Determinants of daughters’ participation in mother-daughter physical activity interventions: a systematic review Restricted; Files Only
Nahta, Rita (Summer 2023)
Abstract
Introduction: Physical activity promotes long-term health and prevents chronic diseases. Current guidelines recommend that children and adolescents ages 6 to 17 years participate in at least one hour of moderate to vigorous physical activity each day. However, less than 25% of children and adolescents meet this guideline. The proportion of girls who participate in daily physical activity is lower than the proportion of boys. Multilevel determinants are likely to influence whether girls participate in physical activity. Because mothers are a potential source of interpersonal influence on their daughters’ behaviors, studies have examined the effects of mother-daughter physical activity interventions on girls’ physical activity levels. Applying the socioecological model to evaluate mother-daughter physical activity interventions can help identify the multilevel determinants influencing whether girls meet physical activity guidelines.
Objective: The objective of this systematic review is to identify the determinants of daughters’ participation in interpersonal mother-daughter physical activity interventions.
Methods: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines was performed. Data abstraction was performed in Excel to characterize studies and interventions and to analyze daughters’ pre- and post-intervention physical activity. Deductive, in vivo coding was performed in MAXQDA to identify the social cognitive theory concepts and socioecological model levels addressed by each intervention. In vivo coding followed by inductive thematic grouping of codes was performed in MAXQDA using the creative coding function to identify barriers and facilitators of daughters’ participation in mother-daughter physical activity interventions.
Results: Eight studies met eligibility criteria. Study, intervention, and population demographic characteristics, as well as the measure of daughters’ physical activity varied across studies. Four studies performed statistical analysis of daughters’ pre- and post-intervention physical activity change. Three of the four studies showed statistically significant improvement in daughters’ post-intervention physical activity. Interventions varied in the use of social cognitive theory concepts and in the levels of the socioecological model that were targeted. Among those that showed significant improvement, two used all six social cognitive theory concepts, and one primarily used observational learning and behavioral capability. All three targeted the individual and interpersonal levels of the socioecological model, and two targeted the institutional level. Among all eight studies, the most common barriers to daughters’ participation were competing obligations, physical limitations due to health, weather, or transport, and the time commitment required for intervention activities. A lack of interest and cultural factors were also identified as barriers. Facilitators of daughters’ participation in mother-daughter interventions were being with their mother and gaining a sense of community and social support.
Conclusions: Identifying multilevel determinants of physical activity participation among girls is critical for improving physical activity behaviors and promoting long-term health benefits. Future mother-daughter physical activity interventions should apply standardized methods to assess physical activity, allowing for systematic meta-analysis and comparison of effects. Future interventions should also consider the social ecology in which mothers and daughters live. Targeting the multilevel determinants influencing daughters’ participation in mother-daughter interventions can help increase the proportion of girls who participate in daily physical activity.
Table of Contents
Table of Contents
Chapter 1. Introduction. 10
Introduction and rationale. 10
Problem statement 10
Social ecological model (SEM) 11
Social cognitive theory (SCT) 13
Purpose statement 13
Research questions. 14
Significance. 14
Table 1. High school students meeting physical activity guidelines, 2021 YRBS. 15
Table 2. Trend in proportion of high school students physically active ≥60 min/day, 7 days/wk. 16
Table 3. Trend in proportion of high school students engaging in muscle strengthening ≥3 days/wk 17
Table 4. Trend in proportion of middle school students physically active ≥60 min/day, 7 days/wk 18
Chapter 2. Review of the Literature. 19
Chronic disease burden in the US. 19
Lifestyle risk factors. 20
Physical activity during childhood and adolescence. 20
Physical activity participation in girls. 22
Social determinants of health. 23
Parental influence on physical activity behaviors of children and adolescents. 25
Summary of current problem and study relevance. 26
Chapter 3. Methodology. 28
Search strategy. 28
Eligibility criteria. 28
Selection process. 29
Data abstraction. 29
Thematic analysis. 30
Table 5. Search terms and concepts. 31
Table 6. SCT concepts and SEM levels. 32
Chapter 4. Results. 33
Study selection. 33
Study characteristics. 33
Intervention characteristics. 35
Post-intervention physical activity improvement among girls. 37
SCT concepts used in interventions. 37
SEM levels targeted by interventions. 38
Inductive thematic analysis of determinants of daughters’ participation in mother-daughter physical activity interventions. 39
Figure 1. PRISMA study selection flow diagram.. 41
Table 7. Study characteristics. 42
Table 8. Intervention characteristics. 46
Table 9. Summary of pre- to post-intervention physical activity changes for daughters. 53
Table 10. Examples of in vivo codes representing SCT constructs used in interventions. 54
Table 11. SCT constructs used in each intervention. 56
Abbreviations: SCT, social cognitive theory. 56
Table 12. Examples of in vivo codes representing SEM levels targeted by interventions. 57
Table 13. SEM levels targeted by each intervention. 58
Table 14. Examples of in vivo codes representing determinants of girls’ participation in interventions 59
Figure 2. Barriers to girls’ participation in interventions. 60
Figure 3. Facilitators of girls’ participation in interventions. 61
Figure 4. Recommendations based on thematic analysis of determinants of girls’ participation in mother-daughter physical activity interventions through the SEM.. 62
Chapter 5. Discussion. 63
Major findings. 63
Findings in context 64
Limitations. 66
Future directions. 67
Conclusion. 68
References. 69
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