Gerards Sanne M P L, Van Kann Dave H H, Kremers Stef P J, Jansen Maria W J, Gubbels Jessica S
Department of Health Promotion, Nutrition and Translational Research Institute Maastricht (NUTRIM), Maastricht University, P.O. Box 616, Maastricht, MD, 6200, The Netherlands.
School of Sport Studies, Fontys University of Applied Sciences, P.O. Box 347, Eindhoven, AH, 5600, The Netherlands.
BMC Public Health. 2021 Jan 19;21(1):168. doi: 10.1186/s12889-021-10224-x.
As many children do not meet the recommended daily physical activity (PA) levels, more research is needed towards environmental determinants of children's PA levels. The aims of this longitudinal study were to investigate whether the physical environment and parenting practices have an impact on changes in children's weekday time spent at various PA levels and whether associations between physical neighbourhood environment and changes in children's PA are moderated by parenting practices.
We performed a secondary data analysis of longitudinal data collected at three timepoints (baseline, 6, and 18 months) from 10 control schools of the Active Living study, a quasi-experimental study, which took place in South Limburg, the Netherlands. In total, 240 children aged 8-12 years were included in the analyses. PA levels were measured using accelerometry (ActiGraph GT3X+). The physical environment was assessed at baseline through neighbourhood audits of the school environment, and PA parenting practices were measured at baseline via validated parental questionnaires. Multivariate multilevel regression analyses were conducted to determine the main effects of the physical environment and parenting practices on changes in children's time spent in sedentary behaviour (SB), light PA and moderate-to-vigorous PA (MVPA) over 18 months. Additionally, moderation of the association between the physical environment and children's PA levels by parenting practices was examined by adding interacting terms to the regression equations.
Walkability of the physical environmental was associated with a decrease in SB at 18 months (B = -5.45, p < .05). In addition, the parenting practice logistic support was associated with an increase in MVPA (at all time points, B = .68, B = .73 and B = 1.02, respectively, all p < .05) and a decrease in SB (at 18 months, B = -1.71, p < .05). Stratified analyses (based on significant interaction terms) showed that the effect of specific physical environmental features (e.g., sports facilities) on children's improvements in PA levels were strengthened by favourable parenting practices.
Besides the main effects of walkability and logistic support, there were indications that several parenting practices moderate the association between the physical environment and changes in children's time in various PA levels. The current findings are exploratory, and need to be confirmed in further research.
由于许多儿童未达到推荐的每日身体活动（PA）水平，因此需要针对儿童PA水平的环境决定因素开展更多研究。这项纵向研究的目的是调查物理环境和育儿方式是否会对儿童在不同PA水平下平日的时间变化产生影响，以及邻里物理环境与儿童PA变化之间的关联是否会受到育儿方式的调节。
我们对来自荷兰南林堡的一项准实验性研究“积极生活研究”的10所对照学校在三个时间点（基线、6个月和18个月）收集的纵向数据进行了二次数据分析。分析共纳入了240名8至12岁的儿童。使用加速度计（ActiGraph GT3X+）测量PA水平。在基线时通过对学校环境的邻里审核评估物理环境，并通过经过验证的家长问卷在基线时测量PA育儿方式。进行多变量多层次回归分析，以确定物理环境和育儿方式对儿童在18个月内久坐行为（SB）、轻度PA和中度至剧烈PA（MVPA）时间变化的主要影响。此外，通过在回归方程中添加交互项，研究育儿方式对物理环境与儿童PA水平之间关联的调节作用。
物理环境的步行便利性与18个月时SB的减少相关（B = -5.45，p <.05）。此外，育儿方式的后勤支持与MVPA的增加相关（在所有时间点，B分别为.68、.73和1.02，均p <.05）以及SB的减少（在18个月时，B = -1.71，p <.05）。分层分析（基于显著的交互项）表明，有利的育儿方式增强了特定物理环境特征（如体育设施）对儿童PA水平改善的影响。
除了步行便利性和后勤支持的主要影响外，有迹象表明几种育儿方式调节了物理环境与儿童在不同PA水平下时间变化之间的关联。当前的研究结果具有探索性，需要在进一步的研究中得到证实。
