HomeSTEAD’s physical activity and screen media practices and beliefs survey: Instrument development and integrated conceptual model

Autoři: Amber E. Vaughn aff001;  Derek P. Hales aff001;  Cody D. Neshteruk aff002;  Dianne S. Ward aff001
Působiště autorů: Center for Health Promotion and Disease Prevention, the University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America aff001;  Department of Nutrition, Gillings School of Global Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article


The home environment has a significant influence on children’s physical activity and obesity risk. Our understanding of this environment is limited by current measurement tools. The Home Self-administered Tool for Environmental assessment of Activity and Diet addresses this gap. This paper describes the development and psychometric testing of its family physical activity and screen media practices and beliefs survey. Methods: Survey development was guided by the Analysis Grid for Environments Linked to Obesity (ANGELO) framework and informed by a literature review, expert opinion, and cognitive interviews. Parents of children ages 3–12 years (n = 129) completed the HomeSTEAD survey three times over 12–18 days. Additionally, parents reported on child behaviors and trained staff measured parent and child height and weight. Five exploratory factor analyses were conducted after categorizing items into: control of physical activity, control of screen media, explicit modeling, implicit modeling, and perceived barriers and facilitators. Scales with 3 or more items underwent scale reduction. Psychometric testing evaluated internal consistency (Chronbach’s alphas), test-retest reliability (analysis of variance and intraclass correlations (ICC)), and construct validity (correlations with child BMI, physical activity, screen time). An integrated conceptual model of parent physical activity and screen media practices and beliefs was developed based on recent literature to aid in the identification and naming of constructs. Results: Final scales demonstrated good internal consistency (median Cronbach’s alpha = 0.81, IQR = 0.74–0.85), test-retest reliability (median ICC = 0.70, IQR = 0.66–0.78), and construct validity (with correlations between scale score and children’s behaviors generally in the expected direction). Comparison with the integrated conceptual model showed that most identified constructs were captured. Conclusions: The family physical activity and screen media practices survey advances the measurement of the home environment related to children’s physical activity, screen time, and weight. The integrated conceptual model provides a useful framework for researchers studying both physical activity and screen media parenting practices.

Klíčová slova:

Behavior – Health screening – Child health – Children – Parenting behavior – Physical activity – Screening guidelines – Video games


1. Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in Obesity and Severe Obesity Prevalence in US Youth and Adults by Sex and Age, 2007–2008 to 2015–2016. JAMA. 2018; 319(16): 1723–5. doi: 10.1001/jama.2018.3060 29570750

2. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014; 384(9945): 766–81. doi: 10.1016/S0140-6736(14)60460-8 24880830

3. Hills AP, Andersen LB, Byrne NM. Physical activity and obesity in children. Br J Sports Med. 2011; 45(11): 866–70. doi: 10.1136/bjsports-2011-090199 21836171

4. Ramires VV, Dumith SC, Goncalves H. Longitudinal Association Between Physical Activity and Body Fat During Adolescence: A Systematic Review. Journal of physical activity & health. 2015; 12(9): 1344–58.

5. Butte NF, Puyau MR, Wilson TA, Liu Y, Wong WW, Adolph AL, et al. Role of physical activity and sleep duration in growth and body composition of preschool-aged children. Obesity (Silver Spring). 2016; 24(6): 1328–35.

6. Janz KF, Kwon S, Letuchy EM, Eichenberger Gilmore JM, Burns TL, Torner JC, et al. Sustained effect of early physical activity on body fat mass in older children. Am J Prev Med. 2009; 37(1): 35–40. doi: 10.1016/j.amepre.2009.03.012 19423269

7. Ness AR, Leary SD, Mattocks C, Blair SN, Reilly JJ, Wells J, et al. Objectively measured physical activity and fat mass in a large cohort of children. PLoS Med. 2007; 4(3): e97. doi: 10.1371/journal.pmed.0040097 17388663

8. Loprinzi PD, Cardinal BJ, Loprinzi KL, Lee H. Benefits and environmental determinants of physical activity in children and adolescents. Obes Facts. 2012; 5(4): 597–610. doi: 10.1159/000342684 22986648

9. Biddle SJ, Asare M. Physical activity and mental health in children and adolescents: a review of reviews. Br J Sports Med. 2011; 45(11): 886–95. doi: 10.1136/bjsports-2011-090185 21807669

10. Janssen I, Leblanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act. 2010; 7: 40. doi: 10.1186/1479-5868-7-40 20459784

11. Jones RA, Hinkley T, Okely AD, Salmon J. Tracking physical activity and sedentary behavior in childhood: a systematic review. Am J Prev Med. 2013; 44(6): 651–8. doi: 10.1016/j.amepre.2013.03.001 23683983

12. Telama R. Tracking of physical activity from childhood to adulthood: a review. Obes Facts. 2009; 2(3): 187–95. doi: 10.1159/000222244 20054224

13. Craigie AM, Lake AA, Kelly SA, Adamson AJ, Mathers JC. Tracking of obesity-related behaviours from childhood to adulthood: A systematic review. Maturitas. 2011; 70(3): 266–84. doi: 10.1016/j.maturitas.2011.08.005 21920682

14. Singh AS, Mulder C, Twisk JW, van Mechelen W, Chinapaw MJ. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008; 9(5): 474–88. doi: 10.1111/j.1467-789X.2008.00475.x 18331423

15. Biddle SJ, Pearson N, Ross GM, Braithwaite R. Tracking of sedentary behaviours of young people: a systematic review. 2010; 51(5): 345–51.

16. Tandon P, Grow HM, Couch S, Glanz K, Sallis JF, Frank LD, et al. Physical and social home environment in relation to children's overall and home-based physical activity and sedentary time. Prev Med. 2014; 66: 39–44. doi: 10.1016/j.ypmed.2014.05.019 24887496

17. Lau EY, Barr-Anderson DJ, Dowda M, Forthofer M, Saunders RP, Pate RR. Associations Between Home Environment and After-School Physical Activity and Sedentary Time Among 6th Grade Children. Pediatr Exerc Sci. 2015; 27(2): 226–33. doi: 10.1123/pes.2014-0061 25386734

18. Spurrier NJ, Magarey AA, Golley R, Curnow F, Sawyer MG. Relationships between the home environment and physical activity and dietary patterns of preschool children: a cross-sectional study. Int J Behav Nutr Phys Act. 2008; 5(1): 31.

19. Maitland C, Stratton G, Foster S, Braham R, Rosenberg M. A place for play? The influence of the home physical environment on children's physical activity and sedentary behaviour. Int J Behav Nutr Phys Act. 2013; 10: 99. doi: 10.1186/1479-5868-10-99 23958282

20. Xu H, Wen LM, Rissel C. Associations of parental influences with physical activity and screen time among young children: a systematic review. J Obes. 2015; 2015: 546925. doi: 10.1155/2015/546925 25874123

21. Trost SG, Loprinzi PD. Parental influences on physical activity behavior in children and adolescents: a brief review. Am J Lifestyle Med. 2011; 5(2): 171–81.

22. Beets MW, Cardinal BJ, Alderman BL. Parental social support and the physical activity-related behaviors of youth: a review. Health Educ Behav. 2010; 37(5): 621–44. doi: 10.1177/1090198110363884 20729347

23. Edwardson CL, Gorely T. Parental influences on different types and intensities of physical activity in youth: A systematic review. Psychol Sport Exerc. 2010; 11(6): 522–35.

24. De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. Do specific parenting practices and related parental self-efficacy associate with physical activity and screen time among primary schoolchildren? A cross-sectional study in Belgium. BMJ Open. 2015; 5(9): e007209. doi: 10.1136/bmjopen-2014-007209 26346871

25. O'Connor TM, Chen TA, Baranowski J, Thompson D, Baranowski T. Physical activity and screen-media-related parenting practices have different associations with children's objectively measured physical activity. Child Obes. 2013; 9(5): 446–53. doi: 10.1089/chi.2012.0131 24028564

26. Sleddens EFC, Gubbels JS, Kremers SPJ, van der Plas E, Thijs C. Bidirectional associations between activity-related parenting practices, and child physical activity, sedentary screen-based behavior and body mass index: a longitudinal analysis. Int J Behav Nutr Phys Act. 2017; 14(1): 89. doi: 10.1186/s12966-017-0544-5 28683749

27. Pinard CA, Yaroch AL, Hart MH, Serrano EL, McFerren MM, Estabrooks PA. Measures of the home environment related to childhood obesity: a systematic review. Public Health Nutr. 2012; 15(1): 97–109. doi: 10.1017/S1368980011002059 21899786

28. Sleddens EF, Kremers SP, Hughes SO, Cross MB, Thijs C, De Vries NK, et al. Physical activity parenting: a systematic review of questionnaires and their associations with child activity levels. Obes Rev. 2012; 13(11): 1015–33. doi: 10.1111/j.1467-789X.2012.01018.x 22845791

29. Davison KK, Masse LC, Timperio A, Frenn MD, Saunders J, Mendoza JA, et al. Physical activity parenting measurement and research: challenges, explanations, and solutions. Child Obes. 2013; 9 Suppl: S103–9.

30. Trost SG, McDonald S, Cohen A. Measurement of general and specific approaches to physical activity parenting: a systematic review. Child Obes. 2013; 9 Suppl: S40–50.

31. Jago R, Edwards MJ, Urbanski CR, Sebire SJ. General and specific approaches to media parenting: a systematic review of current measures, associations with screen-viewing, and measurement implications. Child Obes. 2013; 9 Suppl: S51–72.

32. Thompson DA, Johnson SL, Vandewater EA, Schmiege SJ, Boles RE, Lev J, et al. Parenting and Preschooler TV Viewing in Low-Income Mexican Americans: Development of the Parenting Practices Regarding TV Viewing (PPRTV) Scale. 2016; 37(6): 465–74.

33. Masse LC, O'Connor TM, Tu AW, Watts AW, Beauchamp MR, Hughes SO, et al. Are the Physical Activity Parenting Practices Reported by US and Canadian Parents Captured in Currently Published Instruments? 2016; 13(10): 1070–8.

34. Hales D, Vaughn AE, Mazzucca S, Bryant MJ, Tabak RG, McWilliams C, et al. Development of HomeSTEAD's physical activity and screen time physical environment inventory. Int J Behav Nutr Phys Act. 2013; 10: 132. doi: 10.1186/1479-5868-10-132 24313962

35. Swinburn B, Egger G, Raza F. Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev Med. 1999; 29(6 Pt 1): 563–70. doi: 10.1006/pmed.1999.0585 10600438

36. Vaughn AE, Dearth-Wesley T, Tabak RG, Bryant M, Ward DS. Development of a Comprehensive Assessment of Food Parenting Practices: The Home Self-Administered Tool for Environmental Assessment of Activity and Diet Family Food Practices Survey. J Acad Nutr Diet. 2017; 117(2): 214–27. doi: 10.1016/j.jand.2016.07.021 27660178

37. Masse LC, O'Connor TM, Tu AW, Hughes SO, Beauchamp MR, Baranowski T. Conceptualizing physical activity parenting practices using expert informed concept mapping analysis. BMC Public Health. 2017; 17(1): 574. doi: 10.1186/s12889-017-4487-1 28615050

38. O'Connor TM, Hingle M, Chuang RJ, Gorely T, Hinkley T, Jago R, et al. Conceptual understanding of screen media parenting: report of a working group. Child Obes. 2013; 9 Suppl: S110–8.

39. DeVellis R. Scale Development Theory and Applications. Second ed. Bickman L, Rog DJ, editors. (Thousand Oaks: Sage Publications; 2003.

40. Mokkink LB, Prinsen CAC, Patrick DL, Alonso J, Bouter LM, De Vet HC, et al. COSMIN Study Design Checklist for Patient-Reported Outcome Measurement Instruments. Amsterdam, The Netherlands: COSMIN; 2019 [updated July 2019; cited September 23, 2019]; Available from:

41. Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, et al. 2000 CDC Growth Charts for the United States: methods and development. 2002; (246): 1–190.

42. Costello AB, Osborne J. Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research & Evaluation. 2005; 10(7).

43. Suhr DD. Exploratory or Confirmatory Factor Analysis? Thirty-first Annual SAS® Users Group International Conference (SUGI 31); San Franscisco, CA: SAS Institute Inc.; 2006. p. Paper 200–31, 1–17.

44. Kline RB, editor. Principles and Practice of Structural Equation Modeling. 2nd ed. New York, NY: Guilford Press; 2005.

45. Bland JM, Altman DG. Cronbach's alpha. BMJ. 1997; 314(7080): 572. doi: 10.1136/bmj.314.7080.572 9055718

46. Shrout PE, Fleiss JL. Intraclass correlations: Uses in assessing rater reliability. Psychol Bull. 1979; 86(2): 420–8. doi: 10.1037//0033-2909.86.2.420 18839484

47. Shrout PE. Measurement reliability and agreement in psychiatry. Stat Methods Med Res. 1998; 7(3): 301–17. doi: 10.1177/096228029800700306 9803527

48. Sallis JF, Taylor WC, Dowda M, Freedson P, Pate R. Correlates of vigorous physical activity for children in grades 1 through 12: Comparing parent-reported and objectively measured physical activity. Pediatr Exerc Sci. 2002; 14(1): 30–44.

49. Davison KK, Cutting TM, Birch LL. Parents' activity-related parenting practices predict girls' physical activity. Med Sci Sports Exerc. 2003; 35(9): 1589–95. doi: 10.1249/01.MSS.0000084524.19408.0C 12972881

50. Vaughn A, Hales D, Ward DS. Measuring the Physical Activity Practices Used by Parents of Preschool Children. Med Sci Sports Exerc. 2013.

51. O'Connor TM, Chen TA, del Rio Rodriguez B, Hughes SO. Psychometric validity of the parent's outcome expectations for children's television viewing (POETV) scale. BMC Public Health. 2014; 14: 894. doi: 10.1186/1471-2458-14-894 25175279

52. Davison KK, Blake CE, Blaine RE, Younginer NA, Orloski A, Hamtil HA, et al. Parenting around child snacking: development of a theoretically-guided, empirically informed conceptual model. Int J Behav Nutr Phys Act. 2015; 12: 109. doi: 10.1186/s12966-015-0268-3 26377320

53. Vaughn AE, Tabak RG, Bryant MJ, Ward DS. Measuring parent food practices: a systematic review of existing measures and examination of instruments. Int J Behav Nutr Phys Act. 2013; 10(1): 61.

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