Patterns of Screen Time Parenting Practices among Parent-Adolescent Dyads Who Participated in a Cross-Sectional Internet-Based Study.

Background: Little is known about the simultaneous use of screen time (ST) parenting practices in children. Hence, study objectives were to determine patterns of ST parenting practices and associations with demographic, anthropometric, and sedentary behavior measures in parents and their adolescent children (12-17 years). Methods: Dyadic survey data from Family Life, Activity, Sun, Health, and Eating, a cross-sectional, internet-based study, conducted in 2014 were analyzed using latent class analysis on six ST parenting practices-permissive, rules/limits, monitoring, modeling, accessibility, and negotiated rules. Self-report model covariates included adolescent age and parent and adolescent sex, body weight category, and sedentary behavior. Results: Based on 1200 parent-adolescent dyads, five latent classes were identified representing a continuum of practice use (high to low)-Complete Influencers (16%, reference class), Disagreeing Influencers (18%), Positive Influencers (24%), Negative Influencers (23%), and Indifferent Influencers (20%). Disagreeing, Indifferent, and Negative Influencers were 50%-81% and 45%-49% less likely to contain younger adolescent dyads and male adolescent dyads, respectively. Dyads with adolescent overweight/obesity had twice the odds of belonging to one of the other four classes. Odds of belonging to one of the other four classes were 3%-9% lower for every 1 minute/day increase in adolescent sedentary behavior. Conclusions: Parents utilize distinct patterns of ST practices, which are differentially associated with adolescent age, sex, weight, and sedentary behavior. Advocating for parental use of combinations of practices, like rules/limits and monitoring, to decrease their adolescents' ST may prove more beneficial than no practice use.

Patterns of physical activity parenting practices among parent-adolescent dyads who participated in a cross-sectional internet-based study.

BACKGROUND: While research exploring relationships between individual parenting practices and child physical activity (PA) exists, little is known about simultaneous use of practices. Hence, study objectives were to determine patterns of PA parenting practices and their associations with demographic, anthropometric, and PA measures in a large sample of parents and their adolescent children (12-17 years). METHODS: Dyadic survey data from Family Life, Activity, Sun, Health, and Eating (FLASHE), a cross-sectional, internet-based study, conducted in 2014 were analyzed using latent class analysis on 5 PA parenting practices - pressuring, guided choice, expectations, facilitation, and modeling. Self-report model covariates included adolescent age and parent and adolescent sex, body mass index category (based on height and weight), legitimacy of parental authority regarding PA (PA-LPA), and moderate-to-vigorous PA (MVPA). RESULTS: Based on 1166 parent-adolescent dyads, four latent classes were identified representing a continuum of practice use (high to low) - Complete Influencers (26%), Facilitating-Modeling Influencers (23%), Pressuring-Expecting Influencers (25%), and Indifferent Influencers (27%). Compared to dyads with parent underweight/healthy weight, dyads with parent overweight/obesity had 84% higher odds of belonging to Indifferent Influencers. Compared to dyads with adolescent underweight/healthy weight, dyads with adolescent overweight/obesity had 50 and 46% lower odds of belonging to Facilitating-Modeling and Indifferent Influencers. Odds of belonging to Pressuring-Expecting and Indifferent Influencers were less than 1% lower for every 1 min/day increase in parent MVPA and 2 and 4% lower for every 1 min/day increase in adolescent MVPA. Compared to dyads with high parental and adolescent agreement with PA-LPA, dyads with low agreement had between 3 and 21 times the odds of belonging to Facilitating-Modeling, Pressuring-Expecting, or Indifferent Influencers. CONCLUSIONS: Findings suggest that parents utilize distinct patterns of PA practices ranging from use of many, use of some, to low use of any practice and these patterns are differentially associated with parent and adolescent PA. When planning PA interventions, a counseling or intervening approach with parents to use combinations of practices, like facilitation and modeling, to positively influence their adolescents' and possibly their own participation in PA may prove more efficacious than parental pressuring or lack of practice use.

Evaluating Moderation of Parent-Teen Overweight/Obesity Relation by Household Socioeconomic Status.

Evidence links parent-offspring weight status, but few studies have evaluated whether markers of socioeconomic status moderate this relation. The 2014 Family Life, Activity, Sun, Health, and Eating study was used to assess intergenerational weight status in a national sample of parent-teen dyads. Multivariable logistic regression models assessed the relation between parent-teen weight status, controlling for teen and parent dietary factors, physical activity, demographic factors, and socioeconomic factors. Models with interaction assessed moderation by household food security status and participation in federal assistance programs. In fully adjusted models, sons were 2.66 (95% CI: 1.56, 4.55) times more likely to have overweight/obesity if their mother had overweight/obesity, and daughters were 3.35 (95% CI: 1.91, 5.86) times more likely. This relation was stronger in mother-son pairs in households with lower food security. These findings provide important new information that can be used to inform nutritional counseling efforts and educational programs that support families with socioeconomic disadvantage.

A national examination of neighborhood socio-economic disparities in built environment correlates of youth physical activity.

Adolescents in the U.S. do not meet current physical activity guidelines. Ecological models of physical activity posit that factors across multiple levels may support physical activity by promoting walkability, such as the neighborhood built environment and neighborhood socioeconomic status (nSES). We examined associations between neighborhood built environment factors and adolescent moderate-to-vigorous physical activity (MVPA), and whether nSES moderated associations. Data were drawn from a national sample of adolescents (12-17 years, N = 1295) surveyed in 2014. MVPA (minutes/week) were estimated from self-report validated by accelerometer data. Adolescents' home addresses were geocoded and linked to Census data from which a nSES Index and home neighborhood factors were derived using factor analysis (high density, older homes, short auto commutes). Multiple linear regression models examined associations between neighborhood factors and MVPA, and tested interactions between quintiles of nSES and each neighborhood factor, adjusting for socio-demographics. Living in higher density neighborhoods (B(SE): 9.22 (2.78), p = 0.001) and neighborhoods with more older homes (4.42 (1.85), p = 0.02) were positively associated with adolescent MVPA. Living in neighborhoods with shorter commute times was negatively associated with MVPA (-5.11 (2.34), p = 0.03). Positive associations were found between MVPA and the high density and older homes neighborhood factors, though associations were not consistent across quintiles. In conclusion, living in neighborhoods with walkable attributes was associated with greater adolescent MVPA, though the effects were not distributed equally across nSES. Adolescents living in lower SES neighborhoods may benefit more from physical activity interventions and environmental supports that provide opportunities to be active beyond neighborhood walkability.

Applying the information-motivation-behavioral skills model to explain adolescents' fruits and vegetables consumption.

Inadequate fruits and vegetables consumption in adolescence increases adolescents' current and future chronic disease risk and is predictive of inadequate consumption in adulthood. Given that adolescents' engagement in dietary behaviors is complicated by intrapersonal, interpersonal, and environmental factors, a health behavior model of change incorporating all of these factors is most appropriate to inform research and intervention efforts. Yet, common preventive health behavior models used to explain adolescents' dietary behaviors do not adequately account for these factors. The current study explored the utility of a comprehensive, predictive model, that is the Information-Motivation-Behavioral Skills (IMB) model, for explaining adolescents' fruits and vegetables consumption in a cross-sectional national sample. Study hypotheses included (1) health information and motivation for fruits and vegetables would directly be related to fruits and vegetables consumption; and (2) the relationship between fruits and vegetables consumption and health information and motivation would be mediated by behavioral skills for consumption. Data from the adolescent diet-related surveys of the Family Life, Activity, Sun, Health, and Eating (FLASHE) study (N = 1646) were used. Structural equation modeling was used to test study hypotheses. Fruits and vegetables-related information and motivation were positively related to adolescents' fruits and vegetables consumption. For information and personal motivation (specifically fruits and vegetables preferences), the relationship with fruits and vegetables consumption was partially mediated through behavioral skills. These preliminary findings support the utility of the IMB model to explain adolescents' fruits and vegetables consumption.

The relationship between food parenting practices, parental diet and their adolescents' diet.

OBJECTIVE: To determine whether parents' and adolescents' dietary behaviors for fruits and vegetables [FV], junk foods, and sugar sweetened beverages [SSBs] align with parents' food parenting practices for these behaviors. DESIGN: Data from the Family Life, Activity, Sun, Health and Eating (FLASHE), a cross-sectional, internet-based study, were analyzed. PARTICIPANTS: Parent and adolescent dyads (n = 1859) representative of the general U.S. MAIN OUTCOME MEASURES: Dependent variables: adolescent and parental dietary behaviors. INDEPENDENT VARIABLES: parents' food parenting practices for FV, SSBs, and junk food were assessed. ANALYSIS: General linear models with test of equal slopes were used to test study aims. RESULTS: Parents' diets and food parenting practices were consistent with their dietary behaviors. For their adolescents, parenting practices for FV consumption was positively related to adolescents' FV consumption, but parents/caregivers' rules/limits to avoid junk food/SSBs were positively related to adolescents' junk foods and SSBs consumption. CONCLUSIONS AND IMPLICATIONS: Continued parental modeling of dietary practices is important during adolescence. Future analyses should investigate adolescents' perceptions of parents' practices and behaviors as well as their exposure from other sources and their effect on adolescent (dietary) decision-making.

Interpersonal effects of parents and adolescents on each other's health behaviours: a dyadic extension of the theory of planned behaviour.

OBJECTIVE: Interpersonal relationships are important predictors of health outcomes and interpersonal influences on behaviours may be key mechanisms underlying such effects. Most health behaviour theories focus on intrapersonal factors and may not adequately account for interpersonal influences. We evaluate a dyadic extension of the Theory of Planned Behaviour by examining whether parent and adolescent characteristics (attitudes, subjective norms, perceived behavioural control and intentions) are associated with not only their own but also each other's intentions/behaviours. DESIGN: Using the Actor-Partner Interdependence Model, we analyse responses from 1717 parent-adolescent dyads from the Family Life, Activity, Sun, Health, and Eating study. MAIN OUTCOME MEASURES: Adolescents/parents completed self-reports of their fruit and vegetable consumption, junk food and sugary drinks consumption, engagement in physical activity, and engagement in screen time sedentary behaviours. RESULTS: Parent/adolescent characteristics are associated with each other's health-relevant intentions/behaviours above the effects of individuals' own characteristics on their own behaviours. Parent/adolescent characteristics covary with each other's outcomes with similar strength, but parent characteristics more strongly relate to adolescent intentions, whereas adolescent characteristics more strongly relate to parent behaviours. CONCLUSIONS: Parents and adolescents may bidirectionally influence each other's health intentions/behaviours. This highlights the importance of dyadic models of health behaviour and suggests intervention targets.

Modeling Parental Influence on Teenagers' Food Consumption: An Analysis Using the Family Life, Activity, Sun, Health, and Eating (FLASHE) Survey.

OBJECTIVE: To investigate (1) how perceived parental control, perceived parental modeling, and parent-teen co-decision making are associated with teenagers' consumption of fruits and vegetables as well as sugary drinks and less healthful food; and (2) whether self-efficacy mediates this relationship. DESIGN: Cross-sectional survey. PARTICIPANTS: A total of 1,657 adolescents aged 12-17years. MAIN OUTCOME MEASURE(S): Perceived parental control, perceived parental modeling, parent-teen co-decision making, self-efficacy, and consumption of fruits and vegetables as well as sugary drinks and less healthful food. ANALYSIS: Ordinary least-squares regressions and mediation analyses. RESULTS: After controlling for teenagers' self-efficacy, perceived parental control was not significantly associated with teenagers' fruit and vegetable consumption but it was negatively related to teenagers' consumption of sugary drinks and less nutrient-dense food. Perceived parental modeling had a positive correlation to teenagers' fruit and vegetable consumption and a negative relationship to their consumption of sugary drinks and less healthful food. Parent-teen co-decision making regarding teenagers' food consumption emerged as a positive predictor for teenagers' fruit and vegetable consumption but not for that of sugary drinks and foods with little nutritional value after controlling for self-efficacy. CONCLUSIONS AND IMPLICATIONS: Findings from this study demonstrated that perceived parental behaviors were related to teenagers' nutrition intakes. Not exerting too much control and having teenagers participate in the decision-making process could help teenagers eat more healthily. Furthermore, providing a positive role model for teenagers can be an effective strategy to encourage teenagers to eat better.