Background
Methods
Subjects and procedures
Behavioural model
Questionnaire
Scale/item | # items | Cronbach’s α/Pearson’s coefficient (r) | Examples of items, answer categories and score range |
---|---|---|---|
Outcomes
| |||
Child’s snacking behaviour | 4 | - | How many days a week does your child eat snacks (crisps, cheese cubes etcetera or sweets)? Never (0) – every day (7). How many portions (crisps, cheese cubes etcetera or sweets) does your child eat per day? 1-2 portions a day (1) – more than 4 portions a day (3) |
Child’s outdoors playing | 2 | - | How many days a week does your child play outdoors (outside school time) Never (0) – every day (7). How long does your child generally play outdoors? Less than half an hour per day (1) – more than 3 hours per day (5). |
Intention snack intake | 1 | - | For the next six months, I plan to make sure my child does not eat too many sweets and snacks. Certainly not (-2) – certainly (2)a
|
Intention playing outdoors | 1 | - | Do you plan to be alert to see that your child plays outdoors enough to prevent or diminish overweight in the next six months? Certainly not (-2) – certainly (2) |
Distal factors
| |||
Beliefs about genetic causes of overweight | 8 | α =0.75 | A person’s physique is hereditary. Totally disagree (-2) – totally agree (2) |
Perceived child weight | 2 | r = 0.83 | What do you think of your child’s weight at this moment? Compared to other children of his/her age, I find my child…. Far too heavy (-2) – far too light (2) |
Monitoring (CFQ)b
| 3 | α = 0.91 | How much do you keep track of the sweets (candy, ice cream, cream cake) that your child eats? Never (-2) – Always (2) |
TPB factors
| |||
Attitude snack intake | 6 | α = 0.61 | I think it’s alright to watch my child at all time so he/she does not eat too many sweets and snacks. Totally disagree (-2) – totally agree (2) |
Subjective social norm snack intake | 3 | α = 0.85 | My partner thinks that I should be alert and see that my child does not eat too many candies and snacks. Certainly not (-2) – certainly (2) |
Perceived behavioural control snack intake | 2 | r = 0.42 | Do you think that you will succeed in continuing to watch your child so he/she does not eat too many sweets and snacks if he/she keeps asking for snacks. Certainly not (-2) - certainly (2) |
Attitude playing outdoors | 6 | α = 0.45 | If I make sure my child plays outdoors enough, he/she will not become/be less overweight. Totally disagree (-2) – totally agree (2) |
Subjective social norm playing outdoors | 3 | α = 0.91 | My parents think that I should be alert and make sure my child plays outdoors enough. Certainly not (-2) – certainly (2) |
Perceived behavioural control playing outdoors | 2 | r = 0.50 | Do you think that you will succeed in getting your child to play outdoors enough if he/she wants to watch TV and he/she keeps on at you? Certainly not (-2) - certainly (2) |
Analyses
Results
Response and characteristics of response groups
Total | Dutch | Turkish | ||||
---|---|---|---|---|---|---|
n | % | n | % | n | % | |
Sex of the child | ||||||
female | 432 | 49.2 | 306 | 49.0 | 126 | 49.8 |
male | 446 | 50.8 | 319 | 51.0 | 127 | 50.2 |
Child’s age | ||||||
6-8 years | 466 | 54.3 | 340 | 54.8 | 126 | 52.9 |
≥ 8 years | 392 | 45.7 | 280 | 45.2 | 112 | 47.1 |
Ethnicity | ||||||
Dutch | 626 | 71.0 | - | - | - | - |
Turkish | 256 | 29.0 | - | - | - | - |
Overweight child | ||||||
no overweight | 643 | 84.3 | 506 | 89.9** | 137 | 68.5 |
overweight | 90 | 11.8 | 45 | 8.0** | 45 | 22.5 |
obese | 30 | 3.9 | 12 | 2.1** | 18 | 9.0 |
Sex of the parent | ||||||
female | 773 | 88.2 | 574 | 91.8** | 199 | 79.3 |
male | 103 | 11.8 | 51 | 8.2** | 52 | 20.7 |
Parental education | ||||||
low | 322 | 37.9 | 168 | 27.2** | 154 | 66.4 |
middle | 346 | 40.8 | 284 | 46.0** | 62 | 26.7 |
high | 181 | 21.3 | 165 | 26.7** | 16 | 6.9 |
Beliefs about overweight prevention and management
Total | Dutch | Turkish | |
---|---|---|---|
Mean (sd) | Mean (sd) | Mean (sd) | |
Parental intention outdoor play (-2 = low; 2 = high) | .62 (1.24) | .76 (1.15)** | .27 (1.36) |
Parental intention snack intake (-2 = low; 2 = high) | .98 (1.62) | 1.12 (1.10)** | .62 (1.24) |
Child behaviour playing outdoors (0 = never; 35 = all days more than 3 hours) | 16.05 (9.16) | 16.14 (8.44)** | 15.81 (10.85) |
Child behaviour snack intake (0 = never; 21 = all days more than 4 portions) | 7.54 (5.95) | 7.16 (5.99)** | 8.50 (5.77) |
Belief that genetic factors cause overweight (-2 = not important; 2 = important) | -.15 (.52) | -.18 (.47)** | -.07 (.63) |
Factors associated with parental intentions to monitor physical activity and diet
Outdoor play | Snack intake | |||||
---|---|---|---|---|---|---|
intention | intention | |||||
Step 1 | Step 2 | Step 3 | Step 1 | Step 2 | Step 3 | |
Step 1: Distal factors
| ||||||
Ethnicity (Turkish vs. Dutch (reference) | -.466** | -.399** | -.399** | -.410** | -.373** | -.334* |
Educational level (middle vs low (reference)) | .213* | .128 | .117 | .336** | .171* | .175* |
Educational level (high vs low (reference)) | .137 | .016 | .006 | .340** | .107 | .122 |
Age of child | -.066** | -.047** | -.043** | -.066** | -.033* | -.032* |
Perceived child weight (-2 = far too heavy, 2 = far too light) | -.315** | -.315** | -.436** | -.291** | -.236** | -.500** |
Belief that genetic factors cause overweight (-2 = not important; 2 = important) | -.149 | -.052 | -.050 | -.055 | .015 | .011 |
Step 2: TPB factors
| ||||||
Attitude | .522** | .393** | .524** | .506** | ||
Subjective norm | .366** | .432** | .386** | .407** | ||
Perceived behavioural control | .194** | .242** | .079 | .083 | ||
Step 3: Interaction terms
| ||||||
Perceived child weight x attitude | .149 | .248* | ||||
Perceived child weight x subjective norm | -.100 | .071 | ||||
Perceived child weight x perceived behavioural control | .050 | .080 | ||||
Ethnicity x attitude | .333 | -.034 | ||||
Ethnicity x subjective norm | -.167* | -.105 | ||||
Ethnicity x perceived behavioural control | -.166 | .022 | ||||
ΔR2
| .081 | .242 | .014 | .096 | .252 | .012 |
Full model | R2 = .337 | R2 = .360 |
Factors associated with reported child behaviour regarding physical activity and diet
Outdoor play | Snack intake | |||||
---|---|---|---|---|---|---|
behaviour | behaviour | |||||
Step 1 | Step 2 | Step 3 | Step 1 | Step 2 | Step 3 | |
Step 1: Distal factors
| ||||||
Ethnicity (Turkish vs. Dutch (reference)) | -.081** | -.057* | -.068 | .092** | .049 | .032 |
Educational level (middle vs low (reference)) | -.031 | -.014 | -.015 | -.017 | -.031 | -.026 |
Educational level (high vs low (reference)) | -.042 | -.014 | -.014 | -.026 | -.023 | -.018 |
Age of child | .005 | .010** | .011** | .014** | .009 | .009 |
Perceived child weight (-2 = far too heavy, 2 = far too light) | .008 | -.007 | -.014 | .007 | .025 | -.015 |
Belief that genetic factors cause overweight | .001 | .018 | .016 | .015 | .010 | .008 |
Step 2: TPB factors
| ||||||
Attitude | .014 | .002 | -.082** | -.078** | ||
Subjective norm | .001 | -.003 | .033 ** | .033* | ||
Perceived behavioural control | .144** | .147** | -.054** | -.058** | ||
Step 3: Interaction terms
| ||||||
Perceived child weight x attitude | .024 | .005 | ||||
Perceived child weight x subjective norm | -.017 | -.015 | ||||
Perceived child weight x perceived behavioural control | -.008 | .050* | ||||
Ethnicity x attitude | .037 | -.021 | ||||
Ethnicity x subjective norm | .022 | .000 | ||||
Ethnicity x perceived behavioural control | -.007 | .034 | ||||
ΔR2
| .018 | .200 | .006 | .036 | .049 | .011 |
Full model | R2 = .224 | R2 = .096 |
Discussion
Conclusions
Keypoints
-
A comprehensive study of the relationship between behavioural cognitions of parents of pre-adolescent children and overweight preventive behaviour is lacking.
-
Differences have been found between ethnic populations regarding the children’s physical activity and diet behaviours and parental intentions to monitor these behaviours.
-
Parental attitudes and social norms contribute to the intention to monitor the child’s outdoor play and snack intake.
-
Parental perceived behavioural control is associated with the child’s outdoor play and, in parents who perceive their child to be overweight, with the child’s snacking behaviour.