Videogames That Encourage Healthy Behavior Did Not Alter Fasting Insulin or Other Diabetes Risks in Children: Randomized Clinical Trial.

Background: To date, most research investigating the influence of parents on children's physical activity behavior has been conducted among school-aged children. As a result, we have a limited understanding of the mechanisms through which parents can influence their young children's physical activity behavior. The purpose of this study was to examine the influence of various hypothesized parental influence variables on children's physical activity behaviors. Methods: An on-line survey assessing various hypothesized parental influences and an estimate of the amount of time their child engaged in physical activity behavior was completed by 176 parents. Results: Parents who perceived physical activity to be important for their child, had confidence in providing support for their child's physical activity, had good physical activity experiences as a child, and had high perceptions of their child's physical ability were more likely to employ activity-facilitating parenting practices and behaviors that were associated with their preschool children's physical activity behaviors. Discussion and Translation to Health Education Practice: Parenting practices and behaviors (e.g., parental support for children's activity behaviors) may play an important role in preschool children's physical activity behaviors. Future prospective studies are needed to confirm the findings of the present study.

Introduction Already in early childhood, physical activity (PA) is important for healthy development. Parents are a significant influencing factor on PA behavior (Su et al., 2022), and are therefore, involved in the “Purzelbaum”-daycare project to promote PA (radix, 2011). Purzelbaum is a one-and-a-half-year training program that certifies “movement-friendly” daycare centers upon completion. This study examines whether the participation and perception of PA by parents differs in daycare centers with or without Purzelbaum certification. Methods Between February and April 2024, parents from daycare centers in various Swiss cantons were invited to complete an online questionnaire about PA in daycare centers. In addition to demographic data, five questions assessed the perception of PA. On a Likert scale, parents rated the extent to which they felt that PA is part of the daycare center's daily routine, the importance of PA, and the extent to which children have the opportunity to be physically active. In addition, they were asked to what extent parents are informed by the daycare centers about the topic of PA and whether the daycare centers offer parent-child activities involving PA. The Fisher-Freeman-Halton exact test (in SPSS) was used for analyses. Results Parents (n=353; mean age=37.93, SD=5.24; 86% completed Bachelor; 73% female; mean # of days children spent in daycare=2.39, SD=1.00; 84 Purzelbaum and 278 non-Purzelbaum daycare centers) completed the questionnaire. Age and education differed significantly between the two groups (p=.033 and p=.006, respectively). No group differences were for sex and number of days children spent in daycare (ps>.05). Parents from Purzelbaum daycare centers are more likely to feel that PA is part of everyday life (mpb=3.83, SD=.41; mnpb=3.60, SD=.63; p=.023), that it is highly valued (mpb=3.70, SD=.54; mnpb=3.21, SD=.74; p<.001) and that the children can be physically active at any time in the daycare center (mpb=3.61, SD=.54; mnpb=3.36, SD=.77; p=.034). They also stated more frequently that the daycare center informs them about the child's PA behavior (mpb=3.44, SD=.65; mnpb=2.82, SD=.95; p<.001) and that there are parent-child activities involving PA at daycare center festivals (mpb=3.10, SD=.88; mnpb=2.34, SD=.93; p<.001). Discussion/Conclusion Parents of children in Purzelbaum daycare centers consider PA to be more present in the daycare center than parents of children in non-Purzelbaum daycare centers. They also seem to be better informed about the children's PA behavior and benefit more frequently from joint PA in the daycare centers. Purzelbaum therefore appears to have a positive influence on parents. Whether the perceived PA affinity of the Purzelbaum daycare centers influences PA in the families and whether the PA behavior of the children is actually influenced by the Purzelbaum certification needs to be investigated in further studies. References Caspar, C., & Knecht, C. (2011). Konzept Purzelbaum: Bewegung und gesunde Ernährung in der Kindertagesstätte. RADIX. Su, D. L. Y., Tang, T. C. W., Chung, J. S. K., Lee, A. S. Y., Capio, C. M., & Chan, D. K. C. (2022). Parental influence on child and adolescent physical activity level: A meta-analysis. International Journal of Environmental Research and Public Health, 19(24), 16861. https://doi.org/10.3390/ijerph192416861

Nudging interventions to improve children's sleep, physical activity and sedentary behavior: A scoping review

Two of the Leading Health Indicators of Healthy People 2010 are physical activity (PA) and overweight and obesity. These two indicators are related, in that, overweight is due to an imbalance between dietary intake and energy expenditure. Physical inactivity places individuals at risk for obesity and developing chronic diseases later in life. Understanding the determinants of PA is critical for treating and preventing obesity. Research indicates that parents' PA behaviors and beliefs have an impact on their children's PA behaviors and attitudes but these findings are varying and somewhat limited. PURPOSE: Thus, the purpose of the present study was to determine if the parents of students interested in kinesiology or exercise science had similar physical activity behaviors and fitness beliefs. METHODS: Undergraduate kinesiology students (n = 70, 29 females and 41 males) and their parents (70 mothers, 70 fathers) completed surveys to assess self-reported body mass index (i.e., calculated from self-reported height and weight), PA levels, and fitness and PA beliefs. RESULTS: Participants indicated that their inability to set reachable goals, lack of confidence, and lack of support from others were the greatest barriers when considering PA. Males (fathers and sons) indicated that increased energy, better control over their weight, and clothes fitting better were the most important benefits of PA; whereas females (daughters and mothers) indicated that improved body image, clothes fitting better, and better control over their weight were the most important benefits of PA. Kinesiology students' PA levels were associated with their belief that they would have more energy if they exercised (P < .01). Kinesiology students' internal control fitness beliefs were associated with their mothers' and fathers' internal control fitness beliefs (P < .01). A repeated measure MANOVA revealed that the kinesiology students had higher PA levels and were less likely to believe that chance influenced their PA levels than their parents (P < .001). CONCLUSIONS: Besides being positive role models by participating in habitual physical activity, kinesiology students should learn how to help others set manageable goals that improve perceived competence in being physically active. These skills could then be taught to family members to help improve their PA and fitness levels which may lower their risk of becoming obese and developing chronic diseases.

PURPOSE: This study examined the impact of an 8-week parental modeling physical activity (PA) intervention on parent and child PA and body composition. METHODS: Twenty-six parents participated in an 8-week PA intervention with their 1 - 5 year old child. The adults were randomly placed into an intervention (n=19) or control (n=7) group. The intervention group received weekly phone calls with a coach. The coach discussed strategies to change parent and child PA. PA (activity monitor) and body composition (height, weight, and circumferences) were assessed before and after the intervention. Body mass index (BMI) and BMI z-scores were calculated. Time spent in sedentary behavior, light, moderate, and vigorous PA was determined using cut points by, Freedson et al. (adult), Trost et al. (1 - 2 year old children), and Butte et al. (3 - 5 year old children). Data analyses were conducted using the intention-to-treat method. A series of 2 (group: control/intervention) X 2 (time: pre/post) ANCOVAs were run to examine the effect of the intervention on PA levels in the parents and children adjusting for wear time. A series of 2 (group: control/intervention) X 2 (time: pre/post) ANOVAs were run to examine the effect of the intervention on body composition (weight, BMI, waist circumference) in the parents and children (BMI z-score). Effect sizes (ES) were calculated and significance was set at p<.05. RESULTS: Among the parents, group, time, and interaction effects were non-significant for PA levels, weight, BMI, and waist circumference (p>.05). ES indicated the intervention group had medium reductions in sedentary behavior (-.57) and increases in vigorous PA (.65), whereas controls had small reductions in sedentary behavior (-.14) and medium reductions in vigorous PA (-.76). Regarding the children’s data, the PA levels and BMI z-scores were similar by group and time (p>.05). Small decreases in sedentary behavior (-0.18), light (-.21), and mod (-.11) PA were observed in the intervention children, whereas control children had small increases in sedentary behavior (.24), and large decreases in light (-.92) and moderate (-.90) PA. CONCLUSIONS: A parental modeling PA intervention may have positive effects on parent’s and children’s PA levels. Supported by: Research/Creative Activity Award, East Carolina University

Parent anxiety and perceptions of their child’s physical activity and sedentary behaviour during the COVID-19 pandemic in Canada

BackgroundThe COVID-19 pandemic resulted in public health and policy measures to reduce in-person contact and the transmission of the virus. These measures impacted daily life and mental well-being (MWB). The aims of this study were to explore the MWB impacts of COVID-19 on children and assess the associations among perceived changes in physical activity (PA) and sedentary behaviors (SB), with perceived MWB changes, using a mixed-methods approach.MethodsA convergent parallel mixed-methods design consisting of an online survey with a convenience sample and interviews was conducted from May through July 2020 with parents/caregivers of kindergarten through 5th graders in the St. Louis region. Survey domains assessed included child MWB, PA, and SB. Interviews were recorded, transcribed, and qualitatively analyzed using a code book developed to elicit themes. Survey data was analyzed with chi-squared tests and logistic regressions. The dependent variable was perceived change in child MWB due to the impact of COVID-19. Independent variables included perceived changes in PA, SB, and child concerns about COVID-19.ResultsSample size consisted of 144 surveys and 16 interviews. Most parents reported a perceived decrease in child MWB (74%), a decrease in child PA (61%), and an increase in child SB (91%). Discontentment with stay-at-home orders and concern about COVID-19 were associated with a perceived decrease in MWB. Children whose PA decreased were 53% less likely to have the same or better MWB (OR 0.47) and children whose outside PA decreased were 72% less likely to have the same or better MWB (OR 0.28). Common qualitative themes included difficulty in adjusting to COVID-19 restrictions due to school closures and lack of socializing, child concerns about family getting sick, and PA benefits for improving MWB.ConclusionsBased on parent perceptions, MWB decreased with COVID-19. Maintained or increased child PA improved the chances MWB would remain the same or improve. Parent interviews provide context to these findings by showing how COVID-19 impacted MWB and the associations between PA and MWB. Understanding protective factors for child MWB during COVID-19 is important to offset negative long-term health outcomes from this ongoing pandemic.

BackgroundDuring transition to retirement there is often a rearrangement of daily life which might provide a key opportunity for interventions to promote a non-sedentary and active lifestyle. To be able...

I. The Problem: Childhood Obesity—A Burgeoning Epidemic e490II. Childhood Obesity Research Summit.........e490III. Pathophysiology and Morbidity ofChildhood Obesity e490A. Pathophysiology of Obesity e490B. Medical Consequences of Childhood Obesity. . .e490C. Psychosocial and Societal Consequences ofChildhood Obesity e490IV. Current Healthcare Practices in ChildhoodObesity Prevention and Treatment e492A. Lifestyle Assessment: Diet and Physical Activity . . . .e492B. Clinical Assessment e493C. Psychosocial/Behavioral Assessment .......e493D. Implementing Effective Prevention andTreatment Options: Diet e494E. Implementing Effective Prevention and TreatmentOptions: Exercise and Sedentary Behaviors . . . .e495F. Implementing Effective Prevention TreatmentOptions: Family and Behavioral Approaches . . .e496G. Behavioral Management e497H. Medical and Pharmacological Management. . . .e497I. Surgical Management e498V. Barriers to Optimum Care e498A. Healthcare System Factors e4981. Preparedness of Providers e4982. Models of Coverage and Care e4993. Uninsurance and Underinsurance AmongChildren and Families e5004. Healthcare Providers and Settings asRole Models e500B. The Challenge of Behavior Change ........e5011. Motivational Interviewing for Pediatric Obesity. .e5012. Psychosocial Factors InfluencingBehavior Change e5023. Environmental Factors InfluencingBehavioral Change e503VI. Practice-Based Resources for Preventionand Management e503A. Models From Other Disciplines e5031. Adult Chronic Care Model e5032. Treatment of Heart Failure e5043. Treatment of Type 2 Diabetes Mellitus .....e5044. Treatment of Childhood Asthma.........e505B. Public Health Measures forChildhood Obesity e5061. Tobacco Control: Implications forChildhood Obesity e506C. Specific Research Issues e5061. Specifying Priorities in the Context of aComplex, Multifactorial Problem ........e5062. Taking a Developmental Approach .......e5073. Engaging Stakeholders e5074. Targeting the Appropriate Outcome .......e508VII. Research Challenges e509A. Research in the Busy Practice e509B. Bring Research Into Practices: Web-BasedAssessment for the PediatricObesity Clinic e509C. Research Agenda: NHLBI and thePediatric Heart Network e510D. Research Agenda: The Children’sOncology Group e510E. Research Agenda: CDC e511F. Research Agenda: Foundations e511VIII. Research and Policy: KnowledgeTranslation e512A. From Practice to Policy to Practice ........e512IX. Concluding Remarks e512Appendix A: Planning Committee e513Appendix B: Presenters e513

The theory of planned behavior (TPB) is used to document children's health behaviors linked to their physical activity. The TPB model and its components have been applied to comprehend the adoption of physical activity along informational and motivational parameters. Thus, this exploratory study aims to assess the evolution of children's physical activity levels (MVLPA) during the first weeks of their cancer, in addition to documenting the evolution of the TPB measures, self-reported fitness, and self-esteem in the physical domain to better understand children's physical activity behavior. A total of 16 children (8 boys and 8 girls) with cancer answered psychosocial questionnaires at the diagnosis of cancer (time 1) and at 6 to 8weeks (time 2) to assess the TPB measures, self-reported fitness, self-esteem in the physical domain, and their daily physical activities. A significant decrease of 41.2min/days of daily MVLPA was observed between the time at cancer diagnosis (50.5 ± 32.8min/days) and 6 to 8weeks after the first interview (9.3 ± 9.1min/days). We found that the time after the diagnosis of cancer negatively impacted children's TPB measures (mean in attitude, injunctive norms, identity, facilitating factors, self-confidence, and intention) and MVLPA levels. The TPB model explains 40% of the variance in MVLPA by the injunctive norms during the first weeks following cancer diagnosis in children. The findings of this study highlight the negative impacts of cancer on children's TPB measures, self-reported fitness, and self-esteem in the physical domain and self-reported MVLPA levels over 4 to 6weeks following the diagnosis. These findings help to better understand the effect of cancer diagnosis on children's physical activity behavior.

635 Understanding parent perceptions of healthy physical activity for their child with a chronic medical condition

Previous studies have reported on the associations between obesity and sedentary behavior (SB) or physical activity (PA) in children. This study examined longitudinal and bidirectional associations between adiposity and SB and PA in children. Participants were 356 children in England. PA was measured at 7 and 9 years of age using accelerometry. Outcome and exposures were time in SB and PAs and concurrent body mass index z score and fat index (FI). Adiposity at baseline was positively associated with changes in SB (β = 0.975 for FI) and negatively associated with changes in moderate to vigorous PA (β = -0.285 for body mass index z score, β = -0.607 for FI), vigorous PA (β = -0.095 for FI), and total PA (β = -48.675 for FI), but not vice versa. The changes in SB, moderate to vigorous PA, and total PA for children with overweight/obesity were significantly more adverse than those for children with healthy weight. A high body mass index z score or high body fatness at baseline was associated with lower moderate to vigorous PA and vigorous PA after 2 years, but not vice versa, which suggests that in this cohort adiposity influenced PA and SB, but the associations between adiposity and SB or PA were not bidirectional.

BackgroundSedentary behaviors and physical activity are likely to be affected by the COVID-19 outbreak, and sedentary lifestyles can increase subjective fatigue. The nonpharmaceutical policies imposed as a result of the COVID-19 pandemic may also have adverse effects on fatigue.ObjectiveThis study has two aims: to examine the changes in sedentary behaviors and physical activity of company workers in response to the COVID-19 pandemic in Japan and to examine relationships between changes in these sedentary behaviors and physical activity and changes in fatigue.MethodsData from a nationwide prospective online survey conducted in 2019 and 2020 were used. On February 22, 2019, an email with a link to participate in the study was sent to 45,659 workers, aged 20 to 59 years, who were randomly selected from a database of approximately 1 million individuals. A total of 2466 and 1318 participants, who self-reported their occupation as company workers, answered the baseline and follow-up surveys, respectively. Surveys captured fatigue, workday and daily domain-specific sedentary behaviors and physical activity, and total sedentary behaviors and physical activity. We used multivariable linear regression models to estimate associations of changes in sedentary behaviors and physical activity with changes in fatigue.ResultsIncreases in public transportation sitting during workdays, other leisure sitting time during workdays, and other leisure sitting time were associated with an increase in the motivation aspect of fatigue (b=0.29, 95% CI 0-0.57, P=.048; b=0.40, 95% CI 0.18-0.62, P<.001; and b=0.26, 95% CI 0.07-0.45, P=.007, respectively). Increases in work-related sitting time during workdays, total sitting time during workdays, and total work-related sitting time were significantly associated with an increase in the physical activity aspect of fatigue (b=0.06, 95% CI 0-0.12, P=.03; b=0.05, 95% CI 0.01-0.09, P=.02; and b=0.07, 95% CI 0-0.14, P=.04, respectively). The motivation and physical activity aspects of fatigue increased by 0.06 for each 1-hour increase in total sitting time between baseline and follow-up (b=0.06, 95% CI 0-0.11, P=.045; and b=0.06, 95% CI 0.01-0.10, P=.009, respectively).ConclusionsOur findings demonstrated that sedentary and active behaviors among company workers in Japan were negatively affected during the COVID-19 outbreak. Increases in several domain-specific sedentary behaviors also contributed to unfavorable changes in workers’ fatigue. Social distancing and teleworking amid a pandemic may contribute to the sedentary lifestyle of company workers. Public health interventions are needed to mitigate the negative effects of the COVID-19 pandemic or future pandemics on sedentary and physical activity behaviors and fatigue among company workers.

ObjectiveGrounded in the expectancy-value theory, this study examined how parental expectancy-value beliefs influence children's physical activity, as well as the mediating roles of parental exercise inputs and children's exercise self-efficacy, with children serving as the research subjects.MethodsData were collected from 1,284 children and their parents in South China using the Exercise Expectancy and Value Scale, Parental Exercise Input Quality Scale, Exercise Health Beliefs Scale, and Physical Activity Rating Scale. Path analysis was conducted employing structural equation modeling techniques.Results(1) Parental expectancy-value beliefs, parental exercise input, children's exercise self-efficacy, and children's physical activity exhibited significant positive correlations (P ≤ 0.05). (2) Parental expectancy-value beliefs had a positive direct effect on children's physical activity (β = 8.898, 95% CI [4.754, 13.041]). (3) Parental exercise input positively influenced children's exercise self-efficacy (β = 1.178, 95% CI [0.147, 2.323]), which subsequently positively affected children's physical activity (β = 3.028, 95% CI [1.630, 4.603]). Furthermore, the chain mediation of parental exercise input and children's exercise self-efficacy indirectly influenced children's physical activity (β = 0.974, 95% CI [0.564, 1.498]).ConclusionParental expectancy-value beliefs significantly enhanced both parental exercise input and children's exercise self-efficacy, which subsequently promoted children's physical activity behavior. Future interventions aimed at improving children's PA levels should prioritize strengthening parental expectation beliefs, enhancing parental input to exercise, and boosting children's exercise self-efficacy.

Status and Potential of Community-Engaged Research to Investigate Physical Activity Interventions for Children with Autism Spectrum Disorder in Chinese-American Communities