Maternal practices and perceptions of child body mass status explain child energy expenditure behaviors and body mass.

This study investigated whether maternal perceptions of child body mass status would predict child body mass index (BMI) z-score via two sets of sequential mediators: (1) four maternal practices promoting child energy expenditure and (2) children's energy expenditure behaviors. The data of N = 729 mother-child dyads were collected at baseline [T1; n = 495 at 7- to 8-month follow-up (T2)]. Mothers reported perceptions of child body mass status and maternal practices (T1); children reported sedentary screen use and physical activity (T1, T2). Child body mass was assessed objectively (T1, T2). Higher stimulation to be active (T1) was related to a lower child BMI z-score (T2) via higher levels of child physical activity (T2). Higher levels of monitoring of screen use (T1) were associated with higher child BMI z-score (T2) via lower levels of child physical activity (T2). Encouraging parents to stimulate their children to be active may be beneficial for children's weight maintenance.

Body areas satisfaction and body mass in adolescents: mediating effects of actual-ideal body weight discrepancies.

PURPOSE: This study aims at investigating prospective associations between body areas satisfaction (BAS), actual (objectively measured)-ideal body weight discrepancy, actual (self-reported)-ideal body weight discrepancy and BMI among adolescents from the general population. METHODS: Data were collected at three measurement points: baseline (T1), 2-month follow-up (T2), 13-month follow-up (T3) among 1011 adolescents (59.3% girls) aged 13-19 years (M = 16.30, SD = 0.82) with BMIs ranging from 15.20 to 38.78 (M = 20.01, SD = 3.33). Adolescents completed questionnaires regarding BAS (T1), actual and ideal body weight (T2). Body weight and height were measured objectively (T1 and T3). RESULTS: Adolescents satisfied with most areas of their bodies had lower levels of actual (objectively measured)-ideal body weight discrepancy, which in turn predicted higher BMI, while lower levels of actual (self-reported)-ideal body weight discrepancy predicted lower BMI. No moderating effect of gender was found. CONCLUSIONS: Actual-ideal weight discrepancies may operate in complex manner prompting opposite effects on BMI. LEVEL OF EVIDENCE: Level III, longitudinal study without control group.

Cooking together: The IKEA effect on family vegetable intake.

OBJECTIVE: Based on the idea of the 'IKEA effect', assuming that individuals like self-created objects more than objects created by someone else, this study hypothesizes that parents' involvement of their children in meal planning and preparation is positively related to vegetable intake, mediated via liking vegetables. DESIGN: Longitudinal observational study with two time points (10-month interval). METHOD: Nine hundred and twenty-four parent-child dyads filled out questionnaires measuring involvement, vegetable liking, vegetable intake, and further environmental and food-related determinants of vegetable intake. On average, parents were M = 36.10 (SD = 5.43) and children (54.3% girls) M = 8.24 (SD = 1.44; range 6-11) years old. Hypotheses were tested with path analyses, accounting for intra-dyadic associations among respective constructs (e.g., parents' and children's liking vegetables). RESULTS: Two direct effects were found: (1) parents' involvement of their children in cooking activities impacted children's liking of vegetables and vegetable intake, and (2) liking vegetables impacted vegetable intake. The effect of involvement on vegetable intake was mediated via liking vegetables, but only for children and not for parents. CONCLUSIONS: The findings emphasize the importance of parents' encouragement for involving children in the preparation of healthy meals, as this improves liking of vegetables and, thereby, increases their vegetable intake. Statement of contribution What is already known on this subject? Processes behind the effectiveness of shared cooking activities to increase vegetable intake are unclear. Previous research suggests the IKEA effect as an explanation. It assumes a higher consumption of self-created products due to a higher liking compared to third-party products. What does this study add? First test of the IKEA effect for joint cooking activities under consideration of spillover effects in families. Affirmation of the IKEA effect was found for children, not for parents. Interventions should focus on the involvement of children in cooking activities to improve vegetable intake.

Associations of parental and child food and exercise aversion with child food intake and physical activity.

OBJECTIVE: The interplay between parental and child food and physical activity aversion, briefly defined as fear or avoidance of novelty or breaking from routine, may explain such child behaviors as inadequate food consumption and physical activity. Two studies were conducted to investigate the associations between child and parental food and physical activity aversion (child self-reported aversion, parental-reported aversion, and parental perceptions of child aversion) and child food intake and physical activity. METHOD: Parent-child dyads participated in 2 longitudinal studies. Study 1 (food aversion; the baseline [T1] and the 10-month follow-up [T2]) enrolled 924 dyads (1,848 individuals; 54.3% girls, aged 5-11 years old, 88.9% mothers). Study 2 (physical activity aversion; the baseline [T1] and the 7- to 8-month follow-up [T2]) enrolled 879 dyads (1,758 individuals; 52.4% girls, aged 5-11 years old, 83.2% mothers). There was no overlap between the samples enrolled in the two studies. Dyads completed self-report measures; child and parental body weight and height (for calculation of body mass index [BMI] as covariates/potential moderators) were measured objectively. Mediation analyses with 2 sequential mediators were performed. RESULTS: The association between self-reported parental food aversion (T1) and child fruit and vegetable intake (T2) was mediated sequentially by parental perception of child food aversion (T1) and self-reported child food aversion (T2). The same pattern of associations was found for physical activity aversion. Child BMI did not moderate the hypothesized associations. CONCLUSIONS: High levels of parental and child aversion operated sequentially in explaining lower levels of child fruit and vegetable intake and physical activity. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Why are you eating, mom? Maternal emotional, restrained, and external eating explaining children's eating styles.

This study investigated if three maternal eating styles (emotional eating style, external eating style, and restrained eating style) predict respective eating styles in children. In particular, we tested if these associations are different in mother-daughter dyads, compared to mother-son dyads. Data were collected twice, at the baseline (Time 1; T1) and at the 10-month follow-up (Time 2; T2), with N = 822 mother-child dyads participating at T1. Children (55% girls, 5-12 years old, M = 8.21, SD = 1.40) were interviewed; mothers (aged 23-59 years old, M = 35.93, SD = 5.24) completed the questionnaire assessing their eating styles. Participants' weight and height were measured objectively. Path analysis, accounting for dyadic interdependency and autocorrelations, was applied. In mother-daughter dyads, maternal emotional eating (T1) predicted daughters' emotional eating (T2) whereas maternal restrained eating (T1) predicted daughters' restrained eating (T2). There were no effects of external eating in mother-daughter dyads. A different pattern of associations was found for mother-son dyads, with maternal emotional eating (T1) and external eating (T1) predicting sons' emotional eating (T2) and external eating (T2), respectively. There was no effect of maternal restrained eating in mother-son dyads. Maternal eating styles explain child's eating styles with distinct effects depending on child's sex. Educating mothers about the effects of their own eating styles on daughters' and sons' eating styles might be useful to promote adequate responses to hunger and satiety signals.

Meaning in life and physical quality of life: Cross-lagged associations during inpatient rehabilitation.

OBJECTIVES: This study investigated reciprocal associations between meaning in life and physical quality of life (QOL) in the rehabilitation context. It was hypothesized that a higher level of meaning in life at Time 1 (T1) would predict better physical QOL at Time 2 (T2), and that better physical QOL (T1) would predict a higher level of meaning in life (T2). RESEARCH METHOD: This longitudinal study enrolled 339 participants (aged 19-84 years, 57.9% women) who provided self-report data (T1) at the beginning of the inpatient rehabilitation for central nervous system diseases (CNSD; e.g., stroke; n = 89) or musculoskeletal system diseases (MSD; e.g., dorsopathies; n = 250), and at the end of the inpatient rehabilitation (T2, 1-month follow-up). Data were collected in 6 inpatient rehabilitation centers. Manifest cross-lagged panel analyses were conducted for the total sample. RESULTS: Path analyses indicated a significant cross-lagged-effect (.126, p < .002 [95% BCI: 0.020, 0.132]) from meaning in life (T1) to physical QOL at the follow-up (T2). Physical QOL (T1) did not precede meaning in life (T2). CONCLUSIONS: Among patients participating in rehabilitation due to CNSD or MSD, a higher level of meaning in life may precede better physical QOL. Interventions aimed at physical QOL improvement among patients who participated in an inpatient rehabilitation may benefit from a focus on raising patients' meaning in life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Perceptions of Physical Activity Promotion, Transportation Support, Physical Activity, and Body Mass: an Insight into Parent-Child Dyadic Processes.

BACKGROUND: Socio-ecological models indicate that family, school, and community environment explains children's physical activity and body weight. This study investigated whether parental perceptions of school/community-based physical activity (PA) promotion programs as well as parental and child perceptions of parental instrumental support for child PA (transportation provision) would predict child body weight. Child moderate-to-vigorous physical activity (MVPA) was hypothesized to mediate these associations. METHOD: Data of 879 parent-child dyads were collected at two measurement points: the baseline (T1) and the 7-8-month follow-up (T2). Parents were 23-68 years old (83.3% women), while children were 5-11 years old (52.4% girls). Parents and children reported their perceptions of environment, support (T1), and MVPA (T1, T2). Parental and child body weight and height were measured objectively (T1, T2). RESULTS: Path analyses indicated indirect effects of parental perceptions of school/community-based PA policies (T1) and parental perceptions of transportation provision (T1) on child body weight (T2), with child MVPA (T2) operating as the mediator. There were no direct or indirect effects of child perceptions of parental transportation provision (T1) on child MVPA or body weight (T2). Similar patterns of associations were found for the total sample and the subsample of children with overweight/obesity. CONCLUSION: Parental perceptions of school/community-based PA policies and transportation provision may explain changes in child MVPA and body weight. Interventions aimed at prevention of child overweight/obesity may benefit from a focus on parental transportation provision to PA facilities and parental awareness of PA promotion at local environment.

Parental strategies restricting screen use among children, screen home environment, and child screen use as predictors of child body fat: A prospective parent-child study.

OBJECTIVES: This study provides an insight into associations between: (1) parental and child perceptions of parental strategies restricting screen use among children, (2) child perceptions of the presence and availability of screen-based equipment at home, (3) child sedentary screen use behaviours, and (4) child body fat. DESIGN: A prospective study with two assessment periods (Time 1, T1; Time 2, T2), spanning 7-8 months. METHODS: At T1, 879 parent-child dyads (83.3% mothers; 52.3% girls) were enrolled and provided parental and child (5-11 years old) self-report data. T2 data were obtained from 603 dyads. Child body fat was measured with bioimpedance method (T1 and T2). Path analysis was used to test models calculated with and without additional covariates, such as parental and child age and gender, parental education, and economic status. RESULTS: Path analysis indicated indirect effects of the presence and availability of screen-based equipment at home (T1) on child body fat (T2), with screen use among children (T1) mediating this association. Parental perceptions of restrictions (T1) were unrelated to child body fat (T2). In contrast, child perceptions of parental restrictions (T1) predicted child body fat (T2). Children who perceived that their parents applied a higher level of restrictions (T1) had a lower body fat at the 7- to 8-month follow-up. These associations were found after controlling for baseline levels of child body fat, across models calculated with and without additional covariates. CONCLUSIONS: Child, not parental perceptions of parental restrictions, predicted better obesity-related outcomes in children, such as lower body fat. Statement of contribution What is already known on this subject? Little is known about effects of parental restrictions of screen use on child body fat. Evidence is mostly cross-sectional, except from a recent investigation by Sleddens, Gubbels, Kremers, van der Plas, and Thijs (). To date, effects of parental (not children's) reports of screen use restrictions were investigated. What does this study add? Children reporting more parental restrictions of screen use have less body fat at a follow-up. Parental reports of screen use restrictions are unrelated to child screen use and body fat. Frequent screen use mediate between the number of screen devices at home and higher child body fat.

From enjoyment to physical activity or from physical activity to enjoyment? Longitudinal associations in parent-child dyads.

BACKGROUND: This longitudinal dyadic study used cross-lagged analyses to examine reciprocal patterns of associations between physical activity (PA) enjoyment and moderate-to-vigorous PA (MVPA) among children and their parents. METHODS: At Time 1 (T1) 879 parent-child dyads provided their data. The follow-up (Time 2, T2) took place 7-8-months later. MVPA and PA enjoyment scales were filled out separately by parents and children at T1 and T2. FINDINGS: Child PA enjoyment (T1) predicted a higher level of child MVPA (T2), parental PA enjoyment (T1) explained a higher level of parental MVPA (T2), and parental MVPA (T1) predicted a higher level of parental PA enjoyment (T2). Furthermore, child PA enjoyment (T1) predicted a higher level of parental PA enjoyment (T2). CONCLUSIONS: Child PA enjoyment was the key variable predicting child and parental outcomes. In particular, it explained child MVPA, but also PA enjoyment among parents.

Bi-directional associations between parental feeding practices and children's body mass in parent-child dyads.

OBJECTIVE: This study investigated whether parental feeding practices, such as pressure to eat, permitting unhealthy food, and restriction of unhealthy food predict children's body mass index (BMI) percentile or if children's BMI percentiles predict parental feeding practices. DESIGN: Longitudinal data were collected among 526 dyads of children (6-11 years old) and one of their parents. Parents reported parental feeding practices, restriction of unhealthy food, permission of unhealthy food, and pressure to eat. Children's weight and height were assessed objectively. All measurements were conducted twice with a time lag of 10 months. RESULTS: Cross-lagged panel analyses demonstrated that low levels of children's BMI percentiles (measured at the baseline) predicted parental feeding practices (measured at the follow-up) but not vice versa. Only one effect suggesting bi-directionality was found, with parental restriction of unhealthy food preceding higher levels of children's BMI percentiles at the follow-up. CONCLUSIONS: Parental feeding practices seem to be a reaction to the levels of children's BMI percentiles.

Views of policy makers and health promotion professionals on factors facilitating implementation and maintenance of interventions and policies promoting physical activity and healthy eating: results of the DEDIPAC project.

BACKGROUND: The uptake, implementation, and maintenance of effective interventions promoting physical activity (PA) and a healthy diet and the implementation of policies targeting these behaviors are processes not well understood. We aimed to gain a better understanding of what health promotion professionals and policy makers think are important factors facilitating adoption, implementation, and maintenance of multi-level interventions and policies promoting healthy eating and PA in Belgium, Germany, Ireland, Norway, and Poland. METHODS: Six interventions and six policies were identified based on pre-defined criteria. Forty semi-structured interviews were conducted with stakeholders from various sectors to elicit information on factors impacting adoption, implementation, and maintenance of these interventions and policies. All interview transcripts were coded in NVivo, using a common categorization matrix. Coding in the respective countries was done by one researcher and validated by a second researcher. RESULTS: Active involvement of relevant stakeholders and good communication between coordinating organizations were described as important factors contributing to successful adoption and implementation of both interventions and policies. Additional facilitating factors included sufficient training of staff and tailoring of materials to match needs of various target groups. The respondents indicated that maintenance of implemented interventions/policies depended on whether they were embedded in existing or newly created organizational structures in different settings and whether continued funding was secured. CONCLUSIONS: Despite considerable heterogeneity of interventions and health policies in the five countries, stakeholders across these countries identify similar factors facilitating adoption, implementation, and maintenance of these interventions and policies.

Association between Children's Physical Activity and Parental Practices Enhancing Children's Physical Activity: The Moderating Effects of Children's BMI z-Score.

Objective: Parental practices that aim at increasing children's physical activity were found to be related to children's physical activity. So far, however, the association between these two sets of variables was studied without considering the moderating role of children's BMI z-score, which may determine the effectiveness of parental practices. The present study aims at filling this void. Design: Longitudinal data were collected among 879 dyads of children (6-11 years old) and their parents. Seven parental physical activity practices were assessed at baseline. Physical activity, body mass, and height (measured among children) were assessed twice (at baseline and 7-month follow-up). Body mass and height were measured objectively. Seven moderation analyses were conducted. Results: Six parental practices emerged to predict physical activity of children: collaborative social control, overall support, stimulation to be active, general encouragement for physical activity, positive social control, and modeling. Children's BMI z-score moderated three associations. The relationships between parental positive social control, overall parental support, and general parental encouragement for physical activity (at baseline), and children's physical activity (at follow-up) were significant only among children with low and medium BMI z-score. In turn, collaborative social control and modeling predicted children's physical activity at the follow-up regardless child's BMI z-score. Conclusions: Parental positive social control or overall parental support may be ineffective in children with higher body mass who are in need to increase their physical activity.

Self-Efficacy, Planning, or a Combination of Both? A Longitudinal Experimental Study Comparing Effects of Three Interventions on Adolescents' Body Fat.

BACKGROUND: The superiority of an intervention combining two sets of theory-based behavior change techniques targeting planning and self-efficacy over an intervention targeting planning only or self-efficacy only has rarely been investigated. PURPOSE: We compared the influence of self-efficacy, planning, and self-efficacy+planning interventions with an education-based control condition on adolescents' body fat, assuming mediating effects of respective social cognitive variables and moderate-to-vigorous physical activity (MVPA). The moderating role of the built environment was examined. METHODS: Participants (N = 1217, aged 14-18 years) were randomly assigned to four conditions: planning (n = 270), self-efficacy (n = 311), self-efficacy+planning (n = 351), and control (n = 285). The measurement was conducted at baseline (T1), two-month follow-up (T2), and fourteen-month follow-up (T3). Interventions/control group procedures were delivered at T1 and T2. Percent of body fat tissue (measured at T1 and T3) was the main outcome. Social cognitive mediators (self-efficacy and planning) were assessed at T1 and T2. The behavioral mediator (MVPA) and the presence of built MVPA facilities (the moderator) were evaluated at T1 and T3. RESULTS: Similar small increases of body fat were found across the three intervention groups, but the increment of body fat was significantly larger in the control group. On average, differences between control and intervention groups translated to approximately 1% of body fat. Effects of the interventions on body fat were mediated by relevant social cognitive variables and MVPA. A lower increase of body fat was found among intervention group participants who had access to newly-built MVPA facilities. CONCLUSIONS: We found no superiority of an intervention targeting two social cognitive variables over the intervention targeting one cognition only.

Planning and self-efficacy interventions encouraging replacing energy-dense foods intake with fruit and vegetable: A longitudinal experimental study.

OBJECTIVE: This longitudinal experimental study compared effects of self-efficacy, planning and education-based conditions, encouraging adolescents to eat fruit and vegetable in place of energy-dense foods. DESIGN: Data were collected among 506 adolescents (13-18 years old) who were randomly assigned to control (n = 181), planning (n = 153) or self-efficacy (n = 172) conditions. Measurements were taken at baseline (T1), at a 2-month follow-up (T2), and at a 14-month follow-up (T3). Interventions/control group procedures were delivered at T1 and T2. OUTCOME MEASURES: Self-reports of fruit and vegetable intake (FVI) and energy-dense foods intake were collected at three times. Cognitive mediators (self-efficacy and planning) were assessed at T1 and T2. Body weight and height were objectively measured at T1 and T3. RESULTS AND CONCLUSIONS: Similar significant increases of FVI were found for planning and self-efficacy interventions (T3). The planning intervention did not influence energy-dense food intake (T3), but the self-efficacy intervention tended to result in stabilising intake (compared to an increase found in the control group). There were no effects on body weight. Similar patterns were found for the total sample and for a subsample of adolescents with overweight/obesity. The effects of interventions on FVI were mediated by respective cognitions.

Implementation conditions for diet and physical activity interventions and policies: an umbrella review.

BACKGROUND: This umbrella review aimed at identifying evidence-based conditions important for successful implementation of interventions and policies promoting a healthy diet, physical activity (PA), and a reduction in sedentary behaviors (SB). In particular, we examined if the implementation conditions identified were intervention-specific or policy-specific. This study was undertaken as part of the DEterminants of DIet and Physical Activity (DEDIPAC) Knowledge Hub, a joint action as part of the European Joint Programming Initiative a Healthy Diet for a Healthy Life. METHODS: A systematic review of reviews and stakeholder documents was conducted. Data from nine scientific literature databases were analyzed (95 documents met the inclusion criteria). Additionally, published documentation of eight major stakeholders (e.g., World Health Organization) were systematically searched (17 documents met the inclusion criteria). The RE-AIM framework was used to categorize elicited conditions. Across the implementation conditions 25 % were identified in at least four documents and were subsequently classified as having obtained sufficient support. RESULTS: We identified 312 potential conditions relevant for successful implementation; 83 of these received sufficient support. Using the RE-AIM framework eight implementation conditions that obtained support referred to the reach in the target population; five addressed efficacy of implementation processes; 24 concerned adoption by the target staff, setting, or institutions; 43 referred to consistency, costs, and adaptations made in the implementation process; three addressed maintenance of effects over time. The vast majority of implementation conditions (87.9 %; 73 of 83) were supported by documents referring to both interventions and policies. There were seven policy-specific implementation conditions, which focused on increasing complexities of coexisting policies/legal instruments and their consequences for implementation, as well as politicians' collaboration in implementation. CONCLUSIONS: The use of the proposed list of 83 conditions for successful implementation may enhance the implementation of interventions and policies which pursue identification of the most successful actions aimed at improving diet, PA and reducing SB.

Good practice characteristics of diet and physical activity interventions and policies: an umbrella review.

BACKGROUND: This umbrella review aimed at eliciting good practice characteristics of interventions and policies aiming at healthy diet, increasing physical activity, and lowering sedentary behaviors. Applying the World Health Organization's framework, we sought for 3 types of characteristics, reflecting: (1) main intervention/policy characteristics, referring to the design, targets, and participants, (2) monitoring and evaluation processes, and (3) implementation issues. This investigation was undertaken by the DEDPIAC Knowledge Hub (the Knowledge Hub on the DEterminants of DIet and Physical ACtivity), which is an action of the European Union's joint programming initiative. METHODS: A systematic review of reviews and stakeholder documents was conducted. Data from 7 databases was analyzed (99 documents met inclusion criteria). Additionally, resources of 7 major stakeholders (e.g., World Health Organization) were systematically searched (10 documents met inclusion criteria). Overall, the review yielded 74 systematic reviews, 16 position review papers, and 19 stakeholders' documents. Across characteristics, 25% were supported by ≥ 4 systematic reviews. Further, 25% characteristics were supported by ≥ 3 stakeholders' documents. If identified characteristics were included in at least 4 systematic reviews or at least 3 stakeholders' documents, these good practice characteristics were classified as relevant. RESULTS: We derived a list of 149 potential good practice characteristics, of which 53 were classified as relevant. The main characteristics of intervention/policy (n = 18) fell into 6 categories: the use of theory, participants, target behavior, content development/management, multidimensionality, practitioners/settings. Monitoring and evaluation characteristics (n = 18) were grouped into 6 categories: costs/funding, outcomes, evaluation of effects, time/effect size, reach, the evaluation of participation and generalizability, active components/underlying processes. Implementation characteristics (n = 17) were grouped into eight categories: participation processes, training for practitioners, the use/integration of existing resources, feasibility, maintenance/sustainability, implementation partnerships, implementation consistency/adaptation processes, transferability. CONCLUSIONS: The use of the proposed list of 53 good practice characteristics may foster further development of health promotion sciences, as it would allow for identification of success vectors in the domains of main characteristics of interventions/policies, their implementation, evaluation and monitoring processes.