Three-Year Changes in Low-Income Children’s Physical Activity: Prospective Influence of Neighborhood Environment and Parent Supportive Behaviors

Objectives To prospectively evaluate parent supportive behaviors for child physical activity (PSB) and neighborhood environment variables on changes in child physical activity (PA) over three years. Study design Secondary data analysis of the NET-Works study with 534 parent-child (aged 2-4 yrs) dyads randomized to a community-based pediatric obesity prevention intervention for three years (92% retention). PSB and neighborhood environmental variables were examined in relation to changes in child moderate/vigorous PA (MVPA), light and sedentary activity, and screen time. Child and parent accelerometry data were collected at visit 0, 12, 24, and 36 months. Mixed multivariate models were used to examine independent and interactive effects of parent-level and neighborhood-level variables on changes in child PA outcomes. Results PSB significantly interacted with visit on change in child MVPA (β = 0.12) and sedentary behaviors (β = -0.18). Over three years, a one unit increase in PSB was associated with an average increase of 4.3 mins/day of MVPA and an average decrease of 6.5 mins per day of sedentary time. Significant main effects were observed for PSB and three-year change in child screen time (β = -0.05). The children of parents with higher PSB at baseline watched an average of 1.8 fewer mins/day of screen time compared with parents with lower baseline PSB. Neighborhood-level variables were not significantly associated with changes in child PA outcomes. Conclusions Parents who increase their supportive behaviors for their child's physical activity have children who are more physically active and less sedentary over time. Interventions to increase preschool-aged children's physical activity may enhance their effectiveness by targeting parents' supportive behaviors for their child's physical activity.