Parent-perceived neighbourhood environment, parenting practices and preschool-aged children physical activity and screen time: A cross-sectional study of two culturally and geographically diverse cities

Authors: CERIN, ESTER - Australian Catholic University; BARNETT, ANTHONY - Australian Catholic University; BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC); LEE, REBECCA - Arizona State University; MELLECKER, ROBIN - University Of Hong Kong; SUEN, YI - University Of Hong Kong; MENDOZA, JASON - University Of Washington; Thompson, Deborah - Debbe; O'CONNOR, TERESIA - Children'S Nutrition Research Center (CNRC)

Submitted to: BMC Pediatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/19/2022
Publication Date: 5/27/2022
Citation: Cerin, E., Barnett, A., Baranowski, T., Lee, R.E., Mellecker, R.R., Suen, Y.N., Mendoza, J.A., Thompson, D.J., O'Connor, T.M. 2022. Parent-perceived neighbourhood environment, parenting practices and preschool-aged children physical activity and screen time: A cross-sectional study of two culturally and geographically diverse cities. BMC Pediatrics. 23:309. https://doi.org/10.1186/s12887-022-03377-0.
DOI: https://doi.org/10.1186/s12887-022-03377-0

Interpretive Summary: Preschool children's physical activity and screen use are influenced by a) the neighborhoods in which they live through opportunities to engage in physical activity and the safety of the neighborhood, and b) their parent's behaviors to encourage or discourage physical activity and screen use, called parenting practices. It is not known whether the relationship of these influences on children's physical activity and screen use are the same across cultures and geographic locations. We addressed this gap by pooling data from two studies which had used very similar methods among separate groups on children: one among Chinese children living in Hong Kong, an ultra-dense city, and the other among Hispanic children living in Houston, TX a large, but low-density city in the US. The Hong Kong sample consisted of 164 preschool-aged children and the Houston sample 84 preschool-aged children. Parents reported on the their sociodemographic characteristics, their perceptions of the neighborhood environment, physical activity and screen use parenting practices, and their child's screen use. Children wore accelerometers to measure their physical activity. The analysis took into account clustering of variables at the neighborhood level and found that Chinese children living in Hong Kong accumulated less physical activity during the study period than Hispanic children living in Houston. However, the Hispanic children living in Houston had more screen use time. Parents from Hong Kong used more parenting practices promoting inactivity than Hispanic parents living Houston. Neighborhood physical activity opportunities were positively related to children's physical activity only if parental perceptions of neighborhood safety were favorable. The associations of physical neighborhood environment characteristics with children's physical activity and screen time depended on parenting practices, but the correlates associated with children's physical activity and screen time did not differ by city. These findings support that there are different physical activity and screen use patterns among young children in Hong Kong and Houston, however, physical activity friendly and cohesive community environments, as well as parental support for physical activity are important in both geographic locations to support physical activity for young children.

Technical Abstract: Preschool-aged children's physical activity (PA) and screen time (ST) are important health-related behaviours likely influenced by PA opportunities, parental perceptions of neighbourhood safety and parenting practices pertaining to PA and ST. How these factors interact to impact on young children's PA and ST, and whether their effects are generalisable across cultures and geographical location is not known. This study addressed these knowledge gaps by conducting pooled analyses of comparable data from two culturally and geographically diverse samples - Chinese parent-child dyads from an ultra-dense city (Hong Kong, China) and Latino parent-child dyads from a low-density city (Houston, USA). The analytical sample consisted of 164 Hong Kong Chinese and 84 US Latino parent-child dyads with data on socio-demographic characteristics, parent-perceived neighbourhood destinations and facilities for children's PA, physical and social safety-related neighbourhood attributes, PA-related parenting practices and child's ST and accelerometer-assessed PA. Generalised linear models with robust standard errors accounting for neighbourhood-level clustering were used to estimate associations and interaction effects. Hong Kong Chinese children accumulated less PA than US Latino children, although the latter had more ST. Hong Kong Chinese parents reported more parenting practices promoting inactivity. Neighbourhood PA opportunities were positively related to children's PA only if parental perceptions of neighbourhood safety were favourable, and the associations of physical neighbourhood environment characteristics with children's PA and ST depended on PA-related parenting practices. Community cohesion was positively related to children's PA and negatively related to ST, while parental promotion of ST was positively associated with children's ST. Correlates of children's PA and ST did not differ by city. The substantial differences in activity patterns between Hong Kong Chinese and US Latino preschool-aged children observed in this study are likely due to a combination of cultural and built environmental factors. However, the fact that no between-city differences in correlates of PA and ST were detected indicates that both populations of children are equally affected by parent-perceived neighbourhood environmental characteristics and parenting practices. Overall, this study highlights the importance of considering how various individual-, home- and neighbourhood physical and social factors interact to influence young children's health-promoting activity levels.