دانلود رایگان ترجمه مقاله ترویج فعالیت فیزیکی والدین و فرزند باهم (نشریه Sage 2017)

ترویج فعالیت فیزیکی والدین و فرزند باهم: ایجاد اهداف و اولویت های مداخله بالقوه

Promoting Parent and Child Physical Activity Together: Elicitation of Potential Intervention Targets and Preferences

Abstract

Promoting physical activities that involve both parents and their children would be very useful to the improved health and well-being of families, yet coactivity interventions have been particularly unsuccessful in past research. The purpose of this study was to elicit the salient parental beliefs about coactivity framed through theory of planned behavior in order to inform future intervention content. A representative sample of Canadian parents (N = 483) with children aged 6 to 14 years completed belief elicitation measures of theory of planned behavior, as well as coactivity and program preferences. Analyses included content theming by physical activity belief and preference through tallies of the percentages of parents endorsing each belief. Exploratory analyses of differences in endorsed themes were conducted by parent (mother, father), age of child (6-10 years, 11-14 years), and sex of the child. The results showed that behavioral beliefs about health, interpersonal and educational/learning opportunities and control beliefs about lack of time, various incompatible parent/child factors, parental health, and bad weather were dominant themes. Most of these themes did not vary in endorsement by parent and child characteristics. By contrast, preferences for various activities varied by parent and child characteristics, yet parents overwhelmingly desired the activities to be outdoors, close to home, after work, and originally delivered from community health professionals via Internet or face-to face means. Overall, the findings provide several considerations for specific targets to improve future physical activity intervention approaches among parents and their children.

The importance of fostering physical activity (PA) patterns in youth is difficult to overstate. PA and high physical fitness protect against high blood pressure, high blood cholesterol, metabolic syndrome, low bone density, depression, and obesity (Janssen & LeBlanc, 2010). Unfortunately, few children in developed countries are sufficiently active to reap these benefits. For example, less than 10% of Canadian children and youth accumulate 60 minutes of moderate-to-vigorousintensity PA on a daily basis (Colley et al., 2011). This high prevalence of inactivity suggests that promotion efforts are paramount for public health.

There is clearly a need to promote PA within the family unit. Children spend considerable time within the care of their parents, and indeed parents appear to be the “gatekeepers” of PA during family time (Gustafson & Rhodes, 2006). Rhodes and Quinlan (2014), for example, identified 15 reviews on this particular topic. Parental influence generally includes two basic factors: parental role modeling (performing PA themselves) and parental support (facilitation of child PA), although parental attitudes about PA and parenting styles and family cohesion have also seen limited research attention with mixed findings (Rhodes & Quinlan, 2014; Trost & Loprinzi, 2011). One of the most advantageous forms of parental influence may be coactivity, whereby parents facilitate activities in which they can be active with their children (Rhodes et al., 2015). This form of support models an active lifestyle (Taylor, Baranowski, & Sallis, 1994), encourages healthy family interpersonal dynamics (Trost & Loprinzi, 2011), and also gets parents active, as they are often plagued by lower PA rates compared with adults without children (Bellows-Riecken & Rhodes, 2008). Unfortunately, interventions on parent–child coactivity have been generally unsuccessful, as stated in several reviews (Kitzman-Ulrich et al., 2010; O’Connor, Jago, & Baranowski, 2009; Salmon, Booth, Phongsavan, Murphy, & Timperio, 2007; van Sluijs, Kriemler, & McMinn, 2011). More recent research on coactivity has shown some positive effects of interventions (e.g., Morgan et al., 2011; O’Dwyer, Fairclough, Zoe Knowles, & Stratton, 2012; Rhodes, Naylor, & McKay, 2010), but these are still balanced by several null results (Backlund, Sundelin, & Larsson, 2011; Morrison et al., 2013; Olvera et al., 2008). Furthermore, there is no clear and understandable mechanism or target variable that explains the success or relative failure of these interventions. Thus, while some results are very promising, there is a need to continue to hone the theory behind parent–child coactivity interventions in order to facilitate reliable success.

A better understanding of parental influence and child PA may inform the design and success of family interventions in the future (Loprinzi & Trost, 2010). In line with this approach, Rhodes et al. (2013, 2015) have applied behavioral theory focused on parental support as a behavior onto itself with specific motives and barriers. These researchers applied parental support within the context of a theory of planned behavior (TPB; Ajzen, 1991) model. The TPB suggests that the proximal determinant of behavior is one’s intention to perform that behavior and intention is predicted by attitude (evaluation of the behavior), subjective norm (perceived social pressure), and perceived behavioral control (ease/difficulty of performing the behavior). Commensurate with the model, intention to provide parental support was predicted by attitudes about support (Rhodes et al., 2013; Rhodes et al., 2015), but the largest predictor of child PA via parent–child coactivity, was perceived control over support.

These findings suggest there may be utility to understanding coactivity support behavior onto itself in order to designate targets for intervention. Rhodes et al. (2015), however, suggested that more in-depth understanding of TPB constructs is needed. Ajzen (2002b) also suggests that the content for TPB-based interventions is founded on the underlying beliefs in the constructs (i.e., behavioral beliefs, control beliefs). Currently, no research has focused on the belieflevel markers for parent–child coactivity using any theoretical frame.

Thus, the purpose of this study was to elicit the salient beliefs about coactivity from parents of children younger than 15 years in a representative Canadian sample in order to inform future intervention content. We hypothesized that only a select few beliefs would emerge as important targets of parent–child coactivity that fall into the attitudinal and control domains. Given the developmental differences between children and tweens/teens, we sought to explore whether endorsement of these beliefs differed. Furthermore, the potential gendered perspective of family coactivity (Edwardson & Gorely, 2010) granted an opportunity to explore these beliefs separately by mothers and fathers as well as girls and boys. We also wished to explore the preferences for coactivity and promotion apertures to improve the reach and uptake of future interventions (Estabrooks & Glasgow, 2006) involving parents and their children. We hypothesized that specific preferences for engaging in coactivity, receiving the intervention, and the means of receiving the intervention would result from the elicitation and can be used for future intervention initiatives.