Physical activity (PA) provides multiple health benefits across the life course, including during childhood, with benefits including reduced risk of chronic diseases and all-cause mortality, as well as improved mental health.1,2 However, gender disparities in PA are evident early in life, with girls consistently presenting lower levels of PA than boys.3,4 Recent evidence suggests that these differences may emerge in early childhood and may be shaped by parental attitudes and child-rearing practices.5,6
Despite growing interest in this topic, the mechanisms underlying early gender disparities in PA remain underexplored, particularly in low- and middle-income countries. In Brazil, a country marked by economic inequities, there are currently no instruments validated for the Brazilian context to assess parental attitudes and practices that may contribute to gendered experiences of children's play and physical activity.8,9 Addressing this gap is essential to advance equity-oriented research and inform effective interventions.
This study aims to analyze the intersection of gender and socioeconomic position in physical activity among boys and girls, using instruments adapted to the Brazilian context to assess parental attitudes and practices potentially related to gendered experiences of children's play and physical activity.7,8,9
This project comprises two phases. Phase 1 involved the translation, back-translation, and cultural adaptation of two international instruments, followed by expert panel review and a test–retest study with 140 parents of children aged 7 to 12 years. Phase 2 will apply the adapted questionnaires to parents of elementary school children from schools located in low- and high-income areas of a municipality in Paraná State, Brazil.
Methods
The project comprises two phases: (1) translation and cultural adaptation of two international instruments and (2) administration of the adapted questionnaires to parents of elementary school children. The project was approved and funded in Brazil by the National Council for Scientific and Technological Development (CNPq/MCTI/FNDCT Nº 22/2024 – Grant 444340/2024-6), supporting data collection and equipment.
Phase 1 – Instrument preparation: Both questionnaires, the Tolerance of Risk in Play Scale (TRiPS) and the Child Gender Socialization Scale (CGSS), were independently translated and back-translated. A panel of experts evaluated the translated versions to identify conceptual inconsistencies, assess equivalence between versions, and ensure cultural adaptation. A test–retest study was subsequently conducted with 140 parents of children aged 7 to 12 years, with a 1-week interval between administrations, to evaluate the reproducibility of the questionnaires. Phase 1 has now been completed.
Phase 2 – Field study: Phase 2 is currently being planned, with initial contact being established with elementary schools to initiate data collection, which is expected to take place between September and October 2026. The project aims to include schools from both low- and high-income areas of a municipality in Paraná State, Brazil, allowing the incorporation of socioeconomic position in addition to child gender and enabling the examination of their intersection. The target sample comprises 360 children and their parents, based on the sample size calculation.
Following school recruitment, the research team will provide information about the study and distribute child assent and parental consent forms through the schools. Parents will also be asked to provide contact information for follow-up. Following consent, the research team will contact parents to administer the adapted TRiPS and CGSS questionnaires. Parents will also report on their children’s physical activities. These data will be used to examine the association between parental attitudes and children’s physical activity.
UIUC faculty member collaboration
The UIUC faculty collaborator is Dr. Thaynã Ramos Flores, who has an established collaboration with the Brazilian project manager, Dr. Andrea Wendt. Both researchers have expertise in epidemiology and health inequalities, including physical activity and nutrition, and have published 18 papers together. Their collaboration also includes the co-supervision of one of Andrea Wendt’s master’s students and contributions to two ongoing manuscripts.
Dr. Flores’ expertise in child health across the life course and health inequalities is particularly relevant to the project and will continue to support the analysis, interpretation, and dissemination of the study findings.
Current and next steps of the ongoing project
The researchers are currently preparing for Phase 2, including recruitment of elementary schools and organization of data collection, which is expected to take place between September and October 2026. As part of the ongoing collaboration, a PhD student from the University of Illinois is expected to travel to Brazil in October 2026 to contribute to the project and Phase 2 activities. In 2027, Dr. Flores and the University of Illinois plan to host Dr. Wendt to collaborate on the analysis of the study findings and the development of scientific products. These activities will further strengthen collaboration between NUPHall at the University of Illinois and GPAQ at PUC-PR, Brazil.
References
1. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet. 2012 July 21;380(9838):219–29.
2. Hallal PC, Victora CG, Azevedo MR, Wells JCK. Adolescent physical activity and health: a systematic review. Sports Med. 2006;36(12):1019–30.
3. Wendt A, Ricardo LIC, Costa CS, Knuth AG, Tenório MCM, Crochemore-Silva I. Socioeconomic and Gender Inequalities in Leisure-Time Physical Activity and Access to Public Policies in Brazil From 2013 to 2019. J Phys Act Health. 2021 Oct 25;18(12):1503–10.
4. Health TLP. Time to tackle the physical activity gender gap. The Lancet Public Health. 2019 Aug 1;4(8):e360.
5. Edwards ES, Sackett SC. Psychosocial Variables Related to Why Women are Less Active than Men and Related Health Implications. Clin Med Insights Womens Health. 2016 July 4;9(Suppl 1):47–56.
6. Telford RM, Telford RD, Olive LS, Cochrane T, Davey R. Why Are Girls Less Physically Active than Boys? Findings from the LOOK Longitudinal Study. PLoS One. 2016 Mar 9;11(3):e0150041.
7. Bauer GR, Churchill SM, Mahendran M, Walwyn C, Lizotte D, Villa-Rueda AA. Intersectionality in quantitative research: A systematic review of its emergence and applications of theory and methods. SSM Popul Health. 2021 June;14:100798.
8. Blakemore JEO, Hill CA. The Child Gender Socialization Scale: A Measure to Compare Traditional and Feminist Parents. Sex Roles. 2008 Feb 1;58(3):192–207.
9. Hill A, Bundy AC. Reliability and validity of a new instrument to measure tolerance of everyday risk for children. Child Care Health Dev. 2014 Jan;40(1):68–76.