Investigating within-day and longitudinal effects of maternal stress on children's physical activity, dietary intake, and body composition: Protocol for the MATCH study

Abstract

Parental stress is an understudied factor that may compromise parenting practices related to children's dietary intake, physical activity, and obesity. However, studies examining these associations have been subject to methodological limitations, including cross-sectional designs, retrospective measures, a lack of stress biomarkers, and the tendency to overlook momentary etiologic processes occurring within each day. This paper describes the recruitment, data collection, and data analytic protocols for the MATCH (Mothers And Their Children's Health) study, a longitudinal investigation using novel real-time data capture strategies to examine within-day associations of maternal stress with children's physical activity and dietary intake, and how these effects contribute to children's obesity risk. In the MATCH study, 200 mothers and their 8 to 12 year-old children are participating in 6 semi-annual assessment waves across 3 years. At each wave, measures for mother-child dyads include: (a) real-time Ecological Momentary Assessment (EMA) of self-reported daily psychosocial stressors (e.g., work at a job, family demands), feeling stressed, perceived stress, parenting practices, dietary intake, and physical activity with time and location stamps; (b) diurnal salivary cortisol patterns, accelerometer-monitored physical activity, and 24-hour dietary recalls; (c) retrospective questionnaires of sociodemographic, cultural, family, and neighborhood covariates; and (d) height, weight, and waist circumference. Putative within-day and longitudinal effects of maternal stress on children's dietary intake, physical activity, and body composition will be tested through multilevel modeling and latent growth curve models, respectively. The results will inform interventions that help mothers reduce the negative effects of stress on weight-related parenting practices and children's obesity risk.

Mobile Ecological Momentary Diet Assessment Methods for Behavioral Research: Systematic Review (Preprint)

“…A total of 10 studies described signal-contingent mEMDA methods used in nutritionrelated research [74][75][76][77][78][79][80][81][82][83]. Additional approach details were extracted from multiple related journal articles [79,[84][85][86][87][88][89].…”

“…Of these 7 studies, 5 used mobile apps [75,76,79,80,82], 1 used SMS text messaging [74], and 1 used a web-based survey [83]. Two other studies used a wrist-worn electronic diary device [77,78] and another study used an iPod Touch [81].…”

“…Five studies used random intervals for prompting [75-77, 82, 83] with frequencies ranging from 3 to 10 prompts per day. Three of these 5 studies assessed dietary intake "since the last prompt" at varied time intervals [77,82,83], 1 study assessed dietary intake in the past 2 hours [76], and 1 study assessed dietary intake in real-time [75]. The other 5 studies prompted surveys at fixed intervals [74,[78][79][80][81], and frequencies ranged from 4 to 14 prompts per day.…”

“…Protocol adherence: EMA prompt response rate was reported in 8 out of the 10 studies [74,76,77,[79][80][81][82][83]. Response rate ranged from 23-63% per day to 98% across the study period.…”

Association Between Self-Reported and Objective Activity Levels by Demographic Factors: Ecological Momentary Assessment Study in Children (Preprint)

“…Dyads were excluded from the study if mother or child: (1) was taking medications for thyroid function or psychological conditions, (2) had a health condition that limited PA, (3) was enrolled in a special education program, (4) was currently using oral or inhalant corticosteroids for asthma, (5) was pregnant, (6) child was classified as underweight by a BMI percentile < 5% adjusted for sex and age, or (7) the mother worked more than two weekday evenings (between the hours of 5-9pm) per week or more than 8 hours on any weekend day. The detailed MATCH study protocol are described in further detail elsewhere [17].…”