Physical Activity Behavior In Children Research Articles

Adapting a Parental Support App to Promote Healthy Diet and Physical Activity Behaviors (MINISTOP) for a Multi-Ethnic Setting: A Qualitative Study on the Needs and Preferences of Parents and Nurses within Swedish Child Health Care.

Early efforts for prevention of childhood overweight and obesity are needed. In order to adapt an app promoting healthy diet and physical activity behaviors in children (MINISTOP 1.0) for multi-ethnic communities, we explored: (1) needs and concerns among Somali-, Arabic-, and Swedish-speaking parents in terms of supporting healthy diet and activity behaviors in their children; (2) nurses’ perceptions of parental needs and concerns in relation to diet and physical activity behaviors; and (3) how the features and content of the MINISTOP 1.0 app could be refined to better support health behaviors in children, among both parents and nurses. Focus groups with Somali-, Arabic-, and Swedish-speaking parents (n = 15), and individual interviews with nurses (n = 15) were conducted. Parents expressed several challenges in supporting children’s health behaviors, the need for a tailored app, and alternative ways of accessing the content (audio/video). Nurses emphasized the need of supporting parents early, and the value of a shared platform in different languages, to facilitate communication. This study contributes valuable insights about parental needs and relevant adaptations to a parental support app, such as addition of audio/video files for increased accessibility. This adapted app version—MINISTOP 2.0, can be useful for childhood obesity prevention in multi-ethnic communities.

931-P: Supporting Physical Activity in Children with Type 1 Diabetes: A Survey of Health Care Professionals

Background: The risk of some of the co-morbidities associated with type 1 diabetes (T1D) can be mitigated through physical activity. Despite benefits, research shows that children and adolescents with T1D are not meeting recommended levels of physical activity. Health Care Professionals (HCPs) have an important role in supporting and encouraging children and adolescents to be physically active. Therefore it is important to understand the perspectives of HCPs in relation to understanding physical activity behaviours in children and adolescents, prior to designing interventions to support physical activity. Methods: An online mixed methods survey of HCPs in England and Wales. Respondents were asked questions about how they support physical activity in the clinic and their perceptions of barriers/enablers of physical activity. Quantitative data were analysed descriptively, qualitative data were analysed using a combined deductive framework and inductive thematic analysis using the Capability, Opportunity, Motivation model of behaviour (COM-B). Results: Responses were received from 114 individual HCPs, representing 45% of paediatric diabetes units in England and Wales. Results show that HCPs felt that the promotion of physical activity is important in their clinic (90%) and advise children and adolescents to increase levels of physical activity (88%). Many respondents (43%) felt there was lack of education opportunities for HCPs on this topic. Qualitative responses highlighted three key areas of behaviour that might be a barrier to physical activity in their patients: (1) psychological capacity (i.e., fear of hypoglycaemia and lack of understanding of how to manage insulin and glucose levels), (2) physical opportunity (i.e., time, cost, and access to resources), and (3) social opportunity (i.e., family, school, and peer support). Conclusion: This understanding will help develop future interventions to support physical activity in children and adolescents with T1D. Disclosure E. Cockcroft: None. P. Narendran: Speaker’s Bureau; Self; Novo Nordisk Inc., Sanofi. E. Wooding: None. R. C. Andrews: None. Funding National Institute for Health Research Applied Research Collaboration South West Peninsula (to E.C.)

The reliability and validity of a physical activity and sedentary behaviour home audit tool for children aged 2–5 years

ObjectivesTo test the reliability and validity of a physical activity and sedentary behaviour home environment audit tool for young children (2–5 years old). DesignCross-sectional. MethodsParents of children aged 2–5 years were recruited through online methods (i.e., social media and blogs). Reliability of the SPACES home audit tool was assessed using self-reported surveys (n = 55) completed on two separate occasions, approximately 12 days apart. Validity of the home audit tool was assessed in a separate sample via home observations by researchers conducted after parents completed the self-report survey (n = 21). The audit tool measured indoor and outdoor home environment characteristics hypothesised to influence young children's physical activity and sedentary behaviour. Data were analysed using intraclass correlations (ICCs) and Kappas. ResultsThe majority of items demonstrated acceptable reliability and validity (80.4% and 53.4%, respectively). Size of the child's bedroom showed substantial agreement for reliability (ICC = 0.85), and slight agreement for validity (ICC = 0.23). Physical activity equipment items within the indoor environment showed slight to moderate agreement for reliability (ICC = 0.32–0.68) and slight agreement for validity (ICC = 0.15–0.35). Screen time equipment showed substantial agreement for reliability (ICC = 0.83) and fair for validity (ICC = 0.38). Outdoor items (e.g., backyard size, availability and condition of physical activity equipment, outdoor features) showed substantial agreement for reliability and validity (ICC = 0.84–0.95). ConclusionsThe home audit tool was found to be reliable and valid for many items. This tool could be used in future research to understand the impact of the home environment on young children's physical activity and sedentary behaviour.

Weight-Related Behaviors of Children with Obesity during the COVID-19 Pandemic.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, children and families have had to adapt their daily lives. The purpose of this study was to describe changes in the weight-related behaviors of children with obesity after the onset of the COVID-19 pandemic. Methods: Semistructured interviews (n = 51) were conducted from April to June 2020 with parents of children with obesity. Families were participants in a randomized trial testing a clinic-community pediatric obesity treatment model. During interviews, families described their experience during the COVID-19 pandemic, with a particular emphasis on children's diet, physical activity, sleep, and screen time behaviors. Rapid qualitative analysis methods were used to identify themes around changes in children's weight-related behaviors. Results: The mean child age was 9.7 (±2.8) years and the majority of children were Black (46%) or Hispanic (39%) and from low-income families (62%). Most parent participants were mothers (88%). There were differences in the perceived physical activity level of children, with some parents attributing increases in activity or maintenance of activity level to increased outdoor time, whereas others reported a decline due to lack of outdoor time, school, and structured activities. Key dietary changes included increased snacking and more meals prepared and consumed at home. There was a shift in sleep schedules with children going to bed and waking up later and an increase in leisure-based screen time. Parents played a role in promoting activity and managing children's screen time. Conclusions: The COVID-19 pandemic has created unique lifestyle challenges and opportunities for lifestyle modification. Clinical Trials ID: NCT03339440.

Examining differences in parents' perceptions of children's physical activity versus screen time guidelines and behaviours.

Most Canadian and Australian children do not meet Physical Activity Guidelines (PAG) or Screen Time Guidelines (STG). Regarding the social issue advertising believability model (SIABM), parental support for these behaviours may depend upon how believable parents find guideline messages. The aim of the study was to examine differences in parents' SIABM variables and perceived behavioural control for PAG and STG messages. Data were collected online; 499 Canadian parents with at least one child aged 5-11 years (75.6% mothers) participated. Differences in model variables were analysed using analyses of variance. Parents demonstrated greater issue involvement, attitudes towards the issue, parental support attitudes and perceived behavioural control for the PAG compared to the STG (d > 0.10). Mothers believed the messages more and had more favourable attitudes towards the issues as compared to fathers (d >0.21). Parents' evaluations of PAG messages and corresponding supportive behaviours were generally more positive than STG. Future messages should emphasise supportive behaviours for screen time reduction that are feasible and enjoyable for children.

“Capturing the magic”: identifying the active ingredients of a physical activity participation intervention for children and youth with disabilities

Purpose This study aimed to define the active ingredients of a participation-focused physical activity intervention for children and youth with disabilities. Materials and methods An ethnographic approach was employed, triangulating participant observation, interviews and focus groups. Participant recruitment occurred through purposive sampling of staff employed at Beitostolen Healthsports Centre (BHC), and paediatric service providers visiting the centre. Interviews were transcribed verbatim and coded together with observation data. Secondary coding linked data to corresponding categories of the International Classification of Functioning, Disability and Health: Child and Youth version. Results Thirteen staff from BHC and 7 paediatric service providers participated in the study. Fourteen active ingredients were identified and were characterised at the level of the intervention (k = 8), the organisation (k = 4), and the individual (k = 2). Within the ingredients, 53 unique ICF-CY categories were identified. Twenty-six categories belonged to the ICF-CY component of “environment,” and 26 categories to “activities and participation.” No categories related to “body functions” or “body structures.” Conclusions The role of the environment, and specifically support and relationships, may be an essential consideration for enabling physical activity participation. Outcomes may guide program design and implementation to promote and sustain physical activity behaviours for children and youth with disabilities. Implications for rehabilitation The active ingredients identified in this study may guide the design and implementation of programs to promote and sustain physical activity behaviours of children and youth with disabilities. Leadership qualities and strength-based attitudes may be key characteristics of organisational practice that optimise outcomes for children and families. A “relationship-centred” approach, i.e., a network of children, families, health professionals, peers, mentors, and services in the community, may support children and young people with disabilities to achieve their physical activity participation goals.

Reduced physical activity and increased sedentary behaviour: the damage on young people during the COVID-19 pandemic

Healthy childhood development is fostered through movement behaviours, including sufficient physical activity. This article reviews some of the recently published global studies that have examined the impact of COVID-19 on children's physical activity and sedentary behaviours, the majority of which have indicated that children's physical activity behaviours have lessened significantly during these times, while their sedentary behaviours have risen significantly. The authors make some suggestions for ways to encourage and foster physical activity in both children and their families, for example by showing people different ways of staying active and offering other opportunities for physical activity, as well as ensuring the feeling of staying safe and being protected.

The relationship between educators’ and children's physical activity and sedentary behaviour in early childhood education and care

ObjectivesThe early childhood education and care (ECEC) environment has a significant role to play in the promotion of physical activity and reduction of sedentary behaviour in young children. Educators may be an important social factor influencing children's physical activity and sedentary behaviour, however limited evidence exists on this relationship. The primary aim was to examine the relationships between educators’ and children's physical activity and sedentary behaviours within ECEC settings. DesignA cross sectional study. MethodsThe study involved 11 ECEC centres from NSW, Australia (n=110 educators; n=490 children). Data for each centre were collected over five consecutive days. Objectively measured physical activity and sedentary behaviour were collected from children using Actigraph accelerometers and were analysed using STATA 13c. Linear regression was used to examine relationships between children and educators, adjusted for centre clustering. ResultsA significant association was reported between educators’ sedentary behaviour and children's sedentary behaviour (p=0.047). Educators spent 61% of their work day in sedentary behaviour. No significant associations were reported between educators’ physical activity and children's physical activity, for any intensity of physical activity. ConclusionsThe positive relationship between educators’ sedentary behaviours and children's sedentary behaviour in this study highlights a novel area to target in future interventions. Improving physical activity and sedentary behaviours of educators will likely improve children's physical activity levels and thus health and wellbeing outcomes.

Fidelity and factors influencing implementation of Healthy Me, Healthy: process evaluation of a social marketing campaign for diet and physical activity behaviors of children in childcare.

The effectiveness of interventions targeting children's eating and physical activity behaviors through childcare settings is inconsistent. To enhance public health impact, it is imperative to evaluate fidelity of implementing complex interventions in real-world settings. This study evaluated fidelity and contextual factors influencing implementation of Healthy Me, Healthy We (HMHW). HMHW was an 8-month social marketing campaign delivered through childcare to support children's healthy eating and physical activity. HMHW required two levels of implementation support (research team and childcare providers) and two levels of campaign delivery (childcare providers and parents). Process evaluation was conducted among childcare centers in the intervention group (n=48) of the cluster-randomized control trial. Measures included attendance logs, self-report surveys, observation checklists, field notes, and semi-structured interviews. A 35-item fidelity index was created to assess fidelity of implementation support and campaign delivery. The fidelity with which HMHW was implemented by childcare providers and parents was low (mean 17.4 out of 35) and decreased between childcare providers and parents. Childcare providers had high acceptability of the program and individual components (80 - 93%). Only half of parents felt intervention components were acceptable. Frequently cited barriers to implementation by childcare providers included time constraints, parent engagement, staff turnover, and restrictive policies. The lack of observable effect of HMHW on children's dietary or physical activity behaviors may be due to inadequate implementation at multiple levels. Different or additional strategies are necessary to support implementation of multilevel interventions, particularly when individuals are expected to deliver intervention components and support others in doing so.

Can a Multicomponent-Overnight Camp Increase Physical Activity Among Danish Children? A Retrospective Cross-Sectional Study.

In Denmark, most children are not sufficiently physically active and only a few interventions have been found to increase long-term physical activity among overweight and obese children. The aim of our study was to investigate if children are physically active in correspondence to Danish recommendations after attending a multicomponent-overnight camp. A questionnaire was developed to estimate children's physical activity level and behavior and investigate how transport, economy, availability, time, motivation, and knowledge about physical activity affect children's physical activity level and behavior. In this study, 60.9% of the children did vigorous physical activity (VPA) minimum 30minutes 3times per week up to 3 years after camp. Most children were physically active at a sports club (44.3%) and only 5.7% of the children did not participate in physical activity. Parental physical activity and child motivation toward physical activity were significantly (P < .05) associated with children doing VPA. Our findings suggest that 60.9% of children who attended camp engage in VPA after camp, which compared with a recent Danish study, is more frequent than children who did not attend camp. Further investigations are needed to determine the long-term health effects in children attending interventions such as multicomponent-overnight camps.

The Effectiveness of a Blended In-Person and Online Family-Based Childhood Obesity Management Program.

Background: The purpose of this study was to evaluate the effectiveness of a 10-week blended family-based childhood obesity management program, relative to a wait-list control, in improving child body mass index (BMI) z-scores, child lifestyle behaviors, parental support for healthy eating and physical activity, and self-regulation for healthy eating and physical activity support. Methods: This study was registered as a randomized wait-listed controlled trial; however, due to low recruitment and program delivery logistics, this study transitioned into a quasi-experimental design. Families with children 8-12 years of age with a BMI ≥85th percentile for age and sex were recruited (October 2018 to March 2019) in British Columbia, Canada. The intervention provided families 10 weeks of in-person and online support on improving lifestyle behaviors. Results: Children's BMI z-scores were not significantly changed. Intervention group significantly improved their days of moderate-to-vigorous physical activity relative to control (0.75 ± 1.5; p < 0.01; ηp2 = 0.15); however, child dietary behaviors were not significantly changed. Relative to control, intervention group showed significant improvements in parental support for healthy eating (0.13 ± 0.36; p < 0.05; ηp2 = 0.06) and physical activity (1.0 ± 1.6; p < 0.05; ηp2 = 0.09) and self-regulation for healthy eating (2.0 ± 3.5; p < 0.01; ηp2 = 0.11) and physical activity support (2.0 ± 3.2; p < 0.05; ηp2 = 0.28). Conclusions: Preliminary evidence showed that the intervention was not effective in improving child BMI z-scores, but it was effective in promoting children's physical activity and parents' support behaviors. A longer study period may be required to change BMI z-scores. Clinical Trial Registration number: NCT03643341.

Patterning of Physical Activity and Sedentary Behavior at and Away from School in Preadolescent Children

ABSTRACT Background: Understanding how and where children accumulate their physical activity (PA) and sedentary minutes throughout the day has important implications for behavioral interventions. Purpose: The purpose of this study was to examine the duration and intensity of habitual PA and sedentary time (SED) at and away from school among preadolescent children. Methods: Data from twenty-one children ages 7–11 (57% girls; 57% nonwhite; 24% overweight/obese) were included in this analysis. Proportion of time spent in PA, SED, and SED bouts were examined on school days (in-school and out-of-school) and non-school days via accelerometry. Results: When comparing school time with non-school time on school days, children accumulated a higher proportion of light PA while in-school [49.3% (i.e. 5 min 18 s) vs. 39.6% (i.e. 3 h 53 min), p = .01]. While at school, the proportion of time spent in SED was less [46.3% (i.e. 3 h 7 min) vs. 56.3% (i.e. 5 h 32 min), p = .01] and fewer children spent time engaged in prolonged sitting compared to out-of-school [uninterrupted SED for 30 min 52.4% (i.e. 11 children) vs. 85.7% (i.e. 18 children), p = .02] Discussion: These findings suggest children are proportionately most active and least sedentary when at school, yet children only accumulated approximately 18 min of moderate-to-vigorous PA in this environment. Translation to Health Education Practice: These preliminary findings can help to inform physical activity programming designed to promote life-long physical activity behaviors in children.

Evaluating a child care-based social marketing approach for improving children's diet and physical activity: results from the Healthy Me, Healthy We cluster-randomized controlled trial.

Child care-based interventions offer an opportunity to reach children at a young and impressionable age to support healthy eating and physical activity behaviors. Ideally, these interventions engage caregivers, including both childcare providers and parents, in united effort. This study evaluated the impact of the Healthy Me, Healthy We intervention on children's diet quality and physical activity. A sample of 853 three- to four-year-old children from 92 childcare centers were enrolled in this cluster-randomized control trial. Healthy Me, Healthy We was an 8-month, social marketing intervention delivered through childcare that encouraged caregivers (childcare providers and parents) to use practices that supported children's healthy eating and physical activity behaviors. Outcome measures, collected at baseline and post-intervention, assessed children's diet quality, physical activity, and BMI as well as caregivers' feeding and physical activity practices. Generalized Linear Mixed Models were used to assess change from baseline to post-intervention between intervention and control arms. No significant changes were noted in any of the outcome measures except for small improvements in children's sodium intake and select parent practices. Despite the negative findings, this study offers many lessons about the importance and challenges of effective parent engagement which is critical for meaningful changes in children's health behaviors.

A 3-year longitudinal study of the association of physical activity and sedentary behaviours with childhood obesity in China: The childhood obesity study in China mega-cities.

Examine school children's physical activity (PA) and sedentary behaviours (SB) during 2015 to 2017 in China, and study their associations with children's weight status and relevant gender differences. This open cohort study included students from five major cities (Beijing, Shanghai, Xi'an, Nanjing, and Chengdu) across China. Data were collected from students in 2015, 2016, and 2017 (n = 5535) and from their parents and school personnel. Children's weight, height, and waist circumference were measured. SB and PA factors were evaluated using questionnaires. Mixed-effects models examined the relationship between weight status and PA-/SB-associated factors using this longitudinal data. These children had high rates of obesity (12.4%, 95% CI 11.6%-13.3%) and central obesity (28.1%, 95% CI 26.9%-29.3%) during 2015 to 2017. Boys were more likely to have obesity than girls (16.5% vs 8.4%, respectively) as well as centrally obesity (36.3% vs 19.8%, respectively) and spent more time in screen viewing than girls (hours/week ± SD: 2015, 1.8 ± 2.5 vs 1.5 ± 2.0; 2016, 2.0 ± 2.4 vs 1.8 ± 2.5; 2017, 1.7 ± 2.3 vs 1.4 ± 2.1 hours/week). Those who walked <5 minutes on their average daily walk to school were more likely to have obesity (OR: 1.96, 95% CI 1.03-3.73) than those who spent ≥15 minutes on walking to school. When stratified by gender, this higher risk was only observed in girls (OR: 3.01, 95% CI 1.09-8.35). Children who spent more time in screen viewing were more likely to have obesity (OR: 1.13, 95% CI 1.06-1.21) and have central obesity (OR: 1.05, 95% CI 1.02-1.09). The association for obesity was consistent in boys and girls (boys, OR: 1.15, 95% CI 1.05-1.25; girls, OR: 1.12, 95% CI 1.00-1.24). More screen time and less walking time were risk factors for developing obesity in urban Chinese children. The associations varied by gender.

Identification of Effective Programs to Improve Access to and Use of Trails among Youth from Under-Resourced Communities: A Review.

The primary purpose of this paper is to identify and review studies evaluating the effectiveness of programs to increase access to trails and trails use (physical activity) among youth from under-resourced communities. Three additional goals include identifying: (1) Correlates of physical activity/trail use and features of transportation systems and/or built environment and land use destinations, that may inform and support the planning and implementation of programs to promote trail use among youth, (2) benefits associated with trail use, and (3) barriers to trail use. Under-resourced communities are defined as those lacking sufficient resources (i.e., under-funded). METHODS: A review of the literature was conducted to identify, abstract, and evaluate studies related to programs to promote trail use among youth and youth from under-resourced communities. In anticipation of very few studies being published about this topic, studies were also reviewed to identify correlates of transportation systems and built environment and land use destinations related to increases in physical activity, and benefits of, and barriers to trail use. PUBMED, MEDLINE, PsycINFO, Sportdiscus, Annual Reviews, American Trails, and Google Scholar databases were searched using terms including trails, built environment, physical activity, exercise, walking, children, adolescents, and youth to identify studies that potentially related to the purposes for conducting this review. Review methods identified, 5278 studies based on our search terms. A review of study titles, abstracts, and select full article screens determined that 5049 studies did not meet the study inclusion criteria, leaving 221 studies included in this review. RESULTS: No studies were located that evaluated programs designed to promote and increase trail use among youth, including youth from under-resourced communities. Eight studies used longitudinal or quasi-experimental designs to evaluate physical activity and neighborhood characteristics prospectively among adolescent girls (n = 1), the effects of the path or trail development on physical activity behaviors of children, youth, and adults (n = 4), marketing or media campaigns (n = 2), and wayfinding and incremental distance signage (n = 1) to promote increased trail use. Correlates of transportation systems (e.g., trail access, road traffic congestion related to safe active travel, lack of sidewalks, closer proximity to trails, access to transportation), destinations (e.g., park availability and access, park improvements, greenspaces), or both routes and destinations (e.g., perceptions of safety, lighting), were identified. These correlates may support the planning and implementation of programs to increase trail use among youth, or may facilitate the connection of trails or routes to destinations in communities. Barriers to trail use included costs, crime, lack of transportation, lack of role models using trails, and institutional discrimination. Conclusions: Scientific evidence in support of addressing the underrepresentation of trail use by youth from under-resourced communities is lacking. However, there is a related body of evidence that may inform how to develop programs that support trail use by youth from under-resourced areas. Dedicated, deliberate, and systematic efforts will be required to address research and knowledge gaps, and to evaluate programs and practice related to trail use among youth from low income, often racially or ethnically diverse under-resourced neighborhoods or communities.

Interventions to Change School Recess Activity Levels in Children and Adolescents: A Systematic Review and Meta-Analysis.

The school environment is globally recognised as a key setting to promote child and adolescent physical activity. School recess contributes up to 40% of the school day and recommended physical activity levels, providing a critical physical activity promotion opportunity for children and adolescents. To examine the effectiveness of school recess interventions on children's and adolescents' physical activity (PA) and sedentary behaviour (SED) during this time. Systematic review and meta-analysis. EBSCOhost (Academic Search Complete, Education Source, ERIC, Global Health, MEDLINE complete, SPORTDiscus), Scopus, and ProQuest electronic databases with full text. Forty-three studies were included in the systematic review, trialling eight different intervention strategies including loose equipment, structured recess, and multicomponent studies. The meta-analysis included 16 studies. Overall, between group mean difference for: (i) time spent in moderate to vigorous-intensity physical activity (MVPA) for randomised controlled trials (RCTs) (n = 6) was 0.18 (95% CI - 0.00 to 0.36) with a marginal significant effect of Z = 1.93 (p = 0.05), (ii) time spent in MVPA for non-RCTs (n = 7) was 0.52 (95% CI - 0.01 to 1.03) with an overall effect of Z = 1.99 (p = 0.05), (iii) time spent in sedentary behaviour for RCTs (n = 3) was - 0.48 (95% CI - 1.38 to 0.43) with an overall effect of Z = 1.03 (p = 0.30). All outcomes had high heterogeneity. School recess interventions show promise for increasing MVPA. It was difficult to draw strong conclusions due to low study numbers in the meta-analysis and varied intervention designs. Interventions may need to focus on single component strategies (e.g., loose equipment) to improve understanding of outcome effects for future studies.

Physical activity behaviors in parents of children with disabilities: A systematic review

BackgroundEven though it has been widely known that parents influence physical activity (PA) behaviors of children without disabilities, there is no consensus about the effects of parents on PA behaviors of children with disabilities. AimsThe purpose of this study was to systematically review published literature examining the effects of parents on PA behaviors of children with disabilities. MethodsA systematic literature search was performed in three databases. Outcomes and resultsThe search identified 13 studies which met predetermined inclusion criteria. Of the 13 studies, 10 studies were conducted in United States and Canada. The remaining three studies were from three different countries: Italy, Australia, and Hong Kong. From the 13 studies, 24 parental factors were identified and categorized into four different dimensions: a) participating in PA intervention (four factors included), b) parental support (three factors included), c) parental PA role modeling (five factors included), and d) parental importance of child’s PA (three factors included). Six factors across three dimensions (i.e., participating in PA intervention, parental support, parental importance of their child’s PA) were significantly and positively associated with PA behaviors in children with disabilities, but no factor in parental PA role modeling was significantly associated with PA behaviors in children with disabilities. Conclusions and implicationsThe associations between parental factors and PA behaviors in children with disabilities varied depending on the dimensions of the parental factors. Further studies are warranted to confirm the association between parental factors and PA behaviors in children with disabilities, including cross-cultural comparisons.

The Association Between Socioeconomic Status And Access To Physical Activity Related Built Environment In Children

Minorities and those with lower socioeconomic status (SES) are at higher risk for chronic diseases compared to their Caucasian counterparts and those with higher SES. Establishing life-long physical activity (PA) behavior in childhood could lower the risk for chronic disease in adulthood. Access to opportunities for PA in the built environments is associated with increased PA behavior in children. Understanding patterns of access to these opportunities for minority and low SES children would be useful in developing interventions to increase PA in these populations. PURPOSE: To investigate the relationship among race, SES, proximity to public parks for children and adolescents in a mid-sized city. METHODS: ArcGIS Online was used to map public parks with 10-minute walking buffers, census track-level demographics (race of children and adolescents [≤ 19 yrs], household poverty status, and population density). Central city neighborhoods were also mapped. Partial correlations between the variables were performed, controlling for all other variables. Hierarchical cluster analysis identified homogeneous census tracts with regard to race, SES, park proximity, and population density. One-way ANOVA measured differences in the variables used to construct the clusters. Significance was set at p<0.05. RESULTS: Poverty correlated with black race (r2=0.60, p<0.001) and park proximity (r2=0.53, p=0.54), but there was no significant correlation between race and park proximity. Population density correlated with black race (r2=0.63, p<0.001), but not with any other variables. Two census track clusters were identified. Parks in cluster 1 corresponded with neighborhoods centrally located in the city. Compared to cluster 2, cluster 1 showed higher percentages of households below the poverty level (36.1±13.2 vs 4±8.6), children and adolescents of black race (63.4±18.6 vs 30.3±18.3), and children and adolescents living within 10-minute walking distance to a park (76.7±16.7 vs 8.0±11.4). CONCLUSIONS: Abundant proximity to parks may provide opportunities for physical activity interventions for at-risk children and adolescents in urban areas. Future directions should include the investigation of additional aspects of access in these subgroups such as patterns of PA-promoting park amenities.

Home Environment Factors Associated With Children’s Physical Activity Levels In A Rural Population

The physical and built environments are related to physical activity (PA) in adults and the relationship seems apparent in children. Child PA behavior often depends on parents in a variety of ways including involvement, facilitation, or role modeling. The home environment is one setting in which these relationships may be further examined. PURPOSE: To examine how facets of the home environment and parent perceptions of neighborhood safety may be associated with child total PA and moderate-to-vigorous (MVPA) levels in a rural sample. METHODS: Baseline data were analyzed from NU-HOME, a childhood obesity prevention, randomized controlled trial in rural communities. 105 children (age=8.96±1.06 yrs) and their parents (age=37.91±5.42 yrs) reported on sociodemographics and home/neighborhood environments. Child daily PA (total and MVPA) was measured using accelerometers and, using SAS 9.4, associations were examined with home/neighborhood environment variables through multivariate regression models, both unadjusted and adjusted for economic assistance. Normality was not met for child daily MVPA therefore analyses used the log-transformed variable. RESULTS: Mean child total PA was 259.08±58.22 min/day and MVPA was 44.95±18.58 min/day. In unadjusted analyses, access to PA equipment in the home (p=0.037) and neighborhood safety (p=0.049) were associated with total PA; however, no factors were statistically significantly associated with MVPA, although access to PA equipment (p=0.088) and family support for PA (p=0.062) were trending towards significance. For both total PA and MVPA outcomes, the regression models including all variables and accounting for economic assistance were statistically significant (p=0.026 and p=0.034, respectively). For each model, the individual effects of parent PA and PA equipment were statistically significant (p ranges from 0.008 to 0.037). CONCLUSIONS: This study highlights the potential of the home/neighborhood environment as a space for interventions to increase PA in rural children. Only 14% of children in this rural sample met PA recommendations, so interventions to increase PA, particularly MVPA, are needed. Future studies should include multiple levels of a rural child’s environment (i.e., school, town) to examine which may play the largest role in PA.

Associations between parent and child physical activity and eating behaviours in a diverse sample: an ecological momentary assessment study.

This study is a secondary data analysis that examines the association between parent modelling of dietary intake and physical activity and the same child behaviours among different races/ethnicities using innovative, rigorous and objective measures. Ecological momentary assessment surveys were sent to parents to assess whether their child had seen them exercise or consume food. Dietary recall data and accelerometry were used to determine dietary intake and physical activity behaviours of children. Participants were randomly selected from primary care clinics, serving low-income and racially/ethnically diverse families in Minnesota, USA. Participants were families with children aged 5-7 years old who lived with parents 50 % of the time and shared at least one meal together. A 10 percentage point higher prevalence in parent modelling of fruit and vegetable intake was associated with 0·12 higher serving intake of those same foods in children. The prevalence of parent modelling of eating energy dense foods (10 % prevalence units) was associated with 0·09 higher serving intake of sugar-sweetened beverages. Furthermore, accelerometry-measured parent sedentary hours was strongly correlated with child sedentary time (0·37 child sedentary hours per parent sedentary hours). An exploratory interaction analysis did not reveal any statistical evidence that these relationships depended on the child's race/ethnic background. Interventions that increase parent modelling of healthy eating and minimise modelling of energy dense foods may have favourable effects on child dietary quality. Additionally, future research is needed to clarify the associations of parent modelling of physical activity and children's physical activity levels.