Associations among social capital, parenting for active lifestyles, and youth physical activity in rural families living in upstate New York

Social Science & Medicine 75 (2012) 1488e1496

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Associations among social capital, parenting for active lifestyles, and youth physical activity in rural families living in upstate New York Kirsten K. Davison a, b, *, Akihiro Nishi b, c, Sibylle Kranz d, Lynae Wyckoff e, John J. May e, Giulia B. Earle-Richardson e, David S. Strogatz e, Paul L. Jenkins e a

Department of Nutrition, Harvard School of Public Health, Boston, MA, USA Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA The Institute for Quantitative Social Sciences, Harvard University, Boston, MA, USA d Department of Nutrition Sciences, Purdue University, West Lafayette, IL, USA e Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY, USA b c

a r t i c l e i n f o

a b s t r a c t

Article history: Available online 29 June 2012

While emerging research supports a positive relationship between social capital and youth physical activity (PA), few studies have examined possible mechanisms explaining this relationship and no studies have focused on rural youth. In this study, we examined parents’ support of children’s PA as an intermediary factor linking social capital and youth PA in a largely rural cross sectional sample of American children aged 6- to 19-years and their parents/guardians (N ¼ 767 families) living in upstate New York. Parents completed a self-administered survey assessing demographic factors, perceived social capital, support for children’s PA, and children’s PA including time spent outdoors and days per week of sufficient PA. Structural equation modeling was used to test the hypothesis that higher social capital is linked with higher parental support for PA and, in turn, higher PA in children. Analyses were conducted separately for younger (6e12 years) and older (13e19 years) children and controlled for demographic factors (child age, household education, participation in a food assistance program) and perceived neighborhood safety. Anticipated relationships among social capital, parents’ activity-related support, and children’s PA were identified for older, but not younger children. Findings suggest that parent support for children’s PA is one possible mechanism linking social capital and youth PA and the parents of adolescents may rely more heavily on cues from their social environment to shape their approaches to supporting their children’s PA than parents of younger children. Ó 2012 Elsevier Ltd. All rights reserved.

Keywords: Social capital Physical activity Community Parenting Social support Rural USA Family ecological model

Introduction The physical and psychological benefits of physical activity (PA) are widely documented (Janssen & Leblanc, 2010; Paluska & Schwenk, 2000; Warburton, Nicol, & Bredin, 2006). In children, noted benefits include reductions in risk factors for cardiovascular disease, improved glucose metabolism, and improved self esteem (Janssen & Leblanc, 2010; Sothern, Loftin, Suskind, Udall, & Blecker, 1999). Moreover, research supports a dose-type relationship such that greater benefits are observed with increasingly higher levels of PA (Janssen & Leblanc, 2010). In sum, promoting PA in youth is an important public health investment.

* Corresponding author. E-mail address: [email protected] (K.K. Davison). 0277-9536/$ e see front matter Ó 2012 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.socscimed.2012.06.002

Research conducted over the past two decades documents the significant and positive role that parents can play in promoting and supporting youth PA (Beets, Cardinal, & Alderman, 2010; Edwardson & Gorely, 2010; Trost & Loprinzi, 2011). Positive effects of parental support on youth PA have been observed for children and adolescents (Trost & Loprinzi, 2011) and for varying types and intensities of PA (Edwardson & Gorely, 2010). Such findings, however, have not translated into effective family-based interventions promoting youth PA (O’Connor, Jago, & Baranowski, 2009). Shortfalls in the translation of this knowledge may be explained by a lack of consideration for broader contextual factors affecting parenting specific to children’s diet, PA, and screen time, referred to collectively as parenting for healthy lifestyles. Through the integration of ecological and family systems theories, the Family Ecological Model (FEM) emphasizes that parenting is shaped by factors proximal to children and parents in conjunction with the contexts in which they live and interact (Davison &

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Campbell, 2005; Davison, et. al. 2012). Neighborhoods in particular provide an important social context for families (Davison & Campbell, 2005; Dorsey & Forehand, 2003). In addition to the provision of food and recreational resources, communities can foster or impede positive social relationships among residents which in turn may affect intrafamilial interactions and parenting approaches. Surprisingly few studies, however, have examined relationships between community factors and parenting approaches to foster healthy lifestyles. Social capital, defined herein as valued resources that one can access through social connections (Kawachi, Subramanian, & Kim, 2008), is one community characteristic that may affect parenting for healthy lifestyles. Lower levels of social capital have been linked with negative health outcomes including higher rates of subclinical atheroscelerosis (Kim, Roux, Kiefe, Kawachi, & Liu, 2010) and coronary heart disease (Kawachi, Kennedy, Lochner, & ProthrowStith, 1997), lower self-reported health (Subramanian, Kim, & Kawachi, 2002), and poorer mental health (Almedon & Glandon, 2008). As outlined by Berkman et al., mechanisms linking individual-level social capital and health include social influence, social engagement, and the exchange of social support (Berkman, Glass, Brissette, & Seeman, 2000). Social capital has also been linked with youth PA, with higher social capital predicting higher PA (Craddock, Kawachi, Colditz, Gortmaker, & Buka, 2009; Dollman & Lewis, 2010; Duke, Borowsky, & Pettingell, 2012; Pabayo, Belsky, Gauvin, & Curtis, 2011; Singh, Kogan, Siahpush, & van Dyck, 2008; Tolbert Kimbro, Brooks-Gunn, & McLanahan, 2011). This relationship is independent of potential confounding factors such neighborhood level poverty, individual and neighborhood educational status, race/ethnicity, sex of the respondent and child weight status and age (Craddock et al., 2009; Dollman & Lewis, 2010; Duke et al., 2012; Tolbert Kimbro et al., 2011). Furthermore, associations have been observed using self-administered (Craddock et al., 2009; Dollman & Lewis, 2010; Duke et al., 2012; Tolbert Kimbro et al., 2011) and objective measures of PA (Pabayo et al., 2011). While an emerging literature supports the benefits of social capital for youth PA, few studies have examined mechanisms explaining this association e particularly the role of parent support for children’s PA. Consistent with the mechanisms proposed by Berkman et al. (2000), it is reasonable to expect that social capital may translate into support behaviors such as enrolling children in community sport programs, taking children to places to be active, modeling active lifestyles, and encouraging the use of community resources for PA. Furthermore, there is a lack of research examining the role of social capital in rural communities, where children are at increased risk of obesity (Davis, Bennett, Befort, & Nollen, 2011). In this study we examine interrelationships among social capital, parents’ activity-related support and children’s PA in a sample of rural youth ages 6- to 19-years from upstate New York. In particular, we examine parent support for children’s PA as a potential mechanism through which social capital affects youth PA for younger (6e12 years) and older (13e19 years) school-aged children. Based on the FEM and research examining neighborhood effects on other domains of child health (Dorsey & Forehand, 2003), we anticipate that higher social capital will be linked with higher PA in youth through higher parent support for child PA. Methods Study population Data for this study were collected as part of the 2009 Upstate Health and Wellness Survey. Households were randomly sampled from seven rural Central New York counties using a sampling frame provided by Genesys Corporation of Fort Washington, PA. To increase

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the probability that households would have a child between the ages of 2e19, eligibility was limited to households in which the head of the household was 19e55 years of age. In 2009, the seven counties had a total population of 370,071, a median annual income of $43,036, and a population density of 68.8 person/square miles; comparative figures for the state were 19,541,453 (population), $55,980 (annual income), and 401.9 persons/square miles (population density). In addition, 14.6% of families lived below the federal poverty level and 14e22% of adults had a bachelors degree compared with 13.7% living below poverty and 27.4% with a bachelors degree for the state (United States Census Bureau, 2011b). For each household, a parent or guardian (referred to hereafter as parent) was asked to complete and return a self-administered survey with reference to one child living in their household who was between 2- and 19-years of age; in instances where more than one child lived in the home, parents were asked to select the child with the next birthday. The study design utilized three successive sampling waves. The overall response rate, weighted according to the three sampling waves, was 51.5% and produced 992 responding households. The study protocol and data analysis plan were approved by the research compliance board at Bassett Healthcare Network. Data for the current study were limited to children ages 6e19 years attending school and their parents. Preschool-aged children (2e5 years) (N ¼ 225 households) were not included in the analyses because the measure of parental support for PA has not been validated for use for children younger than 6 years. Furthermore, strategies parents use to encourage PA are anticipated to vary for preschool-aged children (e.g., take child to the playground) in comparison to school-aged children and adolescents (e.g., enroll in community sports). Thus, the final sample included 767 households with 6e19-year old children. Measures Survey questions were drawn from validated instruments and large national studies including the Youth Risk Behavior Surveillance System (YRBSS) (Eaton et al., 2008) and the National Survey of Child Health (NSCH) (Blumberg et al., 2007). Social capital Consistent prior research (Duke et al., 2012; Singh et al., 2008), and drawing on items from the NSCH, social capital was assessed at the individual level using four items including: “People in my community help each other out”, “We watch out for each other’s children in this community”, “There are people I can count on in this community”, and “If my child were outside playing and got hurt or scared, there are adults nearby who I would trust to help my child”. Parents answered each question using a 4 point response scale (3 ¼ definitely agree, 2 ¼ somewhat agree; 1 ¼ somewhat disagree; 0 ¼ definitely disagree). In prior research with a large national sample, this measure exhibited an internal consistency coefficient of a ¼ 0.86 (Duke et al., 2012). Resources for physical activity Neighborhood resources for PA were measured using 3 items from the NSCH. Parents responded yes (1) or no (0) to the following: “Are any of the following places and things available to children in your community in the immediate vicinity?” with reference to (a) sidewalks or walking paths, (b) a park or playground area, and (c) a recreation center or community center. Scores were summed for a total score ranging from 0 to 3. Neighborhood disorder Parents’ ratings of neighborhood physical disorder were measured using 3 items from the NSCH. Parents responded yes (1)

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or no (0) to the following “In your community, is there.?” (a) “litter or garbage on the street or sidewalk”, (b) “poorly kept or rundown housing”, and (c) “vandalism such as broken windows or graffiti”. Scores were summed for a total score ranging from 0 to 3. Parents’ support for children’s physical activity Parents’ activity-related support was assessed using 8 items from the Activity Support Scale for Multiple Groups (ACTS-MG) (Davison et al., 2011). Prior research supports the reliability and validity of this scale in children (Davison, Cutting, & Birch, 2003) and adolescents (Davison, 2004) and with white and African American families (Davison, Lawson, & Coatsworth, 2011; Davison, Li, Baskin, Cox, & Affuso, 2011). Dimensions of activity support assessed in this study include (a) logistic support, a form of instrumental support, (b) modeling and co-participation in activities, or conditional support, and (c) encouragement of child use of community resources for PA which reflects informational support (Beets et al., 2010). The ACTS-MG does not include a measure of emotional support (e.g., “I encourage my child to be active”). In prior measurement work virtually all parents reported the highest possible level of emotional support, indicating emotional support did not contribute meaningfully to the scale. Logistic support included three items (“I enroll this child in sports teams and clubs”; “I take this child to places where s/he can be active”; “I watch this child play sports or participate in other activities such as martial arts or dance”). Modeling/coparticipation included two items (“I try to include this child when I do something active”; “I exercise or am active on a regular basis”). Encouraging child use of community resources included three items (“I find ways for this child to be active when school is out by for example enrolling him/her in summer camp and after school programs”; “I encourage this child to use resources in our neighborhood to be active”; “I encourage this child to walk or ride his/her bike in our neighborhood”). Parents responded to each statement using a 4-point response scale (3 ¼ definitely agree, 2 ¼ somewhat agree, 1 ¼ somewhat disagree, 0 ¼ definitely disagree); a total score for each dimension was based on the item average. Each support dimension exhibited acceptable internal consistency (a ¼ 0.79, logistic support; a ¼ 0.77, use of community resources; r ¼ 0.23, inter-item correlation for the two items assessing modeling). Children’s physical activity Children’s PA was assessed based on parents’ reports of children’s time outdoors and days per week of recommended levels of PA (i.e., 60 min of PA per day). For time spent outdoors, parents responded to the following question “On average, how much time does this child spend outdoors in good weather?” with reference to weekdays and weekend days. Prior research shows that time spent outdoors consistently predicts youth PA (Baranowski, Thompson, DuRant, Baranowski, & Puhl, 1993; Burdette, Whitaker, & Daniels, 2004; Cleland et al., 2008; Sallis & Nader, 1993). Furthermore, parents’ report of children’s time outdoors is significantly and positively associated with objectively measured PA in preschool(Burdette et al., 2004) and school-aged (Cleland et al., 2008) children. Participating in recommended levels of PA was assessed using the following question: “During the past week, on how many days was this child physically active for a total of at least 60 min per day?” (Eaton et al., 2008). Responses ranged from 0 to 7. Prior research from the YRBSS supports the reliability and validity of this single-item measure of youth PA with a testeretest intraclass correlation of 0.51, sensitivity estimates ranging from 0.19 to 0.23 and specificity estimates ranging between 0.74 and 0.92 (Troped et al., 2007).

Socio-demographic factors and covariates Socio-demographic factors that were measured include children’s age, gender, and race/ethnicity (Non-Hispanic White, Black/ African-American, or Other), parent gender, household education, and family participation in a federal food program (e.g., SNAP or food stamps, WIC, or free/reduced cost school breakfast or school lunch). Given that participation in food programs is limited to income-eligible individuals only (i.e., individuals living in households at 185% of the poverty income rate), self-reported participation in a federal food program was used as a proxy for having a low family income (United States Census Bureau, 2011). Parents’ perceived stress, which may be linked with social capital and parenting (Dollman & Lewis, 2010), was measured using the following question from the NSCH: “How would you rate your general level of stress?” Response options included 1 ¼ minimal, 2 ¼ moderate, 3 ¼ very high, 4 ¼ overwhelming. Analytic strategy Correlations between outcome variables from the proposed model (i.e., parent support, children’s PA; see Fig. 1) and potential covariates were calculated using Spearman Rank Correlation analysis. Covariates correlated with an outcome variable at p < 0.10 or higher were included in all subsequent analyses (Katz, 2002). Correlations between social capital, parental support for child PA, and children’s PA were also calculated using Spearman Rank Correlation analysis for children ages 6e12 years and 13e19 years. Structural equation modeling (SEM) was used to test hypothesized relations among social capital, parent support for child PA, and children’s PA as outlined in Fig. 1. Social capital and parent support for children’s PA were modeled as latent variables; all other variables were modeled as manifest variables. Separate models were conducted for younger and older children and each measure of child PA. Measurement and structural models were assessed using Maximum Likelihood Method with Missing Values (MLMV) with Stata12.0; alternate estimation methods were considered, but results did not differ from those reported. Assessment of model fit was based on (a) the Chi-Square, (b) Root Mean Square Error of Approximation (RMSEA), (c) the Comparative Fit Index (CFI), and (d) the TuckereLewis Index (TLI). Acceptable model fit was defined as a non-significant Chi-Square, a RMSEA less than 0.08 (acceptable) (Browne & Cudek, 1993) or less than 0.06 (good) (Hu & Bentler, 1999), and CFI and TLI values approaching 1.0. Additional models accounting for clustering within county were also examined. Few differences between the clustered and non-clustered models were identified, therefore the simpler (i.e., non-clustered) models are reported. Results Sample characteristics Sample characteristics are reported in Table 1. Similar numbers of children were included in each age group (younger and older children). Girls comprised approximately 50% of the sample. Consistent with the demographics of the area, over 95% of

Social Capital

Parenting for physical activity

Physical activity

Fig. 1. Proposed model: associations among social capital, parenting for active lifestyles and children’s physical activity.

K.K. Davison et al. / Social Science & Medicine 75 (2012) 1488e1496 Table 1 Sample characteristics.a Variable

Total sample

Ages 6e12 years

Ages 13e19 yearsþ

N Gender (% girls) Race/ethnicity (% white)

767 48.9 97.4

355 49.9 95.4

412 48.1 99.0

Highest household education (%) Elementary/high school College Graduate school

24.4 52.7 22.9

23.2 55.0 21.8

25.4 50.7 23.9

Respondent relationship with child (%) Mother Father Participate in federal food program (%)

55.0 45.0 23.5

55.5 44.5 28.0

54.5 45.5 19.6

Parents’ perceived stress (%) Overwhelming Very high Minimal/moderate

14.4 62.5 23.1

12.7 63.9 23.4

15.9 61.2 22.9

a

Due to the missing values, some categories do not sum to 100%.

participants were white. Approximately 25% of parents had a high school education, 50% had some college, and 25% had post graduate training. Just over 50% of respondents were mothers and 40% were fathers; the remainder included grandparents and aunts/uncles. Parent respondents rated their environments positively with high reported social capital and neighborhood safety and low perceived neighborhood disorder (see Table 2). Reflecting their largely rural status, parents also reported limited access to resources for PA. Parents’ support for children’s PA was in general moderate to high and children spent approximately 3 h outdoors each day and met PA recommendations on most (approximately 5) days per week. Mean scores for social capital (Duke et al., 2012), parents’ activity-related support (Davison, Lawson, et al., 2011; Davison, Li, et al., 2011), children’s time outdoors (Burdette & Whitaker, 2005) and children’s days of PA (Burdette & Whitaker, 2005; Eaton et al., 2010; Larson, Green, & Cordell, 2011) are consistent with prior research. Bivariate associations between potential covariates and the outcome variables are presented in Table 3. The following variables were associated with one or more of the outcome variables (p < 0.10) and were therefore included as covariates in the path models to control for their confounding effect: child age, child gender, household education, participation in federal food program, and perceived neighborhood safety. Bivariate associations between the primary study variables are presented in Table 4. Higher social capital was associated with significantly higher parent support for child PA and higher PA in

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children (i.e., days/week of 60 min MVPA). Higher parent support for child PA was associated with higher PA in children for both measures of PA. Significant positive relationships were also identified between child time outdoors and days/week of 60 min MVPA. The same pattern of correlations was observed in both age groups, although associations were typically stronger in children ages 13e19 years. Measurement model Measurement models for social capital and parent support were examined for each age group using confirmatory factor analysis. For each construct, the first item loading was specified as 1.0 to establish a metric and the remaining items were allowed to vary freely. Results indicated that the latent construct for social capital displayed sufficient inter-item consistency across the four items (a ¼ 0.86 for younger children and a ¼ 0.87 for older children). Factor loadings ranged from 0.70 to 0.79 for younger children and from 0.74 to 0.81 for older children. For parent support for children’s PA, high inter-item consistency was also observed (a ¼ 0.82 for younger children and a ¼ 0.77 for older children). Factor analysis supported the presence of one factor with factor loadings ranging from 0.71 to 0.83 for younger children and from 0.68 to 0.72 for older children. Structural model Time spent outdoors Among younger children, no significant associations were identified between (a) social capital and parent support for children’s PA, (b) parent support and children’s time outdoors, or (c) social capital and children’s time outdoors (Fig. 2A and B). Among older children, higher social capital was associated with significantly higher parent support for PA which in turn predicted significantly greater time spent outdoors (Fig. 2C). No direct effect of social capital on time spent outdoors was identified (Fig. 2D). Thus, social capital exhibited an indirect effect on time spent outdoors through parent support for child PA (Hayes, 2009). The total variance accounted for in time spent outdoors was R2 ¼ 0.112 in the full model (Fig. 2C) and R2 ¼ 0.087 in the reduced model (Fig. 2D) indicating that at least one fifth of the explained variance in time outdoors was attributable to parent support. Days per week of sufficient PA Among younger children, no association was identified between social capital and parent support for children’s PA. Higher parental support, however, was associated with significantly more days of sufficient PA. Although no direct effect of social capital on days of

Table 2 Descriptive statistics (mean, std). Variable

Total sample

Children ages 6e12 years

Children ages 13 yearsþ

Social capitala Perceived neighborhood safetyb Resources for physical activitya Neighborhood disordera Parent support for child PA totala Logistic support Modeling and co-participation Use community resources for PA Time spent outdoors (avg min/day) b Days/week at least 60 min MVPA (mean, std) % children with 60 min MVPA on all 7 days

2.30 (0.65) 2.28 (0.62) 1.23 (1.13) 0.58 (0.88) 2.46 (0.49) 2.41 (0.67) 2.19 (0.60) 2.38 (0.62) 180.25 (80.43) 4.82 (2.01) 30%

2.26 (0.66) 2.25 (0.59) 1.19 (1.13) 0.59 (0.90) 2.48 (0.50) 2.44 (0.67) 2.21 (0.60) 2.41 (0.63) 183.54 (75.66) 5.19 (1.86) 39%

2.33 (0.65) 2.30 (0.64) 1.26 (1.13) 0.57 (0.87) 2.43 (0.46) 2.39 (0.67) 2.16 (0.59) 2.35 (0.61) 177.07 (84.78) 4.47 (2.05) 25%

b

a The average score was calculated as the simple sum of the each question’s response divided by the number of questions, which was highly correlated with the predictive value of each latent variable calculated by factor analysis (Pearson correlation coefficients ranged from 0.98 to 0.99). Score range ¼ 0(worst) to 3(best). b Internal consistency coefficients were not calculated for measures with fewer than 3 items.

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Table 3 Correlations between outcome variables and potential correlates (Spearman rank correlations). Potential correlates

Outcome variables in proposed model

Child age Child gender Race/ethnicity Household education Mother/father $ Use of food program Perceived stress Resources for PA Neighborhood disorder Neighborhood safety

Parent support for child PA

Child time outdoors

Days/week 60 min MVPA

0.10** 0.05 0.03 0.17*** 0.02 0.04 0.04 0.03 0.01 0.16***

0.07* 0.18*** 0.01 0.09** 0.03 0.12*** 0.06 0.07 0.01 0.02

0.16*** 0.17*** 0.06 0.04 0.03 0.01 0.03 0.05 0.04 0.00

* < 0.10, ** < 0.05, *** < 0.01. PA ¼ physical activity; MVPA ¼ moderate-to-vigorous physical activity. $ A dummy variable was created for relationship with child (mother ¼ 1, father ¼ 0). Variables correlated (p < 0.10) with parent support or children’s PA (i.e., child age, child gender, education, food program participation, and perceived neighborhood safety) were included in the Structural Equation Models to control for their confounding effect. Potential correlates were examined without reference to child age to ensure that the same covariates were included in the path models (i.e., to ensure model comparability).

sufficient PA was identified in the full model (Fig. 3A), a significant direct effect was identified in the reduced model (Fig. 3B). The total variance accounted for in days of sufficient PA was R2 ¼ 0.079 in the full model (Fig. 3A) and R2 ¼ 0.031 in the reduced model (Fig. 3B) indicating that more than half of the explained variance was attributable to parent support. Among older children, significant positive relationships were identified between social capital and parent support for children’s PA and in turn between parent support and days of sufficient PA in children (Fig. 3C). In addition, the direct effect of social capital on days of PA was significant but was smaller in the model with (b ¼ 0.128, p < 0.05; Fig. 3C) compared to without (b ¼ 0.211, p < 0.001; Fig. 3D) parent support. These findings suggest that parent support partially mediated the relationship between social capital and days of PA in older children. The total variance accounted for in days of PA was R2 ¼ 0.182 in the full model (Fig. 3C) and R2 ¼ 0.116 in the reduced model (Fig. 3D); thus one third of the explained variance was attributable to parent support for child PA.

Discussion In a largely rural sample of families, we examined relationships among social capital, parents’ activity-related support and children’s PA, including time spent outdoors and days per week of sufficient PA. Based on the FEM (Davison & Campbell, 2005; Davison et. al., 2012) and prior research on social capital and other indicators of child health (i.e., internalizing and externalizing

behaviors) (Dorsey & Forehand, 2003), we hypothesized that social capital would predict youth PA through parental support for PA. Results partially supported this hypothesis. Anticipated effects were identified in older (ages 13e19 years) but not younger (6e12 years) children. Among older children, social capital predicted higher parental support which in turn predicted greater time spent outdoors. Additionally, direct and indirect relationships between social capital and days of sufficient PA were identified for older children with parent support partially mediating the relationship between social capital and days of PA. Among younger children, no relationships were identified between social capital and parents’ support for children’s PA. Age differences in the results are counter to what might be expected. Given young children’s dependence on their parents, one would anticipate that children’s experiences of their neighborhoods would occur through their parents to a greater extent in younger versus older children. Older children in contrast tend to interact more directly with their environments. It is difficult to rectify counterintuitive age effects through comparisons with prior research as studies to date have examined children over a board age range and have not stratified analyses by age (Dorsey & Forehand, 2003; Duke et al., 2012; Zolotor & Runyan, 2006). Findings may reflect age-related differences in normative parental roles. Parents of younger children are expected to play an active and direct role in supporting their children’s development. In this instance, perceived social capital may have less of an effect on the role parents adopt. As children get older, they gain greater independence from their parents (Eccles, 1999). Indeed prior research shows that parent support for children’s PA declines between middle childhood and adolescence (Davison & Jago, 2009). When parent support is no longer normative, parents may rely more heavily on cues from their social environments to guide parentechild interactions, thus leading to a link between social capital and parent support. Additional research is needed to test the validity of this explanation. To our knowledge, only one prior study that has examined associations among community factors, parenting for PA, and children’s PA (Beets & Foley, 2008). Results from Beets and Foley (2008) showed that parents who perceived lower levels of neighborhood safety reported less support for their children’s PA which in turn was associated with lower PA in children. While perceived neighborhood safety is positively associated with social capital, it is not an indicator of social capital, but rather an intermediary variable between social capital and health (Harpham, 2008). We controlled for the effects of perceived neighborhood safety to better isolate the effects of social capital. Integrating findings across these studies suggests that there may be a cascading effect moving from social capital to proximal processes such as perceived neighborhood safety to more distal processes such as parenting for healthy lifestyles and finally to child outcomes. Future research could explore this pathway in greater detail. This study is also one of the first to examine links between social capital and PA in rural youth, and may be the first to examine the

Table 4 Correlations between social capital, parenting, and children’s physical activity (Spearman rank correlations). Children ages 6e12 years Social capital Parent support for child PA Child time outdoors Days/weeks 60 min MVPA

Parent support for child PA

Children ages 13e19 years Child time outdoors

0.18*** 0.00 0.11*

Social capital

Parent support for child PA

Child time outdoors

0.17** 0.36***

0.36***

0.33*** 0.12* 0.20***

* < 0.10, ** < 0.05, *** < 0.01. PA ¼ physical activity. MVPA ¼ moderate-to-vigorous physical activity.

0.27***

0.05 0.16**

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-0.0588

A

Parenting for physical activity

Social Capital 0.082 0.830***

0.110

Time spent outdoors

0.707***

0.762***

SC1

SC2

0.703***

0.785***

0.796***

SC3

0.898***

SC4

P1

P2

P3

-0.051

B

Time spent outdoors

Social Capital 0.829***

0.708***

0.795*** 0.763***

SC1

SC2

SC3

SC4

-0.043

C

Parenting for physical activity

Social Capital 0.290*** 0.763***

Time spent outdoors

0.780***

0.818***

SC2

0.687***

0.730***

0.830***

SC1

0.182*

SC3

0.787***

SC4

P1

P2

P3

0.012

D

Time spent outdoors

Social Capital 0.768***

0.780***

0.827*** 0.819***

SC1

SC2

SC3

SC4

Fig. 2. Results from structural equation models examining parent support for children’s physical activity as an intermediary factor linking social capital and children’s time spent outdoors. A (younger): Chi-square: 73.70 (df ¼ 43; p ¼ 0.02), RMSEA: 0.048, CFI: 0.963, TLI: 0.941 B (younger): Chi-square: 46.27 (df ¼ 20; p ¼ 0.001), RMSEA: 0.066, CFI: 0.949, TLI: 0.910 C (older): Chi-square: 103.52 (df ¼ 43; p < 0.001), RMSEA: 0.055, CFI: 0.953, TLI: 0.926 D (older): Chi-square: 71.81 (df ¼ 20; p < 0.001), RMSEA: 0.075, CFI: 0.945, TLI: 0.904.

relationship between social capital and a health-related measure of any kind in a rural US population. Prior studies have examined links between social capital and general health outcomes in rural adult populations in China (Norstrand & Xu, 2011; Yip et al., 2007), Australia (Ziersch, Baum, Darmawan, Kavanagh, & Bentley, 2009) (Boyd, Hayes, Wilson, & Bearsley-Smith, 2008), Madagascar (Sirven,

2006), and Finland (Nummela, Sulander, Karisto, & Uutela, 2009). Findings from these studies mirror what has been observed in nonrural samples, with higher social capital predicting greater selfreported health. While the effect of social capital on health appears to be similar across geographic areas, differences in the structure of daily life in rural communities resulting from low

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0.112

A

Parenting for physical activity

Social Capital 0.087 0.829***

0.223***

Days of physical activity

0.709***

0.763***

SC1

SC2

0.707***

0.784***

0.795***

SC3

0.896***

SC4

P1

P2

P3

0.135*

B

Days of physical activity

Social Capital 0.829***

0.710***

0.795*** 0.763***

SC1

SC2

SC3

SC4

0.128*

C

Parenting for physical activity

Social Capital 0.290*** 0.761***

0.782***

0.813***

SC2

0.676***

0.752***

0.834***

SC1

0.279***

Days of physical activity

SC3

0.775***

SC4

P1

P2

P3

0.211***

D

Days of physical activity

Social Capital 0.765***

0.781***

0.832*** 0.814***

SC1

SC2

SC3

SC4

Fig. 3. Results from structural equation models examining parent support for children’s physical activity as an intermediary factor linking social capital and children’s days per week of sufficient physical activity. A (younger): Chi-square: 70.90 (df ¼ 43; p ¼ 0.005), RMSEA: 0.046, CFI: 0.966, TLI: 0.947 B (younger): Chi-square: 42.19 (df ¼ 43; p ¼ 0.003), RMSEA: 0.060, CFI: 0.956, TLI: 0.924 C (older): Chi-square: 99.36 (df ¼ 43; p < 0.001), RMSEA: 0.053, CFI: 0.957, TLI: 0.933 D (older): Chi-square: 69.86 (df ¼ 20; p < 0.001), RMSEA: 0.073, CFI: 0.948, TLI: 0.909.

K.K. Davison et al. / Social Science & Medicine 75 (2012) 1488e1496

population density, the presence of extended family networks and the widely dispersed PA resources suggest that the processes through which social capital shape parenting and PA may be different. Results from this study have implications for intervention design. Family-based interventions promoting PA in youth typically target change within families and schools and rarely consider the broader community in which families reside (O’Connor et al., 2009). Consistent with the FEM, results from this study suggest that contextual factors may need to be addressed when targeting parenting for healthy lifestyles in order to sustain and support behavioral change within families. Stated differently, these findings suggest that programs promoting PA in adolescents may be more effective when integrated with community-based programs fostering social interactions among community members. Key strengths of this study include the assessment of a novel research question, the use of a family-centered theoretical framework, and a focus on rural youth and their families. Additional strengths include the ability to control for constructs often used synonymously with social capital, but which do not reflect social capital (e.g., perceived neighborhood safety) and the use of SEM to account for measurement error. We recognize, however, that this study’s cross sectional design limits the conclusions that can be drawn. In particular, this study does not provide a conclusive test of parent support as a mediator of the relationship between social capital and youth PA. What is more, findings are limited by the use of parent-report measures, particularly for children’s PA, and cannot be generalized beyond white families living in rural areas. At a minimum, however, results from this study suggest that links between social capital and parenting for healthy lifestyles and their relevance for family-based interventions should be explored in greater detail in future research. In summary, in a sample of children and their parents living in a rural area in upstate New York, we identified significant associations between parents’ reports of their individual-level social capital, their activity-related support, and PA in older (13e19 years) but not younger (6e12 years) children. While limited by the use of a cross sectional design, findings suggest that higher social capital predicts greater parental support for PA in older children and in turn higher youth PA. Findings have implications for family-based health promotion efforts, including the potential benefits of merging family and community-based programs to support adolescent health. Future research should replicate these findings using a longitudinal design, a more diverse sample, and an objective measure of children’s PA, and should be designed to test the pathways proposed.

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