The home environment and toddler physical activity: an ecological momentary assessment study.

Abstract

Physical activity (PA) promotion/obesity prevention in toddlerhood should include home environments. The aim of the study was to determine social/physical home environment factors associated with toddler PA using ecological momentary assessment (EMA, real-time data collection). Low-income mother-toddler dyads were recruited and given a handheld EMA device (53 random beeps followed by social/physical environment survey over 8 d). Simultaneously, PA was assessed via accelerometry (data extracted 15 min before/after response, average activity counts per minute). Linear mixed-effects models were used, adjusting for toddler age, urban/suburban residence and time of day; covariate moderating effects were examined; within-subjects and between-subjects findings were reported. PA was hypothesized to be greater when toddlers are outside (vs. inside), children are nearby (vs. alone), toddlers are interacting with their mothers (vs. not) and TV is off (vs. on). The final count was 2454 EMA/PA responses for 160 toddlers (mean age 20 months, range 12-31; 55% male, 66% Black and 54% urban). Associations with PA include (within subjects) the following: outside location (212 additional counts min-1 ), children nearby (153 additional counts min-1 ) and interacting with mother (321 additional counts min-1 ), compared with alternatives. Age was moderated by outside location/PA association (within subjects), with 90 additional counts min-1 per 3-month age group outside vs. inside. No between-subjects or television/PA associations were found. Home environment factors were associated with PA, including outside location, children nearby and mother interaction. EMA is a novel method, allowing identification of contextual factors associated with behaviours in natural environments.