The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study

Sara De Lepeleere, Ilse De Bourdeaudhuij, Greet Cardon, Maïté Verloigne, Sara De Lepeleere, Ilse De Bourdeaudhuij, Greet Cardon, Maïté Verloigne

Abstract

Background: In children, being sufficiently physically active, having low levels of screen-time and having a healthy diet are largely influenced by parenting practices. Children of parents applying positive parenting practices are at lower risk for overweight and obesity. Therefore, we investigated the effect of a health promoting online video intervention for parents ('Movie Models') on children's physical activity (PA), screen-time and healthy diet, and on specific parenting practices and parental self-efficacy related to these parenting practices. The online videos are delivered to parents of primary schoolchildren, and were based on real-life scenarios.

Methods: A two-armed, quasi experimental design was used. Parents of primary schoolchildren were recruited between November and December 2013 by spreading an appeal in social media, and by contacting primary schools. Participating parents were predominantly of high socio-economic status (SES) (83.1%), and only 6.8% of children were overweight/obese. Intervention group participants were invited to watch online videos for 4 weeks. Specific parenting practices, parental self-efficacy, PA, screen-time and healthy diet of the child were assessed at baseline (T0), at one (T1) and at four (T2) months post baseline. Repeated Measures (Multivariate) ANOVAs were used to examine intervention effects. The potential moderating effect of age and gender of the child and parental SES was also examined.

Results: Between T0 and T2, no significant intervention effects were found on children's PA, screen-time or healthy diet. Most significant intervention effects were found for more complex parenting practices (e.g., an increase in motivating the child to eat fruit). Subgroup analyses showed that the intervention had more effect on the actual parenting practices related to PA, screen-time and healthy diet in parents of older children (10-12 years old), whereas intervention effects on parental self-efficacy related to those behaviors were stronger in parents of younger children (6-9 years old).

Conclusions: 'Movie Models' was effective in increasing some important parenting practices and parental self-efficacy related to PA, screen-time and healthy diet in children. Therefore, the current study is an important first step in promoting effective parenting-related factors, and possibly increasing children's healthy diet and PA, and decreasing screen-time.

Trial registration: NCT02278809 in ClinicalTrials.gov on October 28, 2014 (retrospectively registered).

Keywords: Child; Healthy diet; Parent; Parental self-efficacy; Parenting; Parenting practices; Physical activity; Screen-time.

Figures

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Fig. 1
Participants flow through the study

References

    1. Berenson GS. Health consequences of obesity. Pediatr Blood Cancer. 2012;58:117–121. doi: 10.1002/pbc.23373.
    1. Ekelund U, Luan J, Sherar LB, Esliger DW, Griew P, Cooper A. Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents. JAMA. 2012;307:704–712. doi: 10.1001/jama.2012.156.
    1. Gerards SM, Sleddens EF, Dagnelie PC, de Vries NK, Kremers SP. Interventions addressing general parenting to prevent or treat childhood obesity. Int J Pediatr Obes. 2011;6:e28–e45. doi: 10.3109/17477166.2011.575147.
    1. Helland SH, Bere E, Overby NC. Study protocol for a multi-component kindergarten-based intervention to promote healthy diets in toddlers: a cluster randomized trial. BMC Public Health. 2016;16:273. doi: 10.1186/s12889-016-2952-x.
    1. Maffeis C. Aetiology of overweight and obesity in children and adolescents. Eur J Pediatr. 2000;159(Suppl 1):S35–S44. doi: 10.1007/PL00014361.
    1. Magnusson MB, Sjoberg A, Kjellgren KI, Lissner L. Childhood obesity and prevention in different socio-economic contexts. Prev Med. 2011;53:402–407. doi: 10.1016/j.ypmed.2011.09.019.
    1. de Jong E, Schokker DF, Visscher TL, Seidell JC, Renders CM. Behavioural and socio-demographic characteristics of Dutch neighbourhoods with high prevalence of childhood obesity. Int J Pediatr Obes. 2011;6:298–305. doi: 10.3109/17477166.2011.583659.
    1. Verloigne M, Van LW, Maes L, Yildirim M, Chinapaw M, Manios Y, Androutsos O, Kovacs E, Bringolf-Isler B, Brug J, De BI. Levels of physical activity and sedentary time among 10- to 12-year-old boys and girls across 5 European countries using accelerometers: an observational study within the ENERGY-project. Int J Behav Nutr Phys Act. 2012;9:34. doi: 10.1186/1479-5868-9-34.
    1. Brug J, van Stralen MM, Te Velde SJ, Chinapaw MJ, De BI LN, Bere E, Maskini V, Singh AS, Maes L, et al. Differences in Weight Status and Energy-Balance Related Behaviors among Schoolchildren across Europe: The ENERGY-Project. PLoS One. 2012;7 doi: 10.1371/journal.pone.0034742.
    1. Tremblay MS, LeBlanc AG, Janssen I, Kho ME, Hicks A, Murumets K, Colley RC, Duggan M. Canadian sedentary behaviour guidelines for children and youth. Appl Physiol Nutr Metab. 2011;36:59–64. doi: 10.1139/H11-012.
    1. Patrick H, Hennessy E, McSpadden K, Oh A. Parenting styles and practices in children’s obesogenic behaviors: scientific gaps and future research directions. Child Obes. 2013;9(Suppl):S73–S86. doi: 10.1089/chi.2013.0039.
    1. Lindsay AC, Sussner KM, Kim J, Gortmaker S. The role of parents in preventing childhood obesity. Futur Child. 2006;16:169–186. doi: 10.1353/foc.2006.0006.
    1. Campbell K, Hesketh K, Crawford D, Salmon J, Ball K, McCallum Z. The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: cluster-randomised controlled trial. BMC Public Health. 2008;8:103. doi: 10.1186/1471-2458-8-103.
    1. Trost SG, Loprinzi PD. Parental Influences on Physical Activity Behavior in Children and Adolescents: A Brief Review. Am J Lifestyle Med. 2011;5:171–181. doi: 10.1177/1559827610387236.
    1. Ventura AK, Birch LL. Does parenting affect children’s eating and weight status? Int J Behav Nutr Phys Act. 2008;5:15. doi: 10.1186/1479-5868-5-15.
    1. Sleddens EF, Kremers SP, Stafleu A, Dagnelie PC, de Vries NK, Thijs C. Food parenting practices and child dietary behavior. Prospective relations and the moderating role of general parenting. Appetite. 2014;79:42–50. doi: 10.1016/j.appet.2014.04.004.
    1. Rodenburg G, Kremers SP, Oenema A, van de Mheen D. Associations of children’s appetitive traits with weight and dietary behaviours in the context of general parenting. PLoS One. 2012;7 doi: 10.1371/journal.pone.0050642.
    1. Baranowski T, Jago R. Understanding the mechanisms of change in children’s physical activity programs. Exerc Sport Sci Rev. 2005;33:163–168. doi: 10.1097/00003677-200510000-00003.
    1. Jago R, Sebire SJ, Turner KM, Bentley GF, Goodred JK, Fox KR, Stewart-Brown S, Lucas PJ. Feasibility trial evaluation of a physical activity and screen-viewing course for parents of 6 to 8 year-old children: Teamplay. Int J Behav Nutr Phys Act. 2013;10:31. doi: 10.1186/1479-5868-10-31.
    1. Deci EL, Ryan RM. The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychol Inq. 2000;11:227–268. doi: 10.1207/S15327965PLI1104_01.
    1. Deci EL. Why we do wat we do: understanding self-motivation. New York: Penguin; 1995.
    1. Grolnick WS, Deci EL, Ryan RM. Internalization within the family: the Self-Determination Theory Perspective. In: Parenting and children’s internalization of values: A handbook of contemporary theory. Grusec JE, Kuczynski L. Hoboken: Wiley; 1997. p. 135–161
    1. Golley RK, Hendrie GA, Slater A, Corsini N. Interventions that involve parents to improve children’s weight-related nutrition intake and activity patterns - what nutrition and activity targets and behaviour change techniques are associated with intervention effectiveness? Obes Rev. 2011;12:114–130. doi: 10.1111/j.1467-789X.2010.00745.x.
    1. Verloigne M, Bere E, Van LW, Maes L, Lien N, Vik FN, Brug J, Cardon G, De BI. The effect of the UP4FUN pilot intervention on objectively measured sedentary time and physical activity in 10-12 year old children in Belgium: the ENERGY-project. BMC Public Health. 2012;12:805. doi: 10.1186/1471-2458-12-805.
    1. Centis E, Marzocchi R, Di LR, Moscatiello S, Salardi S, Villanova N, Marchesini G. A controlled, class-based multicomponent intervention to promote healthy lifestyle and to reduce the burden of childhood obesity. Pediatr Obes. 2012;7:436–445. doi: 10.1111/j.2047-6310.2012.00079.x.
    1. O’Connor TM, Jago R, Baranowski T. Engaging parents to increase youth physical activity a systematic review. Am J Prev Med. 2009;37:141–149. doi: 10.1016/j.amepre.2009.04.020.
    1. Zenzen W, Kridli S. Integrative review of school-based childhood obesity prevention programs. J Pediatr Health Care. 2009;23:242–258. doi: 10.1016/j.pedhc.2008.04.008.
    1. Shaya FT, Flores D, Gbarayor CM, Wang J. School-based obesity interventions: a literature review. J Sch Health. 2008;78:189–196. doi: 10.1111/j.1746-1561.2008.00285.x.
    1. Gonzalez-Suarez C, Worley A, Grimmer-Somers K, Dones V. School-based interventions on childhood obesity: a meta-analysis. Am J Prev Med. 2009;37:418–427. doi: 10.1016/j.amepre.2009.07.012.
    1. van Sluijs EM, McMinn AM, Griffin SJ. Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials. BMJ. 2007;335:703. doi: 10.1136/.
    1. Stice E, Shaw H, Marti CN. A meta-analytic review of obesity prevention programs for children and adolescents: the skinny on interventions that work. Psychol Bull. 2006;132:667–691. doi: 10.1037/0033-2909.132.5.667.
    1. Plantin L, Daneback K. Parenthood, information and support on the internet. A literature review of research on parents and professionals online. BMC Fam Pract. 2009;10:34. doi: 10.1186/1471-2296-10-34.
    1. Ruiter EL, Fransen GA, Molleman GR, van der Velden K, Engels RC. The effectiveness of a web-based Dutch parenting program to prevent overweight in children 9-13 years of age: study protocol for a two-armed cluster randomized controlled trial. BMC Public Health. 2015;15:148. doi: 10.1186/s12889-015-1394-1.
    1. Onnerfalt J, Erlandsson LK, Orban K, Broberg M, Helgason C, Thorngren-Jerneck K. A family-based intervention targeting parents of preschool children with overweight and obesity: conceptual framework and study design of LOOPS- Lund overweight and obesity preschool study. BMC Public Health. 2012;12:879. doi: 10.1186/1471-2458-12-879.
    1. Raat H, Struijk MK, Remmers T, Vlasblom E, van Grieken A, Broeren SM, te Velde SJ, Beltman M, Boere-Boonekamp MM, L’Hoir MP. Primary prevention of overweight in preschool children, the BeeBOFT study (breastfeeding, breakfast daily, outside playing, few sweet drinks, less TV viewing): design of a cluster randomized controlled trial. BMC Public Health. 2013;13:974. doi: 10.1186/1471-2458-13-974.
    1. De Lepeleere S, DeSmet A, Verloigne M, Cardon G, De Bourdeaudhuij I. What practices do parents perceive as effective or ineffective in promoting a healthy diet, physical activity, and less sitting in children: parent focus groups. BMC Public Health. 2013;13:1067. doi: 10.1186/1471-2458-13-1067.
    1. Brug J, Oenema A, Ferreira I. Theory, evidence and Intervention Mapping to improve behavior nutrition and physical activity interventions. Int J Behav Nutr Phys Act. 2005;2:2. doi: 10.1186/1479-5868-2-2.
    1. De Lepeleere S, Verloigne M, Brown HE, Cardon G, De Bourdeaudhuij I. Using the Intervention Mapping Protocol to develop an online video intervention for parents to prevent childhood obesity: Movie Models. Glob Health Promot. 2016;0:1–11.
    1. Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992;82:816–820. doi: 10.2105/AJPH.82.6.816.
    1. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–1243. doi: 10.1136/bmj.320.7244.1240.
    1. Deforche B, De Bourdeaudhuij I, D’hondt E, Cardon G. Objectively measured physical activity, physical activity related personality and body mass index in 6- to 10-yr-old children: a cross-sectional study. Int J Behav Nutr Phys Act. 2009;6:25. doi: 10.1186/1479-5868-6-25.
    1. Cancela JM, Ayan C, Castro A. An evaluation of questionnaires assessing physical activity levels in youth populations. J Child Health Care. 2013;17:274–293. doi: 10.1177/1367493512461571.
    1. Huybrechts I, De Backer G, De Bacquer D, Maes L, De Henauw S. Relative validity and reproducibility of a food-frequency questionnaire for estimating food intakes among Flemish preschoolers. Int J Environ Res Public Health. 2009;6:382–399. doi: 10.3390/ijerph6010382.
    1. Trost SG, Sallis JF, Pate RR, Freedson PS, Taylor WC, Dowda M. Evaluating a model of parental influence on youth physical activity. Am J Prev Med. 2003;25:277–282. doi: 10.1016/S0749-3797(03)00217-4.
    1. Larios SE, Ayala GX, Arredondo EM, Baquero B, Elder JP. Development and validation of a scale to measure Latino parenting strategies related to children’s obesigenic behaviors. The parenting strategies for eating and activity scale (PEAS) Appetite. 2009;52:166–172. doi: 10.1016/j.appet.2008.09.011.
    1. Sleddens EF, Kremers SP, de Vries NK, Thijs C. Relationship between parental feeding styles and eating behaviours of Dutch children aged 6-7. Appetite. 2010;54:30–36. doi: 10.1016/j.appet.2009.09.002.
    1. Sherwood NE, Taylor WC, Treuth M, Klesges LM, Baranowski T, Zhou A, Pratt C, McClanahan B, Robinson TN, Pruitt L, Miller W. Measurement characteristics of activity-related psychosocial measures in 8- to 10-year-old African-American girls in the Girls Health Enrichment Multisite Study (GEMS) Prev Med. 2004;38(Suppl):S60–S68. doi: 10.1016/j.ypmed.2003.12.030.
    1. Decker JW. Initial development and testing of a questionnaire of parental self-efficacy for enacting healthy lifestyles in their children. J Spec Pediatr Nurs. 2012;17:147–158. doi: 10.1111/j.1744-6155.2012.00330.x.
    1. Crespo NC, Elder JP, Ayala GX, Slymen DJ, Campbell NR, Sallis JF, McKenzie TL, Baquero B, Arredondo EM. Results of a Multi-level Intervention to Prevent and Control Childhood Obesity among Latino Children: The Aventuras Para Ninos Study. Ann Behav Med. 2012;43:84–100. doi: 10.1007/s12160-011-9332-7.
    1. De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. Do specific parenting practices and related parental self-efficacy associate with physical activity and screen time among primary schoolchildren? A cross-sectional study in Belgium. BMJ Open. 2015;5 doi: 10.1136/bmjopen-2014-007209.
    1. Cohen J. Statistical power analysis for the behavioural sciences. 2. Hillsdale: Erlbaum; 1988.
    1. Naylor PJ, Trill DG. Mind the Gap! A randomized comparison trial to explore the impact of a family-based vegetable cooking intervention for children and their parents. Submitted in International Journal of Behaviour Nutrition and Physical Activity. 2016.
    1. Manicavasagar V, Horswood D, Burckhardt R, Lum A, Hadzi-Pavlovic D, Parker G. Feasibility and effectiveness of a web-based positive psychology program for youth mental health: randomized controlled trial. J Med Internet Res. 2014;16 doi: 10.2196/jmir.3176.
    1. Roberts BP, Blinkhorn AS, Duxbury JT. The power of children over adults when obtaining sweet snacks. Int J Paediatr Dent. 2003;13:76–84. doi: 10.1046/j.1365-263X.2003.00434.x.
    1. Yildirim M, van Stralen MM, Chinapaw MJ, Brug J, van Mechelen W, Twisk JW, Te Velde SJ. For whom and under what circumstances do school-based energy balance behavior interventions work? Systematic review on moderators. Int J Pediatr Obes. 2011;6:e46–e57. doi: 10.3109/17477166.2011.566440.
    1. Vik FN, Lien N, Berntsen S, De BI, Grillenberger M, Manios Y, Kovacs E, Chinapaw MJ, Brug J, Bere E. Evaluation of the UP4FUN intervention: a cluster randomized trial to reduce and break up sitting time in European 10-12-year-old children. PLoS One. 2015;10:e0122612. doi: 10.1371/journal.pone.0122612.
    1. Gerards SM, Dagnelie PC, Gubbels JS, van BS HFJ, Jansen MW, van der Goot OH, de Vries NK, Sanders MR, Kremers SP. The effectiveness of lifestyle triple P in the Netherlands: a randomized controlled trial. PLoS One. 2015;10 doi: 10.1371/journal.pone.0122240.
    1. Portney LG, Watkins MP. Foundations of Clinical Research - Applications to Practice. 3. New Jersey: Pearson Education; 2009.

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