Academic journal article Childhood Obesity

Physical Activity Self-Efficacy and Fitness: Family Environment Relationship Correlates and Self-Esteem as a Mediator among Adolescents Who Are Overweight or Obese

Academic journal article Childhood Obesity

Physical Activity Self-Efficacy and Fitness: Family Environment Relationship Correlates and Self-Esteem as a Mediator among Adolescents Who Are Overweight or Obese

Article excerpt

[Author Affiliation]

Nora L. Nock. 1 Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH.

Carolyn E. Ievers-Landis. 1 Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH. 2 University Hospitals Case Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH.

Rachel Dajani. 2 University Hospitals Case Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH.

Darryl Knight. 2 University Hospitals Case Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH.

Alexander Rigda. 2 University Hospitals Case Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH.

Sumana Narasimhan. 2 University Hospitals Case Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH.

Naveen Uli. 2 University Hospitals Case Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH.

Address correspondence to: Nora L. Nock, PhD, Department of Epidemiology and Biostatistics, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, E-mail: nln@case.edu

Introduction

Rates of overweight and obesity in children and adolescents have been rising over the past several decades. Although recent data suggest a plateauing of this trend,1 rates of type 2 diabetes in adolescents, which are largely attributed to obesity, continue to rise2 and may decrease life span and quality of life. Physical inactivity contributes to overweight and obesity, and the World Health Organization (WHO) estimates that ∼70% of premature deaths in adulthood are attributed to poor health behaviors adopted during adolescence.3 Furthermore, positive physical activity patterns established in childhood have been shown to predict higher physical activity and fitness levels in adulthood.4-6

The family environment plays a key role in establishing adolescent health behaviors, particularly physical activity. However, most of the studies conducted have focused on parenting style, parental monitoring, parental support, and parental (modeling) behaviors, as well as the physical environment.7,8 Only a few studies have evaluated associations between relationship domains of the family environment and physical activity in adolescents. One study used an overall health measure (a health "cluster" based on physical activity, BMI, sleep, diet, smoking, and alcohol use), rather than a single measure of physical activity, and found that adolescents in the "most healthy clusters" reported having the highest levels of family cohesion as measured using the Family Adaptability and Cohesion scale.9

Subsequently, Ornelas et al.10 found that greater family cohesion was associated with meeting self-reported moderate-to-vigorous physical activity (MVPA) guidelines, which was defined as 5 or more weekly bouts of at least 30 minutes of MVPA (five to eight metabolic equivalents, METs). In this study, family cohesion was measured by summing responses to three items (how much people in their family understand them, how much they and their family have fun together, and how much their family pays attention to them). Using the relationship dimensions of the Family Environment Scale (FES), Kalavana et al.11 reported that family cohesion was positively associated with self-reported physical activity, but no statistically significant association between family conflict and physical activity was found. Recently, Bigman et al.12 reported that family cohesion but not family conflict, as measured using subscales of the Family Life Questionnaire, was associated with self-reported MVPA, defined as engaging in 60 minutes or more of physical activity on 5 or more days of the week in the past week. …

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