exercise intention and behavior, based on the theory of planned behavior. Data were collected from 740 Korean adolescents through questionnaires that assessed the exercise participation level of these participants’ parents and friends, and the adolescent participants’ personal exercise intention, exercise behavior, action control, and exercise constraints. The results showed that the exercise participation level of friends, but not of parents, mediated the adolescents’ exercise behavior through their exercise intention. This relationship was magnified by higher levels of the adolescents’ action control.

Physical Activity, Sedentary Behaviours and Duration of Sleep as Factors Affecting the Well-Being of Young People against the Background of Environmental Moderators

Mental health problems during adolescence are becoming increasingly frequent. The purpose of this study was to evaluate the total impact of selected behavioural and environmental factors on the variability of mental well-being indexes of young people aged 15 to 17 years. The survey, conducted as part of the last round of the Health Behaviour in School-Aged Children (HBSC) 2017/18 study, covered 3693 secondary school students in Poland at the average age of 16.53 years (SD = 1.09). Dependent variables: depression (CES-DC), stress (Cohen scale), satisfaction with life (Cantril's Ladder), and self-efficacy in social relations (Smith and Betz scale). Independent variables included: physical activity; sedentary behaviours; length of sleep; and perception of the environment in which the respondent was raised. The analyses were adjusted by gender, age, and occurrence of chronic disease. It was demonstrated that gender, duration of sleep, and perception of the surrounding environment proved to be significant predictors of all four mental health indicators. The protective influence of physical activity appeared to be a particular advantage in a less-supportive environment. The intervention programmes aimed at improving the mental well-being of young people should include promoting physical activity and sufficient sleep; furthermore, environmental moderators should be taken into consideration.

Transformational Teaching, Self-Presentation Motives, and Identity in Adolescent Female Physical Education

This study examined whether teachers' use of transformational teaching behaviors, as perceived by adolescent girls, in physical education would predict girls' moderate to vigorous physical activity via mediated effects of physical activity self-presentation motives, physical activity identity, and physical education class engagement. Self-report data were acquired from 273 Scottish high school girls in Grades S1-S3 (the equivalent of Grades 7-9 in North America) at 2 time points separated by 1 week. Significant predictive pathways were found from transformational teaching to girls' moderate to vigorous physical activity via mediated effects of acquisitive self-presentation motives and physical activity identity. This preliminary study provides a novel contribution to the research area by showing how previously unrelated psychosocial constructs work together to predict adolescent girls' moderate to vigorous physical activity. Results are discussed in relation to existing literature and future research directions.

The Relationship Between Physical Activity Level of Parents and That of Their Adolescent Children

BACKGROUND

Intergenerational transmission, which refers to the similarity between parent and their children, is a possible explanation of adolescent physical activity (PA). However, only a few existing studies explore the relationship of parent-adolescent PA in East Asian countries. Therefore, this study aimed to investigate the association of parent-adolescent PA using a nationally representative data in Korea with a large sample size.

METHODS

Data were collected from the Korean National Health and Nutrition Examination Survey conducted from 2010 to 2014. The authors performed a linear mixed effects regression analysis with 1342 cases after using log conversion of parent and adolescent moderate- to vigorous-intensity physical activity (MVPA) levels.

RESULTS

In the study, the median MVPA of adolescents was 150 (interquartile range: 360) minutes per week. Adolescent MVPA levels were significantly correlated with their mother's MVPA (β = 0.055, P = .02). Similar findings of greater association in girls and younger adolescents (age: 13-15 y) were found in subgroup analysis (girls: β = 0.073, P = .05; younger adolescents: β = 0.103, P = .001).

CONCLUSION

Increasing maternal PA levels could stimulate their adolescent's PA levels. Therefore, intervention at the family level may lead to an increase in adolescent PA levels.

Parental Perspectives of Barriers to Physical Activity in Urban Schoolchildren With Asthma

OBJECTIVE

Physical activity (PA) levels are low in today's youth and may even be lower in those with asthma. Barriers to PA have not been well studied in inner-city minority children with asthma. We conducted a qualitative study to characterize parental perceptions of barriers to PA and ways to improve PA levels in children with asthma.

METHODS

We used the socioecologic model to inform development of our interview guide. Questions fell into 2 socioecologic model domains: interpersonal (parent, family) barriers and community (neighborhood, school) barriers. Qualitative semistructured interviews were conducted with 23 parents (21 mothers, 2 fathers) of inner-city children with asthma (aged 8-10 years) from 10 Bronx, New York, elementary schools. Sampling continued until thematic saturation was reached. Interviews were recorded, transcribed, and independently coded for common themes. Emerging themes were discussed and agreed on by investigators.

RESULTS

Three themes surrounding interpersonal barriers to PA emerged: 1) parental fear of exercise-induced asthma due to lack of child symptom awareness, 2) nonadherence and refusal to take medications, and 3) challenges with asthma management. Four themes around community barriers to PA emerged: 1) lack of trust in school management of asthma, 2) lack of school PA facilities, 3) unsafe neighborhoods, and 4) financial burden of PA.

CONCLUSIONS

A complex, multilevel set of barriers to PA exist in children with asthma. Addressing these barriers by involving stakeholders at the family, school, and community levels may improve PA levels in children with asthma.

Physical Activity Among Female Adolescents in Jeddah, Saudi Arabia: A Health Promotion Model-Based Path Analysis

BACKGROUND

In Saudi Arabia, about 14.8% of female children and adolescents of less than 20 years old are obese, compared with only 9.4% of male children and adolescents. One major factor linked to the high prevalence of obesity and related chronic illnesses involves inadequate physical activity (PA). Only 25% of female adolescents in Saudi Arabia meet the recommendation calling for 60 minutes of moderate to vigorous PA per day.

OBJECTIVE

The aim of this research was to examine relationships among self-reported PA and cognitive and affective variables, including perceived barriers to PA, PA self-efficacy, enjoyment of PA, social support for PA, and commitment to PA.

METHODS

Female Saudi adolescents 13-18 years of age were recruited from 10 public intermediate and high schools in Jeddah, Saudi Arabia. Female adolescents who met the inclusion criteria completed surveys and participated in height and weight measurements at schools. A structural equation model based on the health promotion model was estimated, with commitment to PA hypothesized to mediate relationships between health promotion model (HPM) predictors and self-reported PA.

RESULTS

A total of 405 female adolescents with a mean age of 15.4 years took part in the study, of whom 25.3% were overweight or obese. Mean PA level measured via the Physical Activity Questionnaire for Adolescents was 2.1 (SD = 0.66), which is low. Commitment to PA partially mediated the relationships of PA self-efficacy, enjoyment of PA, and social support for PA; 25.4% of the variance in PA was explained. The model did not support the indirect relationship of perceived barriers through commitment or the direct relationship between enjoyment and PA.

DISCUSSION

This study indicates that Saudi female adolescents are in need of interventions to increase their PA. The findings suggest that addressing perceived barriers to PA and targeting PA self-efficacy, enjoyment of PA, and social support for PA to enhance commitment to PA may be a fruitful approach in nursing interventions to increase PA among Saudi female adolescents.

Social and Psychological Factors Associated With Adolescent Physical Activity

OBJECTIVE

The purpose of this study was to examine, using structural equation modeling, the associations between nominated friend physical activity (PA), friend social support with individual PA-related psychological factors, and adolescent PA.

METHODS

Data were obtained from EAT 2010 (Eating and Activity Among Teens), a large cross-sectional study conducted in 20 middle and high schools. The sample consisted of 1951 adolescents (mean age: 14.25 ± 1.96, 54% female, 68% ethnic minorities). PA, parent and friend social support (perceived social support for PA from parents and friends), and psychological measures (PA enjoyment, PA self-efficacy, and PA barriers) were assessed by self-report questionnaires. The SEM analysis consisted of 1 observed variable: friend PA, and 2 latent constructs: psychological factors, perceived social support.

RESULTS

The model was a good fit, indicating that there were significant direct effects of both friend PA (P < .01) and psychological factors (P < .0001) on adolescent PA. In addition, psychological factors mediated the association between friend PA and adolescent PA.

CONCLUSION

The results of this model suggest that psychological factors and friend PA are associated with adolescent PA, and that psychological factors may play an important role. Future studies should further examine the association of both friend PA and psychological variables with adolescent PA.

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 .

Structural equation modeling of the associations between the home environment and obesity-related cardiovascular fitness and insulin resistance among Hispanic children

Hispanic children are disproportionally affected by obesity-related risk of metabolic disease. We used the structural equation modeling to examine the associations between specific diet and physical activity (PA) behaviors at home and Hispanic children's metabolic health. A total of 187 Hispanic children and their parents from an urban community in Wisconsin participated in the study. Exposure variables included, children's daily intake of sugar-sweetened beverages (SSB) and PA; home availability of SSB and PA areas/equipment; and parents' intake of SSB and PA, assessed through self-administered questionnaires. Outcome variables for children's metabolic health included, measured anthropometrics; cardiovascular fitness assessed using the Progressive Aerobic Cardiovascular Endurance Run (PACER); and insulin resistance determined with the homeostasis model assessment of insulin resistance (HOMAIR). We found that children's daily intake of SSB was positively associated with BMI z-score, which in turn, was positively associated with HOMAIR (P < 0.05). Specific diet behaviors at home associated with children's intake of SSB, included home availability of SSB, which mediated the association between parents' and children's intake of SSB (P < 0.05). Children's PA was positively associated with PACER z-score, which in turn, was inversely associated with HOMAIR (P < 0.05). Specific PA behaviors at home associated with children's PA, included home availability of PA areas/equipment, which mediated the association between parents' and children's PA (P < 0.05). The structural equation model indices suggested a satisfactory model fit (Chi-square, X(2) = 53.1, comparative fix index = 0.92, root-mean-squared error associated = 0.04). The findings confirm the need for interventions at the family level that promotes healthier home environments by targeting poor diet and low levels of PA in all family members.

Toward a Better Understanding of the Link Between Parent and Child Physical Activity Levels: The Moderating Role of Parental Encouragement

BACKGROUND

Research on adolescent physical activity is mixed regarding the role of parent activity. This study tested parent encouragement, direct modeling, and perceived influence as moderators of objectively-measured (accelerometer) parent and child moderate-to-vigorous physical activity (MVPA) associations.

METHODS

Parent-child dyads (n = 423; mean child age = 11.33 yrs.) wore accelerometers for 7 days; parents completed surveys. Hierarchical linear regression models tested moderation using a product of constituent terms interaction.

RESULTS

Parent-reported encouragement moderated the association between parent and child MVPA (β = -.15, P = .01, ΔR2 = .02, P < .01). Among parents with lower MVPA, child MVPA was higher for children receiving high encouragement (mean = 3.06, SE = .17) vs. low (mean = 3.03, SE = .15, P = .02) and moderate encouragement (mean = 3.40, SE = .09) vs. low (P = .04).

CONCLUSIONS

Physical activity promotion programs may use parent encouragement as a tool to boost child activity, but must consider other child and parent characteristics that could attenuate effects.

Variety, Enjoyment, and Physical Activity Participation Among High School Students

BACKGROUND

Federal guidelines state that youth should participate in a variety of physical activity (PA) they find enjoyable. Little is known, however, about how variety and enjoyment are associated with PA participation among adolescents.

METHODS

Data came from the 2010 National Youth Physical Activity and Nutrition Survey, a nationally representative survey of adolescents. Path analysis was used to examine the association of a variety of self-reported PA, defined as the number of activities and activity types (ie, team sports/weightlifting, individual activities, and other competitive/recreational sports), on self-reported PA enjoyment and participation. The analysis also examined whether enjoyment mediates the association between a variety of PA and participation. Separate models were estimated for boys and girls.

RESULTS

Number of activities was associated with increased PA enjoyment and participation. For boys and girls, team sports/weightlifting was associated with increased participation, and individual activities were indirectly associated with increased participation through enjoyment. For boys, team sports/weightlifting was indirectly related with participation.

CONCLUSIONS

These findings suggest that participation in a variety of PA is associated with increased PA enjoyment and participation. Providing opportunities for adolescents to engage in a variety of activities might help them identify PA they enjoy and facilitate lifelong PA habits.

Predictors for physical activity in adolescent girls using statistical shrinkage techniques for hierarchical longitudinal mixed effects models

We examined associations among longitudinal, multilevel variables and girls' physical activity to determine the important predictors for physical activity change at different adolescent ages. The Trial of Activity for Adolescent Girls 2 study (Maryland) contributed participants from 8th (2009) to 11th grade (2011) (n=561). Questionnaires were used to obtain demographic, and psychosocial information (individual- and social-level variables); height, weight, and triceps skinfold to assess body composition; interviews and surveys for school-level data; and self-report for neighborhood-level variables. Moderate to vigorous physical activity minutes were assessed from accelerometers. A doubly regularized linear mixed effects model was used for the longitudinal multilevel data to identify the most important covariates for physical activity. Three fixed effects at the individual level and one random effect at the school level were chosen from an initial total of 66 variables, consisting of 47 fixed effects and 19 random effects variables, in additional to the time effect. Self-management strategies, perceived barriers, and social support from friends were the three selected fixed effects, and whether intramural or interscholastic programs were offered in middle school was the selected random effect. Psychosocial factors and friend support, plus a school's physical activity environment, affect adolescent girl's moderate to vigorous physical activity longitudinally.

Parental correlates in child and adolescent physical activity: a meta-analysis

OBJECTIVE

Physical activity (PA) has a profound impact on health and development in children. Parental behaviors (i.e., modeling and support) represent an obvious important factor in child PA. The purpose of this paper was to provide a comprehensive meta-analysis that overcomes the limitations of prior narrative reviews and quantitative reviews with small samples.

METHODS

Ten major databases were used in the literature search. One-hundred and fifteen studies passed the eligibility criteria. Both fixed and random effects models with correction for sampling and measurement error were examined in the analysis. Moderator analyses investigating the effects of child's developmental age, study design, parental gender, measurement of child PA, and quality rating were performed.

RESULTS

Based on the random effects model, the results showed that parental modeling was weakly associated with child PA (summary r = .16, 95% CI .09-.24) and none of the proposed moderators were significant. Separate analyses examining the moderating effects of parental gender and boys' PA found that that father-son PA modeling (r = .29, 95% CI .21-.36) was significantly higher compared to mother-son PA (r = .19, 95% CI .14-.23; p < .05). However, parental gender did not moderate the relationship between parental modeling and girls' PA (p > .05). The random effects model indicated an overall moderate effect size for the parental support and child PA relationship (summary r = .38, 95% CI .30-.46). Here, the only significant moderating variable was the measurement of child PA (objective: r = .20, 95% CI .13-.26; reported: r = .46, 95% CI .37-.55; p < .01).

CONCLUSIONS

Parental support and modeling relate to child PA, yet our results revealed a significant degree of heterogeneity among the studies that could not be explained well by our proposed moderators.

Exploring associations between parental and peer variables, personal variables and physical activity among adolescents: a mediation analysis

BACKGROUND

This study aimed to investigate how parental and peer variables are associated with moderate- to-vigorous intensity physical activity (MVPA) on week- and weekend days among Australian adolescents (13-15 y), and whether perceived internal barriers (e.g. lack of time), external barriers (e.g. lack of others to be physically active with) and self-efficacy mediated these associations.

METHODS

Cross-sectional data were drawn from the Health, Eating and Play Study, conducted in Melbourne, Australia. Adolescents (mean age = 14.11 ± 0.59 years, 51% girls) and one of their parents completed a questionnaire and adolescents wore an ActiGraph accelerometer for a week (n = 134). Mediating effects of perceived barriers and self-efficacy were tested using MacKinnon's product-of-coefficients test based on multilevel linear regression analyses.

RESULTS

Parental logistic support was positively related to MVPA on weekdays (τ = 0.035) and weekend days (τ = 0.078), peer interest (τ =0.036) was positively related to MVPA on weekdays, and parental control (τ = -0.056) and parental concern (τ = -0.180) were inversely related to MVPA on weekdays. Internal barriers significantly mediated the association between parental logistic support and MVPA on weekdays (42.9% proportion mediated). Self-efficacy and external barriers did not mediate any association.

CONCLUSIONS

Interventions aiming to increase adolescents' MVPA should involve parents, as parental support may influence MVPA on weekdays by reducing adolescents' perceived internal barriers. Longitudinal and experimental research is needed to confirm these findings and to investigate other personal mediators.

Physical activity, psychosocial and perceived environmental factors in adolescents from Northeast Brazil

The aim of this study was to evaluate the association between levels of physical activity, psychosocial and perceived environmental factors in adolescents from Northeastern Brazil. A cross-sectional epidemiologic study was conducted with 2,859 adolescents enrolled in secondary schools (57.8% females; mean = 16.5 years; SD = 1.2) in the city of João Pessoa, Paraíba State, Brazil. The following physical activity correlates were measured: attitude, self-efficacy, social support from friends and parents, and perceived environmental characteristics. Physical activity was measured using a questionnaire. Multivariable ordinal logistic regression with proportional odds model analysis showed that the following factors are positively related to physical activity levels in adolescents: attitude, self-efficacy, as well as social support from parents and friends. Physical activity intervention programs should increase self-efficacy and social support from parents and friends, as well as a positive attitude toward physical activity.

Motivation and planning as mediators of the relation between social support and physical activity among U.S. adolescents: a nationally representative study

BACKGROUND

More than half of U.S. high-school students do not meet the moderate and vigorous physical activity (MVPA) 5 hours per week recommendation. The purpose of this study was to determine how individual dimensions (motivation and planning) mediate the relationship of social context with physical activity by integrating available measures of personal characteristic including internal/external motivations (derived from Self-Determination Theory -SDT]) for MVPA, MVPA planning, peer MVPA, and parental support to better understand adolescent MVPA.

METHODS

Survey responses of a nationally representative cohort of 11th graders (N=2439) in the NEXT Generation Health Study were analyzed with structural equation modeling.

RESULTS

Adolescent MVPA was directly, significantly associated with MVPA planning (β=0.17), peer MVPA (β=0.21), and internal motivation (β=0.50). Internal motivation was associated with peer MVPA (β=0.31), parental support for MVPA (β=0.16), and external motivation (β=0.40). A significant relation between parental support and external motivation (β=0.31) was also found.

CONCLUSIONS

Adolescents with higher internal motivation and more active friends were more likely to engage in MVPA. The results are consistent with SDT and suggest that planning is an important construct for adolescent MVPA.

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

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

Statistical Learning Methods for Longitudinal High-dimensional Data

Recent studies have collected high-dimensional data longitudinally. Examples include brain images collected during different scanning sessions and time-course gene expression data. Because of the additional information learned from the temporal changes of the selected features, such longitudinal high-dimensional data, when incorporated with appropriate statistical learning techniques, are able to more accurately predict disease status or responses to a therapeutic treatment. In this article, we review recently proposed statistical learning methods dealing with longitudinal high-dimensional data.

Affective judgment and physical activity in youth: review and meta-analyses

BACKGROUND

A recent meta-analysis on affective judgment and physical activity in adults yielded a medium effect-sized relationship. Despite narrative reviews and topic interest, a meta-analysis in youth has not yet been conducted.

PURPOSE

This study aims to appraise the overall effect of affective judgment on physical activity in youth via meta-analyses and explore moderators of this relationship.

METHODS

Literature searches were conducted between 1990 and 2011. Fixed and random effects meta-analysis with correction for sampling, measurement, and publication bias were employed.

RESULTS

Fifty-six correlational studies and 14 interventions met the inclusion criteria. Among correlational studies, the corrected summary r was 0.26 (95 % CI 0.18-0.32). Significant moderators were gender, measure of physical activity, and recruitment context. Among intervention studies, Cohen's d was 0.25 (95 % CI 0.11-0.40).

CONCLUSIONS

The results are close to a medium effect size which is larger than other meta-analytic physical activity correlates among youth. The construct should be included in our contemporary theories for understanding and intervening upon youth physical activity.

Autoeficácia e atividade física em adolescentes de Curitiba, Paraná, Brasil

Este trabalho teve o objetivo de analisar a associação entre atividade física e autoeficácia em adolescentes. Realizou-se um estudo inquérito de base escolar com 1.698 adolescentes de Curitiba, Paraná, Brasil. A atividade física foi avaliada segundo frequência semanal (dias/semana) de prática de atividade física de intensidade moderada ou vigorosa. A autoeficácia foi analisada segundo a soma de uma escala composta por dez itens. A associação entre autoeficácia e atividade física foi testada pela regressão de Poisson (p < 0,05), estratificada por sexo. Entre os meninos, apenas elevada autoeficácia foi associada com todas as categorias de atividade física (p < 0,001), enquanto para as meninas níveis moderados e elevados de autoeficácia foram associados com todas as categorias de atividade física (p < 0,001). Conclui-se que a autoeficácia tem associação positiva com atividade física entre adolescentes, no entanto esta relação é mais consistente entre as meninas. Este é um aspecto importante para o delineamento de intervenções para a promoção de atividade física nesse grupo populacional.

Associations of parental influence and 10-11-year-old children's physical activity: are they mediated by children's perceived competence and attraction to physical activity?

AIMS

This cross-sectional study had two aims: firstly, to study the associations of parental influence in the form of encouragement, father and mother modelling and involvement on children's physical activity (PA), and secondly, to study the mediation effect of encouragement, father and mother modelling and involvement on children's PA through children's perceived competence and attraction to PA.

METHODS

A total of 1278 children (response rate 79%), aged 10-11 years, participated in the study in the autumn of 2006. Of these children, 883 children completed all the data in a questionnaire assessing their self-reported PA, perceived competence, attraction to PA, and perceived parental influence. The associations were examined by multiple mediator analyses with bootstrapping method. All the models were adjusted with gender and grade.

RESULTS

The analyses pointed out that father modelling had a direct effect on children's physical activity, whereas encouragement, mother modelling, and involvement had an indirect effect through perceived competence and attraction to physical activity on children's physical activity. The strongest indirect association was formed from encouragement through attraction to physical activity to children's physical activity.

CONCLUSIONS

The results show that parents influence on children's physical activity in a variety of ways. Parents influence their children's physical activity in direct and indirect manners through their encouragement, involvement and modelling. Furthermore, mother and father influence their children's physical activity in different ways. This versatility should be taken into consideration in future interventions.

Measurement of general and specific approaches to physical activity parenting: a systematic review

BACKGROUND

Parents play a significant role in shaping youth physical activity (PA). However, interventions targeting PA parenting have been ineffective. Methodological inconsistencies related to the measurement of parental influences may be a contributing factor. The purpose of this article is to review the extant peer-reviewed literature related to the measurement of general and specific parental influences on youth PA.

METHODS

A systematic review of studies measuring constructs of PA parenting was conducted. Computerized searches were completed using PubMed, MEDLINE, Academic Search Premier, SPORTDiscus, and PsycINFO. Reference lists of the identified articles were manually reviewed as well as the authors' personal collections. Articles were selected on the basis of strict inclusion criteria and details regarding the measurement protocols were extracted. A total of 117 articles met the inclusionary criteria. Methodological articles that evaluated the validity and reliability of PA parenting measures (n=10) were reviewed separately from parental influence articles (n=107).

RESULTS

A significant percentage of studies used measures with indeterminate validity and reliability. A significant percentage of articles did not provide sample items, describe the response format, or report the possible range of scores. No studies were located that evaluated sensitivity to change.

CONCLUSION

The reporting of measurement properties and the use of valid and reliable measurement scales need to be improved considerably.

Physical activity behavior and related characteristics of highly active eighth-grade girls

PURPOSE

Although girls are generally less physically active than boys, some girls regularly engage in high levels of physical activity (PA); however, very little is known about these girls and how they differ from those who are less physically active. This study examined the PA behavior and related characteristics of highly active adolescent girls and compared them with those who are less active.

METHODS

Data from 1,866 eighth-grade girls from six field centers across the United States participating in the Trial of Activity for Adolescent Girls (TAAG) were included in the present analysis. Mixed-model analysis of variance examined differences in sociodemographic, anthropometric, psychosocial, and physical activity (accelerometry and self-report) variables between high- and low-active girls; effect sizes were calculated for the differences.

RESULTS

High-active girls were taller, had lower body mass indices and body fat, and were less sedentary. High-active girls scored higher on self-efficacy, enjoyment of PA, self-management strategies, outcome-expectancy value, and support from family and friends than low-active girls. Low-active girls participated in more leisure time and educational sedentary activities than high-active girls. High-active girls participated in more PA classes/lessons outside of school, team sports, and individual sports. They were also more likely to participate in sports in an organized setting in the community or at school than low-active girls.

CONCLUSIONS

Health promotion efforts should focus on decreasing the amount of time girls spend in sedentary activities and replacing that time with organized PA opportunities; such efforts should seek to minimize perceived barriers and increase self-efficacy and support for PA.

The effect of the home environment on physical activity and dietary intake in preschool children

Background

The effects of the home environment on child health behaviors related to obesity are unclear.

Purpose

To examine the role of the home physical activity (PA) and food environment on corresponding outcomes in young children, and assess maternal education/work status as a moderator.

Methods

Overweight or obese mothers reported on the home PA and food environment (accessibility, role modeling and parental policies). Outcomes included child moderate-vigorous PA (MVPA) and sedentary time derived from accelerometer data and two dietary factors (“junk” and healthy food intake scores) based on factor analysis of mother-reported food intake. Linear regression models assessed the net effect (controlling for child demographics, study arm, supplemental timepoint, maternal education/work status, child body mass index and accelerometer wear-time (for PA outcomes)) of the home environment on the outcomes and moderation by maternal education/work status. Data was collected in North Carolina from 2007–2011.

Results

Parental policies supporting PA increased MVPA time, and limiting access to unhealthy foods increased the healthy food intake score. Role modeling of healthy eating behaviors increased the healthy food intake score among children of mothers with no college education. Among children of mothers with no college education and not working, limiting access to unhealthy foods and role modeling reduced “junk” food intake scores while parental policies supporting family meals increased “junk” food intake scores.

Conclusions

To promote MVPA, parental policies supporting child PA are warranted. Limited access to unhealthy foods and role modeling of healthy eating may improve the quality of the child’s food intake.

Influence of friends on children's physical activity: a review

We examined evidence for friendship influences on children's physical activity (PA) through systematic searches of online databases in May 2012. We identified 106 studies (25 qualitative) published in English since 2000 that analyzed indicators of friendship influences (e.g., communication about PA, friends' PA, and PA with friends) among persons younger than 19 years. Children's PA was positively associated with encouragement from friends (43 of 55 studies indicating a positive relationship), friends' own PA (30/35), and engagement with friends in PA (9/10). These findings are consistent with friends influencing PA, but most studies did not isolate influence from other factors that could explain similarity. Understanding friendship influences in childhood can facilitate the promotion of lifelong healthy habits. PA with friends should be considered in health promotion programs.

Multilevel correlates of physical activity for early, mid, and late adolescent girls

BACKGROUND

We examined associations among multilevel variables and girls' physical activity to determine whether they vary at different adolescent ages.

METHODS

All field sites of the Trial of Activity for Adolescent Girls contributed participants from 6th (n = 1576) and 8th grades (n = 3085). The Maryland site contributed an 11th grade sample (n = 589). Questionnaires were used to obtain demographic and psychosocial information (individual- and social-level variables); height, weight, and triceps skinfold to assess body composition; interviews and surveys for school-level data; and geographical information systems and self-report for neighborhood-level variables. Moderate to vigorous physical activity minutes (MVPA) were assessed from accelerometers. Mixed models (13 individual, 5 social, 15 school, 12 neighborhood variables) were used to determine multilevel associations.

RESULTS

Variables at individual, social, school, and neighborhood levels were associated with MVPA, but differed across grades. Lower percent body fat, higher social support from friends, and lower school math scores were associated with higher MVPA at 6th and 8th grade. Higher physical activity self-efficacy was associated with higher MVPA at 11th grade. Only lower physical activity barriers were associated with higher MVPA at all grades.

CONCLUSION

MVPA is a complex behavior with fluid, multilevel correlates that differ among girls across middle and high school.

Determinants of physical activity in primary school students using the health belief model

BACKGROUND

Thailand is a middle-income country in which two-thirds of children demonstrate an insufficient level of physical activity. Physical inactivity is a major risk factor for obesity and many other health-related consequences in children. Thus, it is important to understand how primary school children perceive things in their daily life as determinants of physical activity. The purpose of this study was to investigate the impact of cues, perceived benefits, and perceived barriers on the level of physical activity among primary school students.

METHODS

A cross-sectional study was conducted in Phitsanulok Province, Thailand, in 2011. Multistage sampling selected a total of 123 primary school students. The Physical Activity Questionnaire for Older Children and the Cues, Perceived Benefits, and Barriers to Physical Activity Questionnaire were used to assess the student levels of physical activity, as well as the perceived benefits, barriers, and cues to action. The association between these factors and the level of physical activity was determined by correlation statistics and confirmed by robust regression. Multivariate analysis of variance compared health belief model determinants: perceived benefits, perceived barriers, and cues to action on physical activity between male and female students. Self-administered questionnaires were validated and tested in a pilot study.

RESULTS

The level of activity among primary school children was significantly influenced by perceived barriers, such as fear of strangers when playing outdoors, bad weather, and too much homework. However, activity was not influenced by cues to action or perceived benefits. Perceived benefits, barriers, and cues to physical activity did not differ by gender.

CONCLUSION

A safe environment and fewer barriers, such as amount of homework, could enhance physical activity in primary school children.

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

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

Physical Activity in Child and Adolescent Cancer Survivors: A Review

Childhood cancer survivors are at increased risk for future health problems. As such, physical activity (PA) has been targeted as a health promotion priority in child and adolescent cancer survivors. Research indicates that a large portion of pediatric survivors do not meet PA recommendations. Using Bronfenbrenner's ecological theory as a framework, this review presents a conceptual model to explain child and adolescent survivors' PA. The model considers predictors of PA across six domains: (1) demographic; (2) medical; (3) cognitive/emotional; (4) behavioral; (5) social/cultural; and (6) environmental. A structured literature review found 14 empirical articles examining those predictors of PA among child and adolescent cancer survivors. Much existing research is cross-sectional, but suggests multiple factors work together to encourage or discourage PA among survivors of child/adolescent cancer. The conceptual model, which is based in empirical findings to date, can be used to understand the process through which PA is promoted and maintained, to inform the development of empirically-supported clinical interventions, and to guide future research objectives and priorities.

Physical activity parenting: a systematic review of questionnaires and their associations with child activity levels

Insufficient physical activity (PA) is considered a critical contributor to childhood overweight. Parents are a key in influencing their child's PA through various mechanisms of PA parenting, including support, restriction of PA and facilitation of enrolment in PA classes or activities. However, study findings are difficult to compare because instruments vary in terms of constructs, psychometric assessment and type of PA assessed. The goal of the current review was to identify existing PA parenting questionnaires and report on the validation of these measures through findings of their psychometric performance and correlation to youth's PA. The search of eligible studies was restricted to instruments with multiple items. Eleven unique PA parenting questionnaires were identified, and 46 studies that used these instruments were included. Extracted data include sample characteristics, as well as type and assessment methods of parental influence and PA. Findings highlight the tremendous variation in the conceptualization and measurement of PA parenting, common use of non-validated instruments and lack of comprehensive measures. The development of theory-based PA parenting measures (preferably multidimensional) should be prioritized to guide the study of the parental role in promoting child's PA as well as the design of family-based PA interventions.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Social, demographic, and medical influences on physical activity in child and adolescent cancer survivors

OBJECTIVE

This study evaluated associations between social, environmental, demographic, and medical predictors, and child and adolescent survivors' physical activity (PA).

METHODS

A structured telephone survey was conducted with 105 caregiver-survivor (aged 8-16 years) pairs and 36 caregivers of younger survivors (aged 6-7 years) alone. Participants completed measures assessing survivor PA and proposed predictors of PA including demographic, medical, social, and environmental influences.

RESULTS

Social influences, including family PA, family support for PA, and peer support for PA, emerged as unique predictors of survivor PA. These variables predicted PA after controlling for demographic and medical factors. Child survivors' PA was more strongly predicted by family influences while adolescent survivors' PA was more strongly influenced by family and peer influences.

CONCLUSIONS

Child and adolescent survivors' PA is strongly influenced by social factors. This finding parallels results with healthy children. PA interventions should focus on family and peer support to increase survivors' PA behaviors.

Predicting physical activity and fruit and vegetable intake in adolescents: a test of the information, motivation, behavioral skills model

Most adolescents do not meet national recommendations regarding physical activity and/or the intake of fruits and vegetables. The purpose of this study was to explore whether variables in the information, motivation, behavioral skills (IMB) model of health promotion predicted physical activity and fruit and vegetable intake in 404 adolescents from 2 high schools in the Southwest United States using structural equation modeling (SEM). The SEM models included theoretical constructs, contextual variables, and moderators. The theoretical relationships in the IMB model were confirmed and were moderated by gender and race. Interventions that incorporate cognitive-behavioral skills building may be a key factor for promoting physical activity as well as fruit and vegetable intake in adolescents.

Stressed out and overcommitted! The relationships between time demands and family rules and parents' and their child's weight status

OBJECTIVE

This study aimed to determine the relationship between parent time demands and presence and enforcement of family rules and parent/child dyad weight status.

METHOD

In dyads of one child/parent per family (N = 681 dyads) in Twin Cities, Minnesota, 2007-2008, height and weight were measured, and a survey of demographics, time demands, and family rules-related questions was taken. Parent/child dyads were classified into four healthy weight/overweight categories. Multivariate linear associations were analyzed with SAS, testing for interaction by work status and family composition (p < .10).

RESULTS

In adjusted models, lack of family rules and difficulty with rule enforcement were statistically lower in dyads in which the parent or child was healthy weight compared with dyads in which the parent and child were both overweight (difference in family rules scores = 0.49, p = .03; difference in rule enforcement scores = 1.09, p ≤ .01). Of parents who worked full-time, healthy weight dyads reported lower time demands than other dyads (difference in time demands scores = 1.44, p = .01).

CONCLUSIONS

Family experiences of time demands and use of family rules are related to the weight status of parents and children within families.