Simon J. Sebire

General and Specific Approaches to Media Parenting: A Systematic Review of Current Measures, Associations with Screen-Viewing, and Measurement Implications

BACKGROUND Parent-focused interventions may help to reduce youth screen-viewing (SV). This review synthesized current information on the links between parenting styles, parenting practices, and youth SV with a focus on measurement. METHODS A systematic review of electronic databases was conducted. RESULTS In all, 29 of 1189 studies met the inclusion criteria. Parenting practices were divided into rule and nonrule-based practices. Seven rules: (1) Limits on total time (n studies=23); (2) limits on time of day (n=7); (3) content restriction (n=11); (4) mealtime rules (n=2); (5) parental supervision (n=3); (6) contingent screentime (n=3); and (7) no-TV policy (n=1) were reported. Two nonrule-based practices were reported: Co-viewing (n=6) and encouragement to view (n=2). Three studies (10.3%) provided information on parenting styles. Only 12 studies (41.4%) provided information on the reliability/validity of the outcome measure, 15 (51.7%) studies provided information on the reliability/validity of the parenting measure, and 6 (20.7%) provided information on the reliability/validity of both outcome and exposure measures. CONCLUSIONS There is mixed evidence that parenting styles and media-related parenting practices are associated with youth SV. The assessment of parental influence of youth media use is hampered by the diversity of measures that have been used. There is a need for new measures that assess a range of media parenting practices that are relevant to multiple forms of SV.

Associations between objectively assessed child and parental physical activity: a cross-sectional study of families with 5–6 year old children

BackgroundA number of studies have suggested that there is a need to increase the physical activity levels of children. Parents are important influences on children’s behaviour. There is a lack of information about whether there are associations between the physical activity levels of young children and their parents. The current study examined the associations between the physical activity (PA) of parents and their children at age five to six years old, and determined whether any associations differed by child or parent gender or between week and weekend days.MethodsCross-sectional study, with 1267 Year 1 pupils (five to six years of age) and at least one parent from 57 primary schools. Children and parents wore an accelerometer for five days and mean minutes of moderate-to-vigorous intensity physical activity (MVPA) per day were derived. We used multivariable linear regression to investigate whether parental and child time spent in MVPA was associated with each other. Each model was adjusted for age, child gender, parent BMI and neighbourhood deprivation with subgroup analysis by child gender.Results80% of parents met PA guidelines, however 29% of boys and 47% of girls aged five to six years failed to meet them. Fully-adjusted analyses suggested weak positive associations of parent’s and children’s time spent in MVPA. Every 10 additional minutes of parental MVPA were associated with one additional minute of child MVPA. There was no evidence of a difference in associations for boys and girls or between mothers and fathers.Conclusions29% of boys and 47% of girls aged five to six years did not meet PA guidelines indicating that these children would benefit from new approaches that focus on increasing physical activity. There were weak associations between the MVPA of 5–6 year old children and their parents, demonstrating that the time that children are active with their parents is not a major source of physical activity. Clinicians and public health professionals should encourage parents to create opportunities for their children to be active.

'I'm on it 24/7 at the moment': a qualitative examination of multi-screen viewing behaviours among UK 10-11 year olds

BackgroundScreen-viewing has been associated with increased body mass, increased risk of metabolic syndrome and lower psychological well-being among children and adolescents. There is a shortage of information about the nature of contemporary screen-viewing amongst children especially given the rapid advances in screen-viewing equipment technology and their widespread availability. Anecdotal evidence suggests that large numbers of children embrace the multi-functionality of current devices to engage in multiple forms of screen-viewing at the same time. In this paper we used qualitative methods to assess the nature and extent of multiple forms of screen-viewing in UK children.MethodsFocus groups were conducted with 10-11 year old children (n = 63) who were recruited from five primary schools in Bristol, UK. Topics included the types of screen-viewing in which the participants engaged; whether the participants ever engaged in more than one form of screen-viewing at any time and if so the nature of this multiple viewing; reasons for engaging in multi-screen-viewing; the room within the house where multi-screen-viewing took place and the reasons for selecting that room. All focus groups were transcribed verbatim, anonymised and thematically analysed.ResultsMulti-screen viewing was a common behaviour. Although multi-screen viewing often involved watching TV, TV viewing was often the background behaviour with attention focussed towards a laptop, handheld device or smart-phone. There were three main reasons for engaging in multi-screen viewing: 1) tempering impatience that was associated with a programme loading; 2) multi-screen facilitated filtering out unwanted content such as advertisements; and 3) multi-screen viewing was perceived to be enjoyable. Multi-screen viewing occurred either in the childs bedroom or in the main living area of the home. There was considerable variability in the level and timing of viewing and this appeared to be a function of whether the participants attended after-school clubs.ConclusionsUK children regularly engage in two or more forms of screen-viewing at the same time. There are currently no means of assessing multi-screen viewing nor any interventions that specifically focus on reducing multi-screen viewing. To reduce childrens overall screen-viewing we need to understand and then develop approaches to reduce multi-screen viewing among children.

Parents’ views on child physical activity and their implications for physical activity parenting interventions: a qualitative study

BackgroundEstablishing healthy physical activity (PA) behaviours in early childhood is important for future PA behaviours. Parents play a central role in young children’s PA. However, there is currently little research on parenting interventions to increase child PA. This study was formative work to inform the content of a pilot randomised-controlled trial.MethodsIn-depth telephone interviews were carried out with 32 parents of 6 to 8 year old children residing in two areas that varied in their socio-economic characteristics, in Bristol, UK. Data were analysed thematically using a framework approach.ResultsMost parents described their child as being active or very active and indicated that they did not perceive a need for an increase in their child’s PA. Parents used a variety of visual cues to make this judgement, the most common being that they perceived their child as having lots of energy or that they did not view them as overweight. Parents reported environmental factors such as monetary cost, time constraints, lack of activity provision and poor weather as the main barriers to their child’s PA. Parental support and child’s enjoyment of PA appeared to be important facilitators to children participating in PA.ConclusionImproving parents’ knowledge of the PA recommendations for children, and increasing their awareness of the benefits of PA beyond weight status may be an important first step for a parenting PA intervention. Although parents commonly perceive environmental factors as the main barriers to their child’s PA, parental concern about low levels of child PA, their capacity to support behaviour change, child motivation, self confidence and independence may be key areas to address within an intervention to increase child PA. Effective methods of helping parents address the latter have been developed in the context of generic parenting programmes.

Individual and social predictors of screen-viewing among Spanish school children

Many children exceed suggested screen-viewing guidelines and this is likely to be a risk factor for obesity. Understanding the predictors of screen-viewing may be the first step in designing interventions that target these behaviours, but there is lack of information on predictors among Spanish children. This study examined associations between individual, friend and family based social variables and screen-viewing behaviours, and how these associations differ by age and gender in a sample of Spanish children. Participants were 247 primary school-aged and 256 secondary school-aged children and their parents. Children reported time spent in screen-viewing and information about individual and friend and family based social variables. Body mass index was assessed and children were classified using International Obesity Task Force cut-off points. Parents reported sociodemographic characteristics and family co-viewing practices. Lower self-efficacy for reducing screen-viewing (console playing p < 0.05; overall p < 0.01), stronger sedentary group-norms (TV p < 0.001; console playing p < 0.05; overall p < 0.05) and stronger social reasons (console playing p < 0.05) were associated with higher screen-viewing. For younger children, parental screen-viewing rules appeared to be significant predictors while family co-viewing practices were significant predictors for older children. Older children (TV p < 0.001; console playing p < 0.01; overall p < 0.001) and males (TV p < 0.01; console playing p < 0.001; overall p < 0.01) were likely to spend more time screen-viewing. Individual and social factors influence children’s screen-viewing and operate differently during childhood. Increasing self-efficacy may be important for screen-viewing based behaviour changes. Friends and parents play a central role, therefore understanding the dynamics of friends and targeting family influences may be critical to the success of interventions to reduce screen-viewing.

Bristol Girls Dance Project Feasibility Trial: outcome and process evaluation results

BackgroundMany adolescent girls do not engage in sufficient physical activity (PA). This study examined the feasibility of conducting a cluster randomized controlled trial (RCT) to evaluate an after-school dance program to increase PA among 11–12 year old girls in Bristol, UK.MethodsThree-arm, cluster RCT. Three secondary schools were assigned to intervention arm. Intervention participants received a 9-week dance program with 2, 90-minute dance classes per week. Participants at 2 control schools received incentives for data collection. Participants at 2 additional control schools received incentives and a delayed dance workshop. Accelerometer data were collected at baseline (time 0), during the last week of the dance program (time 1) and 20 weeks after the start of the study (time 2). Weekly attendance, enjoyment and perceived exertion were assessed in intervention participants. Post-study qualitative work was conducted with intervention participants and personnel.Results40.1% of girls provided consent to be in the study. The mean number of girls attending at least one dance session per week ranged from 15.4 to 25.9. There was greater number of participants for whom accelerometer data were collected in control arms. The mean attendance was 13.3 sessions (maximum = 18). Perceived exertion ratings indicated that the girls did not find the sessions challenging. The dance teachers reported that the program content would benefit from revisions including less creative task time, a broader range of dance genres and improved behavioral management policies. At time 2, the 95% confidence intervals suggest between 5 and 12 minutes more weekday MVPA in the intervention group compared with the control incentives only group, and between 6 minutes fewer and 1 minute more compared with the control incentives plus workshop group. Between 14 and 24 schools would be required to detect a difference of 10 minutes in mean weekday MVPA between intervention and control groups.ConclusionsIt is possible to recruit 11–12 year old girls to participate in an after-school dance study. An after-school dance intervention has potential to positively affect the PA levels of 11–12 year old girls but an adequately powered RCT is required to test this intervention approach.

Parental Control, Nurturance, Self-Efficacy, and Screen Viewing among 5- to 6-Year-Old Children: A Cross-Sectional Mediation Analysis to Inform Potential Behavior Change Strategies

Abstract Background: Childrens screen viewing (SV) is associated with higher levels of childhood obesity. Many children exceed the American Academy of Pediatrics guideline of 2 hours of television (TV) per day. There is limited information about how parenting styles and parental self-efficacy to limit child screen time are associated with childrens SV. This study examined whether parenting styles were associated with the SV of young children and whether any effects were mediated by parental self-efficacy to limit screen time. Methods: Data were from a cross-sectional survey conducted in 2013. Child and parent SV were reported by a parent, who also provided information about their parenting practices and self-efficacy to restrict SV. A four-step regression method examined whether parenting styles were associated with the SV of young children. Mediation by parental self-efficacy to limit screen time was examined using indirect effects. Results: On a weekday, 90% of children watched TV for <2 hours per day, decreasing to 55% for boys and 58% for girls at weekends. At the weekend, 75% of children used a personal computer at home, compared with 61% during the week. Self-reported parental control, but not nurturance, was associated with childrens TV viewing. Parental self-efficacy to limit screen time was independently associated with child weekday TV viewing and mediated associations between parental control and SV. Conclusions: Parental control was associated with lower levels of SV among 5- to 6-year-old children. This association was partially mediated by parental self-efficacy to limit screen time. The development of strategies to increase parental self-efficacy to limit screen-time may be useful.

Parental modelling, media equipment and screen-viewing among young children: cross-sectional study

Objective To examine whether parental screen-viewing, parental attitudes or access to media equipment were associated with the screen-viewing of 6-year-old to 8-year-old children. Design Cross-sectional survey. Setting Online survey. Main outcome Parental report of the number of hours per weekday that they and, separately, their 6-year-old to 8-year-old child spent watching TV, using a games console, a smart-phone and multiscreen viewing. Parental screen-viewing, parental attitudes and pieces of media equipment were exposures. Results Over 75% of the parents and 62% of the children spent more than 2 h/weekday watching TV. Over two-thirds of the parents and almost 40% of the children spent more than an hour per day multiscreen viewing. The mean number of pieces of media equipment in the home was 5.9 items, with 1.3 items in the childs bedroom. Children who had parents who spent more than 2 h/day watching TV were over 7.8 times more likely to exceed the 2 h threshold. Girls and boys who had a parent who spent an hour or more multiscreen viewing were 34 times more likely to also spend more than an hour per day multiscreen viewing. Media equipment in the childs bedroom was associated with higher TV viewing, computer time and multiscreen viewing. Each increment in the parental agreement that watching TV was relaxing for their child was associated with a 49% increase in the likelihood that the child spent more than 2 h/day watching TV. Conclusions Children who have parents who engage in high levels of screen-viewing are more likely to engage in high levels of screen-viewing. Access to media equipment, particularly in the childs bedroom, was associated with higher levels of screen-viewing. Family-based strategies to reduce screen-viewing and limit media equipment access may be important ways to reduce child screen-viewing.

If there wasn't the technology then I would probably be out everyday: a qualitative study of children's strategies to reduce their screen viewing.

OBJECTIVE To explore the views of British 10-11 year old children towards reducing their screen-viewing and their screen-viewing reduction strategies. METHOD 10 focus groups were conducted with 55 10-11 year old children (30 girls, 25 boys) in Bristol (UK) in 2010. Data were transcribed and transcripts were analysed using thematic analysis. RESULTS Three main themes were developed: Reaction to Reduction; Reduction: What, when and what else instead?; and Strategies to reduce screen-viewing. Participants reacted largely positively to reducing their screen-viewing although enjoyment, established routines and favourite TV programmes presented barriers. A range of screen-viewing modes were put forward as candidates for reduction and participants believed they would replace screen-viewing with both physically active and non-screen sedentary behaviours. Reduction strategies identified comprised the provision of alternative activities, facilities and after school clubs, peer-led educational interventions, behavioural strategies such as the use of rewards, charts and time limits which involved childrens parents and parent-child collaboration. Unexpectedly, participants identified the focus group itself as a means of encouraging self-reflection and initiating change. CONCLUSION Children appeared open to screen-viewing reduction and identified the strategies that they may respond to best. This can inform the development of interventions designed to reduce screen-viewing.

Randomised feasibility trial of a teaching assistant led extracurricular physical activity intervention for 9 to 11 year olds: Action 3:30

BackgroundExtracurricular programmes could provide a mechanism to increase the physical activity (PA) of primary-school-aged children. The aim of this feasibility study was to examine whether the Action 3:30 intervention, which is delivered by teaching assistants, holds promise as a means of increasing the PA of Year 5 and 6 children.MethodsA cluster randomised feasibility trial was conducted in 20 primary schools. Ten schools received the Action 3:30 intervention and 10 schools were allocated to the control arm. The intervention was 40 one-hour sessions, delivered twice a week by teaching assistants. The proportion of participants recruited per school was calculated. Session delivery and session attendance was calculated for intervention schools. Weekday and after-school (3.30 to 8.30 pm) moderate to vigorous intensity physical (MVPA) was assessed by accelerometer at baseline (T0), during the last few weeks of the intervention (T1) and four months after the intervention had ended (T2). The costs of delivering the intervention were estimated.ResultsFive intervention schools ran all 40 of the intended sessions. Of the remaining five, three ran 39, one ran 38 and one ran 29 sessions. Mean attendance was 53%. The adjusted difference in weekday MVPA at T1 was 4.3 minutes (95% CI -2.6 to 11.3). Sex-stratified analyses indicated that boys obtained 8.6 more minutes of weekday MVPA than the control group (95% CI 2.8 to 14.5) at T1 with no effect for girls (0.15 minutes, 95% CI -9.7 to 10.0). There was no evidence that participation in the programme increased MVPA once the club sessions ceased (T2). The indicative average cost of this intervention was £2,425 per school or £81 per participating child during its first year and £1,461 per school or £49 per participating child thereafter.ConclusionsThe effect of the Action 3:30 intervention was comparable to previous physical activity interventions but further analysis indicated that there was a marked sex difference with a positive impact on boys and no evidence of an effect on girls. The Action 3:30 intervention holds considerable promise but more work is needed to enhance the effectiveness of the intervention, particularly for girls.Trial registrationISRCTN58502739