Key Messages in an Early Childhood Obesity Prevention Intervention : Are They Recalled and Do They Impact Children's Behaviour?

Knowledge of the impact of health messages as an intervention strategy is sparse. The aim of this study was to explore recall and use of health behaviour messages among mothers, and whether recall is associated with child health behaviours. Intervention group data from the 15 months Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) were used (n = 127, children 4 months at commencement). Mothers recalled (unprompted then prompted) at 2 and 3.5 years post-intervention six key messages used in the program, and reported whether they had used them. Children's food intake was measured by three days of 24-h recall; physical activity by accelerometers; and television viewing by parent report. Unprompted recall ranged between 1-56% across messages and follow-up points, and 37-90% for prompted recall. The most commonly recalled messages "tap into water", "parents provide, kids decide" and "color every meal with fruit and veg" were also most commonly used. There were few associations between recall and children's health behaviours. Given the association between recall and reported use, it is important to plan messages so they resonate well with the target group and its needs. Messages should be used as one of multiple strategies within health promotion programs.Peer reviewe

Children\u27s physical activity and screen time : qualitative comparison of views of parents of infants and preschool children

BackgroundWhile parents are central to the development of behaviours in their young children, little is known about how parents view their role in shaping physical activity and screen time behaviours.MethodsUsing an unstructured focus group design, parental views and practices around children&prime;s physical activity and screen time (television and computer use) were explored with eight groups of new parents (n=61; child age &lt;12 months) and eight groups of parents with preschool-aged (3&ndash;5 year old) children (n=36) in Melbourne, Australia.ResultsParents generally believed children are naturally active, which may preclude their engagement in strategies designed to increase physical activity. While parents across both age groups shared many overarching views concerning parenting for children&prime;s physical activity and screen time behaviours, some strategies and barriers differed depending on the age of the child. While most new parents were optimistic about their ability to positively influence their child&prime;s behaviours, many parents of preschool-aged children seemed more resigned to strategies that worked for them, even when aware such strategies may not be ideal.ConclusionsInterventions aiming to increase children&prime;s physical activity and decrease screen time may need to tailor strategies to the age group of the child and address parents&prime; misconceptions and barriers to optimum parenting in these domains.<br /

Early childhood physical activity, sedentary behaviors and psychosocial well-being: a systematic review

ObjectivesLittle is known about how health behaviors such as physical activity (PA) and sedentary behaviors (SB) may be associated with psychosocial well-being during the crucial early childhood period. The aim of this study was to undertake a systematic review of associations between PA, SB and psychosocial well-being during early childhood.MethodsIn February 2013, MEDLINE, PsycINFO, SPORTDiscus and Embase electronic databases were searched. Inclusion criteria were: 1. peer-reviewed publication since 1980 in English; 2. children aged birth&ndash;5 years; 3. PA or SB measured during early childhood; 4. an indicator of child psychosocial well-being; and 5. association between PA/SB and psychosocial well-being reported. Studies could be observational or interventions. Data were extracted by one author and entered into a standardized form in February and March 2013.Results19 studies were identified: four examined PA, 13 examined SB and two examined PA and SB. No interventions met the inclusion criteria; all included studies were observational. In total, 21 indicators of psychosocial well-being were examined, 13 only once with the remaining eight reported in more than one study. Some dose&ndash;response evidence was identified suggesting that PA is positively, and SB inversely, associated with psychosocial well-being.ConclusionsToo few studies exist to draw conclusions regarding associations. Future high-quality cohort and intervention studies are warranted particularly investigating dose&ndash;response associations

Preschool and childcare center characteristics associated with children’s physical activity during care hours: an observational study

STROBE Statement—Checklist of items included in this study. (DOCX 28 kb

Preschool and childcare center characteristics associated with children\u27s physical activity during care hours: an observational study

Background: Preschools and childcare settings offer opportunities to promote adequate levels of physical activity. Research is needed to identify the key features of these settings to optimize young children\u27s activity. The aims of this study were to determine if differences existed in preschool children\u27s physical activity during care hours compared with outside care hours and to examine a comprehensive range of potential center-based correlates of physical activity for preschool boys and girls. Methods: Data are from the Healthy Active Preschool and Primary Years study: 71 childcare centers, 65 preschools and 1002 preschool children. Percent of time in total (light- to vigorous-intensity) physical activity was measured using Actigraph GT1M accelerometers. Center physical environment characteristics, policies and practices were assessed by trained research staff using comprehensive audit tools. Data were collected in 2008/9 and were analyzed separately for boys and girls in Stata using multilevel mixed effects models. Results: Boys and girls were less active during care than outside care hours (51.1 % vs. 52.4 %, p = 0.01; 48.0 % vs. 51.5 %, p \u3c 0.0001, respectively). In the final adjusted models, number of outdoor spaces with natural ground coverings was associated with boys\u27 physical activity (coeff = 0.477, 95 % CI 0.089, 0.867) and the amount of time girls spent indoors before going outdoors was inversely associated with their physical activity (coeff = −0.035, 95 % CI −0.065, −0.004). The models explained 12 and 10 % of boys\u27 and girls\u27 physical activity during care hours, respectively. Conclusions: This study identified that children are significantly less active during than outside care hours. Few center-based correlates of preschool children\u27s physical activity were identified. Future research should explore other aspects of centers, such as what children actually do while they are outside, and broader potential influences on children\u27s behaviours including social, cultural and policy contexts within which centers operat

How does perceived risk mediate associations between perceived safety and parental restriction of adolescents\u27 physical activity in their neighborhood?

BackgroundThere is evidence that adolescence is a critical period of decline in physical activity. However, adolescents may have limited opportunities to be physically active outdoors if their parents are concerned about neighborhood safety and restrict their adolescent&rsquo;s physical activity within their neighborhood. Pathways that lead to parental restriction of adolescents&rsquo; physical activity (constrained behavior) are under-researched. This study aimed to examine perceived risk as a potential mediator of associations between perceived safety/victimization and constrained behavior.MethodsCross-sectional study of adolescents (43% boys) aged 15&ndash;17&thinsp;years (n&thinsp;=&thinsp;270) in Melbourne, Australia. Parents reported perceived safety (road safety, incivilities and personal safety) and prior victimization in their neighborhood, perceived risk of their children being harmed and whether they constrained their adolescent&rsquo;s physical activity. Constrained behavior was categorized as &lsquo;avoidance&rsquo; or &lsquo;defensive&rsquo; behavior depending on a whether physical activity was avoided or modified, respectively, due to perceived risk. MacKinnon&rsquo;s product-of-coefficients test of mediation was used to assess potential mediating pathways between perceived safety/victimization and constrained behavior.ResultsFor girls only, perceived risk was a significant mediator of associations between perceived road safety and avoidance/defensive behavior, and between perceived incivilities, perceived personal safety, victimization and defensive behavior.ConclusionsAssociations between perceived safety/victimization and constrained behavior are complex. Findings may guide the design of interventions that aim to improve actual and perceived levels of safety and reduce perceptions of risk. This is of particular importance for adolescent girls among whom low and declining levels of physical activity have been observed worldwide.<br /

Early childhood predictors of toddlers\u27 physical activity: longitudinal findings from the Melbourne InFANT program

Background:&nbsp;Young children are at risk of not meeting physical activity recommendations. Identifying factors from&nbsp;the first year of life which influence toddlers&rsquo; physical activity levels may help to develop targeted intervention&nbsp;strategies. The purpose of this study was to examine early childhood predictors of toddlers&rsquo; physical activity across&nbsp;the domains of maternal beliefs and behaviours, infant behaviours and the home environment.&nbsp;Methods: Data from 206 toddlers (53% male) participating in the Melbourne InFANT Program were collected in 2008&ndash;2010 and analysed in 2012. Mothers completed a survey of physical activity predictors when their child was 4- (T1) and&nbsp;9- months old (T2). Physical activity was assessed by ActiGraph GT1M accelerometers at 19- months (T3) of age.Results: One infant behaviour at T1 and one maternal belief and two infant behaviours at T2 showed associations with&nbsp;physical activity at T3 and were included in multivariate analyses. After adjusting for the age at which the child started&nbsp;walking and maternal education, the time spent with babies of a similar age at 4-months (&beta; = 0.06, 95% CI [0.02, 0.10])&nbsp;and the time spent being physically active with their mother at 9-months (&beta; = 0.06, 95% CI [0.01, 0.12]) predicted&nbsp;children&rsquo;s physical activity at 19-months of age.&nbsp;Conclusions: Promotion of peer-interactions and maternal-child co-participation in physical activity could serve as a&nbsp;health promotion strategy to increase physical activity in young children. Future research is required to identify other&nbsp;early life predictors not assessed in this study and to examine whether these factors predict physical activity in later life&nbsp;stages.</div

Tracking of maternal self-efficacy for limiting young children\u27s television viewing and associations with children\u27s television viewing time: a longitudinal analysis over 15-months

BACKGROUND: Mothers\u27 self-efficacy for limiting their children\u27s television viewing is an important correlate of this behaviour in young children. However, no studies have examined how maternal self-efficacy changes over time, which is potentially important during periods of rapid child development. This study examined tracking of maternal self-efficacy for limiting young children\u27s television viewing over 15-months and associations with children\u27s television viewing time. METHODS: In 2008 and 2010, mothers (n&thinsp;=&thinsp;404) from the Melbourne InFANT Program self-reported their self-efficacy for limiting their child\u27s television viewing at 4- and 19-months of age. Tertiles of self-efficacy were created at each time and categorised into: persistently high, persistently low, increasing or decreasing self-efficacy. Weighted kappa and multinomial logistic regression examined tracking and demographic and behavioural predictors of change in self-efficacy. A linear regression model examined associations between tracking categories and children\u27s television viewing time. RESULTS: Tracking of maternal self-efficacy for limiting children\u27s television viewing was low (kappa&thinsp;=&thinsp;0.23, p&thinsp;&lt;&thinsp;0.001). Mothers who had persistently high or increasing self-efficacy had children with lower television viewing time at 19-months (&beta;&thinsp;=&thinsp;-35.5; 95 % CI&thinsp;=&thinsp;-54.4,-16.6 and &beta;&thinsp;=&thinsp;37.0; 95 % CI&thinsp;=&thinsp;-54.4,-19.7, respectively). Mothers of children with difficult temperaments were less likely to have persistently high self-efficacy. Mothers who met adult physical activity guidelines had 2.5 greater odds of increasing self-efficacy. CONCLUSIONS: Interventions to increase and maintain maternal self-efficacy for limiting children\u27s television viewing time may result in lower rates of this behaviour amongst toddlers. Maternal and child characteristics may need to be considered when tailoring interventions

Associations between dietary intakes of first-time fathers and their 20-month-old children are moderated by fathers\u27 BMI, education and age

Children\u27s learning about food is considerable during their formative years, with parental influence being pivotal. Research has focused predominantly on maternal influences, with little known about the relationships between fathers\u27 and children\u27s diets. Greater understanding of this relationship is necessary for the design of appropriate interventions. The aim of this study was to investigate the associations between the diets of fathers and their children and the moderating effects of fathers\u27 BMI, education and age on these associations. The diets of fathers and their first-born children (n 317) in the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program were assessed using an FFQ and 3&times;24-h recalls, respectively. The InFANT Program is a cluster-randomised controlled trial in the setting of first-time parents groups in Victoria, Australia. Associations between father and child fruit, vegetable, non-core food and non-core drink intakes were assessed using linear regression. The extent to which these associations were mediated by maternal intake was tested. Moderation of associations by paternal BMI, education and age was assessed. Positive associations were found between fathers\u27 and children\u27s intake of fruit, sweet snacks and take-away foods. Paternal BMI, education and age moderated the relationships found for the intakes of fruit (BMI), vegetables (age), savoury snacks (BMI and education) and take-away foods (BMI and education). Our findings suggest that associations exist at a young age and are moderated by paternal BMI, education and age. This study highlights the importance of fathers in modelling healthy diets for their children

Prevalence and stability of active play, restricted movement and television viewing in infants

This study describes engagement in and stability of physical activity and sedentary behaviours in early life, and assesses associations with sex, maternal education and developmental stage. Maternal-report data at child age 4, 9 and 20 months were collected from 542 families in the Melbourne Infant Feeding Activity and Nutrition Trial Program. Parents estimated average time per day their child spent in active pursuits or pursuits that restricted movement. With increasing age, children generally spent more time in active pursuits and watching television, and less time in situations that restrict movement. Associations were found with age of developmental milestone attainment but not sex or maternal education. Stability over time was strongest for television viewing (&beta; = 0.34&ndash;0.38) and time spent outdoors (&beta; = 0.27&ndash;0.33). Contrary to guidelines, television viewing increased and showed stability, suggesting a need to target this behaviour very early in life to achieve optimal longer term outcomes