Are associations between the perceived home and neighbourhood environment and children′s physical activity and sedentary behaviour moderated by urban/rural location?

Highlights

• Fewer children in urban areas met screen-time public health recommendations.

• Mothers from rural areas have more positive perceptions of their neighbourhood.

• Area of residence moderated some associations between home/neighbourhood and PA and ST.

• Physical activity as a family may be important for urban children′s sedentary time.

• Similar neighbourhood and home environmental features appear to be important for rural and urban children′s physical activity.

Abstract

Associations between parental perceived home and neighbourhood environments and children′s physical activity (PA), and sedentary time (ST) and screen time and moderating effects according to urban/rural location were examined. Data were collected (2007–2008) from a cohort of women (aged 18–45 years) and their children (5–12 years) participating in the Resilience for Eating and Activity Despite Inequality (READI) study. A total of 613 children (47% boys; mean age 9.4±2.2 years) and their mothers were included in the study. Urban children had higher screen time than rural children. Mothers in rural areas reported greater access to physical activity equipment in the home, higher levels of descriptive norms for physical activity, greater knowledge of the neighbourhood, a stronger social network, and higher personal safety than urban mothers. There were five significant interactions between the home and neighbourhood environment and PA/ST according to urban/rural location. Among urban children, the importance of doing PA together as a family was positively associated with ST. Interventions targeting PA and ST may need to target different factors according to urban/rural location.

Introduction

Public health recommendations in Australia suggest that children spend 60 min or more every day in at least moderate-intensity physical activity, and no more than 2 h/day in screen-based behaviours for entertainment (e.g., television viewing, electronic games, computer use) (Australian Government Department of Health and Ageing, 2004). However, the 2007 National Nutrition and Physical Activity Survey found that just 20–40% of 9–16 year olds meet the physical activity recommendations and only 3% met the screen-based guidelines (Commonwealth Scientific Industrial Research Organisation (CSIRO), 2008)). The distribution of these behaviours across the population is not homogenous and has been found to differ, for example, according to gender, socio-economic status (Brug et al., 2012b) and ethnicity (Brug et al., 2012a), as well as area of residence.

Related to the latter, in a study of over 3000 children in the US, urban children engaged in less self-reported physical activity than did their rural counterparts, while children from small cities reported the highest levels of activity (Joens-Matre et al., 2008). A study of 11–12 year old Greek children used pedometers to examine differences in steps on weekdays according to urban/rural location (Loucaides et al., 2004). Seasonal differences in children′s steps by location were found, with children in urban areas recording significantly more steps in winter and rural children recording significantly more steps in summer. While these differences are intriguing, none of the aforementioned studies adjusted for socioeconomic position (SEP), a potentially important confounder of urban/rural differences in health behaviour.

A recent study of almost 5000 Canadian adolescents in school years six to 10 that did adjust for SEP found no differences in self-reported physical activity by region of residence, but young people living in more rural areas were significantly less likely to be in the high screen time category compared with participants living in large metropolitan areas (Bruner et al., 2008). These findings are similar to those of the Australian READI study of 373 5–12 year olds which reported that boys living in low SEP rural areas were three times more likely to meet screen recommendations compared with boys living in low SEP urban areas (Hume et al., 2012). That study also adjusted for maternal education; however, no differences in children′s objectively-assessed physical activity by urban or rural location were identified.

Even with inconsistent evidence of variations in physical activity and sedentary behaviour among urban and rural children, there may be differences in family and neighbourhood environmental influences on these behaviours by area of residence. Ecological models of health behaviour (Bronfenbrenner, 1979, Brug et al., 2010, Davison and Birch, 2001) suggest that aspects of the home and neighbourhood environment are likely to be related to children′s physical activity and sedentary behaviour (Davison and Lawson, 2006, Ferreira et al., 2007), and these associations may be moderated by a range of social demographic as well as personal variables. However, few studies have examined whether perceived home and neighbourhood environmental correlates of children′s physical activity and sedentary behaviour differ by urban or rural location.

This study aimed to examine associations between parents′ perceived home and neighbourhood environments and children′s objectively-assessed physical activity and sedentary time, and proxy-reported screen-based behaviours (main effects), and then to examine whether these associations were moderated by living in urban versus rural low SEP areas controlling for maternal education level. Examining whether living in an urban or rural location moderates associations between the perceived home and neighbourhood environments and children′s physical activity and sedentary behaviour is important for informing the development of interventions that are appropriately tailored for the population of interest. We hypothesised that living in an urban versus rural location would moderate the association between the perceived neighbourhood environment and children′s physical activity and sedentary behaviour, and that the neighbourhood environment would be less important among rural compared with urban children.