Liu 2017

Accepted Manuscript
Title: Associations between parental support for physical activity and

moderate-to-vigorous physical activity among chinese school children: a cross-
sectional study
Author: Yang Liu, Yajun Zhang, Sitong Chen, Jialin Zhang, Zongchen Guo,
Peijie Chen
PII: S2095-2546(17)30119-9
DOI: http://dx.doi.org/doi: 10.1016/j.jshs.2017.09.008
Reference: JSHS 424
To appear in: Journal of Sport and Health Science
Received date: 25-5-2017

Revised date: 4-7-2017
Accepted date: 23-8-2017
Please cite this article as: Yang Liu, Yajun Zhang, Sitong Chen, Jialin Zhang, Zongchen Guo,
Peijie Chen, Associations between parental support for physical activity and moderate-to-
vigorous physical activity among chinese school children: a cross-sectional study, Journal of
Sport and Health Science (2017), http://dx.doi.org/doi: 10.1016/j.jshs.2017.09.008.
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service
to our customers we are providing this early version of the manuscript. The manuscript will
undergo copyediting, typesetting, and review of the resulting proof before it is published in its
final form. Please note that during the production process errors may be discovered which could
affect the content, and all legal disclaimers that apply to the journal pertain.
Original article
Associations between parental support for physical activity and moderate-to-vigorous

physical activity among Chinese school children: A cross-sectional study
Yang Liu,a,b Yajun Zhang,c Sitong Chen,a Jialin Zhang,a Zongchen Guo,d Peijie Chenb,e*
a
School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438,
China
b
Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai
University of Sport, Shanghai 200438, China
c
School of Physical Education, Shaoxing University, Shaoxing 312000, China
d
Educational Management Information Center, Ministry of Education, Beijing 100816, China
e
School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
*Correspondence:
e-mail address: chenpeijie@sus.edu.cn
Running head: Family influences on levels of physical activity among Chinese children
Received 25 May 2017, revised 4 July 2017, accepted 23 August 2017
Page 1 of 35
Abstract
Objectives: The objective of this study was to examine the associations between parental support
for physical activity (PA) and levels of moderate-to-vigorous physical activity (MVPA) among
Chinese school children.
Methods: Study participants were 81,857 school-aged children (aged 9–17 years; mean age = 13
years; 49.0% boys) and their parents/guardians who took part in the 2016 Physical Activity and
Fitness in China—The Youth Study project. The independent variables included various forms of
parental support for PA ascertained through a survey completed by parents/guardians. The
dependent variable was the children’s average MVPA in minutes per day by self-report. Structure
equation modeling was used to examine the associations between parental support for PA and
children’s MVPA minutes.
Results: The overall mean for MVPA participation time for the child participants was 48.82 ± 28.7
min/day. Significant associations between various forms of parental support and MVPA among
children were found. Parental encouragement, accompanying, financial support, involvement, and
role modeling for PA were positively associated with a high level of student MVPA participation.
Parental PA knowledge-sharing was not associated with MVPA. The patterns of the associations
were similar across sex, residence locales (i.e., urban and rural), and school grades (primary, junior
middle, and junior high schools).
Conclusions: Findings from this study suggest that, among Chinese school children, parental
support for PA is important in promoting and facilitating children’s participation in MVPA.
Keywords: children and youth sports, chinese family, exercise, parenting
Page 2 of 35
1. Introduction
Although engaging in regular physical activity (PA) yields major health benefits for children
and youth,1-4 increasing evidence shows an overall low level of PA among Chinese school-aged
children and adolescents.5,6 For example, a recent report on PA in Shanghai revealed that only about
20% of school-aged children and youth met the PA guideline of engaging at least 60 min of daily
moderate-vigorous physical activity (MVPA);7 and in 2010, about 77% of primary school and
junior middle school children nationwide failed to meet PA recommendations.5 Other studies have
shown an increasing trend in sedentary behavior8,9 and rates of obesity in children and youth.10-12
Among many factors that influence children’s PA, family members and/or parents play an
important role in promoting and shaping their children’s behaviors.13 Characteristics such as
parental PA role modeling,6,14-16 support for PA,14,15,17,18 PA motivation,19 family type,20 and
socioeconomic status (SES)21-23 have been shown to be associated children’s participation in PA.
However, few studies in China have systematically examined the specifics of parental support for
PA in regard to their children’s PA, especially studies involving nationally representative samples.
With significant changes in sociodemographics,24 a heavy emphasis on children’s academic
achievement,25 and the low prevalence of PA among Chinese school children,5,7,26 it becomes
increasingly important that family and parent factors that either promote or impede children’s PA be
identified so that targeted, family-based PA promotional strategies can be developed for the most
vulnerable children and youth populations. This study addresses this significant knowledge gap.
The main purpose of this study was to examine associations between various forms of
parental support for PA and levels of MVPA participation among Chinese school-aged children. On
the basis of prior research,13-18 we hypothesized that parental encouragement, accompanying,
financial support, involvement, knowledge-sharing, and role modeling of PA would be positively

3
Page 3 of 35
associated with a high level of participation in MVPA by school children. A secondary purpose of
the study was to examine differences in these associations by sex, residence locale, and school
grades.
2. Method
2.1. Study design and participants
The data analyzed in this study were derived from the 2016 Physical Activity and Fitness in
China – The Youth Study (PAFCTYS), which was conducted between October and November
2016. The PAFCTYS, described in detail by Fan et al.,26 used a 3-stage stratified cluster
(nonprobability) sampling design to sample a nationally representative group of school-aged
children (aged 7–17) in primary schools (Grades 4–6), junior middle schools (Grades 7–9), and
junior high schools (Grades 10–12) from 22 provinces, 4 municipalities, 5 autonomous regions, and
1 independent division within the Xinjiang Uygur Autonomous Region, in the Mainland of China.
The original PAFCTYS survey sample included a total of 125,281 school children, Grades
4–12, who participated in the survey portion of the study. Of these participants, children with
missing information on residence locale (n = 7029) and those who provided out-of-range data or
response values in survey questions, including family-related measures (n = 1636) and outcome
measures of MVPA (n = 34,759), were excluded. As a result, data analyzed in this study came from
a total of 81,857 children who provided PA data and whose parents/guardians also completed a
survey.
The study was approved by the Ethics Committee of Shanghai University of Sport.
Permission to conduct the study was obtained from principals of each school participating in the
PAFCTYS. Verbal consent was obtained from the children’s parents/guardians and from all
participating children prior to data collection.

4
Page 4 of 35
2.2. Procedures
In a school classroom setting, trained research staff provided a detailed description of the
study and instructions on completing the survey. Each child completed a 4-page survey (online or
on paper) that included questions about their PA and other demographic information. The
parents/guardians of each child were also asked to complete a 4-page adult version of the survey at
home that included questions about parental support for PA and other family-related characteristics.
Trained research staff administered the survey and answered any questions about it.
2.3. Measures
2.3.1 MVPA
Children’s MVPA was assessed via a Chinese version27 of the International Physical Activity
Questionnaire Short Form (IPAQ-SF).28 Psychometric properties of the IPAQ-SF with the Chinese
student population have been previously established.27 Relevant to this study, items related to
participating in moderate-intensity and vigorous-intensity activities were used.26 The children’s
report of the average number of daily minutes of engaging in MVPA (in the past 7 days) was
calculated and used as a dependent measure.
2.3.2 Parental support for PA
Parental support for children’s PA was assessed by 6 questions completed by the children’s
parents/guardians. The questions included: (1) “Do you encourage your child take part in
PA/exercise?” (Parental PA encouragement), (2) “Do you accompany your child when he/she
attends PA/exercise sessions?” (Parental PA accompanying), (3) “Do you provide financial support
when your child participates in PA/exercise?” (Parental financial support of PA), (4) “Do you join
your child when he/she participates in PA/exercise?” (Parental PA involvement), (5) “Do you share
your knowledge of the health benefits of PA/exercise with your child?” (Parental PA
5
Page 5 of 35
knowledge-sharing), and (6) “Do you serve as a role model for your child by engaging in
PA/exercise?” (Parental role modeling for PA). The parent/guardian responded these questions on a
5-point scale, based on the following scores: 1 = never, 2 = not very much, 3 = not sure, 4 =
sometimes, and 5 = very much so, with high scores indicating positive support for PA. The 6-item
scale has a Cronbach α (internal consistency) coefficient of 0.82. In this study, we defined the term
“parent” to include any guardian who was responsible for the welfare of the child (i.e., “parent” was
not limited to biological parents).
2.3.3 Other measures
Demographic information about each child’s date of birth was retrieved from his/her student
ID. Children’s height was measured to the nearest 0.1 cm in bare feet whereas body weight was
measured to the nearest 0.1 kg. Both of these measures were assessed using a portable instrument
(GMCS-IV, Jianmin, Beijing, China). Each child’s body mass index (BMI) was then calculated as
(weight in kg)/(height in m)2. Residence locale information (urban, rural) for each child was
obtained through his/her self-report on the survey. Information on family type and SES was
ascertained from the parent/guardian survey in which the parent/guardian was asked who was most
responsible for raising the child: both parents, single parent (father or mother), grandparents,
stepfather, stepmother, or others. The parent/guardian report on educational attainment was used as
a proxy for the family’s SES.
2.4. A path model
To examine the hypothesized associations between parental support for PA and school
children’s MVPA minutes, a path model (Fig. 1) was specified. This model was formulated with a
set of 6 exogenous (parental support for PA) variables: parental PA encouragement, parental PA
accompanying, parental PA-related financial support, parental PA involvement, parental PA

6
Page 6 of 35
knowledge-sharing, and parental PA role modeling. As indicated by the directional arrow lines, all
parental support variables were hypothesized to relate to the endogenous outcome variable of
average daily minutes of MVPA in school-aged children. We tested this model on the total sample
(primary purpose) but also explored differences in the hypothesized associations by sex, residence
locale, and school grades (secondary purpose).
2.5. Statistical analyses
Preliminary statistical analyses were conducted using SPSS Version 21.0 (IBM, Armonk,
NY, USA). Taking into account the complex survey design in the PAFCTYS,26 all analyses used
sample weights to account for the clustering effect of sampling by school. Analyses were performed
using a listwise deletion method in which missing, incomplete, or non-normality data were
removed.
Descriptive statistics were calculated to describe the study population characteristics. We
also calculated bivariate 0-order correlations between parental support for PA variables and average
daily minutes of MVPA overall and separated by sex, resident locale, and school grades. To evaluate
the hypotheses related to the main study aim, we tested the path model (shown in Fig. 1), in which
all variables shown were observed, using Mplus structural equation modeling software (Version
7.4),29 which allow us to account for nonindependence of observations due to cluster sampling of
schools. Important confounders such as family structure,20 family SES,21-23 and children’s
perceptions of academic burden30 were used as control variables in the model tested. Overall model
fit was evaluated by the χ2statistic and root mean square error of approximation (RMSEA), with
values of 0.06 or less indicating an acceptable level of fit.31 The path coefficients in the model were
estimated by the maximum-likelihood method. Both unstandardized (b) and standardized regression
coefficients (β) were calculated, with a conservative p-value < 0.01 (2-tailed) being considered
7
Page 7 of 35
statistically significant.
To address our secondary propose of the study, we conducted subgroup analyses that
evaluated the structural relationships shown in Fig. 1 by sex, residence locale, and school grades.
Analyses were conducted using a multigroup approach in which the structural paths (parameters)
specified in our path model were first allowed to differ (unconstrained model) across the groups of
interest and then tested against a model in which equality constraints on the structural paths were
imposed across groups (constrained model). The difference in unconstrained and constrained
models was tested and evaluated using χ2 statistics.
3. Results
3.1. Participant characteristics
The average age of the school-aged children in this study was 13.06 ± 2.49, approximately
75% reported living with both parents, and about 50% lived in urban areas and received their
schooling there. Sex distribution was about equal (51% girls). The average BMI percentile score
was 19.75 ± 3.50, 14.4% were classified as overweight (85%–94% BMI percentile), and 11.9%
were obese (≥95% BMI percentile). More than half of the children’s parents (50.8%) reported that
they had completed at least a high school degree. Table 1 presents descriptive statistics (weighted)
for the study population.
Overall, children reported spending an average of 48.82 ± 28.71 minutes of MVPA per day
(341.75 ± 200.95 min/week). Higher MVPA time was reported in boys (50.70 ± 29.38 min/day)
compared with girls (47.01 ± 27.93 min/day) (p < 0.001), for rural children (49.87 ± 29.18 min/day)
compared with urban children (47.78 ± 28.19 min/day) (p < 0.001), and for junior middle school
students (51.44 [±28.54] min/day) compared with primary school children (50.46 ± 29.42 min/day)
(p < 0.001) and junior high school children (44.53 ± 27.64 min/day) (p < 0.001). In addition,
8
Page 8 of 35
children living with both parents (49.39 ± 28.93 min/day) or both parents and grandparents (48.91 ±
28.84 min/day) scored higher on MVPA compared with children living in other arrangements
combined (48.71 ± 28.66 min/day) (p = 0.004). Children whose parents’ education level was at the
master or doctoral level (50.56 ± 29.02 min/day) had a higher MVPA time compared to students
whose parents reported lower levels of education (48.76 ± 28.69 min/day) (p < 0.001).
3.2. Relationships between parental support variables for PA and children’s MVPA
Bivariate correlations among the study variables for the total sample (n = 81,857) are shown
in Table 2. All parental support variables for PA were shown to be statistically correlated with
children’s MVPA (all p < 0.001). The overall strength of these observed relationships, however,
varied significantly, ranging from 0.086 (Parental PA knowledge-sharing and MVPA) to 0.108
(Parental PA encouragement and MVPA). Correlation matrices by sex, residence locale, and school
grades are shown in the online supplement (Tables S1–S3).
Testing of the hypothesized path model for the total sample resulted in χ2 = 8212.62; df = 28;
p < 0.001; RMSEA = 0.063 (95%CI: 0.055-0.072), indicating a reasonable fit of the hypothesized
model to the empirical data. Model parameter estimates (both unstandardized and standardized) are
presented in Table 3. Results show that parental encouragement (b = 1.98), accompanying (b =
0.90), financial support (b = 1.07), involvement (b = 0.85), and role modeling (b = 0.71) for PA
were positively associated with a high level of child participation in MVPA. Parental PA
knowledge-sharing, however, was not significantly associated with MVPA (p = 0.53).
3.3. Multigroup analysis by sex, residence locale, and school grades
χ2 difference tests between constrained and unconstrained models in our multigroup
analyses reveal a similar pattern to the structural relationships shown in our main analyses,
indicating that the path estimates in our model were invariant for boys and girls, between children
9
Page 9 of 35
living in urban and rural areas, and across the 3 school grades (see Table S4 of the online
supplement for model testing using χ2 difference). Estimates of path coefficients in the model by
sex, residence locale, and school grades are presented in Table S5 (online supplement). The results
are consistent with the overall model based on the total sample and show no statistically significant
difference in the path coefficients between parental PA support variables and children’s MVPA
across the 3 demographic variables examined.
4. Discussion
Using the 2016 PAFCTYS data, we examined the associations between various forms of
parental support for PA and levels of MVPA participation among Chinese school-aged children. We
found that high parental encouragement, accompanying, engagement, role modeling, and financial
support for PA were positively associated with high levels of children’s participation in MVPA.
These associations were found to be similar across boys and girls, residence locales (urban and
rural), and school grades (primary, junior middle, and junior high schools).
This is one of the few studies that has examined associations between parents’ support of PA
and children’s MVPA in China. Findings from this study are consistent with the extant literature
published in western countries showing the important role parents play in promoting and facilitating
children’s PA13 and findings from China that demonstrate the modeling effect parents have in
influencing their children’s engagement in and levels of MVPA.15,16 The current study, however,
extends the literature in a significant way by examining multiple parenting factors that are deemed
to be relevant and important to Chinese school children in relation to their MVPA.
4.1. Study limitations and strengths
As alluded to in other studies published in this special issue,26,30,32,33 there are inherent
methodological weaknesses in the PAFCTYS data, including the cross-sectional design and the fact
10
Page 10 of 35
that the data are predominantly from self-reports (including the data used in this study). Thus, this
study lacks some of the well-developed, well-tested, and psychometrically sound measurement
tools used to assess parents’ support for PA. Future studies should develop reliable and valid
measures in order to better understand the role of parenting practices in promoting and influencing
children’s PA. Self-reported PA behavior in children is known to be subject to recall bias and to
result in underestimations.27,34 Therefore, our observed associations between parents’ support of PA
and children’s MVPA behavior should be interpreted with that limitation in mind. Last but not least,
among various correlates of PA within a socio-ecological framework,35 we only focused on parental
influences. It is likely that the strengths of parental social support for children’s PA found in this
study may interact with other dimensions of social support (e.g., friends, school teachers,
neighborhood networks) and neighborhood environmental factors (e.g., neighborhood safety,
availability of and access to PA facilities, street connectivity).36–38 Therefore, a comprehensive
evaluation approach may be needed to gain a better understanding of patterns and levels of MVPA
among school children.
A notable strength of the study is its use of a large and nationally representative sample of
Chinese school children. Another strength is that we considered different forms of parental support
for children’s PA, which allowed a clear delineation of the specific types of support provided by
parents in promoting or facilitating their children’s PA behaviors. We were also able to analyze
children’s MVPA levels by various important demographics (sex, residence locales, and school
grades), which are of high practical importance for developing targeted community- and
family-based policies and interventions. The nonsignificant findings across various demographic
variables in our study suggest the need for more finely grained analysis of children’s MVPA by
considering the effect of interactions, such as between sex/age and specific forms of parental
11
Page 11 of 35
support, to show how influences of parental support for PA on children’s MVPA may be moderated
by demographic characteristics.
4.2. Practical implications
Findings from this study on parental support for PA suggest that the parents’ promotion of
certain PA-related behaviors, including accompanying their children to PA sessions, offering their
children financial support (paying fees for PA/sports training and equipment), and being personally
engaged with children in PA, can directly facilitate children’s PA. Our findings corroborate the
existing evidence13,15,39 and indicate that by offering their children intangible (or indirect) social
support, such as verbal encouragement and role modeling for PA, Chinese parents can influence
their children’s MVPA in a positive way. MVPA among Chinese school children could also be
enhanced if appropriate interventions were developed that targeted both children and their parents.
For example, fostering positive parent–child interactions and engagement in routine and
leisure-time PA could reduce sedentary time and improve fitness, both of which are needed for
populations of Chinese school children.32,33
5. Conclusions
This study indicates that parental support, either direct or indirect, is related to increased
levels of MVPA among Chinese school children.
Acknowledgement
This research is supported by the Key Project of the National Social Science Foundation of
China (NO. 16ZDA227).
Authors’ Contributions
12
Page 12 of 35
YL made a substantial contribution to analyze data and wrote the original manuscript. YZ,
SC, JZ and ZG carried out the data collection, discussion and comments on the draft. PC designed
the study and commented on the draft. All authors have read and approved the final version of the
manuscript, and agree with the order of presentation of the authors.
Competing interests
The authors declare that they have no competing interests.
13
Page 13 of 35
References
1. Janssen I, LeBlanc AG. Systematic review of the health benefits of physical and fitness in
school-aged children and youth. Int J Beh Nutr Phys Activ 2010;7:40. doi:
10.1186/1479-5868-7-40
2. Twisk JW. Physical activity guidelines for children and adolescents: a critical review. Sports
Med 2001;31:617-27.
3. U.S. Centers for Disease Control and Prevention. Physical Activity Facts. Available at:
https://www.cdc.gov/healthyschools/physicalactivity/facts.htm. [Accessed 10.08.2017].
4. World Health Organization. Physical activity and young people. Available at:
http://www.who.int/dietphysicalactivity/factsheet_young_people/en/. [Accessed 10.08.2017].
5. Zhang X, Yang SY, Zhang B, Dong B, Ma J. Analysis of the current situation of physical activity
and influencing factors in Chinese primary and middle school students in 2010. Zhonghua Yu
Fang Yi Xue Za Zhi 2012;46:781-8 [in Chinese].
6. Lu C, Stolk RP, Sauer PJJ, Sijtsma A, Wiersma R, Huang G, et al. Factors of physical activity
among Chinese children and adolescents: a systematic review. Int J Beh Nutr Phys Activ
2017;14:36. doi: 10.1186/s12966-017-0486-y
7. Liu Y, Tang Y, Cao ZB, Chen PJ, Zhang JL, et al. Results from Shanghai’s (China) 2016 report
card on physical activity for children and youth. J Phys Activ Health 2016;13 (11 Suppl
2):S124-8.
8. Cui Z, Hardy LL, Dibley MJ, Bauman A. Temporal trends and recent correlates in sedentary
behaviours in Chinese children. Int J Behav Nutr Phys Act 2011;8:93. doi:
10.1186/1479-5868-8-93
9. Duan J, Hu H, Wang G, Arao T. Study on current levels of physical activity and sedentary behavior
14
Page 14 of 35
among middle school students in Beijing, China. PLoS One 2015;10:1371-83.
10. Sun H, Ma Y, Han D, Pan C, Xu Y. Prevalence and trends in obesity among China’s children
and adolescents, 1985-2010. PLos One 2014;9:e105469. doi: 10.1371/journal.pone.0105469
11. Zhai L, Dong Y, Bai Y, Wei W, Jia L. Trends in obesity, overweight, and malnutrition among
children and adolescents in Shenyang, China in 2010 and 2014: A multiple cross-sectional
study. BMC Public Health 2017;17:151. doi: 10.1186/s12889-017-4072-7
12. Gordon-Larsen P, Wang H, Popkin BM. Overweight dynamics in Chinese children and adults.
Obes Res 2014;1:37-48.
13. Beets MW, Cardinal BJ, Alderman BL. Parental social support and the physical activity-related
behaviors of youth: a review. Health Edu Beh 2010;37:621-44.
14. Yao CA, Rhodes RE. Parental correlates in child and adolescent physical activity: a
meta-analysis. Int J Behav Nutr Phys Activ 2015;12:10. doi: 10.1186/s12966-015-0163-y
15. Wang X, Liu QM, Ren YJ, Lv Jun, Li LM. Family influences on physical activity and
sedentary behaviours in Chinese junior high school students: a cross-sectional study. BMC
Public Health 2015;15:287. doi: 10.1186/s12889-015-1593-9
16. Dong F, Howard AG, Herring AH, Thompson AL, Adair LS, Popkin BM, et al. Parent–child
associations for changes in diet, screen time, and physical activity across two decades in
modernizing China: China Health and Nutrition Survey 1991–2009. Int J Behav Nutr Phys
Activ 2016;13:118. doi: 10.1186/s12966-016-0445-z
17. Morrissey JL, Wenthe PJ, Letuchy EM, Levy SM, Janz KF. Specific types of family support
and adolescent non-school physical activity levels. Pediatr Exerc Sci 2012;24:333-46.
18. Zecevic CA, Tremblay L, Lovsin T, Michel L. Parental influence on young children’s physical
activity. Int J Pediatr 2010;7:468526. doi: 10.1155/2010/468526

15
Page 15 of 35
19. Solomon-Moore E, Sebire S, Thompson JL, Zahra J, Lawlor DA, Jago R. Are parents’
motivations to exercise and intention to engage in regular family-based activity associated with
both adult and child physical activity? BMJ Open Sport Exerc Med 2017;2:e000137. doi:
10.1136/bmjsem-2016-000137
20. Wang L, Qi J. Association between family structure and physical activity of Chinese
adolescents. BioMed Res Int 2016; 2016:4278682.. doi: 10.1155/2016/4278682
21. Drenowatz C, Eisenmann JC, Pfeiffer KA, Welk G, Heelan K, Gentile D, et al. Influence of
socio-economic status on habitual physical activity and sedentary behavior in 8- to 11-year old
children. BMC Public Health 2010;10:214. doi: 10.1186/1471-2458-10-214
22. Tandon PS, Zhou C, Sallis JF, Cain KL, Frank LD, Saelens BE. Home environment
relationships with children’s physical activity, sedentary time, and screen time by
socioeconomic status. Int J Behav Nutr Phys Activ 2012;9:88. doi: 10.1186/1479-5868-9-88
23. Stalsberg R, Pedersen AV. Effects of socioeconomic status on the physical activity in
adolescents: a systematic review of the evidence. Scand J Med Sci Sports 2010;20:368-83.
24. Li F. Physical activity and health in the presence of China’s economic growth: meeting the public
health challenges of the aging population. J Sport Health Sci 2016;5:258-69.
25. Tudor-Locke C, Ainsworth BE, Adair LS, Du S, Popkin BM. Physical activity and inactivity in
Chinese school-aged youth: The China Health and Nutrition Survey. Int J Obes Relat Metab
Disord 2001;27:1093-9.
26. Fan X, Chen PJ, Cao ZB. Physical activity among Chinese school-aged children: National
prevalence estimates from the 2016 Physical Activity and Fitness in China—The Youth Study. J
Sport Health Sci In press.
27. Wang C, Chen P, Zhuang J. Validity and reliability of international physical activity
16
Page 16 of 35
questionnaire-short form in Chinese youth. Res Q Exerc Sport 2013;84(Suppl 2): S80-6.
28. Craig CL, Marshall AL, Sjostrom M, Bauman A, Booth ML, Ainsworth BE, et al. International
Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exer
2003,35:1381-95.
29. Muthén LK, Muthén BO. Mplus User’s Guide. 7th ed. Los Angeles, CA: Muthén & Muthén,
1998-2015.
30. Wang L, Tang Y, Luo J. School and community physical activity characteristics and
moderate-to-vigorous physical activity among Chinese school-aged children: A multilevel path
model analysis. J Sport Health Sci In press.
31. Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis:
Conventional criteria versus new alternatives. Struct Equ Modeling 1999;6:1-55.
32. Cai Y, Zhu X, Wu X. Overweight, obesity, and screen-time viewing among Chinese
school-aged children: National prevalence estimates from the 2016 Physical Activity and
Fitness in China – the Youth Study. J Sport Health Sci In press.
33. Zhu Z, Yang Y, Kong Z, Zhang Y, Zhuang J. Prevalence of physical fitness in Chinese
school-aged children: findings from the 2016 Physical Activity and Fitness in China – The
Youth Study. J Sport Health Sci In press.
34. Long C, Brand S, Feldmeth A, Puhse U, Gerber M. Increased self-reported and objectively
assessed physical activity predict sleep quality among adolescents. Physio Beh
2013;120C:46-53.
35. Sallis JF, Cervero RB, Ascher W, Henderson KA, Kraft MK, Kerr J. An ecological approach to
creating active living communities. Annu Rev Public Health 2006;27:297–322.
36. Tappe KA, Glanz K, Sallis JF, Zhou C, Saelens BE. Children’s physical activity and parent’s
17
Page 17 of 35
perception of the neighborhood environment: neighborhood impact on kids study. Int J Beh
Nutri Phys Acti 2013;10:39. doi: 10.1186/1479-5868-10-39
37. Committee on Environmental Health. the built environment: Designing communities to
promote physical activity in children. Pediatrics 2009;123:1591–98.
38. Ding D, Sallis JF, Kerr J, Lee S, Rosenberg DE. Neighborhood environment and physical
activity among youth: a review. Am J Prev Med 2011;41:442–55.

39. Moore LL, Lombardi DA, White MJ, Campbell JL, Oliveria SA, Ellison RC. Influence of
parents’ physical activity levels on activity levels of young children. J Pediatr 1991;118:215-8.
Fig. 1. A path model depicting the associations between parental support for PA factors and MVPA
among Chinese school-aged children
MVPA = Moderate-to-vigorous physical activity; PA = physical activity.
18
Page 18 of 35
Table 1. Descriptive statistics for the study population
Sample size (n MVPA (min/day, mean ±
(%)) SD)
Total sample 81,857 (100) 48.82 ± 28.71
Sex
Boys 40,109 (49.0) 50.70 ± 29.38
Girls 41,748 (51.0) 47.01 ± 27.93**,a
Residence locale
Urban 41,032 (50.1) 47.78 ± 28.19
Rural 40,825 (49.1) 49.87 ± 29.18**,b
School Grade
Primary 27,351 (33.4) 50.46 ± 29.42**,c
Junior middle 27,339 (33.4) 51.44 ± 28.54
Junior high 27,167 (33.2) 44.53 ± 27.64**,c
Family type
Both parents 11,762 (14.4) 49.39 ± 28.93*,d
Both parents and 2393 (2.9) 48.91 ± 28.84*,d
grandparents 61,639 (75.3) 48.80 ± 28.66
Grandparents 809 (1.0) 48.36 ± 28.12
Single parent and step-parent 4724 (5.8) 47.95 ± 28.59
Single parent 530 (0.6) 46.44 ± 29.77
Other
19
Page 19 of 35
Parental education
Primary school or under 10,270 (12.6) 46.13 ± 28.11
Junior middle school 29,989 (36.6) 48.21 ± 28.29
Junior high school 18,849 (23.0) 49.32 ± 28.74
College 8,581 (10.5) 50.31 ± 29.50
University Bachelor 11,075 (13.5) 50.44 ± 29.35
University Master or higher 3093 (3.8) 50.56 ± 29.02
Body Mass Index 81,857 (100) 19.75 ± 3.50
* p < 0.01; ** p < 0.001.
a
compared with boys.
b
compared with urban children.
c
compred with junior middle school students.
d
compared with children living in other arrangements combined.
e
compared with children whose parents reported lower levels of education.
Abbreviation: MVPA = moderate-to-vigorous physical activity
20
Page 20 of 35
Table 2. Zero-order correlations between parental support for PA factors and MVPA
among Chinese school-aged children (n = 81,857)
No. Variable 1 2 3 4 5 6 7
1 MVPA (min/day) –
2 Parental PA 0.108 –
encouragement
3 Parental PA 0.105 0.361 –
accompanying
4 Parental PA-related 0.095 0.407 0.363 –
financial support
5 Parental PA involvement 0.107 0.398 0.604 0.342 –
6 Parental PA 0.086 0.543 0.376 0.378 0.430 –
knowledge-sharing
7 Parental PA role 0.100 0.440 0.465 0.360 0.528 0.447 –
modeling
Note: All correlation coefficients in the table are statistically significant at p < 0.001.
Abbreviations: MVPA = moderate-to-vigorous physical activity; PA = physical
activity.
21
Page 21 of 35
Table 3. Parameter estimates of parental support for PA in association with MVPA in
children (n = 81,857)
Variables Unstandardized Standard p Standardized
estimates (b) error estimates (β)
Parental PA 1.981 0.134 <0.001 0.052
encouragement
Parental PA 0.897 0.083 <0.001 0.038
accompanying
Parental financial 1.074 0.101 <0.001 0.037
support for PA
Parental PA 0.850 0.087 <0.001 0.034
involvement
Parent PA 0.074 0.118 0.528 0.002
knowledge-sharing
Parental PA role 0.706 0.091 <0.001 0.027
modeling
Abbreviations: MVPA = moderate-to-vigorous physical activity; PA = physical
activity.
22
Page 22 of 35
Fig. 1.
23
Page 23 of 35
Online supplement materials
Table S1. Zero-order correlations between parental support for PA factors and MVPA among Chinese school-aged children by sex
No Variable 1 2 3 4 5 6 7
.
Boys
1 MVPA minutes –
2 Parental PA encouragement 0.113** –
3 Parental PA accompany 0.108** 0.372** –
4 Parental PA-related financial support 0.104** 0.428** 0.376** –
5 Parental PA involvement 0.105** 0.396** 0.619** 0.349** –
6 Parental PA knowledge-sharing 0.088** 0.555** 0.382** 0.396** 0.426** –
7 Parental PA role modeling 0.096** 0.446** 0.481** 0.374** 0.536** 0.458** –
Girls
1 MVPA minutes –
3 Parental PA accompanying 0.109** 0.349** –
** p < 0.001.
Abbreviations: MVPA = moderate-to-vigorous physical activity; PA = physical activity.
24
Page 24 of 35
Table S2. Zero-order correlations between parental support for PA factors and MVPA among Chinese school-aged children by residence locale
No Variable 1 2 3 4 5 6 7
Urban
1 MVPA minutes –
Rural
1 MVPA minutes –
** p < 0.001.
25
Page 25 of 35
Table S3. Zero-order correlations between parental support for PA factors and MVPA among Chinese school-aged children by school grades
No. Variable 1 2 3 4 5 6 7
Primary school
1 MVPA minutes –
Junior middle school
1 MVPA minutes –
2 Parental PA encouragement .109** –
Junior high school
1 MVPA minutes –
26
Page 26 of 35
** p < 0.001.
27
Page 27 of 35
Table S4. Multigroup analyses of differences in parameter estimates showing associations between parental support for PA and MVPA in
children by sex, residence locale, and school grades
Variable Path χ2 df Δχ2 p
coefficients
a
Baseline model 8212.65 28
Parental PA encouragement
Boys 2.210** 8137.52 29 1.342 0.123
Girls 1.608**
Urban 2.325** 8183.91 29 1.071 0.217
Rural 1.753**
Primary school 1.481** 8114.02 29 0.754 0.406
Junior middle school 2.283**
Junior high school 2.248**
Parental PA accompanying
Boys 0.995** 8133.58 29 0.005 0.968
Girls 0.974**
Urban 1.153** 8177.64 29 0.520 0.304
Rural 0.666**
Primary school 0.632** 8112.04 29 0.289 0.587
Parental PA-related financial support
Boys 1.327** 8134.26 29 0.976 0.205
Girls 0.797**
Urban 0.934** 8182.44 29 0.013 0.907
28
Page 28 of 35
Rural 1.162**
Primary school 1.383** 8116.88 29 0.586 0.656
Parental PA involvement
Boys 0.718** 8137.64 29 0.788 0.433
Girls 1.011**
Urban 0.473** 8185.28 29 1.249 0.210
Rural 1.129**
Primary school 1.576** 8113.51 29 2.333 0.113
Junior high school 0.439*
Parent PA knowledge-sharing
Boys 0.024 8135.23 29 0.618 0.441
Girls 0.253
Urban 0.117 8176.54 29 3.455 0.092
Rural 0.051
Primary school 0.635 8114.70 29 0.552 0.356
Junior middle school 0.320
Junior high school 0.710
Parental PA role modeling
Boys 0.422** 8139.84 29 2.084 0.128
Girls 0.983**
Urban 0.849** 8183.20 29 0.016 0.732
Rural 0.609**
29
Page 29 of 35
Primary school 0.151 8115.46 29 3.856 0.090
a
Defined as a model in which no inequality constraints were imposed in the structural path model between sex (boys and girls), residence locale
(urban and rural areas), and school grades (primary, junior middle, and junior high schools).
* p < 0.01; ** p < 0.001.
30
Page 30 of 35
Table S5. Parameter estimates of parental support for PA in association with MVPA in children by sex, residence locale, and school grades
Variable Unstandardized Standard error p Standardized estimates
estimates (b) (β)
Parental PA encouragement
Boys 2.210 0.191 <0.001 0.057
Girls 1.608 0.186 <0.001 0.042
Urban 2.325 0.222 <0.001 0.052
Rural 1.753 0.169 <0.001 0.051
Primary school 1.481 0.241 <0.001 0.037
Junior middle school 2.283 0.233 <0.001 0.059
Junior high school 2.248 0.219 <0.001 0.062
Parental PA accompanying
Boys 0.995 0.119 <0.001 0.042
Girls 0.974 0.114 <0.001 0.041
Urban 1.153 0.128 <0.001 0.045
Rural 0.666 0.111 <0.001 0.030
Primary school 0.632 0.147 <0.001 0.026
Parental PA-related financial support
Boys 1.327 0.145 <0.001 0.046
Girls 0.797 0.140 <0.001 0.028
Urban 0.934 0.164 <0.001 0.028
Rural 1.162 0.130 <0.001 0.044
Primary school 1.383 0.176 <0.001 0.047
31
Page 31 of 35
Parental PA involvement
Boys 0.718 0.125 <0.001 0.029
Girls 1.011 0.120 <0.001 0.041
Urban 0.473 0.137 <0.001 0.017
Rural 1.129 0.115 <0.001 0.048
Primary school 1.576 0.156 <0.001 0.061
Junior high school 0.439 0.146 0.003 0.018
Parent PA knowledge-sharing
Boys 0.024 0.168 0.887 0.001
Girls 0.253 0.165 0.125 0.007
Urban 0.117 0.199 0.556 0.003
Rural 0.051 0.147 0.728 0.002
Primary school 0.635 0.223 0.664 0.017
Junior middle school 0.320 0.203 0.995 0.013
Junior high school 0.710 0.188 0.060 0.023
Parental PA role modeling
Boys 0.422 0.130 <0.001 0.016
Girls 0.983 0.126 <0.001 0.038
Urban 0.849 0.139 <0.001 0.030
Rural 0.609 0.120 <0.001 0.025
Primary school 0.151 0.170 0.376 0.005
32
Page 32 of 35
33
Page 33 of 35
JSHS_424_V1.tif
34
Page 34 of 35
JSHS_424_V1_bestsetConverted.png
35
Page 35 of 35

Liu 2017

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Liu 2017

Uploaded by

Copyright:

Available Formats

Accepted Manuscript

Title: Associations between parental support for physical activity and

To appear in: Journal of Sport and Health Science

Received date: 25-5-2017

Associations between parental support for physical activity and moderate-to-vigorous

Received 25 May 2017, revised 4 July 2017, accepted 23 August 2017

Chinese school children.

parental support for PA ascertained through a survey completed by parents/guardians. The

children’s MVPA minutes.

middle, and junior high schools).

support for PA is important in promoting and facilitating children’s participation in MVPA.

Keywords: children and youth sports, chinese family, exercise, parenting

With significant changes in sociodemographics,24 a heavy emphasis on children’s academic

the basis of prior research,13-18 we hypothesized that parental encouragement, accompanying,

financial support, involvement, knowledge-sharing, and role modeling of PA would be positively

2.1. Study design and participants

(nonprobability) sampling design to sample a nationally representative group of school-aged

participating children prior to data collection.

participating in moderate-intensity and vigorous-intensity activities were used.26 The children’s

calculated and used as a dependent measure.

2.3.2 Parental support for PA

not limited to biological parents).

2.3.3 Other measures

a proxy for the family’s SES.

2.4. A path model

accompanying, parental PA-related financial support, parental PA involvement, parental PA

locale, and school grades (secondary purpose).

2.5. Statistical analyses

Descriptive statistics were calculated to describe the study population characteristics. We

models was tested and evaluated using χ2 statistics.

3.1. Participant characteristics

for the study population.

grades are shown in the online supplement (Tables S1–S3).

presented in Table 3. Results show that parental encouragement (b = 1.98), accompanying (b =

knowledge-sharing, however, was not significantly associated with MVPA (p = 0.53).

3.3. Multigroup analysis by sex, residence locale, and school grades

χ2 difference tests between constrained and unconstrained models in our multigroup

across the 3 demographic variables examined.

to be relevant and important to Chinese school children in relation to their MVPA.

4.1. Study limitations and strengths

result in underestimations.27,34 Therefore, our observed associations between parents’ support of PA

among various correlates of PA within a socio-ecological framework,35 we only focused on parental

neighborhood networks) and neighborhood environmental factors (e.g., neighborhood safety,

availability of and access to PA facilities, street connectivity).36–38 Therefore, a comprehensive

among school children.

4.2. Practical implications

populations of Chinese school children.32,33

levels of MVPA among Chinese school children.

China (NO. 16ZDA227).

manuscript, and agree with the order of presentation of the authors.

The authors declare that they have no competing interests.

https://www.cdc.gov/healthyschools/physicalactivity/facts.htm. [Accessed 10.08.2017].

http://www.who.int/dietphysicalactivity/factsheet_young_people/en/. [Accessed 10.08.2017].

Fang Yi Xue Za Zhi 2012;46:781-8 [in Chinese].

2017;14:36. doi: 10.1186/s12966-017-0486-y

and adolescents, 1985-2010. PLos One 2014;9:e105469. doi: 10.1371/journal.pone.0105469

study. BMC Public Health 2017;17:151. doi: 10.1186/s12889-017-4072-7

Obes Res 2014;1:37-48.

behaviors of youth: a review. Health Edu Beh 2010;37:621-44.

meta-analysis. Int J Behav Nutr Phys Activ 2015;12:10. doi: 10.1186/s12966-015-0163-y

Public Health 2015;15:287. doi: 10.1186/s12889-015-1593-9

Activ 2016;13:118. doi: 10.1186/s12966-016-0445-z