Research article
Perception Versus Reality: Awareness of Physical Activity Levels of British Children

https://doi.org/10.1016/j.amepre.2009.08.025Get rights and content

Background

Interventions to increase children's physical activity have had limited success. One reason may be that children and their parents overestimate children's levels of physical activity, although there is a small amount of data on this topic.

Purpose

This study aims to assess awareness of physical activity levels among British school children aged 9–10 years and their parents.

Methods

Physical activity was measured using an accelerometer in a cross-sectional study of 1892 children (44% male; M age=10.3 years, SD=0.3) from 92 Norfolk schools (Sport, Physical Activity and Eating Behavior: Environmental Determinants in Young People [SPEEDY] study). Data were collected between April and July 2007 and analyzed in 2008. Inactive was defined as <60 minutes/day of moderate and vigorous physical activity. Agreement between physical activity perception (child- and parent-rated) and objective physical activity was assessed. Associations between biological (height, weight, fat mass index); parental (support, BMI, physical activity); and peer factors (support, objective physical activity) and child and parental physical activity awareness were studied using multinomial logistic regression.

Results

In all, 39% of girls and 18% of boys were inactive. A total of 80% of parents of inactive children wrongly thought that their child was sufficiently active. In all, 40% of inactive children overestimated their physical activity level. Compared to parents who accurately described their children as inactive, parents who overestimated were more likely to have girls (p=0.005), to have a child with a lower fat mass index (p<0.001), or to report more parental and peer support (p=0.014 and p<0.001, respectively).

Conclusions

Most parents of inactive children wrongly consider their children to be sufficiently active; parents of children with a lower fat mass index appear to assume that their children are adequately active. Increasing awareness regarding health benefits of physical activity beyond weight control might help reverse misperceptions of physical activity levels and encourage behavior change.

Introduction

Inactivity is likely to be a risk factor for obesity and related metabolic disorders among young people.1, 2 Because physical activity declines with age,3, 4 it is important that habits are formed during childhood that will last into adulthood, including prevention of further decline in physical activity.5 Recent literature reviews6, 7, 8 highlight the limited success of physical activity interventions for young people; however, the reasons for this lack of effectiveness are largely unknown and remain uncertain.

One previously posed explanation for the limited effectiveness of physical activity interventions is that people may lack awareness of their health behavior, such as believing themselves to be healthier than they really are.9 This misperception is especially common for complex behaviors such as physical activity, for which thresholds between healthy and unhealthy behaviors may be unclear.10 This may result in those who overestimate their physical activity level, seeing no need to alter their behavior as they are not aware that it is insufficient.10 People also may link specific health benefits to physical activity, for example, believing physical activity to be necessary for weight loss only,11 although there is evidence that physical activity contributes to health beyond weight control. Improving physical activity awareness may be a crucial component of interventions to increase physical activity, although few interventions take this into account.7, 10

Previous studies10, 11, 12 of physical activity awareness have all focused on adult Dutch populations, using self-reported physical activity to assess “true” activity levels. They show that 48%–61% of the inactive population overestimates their physical activity level. Those who overestimate their physical activity level tended to have a healthier lifestyle12 and more favorable anthropometric characteristics11, 12 than those who were aware of their low activity level. Psychosocial, personal, and behavioral factors have been found to be associated with physical activity awareness in adults,10, 11, 12 but no studies have investigated physical activity awareness among young people. Self-reported physical activity is prone to bias,13 and using an objective measure should allow a thorough assessment of the gap between perceived and true physical activity levels.

This study aimed to assess awareness of physical activity levels among British children aged 9–10 years and their parents and to investigate the associated biological and social factors. As no previous research was available, these analyses were mainly exploratory. However, based on the literature in adults, it can be hypothesized that parents of children with a more favorable body composition are more likely to overestimate their children's activity levels.

Section snippets

Methods

The Sport, Physical Activity and Eating Behavior: Environmental Determinants in Young People14 (SPEEDY) study is a population-based study investigating factors associated with physical activity and dietary behavior in children aged 9–10 years attending schools in the county of Norfolk, United Kingdom (UK). Ethical approval for this study was obtained from the University of East Anglia research ethics committee.

Full details on participant recruitment and study procedures have been described

Results

From the total sample of 2064 participants, 1868 (94.5%) had valid physical activity data for at least 3 days. Child and parental physical activity perception data were obtained from 1863 children (92% of the original sample) and 1757 parents (85% of the original sample), respectively. Descriptive data for these participants are presented in Table 3. Those excluded from the main analyses were more likely to be male (52.8% vs 43.6%, p=0.004), but there were no significant differences in body

Discussion

This study assessed physical activity awareness in a population-based sample of British children. Just under one third of children were not meeting the physical activity guidelines of 60 minutes/day of MVPA18, 19; 80% of parents of these children wrongly thought that their child was fairly active. Forty percent of inactive children overestimated their physical activity level. The lower the children's fat mass index, the more likely it was that parents overestimated their children's physical

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