Maternal awareness of 4-year-old children’s physical activity and
correlates of overestimation
Southampton Women’s Survey (SWS)
Kathryn R Hesketh1; Alison M McMinn1,2; Esther MF van Sluijs1,2; Nicholas C Harvey3;
Cyrus Cooper3; Hazel M Inskip3; Keith M Godfrey3; Simon J Griffin1,2
1UKCRC
Centre of Excellence for Diet and Activity Research (CEDAR), Institute of Public Health, Cambridge, UK;
2Medical
Research Council Epidemiology Unit, Cambridge, UK;
3MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
Contact: Kathryn Hesketh: krh40@medschl.cam.ac.uk
Introduction
• Parents are seen as the gatekeepers of young children’s
physical activity (PA).
• Parental awareness of their child’s PA level may be important
to the success of interventions to promote PA.
• Parents of inactive 9-10-year-old children tend to overestimate
their child’s PA levels† but this association has not been
investigated in young children.
Table 1: Classification of children into physical activity awareness
categories by maternal perception and objective measurement of child
PA level
n (%)
Inactive
Active
Perceived Inactive
20 (4.2)
Realistic
Perceived Active
175 (36.6)
Over-estimators
Total
195 (40.8)
20 (4.2)
Under-estimators
263 (55.0)
Realistic
283 (59.2)
Table 2: Association between child and maternal characteristics
and maternal overestimation of their child's physical activity
Aims
Variable
• To assess maternal awareness of PA in 4-year-old children.
• To establish what factors are associated with maternal
overestimation of PA in these children.
Methods
• Data was obtained from the Southampton Women’s Survey, a
UK population-based longitudinal study.
• This cross-sectional analysis used data from a subsample of
participants invited to take part in a secondary study when their
child was 4 years old.
• PA was measured objectively using Actiheart monitors for ≤7
days and daily minutes of moderate-to-vigorous PA (MVPA)
were derived.
• Children were classified as active/inactive based on whether
they accumulated 60 minutes of MVPA. This, along with
maternal perception of PA (active/inactive) was used to
categorise awareness (Table 1).
• 15 child and maternal characteristic exposure variables were
derived from a maternally completed questionnaire.
• Associations between each exposure variable and whether or
not mothers overestimated their child’s PA were assessed using
logistic regression: first unadjusted (Model 1), then adjusted for
variables that were associated with overestimation in the
unadjusted models (Model 2) (Table 2).
• Those children whose mothers underestimated their PA level
were excluded from analyses.
Results
• Data was available for 486 children: mean age 4.1 ± 0.1 years;
47% male; mean ± SD of 70.3 ± 30.7 minutes in MVPA per day.
• 40.8 % of children were inactive: 89.7% of these children were
perceived to be active by their mothers (over-estimators).
• After adjustment, three factors were significantly associated
with maternal overestimation of physical activity (Table 2).
Child characteristics
Sex (ref: male)
Age (in years)
BMI (kgm-2)
Has a sibling living at home (ref: no sibling)
Attends nursery (ref: part-time)
Full-time
Other
Maternal Characteristics
Age (in years)
BMI (kgm-2)
Age leaving full-time education (ref:<16years)
17-18 years
>18 years
Maternal Perception
Child is outgoing (ref: Strongly/disagree)
Neither
Agree
Strongly Agree
Child is restless (ref: Strongly disagree)
Disagree
Neither
Strongly/Agree
Child is well behaved (ref: disagree/no opinion)
Agree
Strongly agree
Child enjoys PA (ref: Disagree/ no opinion)
Agree
Strongly agree
PA is important (ref: disagree/no opinion)
Agree
Strongly agree
Child is not interested in PA (ref: never)
Rarely
Sometimes/often/very often
Child doesn’t have the skills for PA (ref: never)
Rarely
Sometimes/often/very often
Model 1
OR (95% CI)
Model 2
OR (95% CI)
1.18 (0.81, 1.73)
0.62 (0.03, 13.4)
1.05 (0.91, 1.21)
0.53 (0.34, 0.84)** 0.53 (0.33, 0.83)**
2.17 (1.09, 4.32)*
1.04 (0.25, 4.42)
2.28 (1.13, 4.60)*
0.99 (0.23, 4.28)
1.00 (0.95, 1.06)
1.00 (0.97, 1.04)
1.32 (0.83, 2.10)
0.91 (0.56, 1.47)
1.30(0.57, 2.97)
1.35 (0.64, 2.88)
0.97 (0.44, 2.12)
1.02 (0.61, 1.72)
0.91 (0.53, 1.55)
0.66 (0.33, 1.31)
1.65 (1.01, 2.70)
1.85 (1.00, 3.41)
4.77 (1.05, 21.8)*
4.37 (0.98, 19.6)*
4.70 (1.00, 22.1)*
4.56 (0.99, 21.0)*
1.27 (0.42, 3.91)
1.04 (0.47, 4.12)
1.10 (0.68, 1.77)
0.81 (0.52, 1.27)
1.68 (0.99, 2.85)
1.30 (0.78, 2.16)
*p≤0.05 **p<0.01
Model 2: Adjusted for nursery attendance, sibling at home and perceived enjoyment of PA
Conclusions
• A large proportion of mothers of inactive four-year-olds inaccurately perceive their child to be active, as shown previously in
older children. This may be important to consider when developing interventions to promote physical activity in this age group.
• Promoting awareness of activity levels in mothers of inactive children who attend nursery full-time and who do not have siblings may
be particularly important.
† Corder et al. Am J Prev Med 2010; 38(1);1-8
The work of K Hesketh was supported by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research
Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council,
the National Institute for Health Research and the Wellcome Trust under the auspices of the UK Clinical Research Collaboration, is
gratefully acknowledged. www.esrc.ac.uk/publichealthresearchcentres