Abstract
Objective:
Examining associations of mother’s behaviors and home/neighborhood physical activity (PA) environments with preschoolers’ PA and screen time.
Design:
Cross-sectional online survey.
Setting:
Mothers with a 2 to 5 years old preschooler were recruited from the US panel members of Survey Sampling International.
Participants:
Five hundred thirty-one mothers with a preschool child aged 2 to 5 years old.
Outcome Measure:
Child daily screen time and PA, mother–child inside- and outside-home co-PA.
Analysis:
K-mean cluster analysis and Logit and negative binomial regressions.
Results:
Mothers’ healthy behaviors, such as decreased screen time, healthy eating habits, and increased PA, and perceived importance for PA were significantly (P < .05) associated with preschoolers’ decreased screen time and increased PA. Available toys (P < .01) and maternal perceived neighborhood safety (P < .05) were negatively correlated with preschoolers’ screen time, while available room space (P < .01) was positively correlated with preschoolers’ PA. Variables positively correlated with mother–child co-PA included mothers’ PA (P < .001) and healthy eating habits (P < .05), and home room space (P < .05) for inside-home, and yard space and quality (P < .05) for outside-home.
Conclusions:
Mother’s role modeling and home PA environment were positively associated with preschoolers’ PA behavior.
Keywords
Purpose
The preschool years are a time when children first develop eating and physical activity (PA) habits that are likely to continue into adulthood. 1 Understanding contributing factors to preschoolers’ PA behaviors is critical for obesity prevention. 1,2 Literature has investigated parent–child interaction for dietary intake and PA separately 2 ; however, few examined the linkage between parents’ dietary pattern and preschoolers’ PA behaviors. 1 -3 Home and neighborhood environments have received an increasing attention in examining correlates with preschoolers’ PA. 1 This study examines the association of mother’s healthy behaviors and home/neighborhood environments on preschoolers’ PA behaviors.
Methods
Participants
The development and detailed contents of online HOMES (Home Obesogenic Measure of EnvironmentS) survey can be found in our previous work. 4 -6 A total of 531 mothers who were the primary caregivers for their preschooler aged 2 to 5 years old were recruited from the US Survey Sampling International panelists in 2013. Participants were asked to self-report demographic, behavioral, and environmental characteristics for their family.
Measures
The reliable and valid measures and variables summarized in Table 1 have been described in previous publications. 4,6,7 Maternal fruit/vegetable (F/V) intake was evaluated by the Block Food Frequency questionnaire 8 and used as a proxy for mothers’ eating habits. Physical activity behaviors in the past 7 days were self-reported by the mother for self and preschooler using a modified version of the International PA Questionnaire. 9 Self-reported screen time was used to create a dummy variable indicating those with more than 2 hours daily screen time. Mothers’ perception on the importance of PA for their preschooler was also assessed. 4,6 Mother–child inside- and outside-home co-PA frequencies were assessed by how often the mother participated in PA with her preschooler for 15+ minutes each day in the past 7 days. Home PA environment was measured by home room space, number of toys, and yard space and quality. Neighborhood PA environment was measured by mothers’ perception of the available PA infrastructure and equipment in their neighborhood, neighborhood safety, and crime safety for her preschooler. 4,6,10 Sociodemographic characteristics included mother and child’s age, self-reported health, and weight status; mother’s race, education level, and employment status; child’s sex; and family information (single- vs dual-parent household, number of children younger than 18 years, and family affluence level). 5
Sociodemographic Characteristics of Mothers and Their Preschoolers.
Abbreviations: BMI, body mass index; F/V, fruit/vegetable; PA, physical activity; SD, standard deviation.
aMeasured on a 5-point Likert scale from 1 (least favorable) to 5 (most favorable).
bDummy variables (0 = lower level and 1 = higher level) were created base on K-mean cluster analyses.
Data Analysis
K-means cluster analysis was employed based on respondents’ answers to subquestions for home room space, yard space and quality, and neighborhood PA accessibility and safety. A dummy variable for each factor was created with zero suggesting a lower level and one indicating a higher level. Logit regression was employed to examine preschooler’s daily screen time (>2 hours) and negative binomial regressions for preschoolers’ PA and mother–child co-PA. The analyses controlled for covariates listed in Table 1.
Results
As shown in Table 1, on average, mothers had more than 6 hours screen time daily, low PA, and 5 daily servings of F/V; and preschooler spent more than 4 hours of screen time daily and engaged in moderate PA. About 87% of mothers recognized the importance of PA for their preschooler. The average frequencies of mother–child co-PA was ∼5 days for inside-home and ∼3 days for outside-home in the past 7 days.
As shown in Table 2, mothers’ screen time (P < .001), healthy eating habits (P < .05), perceived neighborhood safety (P < .05), and number of toys (P < .01) were negatively associated with preschoolers’ screen time. Mothers’ PA (P < .05), perceived importance of PA (P < .001) healthy eating habits (P < .01), and home room space (P < .01) were positively associated with preschoolers’ PA. Variables positively associated with mother–child co-PA included mothers’ PA (P < .001) and healthy eating habits (P < .05), home room space (P < .05) for inside-home co-PA, and yard space and quality (P < .05) for outside-home co-PA.
Regression Results for Preschoolers’ Screen Time and PA Behaviors.a,b
Abbreviations: CI, confidence interval; F/V, fruit/vegetable; PA, physical activity; SE, standard error.
aN = 531.
bModels controlled for age and health/weight status for mother and child; child’s sex; mother’s race, education and employment status; number of children <18 years old; single versus dual parents; and family affluence level.
cWe employed Logit regression for child’s screen time and negative binomial regressions for PA outcomes.
dDummy variable (0 = lower level and 1 = higher level) were created based on K-mean cluster analyses.
e P < .01.
f P < .05.
gVariable score was dichotomized: 0 for scoring 3 or less and 1 for scoring greater than 3.
h P < .001.
Discussion
Summary
Our findings suggest mother’s healthy behaviors matter more than PA environments for preschoolers’ PA and screen activity. Similar to previous work, 11 we find that children with a physically active mother engaged in more PA and co-PA, but less sedentary time. Mothers’ perceived importance of PA and healthy dietary behaviors were positively associated with preschooler’s PA behaviors.
Our findings also indicate that home environment was more important than neighborhood environment in influencing preschoolers’ PA and screen time. Preschoolers may be less mobile, and thus, less likely to utilize the neighborhood PA environment. Similar findings were reported for toddlers’ (1.6 ± 0.2 years) PA and screen time. 12 Fan and Jin 13 found neighborhood parks/playgrounds made children more fit, and the park/playground effect was stronger for young adolescents aged 10 to 13 years old than adolescents aged 14 to 17 years old. More research is needed to investigate how home and neighborhood environments affect PA behavior of children at different ages.
Limitations
Cross-sectional study design limits ability to make inference of causal relationships. Self-reported survey data may be subject to reporting errors and bias.
Significance
Our findings suggest that family-based interventions aiming to promote preschoolers’ PA may be more effective when focused on improving healthy living of parents and motivating parents to actively engage with their children in the immediate home setting.
SO WHAT?
What is already known on this topic?
Better understanding of sedentary activity and physical activity (PA) behaviors of preschoolers is important to fight against childhood obesity as well as adult obesity as these behaviors can continue into adulthood. Parental influences, home environments, and neighborhood characteristics have received increased attention as correlates with preschoolers’ PA.
What does this article add?
This study finds that mother’s behaviors, compared to PA environments, are important on PA and screen activity of preschoolers aged 2 to 5 years old. The home PA environment is found to be more significantly related to preschoolers’ PA and screen activity than their neighborhood environments.
What are the implications for health promotion practice or research?
Motivating mothers to be physically active and actively engage with their children in the immediate home setting may aid to improve preschoolers’ PA and enhance the efficacy of interventions and education programs for this age cohort.
Footnotes
Authors’ Note
J.M-.B. designed the study and contributed to the development and implementation of the study. M.Z. and Y.J. initiated the research questions and were involved with the analysis and interpretation of the data with the assistance from V.Q. and J.M-.B. M.Z., Y.J., and V.Q. drafted the manuscript. All authors contributed to editing, reviewing of the final manuscript, and read and approved the final manuscript.
Acknowledgments
The authors acknowledge the funding from USDA NIFA #2011-68001-30170.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Received funding from USDA NIFA #2011-68001-30170.
