Review Article

Associations of Parental Influences with Physical Activity and Screen Time among Young Children: A Systematic Review

Table 2

Association between parental influence and children’s PA.

Author (year) country referenceStudy designSampleAge (years)Parental influence (measurement)Child PA
(measurement)
Adjusted confoundersMain findingsQuality score

Alderman et al. (2010)
USA
[19]
Longitudinal69Baseline 4–6
Follow-up 5–15
(1) Parental PA
(2) The amount of time parents report engaging in PA together with their child.
(parent self-administered questionnaire)
Children’s PA
(parent self-administered questionnaire)
No(1) At baseline, the relationship between parental and children’s PA was moderately strong with Pearson’s = 0.44 ( < 0.05).
(2) At follow-up, this relationship was weaker and no longer significant (Pearson’s = 0.08, > 0.05).
(3) The amount of time parents report engaging in PA together with their child decreased significantly over time.
4

Oliver et al. (2010)
New Zealand [20]
Cross-sectional932–5(1) Parental PA rate
(2) Parental PA supports/inhibitors
Encouraged child to be active
Parent was physically active with child
Child was taken out to playground, park, beach, and so forth
Restrict TV viewing
Children’s PA rate
(Actical accelerometers)
Children’s ageUnivariable linear regression model
(1) Parental PA supports/inhibitors were not associated with children’s PA rate.
Multivariable linear regression model
(2) After adjusting children’s age, parental PA rate was positively associated with children’s PA rate ( = 0.09, = 0.01).
6

Loprinzi and Trost (2010)
Australia
[21]
Cross-sectional1562–5(1) Parental PA
(2) Parental enjoyment of PA
(3) Parental support for PA
(4) parental perceived importance of child PA
(5) Parents’ perceptions of their children’s physical competence
(parent self-administered questionnaire)
(1) Children’s PA at home
(parent self-administered questionnaire, PAEC-Q)
(2) Children’s PA at child care
(Actigraph 7164 acclerometer)
(1) Children’s age
(2) Child gender
Path analysis
(1) Parental PA and parents’ perceptions of their children’s physical competence were positively associated with parental support for PA ( = 0.23 and 0.18, respectively, < 0.05).
(2) Parental enjoyment of PA and perceived importance of child PA were not significantly associated with parental support for PA.
Home-based children’s PA
(3) Parental support for PA was positively associated with home-based children’s PA
( = 0.16, < 0.05).
(4) Parents’ perceptions of their children’s physical competence were directly and positively associated with home-based children’s PA ( = 0.2, < 0.05).
Child care MVPA
(5) Parental support for PA was not associated with children’s MVPA at child care ( = 0.01,
= 0.94).
(6) Parents’ perceptions of their children’s physical competence were directly and positively associated with children’s MVPA at child care ( = 0.28, < 0.001).
5

Pfeiffer et al. (2009)
USA
[22]
Clustered cross-sectional3313–5(1) Parental VPA
(2) Parental perception of their child’s athletic competence
(3) Family support for PA (average of responses to frequency of following items)
Family encouraged PA,
participated in PA with child,
provided transportation to PA facilities,
watched the child in activities,
and told the child that PA is good
(parent self-administered questionnaire)
Children’s MVPA and NSA
(ActiGraph accelerometers)
(1) Child gender
(2) Child race
(3) Child BMI -score
(4) Parent education
Mixed model
(1) Parental perception of their child’s athletic competence was positively associated with children’s MVPA and NSA ( = 0.39 and 0.80, respectively, < 0.01).
(2) Parental VPA and family support for PA were not significantly associated with children’s MVPA and NSA.
5

Zecevic et al. (2010)
Canada
[23]
Cross-sectional1023–5(1) Parental PA
(2) Family support for PA (average of responses to frequency of following items)
Family encouraged PA,
participated in PA with child,
provided transportation to PA facilities,
watched the child in activities,
and told the child that PA is good
(3) Parents’ enjoyment of PA
(4) Importance of child’s PA ability
(parent self-administered questionnaire)
(1) Children’s PA (active play/sports)
(2) Parent’s perceived intensity of a child’s PA
(parent self-administered questionnaire)
Not reportedMultiple logistic regression model
Children’s PA
(1) The greater parents’ enjoyment of PA is, the more likely the children were to engage in the recommended amount of daily PA (PA ≥1 hour/day) (AOR 2.01, < 0.05).
(2) Parental PA and family support for PA were positively associated with children’s PA (AOR 1.62 and 2.18, respectively, < 0.10).
(3) Importance of child’s PA ability was not associated with children’s PA.
Intensity of children’s PA
(4) Parental PA and family support for PA were positively associated with children’s intensity of PA (AOR 1.97 and 4.22, respectively, < 0.05).
(5) Parents’ enjoyment of PA and importance of child’s PA ability were not associated with children’s PA.
3

Davison and Birch (2001)
USA
[24]
Longitudinal185Baseline 5
Follow-up 7
Parental PA
(parent self-administered questionnaire: the level of PA: low, medium, and high)
Girl’s PA (level of active)
(parent self-administered questionnaire: the level of PA: low, medium, and high)
NoNo associations between girls’ and parents’ total PA at 5 years of age.4

Jago et al. (2005)
USA
[25]
Longitudinal149Baseline 3-4
3-year follow-up
Parental encouragement/discouragement for PA
(direct observation)
(1) Children’s PA
(1) Heat rate monitoring
(2) Direct observation with Children’s Activity Rating Scale)
(1) Child BMI
(2) Child ethnicity
(3) Child gender
In year 2 of the follow-up
(1) Observed children’s PA was positively associated with encouragements ( = 0.19, < 0.05) and discouragements ( = 0.349, < 0.01) for PA.
In year 3 of the follow-up
(2) Observed children’s PA was significantly associated with encouragements ( = 0.381, < 0.01) and discouragements ( = 0.418, < 0.01) for PA.
(3) Encouragements and discouragements of PA by parents were not significant predictors of PA in regression models.
3

Beets and Foley (2008)
USA
[26]
Clustered cross-sectional106945-6(1) Father-child time
(2) Family sports/activities together time
(parent self-administered questionnaire)
Child physical activity
(parent self-administered questionnaire)
(1) Child race
(2) Child gender
(3) Child BMI
(1) Father-child time was positively associated with child PA on weekdays ( = 0.09, < 0.001) and weekends ( = 0.07, = 0.002).
(2) Family sports time was positively associated with child PA ( = 0.27, < 0.05).
(3) The effect of father-child time on child PA was mediated by family sports time. The indirect effect of father-child time on child PA was 0.03, < 0.001 on weekdays, and 0.02, < 0.001 on weekends.
5

Cleland et al. (2010)
Australia
[27]
Longitudinal130Baseline: 5-6
5-year follow-up
Parental encouragement of playing outdoors
(parent self-administered questionnaire)
Child time spent outdoors
(parent self-administered questionnaire)
(1) Maternal education
(2) Parental marital status
(3) Other
Compared to low parental encouragement, high parental encouragement was associated with more time spent outdoors on average of over 5 years for girls (234 minutes/week, 95% CI 30.1–437.8), but not for boys.7

Dowda et al. (2011)
USA
[28]
Cross-sectional4113–5(1) Family support
Encourage child PA
Play with child outdoors
Provide transportation
Watch child do PA or play outdoors games
Tell child PA is good
(2) Parent PA
(3) Parent enjoys PA
(4) Importance of child PA
(parent self-administered questionnaire)
Child PA
(MVPA created from
(1) ActiGraph accelerometers
(2) Direct observation
(3) Parent-reported child’s athletic coordination)
(1) Child gender
(2) Preschool quality
(3) Home PA equipment
(1) Family support was directly and significantly associated with child MVPA ( = 0.28).
(2) Parent PA was indirectly associated with child’s MVPA ( = 0.015, 95% CI 0.01–0.036) (mediated by family support).
(3) Parent enjoys PA that was indirectly associated with child’s MVPA ( = 0.031, 95% CI 0.005–0.065) (mediated by family support).
(4) Importance of child participation in PA was indirectly associated with child’s MVPA ( = 0.014, 95% CI 0.001–0.034) (mediated by family support).
6

Hinkley et al. (2012)
Australia
[29]
Clustered cross-sectional705 (weekly)
773 (weekday)
605 (weekend)
3–5(1) Father/mother PA
(2) PA interaction
(3) Parent housework
(4) Parent preference (child do the same activities as older siblings)
(5) Parental rules restricting rough games inside
(6) Parental logistic support
(parent self-administered questionnaire)
Child PA
(1) Weekly
(2) Weekday
(3) Weekend-day
(ActiGraph accelerometers)
Child age
Child daily sleep
Number of siblings
Other variables showed significance in models
Boys:
(1) Mother’s PA interaction with child was positively associated with boy’s weekly PA (AOR 1.01, 95% CI 1.00–1.03).
(2) Housework was negatively associated with boy’s weekday PA (AOR 0.91, 95% CI 0.85–0.97).
(3) Parent prefers child to do same activities as older children were negatively associated with boy’s weekly (AOR 0.94, 95% CI 0.88–0.99) and weekday PA (AOR 0.92, 95% CI 0.87–0.97).
(4) Rules restricting rough games inside were positively associated with boy’s weekly PA (AOR 1.06, 95% CI 1.01–1.12) and weekend-day PA (AOR 1.11, 95% CI 1.02–1.20).
Girls:
(5) Paternal time in moderate PA (not total PA) was significantly associated with girl’s weekly PA (AOR 1.01, 95% CI 1.00–1.02). Maternal time in vigorous PA was not significantly associated with girl’s weekly, weekday, and weekend-day PA.
(6) Paternal provision of logistic support was significantly associated with girl’s weekend-day PA (AOR 1.03, 95% CI 1.00–1.05).
7

Ruiz et al. (2011)
USA
[30]
Cross-sectional106 (80)3–5(1) Parent time spent in sedentary behaviour
(2) Parent PA (light, moderate, and vigorous)
(ActiGraph accelerometers)
(1) Child time spent in sedentary behaviour
(2) Child PA (light, moderate, and vigorous)
(ActiGraph accelerometers)
None for Pearson’s correlation.
Child age and gender for linear regression
(1) There was a strong and positive correlation between parents and their children’s daily sedentary (Pearson’s = 0.597, < 0.001), mild (Pearson’s = 0.895, < 0.0001), and moderate (Pearson’s = 0.739, < 0.0001) PA levels but not for vigorous PA levels (Pearson’s = −0.07, = 0.56).
(2) Parent PA was significantly associated with child’s PA ( was not reported, < 0.0001).
6

Schary et al. (2012)
USA
[31]
Cross-sectional1952–5(1) Parental support
Encouragement
Playing with the child
Providing transportation
Watching the child participate in PA
Providing information about PA
(2) Dimensions of parenting style
Warmth
Control
Irritability
(3) Parenting style
Authoritative
Authoritarian
Permissive
Neglectful
(parent self-administered questionnaire)
Active play
(parent self-administered questionnaire with PAEC-Q)
Parent gender (1) Parental support was positively associated with child active play ( = 0.30, < 0.001).
(2) Parental warmth was positively associated with child active play ( = 0.15, = 0.04). Parental control and irritability were not significantly associated with child active play.
(3) Parenting style was not associated with child active play.
(4) After adjusted for parenting style, parental support remained positively associated with child active play ( = 0.30, < 0.001).
(5) Parenting style did not moderate the relationship between parental support and child active play behaviour.
6

Taylor et al. (2009)
New Zealand
[32]
Longitudinal244Baseline: 3
Follow-up at
4 and 5
(1) Mother’s PA
(2) Father’s PA
((a) Actical accelerometers
(b) Parent self-administered questionnaire)
Child PA
((1) Actical accelerometers.
(2) Parent self-administered questionnaire)
(1) Child age
(2) Child sex
(3) Days of the week
(week day/weekend day)
Cross-sectional analysis:
(1) Parental activity was weakly associated with child’s PA measured by AAC at 3 and 4 years but not 5 years (Spearman rank-order = 0.08, = 0.034 and = 0.17, = 0.051 for mothers and = 0.28, = 0.001 and = 0.23, = 0.007 for fathers for 3 and 4 years, respectively).
(2) Mother’s PA was associated with child’s PA by parental ratings at 4 and 5 years but not 3 years ( = 0.21, = 0.003 and = 0.18, = 0.014).
(3) There was no association between parental ratings of their own and their child’s PA.
Mixed model:
(4) Father’s PA was a significant predictor of the child’s PA measured by AAC (adjusted = 0.11, = 0.024).
(5) Mother’s PA was not significantly associated with child’s PA measured by AAC (adjusted = 0.21, = 0.062).
6

MVPA: moderate to vigorous physical activity. PAEC-Q: Physical Activity and Exercise Questionnaire for Children. VPA: vigorous physical activity. NSA: nonsedentary activity. AOR: adjusted odds ratio. AAC: average accelerometry counts.