Impact of the ‘Healthy Youngsters, Healthy Dads’ program on physical activity and other health behaviours: a randomised controlled trial involving fathers and their preschool-aged children

Abstract

Background Targeting fathers may be a key strategy to increase physical activity among their preschool-aged children, but limited research exists in this area. The primary study aim was to examine the impact of a lifestyle program for fathers and their preschool-aged children on child physical activity levels. Methods A total of 125 fathers (aged: 38 ± 5.4 years, BMI: 28.1 ± 4.9 kg/m2) and 125 preschool-aged children (aged: 3.9 ± 0.8 years, BMI z-score: 0.3 ± 0.9, 39.2% girls) recruited from Newcastle, Australia, NSW were randomised to (i) the Healthy Youngsters, Healthy Dads (HYHD) program, or (ii) wait-list control group. The program included two fathers-only workshops (2 h each) and eight father-child weekly educational and practical sessions (75 min each), plus home-based activities targeting family physical activity and nutrition. Assessments took place at baseline, 10-weeks (post-intervention) and 9-months follow-up. The primary outcome was the children’s mean steps/day at 10-weeks. Secondary outcomes included: co-physical activity, fathers’ physical activity levels and parenting practices for physical activity and screen time behaviours, children’s fundamental movement skill (FMS) proficiency, plus accelerometer based light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA), screen time and adiposity for fathers and children. Process measures included; attendance, satisfaction, fidelity and retention. Linear mixed models estimated the treatment effect at all time-points for all outcomes. Results Intention-to-treat analyses revealed a significant group-by-time effect for steps per day at 10-weeks (+ 1417, 95%CI: 449, 2384) and 9-months follow-up (+ 1480, 95%CI: 493, 2467) in intervention children compared to control. There were also favourable group-by-time effects for numerous secondary outcomes including fathers’ physical activity levels, children’s FMS proficiency, and several parenting constructs. No effects were observed for both fathers’ and children’s accelerometer based LPA or MVPA, co-physical activity, screen-time and adiposity measures. Process evaluation data revealed very high levels of satisfaction, attendance, retention, and intervention fidelity. Conclusion Engaging fathers in a lifestyle program is a promising strategy to increase physical activity among preschool-aged children. Additional benefits to fathers’ physical activity levels, children’s FMS proficiency and parenting practices further support the importance of engaging fathers to improve family health outcomes. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12619000105145. Registered 24/01/2019.

Direct Parent Engagement to Improve Fundamental Movement Skills in Children: A Systematic Review

“…With regards to the prescriptive element of the studies included, improvements in FMS were detected in as few as eight weeks [28,77,82] and as many as 26 weeks [29,81], while significant changes were demonstrated in interventions that employed short practice sessions at high frequencies [76,82] and by those that used longer session lengths with lower frequencies [28,60]. From this evidence, it can be deduced that the prescription of an intervention can be highly variable yet still effective when parents are involved.…”

“…Physical inactivity is considered to be one of the major contributors towards an ever-growing childhood obesity epidemic and its associated health consequences, such as type II diabetes mellitus and cardiovascular diseases [27]. It has been estimated that 40 million preschool children are currently overweight or obese worldwide [28]. Disturbingly, the children of this generation are expected to die younger than their parents for the first time in modern history [29], and this highlights the critical need to develop a greater understanding of FMS and how to better engage children in positive PA behaviours.…”

“…Community interventions can increase parent confidence, motivation, and knowledge of physically active behaviours and physical literacy, which in turn encourage self-efficacy to apply learnings at home with their children [72]. The co-activity of parents and children has been postulated to be the most advantageous method of improving FMS in children [73], with an intervention involving fathers' co-activity with their children successfully increasing the PA volume of both parent and child and FMS competence in the children [28,74]. Comparatively, an innovative and novel method of delivering FMS education and guidance to the parent in the home environment without the requirement of specialist support is via digital and mobile applications [75].…”

Feasibility of ‘Daughters and Dads Cricket’: A programme targeting fathers to improve daughters’ engagement and skills in cricket

“…There are several reasons pertaining to these findings; firstly, the structure and content were informed by rigorous formative research with fathers and their children, which have previously achieved high programme satisfaction levels. 28,49,50 Secondly, programme content encompassed the unique values, preferences, motivators and barriers of fathers and their daughters, [11][12][13]44 while also deconstructing gender stereotypes, norms and female ideals that hinder girls' participation in sport. 8 Finally, for girls, spending quality one-on-one time with father may be a key contributor to their enjoyment and satisfaction with the programme.…”

Effect of intervention on screen time in preschoolers: A systematic review and meta-analysis

“…However, the results of current intervention studies on preschool children's excessive ST are inconsistent. Although interventions based on clinic-based personalized counseling effectively reduced the ST in children aged 2-6 years [9] and children spent 17.5 hours less time per week on screen after 6 months of intervention with a TV lockout device [10] , other interventions using online or o ine measures have not shown a signi cant difference compared with control groups in changing ST [11,12] . Systematic review and meta-analysis of intervention effect on ST in preschool children are lacking.…”