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

Adolescent-parent interactions and communication preferences regarding body weight and weight management: a qualitative study

<p>Abstract</p> <p>Background</p> <p>This study aimed to canvass the nature of adolescent-parent interactions about weight, particularly overweight, and to explore ideas of how to foster supportive discussions regarding weight, both in the home and with family doctors.</p> <p>Methods</p> <p>A market research company was contracted to recruit and conduct a series of separate focus groups with adolescents and unrelated parents of adolescents from low-middle socio-economic areas in Sydney and a regional centre, Australia. Group discussions were audio recorded, transcribed, and then a qualitative content analysis of the data was performed.</p> <p>Results</p> <p>Nine focus groups were conducted; two were held with girls (n = 13), three with boys (n = 18), and four with parents (20 mothers, 12 fathers). Adolescent and parent descriptions of weight-related interactions could be classified into three distinct approaches: indirect/cautious (i.e. focus on eating or physical activity behaviors without discussing weight specifically); direct/open (i.e. body weight was discussed); and never/rarely discussing the subject. Indirect approaches were described most frequently by both adolescents and parents and were generally preferred over direct approaches. Parents and adolescents were circumspect but generally supportive of the potential role for family doctors to monitor and discuss adolescent weight status.</p> <p>Conclusions</p> <p>These findings have implications for developing acceptable messages for adolescent and family overweight prevention and treatment interventions.</p

Intention to breastfeed and awareness of health recommendations: findings from first-time mothers in southwest Sydney, Australia

<p>Abstract</p> <p>Background</p> <p>In 2001, the World Health Organisation (WHO) recommended exclusive breastfeeding for the first six months of life. The objectives of this study are to assess awareness of the WHO recommendation among first-time mothers (women at 24 to 34 weeks of pregnancy) and to explore the relationship between this awareness and mothers' intention to exclusively breastfeed for six months.</p> <p>Methods</p> <p>This study was part of the Healthy Beginnings Trial (HBT) conducted in southwest Sydney, Australia. We analysed cross-sectional baseline data of the trial conducted in 2008, including 409 first-time mothers at 24 to 34 weeks of pregnancy. The mothers' awareness of the recommended duration of exclusive breastfeeding and their intention to meet the recommendation were assessed through face-to-face interviews. Socio-demographic data were also collected. Factors associated with awareness of the recommendation, or the intention to meet the recommendation, were determined by logistic regression modeling. Log-binomial regression was used to calculate adjusted risk ratios (ARR).</p> <p>Results</p> <p>Sixty-one per cent of mothers knew the WHO recommendation of exclusive breastfeeding for six months. Only 42% of all mothers intended to meet the recommendation (breastfeed exclusively for six months). Among the mothers who knew the recommendation, 61% intended to meet the recommendation, compared to only 11% among those mothers who were not aware of the recommendation.</p> <p>The only factor associated with awareness of the recommendation was mother's level of education. Mothers who had a tertiary education were 1.5 times more likely to be aware of the recommendation than those who had school certificate or less (ARR adjusted for age 1.45, 95% CI 1.08, 1.94, p = 0.02). Mothers who were aware of the recommendation were 5.6 times more likely to intend to breastfeed exclusively to six months (ARR adjusted for employment status 5.61, 95% CI 3.53, 8.90, p < 0.001).</p> <p>Conclusion</p> <p>Awareness of the recommendation to breastfeed exclusively for six months is independently associated with the intention to meet this recommendation. A substantial number of mothers were not aware of the recommendation, particularly among those with low levels of education, which is of concern in relation to promoting breastfeeding. Improving mothers' awareness of the recommendation could lead to increased maternal intention to exclusively breastfeed for six months. However, whether this intention could be transferred into practice remains to be tested.</p> <p>Trial Registration</p> <p>HBT is registered with the Australian Clinical Trial Registry (ACTRNO12607000168459)</p

Promoting Health and Nutrition Through Sport: Attitudes of the Junior Sporting Community

Introduction: This study aimed to provide information on parents’, children’s and sporting officials’ attitudes to sponsorship arrangements, and their support of potential policy interventions to reorient sponsorship to be more health promoting. Methods: Sports clubs (n=20) known to have food and beverage sponsors in Sydney, Illawarra and Canberra/Queanbeyan were selected. Parents and children at sports clubs were recruited through convenience sampling by approaching those attending the sports club at the time of the survey and those children who had a signed consent form. Sports clubs were visited between May and November 2010. At each club, one sports club official, ten parents of players aged 5 to 14 years, and five children aged 10 to 14 years were surveyed. Results: The majority of sporting officials and parents were supportive of policies to restrict unhealthy food and beverage sponsorship of elite sport and children’s sports clubs. More than two-thirds of all children were able to correctly recall sponsors of their sports club and almost half could correctly name at least one sponsor of their favourite elite sports team. Most children thought that food and beverage companies sponsored sport to help out sports clubs and liked to return the favour to these sponsors by buying their products. Conclusion: Children’s high level of recall of food and beverage sponsors is concerning as this recall is likely to be linked to children’s product preferences and consumption behaviours. Alternative funding mechanisms are required to replace community and elite sport sponsorship from unhealthy food and beverage companies to reduce the promotional effects of this marketing on children’s food choices and eating behaviours

The normative power of food promotions: Australian children\u27s attachments to unhealthy food brands

The formation of food brand associations and attachment is fundamental to brand preferences, which influence purchases and consumption. Food promotions operate through a cascade of links, from brand recognition, to affect, and on to consumption. Frequent exposures to product promotions may establish social norms for products, reinforcing brand affect. These pathways signify potential mechanisms for how children\u27s exposure to unhealthy food promotions can contribute to poor diets. The present study explored children\u27s brand associations and attachments for major food brands. A cross-sectional online survey was conducted. Fourteen study brands were used, with each child viewing a set of seven logos. The questionnaire assessed perceptions of food brands and perceptions of users of brands, using semantic differential scales, and perceived brand \u27personalities\u27, using Likert scales. New South Wales, Australia, October-November 2014. Children aged 10-16 years (n 417). Children demonstrated strong positive affect to certain brands, perceiving some unhealthy food brands to have positive attributes, desirable user traits and alignment to their own personality. Brand personality traits of \u27smart\u27 and \u27sporty\u27 were viewed as indicators of healthiness. Brands with these traits were ranked lower for popularity. Children\u27s brand associations and attachments indicate the potential normative social influences of promotions. While children are aware of brand healthiness as an attribute, this competes with other brand associations, highlighting the challenge of health/nutrition messaging to counter unhealthy food marketing. Restricting children\u27s exposure to unhealthy food marketing and the persuasive nature of marketing is an important part of efforts to improve children\u27s diet-related health

Family and home correlates of television viewing in 12–13 year old adolescents: The Nepean Study

BACKGROUND: Few young people meet television viewing guidelines. PURPOSE: To determine the association between factors in the family and home environment and watching television, including videos and DVDs, in early adolescence. METHODS: Cross-sectional, self-report survey of 343 adolescents aged 12–13 years (173 girls), and their parents (338 mothers, 293 fathers). Main measures were factors in the family and home environment potentially associated with adolescents spending ≥ 2 hours per day in front of the television. Factors examined included family structure, opportunities to watch television/video/DVDs, perceptions of rules and regulations on television viewing, and television viewing practices. RESULTS: Two-thirds of adolescents watched ≥ 2 hours television per day. Factors in the family and home environment associated with adolescents watching television ≥ 2 hours per day include adolescents who have siblings (Adjusted Odds Ratio [95%CI] AOR = 3.0 [1.2, 7.8]); access to pay television (AOR = 2.0 [1.1, 3.7]); ate snacks while watching television (AOR = 3.1 [1.8, 5.4]); co-viewed television with parents (AOR = 2.3 [1.3, 4.2]); and had mothers who watched ≥ 2 hours television per day (AOR = 2.4 [1.3, 4.6]). CONCLUSION: There are factors in the family and home environment that influence the volume of television viewed by 12–13 year olds. Television plays a central role in the family environment, potentially providing a means of recreation among families of young adolescents for little cost. Interventions which target family television viewing practices and those of parents, in particular, are more likely to be effective than interventions which directly target adolescent viewing times

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 /