635 Understanding parent perceptions of healthy physical activity for their child with a chronic medical condition

Abstract

BackgroundA physically active lifestyle is important for long-term heart health and quality of life for children. Young children rely on parents to facilitate their physical activity (PA) participation, emphasizing the need for strong parental support. We sought to identify factors associated with parent questions and uncertainty about their child's PA participation in children with cardiac, respiratory or rheumatologic conditions.Method/resultsThis cross-sectional study of 127 children (female = 73; complex CHD = 72, simple CHD = 16, respiratory = 20, rheumatologic = 19) involved administration of a parent questionnaire about their child's PA participation and measurement of child and parent PA with an omni-directional accelerometer worn at the iliac crest for one week. History of arrhythmia (P < 0.001), parent perception of their child as unwell (P = 0.001) and higher father PA level (427 ± 115 min/day, P < 0.001), among the few fathers participating (n = 10), were associated with more frequent parent questions about their child's current or future PA participation, while parent-reported child activity on school days (P = 0.1), mother's PA level (46 ± 41 min/day, P = 0.3) and gender (P = 0.9) were not. Younger child age was associated with more frequent parent questions about new activities the child could participate in (−3.4 ± 1.6 years, P = 0.04). In children with complex CHD, parent questions about their child's current or future PA participation were associated with lower weekend PA levels (−30 ± 13 min/day, P = 0.02); a similar trend was seen in children with simple CHD (−25 ± 15 min/day, P = 0.09) or arthritis (−25 ± 15 min/day, P = 0.09). Parents with questions about their child's current or future PA participation reported that it was less likely that their child could achieve and maintain a higher activity level even if desired by the child (P = 0.02). Presence of parent questions about their child's current PA participation was not associated with parent-reported importance of PA for the child (P = 0.6).ConclusionMore PA counseling by the child's healthcare team is required when the child is younger, has a history of arrhythmia or is reported by the parents as being less well. Asking if a parent has questions about their child's PA participation may be a useful screening tool to identify children who are less active on weekends when activity is wholly determined by the home environment and/or are less likely to achieve and maintain a higher PA level and thus require more PA counseling. BackgroundA physically active lifestyle is important for long-term heart health and quality of life for children. Young children rely on parents to facilitate their physical activity (PA) participation, emphasizing the need for strong parental support. We sought to identify factors associated with parent questions and uncertainty about their child's PA participation in children with cardiac, respiratory or rheumatologic conditions. A physically active lifestyle is important for long-term heart health and quality of life for children. Young children rely on parents to facilitate their physical activity (PA) participation, emphasizing the need for strong parental support. We sought to identify factors associated with parent questions and uncertainty about their child's PA participation in children with cardiac, respiratory or rheumatologic conditions. Method/resultsThis cross-sectional study of 127 children (female = 73; complex CHD = 72, simple CHD = 16, respiratory = 20, rheumatologic = 19) involved administration of a parent questionnaire about their child's PA participation and measurement of child and parent PA with an omni-directional accelerometer worn at the iliac crest for one week. History of arrhythmia (P < 0.001), parent perception of their child as unwell (P = 0.001) and higher father PA level (427 ± 115 min/day, P < 0.001), among the few fathers participating (n = 10), were associated with more frequent parent questions about their child's current or future PA participation, while parent-reported child activity on school days (P = 0.1), mother's PA level (46 ± 41 min/day, P = 0.3) and gender (P = 0.9) were not. Younger child age was associated with more frequent parent questions about new activities the child could participate in (−3.4 ± 1.6 years, P = 0.04). In children with complex CHD, parent questions about their child's current or future PA participation were associated with lower weekend PA levels (−30 ± 13 min/day, P = 0.02); a similar trend was seen in children with simple CHD (−25 ± 15 min/day, P = 0.09) or arthritis (−25 ± 15 min/day, P = 0.09). Parents with questions about their child's current or future PA participation reported that it was less likely that their child could achieve and maintain a higher activity level even if desired by the child (P = 0.02). Presence of parent questions about their child's current PA participation was not associated with parent-reported importance of PA for the child (P = 0.6). This cross-sectional study of 127 children (female = 73; complex CHD = 72, simple CHD = 16, respiratory = 20, rheumatologic = 19) involved administration of a parent questionnaire about their child's PA participation and measurement of child and parent PA with an omni-directional accelerometer worn at the iliac crest for one week. History of arrhythmia (P < 0.001), parent perception of their child as unwell (P = 0.001) and higher father PA level (427 ± 115 min/day, P < 0.001), among the few fathers participating (n = 10), were associated with more frequent parent questions about their child's current or future PA participation, while parent-reported child activity on school days (P = 0.1), mother's PA level (46 ± 41 min/day, P = 0.3) and gender (P = 0.9) were not. Younger child age was associated with more frequent parent questions about new activities the child could participate in (−3.4 ± 1.6 years, P = 0.04). In children with complex CHD, parent questions about their child's current or future PA participation were associated with lower weekend PA levels (−30 ± 13 min/day, P = 0.02); a similar trend was seen in children with simple CHD (−25 ± 15 min/day, P = 0.09) or arthritis (−25 ± 15 min/day, P = 0.09). Parents with questions about their child's current or future PA participation reported that it was less likely that their child could achieve and maintain a higher activity level even if desired by the child (P = 0.02). Presence of parent questions about their child's current PA participation was not associated with parent-reported importance of PA for the child (P = 0.6). ConclusionMore PA counseling by the child's healthcare team is required when the child is younger, has a history of arrhythmia or is reported by the parents as being less well. Asking if a parent has questions about their child's PA participation may be a useful screening tool to identify children who are less active on weekends when activity is wholly determined by the home environment and/or are less likely to achieve and maintain a higher PA level and thus require more PA counseling. More PA counseling by the child's healthcare team is required when the child is younger, has a history of arrhythmia or is reported by the parents as being less well. Asking if a parent has questions about their child's PA participation may be a useful screening tool to identify children who are less active on weekends when activity is wholly determined by the home environment and/or are less likely to achieve and maintain a higher PA level and thus require more PA counseling.