1. Aims Kathryn R Hesketh 1 ; Alison M McMinn 1,2 ; Esther MF van Sluijs 1,2 ; Nicholas C Harvey 3 ; Cyrus Cooper 3 ; Hazel M Inskip 3 ; Keith M Godfrey 3 ; Simon J Griffin 1,2 1 UKCRC Centre of Excellence for Diet and Activity Research (CEDAR), Institute of Public Health, Cambridge, UK; 2 Medical Research Council Epidemiology Unit, Cambridge, UK; 3 MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK Introduction † Corder et al. Am J Prev Med 2010; 38(1);1-8 The work of K Hesketh was supported by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research and the Wellcome Trust under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. www.esrc.ac.uk/publichealthresearchcentres Methods Data was obtained from the Southampton Women’s Survey, a UK population-based longitudinal study. This cross-sectional analysis used data from a subsample of participants invited to take part in a secondary study when their child was 4 years old. PA was measured objectively using Actiheart monitors for ≤7 days and daily minutes of moderate-to-vigorous PA (MVPA) were derived. Children were classified as active/inactive based on whether they accumulated 60 minutes of MVPA. This, along with maternal perception of PA (active/inactive) was used to categorise awareness (Table 1). 15 child and maternal characteristic exposure variables were derived from a maternally completed questionnaire. Associations between each exposure variable and whether or not mothers overestimated their child’s PA were assessed using logistic regression: first unadjusted (Model 1), then adjusted for variables that were associated with overestimation in the unadjusted models (Model 2) (Table 2). Those children whose mothers underestimated their PA level were excluded from analyses. Maternal awareness of 4-year-old children’s physical activity and correlates of overestimation Southampton Women’s Survey (SWS) Variable Model 1 OR (95% CI) Model 2 OR (95% CI) Child characteristics Sex (ref: male) Age (in years) BMI (kgm -2 ) Has a sibling living at home (ref: no sibling) Attends nursery (ref: part-time) Full-time Other 1.18 (0.81, 1.73) 0.62 (0.03, 13.4) 1.05 (0.91, 1.21) 0.53 (0.34, 0.84)** 2.17 (1.09, 4.32)* 1.04 (0.25, 4.42) 0.53 (0.33, 0.83)** 2.28 (1.13, 4.60)* 0.99 (0.23, 4.28) Maternal Characteristics Age (in years) BMI (kgm -2 ) Age leaving full-time education (ref:<16years) 17-18 years >18 years 1.00 (0.95, 1.06) 1.00 (0.97, 1.04) 1.32 (0.83, 2.10) 0.91 (0.56, 1.47) Maternal Perception Child is outgoing (ref: Strongly/disagree) Neither Agree Strongly Agree Child is restless (ref: Strongly disagree) Disagree Neither Strongly/Agree Child is well behaved (ref: disagree/no opinion) Agree Strongly agree Child enjoys PA (ref: Disagree/ no opinion) Agree Strongly agree PA is important (ref: disagree/no opinion) Agree Strongly agree Child is not interested in PA (ref: never) Rarely Sometimes/often/very often Child doesn’t have the skills for PA (ref: never) Rarely Sometimes/often/very often 1.30(0.57, 2.97) 1.35 (0.64, 2.88) 0.97 (0.44, 2.12) 1.02 (0.61, 1.72) 0.91 (0.53, 1.55) 0.66 (0.33, 1.31) 1.65 (1.01, 2.70) 1.85 (1.00, 3.41) 4.77 (1.05, 21.8)* 4.37 (0.98, 19.6)* 1.27 (0.42, 3.91) 1.04 (0.47, 4.12) 1.10 (0.68, 1.77) 0.81 (0.52, 1.27) 1.68 (0.99, 2.85) 1.30 (0.78, 2.16) 4.70 (1.00, 22.1)* 4.56 (0.99, 21.0)* Table 2: Association between child and maternal characteristics and maternal overestimation of their child's physical activity n (%)Perceived InactivePerceived ActiveTotal Inactive20 (4.2)175 (36.6)195 (40.8) RealisticOver-estimators Active20 (4.2)263 (55.0) 283 (59.2) Under-estimatorsRealistic Table 1: Classification of children into physical activity awareness categories by maternal perception and objective measurement of child PA level Conclusions Parents are seen as the gatekeepers of young children’s physical activity (PA). Parental awareness of their child’s PA level may be important to the success of interventions to promote PA. Parents of inactive 9-10-year-old children tend to overestimate their child’s PA levels † but this association has not been investigated in young children. To assess maternal awareness of PA in 4-year-old children. To establish what factors are associated with maternal overestimation of PA in these children. Results Contact: Kathryn Hesketh: krh40@medschl.cam.ac.uk *p≤0.05 **p<0.01 Model 2: Adjusted for nursery attendance, sibling at home and perceived enjoyment of PA Data was available for 486 children: mean age 4.1 ± 0.1 years; 47% male; mean ± SD of 70.3 ± 30.7 minutes in MVPA per day. 40.8 % of children were inactive: 89.7% of these children were perceived to be active by their mothers (over-estimators). After adjustment, three factors were significantly associated with maternal overestimation of physical activity (Table 2). A large proportion of mothers of inactive four-year-olds inaccurately perceive their child to be active, as shown previously in older children. This may be important to consider when developing interventions to promote physical activity in this age group. Promoting awareness of activity levels in mothers of inactive children who attend nursery full-time and who do not have siblings may be particularly important.