Determinants of Change in Physical Activity in Children 0-6 years of Age: A Systematic Review of Quantitative Literature.

BACKGROUND: Understanding the determinants of children's health behaviours is important to develop successful behaviour-change interventions. OBJECTIVE: We aimed to synthesise the evidence around determinants ('preceding predictors') of change in physical activity (PA) in young children (0-6 years of age). METHODS: As part of a suite of reviews, prospective quantitative studies investigating change in physical activity in children aged 0-6 years were identified from eight databases (to October 2015): MEDLINE, Embase, CINAHL, PsycINFO, Web of Knowledge, British Nursing Index, Applied Social Sciences Index and Abstracts, and Sociological Abstracts. Determinants and direction of association were extracted, described and synthesised according to the socio-ecological model (individual, interpersonal, organisational, community, policy). RESULTS: Forty-four determinants, predominantly in the interpersonal and organisational domains, were reported across 44 papers (six prospective cohort, 38 interventional); 14 determinants were assessed in four or more papers. Parental monitoring showed a consistent positive association with change in PA; provider training was positively associated with change in children's moderate-to-vigorous PA only. Five (sex, parental goal setting, social support, motor skill training and increased time for PA) showed no clear association. A further seven (child knowledge, parental knowledge, parental motivation, parenting skills, parental self-efficacy, curriculum materials and portable equipment) were consistently not associated with change in children's PA. Maternal role-modelling was positively associated with change in PA in all three studies in which it was examined. CONCLUSIONS: A range of studied determinants of change in young children's PA were identified, but only parental monitoring was found to be consistently positively associated. More evidence dealing with community and policy domains from low-/middle-income countries and about lesser-explored modifiable family- and childcare-related determinants is required. INTERNATIONAL PROSPECTIVE REGISTER FOR SYSTEMATIC REVIEWS (PROSPERO) REGISTRATION NUMBER: CRD42012002881.This is independent research funded by the UK National Institute for Health Research School for Public Health Research (NIHR SPHR). The views expressed are those of the author(s) and not necessarily those of the National Health Service, the NIHR or the Department of Health. The NIHR SPHR is a partnership between the Universities of Sheffield, Bristol, Cambridge, UCL; The London School for Hygiene and Tropical Medicine; The Peninsula College of Medicine and Dentistry; the LiLaC collaboration between the Universities of Liverpool and Lancaster; and Fuse, the Centre for Translational Research in Public Health, a collaboration between Newcastle, Durham, Northumbria, Sunderland and Teesside Universities. This work was also supported by the Medical Research Council [Unit Programme numbers MC_UU_12015/7 and MC_UU_12015/2], and undertaken under the auspices of the Centre for Diet and Activity Research, a United Kingdom Clinical Research Collaboration (UKCRC) Public Health Research Centre of Excellence which is funded by the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the NIHR, and the Wellcome Trust (RES-590-28-0002). KH is a Sir Henry Wellcome Postdoctoral Fellow (Wellcome Trust Grant 107337/Z/15/Z)