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Article

Why Do Children Engage in Sedentary Behavior? Child- and Parent-Perceived Determinants

Department of Public and Occupational Health, Amsterdam Public Health Institute, VU University Medical Center, 1081 BT Amsterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2017, 14(7), 671; https://doi.org/10.3390/ijerph14070671
Submission received: 26 April 2017 / Revised: 16 June 2017 / Accepted: 19 June 2017 / Published: 22 June 2017
(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)

Abstract

:
Todays children spend a large amount of their time sedentary. There is limited evidence on the determinants of sedentary behavior in children, and qualitative studies are especially lacking. Therefore, this study aimed to explore determinants of children’s sedentary behavior from the child- and parent perspective. Qualitative data were collected during concept mapping sessions with four groups of 11–13 years old children (n = 38) and two online sessions with parents (n = 21). Children and parents generated sedentary behavior motives, sorted related motives, and rated their importance in influencing children’s sedentary time. Next, multidimensional scaling and hierarchical cluster analysis was performed to create clusters of motives resulting in a concept map. Finally, the researchers named the clusters in the concept map. Concept maps of children yielded eight to ten perceived determinants, and concept maps of parents six to seven. Children and parents identified six similar potential determinants, and both rated as important: Sitting because… “it is the norm (I have to)”, and “I can work/play better that way”. In addition, children rated “there is nobody to play with” as an important potential determinant for engaging in sedentary behavior. The most important child- and parent perceived determinants were related to the social/cultural and physical environment, indicating that these are promising targets for future interventions.

1. Introduction

Worldwide, the majority of children spend more than two hours per day watching TV [1,2], and laptop and phone use in children is increasing substantially [3]. Besides screen activities children engage in many other sedentary behaviors, e.g., sitting in the classroom and doing homework [4,5]. Studies in Europe and the United States, show that children spend approximately 8 h per day sedentary [6,7].
Recently, interest in the health consequences of excessive sedentary behavior is increasing. Systematic reviews only including longitudinal studies concluded no convincing evidence for a prospective relationship between childhood sedentary behavior and various health outcomes [8,9]. However, sedentary behavior tracks from early childhood to later in life [10,11], and for adults evidence for an adverse relationship between sedentary behavior and morbidity and mortality is emerging [12,13]. Therefore, excessive sedentary behavior among children remains a public health concern and developing interventions to reduce sedentary behavior seems appropriate. Unfortunately, existing interventions targeting reductions in children’s sedentary time have disappointing effects, possibly explained by a lack of knowledge on the most important determinants for engaging in sedentary behavior [14].
Previous reviews found that the most commonly examined determinants can be grouped in the following domains: (1) demographic and biological; (2) psychological, cognitive and emotional; (3) behavioral; (4) social and cultural; and (5) physical environmental [15,16,17,18]. Recent reviews found insufficient evidence for determinants of sedentary behavior in children in these five domains, as few prospective studies were available, and the majority of the determinants were examined only once. Furthermore, most studies focused on screen time such as watching television or playing videogames as an indicator of sedentary behavior [17,19,20]. Yet screen time takes up only a small part of the total time spent sedentary [5,21,22,23]. Finally, Brug and Chinapaw [24] state that many studies exploring determinants were not specifically designed for this question, and the determinants identified in the different reviews mainly concern characteristics of sedentary children instead of motivational and contextual reasons for engaging in sedentary behavior, which is essential for the design of effective interventions.
Another major gap in the current evidence on determinants is the perspective of children on why they engage in sedentary behavior. As children are the experts of their own behavior [25], their perspectives could bring new insights into relevant determinants of sedentary behavior. Furthermore, as parents play a significant role in facilitating and regulating their children’s behavior [26], their view on potential determinants of their children’s sedentary behavior is of additional relevance. Previous studies found, for example, that parents’ screen time, and parents’ rules concerning screen time and playing outside, were associated with children’s sedentary time [27,28,29]. Therefore, the aim of this study was to explore child- and parent-perceived determinants of children’s sedentary behavior, using concept mapping with 11 to 13 year old children and their parents. Concept mapping is a helpful participatory method to acquire knowledge about children’s and parents’ perspectives, by allowing them to provide their unique contribution to research concerning their own behavior [30,31].

2. Materials and Methods

2.1. Participants

Children and one group of parents were recruited via different primary schools in The Netherlands. Between April and October 2015 primary schools were selected through purposive sampling, contacted through information letters and follow-up telephone calls, aiming to include both rural and urban primary schools comprising children with different socio-economic backgrounds. After approaching 26 primary schools, the first school was included (response rate 4%). Thereafter, through purposive sampling based on socio-economic background and rural/urban area three other schools were contacted and included (response rate 100%). Thirty-eight children (response rate 40%) and seven parents were willing to participate (response rate 12%). Due to late inclusion of the fourth primary school, parents of the children at this school were not able to participate in the online concept mapping sessions. Therefore, a second group of parents (n = 14) were recruited through convenience sampling in January 2017.
When a school agreed to cooperate, information letters were sent to the children in the 8th grade, aged between 11–13 years old, and their parents. Both parents from non-participating and participating children were allowed to take part, as we were interested in the ideas of parents in general and not specifically the parents of participating children. Parents from the convenience sample received an information letter via email. As a reward for participation children received a small present, parents were offered an update on the results of the study, and the schools were offered a presentation about the results of the study.
The VU University Medical Ethical Committee concluded that the protocol does not fall within the scope of the Medical Research Involving Human Subjects Act. No identifying participant information was collected for the purpose of this study, and written informed consent was signed by one parent and the participating child, or the participating parent.

2.2. Procedures

Concept mapping is a research method in which group data are collected qualitatively in a structured and inductive way, and are analyzed quantitatively. The concept mapping procedure consists of several steps: generation of participants’ statements towards a seeding statement, grouping all statements and rating of their importance, summarizing these data into computer generated concept maps, and interpretation of these concept maps [30,31]. In this way, structure and objectivity to qualitative data are provided [30,31]. Generally, concept mapping studies include an average of 10–20 participants per study [31].
Concept mapping sessions and analyzes were performed between May 2015 and February 2017. At the start of the concept mapping sessions, gender and age were inquired from children, and from parents their age, gender, family structure, amount of siblings, and highest educational level, i.e., pre-vocational-, vocational-, or higher education. The socio-economic status (SES) of the primary schools was assessed based on zip codes of the schools and the status-scores document from the Dutch Social and Cultural Planning Agency. This SES score was divided in tertiles, i.e., low SES, medium SES, or high SES. The whole concept mapping procedure is described in detail below.

2.2.1. Concept Mapping Sessions—Children

The concept mapping sessions with the children took place at their school during school hours, lasting approximately 2 h each. Four groups of 8–10 children, attending different primary schools, participated in these sessions that were facilitated by two trained researchers. Because of children’s limited attention span the whole procedure was divided over two sessions.
The first session comprised a warming up exercise, an individual brainstorm, and a group brainstorm. The purpose of the warming-up exercise was to broaden children’s understanding about sedentary behaviors, i.e., children wrote down their daily activities and divided them in active and inactive activities. Thereafter, the seeding statement was presented in two ways:
Can you think of different reasons why you choose to do activities in which you have a seated position?
“For some things I do, I do them in a seated position, I do these things because”
Subsequently, the individual brainstorm started, in which the participants were stimulated to finish the sentence with as many ideas as possible, and to write down all ideas. In doing this, they were stimulated to think about their own sedentary behavior, as well as the sedentary behaviors of 11–13-year old children in general. Thereafter, participants shared one by one all of their statements in the group brainstorm. This resulted in a list of unique statements.
In the second session, each child individually grouped the statements, printed on separate cards, into piles of related statements. A minimum of three and a maximum of ten piles were required due to settings of the software program, with at least two statements per pile, and a miscellaneous pile was prohibited. Subsequently, children named the different piles. Additionally, children individually rated the importance of the statements in influencing their sedentary time using a 5-point Likert-scale, ranging from very unimportant to very important.

2.2.2. Concept Mapping Sessions—Parents

Concept mapping sessions with the parents were performed online, making it easier for the parents to participate. A comparable procedure as with the children was followed, i.e., a comparable warming-up exercise and the individual brainstorm towards the seeding statement were performed by e-mail, thereby omitting the group brainstorm. The sorting, naming and rating tasks were performed by means of the online program Ariadne [32]. The seeding statement was presented in two ways:
Can you think of different reasons why your child chooses to do activities in which he/she has a seated position?
“For some things my child does, he/she does them in a seated position, he/she does these things because…”

2.3. Statistical Analysis

Separate analyses were carried out for each school and two groups of parents. The data were analyzed by multidimensional scaling and hierarchical cluster analyses using the software program “Ariadne” [32], specifically designed for concept mapping. These analyses showed every statement as a point on a figure, with statements sorted more often together appearing close to each other, and statements never/rarely sorted together widely separated. By default eight clusters were made, combining statements close to each other. Subsequently, three independent researchers (Lisan M. Hidding, Teatske M. Altenburg, and Evi van Ekris) explored whether more or less clusters would represent participant’s ideas more adequate, i.e., each cluster comprising statements related to a similar concept. Based on the importance rating of the individual statements, average ratings for each statement and each cluster were calculated.

2.4. Interpretation of the Maps

Two researchers (LH and TA) interpreted the maps, by discussing similarities in the meaning of statements in each cluster, and subsequently, by determining the concept represented by each cluster. Next, researchers (LH and TA) named the clusters, far as possible derived from the names given by the participants in the individual sorting task. As statistical significance not always results in the best representation of the qualitative data, the researchers critically reflected on the computer-generated clusters. According to the researchers, some statements were not optimally represented in the computer-generated cluster maps. To improve the logic of the concept map, these statements were moved to nearby clusters or newly created clusters, the latter where possible based on clusters created by the participants in the individual sorting task. Original and final cluster compositions are shown in the supplemental material (Appendix A1 and Appendix A2, respectively). Finally, the maps were discussed, listing similarities and differences between the maps of the different primary schools and between the maps of the children and the parents, and an explanation for the findings was searched. A third researcher (Mai. J. M Chinapaw or Evi van Ekris) was consulted in case of disagreement. In the results section the final clusters are presented. The final clusters were interpreted as potential determinants as perceived by children and parents. Whether these potential determinants are actual determinants cannot be concluded based on this concept mapping study.

3. Results

3.1. Participants

The participating children (n = 38; 55% girls) were on average 11.6 ± 0.6 years old. Parents (n = 21; 71% female) were on average 42.1 ± 4.3 years old. One parent was part of a single-parent family and 20 were part of traditional dual-parent families, three comprising one child and 18 more than one child. Furthermore, two parents followed pre-vocational-, three parents vocational-, and 16 parents higher education.

3.2. School Characteristics

The four participating schools had a varying degree of urbanization: located in a small size village, a medium size village, a large size village and a large city. Two of the schools received a medium and two a low SES indication. Concept mapping groups varied from 8 to 10 children generating 31 to 51 statements.

3.3. Children’s Clusters

Recurrent clusters based on children’s concept maps (see Figure 1 for an example, see Appendix A3 for other maps), i.e., present in the concept maps of at least three schools, were: I sit because… (1) “it is the norm/I have to”; (2) “seated activities are fun”; (3) “I’m tired, I want to relax, I want to rest”; (4) “there is nobody to play (actively) with”; (5) “there is nothing to do”; (6) “I can work/play better that way”; and (7) “of the weather”. Additional clusters in the concept maps of one or two schools were: I sit because… (8) “I’m not in the mood to do anything”; (9) “of my health”; (10) “it feels better”; (11) “being active takes a lot of effort”; (12) “it is a habit”; (13) “this posture suits the activity better”; (14) “the physical environment suitable for physical activities is too far away”; (15) “the physical environment is not suitable”; and (16) “I want to make contact with my friends”.
Children of all primary schools rated the cluster “I sit because it is the norm/I have to” as most or second most important motive for engaging in sedentary behavior. Additionally, “I sit because I can work/play better that way”, “I sit because there is nobody to play with”, and “I sit because I want to make contact with my friends” were rated as most or second most important motives. Table 1 presents the child-identified clusters and average importance ratings for each school.

3.4. Parents’ Clusters

The parents generated 24 (purposive sample), and 44 (convenience sample) statements, resulting in six and seven clusters, respectively (see Figure 2 for an example, see Appendix A3 for the other map). Recurrent clusters across both maps were: My child sits because… (1) “he/she can work/play better that way”; (2) “it is the norm”; (3) “there is nothing (active) to do”; (4) “he/she is tired, wants to relax, wants to rest”; (5) “seated activities are fun”; and (6) “it is a habit (and others do so)”. The cluster “My child sits because it is in his/her nature” was only found on one of the maps.
Both groups of parents rated “My child sits because he/she can work/play better that way” as second most important potential determinant. The most important potential determinant differed per group, i.e., “My child sits because he/she is tired, wants to relax, wants to rest”, and “My child sits because it is the norm”. Table 2 presents the parent-identified clusters with their average importance rating.

4. Discussion

To the best of our knowledge this is the first study exploring child- and parent-perceived determinants of children’s sedentary behavior, by performing concept mapping. Children and parents indicated several matching potential determinants, of which “I sit because I can work/play better that way” as one of the most important perceived determinants according to both children and parents. In addition, children indicated “I sit because it is the norm/I sit because I have to” and “I sit because there is nobody to play with” as considerable important determinants of their sedentary behavior.
The potential determinants found in our study fit within the frequently used domains to group determinants [15,16,17,18]. The majority of child- and parent-identified determinants belong to the psychological, cognitive and emotional domain, e.g., “I sit because I’m not in the mood to do anything”, and “I sit because seated activities are fun”. However, the perceived determinants that children and parents rated as most important, i.e., “I sit because of the norm/I sit because I have to” (children, one group of parents), “I sit because I can work/play better that way” (children, all parents), and “I sit because there is nobody to play with (children), in particular belong to the social and cultural domain and the physical environmental domain”. Interestingly, determinants belonging to the demographic and biological domain are extensively discussed in previous studies [17,19], yet they received far less attention in the present study, only one group of parents indicated such a determinant, i.e., “My child sits because it is in his/her nature”. In addition, determinants belonging to the behavioral domain received no attention.
The potential determinants “Sitting because it is the norm/Sitting because I have to” and “Sitting because I can work/play better that way” mentioned by both children and parents both include motives related to the current societal norm of a sedentary lifestyle. Interestingly, one group of parents rated “Sitting because it is the norm” as unimportant, while children and the second group of parents rated it as one of the most important motives for engaging in sedentary behavior. By establishing rules, and commanding children to sit during activities, some parents might unconsciously stimulate their children’s sedentary behavior [27,33]. Owen et al. [34] already found the norm to be a potential determinant in adults, as nowadays it is the norm to sit during many activities, including meetings, classes, and while relaxing at home. Similarly, many of the statements in the “Sitting because I can work/play better that way” clusters relate to the school or home environment, e.g., it is easier to work/play in a sedentary posture as their school environment is decorated for sedentary activities. Lanningham-Foster et al. [35] confirm that the school environment influences children’s sedentary behavior, as children were significantly more physically active when a classroom was made more suitable for active behaviors, e.g., availability of mobile white boards for active learning lessons.
One group of children and parents identified “Sitting because it is a habit” as a potential determinant. This finding is in line with studies in adolescents: de Bruijn et al. [36] found that habit strength was the strongest correlate of television viewing and Chinapaw et al. [37] found that changes in habit strength were significantly related to changes in screen time. In young adults Conroy et al. [38] found that habit strength had a strong bivariate correlation with objectively assessed sedentary behavior. Thus far, no studies examined the relation of habit strength with total sedentary time in children. The mechanism behind habit as a behavioral determinant is previously described in relation to exercise behavior. When behavior is a habit it is automatically activated by environmental stimulus or cues, instead of consciously deciding to engage in the behavior [39]. Due to the current societal norm of a sedentary lifestyle, children learn to be sedentary from an early age. Consequently, sedentary behavior has become a habit, e.g., ‘My child sits because others do so, and it is a habit’ indicated by one group of parents. This cluster additionally indicates that children also learn to sit by imitating others.
Children rated “I sit because there is nobody to play (actively) with” as an important potential determinant of their sedentary behavior, related statements were found in the cluster “Siting because there is nothing (active) to do” which was also indicated by their parents. This might imply that children naturally prefer physically active play but tend to sit when they have nothing to do or nobody to play with. This is in line with the participatory study of Caro et al. [40], where children preferred to be physically active in the school playground and were sedentary when they were bored. The children in this study perceived both social and physical environmental factors of the playground to influence fun of physically active play.
The children also indicated weather conditions as potential determinants, e.g., coldness, rain, or too hot temperatures within the clusters “I sit because of the weather” and “I sit because the physical environment is not suitable”. Additionally, they indicated statements related to safety and distance. Yilderim et al. [41], found a significant positive association between rainfall and sedentary time, confirming that the weather may indeed be a determinant of sedentary behavior. Additionally, a review found that parents may restrict children in playing outside when they have concerns about the safety of the neighborhood [42]. In our study only the children mentioned statements regarding safety of the neighborhood, indicating that it is not just a concern of their parents, however, children might have adopted their parent’s ideas.
Both children and parents identified enjoying sedentary activities as a potential determinant of sedentary behavior. Previous studies emphasized the importance of fun to children’s behavior as well. Norman et al. [43] found a positive association between the enjoyment of sedentary activities and high amounts of sedentary time. Moreover, a review found evidence for a negative association between preference of sedentary activities and time spent on physical activity [17].
Children mentioned statements related to feeling not so well and feeling bored, indicating children’s mood is another potential determinant of their sedentary behavior. This finding is in line with previous research indicating that lower psychological wellbeing was associated with higher TV/Video viewing and computer use during adolescence [44] and higher TV viewing later in life [45]. Rideout et al. [3] found that children who spent more time using media, e.g., mobile/online media and television, were more likely to feel unhappy, sad or bored.
The influence of new media on children’s behavior is highlighted in the cluster “I sit because I want to make contact with my friends”. Underlying statements show the influence of smartphones, social media, and online games. Children use these platforms and devices to keep in touch with their friends and family.

4.1. Strengths and Limitations

An important strength of this study is the focus on both child- and parent perspectives, giving not only new insights in potential determinants but also their relevance/importance in influencing sedentary time. Yet the use of the concept mapping method further strengthens this study by structuring qualitative data in a quantitative way and providing the opportunity to visualize the composite ideas of a group in one map, including participants from different backgrounds. In addition, the method consists of several educational tasks, e.g., sharing ideas in a group context, and sorting related motives into piles. Furthermore, concept mapping gives all participants the opportunity to share their individual ideas, as children share their ideas one by one during the group brainstorm, and parents provided their individual ideas by e-mail. Despite that a few children needed more guidance during the sorting task concept mapping proved a feasible and valuable method for this age group. The online concept mapping sessions with the parents may have reduced social desirable answers.
A limitation of the study is the limited age range of the children (11–13 years old). A strength is that a diverse group of children participated, i.e., with low and medium SES, living in urban and rural areas. In addition, similar clusters were identified across schools, and at the last school no new topics emerged in the underlying statements (i.e., indicating saturation), thereby strengthening the evidence for the representativeness of our findings for 11–13 years old in The Netherlands. Similarly, in the second group of parents no new topics emerged. The participating parents, who were not necessarily the parents of the participating children, were mainly highly educated, which may have limited the representativeness of parent-identified determinants. The low recruitment rate among parents is an additional limitation of our study, which may have resulted in selection bias. Lastly, a few children had difficulties with the sorting task, resulting in more statements being rearranged by researchers in the final concept maps. As the rearranged statements were included in the clusters emerging from the individual sorting task of the other children, the final concept maps are still representative for children’s perspectives.

4.2. Future Recommendations

Although the evidence for the adverse health effects of excessive sedentary behavior in youth is unconvincing, there is little potential harm of implementing sedentary time limiting interventions [8]. Current interventions aiming to reduce sedentary behavior mainly focused on determinants in the psychological, cognitive, emotional domain and behavioral domain. Strategies include for example enhancing children’s knowledge and awareness of their sedentary time, goal setting, and limiting TV time e.g., by using TV budgets [14]. Our study suggests that these may not be the most important determinants for children. The children and most parents in our study rated potential determinants belonging to the social/cultural and the physical environmental domain as most important, namely “I sit because of the norm/I sit because I have to”, and “I sit because I can work/play better that way”. These child- and parent-perceived determinants call for very different intervention strategies targeting the social or physical environment, giving them more freedom being non-sedentary e.g., by allowing children to be active during lessons, homework or screen time or providing gymnastic balls, standing and exercise desks. Additionally, future interventions might benefit from focusing on both the school and home setting, as children indicate being limited by physical activity restricting rules and environments in both settings. Moreover, involving both children and parents in the development of future interventions seems important, as their perceptions were not identical. Lastly, interventions targeting sedentary behavior reductions may be incorporated in interventions promoting moderate-to-vigorous physical activity, for which ample evidence exists of its beneficial health effects in youth. Although, whether the identified factors are indeed determinants of sedentary behavior should first be confirmed in prospective observational and intervention studies. In addition to perceived determinants of overall sedentary behavior, future studies should focus on child- and parent-perceived determinants of specific sedentary behaviors such as screen time and sitting at school, as it is likely that determinants of these behaviors may deviate from that of overall sedentary behavior.

5. Conclusions

This study adds important new insights into potential determinants of children’s sedentary behavior. Interestingly, parents’ and children’s perspectives differed with regard to both type and importance of potential determinants. This highlights the importance of involving children in research concerning their own behavior. The most important child-perceived determinants of sedentary behavior were: “I sit because of the norm/I sit because I have to”, “I sit because I can work/play better that way” and “I sit because there is nobody to play with”. Future observational and intervention studies are needed to confirm the importance of these potential determinants.

Supplementary Materials

Supplementary File 1

Acknowledgments

The contributions of Teatske M. Altenburg, Evi van Ekris and Mai J.M. Chinapaw were funded by The Netherlands Organization for Health Research and Development (ZonMw Project Number 91211057). We thank all primary schools for contributing to the recruitment of participants. In addition, we thank the children and parents for their participation.

Author Contributions

Lisan M. Hidding, Teatske M. Altenburg and Mai J.M. Chinapaw conceived and designed the project; Lisan M. Hidding and Evi van Ekris performed the data acquisition; Lisan M. Hidding, Teatske M. Altenburg, Evi van Ekris and Mai J.M. Chinapaw analyzed and interpreted the data; Lisan M. Hidding wrote the initial manuscript, and Teatske M. Altenburg, Evi van Ekris and Mai J.M. Chinapaw contributed to writing the manuscript. All authors approved the final version.

Conflicts of Interest

The authors declare no conflict of interest.

Appendix A

Appendix A.1. Original Cluster Compositions and Average Rating per Statement

Table A1. Clusters, statements and importance ratings of children (school 1).
Table A1. Clusters, statements and importance ratings of children (school 1).
Clusters and StatementsImportance a
1.I sit because it is the norm/I sit because I have to3.86
4. I sit because what I’m doing has to be done seated4.40
15. I sit because it is safer to stay seated4.30
16. I sit because school, parents or grandparents say so4.20
23. I sit because otherwise the teacher gets mad4.20
24. I sit because I don’t want to draw attention to myself3.60
26. I sit because it is not logical to stand (weird)3.30
30. I sit because I’m not supposed to stand3.80
40. I sit because I feel people stare at me when I stand3.10
2.I sit because I can work better that way3.78
13. I sit because it is hard to stay standing up3.20
20. I sit because I can concentrate better this way4.50
29. I sit because it is easier to sit when I’m working4.30
38. I sit because I get nervous when I stand for too long3.10
3.I sit because it feels better3.75
5. I sit because it is cozy3.80
35. I sit because it is more comfortable3.70
4.I sit because of a specific reason3.40
10. I sit because I have to wait3.20
27. I sit because it is better for my digestion3.10
31. I sit because some activities are designed that way, gaming for example3.90
5.I sit because seated activities are fun3.34
2. I sit because I feel like it2.90
3. I sit because I like it3.10
8. I sit because the most fun things are seated activities3.80
14. I sit because it is nicer to sit3.50
18. I sit because there’s something good on TV3.30
25. I sit because it is more pleasant to sit3.60
28. I sit because sometimes seated activities are more fun3.50
41. When I’m alone I prefer to choose seated activities3.00
6.I sit because I’m tired, I want to relax, I want to3.30
1. I sit because I’m tired3.60
9. I sit because I want to rest4.10
12. I sit because I’m too lazy to stand2.20
19. I sit because it is useless to stand (costs energy)3.30
22. I sit because my legs are tired2.90
33. I sit to give my legs a rest3.00
34. I sit because I want to relax4.00
37. I sit because standing is tiring3.30
7.I sit because there is nothing to do2.80
7. I sit because I have nothing to do2.40
11. I sit because it is raining outside2.70
17. I sit because there is nothing to do2.40
21. I sit because it is too cold outside2.10
36. I sit because things go better that way, reading for example4.40
8.I sit because I’m not in the mood to do anything2.60
6. I sit because I’m bored2.40
32. I sit because I don’t feel like standing2.80
a Rated on a 5-point Likert scale with higher scores indicating higher importance. Remaining numbers which were not included in one of the clusters: 39. Because when I feel calm I sit.
Table A2. Clusters, statements and importance ratings of children (school 2).
Table A2. Clusters, statements and importance ratings of children (school 2).
Clusters and StatementsImportance a
1.I sit because I can work better that way/I sit because it is the norm/I sit because I have to3.74
3. I sit because I have to at school4.11
4. I sit because there is no alternative3.89
5. I sit because I can concentrate better this way4.89
6. I sit because some activities can only be done seated3.44
9. I sit because it is more convenient3.67
18. I sit because I have a lot of homework, which I have to do on the computer3.22
22. I sit because it is easier2.67
24. I sit because I can think better that way3.67
31. I sit because writing while standing up is hard4.11
2.I sit because there is nobody to play with3.42
2. I sit because there are no other children to play with (in the neighborhood)3.56
10. I sit because my parents don’t always have the time to play with me2.56
19. I sit because it’s no fun playing outside on your own4.00
23. I sit because classmates live far away, and contact via the phone is easier3.11
32. I sit because you need two people to play outside, and it’s more fun with two3.89
3.I sit because I’m tired, I want to relax, I want to rest/I sit because seated activities are fun3.30
1. I sit because I want to rest3.89
8. I sit because it is fun2.89
12. I sit because it is comfortable to sit on the couch under a blanket4.00
14. I sit because standing for too long makes me tired2.89
15. I sit because I become calm3.56
16. I sit because sometimes I don’t feel like standing3.33
17. I sit because I’m tired3.78
21. I sit because it doesn’t cost any energy2.78
27. I sit because sitting is calmer2.67
28. I sit because I don’t want to miss my favorite TV-program3.78
29. I sit because sometimes it is more fun2.78
4.I sit because of the weather3.11
11. I sit because it is dark outside2.56
20. I sit because the weather is bad (cold, rain)3.67
5.I sit because being active takes a lot of effort2.67
25. I sit because I have to change my clothes if I want to play outside2.44
26. I sit because going outside takes a lot of effort (living on a farm)2.89
a Rated on a 5-point Likert scale with higher scores indicating higher importance. Remaining numbers which were not included in one of the clusters: 7. I sit because it is a habit; 13. I sit because you can use the computer when you are on your own; 30. I sit because my parents tell me to.
Table A3. Clusters, statements and importance ratings of children (school 3).
Table A3. Clusters, statements and importance ratings of children (school 3).
Clusters and StatementsImportance a
1.I sit because it is the norm/I sit because I have to3.69
17. I sit because sometimes I have to sit at school3.88
18. I sit because my parents tell me to3.88
20. I sit because I’m asked to take part in a seated activity, gaming for example3.38
23. I sit because it’s easier talking with the family when you’re seated3.63
2.I sit because there is nobody to play with3.69
5. I sit because doing something on my own is stupid and I can make contact with the outside world via my phone3.63
19. I sit because I can’t arrange to meet people, so then I use the computer to make contact3.75
3.I sit because I’m tired, I want to relax, I want to rest3.46
2. I sit because I want to rest3.38
13. I sit because it is restful3.38
21. I sit because it is relaxed3.63
4.I sit because seated activities are fun3.40
11. I sit because I think it is fun4.00
14. I sit because sometimes it is more fun to do activities sitting down3.38
16. I sit because it is more logical3.38
25. I sit because it is fun3.13
26. I sit because a seated activity is more interesting3.13
5.I sit because there is nothing to do3.31
4. I sit because there are no nice people outside3.38
6. I sit because I have nothing to do3.75
15. I sit because standing is not convenient3.13
28. I sit because I have to wait a long time3.50
30. I sit because it is too hot3.00
31. I sit because I don’t know what to do3.13
6.I sit because I’m not in the mood to do anything3.31
1. I sit because I’m tired3.63
3. I sit because the weather is bad3.25
7. I sit because I don’t feel so well (not in the mood)4.13
8. I sit because I’m too far from somewhere I can take part in activities (the park)3.25
10. I sit because the seated activity is nearby2.88
12. I sit because I’m still sleepy3.38
22. I sit because I don’t feel like doing anything active3.00
24. I sit because I’m bored3.13
27. I sit because standing for too long makes me tired3.25
29. I sit because I already have to do a lot of standing3.75
a Rated on a 5-point Likert scale with higher scores indicating higher importance. Remaining numbers which were not included in one of the clusters: 9. I sit because I feel like it.
Table A4. Clusters, statements and importance ratings of children (school 4).
Table A4. Clusters, statements and importance ratings of children (school 4).
Clusters and StatementsImportance a
1.I sit because it is the norm/I sit because I have to3.67
7. I sit because I’m not allowed to stand while learning in class2.78
11. I sit because some activities are impossible to do standing3.89
12. I sit because in some activities it is just the way it is done3.78
22. I sit because I have to eat4.00
37. I sit because it’s not possible to stand3.78
40. I sit because I have to pray4.44
41. I sit because in school I have to3.44
42. I sit because sometimes I’m not allowed to stand3.22
2.I sit because I can work better that way3.40
14. I sit because standing and running around can be distracting2.56
31. I sit because I have to concentrate while I’m working4.00
43. I sit because then you can work more accurately3.44
49. I sit because sometimes it is more polite3.67
50. I sit because some locations are too far to cycle, then I’ll go by car3.33
3.I sit because seated activities are fun/I sit because I want to make contact with my friends3.38
2. I sit because I like a particular game a lot3.22
6. I sit because a friend of mine lives far away, to keep in touch we talk to each other on the phone4.00
8. I sit because I play some games online with my friends3.33
13. I sit because I can keep in touch with friends online who live far away3.78
33. Children sit because they may be addicted to a computer game2.56
4.I sit because of a specific reason3.26
32. I sit because when you play hide and seek, people can see you when you stand3.44
38. I sit because sometimes being active is dangerous2.89
47. I sit because sometimes it is more pleasant for others when you sit3.44
5.I sit because seated activities are fun/I sit because there is nobody to play (actively) with3.13
3. I sit because there is nobody to play with3.56
9. I sit because when I have to learn I’ll do it on my computer3.44
21. I sit because I want to watch a program3.00
23. I sit because it is cozy to watch YouTube videos3.44
29. I sit because my friends want to play inside2.78
36. I sit because sometimes I want to laugh at funny videos3.22
44. I sit because I want to stay up to date with my social media2.44
6.I sit because I’m tired, I want to relax, I want to rest2.98
1. I sit because I’m tired3.33
4. I sit when something is bothering me4.33
5. I sit when I’m ill4.00
10. I sit because I prefer to sit2.11
18. I sit because you need less energy for seated activities2.44
20. I sit because I’m lazy2.11
24. I sit because it is more relaxing3.67
25. I sit because it is tiring to stand1.89
27. I sit because I’m bored2.44
30. I sit because when I’m bored it is an easy solution3.11
39. I sit because when you stand for too long you’ll get cramps3.11
45. I sit because standing activities are tiring2.22
46. I sit because I want to rest after a workout3.78
51. I sit because sometimes it is more pleasant3.11
7.I sit because the physical environment is not suitable2.75
15. I sit because I have to practice in order to be a game programmer when I’m older2.89
16. I sit because maybe the weather is bad outside3.22
19. I sit because in my neighborhood there are a lot bushes with thorns2.33
48. I sit because I love it2.56
a Rated on a 5-point Likert scale with higher scores indicating higher importance. Remaining numbers which were not included in one of the clusters: 17. I sit because I have to practice a lot to be able to play a game well; 26. I sit because I often learn for a good grade; 28. I sit because it is nice and funny; 34. I sit because with my parents I often do activities where I have to sit; 35. I sit because some things are more practical while seated.
Table A5. Clusters, statements and importance ratings of parents (purposive sample).
Table A5. Clusters, statements and importance ratings of parents (purposive sample).
Clusters and StatementsImportance a
1.My child sits because he/she is tired, wants to relax, wants to rest4.10
6. Sitting because it is a comfortable posture after some exercise4.29
7. Sitting because it is a relaxed posture4.43
13. Sitting because he/she wants to rest 4.14
18. Sitting because he/she then enjoys him/herself3.43
23. Sitting because it is a comfortable posture4.14
24. Sitting because he/she can then rest4.14
2.My child sits because he/she can work better that way3.88
8. Sitting because the activity requires a sitting posture4.14
9. Sitting because it is more convenient3.29
11. Sitting because it suits the activity4.29
14. Sitting because he/she has to travel3.57
16. Sitting because he/she has to do homework3.86
17. Sitting because the situation demands it4.00
20. Sitting because he/she has schoolwork to do4.14
22. Sitting because he/she has to study3.71
3.My child sits because there is nothing to do2.62
5. Sitting by force of habit2.43
12. Sitting because there is nothing active to do2.14
15. Sitting to make contact with friends, chatting for example3.43
21. Sitting because he/she is bored2.29
4.My child sits because it is the norm2.14
1. Sitting because the interior is designed that way2.00
2. Sitting because other people in the social environment do it as well1.71
10. Sitting because it’s what has been taught2.71
a Rated on a 5-point Likert scale with higher scores indicating higher importance. Remaining numbers which were not included in one of the clusters: 3. Sitting because this is the most practical posture for performing the activity; 4. Sitting because he/she has been told to; 19. Sitting because he/she wants to work quietly.
Table A6. Clusters, statements and importance ratings of parents (convenience sample) a.
Table A6. Clusters, statements and importance ratings of parents (convenience sample) a.
Clusters and StatementsImportance b
1.My child sits because it is the norm3.52
5. Sitting because he/she has to, e.g., at school or while eating/doing homework4.15
6. Sitting because he/she is not allowed to lie down2.46
7. Sitting because he/she has no other option than to sit or lie down during the activity4.00
8. Sitting because there are no desks at school or at home3.46
14. Sitting because the activity is designed for a sitting posture, e.g., the computer and TV are placed at sitting height3.08
24. Sitting because he/she has been taught to perform the activity in a sitting posture2.92
30. Sitting because he/she is expected to sit, e.g., at school, while doing homework or eating4.23
31. Sitting because he/she has been told to3.85
2.My child sits because he/she can work/play better that way3.47
1. Sitting because the activity requires a sitting posture4.00
2. Sitting because it is most appropriate for the activity3.85
4. Sitting because it is practical3.15
10. Sitting because he/she has to concentrate3.15
15. Sitting because he/she can perform the activity more easily that way, eating and doing a puzzle for example3.15
16. Sitting because it is a more natural posture for the activity2.85
17. Sitting because for some activities there is no other way, e.g., playing on a tablet, watching TV or travelling by car4.23
34. Sitting because it is safer to be seated during the activity, playing with a hamster for example3.38
3.My child sits because he/she is tired, wants to rest/relax3.33
20. Sitting because it is relaxing3.62
21. Sitting because he/she is tired3.23
22. Sitting because it is an important relaxation moment3.62
35. Sitting because he/she is in a relaxed mood2.46
36. Sitting because a seated activity can provide peace and quiet3.54
37. Sitting because he/she has to calm down physically3.85
41. Sitting because it is a relaxing activity3.00
4.My child sits because seated activities are fun3.32
11. Sitting because he/she likes to do seated activities3.31
12. Sitting because he/she feels like doing a seated activity3.00
13. Sitting because he/she enjoys doing a seated activity3.54
18. Sitting because he/she enjoys the activity4.38
19. Sitting because he/she likes the seated activity3.31
29. Sitting because he/she forgets the world around him/her, while watching TV for example2.38
5.My child sits because its comfortable, and requires less energy3.04
3. Sitting because a seated/lying posture is the most comfortable3.31
40. Sitting because he/she requires less energy for seated activities2.77
6.My child sits because others do so, and it is a habit2.94
9. Sitting because he/she lives in a sedentary society3.15
23. Sitting by force of habit3.08
25. Sitting because he/she copies sedentary behavior of the parents and others3.00
26. Sitting because others nearby are doing seated activities, e.g., watching TV2.54
7.My child sits because it is in his/her nature2.81
38. Sitting because he/she is naturally a quiet child2.38
39. Sitting because he/she wants to withdraw into him/herself3.23
8.My child sits because there is nothing (active) to do2.52
27. Sitting because there is not much to do (that encourages physical activity)2.54
28. Sitting because he/she is bored2.31
32. Sitting because I (as a parent) don’t have the time or don’t feel like doing something active with my child2.23
33. Sitting because he/she doesn’t feel like doing a more active activity, e.g., playing outside3.00
42. Sitting because some seated activities easily fill up the day, he/she doesn’t have to think about what he/she can do, e.g., watching TV2.46
43. Sitting because he/she can’t think of anything else to do2.15
44. Sitting because he/she has nobody to play with2.92
a Sorting task n = 14, rating task n = 13; b Rated on a 5-point Likert scale with higher scores indicating higher importance.

Appendix A.2. Final Cluster Compositions and Average Rating per Statement

Table A7. Clusters, statements and importance ratings of children (school 1).
Table A7. Clusters, statements and importance ratings of children (school 1).
Clusters and StatementsImportance a
1.I sit because I can work better that way4.40
20. I sit because I can concentrate better this way4.50
29. I sit because it is easier to sit when I’m working4.30
36. I sit because things go better that way, reading for example b4.40
2.I sit because it is the norm/I sit because I have to3.86
4. I sit because what I’m doing has to be done seated4.40
15. I sit because it is safer to stay seated4.30
16. I sit because school, parents or grandparents say so4.20
23. I sit because otherwise the teacher gets mad4.20
24. I sit because I don’t want to draw attention to myself3.60
26. I sit because it is not logical to stand (weird)3.30
30. I sit because I’m not supposed to stand3.80
40. I sit because I feel people stare at me when I stand3.10
31. I sit because some activities are designed that way, gaming for example b3.90
3.I sit because it feels better3.45
5. I sit because it is cozy3.80
35. I sit because it is more comfortable3.70
38. I sit because I get nervous when I stand for too long b3.10
13. I sit because it is hard to stay standing up b3.20
4.I sit because seated activities are fun3.39
2. I sit because I feel like it2.90
3. I sit because I like it3.10
8. I sit because the most fun things are seated activities3.80
14. I sit because it is nicer to sit3.50
18. I sit because there’s something good on TV3.30
25. I sit because it is more pleasant to sit3.60
28. I sit because sometimes seated activities are more fun3.50
5.I sit because I’m tired, I want to relax, I want to rest3.31
1. I sit because I’m tired3.60
9. I sit because I want to rest4.10
12. I sit because I’m too lazy to stand2.20
19. I sit because it is useless to stand (costs energy)3.30
22. I sit because my legs are tired2.90
33. I sit to give my legs a rest3.00
34. I sit because I want to relax4.00
37. I sit because standing is tiring3.30
39. Because when I feel calm I sit b3.40
6.I sit because of my health3.10
27. I sit because it is better for my digestion3.10
7.I sit because there is nobody to play with c3.00
41. When I’m alone I prefer to choose seated activities3.00
8.I sit because there is nothing to do2.67
7. I sit because I have nothing to do2.40
17. I sit because there is nothing to do2.40
10. I sit because I have to waitb3.20
9.I sit because I’m not in the mood to do anything2.60
6. I sit because I’m bored2.40
32. I sit because I don’t feel like standing2.80
10.I sit because of the weather c2.40
11. I sit because it is raining outside2.70
21. I sit because it is too cold outside2.10
a Rated on a 5-point Likert scale with higher scores indicating higher importance; b Indicates a statement is reallocated by researchers; c Indicates a new cluster is created by researchers as a result of reallocation of statements.
Table A8. Clusters, statements and importance ratings of children (school 2).
Table A8. Clusters, statements and importance ratings of children (school 2).
Clusters and StatementsImportance a
1.I sit because I can work better that way3.67
5. I sit because I can concentrate better this way4.89
6. I sit because some activities can only be done seated3.44
9. I sit because it is more convenient3.67
18. I sit because I have a lot of homework, which I have to do on the computer3.22
22. I sit because it is easier2.67
24. I sit because I can think better that way3.67
31. I sit because writing while standing up is hard4.11
2.I sit because it is the norm/I sit because I have to c3.59
3. I sit because I have to at school4.11
4. I sit because there is no alternative3.89
30. I sit because my parents tell me to2.78
3.I sit because I’m tired, I want to relax, I want to rest3.36
1. I sit because I want to rest3.89
12. I sit because it is comfortable to sit on the couch under a blanket4.00
14. I sit because standing for too long makes me tired2.89
15. I sit because I become calm3.56
16. I sit because sometimes I don’t feel like standing3.33
17. I sit because I’m tired3.78
21. I sit because it doesn’t cost any energy2.78
27. I sit because sitting is calmer2.67
4.I sit because it is a habit d3.33
7. I sit because it is a habit3.33
5.I sit because there is nobody to play with3.30
2. I sit because there are no other children to play with (in the neighborhood)3.56
10. I sit because my parents don’t always have the time to play with me2.56
19. I sit because it’s no fun playing outside on your own4.00
23. I sit because classmates live far away, and contact via the phone is easier3.11
32. I sit because you need two people to play outside, and it’s more fun with two3.89
13. I sit because you can use the computer when you are on your own b2.67
6.I sit because seated activities are fun c3.15
8. I sit because it is fun2.89
28. I sit because I don’t want to miss my favorite TV-program3.78
29. I sit because sometimes it is more fun2.78
7.I sit because of the weather3.12
11. I sit because it is dark outside2.56
20. I sit because the weather is bad (cold, rain)3.67
8.I sit because being active takes a lot of effort2.67
25. I sit because I have to change my clothes if I want to play outside2.44
26. I sit because going outside takes a lot of effort (living on a farm)2.89
a Rated on a 5-point Likert scale with higher scores indicating higher importance; b Indicates a statement is reallocated by researchers; c Indicates a new cluster is created by researchers as a result of reallocation of statements; d Indicates cluster based on a single statement, that was originally not included in a cluster.
Table A9. Clusters, statements and importance ratings of children (school 3).
Table A9. Clusters, statements and importance ratings of children (school 3).
Clusters and statementsImportance a
1.I sit because it is the norm/I sit because I have to3.88
17. I sit because sometimes I have to sit at school3.88
18. I sit because my parents tell me to3.88
2.I sit because there is nobody to play with3.69
5. I sit because doing something on my own is stupid and I can make contact with the outside world via my phone3.63
19. I sit because I can’t arrange to meet people, so then I use the computer to make contact3.75
3.I sit because seated activities are fun3.49
11. I sit because I think it is fun4.00
14. I sit because sometimes it is more fun to do activities sitting down3.38
16. I sit because it is more logical3.38
25. I sit because it is fun3.13
26. I sit because a seated activity is more interesting3.13
20. I sit because I’m asked to take part in a seated activity, gaming for example b3.38
9. I sit because I feel like it b4.00
4.I sit because I’m tired, I want to relax, I want to rest3.48
2. I sit because I want to rest3.38
13. I sit because it is restful3.38
21. I sit because it is relaxed3.63
27. I sit because standing for too long makes me tired b3.25
29. I sit because I already have to do a lot of standing b3.75
5.I sit because I’m not in the mood to do anything3.45
1. I sit because I’m tired3.63
7. I sit because I don’t feel so well (not in the mood)4.13
12. I sit because I’m still sleepy3.38
22. I sit because I don’t feel like doing anything active3.00
24. I sit because I’m bored3.13
6.I sit because there is nothing to do3.44
4. I sit because there are no nice people outside3.38
6. I sit because I have nothing to do3.75
28. I sit because I have to wait a long time3.50
31. I sit because I don’t know what to do3.13
7.I sit because this posture suits the activity better c3.38
15. I sit because standing is not convenient3.13
23. I sit because it’s easier talking with the family when you’re seated3.63
8.I sit because of the weather c3.13
30. I sit because it is too hot3.00
3. I sit because the weather is bad3.25
9.I sit because the physical environment suitable for physical activities is too far away c3.01
8. I sit because I’m too far from somewhere I can take part in activities (the park)3.25
10. I sit because the seated activity is nearby2.88
a Rated on a 5-point Likert scale with higher scores indicating higher importance; b Indicates a statement is reallocated by researchers; c Indicates a new cluster is created by researchers as a result of reallocation of statements.
Table A10. Clusters, statements and importance ratings of children (school 4).
Table A10. Clusters, statements and importance ratings of children (school 4).
Clusters and StatementsImportance a
1.I sit because it is the norm/I sit because I have to3.61
7. I sit because I’m not allowed to stand while learning in class2.78
11. I sit because some activities are impossible to do standing3.89
12. I sit because in some activities it is just the way it is done3.78
22. I sit because I have to eat4.00
37. I sit because it’s not possible to stand3.78
40. I sit because I have to pray4.44
41. I sit because in school I have to3.44
42. I sit because sometimes I’m not allowed to stand3.22
9. I sit because when I have to learn I’ll do it on my computer b3.44
34. I sit because with my parents I often do activities where I have to sit b3.33
2.I sit because I want to make contact with my friends3.39
6. I sit because a friend of mine lives far away, to keep in touch we talk to each other on the phone4.00
8. I sit because I play some games online with my friends3.33
13. I sit because I can keep in touch with friends online who live far away3.78
44. I sit because I want to stay up to date with my social media b2.44
3.I sit because I can work better that way3.37
14. I sit because standing and running around can be distracting2.56
31. I sit because I have to concentrate while I’m working4.00
43. I sit because then you can work more accurately3.44
49. I sit because sometimes it is more polite3.67
15. I sit because I have to practice in order to be a game programmer when I’m older b2.89
47. I sit because sometimes it is more pleasant for others when you sit b3.44
17. I sit because I have to practice a lot to be able to play a game well b2.78
26. I sit because I often learn for a good grade b3.56
35. I sit because some things are more practical while seated b4.00
4.I sit because there is nobody to play (actively) with c3.17
3. I sit because there is nobody to play with3.56
29. I sit because my friends want to play inside2.78
5.I sit because I’m tired, I want to relax, I want to rest3.01
1. I sit because I’m tired3.33
4. I sit when something is bothering me4.33
5. I sit when I’m ill4.00
10. I sit because I prefer to sit2.11
18. I sit because you need less energy for seated activities2.44
20. I sit because I’m lazy2.11
24. I sit because it is more relaxing3.67
25. I sit because it is tiring to stand1.89
39. I sit because when you stand for too long you’ll get cramps3.11
45. I sit because standing activities are tiring2.22
46. I sit because I want to rest after a workout3.78
51. I sit because sometimes it is more pleasant3.11
6.I sit because the physical environment is not suitable3.00
16. I sit because maybe the weather is bad outside3.22
19. I sit because in my neighborhood there are a lot bushes with thorns2.33
32. I sit because when you play hide and seek, people can see you when you stand b3.44
38. I sit because sometimes being active is dangerous b2.89
50. I sit because some locations are too far to cycle, then I’ll go by car b3.33
7.I sit because seated activities are fun2.90
21. I sit because I want to watch a program3.00
23. I sit because it is cozy to watch YouTube videos3.44
36. I sit because sometimes I want to laugh at funny videos3.22
48. I sit because I love it b2.56
28. I sit because it is nice and funny b2.33
2. I sit because I like a particular game a lot b3.22
33. Children sit because they may be addicted to a computer game b2.56
8.I sit because there is nothing to do c2.78
27. I sit because I’m bored2.44
30. I sit because when I’m bored it is an easy solution3.11
a Rated on a 5-point Likert scale with higher scores indicating higher importance; b Indicates a statement is reallocated by researchers; c Indicates a new cluster is created by researchers as a result of reallocation of statements.
Table A11. Clusters, statements and importance ratings of parents (purposive sample).
Table A11. Clusters, statements and importance ratings of parents (purposive sample).
Clusters and StatementsImportance a
1.My child sits because he/she it tired, wants to relax, wants to rest4.23
6. Sitting because it is a comfortable posture after some exercise4.29
7. Sitting because it is a relaxed posture4.43
13. Sitting because he/she wants to rest4.14
23. Sitting because it is a comfortable posture4.14
24. Sitting because he/she can then rest4.14
2.My child sits because he/she can work better that way3.97
8. Sitting because the activity requires a sitting posture4.14
9. Sitting because it is more convenient3.29
11. Sitting because it suits the activity4.29
16. Sitting because he/she has to do homework3.86
17. Sitting because the situation demands it4.00
20. Sitting because he/she has schoolwork to do4.14
22. Sitting because he/she has to study3.71
3. Sitting because this is the most practical posture for performing the activity b4.14
19. Sitting because he/she wants to work quietly b4.14
3.My child sits because seated activities are fun c3.43
18. Sitting because he/she then enjoys him/herself3.43
4.My child sits because there is nothing to do2.62
12. Sitting because there is nothing active to do2.14
15. Sitting to make contact with friends, chatting for example3.43
21. Sitting because he/she is bored2.29
5.My child sits because it is the norm2.51
1. Sitting because the interior is designed that way2.00
2. Sitting because other people in the social environment do it as well1.71
10. Sitting because it’s what has been taught2.71
14. Sitting because he/she has to travel b3.57
4. Sitting because he/she has been told to b2.57
6.My child sits because it is a habit c2.43
5. Sitting by force of habit2.43
a Rated on a 5-point Likert scale with higher scores indicating higher importance; b Indicates a statement is reallocated by researchers; c Indicates a new cluster is created by researchers as a result of reallocation of statements.
Table A12. Clusters, statements and importance ratings of parents (convenience sample) a.
Table A12. Clusters, statements and importance ratings of parents (convenience sample) a.
Clusters and StatementsImportance b
1.My child sits because it is the norm3.47
5. Sitting because he/she has to, e.g., at school or while eating/doing homework4.15
6. Sitting because he/she is not allowed to lie down2.46
7. Sitting because he/she has no other option than to sit or lie down during the activity4.00
8. Sitting because there are no desks at school or at home3.46
14. Sitting because the activity is designed for a sitting posture, e.g., the computer and TV are placed at sitting height3.08
24. Sitting because he/she has been taught to perform the activity in a sitting posture2.92
30. Sitting because he/she is expected to sit, e.g., at school, while doing homework or eating4.23
31. Sitting because he/she has been told to3.85
9. Sitting because he/she lives in a sedentary society c3.15
2.My child sits because he/she can work/play better that way3.45
1. Sitting because the activity requires a sitting posture4.00
2. Sitting because it is most appropriate for the activity3.85
4. Sitting because it is practical3.15
10. Sitting because he/she has to concentrate3.15
15. Sitting because he/she can perform the activity more easily that way, eating and doing a puzzle for example3.15
16. Sitting because it is a more natural posture for the activity2.85
17. Sitting because for some activities there is no other way, e.g., playing on a tablet, watching TV or travelling by car4.23
34. Sitting because it is safer to be seated during the activity, playing with a hamster for example3.38
3. Sitting because a seated/lying posture is the most comfortable c3.31
3.My child sits because seated activities are fun3.32
11. Sitting because he/she likes to do seated activities3.31
12. Sitting because he/she feels like doing a seated activity3.00
13. Sitting because he/she enjoys doing a seated activity3.54
18. Sitting because he/she enjoys the activity4.38
19. Sitting because he/she likes the seated activity3.31
29. Sitting because he/she forgets the world around him/her, while watching TV for example2.38
4.My child sits because he/she is tired, wants to rest/relax3.26
20. Sitting because it is relaxing3.62
21. Sitting because he/she is tired3.23
22. Sitting because it is an important relaxation moment3.62
35. Sitting because he/she is in a relaxed mood2.46
36. Sitting because a seated activity can provide peace and quiet3.54
37. Sitting because he/she has to calm down physically3.85
41. Sitting because it is a relaxing activity3.00
40. Sitting because he/she requires less energy for seated activities c2.77
5.My child sits because others do so, and it is a habit2.87
23. Sitting by force of habit3.08
25. Sitting because he/she copies sedentary behavior of the parents and others3.00
26. Sitting because others nearby are doing seated activities, e.g., watching TV2.54
6.My child sits because it is in his/her nature2.81
38. Sitting because he/she is naturally a quiet child2.38
39. Sitting because he/she wants to withdraw into him/herself3.23
7.My child sits because there is nothing (active) to do2.52
27. Sitting because there is not much to do (that encourages physical activity)2.54
28. Sitting because he/she is bored2.31
32. Sitting because I (as a parent) don’t have the time or don’t feel like doing something active with my child2.23
33. Sitting because he/she doesn’t feel like doing a more active activity, e.g., playing outside3.00
42. Sitting because some seated activities easily fill up the day, he/she doesn’t have to think about what he/she can do, e.g., watching TV2.46
43. Sitting because he/she can’t think of anything else to do2.15
44. Sitting because he/she has nobody to play with2.92
a Sorting task n = 14, rating task n = 13; b Rated on a 5-point Likert scale with higher scores indicating higher importance; c Indicates a statement is reallocated by researchers.

Appendix A.3. Concept Maps Children (School 1, 3 and 4) and Parents (Purposive Sample)

Figure A1. Concept map children (school 1). Note that points, i.e., statements, sorted more often together appear closer to each other, and statements never/rarely sorted together appear widely separated; Arrows indicate a statement is reallocated by researchers, circles indicate a new cluster is created by researchers as a result of reallocation of statements; Cluster 1: I sit because I can work/play better that way; Cluster 2: I sit because it is the norm/I sit because I have to; Cluster 3: I sit because it feels better; Cluster 4: I sit because seated activities are fun; Cluster 5: I sit because I’m tired, I want to relax, I want to rest; Cluster 6: I sit because of my health; Cluster 7: I sit because there is nobody to play with; Cluster 8: I sit because there is nothing to do; Cluster 9: I sit because I’m not in the mood to do anything; Cluster 10: I sit because of the weather.
Figure A1. Concept map children (school 1). Note that points, i.e., statements, sorted more often together appear closer to each other, and statements never/rarely sorted together appear widely separated; Arrows indicate a statement is reallocated by researchers, circles indicate a new cluster is created by researchers as a result of reallocation of statements; Cluster 1: I sit because I can work/play better that way; Cluster 2: I sit because it is the norm/I sit because I have to; Cluster 3: I sit because it feels better; Cluster 4: I sit because seated activities are fun; Cluster 5: I sit because I’m tired, I want to relax, I want to rest; Cluster 6: I sit because of my health; Cluster 7: I sit because there is nobody to play with; Cluster 8: I sit because there is nothing to do; Cluster 9: I sit because I’m not in the mood to do anything; Cluster 10: I sit because of the weather.
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Figure A2. Concept map children (school 3). Note that points, i.e., statements, sorted more often together appear closer to each other, and statements never/rarely sorted together appear widely separated; Arrows indicate a statement is reallocated by researchers, circles indicate a new cluster is created by researchers as a result of reallocation of statements; Cluster 1: I sit because it is the norm/I sit because I have to; Cluster 2: I sit because there is nobody to play with; Cluster 3: I sit because seated activities are fun; Cluster 4: I sit because I’m tired, I want to relax, I want to rest; Cluster 5: I sit because I’m not in the mood to do anything; Cluster 6: I sit because there is nothing to do; Cluster 7: I sit because this posture suits the activity better; Cluster 8: I sit because of the weather; Cluster 9: I sit because the physical environment suitable for physical activities is too far away.
Figure A2. Concept map children (school 3). Note that points, i.e., statements, sorted more often together appear closer to each other, and statements never/rarely sorted together appear widely separated; Arrows indicate a statement is reallocated by researchers, circles indicate a new cluster is created by researchers as a result of reallocation of statements; Cluster 1: I sit because it is the norm/I sit because I have to; Cluster 2: I sit because there is nobody to play with; Cluster 3: I sit because seated activities are fun; Cluster 4: I sit because I’m tired, I want to relax, I want to rest; Cluster 5: I sit because I’m not in the mood to do anything; Cluster 6: I sit because there is nothing to do; Cluster 7: I sit because this posture suits the activity better; Cluster 8: I sit because of the weather; Cluster 9: I sit because the physical environment suitable for physical activities is too far away.
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Figure A3. Concept map children (school 4). Note that points, i.e., statements, sorted more often together appear closer to each other, and statements never/rarely sorted together appear widely separated; Arrows indicate a statement is reallocated by researchers, circles indicate a new cluster is created by researchers as a result of reallocation of statements; Cluster 1: I sit because it is the norm/I sit because I have to; Cluster 2: I sit because I want to make contact with my friends; Cluster 3: I sit because I can work/play better that way; Cluster 4: I sit because there is nobody to play (actively) with; Cluster 5: I sit because I’m tired, I want to relax, I want to rest; Cluster 6: I sit because the physical environment is not suitable; Cluster 7: I sit because seated activities are fun; Cluster 8: I sit because there is nothing to do.
Figure A3. Concept map children (school 4). Note that points, i.e., statements, sorted more often together appear closer to each other, and statements never/rarely sorted together appear widely separated; Arrows indicate a statement is reallocated by researchers, circles indicate a new cluster is created by researchers as a result of reallocation of statements; Cluster 1: I sit because it is the norm/I sit because I have to; Cluster 2: I sit because I want to make contact with my friends; Cluster 3: I sit because I can work/play better that way; Cluster 4: I sit because there is nobody to play (actively) with; Cluster 5: I sit because I’m tired, I want to relax, I want to rest; Cluster 6: I sit because the physical environment is not suitable; Cluster 7: I sit because seated activities are fun; Cluster 8: I sit because there is nothing to do.
Ijerph 14 00671 g005
Figure A4. Concept map parents (purposive sample). Note that points, i.e., statements, sorted more often together appear closer to each other, and statements never/rarely sorted together appear widely separated; Arrows indicate a statement is reallocated by researchers, circles indicate a new cluster is created by researchers as a result of reallocation of statements; Cluster 1: My child sits because he/she it tired, wants to relax, wants to rest; Cluster 2: My child sits because he/she can work/play better that way; Cluster 3: My child sits because seated activities are fun; Cluster 4: My child sits because there is nothing to do; Cluster 5: My child sits because it is the norm; Cluster 6: My child sits because it is a habit.
Figure A4. Concept map parents (purposive sample). Note that points, i.e., statements, sorted more often together appear closer to each other, and statements never/rarely sorted together appear widely separated; Arrows indicate a statement is reallocated by researchers, circles indicate a new cluster is created by researchers as a result of reallocation of statements; Cluster 1: My child sits because he/she it tired, wants to relax, wants to rest; Cluster 2: My child sits because he/she can work/play better that way; Cluster 3: My child sits because seated activities are fun; Cluster 4: My child sits because there is nothing to do; Cluster 5: My child sits because it is the norm; Cluster 6: My child sits because it is a habit.
Ijerph 14 00671 g006

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Figure 1. Concept map children (school 2). Note that points, i.e., statements, sorted more often together appear closer to each other, and statements never/rarely sorted together appear widely separated.; Arrows indicate a statement is reallocated by researchers, circles indicate a new cluster is created by researchers as a result of reallocation of statements.; Cluster 1: I sit because I can work/play better that way; Cluster 2: I sit because it is the norm/I sit because I have to; Cluster 3: I sit because I’m tired, I want to relax, I want to rest; Cluster 4: I sit because it is a habit; Cluster 5: I sit because there is nobody to play with; Cluster 6: I sit because seated activities are fun; Cluster 7: I sit because of the weather; Cluster 8: I sit because being active takes a lot of effort.
Figure 1. Concept map children (school 2). Note that points, i.e., statements, sorted more often together appear closer to each other, and statements never/rarely sorted together appear widely separated.; Arrows indicate a statement is reallocated by researchers, circles indicate a new cluster is created by researchers as a result of reallocation of statements.; Cluster 1: I sit because I can work/play better that way; Cluster 2: I sit because it is the norm/I sit because I have to; Cluster 3: I sit because I’m tired, I want to relax, I want to rest; Cluster 4: I sit because it is a habit; Cluster 5: I sit because there is nobody to play with; Cluster 6: I sit because seated activities are fun; Cluster 7: I sit because of the weather; Cluster 8: I sit because being active takes a lot of effort.
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Figure 2. Concept map parents (convenience sample). Note that points, i.e., statements, sorted more often together appear closer to each other, and statements never/rarely sorted together appear widely separated.; Arrows indicate a statement is reallocated by researchers, circles indicate a new cluster is created by researchers as a result of reallocation of statements. Cluster 1: My child sits because it is the norm; Cluster 2: My child sits because he/she can work/play better that way; Cluster 3: My child sits because seated activities are fun; Cluster 4: My child sits because he/she is tired, wants to relax, wants to rest; Cluster 5: My child sits because others do so, and it is a habit; Cluster 6: My child sits because it is in his/her nature; Cluster 7: My child sits because there is nothing (active) to do.
Figure 2. Concept map parents (convenience sample). Note that points, i.e., statements, sorted more often together appear closer to each other, and statements never/rarely sorted together appear widely separated.; Arrows indicate a statement is reallocated by researchers, circles indicate a new cluster is created by researchers as a result of reallocation of statements. Cluster 1: My child sits because it is the norm; Cluster 2: My child sits because he/she can work/play better that way; Cluster 3: My child sits because seated activities are fun; Cluster 4: My child sits because he/she is tired, wants to relax, wants to rest; Cluster 5: My child sits because others do so, and it is a habit; Cluster 6: My child sits because it is in his/her nature; Cluster 7: My child sits because there is nothing (active) to do.
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Table 1. Children’s clusters and average importance ratings.
Table 1. Children’s clusters and average importance ratings.
ClustersImportance a
School 1
1. I sit because I can work/play better that way4.4
2. I sit because it is the norm/I sit because I have to3.9
3. I sit because it feels better3.5
4. I sit because seated activities are fun3.4
5. I sit because I’m tired, I want to relax, I want to rest3.3
6. I sit because of my health3.1
7. I sit because there is nobody to play with3.0
8. I sit because there is nothing to do2.7
9. I sit because I’m not in the mood to do anything2.6
10. I sit because of the weather2.4
School 2
1. I sit because I can work/play better that way3.7
2. I sit because it is the norm/I sit because I have to3.6
3. I sit because I’m tired, I want to relax, I want to rest3.4
4. I sit because it is a habit3.3
5. I sit because there is nobody to play with3.3
6. I sit because seated activities are fun3.2
7. I sit because of the weather3.1
8. I sit because being active takes a lot of effort2.7
School 3
1. I sit because it is the norm/I sit because I have to3.9
2. I sit because there is nobody to play with3.7
3. I sit because seated activities are fun3.5
4. I sit because I’m tired, I want to relax, I want to rest3.5
5. I sit because I’m not in the mood to do anything3.5
6. I sit because there is nothing to do3.4
7. I sit because this posture suits the activity better3.4
8. I sit because of the weather3.1
9. I sit because the physical environment suitable for physical activities is too far away3.0
School 4
1. I sit because it is the norm/I sit because I have to3.6
2. I sit because I want to make contact with my friends3.4
3. I sit because I can work/play better that way3.4
4. I sit because there is nobody to play (actively) with3.2
5. I sit because I’m tired, I want to relax, I want to rest3.0
6. I sit because the physical environment is not suitable3.0
7. I sit because seated activities are fun2.9
8. I sit because there is nothing to do2.8
a Rated on a 5-point Likert scale with higher scores indicating higher importance in influencing children’s sedentary time.
Table 2. Parents’ clusters and average importance ratings.
Table 2. Parents’ clusters and average importance ratings.
ClustersImportance a
Parents (purposive sample)
1. My child sits because he/she it tired, wants to relax, wants to rest4.2
2. My child sits because he/she can work/play better that way4.0
3. My child sits because seated activities are fun3.4
4. My child sits because there is nothing to do2.6
5. My child sits because it is the norm2.5
6. My child sits because it is a habit2.4
Parents (convenience sample) b
1. My child sits because it is the norm3.5
2. My child sits because he/she can work/play better that way3.5
3. My child sits because seated activities are fun3.3
4. My child sits because he/she is tired, wants to relax, wants to rest3.3
5. My child sits because others do so, and it is a habit2.9
6. My child sits because it is in his/her nature2.8
7. My child sits because there is nothing (active) to do2.5
a Rated on a 5-point Likert scale with higher scores indicating higher importance in influencing children’s sedentary time; b Sorting task n = 14, rating task n = 13.

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MDPI and ACS Style

Hidding, L.M.; Altenburg, T.M.; Van Ekris, E.; Chinapaw, M.J.M. Why Do Children Engage in Sedentary Behavior? Child- and Parent-Perceived Determinants. Int. J. Environ. Res. Public Health 2017, 14, 671. https://doi.org/10.3390/ijerph14070671

AMA Style

Hidding LM, Altenburg TM, Van Ekris E, Chinapaw MJM. Why Do Children Engage in Sedentary Behavior? Child- and Parent-Perceived Determinants. International Journal of Environmental Research and Public Health. 2017; 14(7):671. https://doi.org/10.3390/ijerph14070671

Chicago/Turabian Style

Hidding, Lisan M., Teatske M. Altenburg, Evi Van Ekris, and Mai J. M. Chinapaw. 2017. "Why Do Children Engage in Sedentary Behavior? Child- and Parent-Perceived Determinants" International Journal of Environmental Research and Public Health 14, no. 7: 671. https://doi.org/10.3390/ijerph14070671

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