The moderating role of parent perceptions in relationships between objectively measured neighbourhood environment attributes and pre-schooler’s physical activity: Findings from the PLAYCE study

The early years (0–5 years of age) are a crucial period for establishing healthy behaviours such as regular physical activity (Okely et al., 2017). For young children, the health benefits of physical activity include maintaining a healthy weight, developing cardiovascular fitness, good muscle and bone health, as well as improved motor, cognitive, emotional, and psychosocial development (Carson et al., 2017). Physical inactivity is a major cause of childhood obesity (Timmons et al., 2012), with inactivity tracking from early childhood into adolescence (Jones et al., 2013; Malina, 1996), negatively influencing health and increasing the risk of non-communicable diseases throughout the life course (Carson et al., 2017; Kuzik et al., 2017). Device-based measures of physical activity show less than a third of Australian pre-schoolers (defined as children aged 2–5 years) achieve the recommended 3 h of daily physical activity required for health and development (Christian et al., 2018). Globally, there is large variation with estimates ranging from 19% to 99% of pre-schoolers meeting physical activity guideline recommendations (Hnatiuk et al., 2014; Rollo et al., 2020). A much greater understanding of the factors positively and negatively influencing physical activity behaviour early in life is needed.

Socio-ecological models emphasise the importance of multiple, interacting levels of influence on pre-schooler’s physical activity (Hinkley et al., 2012; Mehtälä et al., 2014). To date, most research has investigated individual-level correlates of pre-schoolers physical activity behaviour as well as the influence of psychosocial environments, such as family, peers and childcare (Mehtälä et al., 2014). Specifically, there is consistent evidence identifying child level factors (i.e., sex, gross motor skills) and parent/carer level factors (i.e., parent physical activity and role modelling, opportunities for play, parental support, TV viewing rules, childcare educator physical activity promoting practices) as correlates of physical activity in young children (Arts et al., 2023). Moreover, time spent in outdoor environments and convenience of play spaces are also reported as consistent and strong predictors of physical activity levels in pre-schoolers (Bingham et al., 2016; Arts et al., 2023). But our understanding of the specific attributes of outdoor environments and play spaces which are important for supporting pre-schoolers physical activity is poor. Indeed, a recent review by Prince et al. (2022) highlighted research on the relationship between the built environment and physical activity in pre-schoolers was a significant evidence gap. Early investment in supporting pre-schooler’s physical activity levels through neighbourhood environments lays the foundation for benefits to compound over a lifetime (Clark et al., 2020).

Of the handful of studies to investigate relationships between neighbourhood built environment features and pre-schooler physical activity, more green space and local child-relevant destinations, and greater perceived neighbourhood safety are hypothesised to be associated with increased pre-schooler physical activity levels (Christian et al., 2016; Terrón-Pérez et al., 2021). However, for the most part the evidence-base is mixed. One reason for this may be that studies tend to measure built environment attributes either objectively (e.g., Geographic Information Systems (GIS), environmental audits) or subjectively (e.g., parent reported perceptions). For example, distance to parks can be measured objectively as distance from a pre-schoolers residence to the closest park using a GIS, or subjectively by asking a parent to report the perceived proximity to their pre-schoolers nearest park. However, few studies to date have considered both measurement types when examining the influence of neighbourhood environments on pre-schooler physical activity behaviour. A greater understanding of the role played by parents in their pre-schooler’s exposure to neighbourhood environments supportive or unsupportive of pre-schooler physical activity has the potential to inform environmental interventions that cater to different age groups of children.

Studies of the influence of the built environment and adult physical activity have examined the mismatch between objective and perceived measures of built environment attributes. These studies have identified that perceived and objective measures of neighbourhood environments appear to capture distinct aspects of the built environment that differentially influence walking behaviours (Koohsari et al., 2015). For example, residents who perceived their streets as being more connected (but were less connected when measured objectively) were more likely to walk locally for transport compared to residents who both perceived their streets as less connected and had low objectively measured connectivity (Koohsari et al., 2015). Such findings highlight the need for environmental interventions that modify the planning and design of environments but also address how these environments are perceived by residents. There is also a need for a greater understanding of how perceived and objective measures of the built environment interact to influence young children’s physical activity behaviour.

For young children, perceived neighbourhood environment measures are commonly operationalised as parent-report measures. Since pre-school children are not independently mobile they are entirely dependent on their parents and/or caregivers for opportunities to interact with, and be active in, their local neighbourhood (Xu et al., 2017). As gatekeepers to young children’s early experiences of the neighbourhood environment, parental perceptions can significantly influence the extent to which pre-school children are active or inactive in their local neighbourhood, regardless of whether the neighbourhood is conducive or non-conducive for young children to be active. The moderating role of parent perceptions of built environments on relationships between objectively measured built environment attributes and pre-schooler’s physical activity requires investigation. Two studies to date have considered the moderating effect of parental perceptions on associations between built environment attributes and physical activity in young children (Cerin et al., 2016, 2022). In the first study Latino pre-schooler’s outdoor and indoor physical activity and sedentary behaviour was dependent on parental attitudes and practices related to neighbourhood safety (Cerin et al., 2016). Data from this first study was then pooled with comparable data from Hong Kong (Cerin et al., 2022) showing that perceived availability of active play equipment was associated with total physical activity on weekend days but only among pre-schoolers whose parents reported below average traffic hazards in the neighbourhood. This suggests parental perceptions of neighbourhood safety may be an important moderator to consider, however these studies were limited by relatively small sample sizes, the use of cut-points to process accelerometery measures of physical activity, and the lack of comparable objective environmental data on the neighbourhood environment. The aim of this study was to examine the moderating effects of parent perceptions of neighbourhood environments on associations between objectively measured neighbourhood environment attributes and physical activity among pre-schoolers.

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