Accelerometer-Measured Patterns of Shared Physical Activity Among Mother-Young Child Dyads

Prevalence of toddlers meeting 24-hour movement guidelines and associations with parental perceptions and practices

OBJECTIVES

Whether toddlers (1-2 years) meet 24-hour Movement Guidelines and how parental practices and perceptions are related to compliance are uncertain. This study: a) estimated the proportion of toddlers meeting individual and combined movement guidelines; and b) examined associations between parental perceptions/practices and toddlers' compliance with movement guidelines.

DESIGN

Cross-sectional study.

METHODS

Australian parents self-reported their parenting practices/perceptions (routines, co-participation, restrictions, concerns, knowledge) and toddlers' movement behaviours in the baseline assessment of Let's Grow (n=1145), a randomised controlled trial. The World Health Organization's Guidelines on Physical Activity, Sedentary Behaviour, and Sleep for children under 5 years were used to estimate the prevalence of compliance with individual and combined movement guidelines. Logistic models assessed cross-sectional associations.

RESULTS

The prevalence of meeting guidelines was 30.9% for screen time, 82.3% for sleep, 81.6% for physical activity, 20.1% for combined, and 2.1% meeting none. Parents' knowledge of the guidelines, fewer concerns and more favourable restrictions concerning movement behaviours were associated with greater compliance with individual and combined movement guidelines. Routines for screen time and for combined behaviours were associated with adherence to their respective guidelines. Less co-participation in screen time and more co-participation in physical activity were associated with greater compliance with the relevant guidelines.

CONCLUSIONS

Given only 20% of toddlers met all guidelines, strategies early in life to establish healthy movement behaviours, especially screen time, are needed. Future studies could target the parental practices/perceptions identified in this study to support toddlers with optimal sleep and physical activity and reduced screen time.

Promotion of physical activity among people who identify as women through the ParticipACTION mobile app

OBJECTIVE

Health and fitness mobile applications can increase users' physical activity (PA) levels (Lister et al., 2014). ParticipACTION is a national non-profit organization that developed a mobile app to target PA among adults (Truelove et al., 2020). The aim of this research was to examine how women's PA is related to their use of the ParticipACTION app.

METHODS AND MEASUREMENT

Using a mixed-methods design, participants (n = 3,493) completed a survey regarding their PA levels, motivation for PA (capability, opportunity, motivation; COM-B, Keyworth et al., 2020), and motivation for using the ParticipACTION app. Nine focus groups were conducted (n = 37) to discuss the mobile app further.

RESULTS

Path analyses revealed that users' app use was positively associated with motivations for various app functions (e.g. self-monitoring, seeking exercise guidance), however, only motivation in-turn predicted PA. Descriptive results indicated that many women in Canada who used the app do not meet national guidelines for PA per week. Qualitative findings highlight women's motivation for using the app, concerns with app functionality, and feelings of guilt for not engaging in PA.

CONCLUSION

The ParticipACTION app may have some benefit for improving women's PA; intervention studies are needed to determine efficacy of mobile applications.

Feasibility of the Mothers and Daughters Moving Together Physical Activity Intervention

PURPOSE

Preschool-aged children, especially girls, have low levels of physical activity that may be influenced through parent role modeling. Evidence for mother-daughter interventions that include preschool-aged children is sparse. The primary purpose of this study was to examine the feasibility of recruitment procedures, protocol compliance, and participant retention for the Mothers and Daughters Moving Together intervention. The secondary aim was to provide initial estimates of the intervention effect on mother-daughter and family physical activity co-participation, moderate to vigorous physical activity, and maternal physical activity enjoyment and support.

METHOD

This nonrandomized feasibility study included mother-daughter (2-5 y) dyads who self-selected into the intervention (n = 21 dyads) or comparison (n = 10 dyads) group.

RESULTS

The recruitment rate was 41.9% (31 enrolled/74 interested). Intervention group mother-daughter dyads attended 57% of intervention sessions. Among the whole sample, 70% to 80% of participants (mothers and daughters) had at least 4 valid days of accelerometer data at preintervention and postintervention. The retention rate was 90% (28/31 dyads completed the study). Initial estimates of intervention effect indicated small, positive changes for mother-daughter physical activity co-participation, and maternal physical activity support and enjoyment.

CONCLUSIONS

This study provides valuable information that should be confirmed using an adequately powered and randomized study design.

Parents and Children Should Be More Active Together to Address Physical Inactivity and Sedentary Behaviours

Increasing rates of physical inactivity and sedentary behaviours among children and the youth are important determinants of chronic disease. Supporting children's participation in organised physical activities like sports has been promoted as a public health strategy to increase physical activity. Evidence shows that successful interventions are family-focused, although research on how parental eating and physical activity behaviours influence children's behaviours is deficient. In this commentary, we argue that interventions for countering physical inactivity and sedentary behaviours should include greater focus on home and social environments, specifically the influence and involvement of parents, siblings, and friends in supporting these health behaviours. We conclude that the design of interventions to prevent chronic diseases in children should also consider more carefully the conditions in which the behaviours of children and their parents occur. This means encouraging parents and children to be active together to address physical inactivity and sedentary behaviours, while being mindful of unintended consequences of focusing on one behaviour over another.

Use of Wearable Devices to Study Physical Activity in Early Childhood Education

Physical activity recommendations for early childhood are gradually being met to a lesser extent today. The objectives of the study were: (i) to assess the degree of compliance with physical activity (PA) recommendations by gender; and (ii) to analyze the level of PA and steps in different periods over a week. This study was an observational cross-sectional study. Sixty-three young children (33 boys and 30 girls) aged two years (2.15 ± 0.35) were recruited for this study. Participants wore a “Garmin vivofit® jr.” activity tracker for seven days, collecting minutes of moderate-to-vigorous physical activity (MVPA) and step volume (Out-of-School Time and School Time). The results show a 50% compliance of the 120 min/day MVPA and 13,000 steps per day. No gender differences were detected. The findings in the analysis indicated a trend towards higher PA and steps at the Weekend. Moreover, participants reached higher PA and steps values “Out-of-School Time” than “School Time” (MVPA) (min/day). This study can provide strategies and motivational PA guidelines at school to enhance well-being at an early age. These activity trackers could stimulate more sustainable forms of urban mobility, such as walking, as the environment would accompany the child to meet daily PA recommendations.

Improving children's fundamental movement skills through a family-based physical activity program: results from the "Active 1 + FUN" randomized controlled trial

Background

Physical activity is related to many positive health outcomes, yet activity levels of many children are low. Researchers have suggested that family-based interventions may improve physical activity behaviors of both children and their parents. In this study, we evaluated the “Active 1 + FUN” program, which was designed based on tenets of self-determination theory. Intervention components included free sporting equipment, ten coach-led workshops and activity sessions, and one booster session.

Methods

We evaluated the intervention program using a randomized controlled trial. One hundred seventy-one families were randomly allocated to either an experimental group or a wait-list control group. Participants were exposed to program contents over a nine-month period, while families in the control did not receive any form of intervention. Measured constructs included moderate-to-vigorous physical activity, co-physical activity behaviors, fundamental movement skills, BMI, and several self-reported questionnaire outcomes. Hierarchical linear modeling was used to compare changes in measured outcomes across the two groups.

Results

No significant intervention effects were found for children’s and parents’ accelerometer-measured moderate-to-vigorous physical activity, or their co-physical activity. However, in terms of children’s fundamental movement skills, a significant Time*Group interaction (B = 0.52, 95% CI [0.07, 0.96] for Times 1 to 2; B = 0.24, 95% CI [0.01, 0.48] for Times 1 to 3) in favor of the experimental group was found.

Conclusions

Results suggested that the “Active 1 + FUN” program was effective in improving children’s fundamental movement skills. Additional research is needed to examine how family-based initiatives could effectively improve physical activity behaviors too.

Trial registration

ANZCTR, ACTRN12618001524280. Registered 11 September 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375660.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01160-5.

Sociodemographic Correlates of Parental Co-Participation in Digital Media Use and Physical Play of Preschool-Age Children

Young children’s digital media use and physical activity have gained attention in recent research. Parental co-participation has a major impact on children’s health consequences. This study addressed a gap in the research by investigating daily parental co-participation in children’s digital media use and physical play, using the family ecological model theoretical framework. The participants in this nationally representative cross-sectional study were 2512 Finnish parents with two- to six-year-old children. Parents completed a questionnaire. Sociodemographic correlates of co-participation and of the awareness of guidelines regarding co-participation and correlation between co-participation in digital media use and physical play were analysed. Parental co-participation in physical play and digital media use correlated positively. Lower parental age, male parental gender, Finnish and Swedish languages, a fewer number of children, and a male child gender were associated with more co-participation in one or both activities, and parental female gender and low family income were associated with more awareness. The awareness of guidelines was not associated with co-participation in digital media use. There were sociodemographic differences in parental co-participation. From a health counselling perspective, parents may benefit from national recommendations on digital media use and physical activity, but adherence to guidelines depends on the family context.

Physical Activity and Enjoyment in Parent-Child Dyads During Shared Physical Activity

Purpose: The purpose of this study was to compare objectively-measured physical activity (PA) and enjoyment of five shared PAs in parent-child dyads. Method: Thirty-one parent-child dyads (mean±SD; age, parents: 38.0 ± 6.6 years, children: 5.9 ± 1.7 years) completed separate PA sessions, which included five standardized PAs (brisk walking, jumping games, dancing, body-weight exercises, and tag games) in random order for each dyad. Parent and child moderate-to-vigorous PA (MVPA) and accelerometer counts per minute (CPM) were measured using Actigraph GT9X activity monitors. The Visual Analog Scale was used to assess enjoyment of children and parents. Repeated measures ANOVAs and paired t-tests determined differences in PA within and between children and parents for the activities, respectively. Friedman Tests with post hoc Wilcoxon signed-rank tests determined significant differences in enjoyment across the activities for children and parents and Wilcoxon signed-rank tests compared enjoyment between children and parents for each PA. Results: Jumping games resulted in the highest proportion of time spent in MVPA and highest overall CPM for children and parents (p < .05). Compared to parents, children spent proportionally more time in MVPA during jumping games, body-weight exercises, and tag games (all, p < .05). Tag games were the most enjoyable PA for children and parents (p < .05). Children enjoyed body-weight exercises more than parents (p < .05). Conclusions: Future indoor PA programs and research interventions that include parent-child dyads should consider implementing jumping games, body-weight exercises, and tag games during shared PA, which resulted in higher MVPA and enjoyment by both children and parents when compared to walking and dancing.

Relation between Perceived Barrier Profiles, Physical Literacy, Motivation and Physical Activity Behaviors among Parents with a Young Child

Objectives: to reveal distinct subgroups of parents by their perception of 6 types of physical activity barriers and challenges (i.e., lack of time, poor health, lack of company, lack of facilities, childcare responsibility, lack of motivation), and examine its relation with related constructs. Design: cross-sectional survey data. Method: the sample consisted of 424 parents who had at least 1 child of primary school age. Latent profile analysis was conducted to identify latent subgroups within participants. Group differences on physical literacy, autonomous motivation, and self-report physical activity (PA) levels were explored. Results: a four-profile solution was obtained from latent profile analysis, labelled as: “Struggling” (29.0%), “Family burden” (41.3%), “Lazy” (13.0%), and “Barriers free” (16.7%). The “Barriers free” profile experienced the least difficulties with physical activity, but the “Struggling” profile suffered the most severe barriers and challenges. “Family burden” and “Lazy” profiles demonstrated qualitative differences on one or two given challenges. Significant group differences on physical literacy, autonomous motivation, and PA levels were found, showing the “Barriers free” profile as the most robust and adaptive group of parents. Conclusions: the findings suggest that it is common for a substantial portion of parents to experience multiple barriers and challenges to a relatively high degree. Intervention on raising parent’s physical literacy to reduce barriers and sustain their motivation may be a target for intervention.

Physical Activity Coparticipation Among Parent-Young-Child Dyads

PURPOSE

This study examined patterns of physical activity coparticipation among parent-child (2-5 y) dyads.

METHOD

The dyads (N = 47; 51% mother-child) each wore a Bluetooth-enabled accelerometer for 8 days to measure physical activity and physical activity coparticipation. The parents completed demographic and self-reported family physical activity questionnaires.

RESULTS

The parent-child dyads spent 145 (79) minutes per day in-proximity according to the Bluetooth-enabled accelerometers. The majority (90%) of parent-child in-proximity time was spent with the parent and child engaged in some combination of sedentary or light activities. Child light, moderate, and vigorous physical activity was not associated with parent light (P = .12) or moderate to vigorous physical activity (P = .45), but was positively associated with parent-child in-proximity active minutes (light, moderate, and vigorous) (P < .01). Children in the highest tertile of parent-child physical activity coparticipation engaged in more daily moderate to vigorous physical activity compared with children in the lowest tertile (72.7 vs 50.3 min). There was a positive, statistically significant association between self-reported and objective measures of physical activity coparticipation (r = .47, P = .001).

CONCLUSION

Children who engaged in the most physical activity with their parent had the highest moderate to vigorous physical activity. Future studies should continue to provide contextual information about how parents and children spend their time together to improve family-based physical activity interventions.

Association between parent and child physical activity: a systematic review

Background

Childhood represents an important life stage for establishment of physical activity (PA) habits. Parents are assumed to play an important role in influencing children’s PA. Earlier reviews have mainly focused on parental modelling, encouragement, and support for PA, rather than the actual PA levels of parents. Therefore, the purpose of this review was to systematically summarize the evidence on the relationship between parent and child PA.

Methods

Papers were identified using electronic databases and manual searches of reference lists. Papers reporting on associations between objectively measured child PA and at least one measure of parental PA were included. The quality of the papers was assessed using a modified version of the ROBINS-I tool. For interpretation of the results across studies, we produced albatross plots for all studies combined and by age-groups, sex of the parents, sex of the child, methodology of assessment of parental PA, and type of PA.

Results

Thirty-nine papers were included with sample size of parent-child dyads ranging from 15 to 1267 (mean = 319 dyads, median = 227 dyads). The majority of studies were published from 2008 to 2018 and used accelerometry to assess PA. Most of the studies were classified as having moderate, serious, or critical risk of bias. The albatross plot for all studies combined showed that the clear majority of studies observed a positive relationship between parent and child PA. The plot suggested an average magnitude of correlation across studies to be around 0.13, and the overall impression was that this was fairly similar across child age-groups and gender of parent-child dyads. Studies using objective assessment of parental PA showed stronger relationship between parent and child PA compared with studies using self-report (average magnitude of correlation around 0.16 vs 0.04 respectively). No clear evidence was found for the strength of relationship being dependent on type of PA measure of parent and child (total PA, moderate-to-vigorous PA, steps), however, the relationship for light PA appeared weaker.

Conclusion

This systematic review showed that the clear majority of studies observed a weak positive relationship between parent and child PA regardless of age of the child, the gender of the parent-child dyad, and type of PA.

Trial registration

Registration in PROSPERO: CRD42019093462.

Sedentary Time and Physical Activity Associations Between Child Care Educators and Children

INTRODUCTION

This study examines the associations between objectively measured sedentary time and physical activity among child care educators and children in their direct care and aims to determine if the associations differed between toddlers (aged 19-35 months) and preschoolers (aged 36-60 months).

METHODS

The participants were educators and children from 19 child care centers in Edmonton and Ottawa, Canada, as part of the Supporting Healthy Active Child Care Settings study. Sedentary time, light-intensity physical activity, and moderate to vigorous-intensity physical activity during child care were measured with accelerometers in 2017-2018. Nap time data were removed for children and educators based on room schedules. Children were matched with the main educator in their room that had the highest total physical activity, resulting in 187 children and 38 educators. Multilevel linear regression models with interaction terms were conducted in 2019.

RESULTS

Children engaged in 30.0, 23.1, and 6.9 minutes per hour of sedentary time, light-intensity physical activity, and moderate to vigorous-intensity physical activity, respectively. Educators engaged in 33.5, 23.6, and 2.9 minutes per hour of sedentary time, light-intensity physical activity, and moderate to vigorous-intensity physical activity, respectively. No significant interactions were observed, so age-stratified analyses were not conducted. Each additional 5 minutes per hour of educator sedentary time was significantly associated with 0.5 minutes per hour lower child moderate to vigorous-intensity physical activity. Each additional 5 minutes per hour of educator moderate to vigorous-intensity physical activity was significantly associated with 1.3 minutes per hour higher child moderate to vigorous-intensity physical activity. No other significant observations were observed.

CONCLUSIONS

The educators' sedentary time and moderate to vigorous-intensity physical activity may have a small but potentially meaningful influence on children's moderate to vigorous-intensity physical activity because educators directly care for multiple children. Targeting these educator behaviors may be one strategy to increase children's moderate to vigorous-intensity physical activity during child care.

Infants' and toddlers' physical activity and sedentary time as measured by accelerometry: a systematic review and meta-analysis

BACKGROUND

Early experiences in physical activity (PA) are important to shape healthy movement behaviours long-term; as such, it is critical that PA is promoted from infancy, and that detrimental behaviours (e.g., prolonged sedentary time [ST]) are minimized. The purpose of this systematic review and meta-analysis was to examine infants' and toddlers' movement behaviours across daytime hours.

METHODS

Seven online databases were searched for terms related to infants (< 12 months), toddlers (12-35.9 months), PA, ST, and accelerometry. Two independent reviewers examined 4873 articles for peer-reviewed original research, published in English, that assessed infants' (counts/min) and/or toddlers' PA or ST (min/day) using accelerometry across daytime hours. Infants' mean PA level (counts/min) was averaged across studies, and ranges were produced. Estimates of toddlers' movement behaviours were aggregated meta-analytically to produce average daily rates, and accelerometer placement, cut-point validity, device type, and epoch length were tested as a moderating variables.

RESULTS

Twenty-four studies from 16 countries (published 2011-2019), representing 3699 participants, were included in the systematic review. Five studies reported on infants' PA, which ranged from 78.2 to 2580.5 cpm. Across 20 studies, toddlers' total PA, light PA, moderate-to vigorous-intensity PA, and ST ranged from 72.9 to 636.5, 48.5 to 582.4, 6.5 to 89.9, and 172.7 to 545.0 min/day, respectively. After taking into account accelerometer placement, cut-point validity, device type, and epoch length, we found that toddlers engaged in 246.19 min/day (SE = 28.50; 95% CI: 190.34, 302.04) of total PA, 194.10 min/day (SE = 28.76; 95% CI: 137.73, 250.47) of light PA, and 60.16 min/day (SE = 5.88; 95% CI: 48.64, 71.69) of moderate-to vigorous-intensity PA. Toddlers engaged in 337.04 min/day (SE = 32.67; 95% CI: 273.01, 401.07) of ST.

CONCLUSIONS

With limited studies conducted in infants (n = 5), PA estimates are inconclusive and largely heterogeneous. Overall, toddlers tend to exceed the total PA recommendation of 180 min/day; however, very little of this time is spent at higher movement intensities. Even with high PA rates, toddlers still engage in substantial ST. More consistent and valid measurement protocols are needed to improve comparability across studies.

The Effects of Varying Structured Physical Activity Duration on Young Children's and Parents' Activity Levels

Purpose: The purpose of this study was to examine whether structured physical activity (PA) in a family-based community exercise program affects PA of young children and parents. Method: Twenty-two children (mean ± SD; age, 4.9 ± 2.1 years) and their parents (age, 34.3 ± 7.6 years) participated in unstructured PA sessions followed by either short- or long-duration structured PA sessions, while wearing an ActiGraph GT9X activity monitor on their right hip to estimate PA. Independent t-tests compared children's and parents' PA during short- and long-structured PA sessions. Paired t-tests compared short- versus long-structured PA sessions. A mixed model ANOVA compared PA during unstructured versus structured sessions and between children and parents. Results: Children spent proportionately more time in moderate-to-vigorous PA (MVPA) and had higher accelerometer counts/min than parents during short-structured PA (children:60.9 ± 18.8% vs. parents:17.7 ± 6.8%, children:3870 ± 742 vs. parents:1836 ± 556 counts/min, p < .05) and long-structured PA (children:61.1 ± 20.1% vs. parents:12.6 ± 4.9%, children:3415 ± 758 vs. parents:1604 ± 633 counts/min, p < .05). No statistical differences were found between short- and long-structured PA sessions for proportion of time spent in MVPA or counts/min for children or parents (all, p > .05). Children spent proportionally more time in MVPA and had higher counts/min during unstructured PA compared to structured PA (unstructured MVPA:54.4 ± 3.9% vs. structured MVPA:38.2 ± 4.2%, unstructured counts/min:3830 ± 222 vs. structured counts/min:2768 ± 239 counts/min; p < .05). Conclusions: Children were more active than parents during both the unstructured and structured PA sessions. However, unstructured PA sessions resulted in 63-77% and 10-11% of PA recommendations for children and adults, respectively. Family-based exercise programming can provide an opportunity for children and their parents to attain MVPA during the week.

Association Between Lifestyle Characteristics and Body Mass Index of Mothers of Children With Allergic Diseases

Background

For mothers of children with allergic diseases, the amount of physical activity involved in childcare increases owing to factors, such as the need for diet therapy and environmental improvements. Reportedly, the body mass index (BMI) of mothers of children with food allergies (FAs) is significantly lower than that of those of children without allergies (non-FA mothers). The aim of this study was to evaluate the characteristics of diet and physical activity in FA mothers and to clarify their effects on BMI.

Methods

To investigate the association between lifestyle characteristics and BMI in 69 mothers of children with FA, bronchial asthma and atopic dermatitis, their diets and physical activity pattern (using a three-axis accelerometer) were investigated; dietary and physical activity patterns (every hour) were extracted using principal component analysis, and multiple regression analyses were performed.

Results

Multiple regression analyses revealed a significant positive correlation (P = 0.037) between BMI and the third principal component of dietary patterns (positive correlation with cereals and negative correlation with sweets), a significant negative correlation (P = 0.004) between BMI and FA and the total daily duration of performing low- and moderate-intensity physical activity (P = 0.031) and a significant positive correlation (P = 0.008) between FA and the first principal component of physical activity expenditure patterns (patterns of ongoing physical activity throughout the day). In FA mothers (n = 51), a significant positive correlation (P = 0.042) was observed between the third principal component of dietary patterns and BMI.

Conclusion

Low BMI in FA mothers may be related to reduced cereal intake, increased sweets intake and prolonged and continuous low- and moderate-intensity physical activity.

Moderating Effects of Components of Resilience on Obesity Across Income Strata in the National Survey of Children's Health

OBJECTIVE

This study examined whether components of resilience at the family or child level are associated with a decreased risk of obesity in children after accounting for community-, family-, and individual-level stressors associated with an increased risk of obesity.

METHODS

Data are from the 2016 National Survey of Children's Health, using the subset of children 10 to 17 years of age with weight data. We examined whether or not components of family- or child-level resilience were associated with weight status. Community-, family-, and individual-level risk factors for obesity were examined within each income stratum. We used multinomial logistic regression to evaluate if components of resilience are associated with lower overweight or obesity.

RESULTS

The sample included 24,405 10- to 17-year-old children. Child-level but not family-level resilience components were associated with a decreased risk of child obesity across income strata. Food security and adverse childhood experiences (ACEs) were only associated with obesity within higher income strata; bullying was consistently associated across strata. Physical activity was strongly associated with increased emotional resilience. The association between higher emotional resilience and lower obesity remained after adjusting for community-level factors (parks), family-level factors (ACEs), and individual-level factors (bullying). Better maternal health was associated with increased emotional resilience and lower risk of obesity.

CONCLUSIONS

Resilience, specifically emotional resilience, may be a protective factor against obesity in children regardless of income stratum. Physical activity of the child is associated with greater emotional resilience, and better maternal health may mediate the association between this component of resilience and weight.

Interactive Dyadic Physical Activity and Spatial Proximity Patterns in 2-Year-Olds and Their Parents

This study aimed to characterize daily physical activity (PA) behaviors in 2-year-old girls and boys and their parents, with and without an objective measure of dyadic spatial proximity. Urban-dwelling parent⁻toddler dyads (N = 110) wore accelerometers for 7 days, and parents completed a sociodemographic questionnaire. Accelerometers were initialized to collect PA and Bluetooth-based proximity data. After applying wear-time algorithms, n = 65 dyads were further analyzed using a dyadic analysis statistical methodology. Toddler⁻parent sedentary and light PA time were respectively interdependent, conditional on child sex and child-parent proximity, but moderate⁻vigorous physical activity (MVPA) time was not. Toddlers were significantly more active on weekdays and weekends than their parents, and no differences were found in daily PA volumes between girls and boys. In dyads with proximity data (n = 34), analyses of joint (i.e., proximal and mutual) PA time showed that girls participated in significantly more joint PA with their mothers than boys. Children who engaged in ≥60 min of MVPA/day participated in ~2 h of joint PA/day, on average, while children with <60 min of MVPA/day engaged in ~30 min less joint-PA time with their mothers. Boys and girls who participated in higher daily MVPA volumes engaged in joint PA with their mothers across greater relative distances, as compared to less active boys who engaged in joint PA at closer relative distances to their mothers. Toddlers who engaged in ≥60 min of daily MVPA participated in joint PA with their mothers at greater relative distances and for longer durations than less active children. Further research on the dyadic activity⁻proximity relationship is needed across early childhood development.