Pyper Evelyn, Harrington Daniel, Manson Heather
Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Ontario, M5G 1V2, Canada.
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Toronto, N2L 3G1, Canada.
BMC Public Health. 2016 Aug 24;16(1):568. doi: 10.1186/s12889-016-3245-0.
In Canada, 31.5 % of children are overweight or obese, putting them at an increased risk of chronic co-morbidities and premature mortality. Physical activity, healthy eating, and screen time are important behavioural determinants of childhood overweight and obesity that are influenced by the family environment, and particularly parents' support behaviours. However, there is currently a limited understanding of which types of these support behaviours have the greatest positive impact on healthy child behaviours. This study aims to determine the relative contribution of different types of parental support behaviours for predicting the likelihood that children meet established guidelines for daily physical activity, daily fruit and vegetable consumption, and recreational screen time.
A Computer Assisted Telephone Interview survey was used to collect data from a random sample of parents or guardians with at least one child under the age of 18 in Ontario (n = 3,206). Three multivariable logistic regression models were built to predict whether or not parents reported their child was meeting guidelines. Independent variables included parent and child age and gender, multiple indicators of parental support behaviours, and socio-demographic characteristics. Parental support behaviours were categorized post-hoc as motivational, instrumental, regulatory, and conditional based on an adapted framework.
Controlling for all other factors in the model, several parental support behaviours were found to be significant predictors of children meeting established health guidelines. For example, conditional support behaviours including taking the child to places where they can be active (OR: 2.06; 95 % CI: 1.32-3.21), and eating meals as a family away from the TV (95 % CI: 1.15-2.41) were significant positive predictors of children meeting physical activity and fruit and vegetable guidelines, respectively.
Health promotion efforts aimed at improving particular parent support behaviours could be effective levers for mitigating the burden of excess body weight in childhood. As such, the influence of support behaviours should be fully considered in any comprehensive approach to prevention and reduction of childhood overweight and obesity.
在加拿大,31.5%的儿童超重或肥胖,这使他们患慢性合并症和过早死亡的风险增加。身体活动、健康饮食和屏幕使用时间是儿童超重和肥胖的重要行为决定因素,这些因素受家庭环境影响,尤其是父母的支持行为。然而,目前对于这些支持行为的哪些类型对儿童健康行为有最大的积极影响了解有限。本研究旨在确定不同类型的父母支持行为对预测儿童达到每日身体活动、每日水果和蔬菜摄入量以及娱乐性屏幕使用时间既定指南的可能性的相对贡献。
采用计算机辅助电话访谈调查,从安大略省至少有一名18岁以下儿童的父母或监护人的随机样本中收集数据(n = 3206)。建立了三个多变量逻辑回归模型,以预测父母是否报告其孩子符合指南。自变量包括父母和孩子的年龄及性别、父母支持行为的多个指标以及社会人口学特征。根据一个改编框架,父母支持行为事后被分类为动机性、工具性、监管性和条件性。
在控制模型中的所有其他因素后,发现几种父母支持行为是儿童达到既定健康指南的重要预测因素。例如,条件性支持行为,包括带孩子去可以活动的地方(比值比:2.06;95%置信区间:1.32 - 3.21),以及与家人一起在远离电视的地方用餐(95%置信区间:1.15 - 2.41),分别是儿童达到身体活动和水果及蔬菜指南的显著正向预测因素。
旨在改善特定父母支持行为的健康促进努力可能是减轻儿童超重负担的有效杠杆。因此,在任何预防和减少儿童超重和肥胖的综合方法中,都应充分考虑支持行为的影响。