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How to Change Young Children's Physical Activity and Sedentary Behavior: Mechanisms of Behavior Change in the INFANT
Kylie D Hesketh1, Konsita Kuswara1, Gavin Abbott1
1Deakin University, Institute for Physical Activity and Nutrition, Geelong 3220, Australia.
Insights
Improving maternal knowledge on television use significantly reduced child screen time in an early childhood trial. Mechanisms for increasing physical activity in young children remain unclear.
Area of Science:
- Behavioral science
- Public health
- Child development
Background:
- Understanding behavior change mechanisms is key for effective interventions.
- Mechanisms are rarely reported in intervention studies.
- This study examines mediators of intervention effects on child physical activity and television viewing.
Purpose of the Study:
- To investigate the mechanisms explaining intervention effects on child physical activity and television viewing.
- To identify mediators influencing behavior change in an early childhood obesity prevention trial.
Main Methods:
- Secondary analysis of the Melbourne Infant Feeding, Activity and Nutrition Trial (INFANT) data.
- Utilized linear regression with the product of coefficients method.
- Assessed child physical activity, television viewing, and 12 mediator scales.
Main Results:
- No intervention effect on children's physical activity; mechanisms unclear.
- Intervention improved maternal television knowledge (b=0.34, CI=0.22-0.45).
- Maternal television knowledge mediated 75% of the intervention's effect on child television viewing.
Conclusions:
- Improving maternal behavioral knowledge is an effective strategy to reduce early childhood television viewing.
- This knowledge-based strategy is simple and applicable in clinical and public health settings.
- Mechanisms for increasing physical activity in this age group require further investigation.
Background:
Understanding the mechanisms (mediators) of behavior change is crucial to designing more effective interventions. However, this is rarely reported. This paper investigates the mechanisms that explain the lack of intervention effect on physical activity and the significant effect on television viewing time from an early childhood trial.
Methods:
Secondary analyses were undertaken of data from a cluster randomized controlled trial. The Melbourne Infant Feeding, Activity and Nutrition Trial (INFANT) was a 15-month group program promoting obesity-protective behaviors from the age of 4 months. Outcomes relevant to the current study were child physical activity (accelerometer), television viewing time (maternal report) and 12 potential mediator scales (maternal report). Linear regression models used the product of coefficients method with a joint significance test.
Results:
Complete data were from 398 mother-child dyads. Despite weak evidence of an intervention effect on the mother's physical activity knowledge and optimism, there was no effect on children's physical activity, and no clear mechanisms were identified. An intervention effect was observed for the mothers' television knowledge (unstandardized regression coefficient for a path (a) = 0.34, 95% confidence interval (CI95) = 0.22, 0.45), with weak evidence for maternal efficacy (a = 0.11, CI95 = -0.02, 0.24) and the use of television (a = -0.10, CI95 = -0.22, 0.01). The intervention impact on television knowledge explained 75% of the difference between the intervention and control groups in children's television viewing.
Conclusions:
In the very early childhood period, as mothers are commencing their parenting journey, improving their behavioral knowledge appears to be the biggest contributor to reducing child television viewing, constituting a relatively simple strategy that could be implemented across clinical and public health settings. In contrast, it remains unclear what mechanisms may increase physical activity levels in this age group.
