Trajectories of Physical Activity and Screen Media Use in Toddlers and Related Parenting Practices: Child and Mother Physical Activity Study (CAMPAS)

Background: Physical activity (PA) and screen media use are key behaviors for healthy development in early childhood. This study aimed to investigate 12-month trajectories of PA and screen time among toddlers and examine their associations with parenting practices. Methods: The Child and Mother PA Study (CAMPAS) recruited toddler-mother dyads in the US Chicago area from 2022-2024. Assessments were conducted at approximately 12, 18, and 24 months of age (Waves 1-3). Toddlers’ PA was measured using hip-worn ActiGraph accelerometers and their screen time was mother-reported. The PA Parenting Practices for Preschoolers (PAPPP) questionnaire was used to assess PA-encouraging and screen time-limiting parenting practices. Mixed-effects models were fit to model trajectories of moderate and vigorous-intensity PA (MVPA) and screen time over age. Multivariable regression models examined the associations between toddlers’ MVPA and screen time and their parents’ parenting practice scores. Results: The CAMPAS included 139 toddler participants (74 females). At Waves 1-3, average age was 13.6 (SD=1.7), 19.9 (SD=1.6), and 26.9 (SD=2.1) months, respectively. Average MVPA was 74 (95%CI=70-79), 73 (95%CI=69-77), and 80 (95%CI=75-85) minutes/day, respectively, with no significant change over time ( p =0.13). Average screen time was 27 (95%CI=21-33), 46 (95%CI=38-55), and 59 (95%CI=50-69) minutes/day, respectively, significantly increasing over time ( p <0.01). Every one-point higher PA-encouraging parenting practice score was associated with 9 additional minutes of daily MVPA (95%CI=2-15). For every one-point higher screen time-limiting parenting practice score was associated with 45 fewer minutes of daily screen time (95%CI=38-52). Conclusion: During the second year of life, toddlers exhibited a substantial increase in screen time but minimal changes in MVPA. Parenting practices were associated with toddlers’ MVPA and screen time. Findings suggest that promoting parenting practices that encourage PA and limit screen time may be an effective intervention strategy to support healthy PA and screen use development during this critical developmental period. Clinical trial number: not applicable