Do parents perceive that organized activities interfere with family meals? Associations between parent perceptions and aspects of the household eating environment

Abstract

Background:

Research has related child participation in organized activities to health and academic benefits; however, participation may interfere with family meals.

Objective:

Examine whether parents perceive child participation in organized activities to interfere with family meals, and how perceptions are related to the household eating environment.

Design:

A cross-sectional analysis was completed using survey data collected in 2015-2016 as part of the Project EAT cohort study.

Participants:

Survey participants were originally recruited in Minneapolis-St. Paul schools in 1998-1999. The analytic subsample of parents (one per household, n=389, 69% female, 31% non-white race, mean age=31) had one or more children involved in an organized activity. Approximately 33% of households included a child aged 2-5 and no older child; two thirds of households included school-aged children (6-18 years).

Main outcome measures:

Parents reported family meal frequency; family meal scheduling difficulties; frequency of at-home meal preparation; and their own intake of fast food, fruit, and vegetables.

Statistical analyses performed:

Analyses compared household environment characteristics reported by parents who perceived low interference between organized activities and family meals to characteristics reported by parents who perceived moderate-to-high interference from at least one form of activity. Regression models included a dichotomous indicator of interference as the independent variable and were adjusted for parental and household characteristics.

Results:

Among parents with children at any age, moderate-to-high interference was associated with lower family meal frequency, greater difficulty scheduling family meals, and more fast food intake (all P≤0.01). The perception of moderate-to-high interference was more common among parents that reported involvement in both sport and non-sport activities (P<0.001) and those with a school-aged child (P<0.001) versus only preschool-aged children.

Conclusions:

Follow-up research, including qualitative studies, are needed to identify the specific aspects of child participation in organized activities (e.g., scheduled time of day) that may interfere with family meals.

The participation of school-age and preschool-age children in team sports and other organized activities is linked to many benefits for health, development, and academic outcomes.^1-9 Organized activities provide contexts for forming supportive relationships, occasions to learn new skills, and opportunities for physical activity.^{5, 10, 11} Prior research focused on organized sports has shown that nearly a third of high school students and even higher percentages of children 6-14 years are participating in sports.¹² Although young children (≤6 years) are less often enrolled in sports, rates of participation have increased in recent years.¹³ The involvement of these youth in sports is related to higher healthy self-image; better nutrient intake; more physical activity; lower risk of emotional distress and substance use; and better social skills.^{1, 5, 6, 14}

There is further evidence that the benefits of sport participation are greatest for young people who additionally participate in other organized, non-sport activities (e.g., religious activities, performing arts, scouts).^{15, 16} School-age children who are involved in various organized activities report more positive attitudes about school and achieve better grades than their uninvolved peers.^{4, 7,8} Similarly, at least one study has found that preschool-age children (2-5 years) who participate in organized sports or activities tend to have a lower body mass index.¹⁷ Evidence of benefits has been observed in diverse population groups and contexts; however, families that are highly involved in organized activities may experience more barriers to carrying out other health promoting practices.^{2, 4, 5}

More specifically, there is growing evidence that time-related challenges are a common barrier to having family meals and the participation of children in organized activities is perceived by parents to contribute to these challenges.^18-20 Having regular family meals has been related to markers of better psychosocial health and diet quality among parents and children 2-18 years, stronger vocabulary skills for preschool-aged children and better academic outcomes for school-age children, and higher likelihood of healthy weight maintenance over time.^21-26 Given the benefits of family meals and organized activities, and their potential public health impact, there is a great need for strategies to support families that would like to benefit both from participation in organized activities as well as eating nutritious meals together.

It will be important for the design of such strategies to be informed by an understanding of how perceptions regarding organized activities differ among diverse families according to parental characteristics (e.g., employment status) and household characteristics (e.g., number and developmental stages of children). Further, there is a need to build understanding of how perceptions regarding organized activities as a barrier to family meals may be related to aspects of the household eating environment. It is possible that the time pressures could play a role in how often families eat together, communication at mealtimes, frequency of purchasing fast food, and parents’ healthy eating behaviors.

The current study was completed to help fill these research needs, build the literature on the participation of preschool-aged children in organized activities,⁹ and to inform the design of future studies that will be required to evaluate interventions for families with children ages 2-18 years. The first aim was a) to describe the perceived interference of children participating in organized activities with family meals for households with only preschool-age children and for households that include older school-age children, and b) to assess the association of the perceptions with parental and household characteristics. In addition, a second aim was to examine how parental perceptions of organized activities as a barrier to family meals may be related to aspects of the household eating environment. It was hypothesized on the basis of prior research findings that perceived interference would be related to lower family meal frequency, more frequent purchases of food from fast food restaurants, and lower fruit and vegetable intake.^{18, 19}

METHODS

Sample and Study Design

Project EAT (Eating and Activity in Teens and Young Adults) is a large, population-based study of weight-related outcomes that has followed young people from adolescence to adulthood. At the original assessment (1998-1999), a total of 4,746 adolescents enrolled at 31 public middle schools and senior high schools in the Minneapolis-St. Paul metropolitan area of Minnesota completed surveys and anthropometric measures.^{27, 28}

Given the aims of the current study, the cross-sectional analysis reported here used data from the fourth survey wave in 2015-2016. Original participants who had responded to at least one previous follow-up survey were mailed letters inviting them to complete the EAT-IV survey. EAT-IV survey data were collected online, by mail, or by phone from 66.1% of those for whom current contact information was available (N=1830 respondents), and approximately one third of participants were parents. The subsample of parents included in the current analysis was identified by report of having one or more children (≥2 yrs) and living with one’s own child(ren) for the majority of the past year; each parent represented a separate household. Analyses focused on those having one or more children involved in an organized activity and thus the analytic sample included 389 parents (69% female).

All study protocols were approved by the University of Minnesota’s Institutional Review Board Human Subjects Committee. Parental consent and written assent from participants was obtained in 1998-1999. For the fourth survey wave, participants were mailed a consent form with their paper survey or reviewed a consent form as part of the online survey. Completion of the follow-up survey implied written consent.

Survey Development

The EAT-IV survey was based on surveys used in previous study waves but modified to assess age-appropriate topics (e.g., parenting of children ages 2-18) and to explore issues of emerging interest. Based on prior EAT study research and related studies addressing family meals, the survey included measures of family meal frequency, mealtime importance, and barriers to family meals.^{23, 29-33} In addition, as community-based initiatives have raised concerns about “overscheduled kids”, measures were added to assess whether parents with children 2-18 years perceived youth activities to interfere with family meals.³⁴ Focus groups with a separate community-based sample of 35 participants (ages 25-35 years), including parents and non-parents, were used to pre-test a draft survey. Scale psychometric properties were examined in the full sample of responders to the EAT-IV survey and estimates of item test-retest reliability were determined in a subgroup of 103 participants who completed the EAT-IV survey twice within a period of one to four weeks. Cronbach’s alpha is reported for scales as a measure of internal consistency or, in other terms, how closely the set of survey items are related as a group.³⁵

Family meals and organized activities.

Frequency of eating family meals was assessed with the question: “In the past week, how many times did all, or most, of the people living in your household eat a meal together?” (test-retest r=0.64; r=reliability correlation coefficient).²³ Response categories ranged from “never,” to “more than seven times”. To allow for comparison of mean meal frequencies, the number of meals was assigned a score of 0.0, 1.5, 3.5, 5.5, 7, or 9 to correspond to the six possible responses. Parent perceptions regarding organized activities were assessed by asking the following questions: (1) “To what extent does your children’s participation in youth sports interfere with having family meals?” and (2) “To what extent does your children’s participation in organized activities (e.g., scouts; clubs; cultural, arts, and music activities), other than youth sports, interfere with having family meals?”. Response categories for both questions about organized activities included the option to indicate “my children do not participate” and a 4-point scale ranging from “does not interfere at all” to “interferes a lot”. For the present analysis, responses to the two questions were combined to create a dichotomous indicator of the perception that one or both forms of activity (sport, non-sport) interfered with family meals. The indicator was created only for respondents with a child involved in one or more form of activity and the perception of interference was considered moderate-to-high when for at least one form of activity the respondent reported either “somewhat interferes” or “interferes a lot” (test-retest agreement=84%).

Mealtime importance, scheduling difficulties, and positive interactions.

Response options for all of the survey items about mealtimes were “strongly disagree”, “disagree”, “agree”, and “strongly agree”. The perceived importance of eating meals together as a family was assessed by asking participants to indicate how strongly they disagreed or agreed with the statement “In my family, it is important that the family eat at least one meal a day together” (test-retest agreement on disagree/agree=91%). In alignment with previous research, response options for the importance item were dichotomized by grouping the disagree responses and the agree responses.³⁶ Scheduling difficulties were assessed by asking participants to indicate how strongly they disagreed or agreed with three statements regarding time-related barriers (e.g., “In my family, it is often difficult to find a time when family members can sit down to a meal together”, Cronbach’s alpha = 0.83, test-retest r=0.78). Similarly, positive interactions at meals eaten together as a family was assessed with four statements (e.g., “In my family, dinner time is about more than just getting food; we all talk with each other”, Cronbach’s alpha = 0.75, test-retest r=0.58). Responses to individual items about scheduling and interactions at meals were summed in a manner similar to prior research,³⁷ to form scores with higher values indicating greater scheduling difficulties and more positive interactions.

Parental and household characteristics.

Parental characteristics were self-reported and included sex (test-retest agreement = 97%), age (calculated from birth year), and employment status (test-retest agreement =82%).²³ Employment status was based on report of working full-time, working part-time, or not working for pay (e.g., stay at home caregiver, currently unemployed). Given prior evidence of relevance for weight-related health,³⁸ family functioning was assessed using six items drawn from the general functioning scale of the Family Assessment Device.^39-41 This tool captures structural and organizational properties of the family group and patterns of transactions, including problem solving, communication, roles, affective responsiveness, affective involvement, and behavior control among family members.^39-41 The range of responses for the six-item family functioning scale was 6-24, with higher scores representing higher functioning (Cronbach’s alpha = 0.72, test-retest r=0.71).²³ The number of adults living within a household was based on report of with whom the participant lived for the majority of the time in the past year. Educational attainment was reported by the participant (test-retest agreement=97%) and, when applicable, additionally reported for a spouse/partner living in the household; the higher level was used in analyses as a marker of household socioeconomic status.⁴² The number and developmental stages of children in each household was assessed by asking parents to report their living situation for the majority of the past year (test-retest agreement = 100%) and ages for each of their children. Developmental stages were defined as preschool (2-5 years) and school-age children (6-18 years). Parent ethnicity/race was based on self-report on the original school-based survey (test-retest κ = 0.70 to 0.83; κ=Cohen’s kappa for intrarater reliability).⁴²

Restaurant use.

Parent frequency of eating food from fast-food restaurants was assessed with the question: “In the past month, how often did you eat something from the following types of restaurants (include take-out and delivery)?”⁴³ Participants were asked separately about six categories of fast-food restaurants (e.g., burger-and-fries). Response options ranged from “never/rarely,” to “one or more times per day.” The six options were correspondingly assigned scores of 0, 2, 6, 14, 22, and 28 times per month to allow for comparison of mean total frequency of eating food from a fast-food restaurant after summing across categories. Summed frequency scores were reviewed for extreme values and those indicating that a parent ate fast food more than three times per day on every day of the month were reassigned to a maximum value of 90 times per month. The test-retest reliability of reported frequencies among adults varied according to the type of food served at restaurants, ranging from r=0.52 (Asian food, pizza) to r=0.71 (sandwich/sub).⁴² Frequency of purchasing fast food for family meals was also assessed with the question: “During the past week, how many times was a family meal purchased from a fast food restaurant and eaten together either at the restaurant or at home? (pizza counts)”.⁴⁴ Four response categories were combined for analysis based on the distribution to represent 0-1 purchases or 2+ purchases of fast food in a given week (test-retest agreement=79%).

Preparation of meals at home.

Frequency of preparing meals at home was assessed with the question: “During the past month, how often have you prepared a meal that included vegetables?” (test-retest r=0.84).⁴⁵ Responses were “never,” “one time,” “a few times,” “weekly,” “a few times a week,” and “most days of the week”. For the current analysis, responses were dichotomized based on the distribution to examine preparing meals most days of the week versus less often.

Parent fruit and vegetable intake.

A semi-quantitative food frequency questionnaire was administered at the same time as the Project EAT-IV survey to assess usual past year dietary intake.^{46, 47} For fruit and vegetables, a daily serving was defined as the equivalent of one-half cup and examined in relation to total calorie intake (servings per 1000 calories). Previous studies have examined and reported acceptable reliability and validity for intake estimates.^{48, 49} Responses to the FFQ were excluded if participants reported a biologically implausible level of total energy intake (<500 kcal/day or >5000 kcal/day) or left 20 or more items blank.

Statistical Analysis

The first aim, to describe the perceived interference of children participating in organized activities with family meals for households with only preschool-age children and for households that include school-age children, was examined by calculating percentages for each ranking of perceived interference in the full sample of parents with a participating child (n for sports=313, n for other activity=306). A dichotomous variable was then defined to indicate the perception that both activities interfered only slightly or not at all (low interference) versus at least one form of organized activity interfered somewhat or a lot (moderate-to-high interference). Among parents that reported having a child involved in at least one form of organized activity, percentages and least square mean estimates were then calculated to examine the distribution of parental and household characteristics according to perceived interference in the parent sample (n=389). Least square mean estimates were calculated by examining an unadjusted regression model. Chi-square tests and t-tests were used to test unadjusted differences in the distribution of categorical and continuous variables, respectively.

The second aim regarding associations between perceived interference and markers of the eating environment was likewise addressed within the sample of parents having a child involved in one or more form of activity. The dichotomous indicator of low versus moderate-to-high interference was the independent variable in all regression models that were used to separately assess associations with each variable representing parental report of family meals, the home eating environment, and their own eating behaviors. Some of the family/home eating environment outcomes were dichotomized for these analyses to simplify interpretation; cut-points were selected based on the distribution of responses or to align with other research.⁵⁰ Regression models with family/home eating environment outcomes were adjusted for number of forms of activity in which the child(ren) participated along with parental and household characteristics on the basis of previous research.^{51, 52} Regression models of parental eating and meal behaviors were additionally adjusted for family meal frequency given the authors expect it is a mediator based on existing evidence that parents who participate in more family meals tend to have better diet quality and consume less food from fast-food restaurants.^{23, 50} Collinearity diagnostics were generated for these regression models using Proc reg and, based on examination of the variance inflation factors and tolerance values, it was determined there was no need for concern regarding collinearity between the independent variables. In order to further determine if observed associations between perceived interference and markers of the eating environment were consistent for families with only preschool-age children and those that included school-age children, interaction terms were added to each regression model (child developmental stage by perceived interference). Interaction terms were examined and in all cases were not statistically significant (P>0.10).

All analyses were conducted using the Statistical Analysis System (version 9.4, 2015, SAS Institute Inc., Cary, NC).⁵³ An alpha of <0.05 was set to determine statistical significance. Individual variables from the EAT-IV survey in this sample had relatively few missing observations. Only the preparation of meals at home variable had greater than 5% of the data missing; within the set of food preparation questions, 16% of the data was missing due to skip patterns. For fruit and vegetable intake, there was 13% of the data missing because of non-response to the food frequency questionnaire. Missing data was assumed to be missing at random.

RESULTS

Parental Perceptions of Organized Activities

Among parents with a sport-involved child (n=313), 43.8% reported the perception that participation did not interfere at all with family meals, 36.7% perceived slight interference, and 19.5% perceived that participation interfered somewhat or a lot. Parents also reported the perception that participation in other non-sport organized activities interfered with family meals, but this perception was less common. Among parents with a child involved in non-sport activities (n=306), 61.1% reported the perception that participation in non-sport activities did not interfere at all with family meals, 29.4% perceived slight interference, and 9.5% perceived that participation interfered somewhat or a lot.

Parental and Household Characteristics

Associations between perceived interference and characteristics of parents and households were examined in the sample of 389 parents that reported having a child involved in at least one form of organized activity (Table 1). This sample of parents had a mean age of 31.4± 1.5 years and 68.6% identified as female. The majority of parents had at least one school-aged child, but 32.6% of parents reported having children ages 2-5 and no older children. The mean number of children living with a parent was 2.1. The ethnic/racial backgrounds identified by parents were 69.5% white, 10.1% African American or Black, 10.3% Asian American, and 10.1% mixed or other. The distribution of maximum household educational attainment was: 13.4% high school degree, 37.5% some college, 32.0% four-year degree, and 17.0% graduate degree.

Table 1.

Perceived interference of organized youth activities with family meals by individual and household characteristics of parent participants in the 2015-2016 Project EAT-IV (Eating and Activity in Teens and Young Adults) follow-up survey of cohort members enrolled in public schools in Minneapolis-St. Paul, MN in 1998-1999^a

		Perceived extent of interference
	N	Lowb	Moderate-to-highb	P valuec
Overall	389	82.3	17.7
Parental characteristics
Sex, %				0.85
Female	267	82.0	18.0
Male	122	82.8	17.2
Age, %				0.57
Under 30 years	59	79.7	20.3
30+ years	330	82.7	17.3
Ethnicity/race, %				0.55
White	269	83.3	16.7
Black or African American	39	74.4	25.6
Asian	40	85.0	15.0
Other	39	82.0	18.0
Employment status, %				0.20
Not employed	48	79.2	20.8
Part time	47	91.5	8.5
Full time	274	81.4	18.6
Household characteristics
Number of adults, %
Single parent	50	80.0	20.0	0.67
2+ adults	337	82.5	17.5
Number of children, %				0.63
1 child	83	84.3	15.7
2 children	178	83.1	16.9
3+ children	128	79.7	20.3
Developmental stages, %				<0.001
No school-age child(ren)	127	92.9	7.1
Any school-age childd	262	77.1	22.9
Forms of activity, %				<0.001
1 form (sport or non-sport)	158	90.5	9.5
2 forms (sport and non-sport)	230	76.5	23.5
Educational attainment,e %				0.06
High school degree	52	69.2	30.8
Some college	145	82.8	17.2
4-year degree	124	84.7	15.3
Graduate degree	66	86.4	13.6
Family functioningf, mean (95% CI)g	389	20.8 (20.5-21.1)	20.2 (19.5-20.8)	0.08

^aThe number of parents reporting on perceptions of interference was limited to those who reported their preschool-age or school-age child(ren) were participating in sports and/or a nonsport organized activity.

^bLow was defined by report of youth activities interfering “not at all” or “slightly” and moderate-to-high by report of youth activities interfering “somewhat” or “a lot”.

^cP values represent testing for independence of parent/household categorization and perceived interference by the χ² test or as appropriate a t-test from an unadjusted general linear model (i.e., family functioning).

^dThere were 144 households with a school-age child that also included at least one preschool-age child.

^eHighest level of educational attainment for the parent participant or for their spouse or partner. The Cochran-Armitage test of trend for educational attainment was statistically significant (P=0.03).

^fMeasure of structural and organizational properties of the family group and patterns of transactions, including problem solving, communication, roles, affective responsiveness, affective involvement, and behavior control among family members (Range: 6-24). Higher mean scores representing higher functioning.

^gCI=95% confidence interval

Analyses in this sample compared the parental and household characteristics of parents that indicated no or only slight interference of an organized activity with family meals (low interference: 82.3%) to characteristics reported by parents that indicated at least one form of activity interferes somewhat or a lot (moderate-to-high interference: 17.7%). Moderate-to-high perceived interference from organized activities was more common among parents that reported having children involved in both sport and non-sport forms of activity versus one form (23.5% versus 9.5%, P<0.001) and having at least one child aged 6-18 versus only preschool-aged children (22.9% versus 7.1%, P<0.001). Based on this finding, differences in perceptions according to child developmental stage were further examined by form of organized activity (Figure 1) and found to be most pronounced for sport activities; 25% of parents with a school-aged child versus 5% of parents having all preschool-aged children reported that sport participation interfered somewhat or a lot with family meals.

Figure 1.

Differences in the percentage of parents reporting perceived interference according to child developmental stage and form of organized activity among 389 participants in the 2015-2016 Project EAT-IV (Eating and Activity in Teens and Young Adults) survey. The number of parents reporting on perceived interference was limited to those who reported their child(ren) were participating: any school-age child(ren) in sports (n=221,6-18 years), only preschool-age child(ren) in sports (n=92, 2-5 years), any school-age child(ren) in a non-sport organized activity (n=217, 6-18 years), only preschool-age child(ren) in a non-sport organized activity (n=89, 2-5 years).

Family Meal Scheduling Difficulties and Frequency

Among parents with children 2-18 years, the models accounting for parental and household characteristics showed the perception of moderate-to-high interference from organized activities was related to greater family meal scheduling difficulties and less frequent family meals (Table 2). The average scheduling difficulty score was 7.6 among parents who perceived moderate-to-high interference and 5.4 among those who perceived low interference (P<0.001). Compared to parents who reported low interference, parents that perceived moderate-to-high interference from organized activities had on average fewer meals per week (6.3 versus 5.4, P=0.01) and were less likely to have family meals at a minimum weekly frequency of five times (69.9% versus 52.2%, P=0.01).

Table 2.

Parental report of family meals, the household eating environment, and their own eating behaviors among parents who perceive low and moderate-to-high interference between organized youth activities and family meals: results from 389 parent participants in the 2015-2016 Project EAT-IV (Eating and Activity in Teens and Young Adults) survey^a

	Perceived interference
	Lowb	Moderate-to-highb	P valuec
Family mealsd
Scheduling difficulties score, range: 3-12, mean (95% CI)e	5.4 (5.1-5.6)	7.6 (7.0-8.1)	<0.001
Important to eat meals together (% agree)	91.5	88.9	0.52
Family meal frequency, mean (95% CI)	6.3 (6.0-6.6)	5.4 (4.9-6.0)	0.01
Frequent family meals (% that have 5+ meals/week)	69.9	52.2	0.01
Eating environment and behaviorf
Parent fast-food restaurant purchases, mean (95% CI)	9.5 (8.5-10.5)	13.2 (11.0-15.5)	0.004
Parent fruit and vegetable intake, mean (95% CI) of daily servings/1000 calories	2.4 (2.2-2.5)	2.6 (2.2-2.9)	0.35
Prepare meals with vegetables (% that prepare meals most days of the week)	58.3	61.2	0.72
Positive interactions score, range: 4-16, mean (95% CI)	14.3 (14.1-14.5)	14.3 (13.9-14.7)	0.90
Purchase fast food for family meals (% that report purchases 2+ times/week)	36.6	44.6	0.25

^aThe number of parents reporting on perceptions of interference was limited to those who reported their preschool-age or school-age child(ren) were participating in sports and/or a non-sport organized activity.

^bLow was defined by report of youth activities interfering “not at all” or “slightly” and moderate-to-high by report of youth activities interfering “somewhat” or “a lot”.

^cP values are from generalized linear or logistic regression models that included the covariates listed in footnotes d and e. The skewness and kurtosis of continuous variables were examined before entry in these regression models and no concerns for normality assumptions were identified.

^dModel including characteristics of parents (sex, age, employment) and households (number of adults, number and ages of children, maximum education, number of forms of organized activity) was used to estimate the prevalence or mean of family meal characteristics.

^eCI=95% confidence interval

^fModel including characteristics of parents (sex, age, employment), households (number of adults, number and ages of children, maximum education, number of forms of organized activity), and family meal frequency was used to estimate the prevalence or mean of eating environment characteristics and behaviors.

Fast-food Restaurant Use and Fruit/Vegetable Intake

Among parents with children 2-18 years, the models accounting for family meal frequency along with parental and household characteristics showed the perception of moderate-to-high interference from organized activities was related to more frequent parental purchases at fast-food restaurants (Table 2). Parents that perceived moderate-to-high interference from organized activities reported eating at fast-food restaurants a mean monthly frequency of 13.2 times as compared to the mean of 9.5 times reported by parents that perceived low interference (P=0.004).

DISCUSSION

This study described parents’ perceptions of whether the participation of their preschool-age and school-age children in organized activities interferes with family meals, and how perceptions are related to aspects of household eating environments. Whereas perceptions of more than a slight interference were uncommon among parents with only preschool-age children, participation in organized activities was perceived to be a barrier to family meals for more than one in five families with a school-age child.

The results of the current study align with and extend previous research that has described perceived time-related barriers to family meals with preadolescent and adolescent children.^18-20 These results go beyond previous research in describing perceived interference by focusing specifically on child participation in organized activities and in describing the perceptions of parents with only preschool-age children. In finding that participation in organized activities is commonly perceived as a barrier to family meals for households with school-age children, the results align with prior qualitative reports of parents.¹⁸ As the demands of organized activities (e.g., time required for attending team practices, games, tournaments) tend to increase with age and sport specialization among school-age youth,¹³ it may be that the impact on family meals further varies across school grade. There are many possible reasons why the participation of preschoolers in organized activities may be less often perceived as a barrier to family meals (e.g. activities are less likely to be scheduled near mealtimes). Reasons for the observed difference in parent perceptions across child developmental stage may be helpful to understand in designing interventions.

Strengths of this study included the sociodemographic diversity of parents (e.g., one in four were not employed full time) that participated in the survey, assessment of both sport and other non-sport organized activities, and the multiple measures of eating environments. Despite the population-based nature of the sample, there was limited representation of children at different ages within households. Future research in larger samples that represent households including only young school-aged children (e.g., 6-8 years) versus older adolescents (e.g., 16-18 years) will be useful for more detailed learning about the demands of organized activities across the course of development. Additional study limitations include the lack of measures to assess specifically whether participation in organized activities interfered with preparing healthy foods for meals, having time for conversation at meals, or including all household members at meals. Further, there were no measures available to account for potentially important factors such as the number of children in the household that were involved in organized activities, the number of different organized sport and non-sport activities in which they were enrolled, and the frequency and intensity of participation (percentage of the year during which children participate, average weekly hours of participation). There was no assessment of child dietary intake and measures of parental dietary behavior were not asked in relation to family meals or participation in organized activities. The survey items used to assess perceived interference of organized activities with family meals were pilot tested in focus groups prior to fielding in the EAT cohort; however, the authors were unable to locate previously validated measures of this construct and there was no validity assessment as part of the current study.

CONCLUSIONS

The perceptions of parents regarding the interference of organized activities with family meals suggest it will be important to further investigate the potential for child participation to influence family meal practices and consequently the dietary intake patterns of children, adolescents, and parents. It could be useful, for instance, to identify any characteristics of families and households that might enable them to better continue having frequent family meals consisting of nutrient-dense foods in spite of demands associated with organized activities. Follow-up studies are also needed to identify the specific aspects of participation in organized activities (e.g., scheduled time of day) that may interfere with family meals and likewise what aspects of family meals may be disrupted. The results of such follow-up studies could inform how providers of organized activities might be able to better support families in eating meals together.⁵⁴ Given the cumulative benefits associated with participation in both sport and non-sport activities,^{15, 16} it will be important to explore in more depth how participation in a greater number of activities and multiple forms of activity may create unique challenges for family meals.

RESEARCH SNAPSHOT.

Research question: To what extent do parents perceive child participation in organized activities to interfere with family meals and how are perceptions associated with the household eating environment?

Key findings: Cross-sectional analysis of surveys collected from 389 parents of children ages 2-18 showed that there are fewer family meals, greater difficulty scheduling family meals, and more frequent parental fast food intake when a parent perceives that child participation in organized activities interferes with family meals (all P<0.01). Participation in organized activities represented a barrier to family meals for more than one in five families with a school-age child (6-18 years).