evidence based practice
Melanie513
childhoodobesity3research.pdf
Literature Review
Parenting Practices and Children’s Physical Activity: An Integrative Review
Amy Hutchens, PhD(c), RN, CNE1, and Rebecca E. Lee, PhD2
Abstract
The purpose of this integrative review was to analyze the state of science concerning the influence of parenting practices on children’s physical activity (PA) levels. A total of 38 studies met the inclusion criteria after full-text review. The body of research is limited in experimental designs with only three studies measuring the influence of the intervention on parenting practices. Seven of the 30 quantitative studies (23.3%) found significant associations between parental role modeling of PA and children’s PA levels. Seven of the eight (87.5%) qualitative studies identified parental role modeling of PA as important in promoting children’s PA. Sixteen of the 30 (53.3%) quantitative studies found that parental support of PA was significantly associated with children’s PA. Five of the eight (62.5%) qualitative studies identified logistic support as supporting PA in children. The science could be expanded by the development of randomized controlled trials aimed at this area.
Keywords
parenting, exercise, child, review, school nursing
A dramatic reduction in the amount of physical activity (PA)
occurs between the school age and adolescent years. People
who are physically active typically live longer than those
who are not (Paffenbarger, Hyde, Wing, & Hsieh, 1986).
They also have lower rates of heart disease, stroke, type 2
diabetes, depression, and some cancers (American Heart
Association, 2013). This is also true for children. PA leads
to substantial physical and psychological health benefits
for youth (Strong et al., 2005). Parents influence children’s
PA levels; however, the extent and nature of this relation-
ship is not clearly defined or documented. Parenting prac-
tices include ways in which parents may shape their
children’s PA habits including increasing knowledge, mod-
eling PA, and providing accessibility to healthy PA options
(Davison & Campbell, 2005). It is critical to understand the
role that parents play in children’s activity behaviors. The
purpose of this integrative review is to analyze the state of
science concerning the influence of parenting practices on
children’s PA.
Purpose
PA is a vital component for good health and long life. It is
associated with increased fitness, improved cardiovascular
and metabolic disease risk factors, decreased likelihood of
developing type 2 diabetes, improved bone strength, and
improved mental well-being (National Physical Activity
Plan, 2014). In the United States, although 42% of children ages 6–11 years meet the recommended daily levels of 60 or
more min of moderate to vigorous PA per day, only 8% of youth aged 12- to 15 years old meet that recommendation
(National Physical Activity Plan, 2014). PA helps one main-
tain a healthy body weight (McTiernan et al., 2007). By
2030, 13 states could have obesity rates above 60% (Levi, Segal, St. Laurent, Lang, & Rayburn, 2012). Improvement in
PA levels may help to prevent obesity.
Although many factors have been shown to contribute to
children’s PA, parents have been identified as key in the
promotion of PA (O’Connor, Jago, & Barnowski, 2009).
Parents serve as important guides and role models for PA,
and they organize and fund children’s involvement in phys-
ical activities (Davison, Cutting, & Burch, 2003). Evidence
aimed at understanding the influence of parenting practices
on children’s PA levels is emerging, but the depth and
breadth are not clear. A review of parenting practices was
conducted by Xu, Wen, and Rissel (2015) but did not include
qualitative evidence (Xu, Wen, & Rissel, 2015), limiting the
depth of the review and conclusions that might be drawn
1 Fran and Earl Ziegler College of Nursing, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, USA 2 Center for Health Promotion and Disease Prevention, College of Nursing
and Health Innovation, Arizona State University, Phoenix, AZ, USA
Corresponding Author:
Amy Hutchens, PhD(c), RN, CNE, Fran and Earl Ziegler College of Nursing,
University of Oklahoma Health Sciences Center, 1100 N. Stonewall,
Oklahoma City, OK 73117, USA.
Email: [email protected]
The Journal of School Nursing 2018, Vol. 34(1) 68-85 ª The Author(s) 2017 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/1059840517714852 journals.sagepub.com/home/jsn
from it. That review found that parental encouragement and
support increase children’s PA (Xu et al., 2015). An inte-
grative review is necessary to provide unique insight through
the consideration of qualitative as well as quantitative evi-
dence. This review will critically analyze the state of science
concerning the influence of parenting practices and chil-
dren’s PA levels.
The family ecological model (FEM) and the ecological
model of physical activity (EMPA) provided the theoretical
background for the study (Davison, Jurkowski, & Lawson,
2012; Spence & Lee, 2003). The FEM was developed to
explain the relationships among the environment and parent-
ing aimed at the promotion of healthy lifestyles (Davison
et al., 2012). The FEM accounts for contextual and family
factors influencing children’s PA-related behaviors
(Davison et al., 2012). Parenting is a well-developed, main
component of the FEM. The FEM posits that to understand
behavior, one must consider the context in which the person
is living and that family provides the environment in which
behavior patterns emerge (Davison & Campbell, 2005). Par-
enting is encompassed within the EMPA as a dynamic envi-
ronmental linkage that helps to promote PA in children
(Spence & Lee, 2003). The model notes the direct and indi-
rect effects of multiple levels of the environment and their
influence on PA, and it accounts for the variations in distal
and proximal influences on PA. Distal influences of PA are
buffered by proximal factors (Spence & Lee, 2003). For
example, poor neighborhood conditions would have less
influence on children’s PA if parents were able to provide
a supportive home environment for PA.
The existing research suggests that parents influence chil-
dren’s PA by providing the context through behavior patterns
emerge (Davison & Campbell, 2005). The purpose of this
integrative review was to identify the PA parenting practices
that potentially influence children’s PA. The integrative
review is the broadest type of review; it allows for inclusion
of experimental and nonexperimental research to obtain a bet-
ter understanding of the phenomenon of concern (Whittemore
& Knafl, 2005) including problem identification, literature
search, data reduction, data display, and data comparison as
strategies to enhance rigor in integrative reviews.
Method
Eligibility Criteria
This review covered a 19-year period (1998–2017). A 19-
year period was used, as the combination of search terms did
not generate articles prior to 1998. The CINAHL, Ovid
Medline, and PubMed databases were searched in January
of 2017 for eligible studies. The search terms consisted of
combinations of “parenting,” “children,” “and “physical
activity.” Inclusion criteria for this study necessitated that
studies used qualitative or quantitative designs, were pub-
lished in English-language peer-reviewed journals, and
investigated parenting practices that influence PA in chil-
dren and adolescents. Reference lists of included papers
were examined to determine whether any of the studies met
the inclusion criteria. Studies were not considered if they did
not address parenting practices specific to PA. Studies solely
examining parenting style (without parenting practices)
were excluded. Parenting style as described by Maccoby and
Martin (1983) includes authoritarian, authoritative, permis-
sive, and uninvolved. Unpublished studies were not included
in the review. Four hundred and seven studies were initially
identified from the database searches. A total of 38 studies
met the inclusion criteria after full-text review (see flow-
chart in Figure 1).
Polit and Beck’s (2012) evidence hierarchy was used to
identify the levels of evidence for each study to determine
the strength of available evidence. The strongest level of
research ranked as Level 1 by Polit and Beck includes sys-
tematic reviews of randomized and nonrandomized control
trials. Level 2 includes single-randomized and nonrando-
mized clinical trials. The third level is systematic reviews
of correlational and observational studies. Level 4 incorpo-
rates single correlational and observational studies, and
Level 5 includes systematic reviews of descriptive and qua-
litative studies. The sixth level described by Polit and Beck
are single descriptive and qualitative studies. Last, the
seventh level entails opinions from experts.
Quality Assessment
Quantitative studies were evaluated for quality using the
Grading of Recommendations, Assessment, Development,
and Evaluation (GRADE) approach (Higgins & Green,
2011; see Table 1). This approach ranks the quality of evi-
dence as high, moderate, low, and very low. Rankings are
based on underlying methodology, and reviewers may mod-
ify the quality of a study based on an assessment of factors
that may increase or decrease the quality of the study. Ran-
domized control trials (RCTs) are ranked as high but can be
downgraded to moderate low or very low if they have lim-
itations in design, inconsistent results, imprecision of results,
or publication bias (Higgins & Green, 2011). Observational
studies are ranked as low but can be upgraded for reasons
that include a large magnitude effect. Observational studies
can also be downgraded to very low using the same criteria
used to downgrade RCTs.
A variety of methods were utilized for data collection
within the qualitative studies. Three of the studies employed
1:1 interviews for data collection (Bentley et al., 2012;
Hosseini, Anoosheh, Abbaszadeh, & Ehsani, 2013; Ickes,
Mahoney, Roberts, & Dolan, 2016). Three employed focus
groups (De Lepeleere, De Smet, Verloigne, Cardon, & De
Bourdeaudhuij, 2013; Hesketh, Hinkley, & Campbell, 2012;
Wright, Wilson, Griffin, & Evans, 2008). Nominal group
technique was used by two of the qualitative studies
(O’Connor, Cerin, et al., 2013; Suen, Cerin, & Wu, 2015).
Hutchens and Lee 69
Nominal group technique eliminates potential bias that may
occur in traditional focus groups by utilizing a structured
method, so that on person cannot dominate the discussion
(O’Connor, Cerin, et al., 2013), Only two of the qualitative
studies provided interrater reliability between coders. Those
were reported at r ¼ .87 and r ¼ .84 (De Lepeleere et al., 2013; Wright et al., 2008).
Data Extraction and Synthesis
Key concepts were identified, and methodological evidence
was evaluated (Whittemore & Knafl, 2005). The design of
this review also included principles of cross-case analysis
described by Miles, Huberman, and Saldana (2014). The
cross-case analysis seeks to enhance generalizability and
deepen understanding and explanation. This review utilized
the elements of the variable-oriented approach described by
Miles et al. (2014) through an examination of variables
within each study and their interrelationships. Research arti-
cles were read and critically reviewed several times.
Matrices were developed and analyzed for cross-case and
within-case analysis that included identifying levels of
evidence, study design, quality, sample sizes, sample char-
acteristics, measure of PA, and relevant themes.
Parental role modeling of PA included the factors of
parents’ enjoyment of PA, parents’ frequency of PA, fam-
ilies’ use of sports as recreation, and parents’ use of their
own behavior to encourage PA (Davison et al., 2003).
Studies examining parental role modeling of PA defined
it as parents’ participation, enjoyment, and recreation in
PA in front of the child. Parental modeling of behaviors
believed to increase children’s PA included parental par-
ticipation in PA alone or with their children and parents’
arranging of activities that included PA such as walking
together, visiting the swimming pool, family sports
events, and skating together (Davison & Campbell,
2005). Logistic support of PA incorporated parents enrol-
ling children in sports, attending child sporting events,
and assisting with transportation to PA events (Davison
et al., 2003). Monitoring PA included keeping track of
how much PA the child performed (Gubbels et al., 2011).
Restriction of sedentary behaviors included the parents
intentional efforts to limit the amount of time that the
child spent being sedentary.
Records identified through database searching
(n = 731) Sc
re en
in g
In cl
ud ed
E
lig ib
ili ty
Id
en ti
fi ca
ti on
Additional records identified through citations
(n = 1)
Records after duplicates removed (n =407)
Records screened (n =407)
Records excluded (n =319)
Full-text articles assessed for eligibility
(n =88)
Full-text articles excluded, no measure of parenting or children’s PA, protocols, reviews
(n = 50)
Studies included in qualitative synthesis
(n = 8)
Studies included in quantitative synthesis
(n = 30)
Figure 1. Flow diagram of study selection.
70 The Journal of School Nursing 34(1)
Results
Sample
Sample characteristics of the 38 manuscripts reviewed are
presented in Table 2. Descriptive correlational studies of the
topic were abundant, with 27 of the studies (71.1%) utilizing those methods to investigate potential association between
parenting practices and children’s PA. Eight (21.1%) of the studies were qualitative. One (2.6%) was a quasi-experimental design (Davison, Jurkowski, Li, Kranz, & Lawson, 2013), one
was a randomized controlled trial (Gerards et al., 2015), and
one was a pilot randomized controlled trial (O’Connor, Hil-
mers, Watson, Baranowski, & Giardino, 2011).
Demographic Characteristics
The children’s ages in the study ranged from infancy to 19
years old. The majority of the studies (n ¼ 19) focused on
school-aged children ages 6–12 years. Five studies focused
on preschool-aged children, and one study included infants
and preschoolers. Sample size of participants in the studies
ranged from 21 to 3,175. Studies conducted outside of the
United States were abundant. Studies conducted within the
United States focused predominantly on White families with
three studies focused on predominantly African American
samples and three on predominantly Hispanic samples (see
Table 2 for demographic characteristics of the samples).
Data Collection and Measurement
A variety of tools were used to measure the influence of
parenting practices on children’s PA levels. Nine of the 30
quantitative studies (30%) used the Activity-Related Parent- ing Practices Scale developed by Davison, Cutting, and
Burch (2003), developed specifically to measure parents’
PA-related parenting practices influencing girls’ PA. The
Activity-Related Parenting Practices Scale demonstrated
moderate to high Cronbach’s a (.61 to .86) in all studies. The Activity-Related Parenting Practices Scale was the most
frequently used tool to assess parenting practices across the
studies included in this review.
Studies not using the Activity-Related Parenting Prac-
tices Scale used a range of instruments to operationalize
parenting practices. Four studies used the Child Feeding
Questionnaire to measure parenting practices influencing
children’s activity (Arredondo et al., 2006; Gerards et al.,
2015; Gubbels et al., 2011; Remmers et al., 2014). Average
reported reliability of the Child Feeding Questionnaire was
0.67 (Remmers et al., 2014). Two of the quantitative studies
used the Parenting Strategies for Eating and Activities Scale
(PEAS). The PEAS included items about parental monitor-
ing of PA and parental reinforcement of PA. Reliability of
the PEAS for the included studies ranged from .7 to .88
(Lloyd, Lubans, Plotnikoff, Collins, & Morgan, 2014).
Ostybe and colleagues (2013) used the Home Environ-
ment Survey (HES) to measure parenting practices related to
PA in the physical, political, and sociocultural home envi-
ronment. The HES was the most detailed and inclusive
instrument used to measure parenting practices. Cronbach’s
a for items of the HES ranged between .65 and .8.
Quality
Eighteen of the 30 quantitative studies included in the
review were graded as low-quality evidence, as a result of
the majority of the studies were observational (see Table 1
for quality rankings of all quantitative studies in the review).
Accelerometers have been endorsed as the most reliable
and valid measure of PA in children (Eston, Rowlands, &
Ingledew, 1998). Fifteen of the 30 (50%) quantitative studies used accelerometers to measure children’s PA levels and 14
of the quantitative studies (46.7%%) used self-report scales as to measure PA. One (3.3%) of the quantitative studies used pedometers to measure PA (Lloyd et al., 2014).
Table 1. Quality of quantitative studies using GRADE criteria.
Studies GRADE Rating
Arredondo et al. (2006) Low Barnes, Plotnikoff, Collins, and Morgan (2015) Low Bradley, McRitchie, Houts, Nader, and O’Brien
(2011) Moderate
Crawford et al. (2010) Moderate Davison, Cutting, and Birch (2003) Low Davison et al. (2012) Low Davison, Jurkowski, Li, Kranz, and Lawson (2013) Moderate De Lepeleere, De Bourdeaudhuij, Cardon, and
Verloigne (2015) Low
Edwardson and Gorely (2010) Low Forthofer, Dowda, McIver, Barr-Anderson, and Pate
(2015) Moderate
Gerards et al. (2015) Moderate Gubbels et al. (2011) Low Heitzler, Martin, Duke, and Huhman (2006) Low Hennessy, Hughes, Goldberg, Hyatt, and
Economos (2010) Low
Jago et al. (2011) Moderate King et al. (2010) Low Lam and McHale (2014) Low Langer, Crain, Senso, Levy, and Sherwood (2014) Moderate Lloyd, Lubans, Plotnikoff, Collins, and Morgan (2014) Low Loprinzi, Schary, Beets, Leary, and Cardinal (2013) Low O’Connor, Chen, Baranowski, Thompson, and
Baranowski (2013) Low
O’Connor, Hilmers, Watson, Baranowski, and Giardino (2011)
Moderate
Ostbye et al. (2013) Low Remmers et al. (2014) Moderate Rhodes et al. (2015) Moderate Seabra et al. (2012) Low Tandon et al. (2014) Moderate Taylor, Wilson, Slater, and Mohr (2011) Low Verloigne, Van Lippevelde, Maes, Brug, and De
Bourdeaudhuij, (2012) Low
Zhao, Gao, and Settles (2013) Moderate
Hutchens and Lee 71
T a b
le 2 .
P ar
en ti n g
p ra
ct ic
es st
u d ie
s as
se ss
in g
p h ys
ic al
ac ti vi
ty o u tc
o m
es in
ch ild
re n .
A u th
o r,
Y ea
r
D es
ig n
Le ve
l o f
E vi
d en
ce Sa
m p le
P u rp
o se
P ar
en ti n g
P ra
ct ic
es V
ar ia
b le
s C
h ild
re n ’s
P h ys
ic al
A ct
iv it y
(P A
) V
ar ia
b le
s Si
gn ifi
ca n t
R es
u lt s
A rr
ed o n d o
et al
. (2
0 0 6 )
C ro
ss -s
ec ti o n al
, d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
8 1 2
La ti n o
M ea
n ag
e ¼
6 ye
ar s
P ar
en ts
: 9 6 %
fe m
al e,
4 %
m al
e 4 8 %
B o ys
an d
5 2 %
gi rl
s 4 0 %
W it h
in co
m e
≤ $ 1 ,5
0 0
p er
m o n th
U n it ed
St at
es
E va
lu at
e th
e in
flu en
ce o f
p ar
en ti n g
st yl
e o n
ch ild
re n ’s
P A
an d
d ie
t
C h ild
Fe ed
in g
Q u es
ti o n n ai
re M
o n it o ri
n g
P A
: K
ee p in
g tr
ac k
o f am
o u n t
o f T
V w
at ch
ed an
d ex
er ci
se ch
ild is
ge tt
in g
P ar
en ta
l re
in fo
rc em
en t
o f P A
: P ra
is e
ch ild
fo r
b ei
n g
ac ti ve
D is
ci p lin
e th
e ch
ild fo
r sc
re en
ti m
e ac
ti vi
ti es
w it h o u t
p er
m is
si o n
Li m
it se
tt in
g: Li
m it
sc re
en ti m
e ac
ti vi
ti es
P ar
en t
co m
p le
te d
q u es
ti o n n ai
re P ar
en ta
l m
o n it o ri
n g
o f P A
w as
si gn
ifi ca
n tl y
as so
ci at
ed w
it h
ch ild
re n ’s
P A
P ar
en ta
l re
in fo
rc em
en t
o f P A
w as
si gn
ifi ca
n tl y
as so
ci at
ed w
it h
ch ild
re n ’s
P A
B ar
n es
, P lo
tn ik
o ff ,
C o lli
n s,
an d
M o rg
an (2
0 1 5 )
C ro
ss -s
ec ti o n al
, d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
4 0 , m
o th
er s
an d
d au
gh te
rs M
ea n
ag e ¼
8 .8
ye ar
s P ar
en ts
: 1 0 0 %
fe m
al e
1 0 0 %
G ir
ls SE
S n o t
re p o rt
ed A
u st
ra lia
A ss
es s
m at
er n al
co rr
el at
es o f
o b je
ct iv
el y
m ea
su re
d P A
in gi
rl s
A ct
iv it y
Su p p o rt
(A C
T S)
Sc al
e Lo
gi st
ic su
p p o rt
M o d el
in g
G T
3 X
ac ce
le ro
m et
er s
Lo gi
st ic
su p p o rt
w as
p o si
ti ve
ly as
so ci
at ed
w it h
M V
P A
B en
tl ey
et al
. (2
0 1 2 )
Q u al
it at
iv e
st u d y
Le ve
l IV
n ¼
3 2 , p ar
en ts
6 -
to 8 -y
ea r-
o ld
s P ar
en ts
: 9 0 .6
% fe
m al
e, 9 .4
% m
al e
6 2 %
G ir
ls , 3 8 %
b o ys
SE S
U n it ed
K in
gd o m
Fo rm
at iv
e w
o rk
to in
fo rm
th e
co n te
n t
o f a
p ilo
t ra
n d o m
iz ed
co n tr
o l tr
ia l
(R C
T )
N A
N A
P ar
en ta
l lo
gi st
ic su
p p o rt
o f P A
fa ci
lit at
ed ch
ild ’s
P A
B ra
d le
y, M
cR it ch
ie ,
H o u ts
, N
ad er
, an
d O
’B ri
en (2
0 1 1 )
C ro
ss -s
ec ti o n al
, d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
8 0 1
7 7 .3
% W
h it e
9 -
to 1 5 -y
ea r-
o ld
s P ar
en ts
: 1 0 0 %
fe m
al e
4 9 .4
% B o ys
, 5 0 .6
% gi
rl s
2 6 .1
% Lo
w SE
S U
n it ed
St at
es
E x am
in e
co n n ec
ti o n s
b et
w ee
n p ar
en ti n g
an d
o b je
ct iv
el y
m ea
su re
d P A
in 9 -
to 1 5 -
ye ar
-o ld
s
P ar
en ta
l en
co u ra
ge m
en t
o f
ch ild
P A
, p ar
ti ci
p at
in g
in P A
w it h
th e
ch ild
, an
d tr
an sp
o rt
at io
n to
P A
ac ti vi
ty
A cc
el er
o m
et er
B o ys
w it h
lo w
er p ar
en ta
l m
o n it o ri
n g
an d
m o re
p ar
en ta
le n co
u ra
ge m
en t
h ad
m o re
M V
P A
. In
gi rl
s, p ar
en ta
le n co
u ra
ge m
en t w
as p o si
ti ve
ly as
so ci
at ed
w it h
m o re
M V
P A
. C
ra w
fo rd
et al
.( 2 0 1 0 )
D es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
3 0 1
1 0
to 1 2 -y
ea r-
o ld
s 4 2 .5
% B o ys
, 5 7 .5
% gi
rl s
P ar
en t
ge n d er
n o t
re p o rt
ed H
ig h
an d
lo w
so ci
o ec
o n o m
ic st
at u s
M el
b o u rn
e, A
u st
ra lia
D et
er m
in e
th e
co n tr
ib u ti o n s
o f fa
m ily
an d
n ei
gh b o rh
o o d
en vi
ro n m
en ts
to ch
an ge
s in
yo u th
P A
an d
B M
I sc
o re
o ve
r 5
ye ar
s
P ar
en ta
l ro
le m
o d el
in g
o f P A
P ar
en ta
l ru
le s
an d
re st
ri ct
io n s
o n
se d en
ta ry
b eh
av io
r P ar
en ta
l so
ci al
su p p o rt
o f P A
: P ar
ti ci
p at
io n
in P A
w it h
th e
ch ild
C h ild
re n ’s
M V
P A
, A
ct ig
ra p h
ac ce
le ro
m et
er
M at
er n al
ro le
m o d el
in g
o f P A
w as
p o si
ti ve
ly as
so ci
at ed
w it h
M V
P A
in b o ys
. A
m o n g
gi rl
s, p at
er n al
M V
P A
ro le
m o d el
in g,
P A
ru le
s, an
d p ar
en ta
l P A
co p ar
ti ci
p at
io n
w er
e p o si
ti ve
ly as
so ci
at ed
w it h
M V
P A
.
(c on
tin ue
d)
72
T a b
le 2 .
(c o n ti n u ed
)
A u th
o r,
Y ea
r
D es
ig n
Le ve
l o f
E vi
d en
ce Sa
m p le
P u rp
o se
P ar
en ti n g
P ra
ct ic
es V
ar ia
b le
s C
h ild
re n ’s
P h ys
ic al
A ct
iv it y
(P A
) V
ar ia
b le
s Si
gn ifi
ca n t
R es
u lt s
D av
is o n , C
u tt
in g,
an d
B ir
ch (2
0 0 3 )
C ro
ss -s
ec ti o n al
, d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
1 8 0
N o n -H
is p an
ic W
h it e
gi rl
s P ar
en ts
: 1 0 0 %
fe m
al e
1 0 0 %
G ir
ls 9 -y
ea r-
o ld
s M
ed ia
n co
m b in
ed in
co m
e >
$ 5 0 ,0
0 0
U n it ed
St at
es
E x am
in e
p ar
en t’ s
ac ti vi
ty -
re la
te d
p ar
en ti n g
st ra
te gi
es an
d si
m ila
ri ti es
an d
d iff
er en
ce s
in th
o se
st ra
te gi
es b et
w ee
n m
o th
er s
an d
fa th
er s.
E x am
in e
lin ks
b et
w ee
n ac
ti vi
ty -r
el at
ed p ar
en ti n g
st ra
te gi
es an
d gi
rl s
P A
p at
te rn
s.
A ct
iv it y-
R el
at ed
P ar
en ti n g
P ra
ct ic
es Sc
al e
Fa th
er ’s
an d
m o th
er ’s
lo gi
st ic
su p p o rt
: E n ro
lls ch
ild in
sp o rt
s, go
es to
sp o rt
in g
ev en
ts w
it h
ch ild
, an
d im
p o rt
an t
fo r
p ar
en t
to b e
in vo
lv ed
Fa th
er ’s
an d
m o th
er ’s
ex p lic
it m
o d el
in g:
P ar
en t
en jo
ym en
t o f P A
, p ar
en t
fr eq
u en
cy o f
P A
, fa
m ily
u se
o f P A
as re
cr ea
ti o n , an
d p ar
en ta
l u se
o f P A
to en
co u ra
ge ch
ild to
b e
ac ti ve
C h ild
re n ’s
P A
Sc al
e M
o th
er ’s
lo gi
st ic
su p p o rt
an d
fa th
er ’s
ex p lic
it m
o d el
in g
ar e
as so
ci at
ed w
it h
h ig
h er
le ve
ls o f P A
in th
ei r
d au
gh te
rs (p
< .0
1 )
D av
is o n , Ju
rk o w
sk i,
Li , K
ra n z,
an d
La w
so n
(2 0 1 3 )
Q u as
i- ex
p er
im en
ta l
Le ve
l II
n ¼
1 1 9
3 8 .5
% W
h it e,
1 7 .8
% B la
ck 1 3 .5
% B ir
ac ia
l, 6 .1
% H
is p an
ic , an
d 2 4 %
u n d o cu
m en
te d
ra ce
2 -
to 5 -y
ea r-
o ld
s P ar
en ts
: 9 2 %
fe m
al e,
8 %
m al
e 5 5 %
G ir
ls , 4 5 %
b o ys
SE S
n o t
re p o rt
ed U
n it ed
St at
es
A p ar
en t
ce n te
re d
ch ild
h o o d
o b es
it y
in te
rv en
ti o n
to im
p ro
ve fo
o d , P A
- an
d m
ed ia
-r el
at ed
p ar
en ti n g
o u tc
o m
es
A ct
iv it y-
re la
te d
P ar
en ti n g
P ra
ct ic
es Sc
al e
Su p p o rt
fo r
P A
Fa m
ily co
p ar
ti ci
p at
io n
in P A
Sc re
en -r
el at
ed p ar
en ti n g
A ct
ig ra
p h
G T
3 X
ac ce
le ro
m et
er Si
gn ifi
ca n tl y
h ig
h er
m in
u te
s p er
h o u r
o f lig
h t
P A
an d
fe w
er m
in u te
s p er
d ay
o fs
ed en
ta ry
ac ti vi
ty p o st
in te
rv en
ti o n .
P ar
en ts
re p o rt
ed in
cr ea
se d
su p p o rt
fo r
ch ild
re n ’s
P A
.
D av
is o n
et al
. (2
0 1 2 )
D es
cr ip
ti ve
co rr
el at
io n al
st u d y
Le ve
l IV
n ¼
7 6 7
9 7 .4
% W
h it e
6 -
to 1 9 -y
ea r-
o ld
s P ar
en ts
: 5 5 %
fe m
al e,
4 5 %
m al
e 5 1 .1
% B o ys
, 4 8 .9
% gi
rl s
2 3 .5
% Lo
w in
co m
e U
n it ed
St at
es
E x am
in e
p ar
en ts
su p p o rt
o f
ch ild
re n ’s
P A
as a
m ed
ia to
r lin
ki n g
so ci
al ca
p it al
an d
yo u th
P A
A ct
iv it y-
R el
at ed
P ar
en ti n g
P ra
ct ic
es Sc
al e
Lo gi
st ic
su p p o rt
M o d el
in g
an d
co p ar
ti ci
p at
io n
E n co
u ra
ge m
en t
o f ch
ild u se
o f
co m
m u n it y
re so
u rc
es fo
r P A
P ar
en t
re p o rt
o f
ch ild
re n ’s
ti m
e o u td
o o r
an d
d ay
s p er
w ee
k o f
re co
m m
en d ed
le ve
ls o f P A
P ar
en t
su p p o rt
fo r
ch ild
P A
w as
as so
ci at
ed w
it h
h ig
h er
P A
in ch
ild re
n
D e
Le p el
ee re
, D
e B o u rd
ea u d h u ij,
C ar
d o n , an
d V
er lo
ig n e
(2 0 1 5 )
C ro
ss -s
ec ti o n al
, d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
2 0 7 , p ar
en ts
6 -
to 1 2 -y
ea r-
o ld
s P ar
en ts
: 8 7 .4
% fe
m al
e, 1 2 .6
% m
al e
5 1 .7
% B o ys
, 4 8 .3
% gi
rl s
8 3 .5
% M
ed iu
m to
h ig
h SE
S B el
gi u m
A ss
es s
th e
as so
ci at
io n
b et
w ee
n p ar
en ti n g
p ra
ct ic
es an
d p ar
en ta
l se
lf- ef
fic ac
y w
it h
ch ild
re n ’s
P A
P ar
en ta
l Su
p p o rt
fo r
P A
Sc al
e Fl
em is
h P A
Q u es
ti o n n ai
re C
h ild
re n
w er
e m
o re
p h ys
ic al
ly ac
ti ve
w h en
sp o rt
s eq
u ip
m en
t w
as av
ai la
b le
an d
w h en
p ar
en ts
fo u n d
it ea
sy to
m o ti va
te th
ei r
ch ild
to d o
P A
(c on
tin ue
d)
73
T a b
le 2 .
(c o n ti n u ed
)
A u th
o r,
Y ea
r
D es
ig n
Le ve
l o f
E vi
d en
ce Sa
m p le
P u rp
o se
P ar
en ti n g
P ra
ct ic
es V
ar ia
b le
s C
h ild
re n ’s
P h ys
ic al
A ct
iv it y
(P A
) V
ar ia
b le
s Si
gn ifi
ca n t
R es
u lt s
D e
Le p el
ee re
, D
e Sm
et , V
er lo
ig n e,
C ar
d o n , an
d D
e B o u rd
ea u d h u ij
(2 0 1 3 )
Q u al
it at
iv e
st u d y
Le ve
l V
I n ¼
2 1
p ar
en ts
6 -
to 1 2 -y
ea r-
o ld
s P ar
en ts
: 7 1 %
fe m
al e,
2 9 %
m al
e C
h ild
ge n d er
u n re
p o rt
ed 7 1 %
M ed
iu m
to h ig
h SE
S B el
gi u m
A n
ex p lo
ra ti o n
o f p er
ce iv
ed ef
fe ct
iv e
an d
in ef
fe ct
iv e
p ar
en ti n g
p ra
ct ic
es in
d iff
ic u lt
si tu
at io
n s
co n ce
rn in
g ra
is in
g h ea
lt h y
ch ild
re n
N A
N A
P ar
en ts
ex p er
ie n ce
d th
at m
o n it o ri
n g,
b ei
n g
co n si
st en
t, o ff er
in g
al te
rn at
iv es
, re
ac ti n g
em p at
h et
ic al
ly , m
o d el
in g,
m o ti va
ti n g,
in cr
ea si
n g
in tr
in si
c va
lu e,
an d
av ai
la b ili
ty as
ef fe
ct iv
e p ar
en ti n g
p ra
ct ic
es in
en co
u ra
gi n g
P A
in ch
ild re
n E d w
ar d so
n an
d G
o re
ly (2
0 1 0 )
C ro
ss -s
ec ti o n al
, d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
1 1 7
9 5 %
C au
ca si
an 7 -
to 1 0 -y
ea r-
o ld
s B o th
m o th
er s
an d
fa th
er s
an sw
er ed
su rv
ey q u es
ti o n s
4 6 %
B o ys
an d
5 4 %
gi rl
s SE
S n o t
av ai
la b le
B ri
ti sh
E x p lo
re m
o th
er s
an d
fa th
er s
ac ti vi
ty -r
el at
ed su
p p o rt
an d
ex am
in e
it s
ef fe
ct o n
o b je
ct iv
el y
m ea
su re
d P A
A ct
iv it y-
re la
te d
P ar
en ti n g
P ra
ct ic
es Sc
al e
(m o d ifi
ed ve
rs io
n )
Fa th
er ’s
lo gi
st ic
su p p o rt
Fa th
er ’s
ex p lic
it m
o d el
in g
M o th
er ’s
lo gi
st ic
su p p o rt
M o th
er ’s
ex p lic
it m
o d el
in g
Fa th
er ’s
su p p o rt
fo r
lim it in
g se
d en
ta ry
b eh
av io
r M
o th
er s’
su p p o rt
fo r
lim it in
g se
d en
ta ry
b eh
av io
r
A ct
ig ra
p h
G T
1 M
ac ce
le ro
m et
er Fa
th er
’s ex
p lic
it m
o d el
in g
w as
si gn
ifi ca
n tl y
as so
ci at
ed w
it h
m o d er
at e
vi go
ro u s
an d
vi go
ro u s
P A
in b o ys
. N
o o th
er va
ri ab
le s
w er
e si
gn ifi
ca n tl y
as so
ci at
ed w
it h
ch ild
re n ’s
P A
.
Fo rt
h o fe
r, D
o w
d a,
M cI
ve r,
B ar
r- A
n d er
so n ,a
n d
P at
e (2
0 1 5 )
C ro
ss -s
ec ti o n al
, d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
6 9 3
3 4 %
B la
ck , 1 0 .6
% H
is p an
ic ,
1 6 .5
% O
th er
,a n d
3 8 .9
% W
h it e
M ea
n ag
e ¼
1 0 .6
ye ar
s P ar
en ts
: 1 0 0 %
fe m
al e
4 4 .9
% B o ys
, 5 5 .1
% gi
rl s
SE S
n o t
re p o rt
ed U
n it ed
St at
es
E x am
in e
ag re
em en
t b et
w ee
n p ar
en t
an d
ch ild
p er
ce p ti o n s
o f p ar
en t
su p p o rt
fo r
P A
an d
as so
ci at
io n s
w it h
ch ild
re n ’s
M V
P A
P ar
en ta
l su
p p o rt
fo r
P A
A ct
ig ra
p h
G T
1 M
an d
G T
3 X
M o th
er ’s
p er
ce p ti o n s
o f
su p p o rt
h ad
m o d es
t p o si
ti ve
as so
ci at
io n s
w it h
to ta
l M
V P A
G er
ar d s
et al
., (2
0 1 5 )
R C
T Le
ve l II
n ¼
8 6 , p ar
en t–
ch ild
tr ia
d s
4 -
to 8 -y
ea r-
o ld
s B o th
m o th
er s
an d
fa th
er s
an sw
er ed
su rv
ey q u es
ti o n s
4 3 .2
% b o ys
, 5 6 .8
% gi
rl s
SE S
n o t
re p o rt
ed th
e N
et h er
la n d s
T o
as se
ss ef
fe ct
iv en
es s
o f th
e Li
fe st
yl e
T ri
p le
P in
te rv
en ti o n
C h ild
Fe ed
in g
Q u es
ti o n n ai
re M
o n it o ri
n g
P A
P ar
en ta
l re
sp o n si
b ili
ty re
ga rd
in g
P A
G T
1 M
A ct
ig ra
p h
ac ce
le ro
m et
er D
ay s
p er
w ee
k o f P A
b eh
av io
rs
N o
si gn
ifi ca
n t
ef fe
ct s
fo u n d
fo r
ch ild
re n ’s
P A
(c on
tin ue
d)
74
T a b
le 2 .
(c o n ti n u ed
)
A u th
o r,
Y ea
r
D es
ig n
Le ve
l o f
E vi
d en
ce Sa
m p le
P u rp
o se
P ar
en ti n g
P ra
ct ic
es V
ar ia
b le
s C
h ild
re n ’s
P h ys
ic al
A ct
iv it y
(P A
) V
ar ia
b le
s Si
gn ifi
ca n t
R es
u lt s
G u b b el
s et
al . (2
0 1 1 )
C ro
ss -s
ec ti o n al
, d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
2 ,0
2 1
5 -
to 7 -y
ea r-
o ld
s P ar
en t
ge n d er
u n sp
ec ifi
ed 5 1 .2
% B o ys
, 4 8 .8
% gi
rl s
SE S
u n sp
ec ifi
ed th
e N
et h er
la n d s
E x am
in e
ch ild
an d
p ar
en t
co rr
el at
es o f en
er gy
b al
an ce
-r el
at ed
p ar
en ti n g
p ra
ct ic
es
C h ild
Fe ed
in g
Q u es
ti o n n ai
re R
es tr
ic ti o n
o f se
d en
ta ry
b eh
av io
r M
o n it o ri
n g
ac ti vi
ty St
im u la
ti o n
to b e
ac ti ve
Q u es
ti o n n ai
re fo
r m
ea su
ri n g
ac ti vi
ty b eh
av io
r u se
d in
D u tc
h Y
o u th
H ea
lt h
C ar
e
R es
tr ic
ti o n
o f se
d en
ta ry
ti m
e w
as n eg
at iv
el y
co rr
el at
ed w
it h
P A
m in
u te
s p er
d ay
(p <
.0 0 1 ).
P ar
en ta
l st
im ul
at io
n to
be ph
ys ic
al ly
ac ti ve
w as
po si
ti ve
ly as
so ci
at ed
w it h
P A
m in
ut es
pe r
d ay
(p <
.0 01
). H
ei tz
le r,
M ar
ti n ,
D u ke
, an
d H
u h m
an (2
0 0 6 )
D es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
3 ,1
1 4
6 1 .5
% W
h it e,
1 5 .4
% A
fr ic
an A
m er
ic an
, 1 7 .1
% H
is p an
ic , an
d O
th er
6 %
9 -
to 1 3 -y
ea r-
o ld
s P ar
en t ge
n d er
n o t sp
ec ifi
ed 5 1 .1
% B o ys
, 4 8 .9
% gi
rl s
H o u se
h o ld
in co
m e
≤ $ 2 5 ,0
0 0 ¼
2 2 .6
% ,
> $ 2 5 ,0
0 0
≤ $ 5 0 ,0
0 0 ¼
2 7 .6
% , >
$ 5 0 ,0
0 0
≤ $ 7 5 ,0
0 0 ¼
2 2 .9
% , an
d >
$ 7 5 ,0
0 0 ¼
2 6 .8
% U
n it ed
St at
es
A ss
es s
co rr
el at
es o f P A
in a
U .S
. sa
m p le
o f 9 -
to 1 3 -y
ea r-
o ld
s
Sc al
e d ev
el o p ed
fo r
th e
st u d y
P ar
en ta
l su
p p o rt
P ar
en ta
l b el
ie fs
P ar
en ta
l b ar
ri er
s
Y M
C LS
se lf-
re p o rt
ed su
rv ey
P ar
en ta
l su
p p o rt
fo r
P A
an d
p ar
en ta
l b el
ie fs
ab o u t
P A
w er
e p o si
ti ve
ly as
so ci
at ed
w it h
ch ild
re n ’s
p ar
ti ci
p at
io n
in o rg
an iz
ed P A
. P ar
en ta
l p ar
ti ci
p at
io n
in P A
w it h
th e
ch ild
w as
p o si
ti ve
ly as
so ci
at ed
w it h
ch ild
re n ’s
p ar
ti ci
p at
io n
in fr
ee ti m
e P A
.
H en
n es
sy , H
u gh
es ,
G o ld
b er
g, H
ya tt
, an
d E co
n o m
o s
(2 0 1 0 )
C ro
ss -s
ec ti o n al
st u d y,
d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
7 6 , p ar
en t–
ch ild
d ya
d s
2 4 %
W h it e,
3 3 %
B la
ck ,a
n d
1 9 %
H is
p an
ic 6 -
to 1 1 -y
ea r-
o ld
s P ar
en ts
: 8 9 %
fe m
al e,
1 1 %
m al
e 3 3 %
B o ys
, 6 6 %
gi rl
s Lo
w in
co m
e U
n it ed
St at
es
D et
er m
in e
th e
re la
ti o n sh
ip b et
w ee
n p ar
en t’ s
P A
- re
la te
d p ra
ct ic
es , p ar
en ti n g
st yl
e, an
d ch
ild re
n ’s
P A
le ve
l
A C
T S
Sc al
e an
d P ar
en ti n g
St ra
te gi
es fo
r E at
in g
an d
A ct
iv it y
Sc al
e (P
E A
S) Lo
gi st
ic su
p p o rt
E x p lic
it m
o d el
in g
A ct
ig ra
p h
m o d el
7 1 6 4
ac ce
le ro
m et
er s
P ar
en ta
l lo
gi st
ic su
p p o rt
w as
as so
ci at
ed w
it h
ch ild
M V
P A
(c on
tin ue
d)
75
T a b
le 2 .
(c o n ti n u ed
)
A u th
o r,
Y ea
r
D es
ig n
Le ve
l o f
E vi
d en
ce Sa
m p le
P u rp
o se
P ar
en ti n g
P ra
ct ic
es V
ar ia
b le
s C
h ild
re n ’s
P h ys
ic al
A ct
iv it y
(P A
) V
ar ia
b le
s Si
gn ifi
ca n t
R es
u lt s
H es
ke th
, H
in kl
ey , an
d C
am p b el
l (2
0 1 2 )
Q u al
it at
iv e
Le ve
l V
I n ¼
6 1
P ar
en ts
: 1 0 0 %
fe m
al e
4 8 %
G ir
ls , 5 2 %
b o ys
< 1 2
m o n th
s an
d 3 -
to 5 -y
ea r-
o ld
s 9 4 %
M o th
er s
5 8 %
G ir
ls , 4 2 %
b o ys
SE S
n o t
re p o rt
ed A
u st
ra lia
n
D et
er m
in e
h o w
p ar
en ts
sh ap
e P A
an d
sc re
en ti m
e b eh
av io
rs
N A
N A
P ro
vi d in
g ch
ild re
n w
it h
a su
p p o rt
iv e
en vi
ro n m
en t
in cl
u d in
g p ro
vi d in
g sp
o rt
s eq
u ip
m en
t, p et
s, an
d ac
ti ve
tr an
sp o rt
w er
e th
o u gh
t to
su p p o rt
P A
in ch
ild re
n .
E n ro
lli n g
ch ild
re n
in o rg
an iz
ed P A
, p ar
en ta
l m
o d el
in g,
an d
en co
u ra
ge m
en t
o f P A
; te
ac h in
g th
ei r
ch ild
re n
P A
; an
d en
co u ra
gi n g
o u td
o o r
p la
y w
er e
th o u gh
t to
su p p o rt
ch ild
re n ’s
P A
. H
o ss
ei n i,
A n o o sh
eh ,
A b b as
za d eh
, an
d E h sa
n i (2
0 1 3 )
Q u al
it at
iv e
Le ve
l V
I n ¼
2 5 , p ar
en ts
an d
ch ild
re n
Ir an
ia n
1 0 -
to 1 9 -y
ea r-
o ld
s 1 6
G ir
ls , 7
m o th
er s,
an d
2 fa
th er
s SE
S n o t
re p o rt
ed Ir
an
E x p lo
ra ti o n
o f p ar
en t’ s
ro le
s in
Ir an
ia n
ad o le
sc en
t gi
rl s
P A
d ev
el o p m
en t
N A
N A
P ar
en ts
in flu
en ce
ad o le
sc en
t gi
rl s
P A
b y
d ev
el o p in
g in
te re
st in
P A
th ro
u gh
m ak
in g
th em
fa m
ili ar
w it h
it ,
d is
co ve
ri n g
th ei
r ta
le n ts
,a n d
ro le
m o d el
in g
P A
. P ar
en ts
in flu
en ce
gi rl
s P A
b y
p ro
vi d in
g b o th
m at
er ia
l an
d im
m at
er ia
l su
p p o rt
fo r
P A
Ic ke
s, M
ah o n ey
, R
o b er
ts , an
d D
o la
n (2
0 1 6 )
Q u al
it at
iv e
Le ve
l V
I n ¼
5 7 , p ar
en ts
6 7 %
A fr
ic an
A m
er ic
an ,
2 6 %
C au
ca si
an , an
d 7 %
La ti n o
C h ild
re n ’s
ag e
n o t
re p o rt
ed P ar
en ts
: 9 4 .7
% fe
m al
e, 5 .3
% m
al e
SE S
n o t
re p o rt
ed U
n it ed
St at
es
Id en
ti fy
fa ct
o rs
th at
en ab
le o r
co n st
ra in
p ar
en ts
su p p o rt
o f an
d in
vo lv
em en
t in
m ak
in g
d ie
ta ry
an d
P A
ch an
ge s
at h o m
e
N A
N A
Sh ar
ed go
al s,
m o d el
in g,
an d
co lle
ct iv
e ac
ti vi
ti es
p ro
m o te
P A
in fa
m ili
es
Ja go
et al
. (2
0 1 1 )
C ro
ss -s
ec ti o n al
, d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
7 9 2
1 0 -
to 1 1 -y
ea r-
o ld
s B o th
m o th
er s
an d
fa th
er s
co m
p le
te d
th e
sc al
e 4 3 %
B o ys
, 5 7 %
gi rl
s SE
S n o t
re p o rt
ed U
n it ed
K in
gd o m
T o
d et
er m
in e
w h et
h er
p ar
en ti n g
st yl
es an
d p ra
ct ic
es ar
e as
so ci
at ed
w it h
ch ild
re n ’s
P A
A ct
iv it y-
R el
at ed
P ar
en ti n g
P ra
ct ic
es Sc
al e
Lo gi
st ic
su p p o rt
R o le
m o d el
in g
Lo gi
st ic
su p p o rt
P ar
en ta
l ru
le s
fo r
P A
A ct
ig ra
p h
ac ce
le ro
m et
er s
M at
er n al
lo gi
st ic
su p p o rt
w as
as so
ci at
ed w
it h
m ea
n C
P M
fo r
gi rl
s. P at
er n al
lo gi
st ic
su p p o rt
w as
as so
ci at
ed w
it h
b o ys
m ea
n M
V P A
an d
m ea
n C
P M
(c on
tin ue
d)
76
T a b
le 2 .
(c o n ti n u ed
)
A u th
o r,
Y ea
r
D es
ig n
Le ve
l o f
E vi
d en
ce Sa
m p le
P u rp
o se
P ar
en ti n g
P ra
ct ic
es V
ar ia
b le
s C
h ild
re n ’s
P h ys
ic al
A ct
iv it y
(P A
) V
ar ia
b le
s Si
gn ifi
ca n t
R es
u lt s
K in
g et
al . (2
0 1 0 )
C ro
ss -s
ec ti o n al
, d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
4 8 0
C au
ca si
an 7 -y
ea r-
o ld
s P ar
en ts
: 9 6 %
fe m
al e,
4 %
m al
e 5 0 .8
% B o ys
, 4 9 .2
% gi
rl s
SE S
n o t
re p o rt
ed E n gl
an d
T o
id en
ti fy
co rr
el at
es o f P A
an d
se d en
ta ry
b eh
av io
r am
o n g
7 -y
ea r-
o ld
ch ild
re n
in E n gl
an d
P ar
en t
Q u es
ti o n n ai
re P ar
en ta
l p er
ce iv
ed im
p o rt
an ce
o f ac
ti ve
p la
y P ra
is e
an d
en co
u ra
ge m
en t
o f
P A
P ar
en ta
l m
o d el
in g
o f P A
P ar
en ta
l P A
P ar
en ta
l re
gu la
r u se
o f ac
ti ve
tr an
sp o rt
A ct
ig ra
p h
ac ce
le ro
m et
er s
N o n e
o f th
e p ar
en ti n g
p ra
ct ic
es as
se ss
ed w
er e
si gn
ifi ca
n tl y
as so
ci at
ed w
it h
ch ild
re n ’s
P A
La m
an d
M cH
al e
(2 0 1 4 )
C ro
ss -s
ec ti o n al
st u d y,
d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
2 0 1 , p ar
en t–
ch ild
d ya
d s
C au
ca si
an 7 -
to 1 8 -y
ea r-
o ld
s P ar
en ts
m al
e an
d fe
m al
e 4 9 .5
% B o ys
, 5 0 .5
% gi
rl s
M ed
ia n
in co
m e
$ 5 5 ,0
0 0
U n it ed
St at
es
E x am
in e
th e
d ev
el o p m
en ta
l p at
te rn
s an
d p ar
en ta
l co
rr el
at es
o f le
is u re
ti m
e P A
in yo
u th
P ro
p o rt
io n
o f fa
th er
an d
m o th
er yo
u th
jo in
t in
vo lv
em en
t in
P A
, en
ga gi
n g
in P A
w it h
ch ild
, an
d co
ac h in
g o r
w at
ch in
g
Y o u th
le is
u re
ti m
e P A
, su
rv ey
Fa th
er ’s
in vo
lv em
en t
in P A
an d
m o th
er s
in vo
lv em
en t
in P A
w as
si gn
ifi ca
n tl y
as so
ci at
ed w
it h
yo u th
le is
u re
ti m
e P A
La n ge
r, C
ra in
, Se
n so
, Le
vy , an
d Sh
er w
o o d
(2 0 1 4 )
C ro
ss -s
ec ti o n al
st u d y,
d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
4 2 1 , p ar
en t–
ch ild
d ya
d s
7 3 .4
% W
h it e,
6 .9
% H
is p an
ic 5 -
to 1 0 -y
ea r-
o ld
s P ar
en ts
: 9 2 .9
% fe
m al
e, 7 .1
% m
al es
4 9 .4
% gi
rl s
SE S
n o t
re p o rt
ed U
n it ed
St at
es
T o
ex am
in e
th e
re la
ti o n sh
ip s
b et
w ee
n p ar
en ti n g
st yl
es an
d p ra
ct ic
es an
d ch
ild M
V P A
an d
sc re
en ti m
e
E n co
u ra
ge m
en t
o f ch
ild to
p er
fo rm
P A
P ar
ti ci
p at
ed in
sp o rt
s w
it h
th e
ch ild
W at
ch ed
th e
ch ild
p la
y sp
o rt
s
A ct
ig ra
p h
G T
1 M
ac ce
le ro
m et
er s
P ar
en ta
l su
p p o rt
fo r
P A
w as
as so
ci at
ed w
it h
ch ild
M V
P A
Ll o yd
, Lu
b an
s, P lo
tn ik
o ff , C
o lli
n s,
an d
M o rg
an (2
0 1 4 )
C ro
ss -s
ec ti o n al
, d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
7 0
fa m
ili es
5 -t
o 1 2 -y
ea r-
o ld
s B o th
m o th
er s
an d
fa th
er s
co m
p le
te d
th e
sc al
e 5 8 .6
% B o ys
, 4 1 .4
% gi
rl s
5 5 .7
% H
ig h
SE S,
4 1 .4
% m
id SE
S, an
d 2 .9
% lo
w SE
S A
u st
ra lia
E x am
in e
a ra
n ge
o f b eh
av io
ra l
an d
m at
er n al
/p at
er n al
co rr
el at
es o f ad
ip o si
ty in
ch ild
re n
P E A
S Y
am ax
2 0 0
p ed
o m
et er
Fa th
er ’s
re in
fo rc
em en
t o f P A
w as
n eg
at iv
el y
as so
ci at
ed w
it h
ch ild
re n ’s
st ep
s p er
d ay
(p <
.0 1 )
Lo p ri
n zi
, Sc
h ar
y, B ee
ts . Le
ar y,
an d
C ar
d in
al (2
0 1 3 )
C o rr
el at
io n al
o b se
rv at
io n al
st u d y
Le ve
l IV
n ¼
1 7 6 , p ar
en ts
an d
th ei
r ch
ild re
n 2 -
to 5 -y
ea r-
o ld
s 8 9 .1
% C
au ca
si an
P ar
en ts
8 4 .6
% fe
m al
e 4 6 .8
% B o ys
SE S
n o t
re p o rt
ed U
n it ed
St at
es
E x am
in e
th e
in flu
en ce
o f
p ar
en ta
l in
flu en
ce va
ri ab
le s
o n
ch ild
re n ’s
P A
P ar
en ta
l su
p p o rt
fo r
P A
, re
st ri
ct iv
e p la
y ru
le s,
an d
m o n it o ri
n g
P A
P A
an d
E x er
ci se
Q u es
ti o n n ai
re fo
r C
h ild
re n
P ar
en ta
l P A
, p ar
en ta
l su
p p o rt
, an
d p ar
en ta
l m
o n it o ri
n g
w er
e p o si
ti ve
ly as
so ci
at ed
w it h
ch ild
re n ’s
P A
(c on
tin ue
d)
77
T a b
le 2 .
(c o n ti n u ed
)
A u th
o r,
Y ea
r
D es
ig n
Le ve
l o f
E vi
d en
ce Sa
m p le
P u rp
o se
P ar
en ti n g
P ra
ct ic
es V
ar ia
b le
s C
h ild
re n ’s
P h ys
ic al
A ct
iv it y
(P A
) V
ar ia
b le
s Si
gn ifi
ca n t
R es
u lt s
O ’C
o n n o r,
C h en
, B ar
an o w
sk i,
T h o m
p so
n , an
d B ar
an o w
sk i (2
0 1 3 )
C ro
ss -s
ec ti o n al
, d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
8 3 , p ar
en t–
ch ild
d ya
d s
4 3 %
A fr
ic an
A m
er ic
an ,
1 3 %
W h it e,
1 2 %
H is
p an
ic ,6
% O
th er
,a n d
2 5 %
m ix
ed et
h n ic
it y
h er
it ag
e 9 -
to 1 2 -y
ea r-
o ld
s P ar
en t ge
n d er
n o t sp
ec ifi
ed 5 7 .3
% in
co m
e ≥
$ 2 0 ,0
0 0 –
$ 5 9 ,9
9 9
U n it ed
St at
es
In ve
st ig
at e
th e
as so
ci at
io n
o f
P A
-a n d
sc re
en -r
el at
ed p ar
en ti n g
p ra
ct ic
es w
it h
ch ild
re n ’s
P A
A ct
iv it y-
R el
at ed
P ar
en ti n g
P ra
ct ic
es Sc
al e
Lo gi
st ic
su p p o rt
E x p lic
it m
o d el
in g
A ct
ig ra
p h
G T
3 X
ac ce
le ro
m et
er P ar
en ts
w h o
re p o rt
ed h ig
h er
P A
lo gi
st ic
su p p o rt
h ad
ch ild
re n
w it h
gr ea
te r
m o d er
at e
to vi
go ro
u s
P A
an d
co u n ts
p er
m in
u te
(p <
.0 0 1 )
O ’C
o n n o r,
C er
in ,
et al
. (2
0 1 3 )
Q u al
it at
iv e
st u d y
Le ve
l V
I n ¼
7 4 , p ar
en ts
1 0 0 %
H is
p an
ic 3 -
to 5 -y
ea r-
o ld
s P ar
en ts
: 9 2 %
fe m
al e,
8 %
m al
e 4 7 %
B o ys
, 5 3 %
gi rl
s 8 2 %
Fa m
ily in
co m
e <
$ 2 0 ,0
0 0
p er
ye ar
U n it ed
St at
es
Id en
ti fy
w h at
p ar
en ts
d o
to en
co u ra
ge an
d d is
co u ra
ge P A
am o n g
H is
p an
ic 3 -
to 5 -y
ea r-
o ld
ch ild
re n
N A
N A
P ar
en ta
l en
ga ge
m en
t in
ch ild
ac ti vi
ti es
, m
o d el
in g
P A
, an
d fe
ed in
g th
e ch
ild w
el l w
er e
n am
ed as
p ra
ct ic
es th
at in
cr ea
se ch
ild re
n ’s
P A
. P er
m it ti n g
T V
an d
vi d eo
ga m
e u se
, p sy
ch o lo
gi ca
l co
n tr
o l,
p h ys
ic al
an d
em o ti o n al
ab u se
, an
d la
ck o f p ar
en ta
l en
ga ge
m en
t w
er e
id en
ti fie
d as
p ar
en ti n g
p ra
ct ic
es th
at d is
co u ra
ge P A
O ’C
o n n o r,
H ilm
er s,
W at
so n ,
B ar
an o w
sk i,
an d
G ia
rd in
o (2
0 1 1 )
P ilo
t R
C T
Le ve
l II
n ¼
4 0 , p ar
en ts
an d
th ei
r ch
ild re
n 8 2 .5
% H
is p an
ic ,1
2 .5
% A
fr ic
an A
m er
ic an
, an
d 5 %
C au
ca si
an 5 -
to 8 -y
ea r-
o ld
s P ar
en t ge
n d er
n o t sp
ec ifi
ed 8 0 %
G ir
ls , 2 0 %
b o ys
9 0 %
< $ 3 0 ,0
0 0
an n u al
h o u se
h o ld
in co
m e
U n it ed
St at
es
T es
t th
e fe
as ib
ili ty
o f th
e H
el p in
g H
ea lt h y
A ct
iv it y
an d
N u tr
it io
n D
ir ec
ti o n s
O b es
it y
in te
rv en
ti o n
A ct
iv it y-
R el
at ed
P ar
en ti n g
P ra
ct ic
es Sc
al e
Lo gi
st ic
su p p o rt
R o le
m o d el
in g
A ct
ig ra
p h -7
0 6 4
ac ce
le ro
m et
er T
h e
p ar
en ti n g
p ra
ct ic
es d ir
ec te
d in
te rv
en ti o n
h ad
n o
si gn
ifi ca
n t
ef fe
ct o n
P A
o u tc
o m
es
O st
b ye
et al
. (2
0 1 3 )
C ro
ss -s
ec ti o n al
st u d y,
d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
2 0 8 , m
o th
er s
an d
p re
sc h o o le
rs 1 3 %
B la
ck , 8 7 %
W h it e
2 -
to 5 -y
ea r-
o ld
s P ar
en ts
: 1 0 0 %
fe m
al e
5 6 %
B o ys
, 4 4 %
gi rl
s SE
S n o t
re p o rt
ed U
n it ed
St at
es
T o
ex am
in e
th e
ro le
o f h o m
e P A
an d
fo o d
en vi
ro n m
en t
o n
ch ild
h ea
lt h
b eh
av io
rs
H o m
e P A
E n vi
ro n m
en t
Sc al
e A
cc es
si b ili
ty o f P A
R o le
m o d el
in g
o f P A
P ar
en ta
l p o lic
ie s
in su
p p o rt
o f
P A
A ct
ic al
ac ce
le ro
m et
er s
P ar
en ta
lp o lic
ie s
su p p o rt
in g
P A
in cr
ea se
d M
V P A
ti m
e
(c on
tin ue
d)
78
T a b
le 2 .
(c o n ti n u ed
)
A u th
o r,
Y ea
r
D es
ig n
Le ve
l o f
E vi
d en
ce Sa
m p le
P u rp
o se
P ar
en ti n g
P ra
ct ic
es V
ar ia
b le
s C
h ild
re n ’s
P h ys
ic al
A ct
iv it y
(P A
) V
ar ia
b le
s Si
gn ifi
ca n t
R es
u lt s
R em
m er
s et
al .(
2 0 1 4 )
C ro
ss -s
ec ti o n al
st u d y,
d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
1 ,8
7 5
C au
ca si
an 5 -
to 7 -y
ea r-
o ld
s P ar
en ts
: 9 7 .8
% fe
m al
e 5 0 %
B o ys
, 5 0 %
gi rl
s SE
S n o t
re p o rt
ed th
e N
et h er
la n d s
In ve
st ig
at e
if so
ci al
fa ct
o rs
m o d er
at e
th e
re la
ti o n sh
ip b et
w ee
n th
e p h ys
ic al
en vi
ro n m
en t
an d
o u td
o o r
p la
y
C h ild
Fe ed
in g
Q u es
ti o n n ai
re P er
ce iv
ed in
flu en
ce o f th
e re
sp o n d en
t an
d th
ei r
p ar
tn er
o n
th e
ch ild
’s P A
b eh
av io
r A
tt it u d e,
re sp
o n si
b ili
ty , an
d co
n ce
rn to
w ar
d ch
ild P A
R es
tr ic
ti o n
o fc
h ild
sc re
en ti m
e P re
ss u re
to w
ar d
ch ild
to b e
ac ti ve
M o n it o ri
n g
ch ild
P A
O u ts
id e
p la
y q u es
ti o n n ai
re P o si
ti ve
p ar
en ta
l at
ti tu
d e
to w
ar d
P A
w as
p o si
ti ve
ly as
so ci
at ed
w it h
m o re
o u td
o o r
p la
y
R h o d es
et al
. (2
0 1 5 )
C ro
ss -s
ec ti o n al
st u d y,
d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
1 ,2
5 3 , p ar
en ts
an d
th ei
r ch
ild re
n 5 -
to 1 3 -y
ea r-
o ld
s P ar
en ts
:5 1 .4
% b o ys
,4 8 .6
% gi
rl s
5 4 %
H o u se
h o ld
in co
m e
> $ 7 5 ,0
0 0
C an
ad a
T o
m o d el
p ar
en ta
l su
p p o rt
b eh
av io
rs as
m ed
ia to
rs o f
m o th
er ’s
p er
ce p ti o n s
o f
ch ild
re n ’s
P A
E n co
u ra
ge m
en t
o f ch
ild re
n ’s
P A
Lo gi
st ic
al su
p p o rt
o f ch
ild re
n ’s
P A
C o ac
ti vi
ty
Su rv
ey re
co rd
in g
ch ild
re n ’s
p ar
ti ci
p at
io n
in 6 0
m in
o r
m o re
P A
o ve
r th
e p as
t 7
d ay
s
E n co
u ra
ge m
en t,
lo gi
st ic
su p p o rt
,a n d
co ac
ti vi
ty w
er e
p o si
ti ve
ly as
so ci
at ed
w it h
ch ild
re n ’s
P A
Se ab
ra et
al . (2
0 1 2 )
D es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
6 8 3
ch ild
re n
8 -
to 1 0 -y
ea r-
o ld
s P ar
en t ge
n d er
n o t sp
ec ifi
ed 5 1 .6
% B o ys
, 4 8 .4
% gi
rl s
2 4 .5
% Lo
w SE
S, 1 3 .9
% m
ed iu
m SE
S, an
d 6 1 .6
% h ig
h SE
S P o rt
u ga
l
E x am
in e
ge n d er
d iff
er en
ce s
in re
la ti o n sh
ip s
b et
w ee
n b io
lo gi
c, d em
o gr
ap h ic
, an
d p sy
ch o so
ci al
co rr
el at
es o f
P A
an d
le ve
l o f P A
in P o rt
u gu
es e
ch ild
re n
P ar
en ta
l in
flu en
ce o n
so ci
al iz
at io
n (P
SI )
in to
P A
P ar
en ta
l ro
le m
o d el
in g
o f P A
P ar
en ta
l en
co u ra
ge m
en t
o f P A
P ar
en ta
l en
jo ym
en t
o f P A
C h ild
re n ’s
le is
u re
ti m
e P A
, G
o d in
– Sh
ep ar
d Q
u es
ti o n n ai
re
P ar
en ta
l en
co u ra
ge m
en t
o f P A
w as
p o si
ti ve
ly as
so ci
at ed
w it h
P A
in gi
rl s
Su en
, C
er in
, an
d W
u (2
0 1 5 )
Q u al
it at
iv e
Le ve
l V
I n ¼
5 7
p ar
en ts
3 -
to 5 -y
ea r-
o ld
s P ar
en t ge
n d er
n o t sp
ec ifi
ed 5 2 .6
% B o ys
, 5 4 .4
% gi
rl s
5 0 .9
% Lo
w – m
id d le
SE S,
4 9 .1
% m
id d le
to h ig
h SE
S C
h in
a
T o
id en
ti fy
p ar
en ti n g
p ra
ct ic
es en
co u ra
gi n g
o r
d is
co u ra
gi n g
P A
in H
o n g
K o n g
p re
sc h o o le
rs
N A
N A
T ra
n sp
o rt
at io
n to
P A
p la
ce s,
p ay
m en
t fo
r sp
o rt
s ac
ti vi
ti es
, ve
rb al
en co
u ra
ge m
en t
an d
p ra
is e
o fP
A ,a
n d
en ga
ge m
en t
in P A
w it h
th e
ch ild
w er
e id
en ti fie
d as
p ar
en ti n g
p ra
ct ic
es th
at en
co u ra
ge P A
(c on
tin ue
d)
79
T a b
le 2 .
(c o n ti n u ed
)
A u th
o r,
Y ea
r
D es
ig n
Le ve
l o f
E vi
d en
ce Sa
m p le
P u rp
o se
P ar
en ti n g
P ra
ct ic
es V
ar ia
b le
s C
h ild
re n ’s
P h ys
ic al
A ct
iv it y
(P A
) V
ar ia
b le
s Si
gn ifi
ca n t
R es
u lt s
T an
d o n
et al
. (2
0 1 4 )
C ro
ss -s
ec ti o n al
st u d y,
d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
7 1 3
ch ild
re n
8 9 %
W h it e,
2 %
B la
ck , 4 %
A si
an , an
d 4 %
O th
er 6 -
to 1 1 -y
ea r-
o ld
s P ar
en ts
: 8 6 %
fe m
al e,
1 4 %
m al
e 5 1 %
B o ys
, 4 9 %
gi rl
s 9 %
≤ $ 3 9 ,0
0 0 , 3 1 %
$ 4 0 ,0
0 0 – $ 8 9 ,0
0 0 , an
d 6 0 %
≥ $ 9 0 ,0
0 0
U n it ed
St at
es
E x am
in e
re la
ti o n sh
ip s
b et
w ee
n ch
ild P A
an d
h o m
e en
vi ro
n m
en t
fa ct
o rs
P ar
en t
Su p p o rt
fo r
P A
Sc al
e W
at ch
ch ild
p ar
ti ci
p at
e in
sp o rt
s E n co
u ra
ge ch
ild to
d o
sp o rt
s o r
P A
P ro
vi d e
ch ild
w it h
tr an
sp o rt
to sp
o rt
s o r
P A
G T
1 M
A ct
ig ra
p h
ac ce
le ro
m et
er P ar
en ta
l su
p p o rt
fo r
P A
w as
p o si
ti ve
ly as
so ci
at ed
w it h
M V
P A
T ay
lo r,
W ils
o n ,S
la te
r, an
d M
o h r
(2 0 1 1 )
D es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
1 7 5
5 6 %
Fe m
al e
7 -
to 1 1 -y
ea r-
o ld
s P ar
en ts
: 9 1 %
fe m
al e,
9 %
m al
e 4 4 %
G ir
ls , 5 6 %
b o ys
SE S
n o t
re p o rt
ed A
u st
ra lia
A n
in ve
st ig
at io
n o f
as so
ci at
io n s
b et
w ee
n p ar
en t
an d
ch ild
re p o rt
ed p er
ce iv
ed p ar
en ti n g
st yl
es an
d p ra
ct ic
es w
it h
w ei
gh t-
re la
te d
b eh
av io
rs
P ar
en ta
l ac
ti vi
ty -r
el at
ed p ra
ct ic
es E n co
u ra
ge m
en t
o f ch
ild P A
M o d el
in g
o f P A
T im
e U
se D
ia ry
o f th
e Lo
n gi
tu d in
al St
u d y
o f A
u st
ra lia
n C
h ild
re n
P ar
en t
re p o rt
ed m
ea su
re es
ti m
at in
g th
e ch
ild ’s
P A
o ve
r th
e p as
t 2 4
h r
C h ild
P A
w as
as so
ci at
ed w
it h
p ar
en ta
l en
co u ra
ge m
en t
o f
P A
V er
lo ig
n e,
V an
Li p p ev
el d e,
M ae
s, B ru
g, an
d D
e B o u rd
ea u d h u ij
(2 0 1 2 )
Lo n gi
tu d in
al ,
d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
7 2 7
9 -y
ea r-
o ld
s P ar
en t ge
n d er
n o t sp
ec ifi
ed 4 8 .1
% B o ys
, 5 1 .9
% gi
rl s
5 1 .9
% H
ig h
SE S
B el
gi u m
E x am
in e
fa m
ily -a
n d
sc h o o l-
b as
ed p re
d ic
to rs
o f
b re
ak fa
st an
d so
ft d ri
n k
co n su
m p ti o n , an
d P A
an d
m o d er
at in
g ef
fe ct
s o f
ge n d er
an d
SE S
So ci
o cu
lt u ra
l- re
la te
d P A
(P A
w it h
th e
ch ild
) M
o d el
in g
Lo gi
st ic
su p p o rt
P A
en co
u ra
ge m
en t
P A
b en
ef it s
Fl em
is h
P A
Q u es
ti o n n ai
re P o si
ti ve
p ar
en ta
l at
ti tu
d e
to w
ar d
P A
, p ar
en ta
l en
co u ra
ge m
en t
o f P A
at ag
e 1 0
ye ar
s re
su lt ed
in m
o re
P A
at 1 6
ye ar
s
W ri
gh t,
W ils
o n ,
G ri
ff in
, an
d E va
n s
(2 0 0 8 )
Q u al
it at
iv e
st u d y
Le ve
l V
I n ¼
5 2
8 5 %
A fr
ic an
A m
er ic
an , 8 %
C au
ca si
an , 1 %
H is
p an
ic ,
an d
5 %
O th
er 1 0 -
to 1 4 -y
ea r-
o ld
s P ar
en ts
n o t
in cl
u d ed
in st
u d y
4 2 .3
% B o ys
, 5 7 .7
% gi
rl s
Lo w
-i n co
m e
SE S
U n it ed
St at
es
T o
as se
ss h o w
p ar
en ta
l ro
le m
o d el
in g
an d
so ci
al su
p p o rt
in flu
en ce
P A
in m
in o ri
ty an
d lo
w in
co m
e ad
o le
sc en
ts
N A
N A
P ar
en ta
l ro
le m
o d el
in g
o f P A
an d
p ar
en ta
l em
o ti o n al
an d
ta n gi
b le
su p p o rt
o f P A
in flu
en ce
ad o le
sc en
t P A
le ve
ls
Z h ao
, G
ao , an
d Se
tt le
s (2
0 1 3 )
C ro
ss -s
ec ti o n al
st u d y,
d es
cr ip
ti ve
co rr
el at
io n al
Le ve
l IV
n ¼
3 ,1
7 5
6 6 .7
% C
au ca
si an
, 1 7 .2
% A
fr ic
an A
m er
ic an
, 7 .2
% H
is p an
ic , an
d 8 .9
% O
th er
2 -
to 1 7 -y
ea r-
o ld
s 4 9 .8
% B o ys
, 5 0 .2
% gi
rl s
M ed
iu m
SE S
E x am
in e
im p ac
t o f p ar
en ta
l p er
ce p ti o n
o f ch
ild re
n ’s
w ei
gh t an
d p ar
en ta
ls u p p o rt
o n
ch ild
re n ’s
P A
P ar
en ta
l su
p p o rt
fo r
P A
P ar
en t
re p o rt
P ar
en ta
ls u p p o rt
w as
p o si
ti ve
ly as
so ci
at ed
w it h
ch ild
re n ’s
P A
N ot
e. SE
S ¼
so ci
o ec
o n o m
ic st
at u s;
P E A
S ¼
P ar
en ti n g
St ra
te gi
es fo
r E at
in g
an d
A ct
iv it ie
s Sc
al e;
N A ¼
n o t
ap p lic
ab le
;B M
I¼ b o d y
m as
s in
d ex
;C P M ¼
co u n ts
p er
m in
u te
;M V
P A ¼
m o d er
at e
to vi
go ro
u s
p h ys
ic al
ac ti vi
ty .
80
Accelerometers provided an objective measure of PA and
contributed to reduced measurement error and higher inter-
nal validity, increasing the quality of those studies.
Parental Role Modeling of PA
Seven of the 30 quantitative studies (23.3%) found signifi- cant associations between parental role modeling of PA and
children’s PA levels. According to the Polit and Beck cri-
teria, those seven studies were all Level IV evidence. Three
of those studies used continuous monitoring of PA, via
accelerometers, to measure children’s PA (Crawford et al.,
2010; Edwardson & Gorely, 2010). The other five studies
used survey methods to measure children’s PA (Davison
et al., 2003, Heitzler, Martin, Duke, & Huhman, 2006; Lam
& McHale, 2014; Loprinzi, Schary, Beets, Leary, & Cardi-
nal, 2013; Rhodes et al., 2015). Seven of the eight (87.5%) qualitative studies identified parental role modeling of PA as
important in promoting children’s PA (see Table 2).
Logistic Support
Sixteen of the 30 (53.3%) quantitative studies found that parental support of PA was significantly associated with
children’s PA. Fifteen of those studies were Level IV evi-
dence, and one was Level II. Of these, six used acceler-
ometers to measure PA and three used parent completed
surveys. Five of the eight (62.5%) qualitative studies iden- tified logistic support as a mechanism of parenting that sup-
ports PA in children. One qualitative study using nominal
group technique identified “signing the child up for sports,”
“participating in activities with the child,” “playing sports
with the child,” and “letting the child see the parent be
active” as parenting practices that encouraged children’s
PA (O’Connor, Cerin, et al., 2013).
Quantitative studies in the current review consistently
operationalized logistic support as enrolling the child in
sports activities, attending sports activities with the child,
and the importance of parents being actively involved with
the child (Davison et al., 2003, 2013; Davison, Nishi, et al.,
2012; Heitzler et al., 2006; Henessy, Hughes, Goldberg,
Hyatt, & Economos, 2010; Jago et al., 2011; O’Connor,
Chen, Baranowski, Thompson, & Baranwoski, 2013). Two
studies operationalized support for PA as encouraging the
child to participate in PA or play sports, providing the child
with transportation to sports activities, and watching the
child perform PA or sports (Langer, Crain, Senso, Levy, &
Sherwood, 2014; Tandon et al., 2014). The research widely
noted the use of logistic support as a concept involved in
parenting practices influencing children’s PA; however, the
results were equivocal.
Monitoring PA
Two quantitative studies and one qualitative study found
monitoring PA as a significant parenting practice that led
to increasing children’s PA levels (see Table 2). Bradley,
McRitchie, Houts, Nader, and O’Brien (2011) found that
boys with lower parental monitoring had significantly more
moderate to vigorous physical activity (MVPA) than those
with more parental monitoring of PA (Bradley, McRitchie,
Houts, Nader, & O’Brien, 2011). The majority of the studies
in this review did not measure parental monitoring of PA.
Parental Encouragement of PA
An additional theme generated from the review was parental
encouragement of PA. Six of the 30 (20%) quantitative stud- ies identified parental encouragement of PA as positively
associated with children’s PA. Two qualitative studies iden-
tified encouragement of PA as influencing children’s PA
(Hesketh, Hinkley, & Campbell, 2012; Hosseini et al.,
2013). Moreover, lack of parental engagement was also
identified as discouraging PA (O’Connor, Cerin, et al.,
2013).
Discussion
The purpose of this integrative review was to critically ana-
lyze the state of the science concerning the influence of
parenting practices on children’s PA levels. Parental role
modeling of PA and logistic support for PA showed the
greatest promise as parenting practices that may influence
children’s PA. It should be considered that these two vari-
ables were consistently measured across studies examining
parenting practices, and other variables that may fall under
parenting practices may not have been measured. Variables
that may need further examination include parental monitor-
ing of children’s PA and parental restriction of sedentary
behaviors. Arredondo and colleagues (2006) found parental
monitoring of children’s PA was significantly associated
with children’s PA (Arredondo et al., 2006). More studies
are needed that examine parental monitoring of PA to deter-
mine how it is influential in children’s PA, but it shows
promise as a potential strategy to increase PA in children.
The inclusion and examination of qualitative studies have
provided guidance for additional variables to explore in
quantitative studies. It may be beneficial to measure parents’
ability to influence children’s intrinsic value of PA. One
qualitative study found that parents who increased children’s
intrinsic value of PA also encouraged PA in their children.
Although it was not the aim of this study to examine the
viewpoint of the children, an assessment of what parenting
practices influenced children’s PA from the perspective of
the child may provide helpful insights. One qualitative study
also identified physical and emotional abuse as a deterrent to
children’s PA (O’Connor, Cerin, et al., 2013). Although this
variable might be difficult to measure, it may provide valu-
able information and treatment for a vulnerable population.
Findings were less consistent for parental monitoring of
PA and parental restriction of sedentary behaviors. This may
reflect that parental monitoring of PA and parental restric-
tion of sedentary behaviors were not routinely examined as
Hutchens and Lee 81
variables in these studies. In general, there is room for
improved measurement and measurement development of
these parenting constructs. Understanding of the complex-
ities surrounding the relationship between parenting prac-
tices and child PA may be expanded by using instruments
with more detail, depth, and contextual reach like the HES.
The level of evidence of the existing literature linking
parenting practices to PA was low to moderate. Most of the
existing information relied on cross-sectional studies aimed
at investigating the influence of parenting practices on chil-
dren’s PA, with few randomized controlled trials. The
majority of the studies in this review were cross-sectional,
nonexperimental studies. Three studies at the prediction and
control level were located. One of those was a pilot rando-
mized controlled trial and one was quasi-experimental.
Longitudinal designs and randomized controlled trials
would provide meaningful gains in this research area. The
knowledge on the topic could be broadened with the addition
of studies higher quality evidence employing experimental
designs with high internal validity.
An additional gap in the literature was the lack of
research directed specifically at ethnic/racial minority popu-
lations. The available literature contained two (9.5%) studies with predominantly Hispanic samples and two studies with
predominantly African American samples (Arredonodo
et al. 2006; Hennessy, Hughes, Goldberg, Hyatt, & Econo-
mos, 2010; O’Connor, Cerin et al., 2013; Wright et al.,
2008). PA is a major contributor to maintaining health body
weight, an arena where there are health disparities in Hispa-
nic and African American communities. Hispanic youth
have obesity rates as high as 22.4% compared to 20.2% of African Americans and 14.3% of Caucasians (Trust for America’s Health and the Robert Wood Johnson Founda-
tion, 2014). While Hispanic and African American children
engage in equivalent amounts of PA as their non-Hispanic
White counterparts, they are likely to follow the same pat-
tern of sedentary behavior as adult Hispanic and African
Americans. Twenty-three percent of non-Hispanic White
adults meet PA guidelines compared to 18% of African Americans and 16% of Hispanic adults (Centers for Disease Control and Prevention, 2014). Data are lacking regarding
parenting practices influencing ethnic minority children’s
PA levels, and it is essential that research be developed
pertaining to these populations to promote health equity
within these groups.
Strengths and Limitations
Strengths of the review included a large sample size, gener-
ation of definite themes, and the inclusion of qualitative as
well as quantitative evidence. The limitations to this study
were that studies could have been omitted from the search.
Three databases were searched, and others may exist. The
primary limitation in the literature was that the extant
research is lacking in randomized control trails or other
well-controlled experimental designs, limiting the quality
of the available evidence.
Implications for Research
Indications for future research include examining of the
influence of parenting practices on children’s PA in eth-
nic/racial minority populations. Interventions need to be
developed that utilize the body of evidence that parental role
modeling and logistic support are significant components of
children’s PA. The body of knowledge could be further
developed by original studies with aims of investigating
parenting practices influencing children’s PA. The existing
research could be strengthened by using objective, continu-
ous monitoring measures of PA like accelerometry and
pedometry. High-quality research is needed to determine
whether parental role modeling of PA influences children’s
PA levels. Additional research, within ethnic minority popu-
lations, aimed at parenting practices may help address health
disparities.
Application to School Nursing
School nurses are in the optimal setting for promotion of
student health. Information on the nature of influence of
parents on children’s PA can provide helpful insight for
school nurses. Regular PA is important in the prevention
of child overweight and obesity. This research can help
school nurses in the development of interventions to increase
PA and prevent childhood overweight and obesity in
children.
School nurses should have an understanding of the
dynamics of parenting and children’s PA when implement-
ing health promotion activities. School nurses could utilize
instruments such as the PA Parenting Practices tool to assess
what parenting practices parents are utilizing the encourage
and discourage children’s PA (Davison et al., 2003). By
gaining an understanding of parental influences on chil-
dren’s PA, the school nurse may tailor interventions to fit
the family’s needs.
Health promotion interventions in schools should incor-
porate the plausible influences that parents have on chil-
dren’s PA. School nurses should consider the research on
parental role modeling of PA and logistic support for PA
when developing and implementing health promotion
efforts. Incorporation of this evidence along with the inclu-
sion of the parents in health promotion has potential to result
in improved health outcomes.
Conclusion
The science concerning the influence of parenting practices
on children’s PA levels is mainly supported by cross-
sectional, nonexperimental studies. Strong measurement
tools exist to measure many parenting practices, and the
82 The Journal of School Nursing 34(1)
definition of parenting practices has some consistency
across studies. The science could be expanded by the devel-
opment of randomized controlled trials aimed exclusively at
this area. Research involving ethnic minority populations
would provide meaningful gains and potentially promote
health equity. Parental role modeling of PA and logistic
support for PA showed the greatest promise as parenting
practices that may influence children’s PA and warrant fur-
ther investigation to determine how these influences may be
most effective for promoting PA.
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) received no financial support for the research, author-
ship, and/or publication of this article.
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Author Biographies
Amy Hutchens, PhD(c), RN, CNE, is a Clinical Assistant Profes-
sor at Fran and Earl Ziegler College of Nursing, University of
Oklahoma Health Sciences Center.
Rebecca E. Lee, PhD, is a Professor at the Center for Health
Promotion and Disease Prevention, College of Nursing and Health
Innovation, Arizona State University.
Hutchens and Lee 85
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