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Table 2 Search details and key findings of reviews #1–3

From: Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth

 

Timeline

Databases Used

Search Terms

Number of reviewers

Number of articles included

Review #1 – Physical activity

Nov. 2018 –

Nov. 2019

Ovid MEDLINE, Embase

Family: Family characteristics: family relations; parent-child relations; father-child relations; mother-child relations; parenting; parenting styles; parental behaviour; parents; fathers; mothers; siblings; sibling relations; bother; sister; attitudes; perception; attitude to health; health behaviours.

Physical activity: Physical activity; exercise; sport; physical exertion; aerobic; active transportation; active neighbourhood

2

739

Key findings

Physical activity modelling (n = 359):

• A review of reviews (k = 18; 375 quantitative studies) demonstrated that family behaviours, such as modelling or co-participation, had a stronger positive relationship with children’s physical activity than more general family household practices and beliefs [81].

• Parental physical activity was positively associated with their children’s physical activity levels (k = 10) [53].

• Longitudinal studies that followed families over a period of 5 years (from the time children were 5–6-year-olds to 10–12-year-olds) demonstrated that maternal physical activity [82], paternal reinforcement [82], and sibling co-participation [83] were positively associated with MVPA among pre-adolescent and adolescent boys and girls; however, only girls’ MVPA was negatively associated with maternal sedentary behavior [83].

• Findings from a systematic review of cross-sectional studies (k = 10) demonstrated that both parents’ modelling behaviours were positively associated with their children’s (3–19 years) physical activity behaviors [84].

• Parental modelling of active transportation was also important, such that it reduced the negative association between perceived safety and youth’s active transport [85], which is a significant barrier for active transportation for children and adolescents [86,87,88,89].

Parental emotional support (n = 234):

• Systematic reviews on children ([90] k = 3, [79]k = 11) and adolescents ([90] k = 4, [91]k = 75, [92] k = 52) found that familial and parental social support were consistently positively associated with increased physical activity in cross-sectional and longitudinal studies. For adolescent girls, this effect was slightly stronger when support came from the mother (r = .22) compared to support from both parents (r = .19) [92]. When examining studies that included both genders, more consistent positive associations were found when support came from the entire family or from both parents rather than each family member separately (e.g., mother, father, siblings) [91].

• Mixed results were found when examining the relationship between parental encouragement/support and outdoor play in children, with studies showing either positive or null relationships (k = 11) [93].

Sociodemographic factors (n = 172):

• Parental education and income, but not employment status, were associated with children’s physical activity [93].

• A systematic review (k = 12) indicated that children of higher educated parents engaged in less outdoor play [93]. This result was most consistent when maternal education was high (k = 6) [93]. This finding is also supported by independent studies and other systematic reviews, whereby children of mothers with a graduate or professional degree were more likely to be inactive [94] and less likely to use active transportation (k = 9) [95].

• Association between household income and physical activity varied depending on the type of physical activity. For outdoor play, a systematic review (k = 5) showed that there was no association between household income and time spent in outdoor play [93].

• Findings from independent studies show that higher household income was positively associated with children’s leisure physical activity [94] and engagement in sports [96, 97]; however, evidence from a systematic review (k = 21) showed that higher household income was negatively associated with use of active transportation [95].

Parental beliefs, attitudes, and knowledge (n = 134):

• Parental beliefs about safety of physical activity-related activities and their neighbourhood were shown to be important for outdoor play [88, 98], leisure [86, 99], and organized physical activity [99].

• Parental attitudes toward physical activity have been shown to be associated with youth’s physical activity; children of parents who believe physical activity is important are more likely to engage in organized [99, 100] and leisure [99, 101] physical activities.

• Parental modelling [102,103,104] and child stimulation of healthy dietary intake [104] were positively associated with children and youth physical activity levels.

Review #2 – Sedentary behaviour

Nov. 2018 –

Nov. 2019

Ovid MEDLINE, Embase

Family: Same search terms outlined in review #1

Sedentary behaviour: Sedentary lifestyle; sedentary behaviour; inactivity; physical inactivity; sitting; laying; TV; video games; Internet; computer; screen; smartphone; iPad; apps; mobile applications; social media; Facebook; YouTube; Twitter; Snapchat; Instagram; Pinterest; screen viewing; screen-time.

2

313

Key Findings

Parental behaviours (n = 104)

• Substantial evidence showed that parents’ sedentary behaviour and screen-time were positive correlates of children’s sedentary behaviour and screen-time [105,106,107,108,109,110,111,112,113,114,115,116,117,118,119].

• Studies that specifically examined mothers’ screen-based behaviours showed a positive correlation between mother and child’s screen-time [108, 120, 121].

• Some evidence showed that co-viewing with parents was associated with increased screen-time in children [121, 122].

Sociodemographic factors (n = 92)

• Parental education specifically and socioeconomic status more generally were negatively associated with sedentary behaviour and screen-time [123,124,125,126,127,128,129,130,131,132,133,134].

• Children and youth from families with higher socioeconomic status, but living in low- and middle-income countries, reported higher screen-time use than those from families with lower socioeconomic status [135].

• Mixed findings regarding how the presence, number, or type (younger vs., older) of sibling are associated with children’s sedentary behaviour and/or screen-time [121, 136,137,138].

Household practices (n = 84)

• Children who lived in a family with screen-time restrictions spent less time engaged in screen-based behaviours [126, 133, 139,140,141,142,143,144,145,146,147,148,149].

• Electronics in children and youth’s bedrooms were associated with increased time spent in screen viewing [110, 111, 134, 150,151,152,153,154,155,156].

• Number of electronics in the household was a positive predictor of screen viewing [144, 157].

• Eating meals in front of the TV was linked with greater sedentary behaviour and screen viewing [134, 144, 157,158,159].

Review #3 – Sleep

Nov. 2018 –

Nov. 2019

Ovid MEDLINE, Embase

Family: Same search terms outlined in review #1

Sleep: Sleep duration; sleep quality; sleep timing; sleep routine; sleep hygiene; sleep habits; sleep patterns; sleep efficiency; sleep behaviour; sleep interruption; sleep schedule.

2

189

Key Findings

Household practices (n = 81):

• Evidence showed that good sleep hygiene (e.g., regular bedtimes, read at bedtime, or fall asleep in bed) was positively associated with sleep duration [160,161,162,163,164,165,166], sleep quality [167], and negatively associated with sleep latency (the amount of time it takes to go from being fully awake to sleeping) [168].

• Implementing consistent bedtime routines (e.g., bath, massage, brushing teeth, and quiet activities) has been shown to be beneficial for sleep onset latency, frequency and duration of nighttime awakenings, and sleep consolidation [169].

• Electronic use was associated with shorter sleep duration [162, 170,171,172], and accessibility to electronics in the child’s bedroom was adversely associated with sleep outcomes (e.g., shorter sleep duration, delayed bedtime, increased daytime sleepiness) [164, 173,174,175,176,177].

• Parental presence until sleep onset (e.g., holding, rocking, feeding) was consistently associated with shorter sleep duration [170, 176, 178, 179].

• Sharing a bedroom or bed with siblings/parents was linked with adverse sleep outcomes such as shorter sleep duration, poor sleep quality, night awakenings, and daytime sleepiness [163, 180,181,182,183].

• Presence of positive parenting practices (e.g., eating dinner together, limiting screen-time, encouraging social maturity) was associated with longer sleep durations [184,185,186,187].

Sociodemographic factors (n = 54):

• Higher maternal education [172, 177, 188] and maternal employment [189,190,191] were associated with poor sleep outcomes (e.g., shorter sleep duration, sleep problems).

• Less optimal sleep outcomes (e.g., decreased sleep duration, delayed sleep onset) were evident in low socioeconomic families [192,193,194,195,196], and better sleep hygiene was more common in high socioeconomic families [177, 197].

Family environment (n = 29):

• More chaotic, disorganized, and irregular family environments were associated with negative sleep outcomes, including lower levels of sleep quality [160, 198], bedtime resistance and inconsistency [199], sleep problems (e.g., sleep assistance, daytime sleepiness) [200, 201] and delayed sleep onset [202].

• Good family relationships were associated with better sleep quality [167], whereas poor family relationships (e.g., emotional insecurity, low parental hardiness, marital insecurity) were associated with short sleep duration, poor sleep quality, and greater sleep problems [175, 203,204,205].