Parent–child interactions and obesity prevention : a systematic review of the literature

Child obesity research has generally not examined multiple layers of parent&ndash;child relationships during weight-related activities such as feeding, eating and play. A literature review was conducted to locate empirical studies that measured parent&ndash; child interactions and child eating and child weight variables; five papers met the inclusion criteria and were included in the review. The findings of the review revealed that parent&ndash;child relationships are an important element in explaining the unhealthy trend of childhood obesity. We argue that prevention/intervention strategies must extend on the current models of parenting by targeting the family from a bi-directional perspective, and focusing, specifically, on the mutually responsive orientation that exists in the parent&ndash;child relationship.<br /

Physical activity in young children : a systematic review of parental influences

The primary aim of this review was to identify and evaluate the strength of associations of the key parental factors measured in studies examining early childhood physical activity (PA). A systematic review of the literature, using databases PsychINFO, Medline, Academic Search Complete, PSYCHinfo, and CINHAL, published between January 1986 and March 2011 was conducted; 20 papers were relevant for the current review. While 12 parenting variables were identified, only 5 of these had been investigated sufficiently to provide conclusive findings. There were inconsistencies in the findings involving the social learning variable parental enjoyment and variables involving parental behaviours such as maternal depression and self-efficacy, and rules for sedentary behaviour, and parental perceptions, which included perceived importance of PA, fear of safety, and perception of child&rsquo;s motor competence. Given these inconsistencies, a metaanalysis was conducted to determine whether the method of measuring PA (objective or subjective) influenced the strength of associations between the parental factors and young children&rsquo;s PA. There was no difference in the strength of associations in the studies that used objective or subjective measurement (via parent self-report). Further investigation is needed to clarify and understand the specific parental influences and behaviours that are associated with PA in young children. In particular, longitudinal research is needed to better understand how parental influences and PA levels of children during the formative preschool and early elementary school years are associated.<br /

Home and neighbourhood correlates of BMI among children living in socioeconomically disadvantaged neighbourhoods

A detailed understanding of the underlying drivers of obesity-risk behaviours is needed to inform prevention initiatives, particularly for individuals of low socioeconomic position who are at increased risk of unhealthy weight gain. However, few studies have concurrently considered factors in the home and local neighbourhood environments, and little research has examined determinants among children from low socioeconomic backgrounds. The present study examined home, social and neighbourhood correlates of BMI (kg/m2) in children living in disadvantaged neighbourhoods. Cross-sectional data were collected from 491 women with children aged 5&ndash;12 years living in forty urban and forty rural socioeconomically disadvantaged areas (suburbs) of Victoria, Australia in 2007 and 2008. Mothers completed questionnaires about the home environment (maternal efficacy, perceived importance/beliefs, rewards, rules and access to equipment), social norms and perceived neighbourhood environment in relation to physical activity, healthy eating and sedentary behaviour. Children\u27s height and weight were measured at school or home. Linear regression analyses controlled for child sex and age. In multivariable analyses, children whose mothers had higher efficacy for them doing physical activity tended to have lower BMI z scores (B = &minus; 0&middot;04, 95 % CI &minus; 0&middot;06, &minus; 0&middot;02), and children who had a television (TV) in their bedroom (B = 0&middot;24, 95 % CI 0&middot;04, 0&middot;44) and whose mothers made greater use of food as a reward for good behaviour (B = 0&middot;05, 95 % CI 0&middot;01, 0&middot;09) tended to have higher BMI z scores. Increasing efficacy among mothers to promote physical activity, limiting use of food as a reward and not placing TV in children\u27s bedrooms may be important targets for future obesity prevention initiatives in disadvantaged communities

Sydney principles for reducing the commercial promotion of foods and beverages to children

A set of seven principles (the &lsquo;Sydney Principles&rsquo;) was developed by an International Obesity Taskforce (IOTF) Working Group to guide action on changing food and beverage marketing practices that target children. The aim of the present communication is to present the Sydney Principles and report on feedback received from a global consultation (November 2006 to April 2007) on the Principles.The Principles state that actions to reduce marketing to children should: (i) support the rights of children; (ii) afford substantial protection to children; (iii) be statutory in nature; (iv) take a wide definition of commercial promotions; (v) guarantee commercial-free childhood settings; (vi) include cross-border media; and (vii) be evaluated, monitored and enforced.The draft principles were widely disseminated and 220 responses were received from professional and scientific associations, consumer bodies, industry bodies, health professionals and others. There was virtually universal agreement on the need to have a set of principles to guide action in this contentious area of marketing to children. Apart from industry opposition to the third principle calling for a statutory approach and several comments about the implementation challenges, there was strong support for each of the Sydney Principles. Feedback on two specific issues of contention related to the age range to which restrictions should apply (most nominating age 16 or 18 years) and the types of products to be included (31 % nominating all products, 24 % all food and beverages, and 45 % energy-dense, nutrient-poor foods and beverages).The Sydney Principles, which took a children&rsquo;s rights-based approach, should be used to benchmark action to reduce marketing to children. The age definition for a child and the types of products which should have marketing restrictions may better suit a risk-based approach at this stage. The Sydney Principles should guide the formation of an International Code on Food and Beverage Marketing to Children.<br /

What do parents and preschool staff tell us about young children's physical activity: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Physical activity and small screen recreation are two modifiable behaviours associated with childhood obesity and the development of chronic health problems. Parents and preschool staff shape behaviour habits in young children. The aims of this qualitative study were to explore the attitudes, values, knowledge and understanding of parents and carers of preschool-age children in relation to physical activity and small screen recreation and to identify influences upon these behaviours.</p> <p>Methods</p> <p>This research involved a focus group study with parents and carers of the target population. A purposive sample of 39 participants (22 parents, 17 carers) participated in 9 focus groups. Participants were drawn from three populations of interest: those from lower socioeconomic status, and Middle-Eastern and Chinese communities in the Sydney (Australia) metropolitan region.</p> <p>Results</p> <p>All participants understood the value of physical activity and the impact of excessive small screen recreation but were unfamiliar with national guidelines for these behaviours. Participants described the nature and activity patterns of young children; however, the concept of activity 'intensity' in this age group was not a meaningful term. Factors which influenced young children's physical activity behaviour included the child's personality, the physical activity facilities available, and the perceived safety of their community. Factors facilitating physical activity included a child's preference for being active, positive parent or peer modelling, access to safe play areas, organised activities, preschool programs and a sense of social connectedness. Barriers to physical activity included safety concerns exacerbated by negative media stories, time restraints, financial constraints, cultural values favouring educational achievement, and safety regulations about equipment design and use within the preschool environment. Parents considered that young children are naturally 'programmed' to be active, and that society 'de-programs' this behaviour. Staff expressed concern that free, creative active play was being lost and that alternate activities were increasingly sedentary.</p> <p>Conclusion</p> <p>The findings support the relevance of the socioecological model of behavioural influences to young children's physical activity. In this age group, efforts may best be directed at emphasising national guidelines for small screen recreation and educating families and carers about the importance of creative, free play to reinforce the child's inherent nature to be active.</p

The validity and reliability of a home environment preschool-age physical activity questionnaire (Pre-PAQ)

<p>Abstract</p> <p>Background</p> <p>There is a need for valid population level measures of physical activity in young children. The aim of this paper is to report the development, and the reliability and validity, of the Preschool-age Children's Physical Activity Questionnaire (Pre-PAQ) which was designed to measure activity of preschool-age children in the home environment in population studies.</p> <p>Methods</p> <p>Pre-PAQ was completed by 103 families, and validated against accelerometry for 67 children (mean age 3.8 years, SD 0.74; males 53%). Pre-PAQ categorizes activity into five progressive levels (stationary no movement, stationary with limb or trunk movement, slow, medium, or fast-paced activity). Pre-PAQ Levels 1-2 (stationary activities) were combined for analyses. Accelerometer data were categorized for stationary, sedentary (SED), non-sedentary (non-SED), light (LPA), moderate (MPA) and vigorous (VPA) physical activity using manufacturer's advice (stationary) or the cut-points described by Sirard et al and Reilly et al. Bland-Altman methods were used to assess agreement between the questionnaire and the accelerometer measures for corresponding activity levels. Reliability of the Pre-PAQ over one week was determined using intraclass correlations (ICC) or kappa (κ) values and percentage of agreement of responses between the two questionnaire administrations.</p> <p>Results</p> <p>Pre-PAQ had good agreement with LPA (mean difference 1.9 mins.day^-1) and VPA (mean difference -4.8 mins.day^-1), was adequate for stationary activity (mean difference 7.6 mins.day^-1) and poor for sedentary activity, whether defined using the cut-points of Sirard et al (mean difference -235.4 mins.day^-1) or Reilly et al (mean difference -208.6 mins.day^-1) cut-points. Mean difference between the measures for total activity (i.e. Reilly's non-sedentary or Sirard's LMVPA) was 20.9 mins.day^-1and 45.2 mins.day^-1. The limits of agreement were wide for all categories. The reliability of Pre-PAQ question responses ranged from 0.31-1.00 (ICC (2, 1)) for continuous measures and 0.60-0.97 (κ) for categorical measures.</p> <p>Conclusions</p> <p>Pre-PAQ has acceptable validity and reliability and appears promising as a population measure of activity behavior but it requires further testing on a more broadly representative population to affirm this. Pre-PAQ fills an important niche for researchers to measure activity in preschool-age children and concurrently to measure parental, family and neighborhood factors that influence these behaviors.</p