The impact of different types of parental support behaviours on child physical activity, healthy eating, and screen time: a cross-sectional study.

BACKGROUND
In Canada, 31.5 % of children are overweight or obese, putting them at an increased risk of chronic co-morbidities and premature mortality. Physical activity, healthy eating, and screen time are important behavioural determinants of childhood overweight and obesity that are influenced by the family environment, and particularly parents' support behaviours. However, there is currently a limited understanding of which types of these support behaviours have the greatest positive impact on healthy child behaviours. This study aims to determine the relative contribution of different types of parental support behaviours for predicting the likelihood that children meet established guidelines for daily physical activity, daily fruit and vegetable consumption, and recreational screen time.

METHODS
A Computer Assisted Telephone Interview survey was used to collect data from a random sample of parents or guardians with at least one child under the age of 18 in Ontario (n = 3,206). Three multivariable logistic regression models were built to predict whether or not parents reported their child was meeting guidelines. Independent variables included parent and child age and gender, multiple indicators of parental support behaviours, and socio-demographic characteristics. Parental support behaviours were categorized post-hoc as motivational, instrumental, regulatory, and conditional based on an adapted framework.

RESULTS
Controlling for all other factors in the model, several parental support behaviours were found to be significant predictors of children meeting established health guidelines. For example, conditional support behaviours including taking the child to places where they can be active (OR: 2.06; 95 % CI: 1.32-3.21), and eating meals as a family away from the TV (95 % CI: 1.15-2.41) were significant positive predictors of children meeting physical activity and fruit and vegetable guidelines, respectively.

CONCLUSIONS
Health promotion efforts aimed at improving particular parent support behaviours could be effective levers for mitigating the burden of excess body weight in childhood. As such, the influence of support behaviours should be fully considered in any comprehensive approach to prevention and reduction of childhood overweight and obesity.