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

Being physically active is essential for maintaining and improving health, with benefits including normal growth and development, better mental functioning and sleep quality, and reduced risk for several chronic diseases and cancers [1]. Physical activity (PA) is important in childhood and adolescence because they are critical periods for developing movement skills, learning healthy habits, and establishing a foundation for lifelong health and well-being [1]. Yet evidence indicates that PA levels are insufficient in United States (US) adolescents 12–19 years of age with just 45% meeting the recommendation to engage in PA at least 1 h per day [2]. Thus, efforts are needed to increase PA levels of US adolescents to reduce their risk for chronic diseases and thus positively impact the nation’s health.

Parents can influence their children’s PA behaviors through the practices they use to support, encourage, and promote engagement in PA [3]. Parenting practices are the content and context specific childrearing approaches parents use to bring about behavioral outcomes in their children including participation in PA [4]. While systematic reviews have identified parenting practices, such as encouragement, support, and modeling, that are associated with child PA, findings across studies are inconsistent [3, 5, 6]. Lack of accordance in identifying dimensions of and operationalizing PA parenting practices may be partly to blame for inconclusive findings [4]. To address these issues, Mâsse and colleagues proposed a content map that includes three overarching, higher order PA parenting practice domains – neglect/control, autonomy support, and structure [4]. Neglect/control includes practices that are permissive (neglecting to plan child participation in PA) and pressuring (forcing child to participate in PA without consideration of child’s interest). Autonomy support includes encouragement, guided choice, involvement, and praise/reward practices that are intended to support child participation in PA. Structure practices include co-participation, expectations, facilitation, modeling, monitoring, and restriction for safety/academic concerns and are designed to structure the child’s physical and social environments to promote participation in PA. Autonomy support and structure practices are generally associated with positive PA outcomes in children [6, 7], while neglect/control practices are associated with negative outcomes [7].

Inconsistencies in research findings also may be partly due to studying individual relationships between parenting practices and children’s PA. That is, practices are often examined independently for associations with specific child outcomes of interest, like PA. Parenting practices often are not used in isolation with the use of some practices influencing the need for others [8]. For example, facilitating children’s PA by enrolling them in sports may influence parental involvement, such as watching their children play sports. Studies designed to determine which PA parenting practices are used in combination are lacking in the literature.

Research assessing relationships between use of PA parenting practices and parent and child characteristics, such as sex and body weight, is important because parenting practices may be influenced by their child’s phenotype as well as parent’s concerns and perceptions of the child’s risk for developing a particular problem (e.g., obesity) [3]. This concept is known as domain-specific parenting and may be associated with adolescent adjustment and adolescents’ experiences with their parents [9]. In one study designed to examine associations among parenting style, parenting practices, and child PA, maternal logistic support was associated with higher levels of PA among girls while paternal logistic support was associated with higher levels of PA among boys [10]. In another study designed to examine maternal and paternal correlates of child adiposity, an inverse association was found between paternal reinforcement and child PA; mothers reported higher use of limit setting and monitoring while fathers reported higher use of control [11]. However, a systematic review found limited evidence for associations between parental and child weight status and use of specific parenting practices [3]; hence results are inconsistent. For public health professionals to develop interventions promoting effective parenting practices that positively impact child PA, identifying which PA parenting practices are used in combination and which patterns are associated with increased PA, as well as exploring associations with parent and child characteristics is essential.

Most research has focused on specific PA parenting practices with less attention given to children’s willingness to comply with those practices. The choice to obey or not obey their parents’ behavioral rules is partially dictated by whether children believe their parents have the right to set such rules – a concept known as legitimacy of parental authority (LPA) [12]. As children age, they tend to desire more autonomy and less parental control or authority which may affect their behaviors. Domain-specific conceptions of LPA are important because adolescents’ domain-specific conceptions of LPA can be related to adolescent adjustment [9]. To date, LPA related to PA parenting practices has not been studied in both children and parents simultaneously.

In this paper, latent class analysis (LCA) was applied to publicly available data from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study to identify subtypes of parent-adolescent dyads that exhibited similar patterns of PA parenting practices. Because it was believed that relationships among parenting practices differed among individuals, a person-oriented approach (LCA) was used rather than a variable-oriented approach, such as factor analysis that assumes relationships between variables are the same for all individuals. FLASHE was designed to examine psychosocial, generational (parent-child), and environmental correlates of cancer preventive behaviors from individual and dyadic perspectives [13]. All three domains of PA parenting practices were measured – neglect/control, autonomy support, and structure – and fathers, underrepresented in the PA parenting practice literature [11], were purposively included [13]. A dyadic approach allowed for exploration of interdependence between parent- and adolescent-reported PA parenting practices. Hence, the objectives of this paper addressed three gaps in the literature: 1) determining patterns of PA parenting practices using a dyadic approach (simultaneous inclusion of both parent and child); 2) and person-oriented approach; and 3) investigating associations among patterns and parent and adolescent demographic, anthropometric and PA measures.

Demographic and anthropometric comparisons between analytic and excluded dyads (those missing PA data) revealed that significantly more parents were female (75% vs. 66%), non-Hispanic white (70% vs. 58%), and married (73% vs. 61%) in the analytic sample while more parents where male (34% vs. 25%), non-Hispanic black/African American (29% vs. 17%), divorced/widowed/separated (18% vs. 12%), and never married (16% vs. 9%) in the excluded sample. Additionally, more adolescents were non-Hispanic white (64%vs. 51%) and had healthy weight (69% vs. 58%) in the analytic sample while more adolescents were non-Hispanic black/African American (30% vs. 16%) and had overweight (29% vs. 15%) in the excluded sample. Characteristics of the parent-adolescent dyads in the analytic sample are presented in Table 1. The majority of parents were between 35 and 59 years of age (87%), female (73%), non-Hispanic white (71%), married (75%), and had overweight/obesity (58%). The majority of adolescents were female (52%), non-Hispanic white (66%), and had healthy weight (70%). Mean parent and adolescent MVPA were 84 and 110 min/day, respectively. Mean parent-reported parenting practices and PA-LPA values were generally higher than adolescent-reported values.

Correlations among PA parenting practices are presented in Table 2. For parent-reported practices, correlations ranged from weak (r_s = 0.24 between expectations and facilitation) to strong (r_s = 0.59 between pressuring and guided choice). For adolescent-reported practices, correlations ranged from moderate (r_s = 0.31 between expectations and facilitation) to strong (r_s = 0.59 between pressuring and expectations). Agreement between parent- and adolescent-reported practices ranged from fair (κ = 0.36 for expectations) to moderate (κ = 0.46 for pressuring). Agreement between parent- and adolescent-reported PA-LPA was fair (κ = 0.25, p < 0.001).

The purpose of this study was to determine patterns of parent- and adolescent-reported PA parenting practices and to investigate their associations with demographic, anthropometric, and PA measures. A continuum of four patterns emerged representing parents and adolescents who reported use of all 5 PA parenting practices (Complete Influencers), use of some of the practices (Facilitating-Modeling and Pressuring-Expecting Influencers), and low use of the practices (Indifferent Influencers). Significant associations among the four patterns and adolescent age, parent and adolescent BMI category and MVPA, as well as parent and adolescent agreement with PA-LPA were observed.

While it is somewhat difficult to compare the present study’s results to those in the literature due to the unique application of LCA which considers parenting practices in combination rather than separately, notable similarities were found. In an integrative review of PA parenting practices covering the period from 1998 to 2017, parental role modeling of PA and logistic support (facilitation) were found to have the greatest promise for positively influencing children’s PA [6]. Results from two subsequent studies conducted with adolescents with overweight/obesity also indicated that parental modeling of PA was associated with higher levels of adolescents’ self-reported MVPA [24] and tangible home support (facilitation) for PA was associated with higher levels of objectively measured light PA [25]. The present study’s results support these findings as facilitation and modeling were two practices reported as being used by parents in the Complete and Facilitating-Modeling Influencers, classes with higher parent and adolescent MVPA.

Interestingly, while Complete Influencers had the highest amounts of adolescent MVPA, Facilitating-Modeling and Indifferent Influencers had the lowest percentages of adolescents with overweight/obesity. Although these results appear somewhat contradictory, it is possible that parents in the Complete Influencers class were more aware of their adolescents’ health behaviors, as evidenced by their use of all PA practices, and this awareness extends to their adolescents’ weight status. Hence, parents of adolescents with overweight/obesity may use multiple practices to increase their adolescents’ PA whereas parents of adolescents with underweight/healthy weight are less concerned about and thus do not attempt to influence their adolescents’ PA. Another possibility is that parents of adolescents with overweight/obesity are more likely to use neglect/control practices, such as pressuring, that have adverse effects on child PA and hence might explain the higher percentages of adolescents with overweight/obesity in the Complete and Pressuring-Expecting Influencers classes. In a study assessing domain-specific parenting practices and adolescent behavior and adjustment, parental use of positive practices (e.g., monitoring) was related to positive adolescent adjustment while parental use of negative practices (e.g., neglect) was related to negative adolescent adjustments [9]. However, the study did not include adolescent PA or PA parenting practices so results may not directly relate to the current study’s results. Also, because FLASHE is a cross-sectional study, it is not possible to determine if parents are using PA practices in response to their adolescents’ weight status (i.e., domain-specific parenting) or if adolescents’ weight status is affected by the PA practices used (or not used) by their parents. Additional research is needed to either confirm or refute these findings as well as assess domain-specific use of PA parenting practices in adolescent children.

Somewhat contrasting the adolescent results, Complete and Facilitating-Modeling Influencers had the highest amounts of parent MVPA and the lowest percentages of parents with overweight/obesity. Results suggest that parents’ use of PA practices in combination, particularly structure practices, may positively influence their own PA behavior and weight status. One possible explanation for these results is that parents belonging to these two classes had more positive beliefs and attitudes and/or greater motivation and self-efficacy about their own physical activity, factors that have been associated with higher PA levels in adults [26‐28]. However, assessment of these factors was outside the scope of the current study. Clearly, associations between PA parent practices and parent PA behaviors and weight status deserve further study as they have not been previously reported in the literature.

One of the more intriguing findings is the positive association between PA parenting practices and PA-LPA. The likelihood of low agreement with PA-LPA increased as the number of reported practices used decreased across classes for both parents and adolescents. These results suggest that the more PA parenting practices perceived as being used, the more likely parents and their adolescents are to agree that parents have the legitimate authority to set rules about adolescent PA behaviors. Another supporting explanation is that as adolescent children move from childhood to adulthood, they demand, and parents grant them, increasing autonomy [29]. In the present study, this is evidenced by lower percentages of older adolescents in the Facilitating-Modeling and Indifferent Influencers, classes with the lowest use of parent-reported PA practices. The higher percentage of younger adolescents in the Pressuring-Expecting Influencers, a class with low use of adolescent-reported but not parent-reported PA practices, may reflect conflict between parents and adolescents, particularly given the discordance between parent agreement (high) and adolescent agreement (low) with PA-LPA. More research is needed in this area as few studies addressing PA or other obesity preventive behaviors in children have included constructs like LPA.

Several limitations of this study bear mentioning. All data, including height and weight, were based on self-report and hence are subject to bias. However, some studies suggest that self-reported height and weight result in low misclassification rates for BMI status in adults and adolescents [30, 31]. Dichotomizing measures of parenting practices and PA-LPA limited the ability to examine class differences in scales of agreement. Data are cross-sectional in nature and therefore causal relationships cannot be determined. Although the inclusion of multiple health behaviors is a strength of FLASHE, measuring constructs with single items may not have provided a comprehensive assessment. For example, facilitation involves not only taking children places to be physically active but also practices such as providing children with PA/sports equipment, enrolling children in sports and PA programs, and making PA into a game [4]. However, as is often the case with broad scope surveys, measures need to be brief to reduce participant burden. Although balanced sampling was used for FLASHE for similarity to the general US population for sex, income, age, household size, and region, demographic and anthropometric differences between the analytic and excluded dyads may limit generalizability of the study results. In particular, the current study’s lack of differential findings for parent and adolescent sex may at least partially be due to the higher proportion of male parent dyads missing relevant PA measures.

The study findings suggest that parents utilize distinct patterns of practices regarding PA ranging from high use of practices from all three domains (neglect/control, autonomy support, and structure), use of some neglect/control and/or structure practices, and low use of any practice. The highest and lowest use patterns are associated with the greatest and lowest amounts, respectively, of PA in both parents and adolescents. When planning PA interventions, a counseling or intervening approach with parents to advocate for use of 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.