# Exercise as it relates to Disease/Mum or Dad? Who makes the biggest difference?

The following fact sheet relates to the article "The influence of parental modelling on children's physical activity and screen time: Does it differ by gender?"

## What is the background to this research?

Childhood obesity has been shown to have a large burden to the healthcare system in Australia. Furthermore, low levels of physical activity in childhood and increased sedentary activity have been found to not only be a risk factor for obesity but also to be deterimemental to many aspects of childhood growth and development.
Behavioural patterns relating to physical activity and sedentary activity developed in childhood are shown to be consistent with behaviours displayed in later life. Current research suggest that while school based interventions can increase physical activity in the short term familial interventions may hold the key for maintaining these changes over the long term.
The researchers investigated whether parental physical activity and sedentary behaviour play a role in the same behaviours in children, as well as whether gender (parental or child) makes any difference to the level of impact of these behaviours

## Where is the research from?

The research was conducted in 62 European schools (Greece, Belgium, Germany, Hungary, Norway) all of which were participating in the "UP4FUN" intervention program. The "UP4FUN" intervention involved a 6 week educational program aimed at increasing the physical activity and decrease sedentary behaviour (screen time) of both child and parent.. While the participants were from a large number of countries the results might not be applicable to all populations. This is due to factors such as access to transport, urban planning, service availability, safety concerns and cultural norms varying depending on location.

## What kind of research was this?

The research was a qualitative, cross sectional study. This type of study identifies the correlation between two (or more) variables, but does not identify if either variable is dependent on the other. In order to increase the gravity of this study the researchers could have applied an intervention (eg, increasing parental physical activity) and measure the desired outcome ( e.g. child physical activity) and compared this to a similar group who did not receive the intervention, as in an RCT.

## What did the research involve?

Participants were given surveys to complete (child and parent). The surveys asked questions regarding physical activity as well as sedentary behaviour. Both the parental and the child surveys ask questions around structured physical activity (Sport), un structured outdoor play/leisure and active forms of transport. Sedentary behaviour was assessed through questioning screen time activities, both frequency and duration. A large number of child questionnaires focusing on sedentary behaviour have been found to not be valid or reliable.. However, previous studies report moderate to good test re-test reliability and construct reliability for most of the items used in the questionnaire. Additionally the use of self report measures only, as discussed by the researchers, may lead to recall bias, which has been shown in a number of studies.

## What were the basic results?

The descriptive statistics are shown in the below table. The results which had statistical significance were; compared to girl children, boy children reported more screen time, but participated more often in sport and outdoor leisure activities. Fathers also reported higher screen time but walked/cycled for transport more. Following multilevel-multivariate analysis it was found that maternal physical activity was positively associated with children's levels of activity, whereas both parents' levels of sedentary behaviour had a negative effect on children screen time there appeared to be a stronger influence for same gender pairs of children and parent. These results could however be due to the fact that only 494 fathers answered the survey compared to 2439 mothers, resulting in only a subset of participants being analysed for gender differences. The fact that all data was self reported needs to be taken into consideration as well as the amount, of activity, being estimated may not be accurate.
| | Children (M, F) | Parents (M, F) |
| Respondents | 3300 (1610M, 1690F) | 2933 (494M, 2439F) |
| Sports mean#/wk | 5.4(5.7M, 5.1F) | 3.5 (3.4M, 3.5F) |
| Outdoor activities#/wk | 6(6.2M, 5.8F) | in nature: 2.7 (2.7M, 2.7F) in parks 2.8 (2.8M, 2.8F) |
| Walking for transport min/day | 9.5 (9.4M, 9.7F) | 6.7 (3.8M, 7.4F) |
| Cycling for transport min/day | 6.6 (6.7M, 6.6F) | 5.8 (8.7M, 5.3F) |
| TV/DVD min/day | 96(102M, 90F) | 96 (102M, 96f) |
| Computer/games console min/day | 72 (84M, 54F | 36 (48M, 36F) |

## What conclusions can we take from this research?

Parental behaviour should be considered when addressing child physical activity and sedentary behaviour. Addressing child behaviour within school interventions without addressing at home/parental behaviour has been shown to not have lasting effects, with one study showing improvements made during school time being reversed following vacation time. The researchers suggests that based on the data maternal influence may be greater. However they also suggest that this may only be the case due to limited number of paternal respondents or due to the age range of the child subjects detailing the possibility of paternal influence becoming greater as the child ages.

## Practical advice:

Interventions should address both parental and child physical activity and sedentary behaviour.
Family based interventions should target both paternal and maternal behaviours to achieve the greatest effect.
Future studies should try to achieve more even levels or maternal/paternal respondents.

## Further information/resources:

Go 4 Fun: NSW government lifestyle intervention program aimed at improving lifestyle factors. The program incorporates education and activities for both children and parents https://go4fun.com.au/
Good Habits for Life: A part of ACT government healthy weight initiative aimed at helping parents make good choices to start good behaviours for their children http://goodhabitsforlife.act.gov.au/

## References:

* ↑ Schoeppe, S., Vandelanotte, C., Bere, E., Lien, N., Verloigne, M., Kovács, É., Manios, Y., Bjelland, M., Vik, F.N. and Van Lippevelde, W., 2016. The influence of parental modelling on children’s physical activity and screen time: Does it differ by gender?. The European Journal of Public Health, 27(1), pp.152-157
* ↑ Hayes A, Chevalier A, D'Souza M, Baur L, Wen LM, Simpson J. Early childhood obesity: Association with healthcare expenditure in Australia. Obesity (Silver Spring). 2016;24(8):1752-8.
* ↑ Poitras VJ, Gray CE, Borghese MM, Carson V, Chaput JP, Janssen I, et al. Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. Appl Physiol Nutr Metab. 2016;41(6 Suppl 3):S197-239.
* ↑ Telama R, Yang X, Viikari J, Välimäki I, Wanne O, Raitakari O. Physical activity from childhood to adulthood: a 21-year tracking study. American journal of preventive medicine. 2005 Apr 30;28(3):267-73.
* ↑ Hancox RJ, Milne BJ, Poulton R. Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study. The Lancet. 2004 Jul 23;364(9430):257-62.
* ↑ Waters E, Silva-Sanigorski AD, Burford BJ, Brown T, Campbell KJ, Gao Y, Armstrong R, Prosser L, Summerbell CD. Interventions for preventing obesity in children. Sao Paulo Medical Journal. 2014;132(2):128-9.
* 1 2 Vik FN, Lien N, Berntsen S, De Bourdeaudhuij I, Grillenberger M, Manios Y, et al. Evaluation of the UP4FUN intervention: a cluster randomized trial to reduce and break up sitting time in European 10-12-year-old children. PLoS One. 2015;10(3):e0122612.
* ↑ Hidding LM, Altenburg TM, Mokkink LB, Terwee CB, Chinapaw MJ. Systematic Review of Childhood Sedentary Behavior Questionnaires: What do We Know and What is Next? Sports Med. 2017;47(4):677-99.
* ↑ Dyrstad SM, Hansen BH, Holme IM, Anderssen SA. Comparison of self-reported versus accelerometer-measured physical activity. Med Sci Sports Exerc. 2014;46(1):99-106.
* ↑ Carrel AL, Clark RR, Peterson S, Eickhoff J, Allen DB. School-Based Fitness Changes Are Lost During the Summer Vacation. Arch Pediatr Adolesc Med. 2007;161(6):561–564. doi:10.1001/archpedi.161.6.561