Influence of the Home Environment on Physical Activity Behaviors in African American Youth

Abstract

Background:

This study examined the relationships between components of the home environment and physical activity (PA) behaviors among African American adolescents.

Methods:

A community-based sample of 99 African American parent–child dyads (62% girls; 42% overweight/obese, 15.0 ± 0.2 years) were included in this analysis. The home environment (PA equipment, family support for PA, and internet access) was evaluated using the Health and Environment Survey. Child PA was measured objectively using accelerometry. Data collection occurred between 2014 and 2016.

Results:

Internet access was associated with 29 fewer minutes of light physical activity [p = 0.011, β = −29.25 ± 11.28 (95% confidence interval: −51.65 to −6.86)], 9 fewer minutes of moderate-to-vigorous physical activity [p = 0.045, β = −9.10 ± 4.48 (−17.98 to −0.21)], and 38 fewer minutes of total PA (TPA) [p = 0.006, β = −38.35 ± 13.38 (−65.62 to −11.08)]. Family support was associated with 2 minutes of TPA [p = 0.044, β = 2.25 ± 1.10 (−1.97 to 3.19)]. PA equipment was not significantly associated with greater PA (all p's > 0.05).

Conclusions:

These findings suggest that home internet access may hinder participation in PA among African American adolescents. Future research should continue to identify barriers in the home environment that contribute to physical inactivity among African American adolescents.

Introduction

Children's participation in daily moderate-to-vigorous physical activity (MVPA) decreases by 38 minutes per year from ages 9 to 15, equating to a 75% drop during a critical period of growth and development.¹ The rate of decline in physical activity (PA) is even greater among ethnic minority youth, with the highest levels of inactivity observed in African Americans.^2,3 The Youth Risk Behavior Survey suggests only 42% of African American adolescents compared with 49% of white adolescents are meeting the daily 60-minute PA recommendations.⁴ Physical inactivity disparities during adolescence tracks into adulthood with the highest prevalence of inactivity observed among African American adults.⁵ Such findings are alarming as inactivity in both children and adults is associated with negative health outcomes, including obesity, type 2 diabetes, and hypertension.⁶

School- and community-based programs have demonstrated success in increasing youth PA. For example, low-cost changes to the school environment, including classroom-based PA programs, have helped children accumulate greater levels of PA throughout the school day.^7,8 Physical education classes and recess have also contributed to increased levels of MVPA. Among African American adolescents, daily participation in physical education classes was associated with a greater likelihood of MVPA.⁹ Additionally, recess interventions that have targeted teacher training, recess equipment, and games were associated with more MVPA and enjoyment with one study reporting an increase in youth MVPA levels to 56% of recess time.^10–12 Changes to the built environment, including park and sidewalk renovations have also helped children achieve greater levels of PA in their neighborhoods.⁷

These changes to the neighborhood environment are particularly important for increasing PA among African American girls given the concerns voiced by African American mothers regarding their daughters' safety while exercising outside and their desire for safe spaces near the home to be physically active.¹³ Despite improvements in both school and neighborhood environments, disparities in PA participation among African American adolescents persist. As such, increased attention should be given to the home environment where children and adolescents are able to safely engage in PA.

In the home environment, families play an important role in shaping a child's PA behavior by providing the children with support to be active. Specifically, family members can provide support by encouraging, exercising with, providing transportation, and watching another family member participate in physical activities or sports. In a sample of primarily white households, Tandon et al. demonstrated that family support from parents is associated with 12 more minutes of daily MVPA.¹⁴ In multiethnic cohorts, Griffith et al. and Graham et al. found that family support from parents, including parent role modeling of PA, was also associated with adolescent PA.^15,16

While many studies focus primarily on the role of parent support,^14,15,17,18 siblings and other family members may also shape the PA behavior of adolescents. Among African American girls and boys, Baskin et al. demonstrated that family social support was an important PA-promoting factor.¹⁷ Tandon et al. reported that homes with more children (i.e., having one or more siblings), were associated with 5 additional minutes of overall MVPA, 11 additional minutes of MVPA at home, and 6 fewer minutes of screen time.¹⁴ Taken together, these findings suggest support from family members is an important facilitator of adolescent PA.

Characteristics of the home environment, such as the availability of PA equipment, has also been associated with adolescent PA.¹⁵ Yet, the rapid advancements in communication and entertainment technologies have dramatically increased the accessibility of screen time in the home. Watching television and using a mobile device, computer, or tablet is an established norm in children's lives, effectively displacing participation in physical activities.¹⁹ Today, the broad array of screen-time activities available in the home makes being sedentary a more convenient choice. Furthermore, the impact of PA-promoting (PA equipment) and sedentary-promoting (internet access) factors in the home and its impact on PA participation in African American youth is understudied.

The purpose of this study was to conduct a cross-sectional analysis of the relationships between specific components of the home environment and PA behaviors in African American adolescents. We hypothesized that a PA-promoting home environment (PA equipment available at home, family support for PA, and no internet access) would be positively associated with more adolescent PA. We also hypothesized that the PA-promoting home environment would be associated with more MVPA than light physical activity (LPA) in African American adolescents.

Methods

Sample Population, Recruitment, and Procedure

Children and adolescents were recruited from communities in southeast Michigan to participate in the Health & Culture Project, a nutrition and PA education program examining the social, cultural, and psychological predictors of adolescent obesity. Adolescent PA behaviors were secondary outcomes of the project. Data collection began in July 2014 and was completed in August 2016. A convenience sample of adolescent participants was recruited from middle schools (n = 85), high schools (n = 31), afterschool programs (n = 46), community centers (n = 30), and the general community in Washtenaw County, Michigan (n = 81) through flyers and word of mouth. A total of 273 participants between the ages of 11 and 18 were recruited for the study. Data collection occurred at the Childhood Disparities Research Laboratory or off-site at a school, afterschool program, or community center. During the informed consent process where parents and children were present, parents of child participants were asked to complete a questionnaire about their home environment. A subset of 121 parents completed a parent questionnaire about their home environment.

Parent–child dyads were excluded from the sample for the following reasons: 114 child participants had invalid accelerometer data, 38 child participants did not self-identify as African American or Black, and 22 parents did not complete the questionnaire. Thus, a total of 99 parent–child dyads were included in this analysis. Adolescent participants included in the dyad had similar BMI, height, weight, minutes of LPA, MVPA, and total PA (TPA) compared with participants not included in the dyad (data not shown, p's > 0.05). The 99 adolescent participants also had at least 4 days of valid accelerometer data. Before participation, written consent was obtained from the adolescent and parent, if under the age of 18. This study was reviewed and approved by the University of Michigan Institutional Review Board.

Dependent Variables

Adolescent PA

Adolescent LPA, MVPA, and TPA were measured using GT3X Actigraph accelerometers. Participants were asked to wear the accelerometer snugly on their right hip using an adjustable belt for 1–2 weeks. At home, they were advised to remove the device when bathing, doing water-based activities, participating in contact sports, and while sleeping. In addition, participants were asked to complete a nonwear and sleep diary. The accelerometers were initialized to collect raw data at a frequency of 30 Hz. The raw data were downloaded and integrated into 60-second epochs using ActiLife software, version 6.11.8. In addition to manually recorded sleep time, consecutive periods of zero counts for more than 60 minutes were defined as nonwear time, allowing for 1–2 minutes of counts between 0 and 100.³

Nonwear times were excluded from the analyses. Puyau's cut points,²⁰ which are validated in adolescent populations, were used to derive activity intensities (i.e., light and moderate-to-vigorous physical activities).^21,22 TPA was calculated by adding the total minutes of LPA and MVPA. Participant criteria for valid wear time data included a wear time of at least 600 minutes/day for at least 4 days (3 weekdays and 1 weekend day) out of 7 consecutive days.³

Independent Variables

The Health and Environment Survey is a comprehensive survey used to assess environmental and psychosocial correlates of PA in the Patient-Centered Assessment and Counseling for Exercise (PACE) study.²³ This survey was developed from existing measures, previous research, and through a formative research process. This formative process included phone and in-person interviews conducted with children and parents in San Diego and Cincinnati. The survey was pilot tested to confirm comprehension and acceptability. All measures used in the current study are available at www.drjamessallis.sdsu.edu/measures.html. Below is a description of the items used to assess family support for PA, home environment, and internet access.

Family support for PA

Items from the Amherst Health and Activity Study Questionnaire²⁴ assessed family members' (including parents’) reported level of support for their child's PA during a typical week. Four items formed a composite measure with an internal consistency of α = 0.71: (1) watched your child participating in PA or play sports; (2) encouraged your child to do physical activities or play sports; (3) provided transportation so your child could go to a place where he or she could do PA or play sports; and (4) did a PA or played sports with your child. The 5-point scale for these items ranged from “never” to “every day.”

Home environment

Sixteen items assessed the presence of items in the home that would facilitate PA. Sallis et al. found this scale to have a high test/retest reliability (0.89) and to be correlated with self-reported PA.²⁵ Parents responded “yes” or “no” for whether each item was in the home, yard, apartment complex, or community. The number of “yes” responses was totaled to form a single score. Items included bicycle, dog, swimming pool, sports equipment, skis, and toning devices. Internal consistency for the scale in the present study was α = 0.73.

Home computer use and internet access

One item from the PACE Health & Environment Survey²³ was used to assess internet access. Parents responded to whether they had internet access in their home.

Covariates

Given the effects of adolescent sex and age on adolescent PA, these variables were also included in the linear regression models.²⁶ Biological sex and age were assessed through self-report.

Statistical Analyses

Analyses were conducted using Stata Special Edition 16.0. A total of 99 parent–child dyads with complete data (valid accelerometer and parent questionnaire data) were included in this analysis. Before analysis, data were evaluated for normality and potential outliers. Linear regression models were used to examine the relationship between child PA and the home environment variables. All covariates were entered into the regression model simultaneously. The significance level for all analyses was set at α < 0.05. A post hoc power analysis indicated that a sample size of 99 dyads was sufficient to detect a medium effect size (d = 0.39) with a power of 0.91.

Results

Table 1 displays the participant characteristics for the 99 child–parent dyads. The average age of the adolescent participants was 15 years and almost two-thirds were female. The average adolescent BMI was 25.4 kg/m² with less than half of adolescent participants classified as overweight or obese using BMI-for-age percentiles based on the CDC growth charts for children and teens (ages 2 through 19 years).^27,28 On average, adolescent participants engaged in 112 minutes of TPA per day (13 minutes of MVPA per day, and 99 minutes of LPA per day). Females accumulated 14 fewer minutes of LPA, 13 fewer minutes of MVPA, and as a result, 27 fewer minutes of TPA compared with their male counterparts. Additionally, younger children averaged 8 more minutes of TPA than older children. The average score for family support for PA was 8.0 ± 0.3 (out of a maximum score of 15). Approximately 93% of participants had at least two items of PA equipment at home (out of a possible 16) and 92% of the participants had home internet access.

Table 1.

Participant Characteristics

	Participants
	n	Mean ± SE	%
Adolescent characteristics
% female	62	—	62
Age (years)	99	15.00 ± 0.18	—
Weight (kg)	99	67.83 ± 1.76	—
Height (cm)	99	9.38 ± 0.94	—
BMI (kg/m2)	99	25.40 ± 0.68	—
BMI percentile	99	74.39 ± 2.56	—
LPA (minutes/day)	99	99.32 ± 3.59	100
MVPA (minutes/day)	99	12.65 ± 1.39	100
TPA (minutes/day)	99	111.97 ± 4.42	100
Parent characteristics
% female	89	—	90
Access to PA equipment	99	—	100
0–3	19	—	19
4–7	48	—	48
8–11	29	—	29
12–16	3	—	3
Family support for PA	99	8.03 ± 0.32	—
Internet access	99	—	100
Yes	91	—	92
No	8	—	8

LPA, light physical activity; MVPA, moderate-to-vigorous physical activity; PA, physical activity; SE, standard error; TPA, total physical activity.

The relationship between the home environment predictors and adolescent PA are displayed in Table 2. Home internet access was negatively associated with LPA [p = 0.011, β = −29.25 ± 11.28 (95% confidence interval [CI]: −51.65 to −6.86)], MVPA [p = 0.045, β = −9.10 ± 4.48 (−17.98 to −0.21)], and TPA [p = 0.006, β = −38.35 ± 13.73 (65.62 to −11.08)], resulting in 29, 9, and 38 fewer minutes of LPA, MVPA, and TPA, respectively. Family support for PA was positively associated with TPA [p = 0.044, β = 2.25 ± 1.10 (−1.97 to 3.19)]. PA equipment was not associated with any of the PA outcomes (p > 0.05).

Table 2.

Associations Between Home Environment Characteristics and Physical Activity Behaviors

	LPA^a				MVPA^b				TPA^c
	β	SE	p	95% CI	β	SE	p	95% CI	β	SE	p	95% CI
PA equipment	0.44	1.07	0.68	−1.68 to 2.56	0.16	0.42	0.698	−0.68 to 1.01	0.61	1.30	0.642	−1.97 to 4.43
Parent support	1.72	0.90	0.59	−0.07 to 3.53	0.52	0.36	0.153	−0.20,1.23	2.25	1.10	0.044^*	−1.97 to 3.19
Home internet access	−29.25	11.28	0.011^*	−51.65 to −6,86	−9.10	4.48	0.045^*	−17.98 to −0.21	−38.35	13.73	0.006^*	−65.62 to −11.08

Standardized beta coefficients are shown.

Ninety-nine observations, df = 98, F = 8.55, r² = 0.32.

Ninety-nine observations, df = 98, F = 7.30, r² = 0.28.

Ninety-nine observations, df = 98, F = 9.14, r² = 0.33.

Significance p < 0.05 (in bold).

CI, confidence interval.

Discussion

Understanding the role of the home environment on African American adolescent PA may aid in the development of home-based strategies targeting African American youth who experience many barriers to lifelong PA. The present study examined three aspects of the home environment: PA equipment in the home, family support, and home internet access. Contrary to our hypothesis, PA-promoting home characteristics (equipment and family support) were not associated with MVPA, whereas home internet access was identified as a PA-hindering factor among African American adolescents. If longitudinal studies confirm these findings, greater attention should be given to reducing PA barriers in the home.

In the present study, African American adolescents averaged 13 minutes of MVPA daily, which is consistent with findings from the National Health and Nutrition Examination Survey (NHANES).²⁹ Our results are substantially lower, however, compared with Belcher et al. and Baskin et al., who reported 33 and 40 minutes of daily adolescent MVPA, respectively.^17,30 This considerable difference may be attributed to the use of Puyau's cut points²⁰ in our analysis (to avoid the overestimation of MVPA) rather than the Freedson cut points³¹ used by Belcher et al.³⁰ and Baskin et al.¹⁷ Consistent with NHANES data, females were less active than males in the present cohort and PA declined with age with younger children averaging more minutes of TPA than older children. This decline in PA was at a slower rate than previous findings,¹ which may be related to the cross-sectional nature of this data and the lower initial PA levels of this cohort.

Within the framework of the Canadian 24-hour Movement Guidelines (recommending 60 minutes of MVPA, several hours of LPA, 8–10 hours of sleep for adolescents between 14 and 17 years, and <2 hours of recreational sedentary time), participants in this study engaged in less PA than recommended.^32,33 On average participants engaged in 22% of the daily recommended levels of MVPA, and <2 hours of structured and unstructured PA (measured as LPA in this study). While sleep time was not collected in this study, the negative relationship between internet access and PA may indicate greater sedentary time in this sample.

Previous studies investigating screen time found that greater screen time was also associated with reduced PA.^34,35 Serrano-Sanchez et al. examined the relationship between screen time and PA in adolescents in Spain and determined that boys who participated in more than 4 hours of screen-related activities (TV watching, video games, computer use) were less likely to achieve the recommended level of MVPA.³⁴ In a national youth sample of mostly white children, Sisson et al. found that more daily screen-based activities were associated with less daily PA in both boys and girls.³⁵ In the present study, we observed that internet access was associated with 13 fewer minutes of MVPA in African American youth.

It is important to note that only 8% of our participant sample did not have internet access. Nevertheless, it is plausible that internet access and screen-related activities may be displacing PA. Compared with adolescents in the early 2000s, today's adolescents engage in 40 more minutes of technology-related activities, including internet use.³⁶ This is particularly relevant to African American youth given the Youth Risk Behavior Survey reporting that 47.2% of African American adolescents play video games or use the computer for more than 3 hours a day, the highest of any other ethnic group.⁴ Additional studies are needed to explore the relationship between adolescent screen time regulation and MVPA, which may provide a promising avenue for replacing screen time with PA.

The role of family support on adolescent PA has been mixed. A review of family support from parents on child PA behaviors by Loprinzi and Trost determined that only 52% of studies that assessed multiple forms of support (appraisal, emotional, informational, and instrumental) had a positive association with child PA, whereas 62% of studies assessing one type of support were significant and positive.³⁷ More recently Rhodes et al. conducted a review where families (parents, siblings, etc.) were identified as an important source for encouraging, modeling, and engaging youth in healthy PA, sedentary, and sleep behaviors.³⁸ The review acknowledged that parent attitudes, perceived control, intentions, and planned support were important correlates for youth PA.

A review by Beets et al. also found that overall parent social support had a positive effect on youth PA.¹⁸ The review identified four types of social support provided by parents: instrumental (e.g., providing payment or transportation), conditional (e.g., participating in the activity with the child), motivational (e.g., providing encouragement), and informational (e.g., a discussion of the benefits of PA). Each of the four questions used to evaluate family support in this study aligns with one of these four categories of social support for PA.

In addition to parent support, adolescents in households with siblings and other family members of similar ages (such as cousins) may also benefit from sibling and peer support. Davison examined the relationship between parent, peer, and sibling support and PA levels among white middle schoolers and found that active boys reported slightly more support from a sister (having a brother did not appear to have an effect) compared with the less active boys.³⁹ In the Davison study, the more active girls reported significantly more support from a brother or sister compared with the less active girls, indicating that sibling support is more important in promoting PA among girls than boys.

Additionally, Rhodes et al. found that girls in either two-parent households or had zero or one sibling participated in more sports, lessons, and leagues than girls in one-parent or two or more sibling households. Boys with two or more siblings participated in more unstructured play than boys with zero or one sibling. In the present study, family support was associated with a small but significant increase in TPA. Given the positive relationship between family support for PA and TPA in this study and previous research, future research should investigate the independent effect of sibling support on the PA of African American youth and its potential role in increasing PA. In addition, future research should continue to identify the types of family support that may benefit African American adolescent PA.

In this cohort, access to PA equipment was not associated with adolescent PA, which is consistent with previous studies in African American adolescents.^40,41 Eisenberg et al. observed that the number of PA equipment items at home was not related to adolescent MVPA for African Americans but was related to adolescent MVPA for Asian and Hispanic youth.⁴¹ Similarly, in a multiethnic sample, Dunton et al. found that although adolescent girls were more aware of exercise resources at home than in the community, availability of these resources was not associated with more PA.⁴⁰

In a study by Duncan, Strycker, and Chaumeton, African American adolescent girls' MVPA and sports participation was positively associated with friends' support, highlighting the importance of social interaction for PA engagement in this group.⁴² Hence, the limited influence of PA equipment within the home on African American adolescent PA may be explained by the lack of social interaction involved in these activities in this environment, potentially making them unappealing to adolescents. Future research should directly assess the impact of social interaction (or the lack thereof) in the home environment and its impact on African American adolescent PA.

An important strength of this study includes using accelerometers to measure PA behaviors. Inclusion of LPA, MVPA, and TPA data provided a more complete picture of African American adolescent PA behaviors. Limitations of this study include a limited sample size, the cross-sectional study design, and the use of a single item to assess home internet access. In addition, family income information and more specific screen use data were not collected for this study. Using a more comprehensive assessment of computer and internet use that includes more specific information regarding screen time is warranted to better understand how an interventionist can target aspects in the home environment to improve PA participation among African American adolescents.

Due to the small sample size, 90% of parents were female, which may have limited the generalizability of these findings to female-led households. Previous studies have reported high female parent response rates, including the FLASHE study that used parent–adolescent dyads to evaluate cancer-preventive behaviors, including PA.^43,44 This high female respondent rate may be attributed to mothers, who are more likely to accompany their child to the doctor's office or a research visit and thus, providing more opportunities to participate in the study.⁴⁵ In addition, in the United States, over 80% of African American households with children are female led.⁴⁶ Lack of parent PA data also prohibited our ability to assess how parent PA behavior may translate to adolescent PA behavior. The influence of parent role modeling behavior, however, decreases with age, hence parent PA participation may be less important at this age compared with parenting behaviors that promote adolescent PA.⁴⁷ Additionally, due to insufficient power, we were unable to test effect modification; sex and age could be effect modifiers in the relationship between internet access and PA participation.

In the present study, internet access was associated with 9 fewer minutes of MVPA, which is approximately one-sixth of the 60-minute daily recommendations for youth PA. Given the current ongoing COVID-19 pandemic internet use in the home increased dramatically in part contributing to the steep decline in youth PA and a widening gap in PA disparities among ethnic minorities.^48,49 This trend is likely to continue with adolescents spending more time at home even with access to vaccinations and the reopening of schools, creating a “new normal.”

We recognize that there is a significant time lag between data collected for this analysis and the current COVID-19 pandemic. However, given the significant increase in time children and adolescents spent in the home environment due to school closures and shelter-in-place mandates and subsequent decline in PA during the pandemic,⁵⁰ we were interested in examining the psychosocial and environmental correlates of PA in this context before the pandemic. It is plausible that factors within the home environment as well as factors outside of the home may have contributed to pandemic-related declines in PA. Future research is needed to confirm or refute this hypothesis.

Nevertheless these preliminary findings reinforce the idea that targeting the home environment to provide more opportunities to engage in PA may help to reduce PA disparities. Hence a renewed focus on promoting PA in the home environment is needed to promote life-long PA habits, particularly among African American adolescents.

Footnotes

Authors' Contributions

Conceptualization, S.B., L.A., M.S., A.K.G., and R.E.H.; data curation, L.A., K.C.M., A.K.G., and R.E.H.; formal analysis, S.B.; funding acquisition, R.E.H.; investigation, R.E.H.; methodology, K.C.M, A.K.G., and R.E.H.; project administration, K.C.M and R.E.H.; supervision, R.E.H.; writing—original draft, S.B.; writing—review and editing, S.B., L.A., M.S., K.C.M., A.K.G., and R.E.H.

Acknowledgments

The authors thank the Health & Culture Project team and Michigan Consulting for Statistics, Computing, and Analytics Research. They are also grateful to their study participants and their families for their involvement. The results of this study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. This work was supported by the University of Michigan Office of Research and the University of Michigan School of Public Health Momentum Center.

Funding Information

The University of Michigan Office of Research and the University of Michigan School of Public Health Momentum Center supported this work.

Author Disclosure Statement

No competing financial interests exist.

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