Associations of maternal influences with outdoor play and screen time of two-year-olds: Findings from the Healthy Beginnings Trial

Aim: This study aims to investigate if maternal influences are associated with children's outdoor playtime and screen time at the age of 2 years. Methods: A cross-sectional study with 497 first-time mothers and their children was conducted using the data from the Healthy Beginnings Trial undertaken in Sydney, Australia during 2007-2010. Maternal influences included their own physical activity and screen time, television rules for their child, perceived neighbourhood environment, parental self-efficacy and parenting style (warmth and hostility). Children's outdoor playtime, screen time and maternal influences were collected through face-to-face interviews with participating mothers when the children were 2 years old. Logistic regression analysis was conducted to examine the associations between maternal influences and children's outdoor play and screen time. Results: Mothers with low levels of parental hostility and high perceived safe outdoor play environment were more likely to have children playing outdoor for = 2 h/day with adjusted odds ratio (AOR) 2.65 (95% confidence interval (CI) 1.68-4.20, P < 0.0001) and AOR 2.44 (95% CI 1.85-3.85, P < 0.0001) respectively. Mothers' own screen time was the sole factor associated with children's screen time (AOR 1.90 (95% CI 1.29-2.81, P = 0.001)). Conclusion: Different maternal influences were independently associated with children's outdoor play or screen time at an early stage of life. Therefore, different intervention strategies are needed to increase children's outdoor playtime and decrease their screen time.