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Feng J, Huang WY, Zheng C, Jiao J, Khan A, Nisar M, Wong SHS. The Overflow Effects of Movement Behaviour Change Interventions for Children and Adolescents: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Sports Med 2024:10.1007/s40279-024-02113-1. [PMID: 39292361 DOI: 10.1007/s40279-024-02113-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND Considering the finite time within a 24-h day, the distribution of time spent on movement behaviours has been found to be associated with health outcomes. OBJECTIVES This systematic review and meta-analysis aimed to summarise and evaluate the overflow effects of interventions targeting a single behaviour (physical activity, sedentary behaviour/screen time, or sleep) on other non-targeted behaviours among children and adolescents. METHODS Six databases (MEDLINE [Ovid], PsycINFO [ProQuest], EMBASE [Ovid], PubMed, Web of Science and SPORTDiscus [EBSCO]) were searched for relevant studies published before 13 May, 2024. Randomised controlled trials and clustered randomised controlled trials that targeted a single behaviour and also assessed the effects on non-targeted behaviours, comprised of healthy children under the age of 18 years, were included. Movement behaviours can be measured either objectively or subjectively. The revised Cochrane risk-of-bias tool for randomised trials was adopted to evaluate the risk of bias. RESULTS A total of 102 studies with 45,998 participants from 21 countries were identified, and 60 of them with 26,183 participants were incorporated into the meta-analysis. The meta-analysis demonstrated that physical activity interventions led to a reduction in the proportion of each day spent in sedentary behaviour (mean difference = - 0.95% of wear time, 95% confidence interval - 1.44, - 0.45, I2 = 39%). Sedentary behaviour interventions resulted in increased standing time (mean difference = 3.87%, 95% confidence interval 1.99, 5.75, I2 = 0%). Interventions targeting screen time did not yield changes in physical activity or sleep. The findings on the effectiveness of sleep interventions on non-targeted behaviours and of physical activity interventions on sleep were inconclusive. CONCLUSIONS Overall, the findings suggested that interventions aimed at increasing physical activity or reducing sedentary behaviour had overflow effects on non-targeted behaviours, but the effect sizes were small. Additional evidence is needed to reach definitive conclusions regarding the impact of behaviour change interventions on sleep and of the overflow effects of sleep interventions.
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Affiliation(s)
- Jie Feng
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Wendy Yajun Huang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.
- Dr. Stephen Hui Research Centre for Physical Recreation and Wellness, Hong Kong Baptist University, Hong Kong, China.
| | - Chen Zheng
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - Jiao Jiao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Mehwish Nisar
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Stephen Heung-Sang Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
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Al-Walah MA, Donnelly M, Cunningham C, Heron N. Which behaviour change techniques are associated with interventions that increase physical activity in pre-school children? A systematic review. BMC Public Health 2023; 23:2013. [PMID: 37845721 PMCID: PMC10580560 DOI: 10.1186/s12889-023-16885-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Insufficient physical activity (PA) is a significant risk factor that contributes to several health problems and there is a need to improve our understanding of how to increase PA, particularly among young children. This review (PROSPERO registration: CRD42022328841) investigated the relationship between behaviour change techniques (BCTs) and interventions that increased PA among pre-school children aged < 6 years old. METHODS Systematic searches of six databases were undertaken from inception to July 2022, updated in December 2022, to locate studies that evaluated interventions and reported a positive change in PA levels in children aged < 6 years old. RESULTS A total of 5,304 studies were screened, and 28 studies involving 10,605 subjects aged 2.5 to 5.9 years met the eligibility criteria. Each eligible study (n = 28) was independently appraised by two researchers using the Cochrane risk of bias tool. The BCT Taxonomy v1 and the Template for Intervention Description and Replication (TIDieR) guided the extraction and analysis of data, and this process led to the identification of 27 BCTs. CONCLUSIONS Potentially promising BCTs for increasing PA among young children included 'shaping knowledge,' 'antecedents,' 'goals and planning,' and 'comparison of behaviour.' Future PA interventions that target young children should consider integrating these promising BCTs into their programmes. However, such consideration needs to be tempered by the fact that most of the reviewed studies were deemed to have a high or unclear risk of bias and/or were limited with respect to the populations that they targeted. Further research using rigorous methodologies is required to establish a higher standard that addresses the needs of young children who are expected to have insufficient levels of physical activity.
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Affiliation(s)
- Mosfer A Al-Walah
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK.
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, 21974, Taif, Saudi Arabia.
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK
| | - Conor Cunningham
- School of Health Science, Ulster University, Northern Ireland, UK
| | - Neil Heron
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK
- School of Medicine, Keele University, England, UK
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Caldwell HAT, Spencer RA, Joshi N, Branje K, Cawley J, Hobson H, Kirk SFL, Stevens D, Stone MR. Impact of an outdoor loose parts play intervention on Nova Scotian preschoolers' physical literacy: a mixed-methods randomized controlled trial. BMC Public Health 2023; 23:1126. [PMID: 37308842 DOI: 10.1186/s12889-023-16030-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Physical activity participation among preschoolers in childcare settings are low, and interventions to increase physical activity levels have produced mixed results. The Physical Literacy in the Early Years (PLEY) project implemented a six-month childcare-based outdoor loose parts play intervention in childcare centres in Nova Scotia, Canada. The purpose of this study was to examine the impact of the PLEY project on the development of domains of physical literacy (physical activity, physical competence, confidence and motivation, knowledge and understanding) in preschoolers attending childcare centres using mixed-methods. METHODS Preschoolers (3-5 years) were recruited from 19 childcare centres in Nova Scotia and centres were randomized (parallel design) to the outdoor loose parts play intervention group (n = 11) or control (n = 8) group for 6 months. Participants, early childhood educators, and assessors were not blinded to group assignment. Quantitative and qualitative measures were used to comprehensively assess the impact of the PLEY project on all domains of physical literacy. At 3- and 6-months, early childhood educators participated in focus groups to assess how the intervention supported the development of 4 physical literacy domains: physical activity, physical competence, confidence and motivation, and knowledge and understanding. Physical activity and physical competence were also assessed with accelerometry and the Test of Gross Motor Development-3, respectively. RESULTS Two hundred and nine preschoolers participated in the study (intervention group: n = 115; control group: n = 94). Accelerometer data showed that while baseline physical activity was similar between groups, children in the intervention group had higher physical activity at 3- (F(1,187) = 8.30, p = 0.004) and 6-months (F(1,187) = 9.90, p = 0.002) post-intervention. There was no intervention effect on physical competence scores. Thematic analysis of focus group data revealed that outdoor loose parts play contributed to development in all 4 physical literacy domains, including increased movement repertoires, social development, and enjoyment of physical activity. No adverse events or side effects of the intervention were reported. CONCLUSIONS Participation in the PLEY project was associated with increased development of various domains of physical literacy and perceived physical literacy among preschoolers, and outdoor loose parts play may be encouraged as an effective strategy to increase physical literacy in early learning settings. TRIAL REGISTRATION Biomed Central (ISRCTN14058106), 20/10/2017.
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Affiliation(s)
- Hilary A T Caldwell
- Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Rebecca A Spencer
- School of Health and Human Performance, Dalhousie University, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Nila Joshi
- School of Health and Human Performance, Dalhousie University, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Karina Branje
- School of Health and Human Performance, Dalhousie University, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Jane Cawley
- Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Heather Hobson
- Interdisciplinary Studies, Dalhousie University, 6299 South Street, Halifax, NS, B3H 4R2, Canada
| | - Sara F L Kirk
- Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Box 15000, Halifax, NS, B3H 4R2, Canada
- School of Health and Human Performance, Dalhousie University, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Daniel Stevens
- School of Health and Human Performance, Dalhousie University, PO Box 15000, Halifax, NS, B3H 4R2, Canada
- Department of Pediatrics, Dalhousie University, IWK Health Centre, 5850 University Avenue, PO Boc 9700, Halifax, NS, B3K 6R8, Canada
| | - Michelle R Stone
- Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Box 15000, Halifax, NS, B3H 4R2, Canada.
- School of Health and Human Performance, Dalhousie University, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
- Department of Pediatrics, Dalhousie University, IWK Health Centre, 5850 University Avenue, PO Boc 9700, Halifax, NS, B3K 6R8, Canada.
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Buckler EJ, Faulkner GE, Beauchamp MR, Rizzardo B, DeSouza L, Puterman E. A Systematic Review of Educator-Led Physical Literacy and Activity Interventions. Am J Prev Med 2023; 64:742-760. [PMID: 37085246 DOI: 10.1016/j.amepre.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Early childhood is a key time for the development of physical activity behaviors and physical literacy. A growing proportion of children spend a significant portion of their daytime in early childhood education and care settings where an early childhood educator cares for them. This systematic review (PROSPERO CRD42018087249) aimed to identify the differences between effective and noneffective educator-led interventions with a goal to improve physical literacy and/or physical activity in children aged 3-5 years in early childhood education and care settings. METHODS Interventions were included if they aimed to improve at least 1 physical literacy component or physical activity time in children aged 2-6 years through educator training. MEDLINE, Embase, CINAHL, ERIC, Australian Education Index, and Sport Discus were searched in March 2018 and April 2021. Risk of bias was assessed through a modified Cochrane assessment tool. RESULTS Data from 51 studies were analyzed in 2021 and 2022 and summarized narratively. Thirty-seven interventions aimed to promote physical activity, and 28 sought to promote physical literacy; 54% and 63% of these were effective, respectively. Interventions that were underpinned by theory, included ongoing support, or measured intervention fidelity were more effective, especially when all 3 were done. DISCUSSION This review was limited by a high risk of bias and inconsistency in reporting results across interventions. Reporting physical activity by minutes per hour and reporting both sub and total scores in physical literacy assessments will allow for greater cross-comparison between trials. Future training of educators should be underpinned by theory and incorporate ongoing support and objective fidelity checks.
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Affiliation(s)
- E Jean Buckler
- School of Exercise Science, Physical & Health Education, Faculty of Education, University of Victoria, Victoria, British Columbia, Canada; Institute on Aging & Lifelong Health, University of Victoria, Victoria, British Columbia, Canada.
| | - Guy E Faulkner
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark R Beauchamp
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Beth Rizzardo
- Department of Kinesiology, Langara College, Vancouver, British Columbia, Canada
| | - Liz DeSouza
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eli Puterman
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
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Nielsen JV, Koch S, Skovgaard T. Mind the gap: Danish school heads' ability to implement a national physical activity school requirement. Health Promot Int 2023; 38:7026244. [PMID: 36738453 DOI: 10.1093/heapro/daac193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
In 2014, the Danish government introduced a wide-ranging reform of primary and lower secondary education that applied to all public schools. A distinctive feature was that it became mandatory for schools to provide an average of 45 min of daily physical activity (PA). The capacity for change of local school heads and the schools overall are considered key to fulfilling such a policy-driven requirement. The aim of this study is therefore to explore local school heads' ability to implement the stated requirement of 45 min of daily PA within their local organizational capacity for change. Eleven semi-structured interviews were conducted across 11 schools. Respondents were school staff with management responsibilities (leading teachers with school management responsibilities, deputy heads and school heads). Results indicate that local school heads are central agents in converting the Danish school requirement of 45 min of daily PA into local action. This includes their ability to advance broad aims into concrete goals, secure supportive structures and organize the implementation strategy. Heads also need to support the staff in building sufficient knowledge capacity on how to arrange and incorporate PA into their daily practice, support the widespread dissemination of this knowledge across the school and reserve work hours for such activities. Assigning local PA ambassadors was particularly highlighted as important implementation support, as they can help build and disseminate knowledge while also broadcasting the school head's strategy and focus on integrating and upholding students' PA levels.
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Affiliation(s)
- Jonas Vestergaard Nielsen
- Centre for Primary and Lower Secondary Education Research, University of Southern Denmark, Odense M, Denmark.,Active Living, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Sofie Koch
- Active Living, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Thomas Skovgaard
- Centre for Primary and Lower Secondary Education Research, University of Southern Denmark, Odense M, Denmark.,Active Living, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
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Wick K, Kriemler S, Granacher U. Effects of a Strength-Dominated Exercise Program on Physical Fitness and Cognitive Performance in Preschool Children. J Strength Cond Res 2021; 35:983-990. [PMID: 33752222 DOI: 10.1519/jsc.0000000000003942] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
ABSTRACT Wick, K, Kriemler, S, and Granacher, U. Effects of a strength-dominated exercise program on physical fitness and cognitive performance in preschool children. J Strength Cond Res 35(4): 983-990, 2021-Childhood is characterized by high neuroplasticity that affords qualitative rather than quantitative components of physical activity to maximize the potential to sufficiently develop motor skills and foster long-term engagement in regular physical activity. This study examined the effects of an integrative strength-dominated exercise program on measures of physical fitness and cognitive performance in preschool children. Children aged 4-6 years from 3 kindergartens were randomized into an intervention (INT) group (n = 32) or a control group (n = 22). The 10-week intervention period was conducted 3 times per week (each session lasted 30 minutes) and included exercises for the promotion of muscle strength and power, coordination, and balance. Pre and post training, tests were conducted for the assessment of muscle strength (i.e., handgrip strength), muscle power (i.e., standing long jump), balance (i.e., timed single-leg stand), coordination (hopping on right/left leg), and attentional span (i.e., "Konzentrations-Handlungsverfahren für Vorschulkinder" [concentration-action procedure for preschoolers]). Results from 2 × 2 repeated-measures analysis of covariance revealed a significant (p ≤ 0.05) and near significant (p = 0.051) group × time interaction for the standing long jump test and the Konzentrations-Handlungsverfahren. Post hoc tests showed significant pre-post changes for the INT (p < 0.001; d = 1.53) but not the CON (p = 0.72; d = 0.83). Our results indicate that a 10-week strength-dominated exercise program increased jump performance with a concomitant trend toward improvements in attentional capacity of preschool children. Thus, we recommend implementing this type of exercise program for preschoolers.
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Affiliation(s)
- Kristin Wick
- University of Applied Sciences for Sport and Management Potsdam, Potsdam, Germany
- Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany; and
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Urs Granacher
- Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany; and
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Mak TCT, Chan DKC, Capio CM. Strategies for Teachers to Promote Physical Activity in Early Childhood Education Settings-A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030867. [PMID: 33498374 PMCID: PMC7908495 DOI: 10.3390/ijerph18030867] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 01/28/2023]
Abstract
Recent evidence has emphasized the importance of the early childhood years for developing lifelong physical activity patterns. As such, evidence-informed programs that create opportunities for young children to engage in physical activity are needed and education settings present an important context. This review aimed to identify strategies that are implemented by teachers to promote physical activity in early childhood education and care settings. This is a scoping review that followed the framework proposed by the Joanna Briggs Institute. Searches were conducted using the databases of PubMed, SCOPUS, PsycINFO, SPORT Discus, ERIC and Web of Science for publications up to September 2020. From a total of 8974 articles, 19 were deemed eligible. Ten types of strategies, performed by teachers with the intention to improve physical activity-related primary outcomes, were identified. Physical activity promotion by teachers in early childhood settings is recommended to take a multi-strategy approach, in conjunction with professional development training opportunities and continuous follow-up support for teachers. Future work is warranted to fill the evidence gap in other regions (e.g., Asia, Africa and South America) and strengthen the evidence base to establish best practice standards.
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Affiliation(s)
- Toby C. T. Mak
- Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong, China; (T.C.T.M.); (D.K.C.C.)
| | - Derwin K. C. Chan
- Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong, China; (T.C.T.M.); (D.K.C.C.)
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Catherine M. Capio
- Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong, China; (T.C.T.M.); (D.K.C.C.)
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Health Science Department, Ateneo de Manila University, Quezon City 1108, Philippines
- Correspondence:
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Veldman SLC, Chin A Paw MJM, Altenburg TM. Physical activity and prospective associations with indicators of health and development in children aged <5 years: a systematic review. Int J Behav Nutr Phys Act 2021; 18:6. [PMID: 33413484 PMCID: PMC7791660 DOI: 10.1186/s12966-020-01072-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/14/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Early childhood is a critical period for growth and development, yet the association with physical activity during this important period is unknown. The aim of this review is to critically summarize the evidence on the prospective associations between physical activity and health and development in children aged < 5 years. METHODS A systematic search in three electronic databases (Pubmed, PsycINFO, and Sportdiscus) was conducted to identify prospective studies examining the associations between physical activity (all types; specified by quantity) and health indicators (body composition, cardiometabolic health, bone health and risks/harm) or development (motor, cognitive and social-emotional development) in young children (mean age < 5 years at baseline). Two independent researchers assessed the methodological quality using the 'Quality Assessment Tool for Quantitative Studies' (EPHPP). This tool covers eight quality criteria: selection bias, study design, confounders, blinding, data collection methods, withdrawals and drop-outs, intervention integrity and data-analysis. RESULTS Thirty-nine studies, predominantly conducted in preschoolers (ages 3-5 years), were included of which nine were rated as high methodological quality. There was moderate evidence for a positive association between physical activity and motor (n = 11 studies) and cognitive development (n = 10 studies) based on consistent findings from studies having low-to-moderate methodological quality. There was insufficient evidence for an association between physical activity and body composition (n = 15 studies), cardiometabolic health indicators (n = 7 studies), social-emotional development (n = 2 studies) and bone health (n = 2 studies) based on inconsistent findings from studies having weak-to-high methodological quality. CONCLUSIONS There is a need for more high-quality research in order to determine the dose-response relationship between physical activity and health and development in early childhood. Special attention should be paid to studies in children below the age of 3 years.
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Affiliation(s)
- Sanne L C Veldman
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Mai J M Chin A Paw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Tompkins CL, Shoulberg EK, Meyer LE, Martin CP, Dennis M, Krasner A, Cook H, Hoza B. Variations in Preschoolers’ Physical Activity Across the School Year. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2021. [DOI: 10.1249/tjx.0000000000000164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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10
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Coelho VAC, Tolocka RE. Levels, factors and interventions of preschool children physical activity: a systematic review. CIENCIA & SAUDE COLETIVA 2020; 25:5029-5039. [PMID: 33295520 DOI: 10.1590/1413-812320202512.14332018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 04/15/2019] [Indexed: 11/22/2022] Open
Abstract
The goal of this study was to complete a systematic review of research on the occurrence the levels of physical activity (PA), forms of intervention and factors associated with this practice among preschool children. Studies published in the period between 2006 and 2016 were investigated, using the PubMed and SPORTDiscus databases. The search terms identified 177 articles, of which 41 met the inclusion criteria. Goals, methodologies and results were analysed. The studies used various cut-off points to establish the desired level of PA, along with different types of interventions. Overall, the problem of low level of PA among preschool children appears to be increasing. Involvement and participation of parents and teachers, guidance from booklets and other information sources, parent instruction and availability of extracurricular activities were considered positive factors that tended to increase children's PA levels, whereas parental obesity was a negative factor. New studies to define sedentary behaviour in preschool children are required to clarify the nature of this problem, along with the establishment of prevention programmes with ecological design aimed at schools, families and other sectors of society.
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Affiliation(s)
- Vitor Antonio Cerignoni Coelho
- Universidade Federal do Tocantins. Av. Lourdes Solino s/n, Setor Universitário. 77650-000 Miracema do Tocantis TO Brasil.
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Tassitano RM, Weaver RG, Tenório MCM, Brazendale K, Beets MW. Physical activity and sedentary time of youth in structured settings: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2020; 17:160. [PMID: 33276782 PMCID: PMC7716454 DOI: 10.1186/s12966-020-01054-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 11/09/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Structured settings, such as school, childcare, afterschool programs, summer camps, and physical activity/sport programs are crucial to promoting physical activity (PA) opportunities and reducing sedentary (ST) for children and adolescents. However, little is known about how much PA and ST children and adolescents accumulate in structured settings. The aim of this study is to conduct a systematic review and meta-analysis of the absolute amount of time youth spend physically active and sedentary in different structured settings (Prospero number: 42018111804). METHODS Observational and experimental/quasi-experimental studies (baseline data only) with full-text available, written in English and published in a peer-reviewed journal, reporting the total amount of objectively measured PA (light, moderate, vigorous, and/or total physical activity) and/or time spent ST during structured settings among youth (3 to 18 years) were eligible. Adjusted meta-analysis was conducted to estimate the pooled mean of time spent in PA and ST, by settings and sex. RESULTS A total of 187 studies (childcare n=60; school n=91; afterschool programs n=14; summer camp n=4; and Physical activity/ sport programs n=18) from 30 countries (47.9% United States), representing 74,870 youth (mean age 8.6 years old) were included. Overall, there was a high variation between studies in outcomes and settings. The meta-analyses revealed, on average, youth spend 221.8 minutes (36.7 min/hour) in ST and 32.1 minutes (5.1 min/hour) in MVPA during childcare hours, and 223.9 minutes (36.7min/hour) in ST and 27.8 min (4.4 min/hour) in MVPA at school. Relatively, youth are engaged in more MVPA in afterschool programs (11.7 min/hour), PA/ sport programs (20.9 min/hour), and summer camps (6.4 min/hour), when compared to childcare and school. CONCLUSION Total PA accumulated during childcare and MVPA accumulated during schools hours were close to recommendations, despite high proportion of ST. Afterschool programs, summer camp and PA/ sport programs are important settings that can contribute to daily PA and reduced ST. Ensuring all youth have access to these structured settings may be an important step forward for public health.
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Affiliation(s)
- Rafael M Tassitano
- Department of Physical Education, Federal Rural University of Pernambuco, SN Dom Manoel de Medeiros St, Recife, PE, 52171-900, Brazil.
| | | | - Maria Cecília M Tenório
- Department of Physical Education, Federal Rural University of Pernambuco, SN Dom Manoel de Medeiros St, Recife, PE, 52171-900, Brazil
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12
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The effects of intervening with physical activity in the early years (ages 3-5) on health-related quality of life: a secondary analysis of the Activity Begins in Childhood (ABC) trial. Qual Life Res 2020; 30:221-227. [PMID: 32700186 DOI: 10.1007/s11136-020-02587-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Limited research has measured the effect of physical activity (PA) interventions on health-related quality of life (HRQoL) among pre-school-aged children. This study evaluates the effect of the Activity Begins in Childhood (ABC) cluster-randomized controlled trial designed to increase PA in the ages 3-5 years on HRQoL. METHODS This was a cluster-randomized controlled trial where the intervention group included PA education delivered to daycare providers only, or daycare providers and parents. In the current study, the two PA intervention groups were combined. The comparator group received standard daycare curriculum (COM). A total of 215 children were included (PA n = 161, COM n = 54). Parents completed the proxy Pediatric Quality of Life Inventory Generic Core Scale (PedsQL™ 4.0) to measure HRQoL at baseline and the end of the 6-month trial. HRQoL scores were analyzed as physical, psychosocial, and total domains. Baseline and 6-months measurements were compared for PA and COM groups, and mean changes in scores (95% confidence intervals) were measured using absolute values. RESULTS No between-group differences were observed for the physical (p = 0.17), psychosocial (p = 0.95) or total scores (p = 0.20). Paired comparisons showed that only the PA group improved psychosocial- (PA mean difference = 2.18 (0.20, 4.15), p = 0.03; COM mean difference = 2.05 (- 1.03, 5.13), p = 0.19) and total-HRQoL scores (PA mean difference = 2.83 (1.83, 3.84), p < 0.001; COM mean difference = 0.19 (- 1.78, 2.16), p = 0.84) after 6 months. CONCLUSION Although the within-PA group analysis showed an improvement in psychosocial and total HRQoL scores from baseline, no between-group differences were observed in the HRQoL over time among children aged 3-5 years.
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Aadland E, Tjomsland HE, Johannessen K, Nilsen AKO, Resaland GK, Glosvik Ø, Lykkebø O, Stokke R, Andersen LB, Anderssen SA, Pfeiffer KA, Tomporowski PD, Størksen I, Bartholomew JB, Ommundsen Y, Howard SJ, Okely AD, Aadland KN. Active Learning Norwegian Preschool(er)s (ACTNOW) - Design of a Cluster Randomized Controlled Trial of Staff Professional Development to Promote Physical Activity, Motor Skills, and Cognition in Preschoolers. Front Psychol 2020; 11:1382. [PMID: 32719636 PMCID: PMC7350704 DOI: 10.3389/fpsyg.2020.01382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/25/2020] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION There is a dearth of high-quality evidence on effective, sustainable, and scalable interventions to increase physical activity (PA) and concomitant outcomes in preschoolers. Specifically, there is a need to better understand how the preschool context can be used to increase various types of physically active play to promote holistic child development. The implementation of such interventions requires highly competent preschool staffs, however, the competence in promoting PA is often low. The main aim of the ACTNOW study is therefore to investigate the effects of professional development for preschool staffs on child PA and developmental outcomes. METHODS The study will be conducted in Norway 2019-2022 and is designed as a two-arm (intervention, control) cluster randomized controlled trial (RCT) with 7- and 18-months follow-ups. We aim to recruit 60 preschools and 1,200 3- to 5-years-old children to provide sufficient power to detect effect sizes (ESs) between 0.20 and 0.30. The intervention is nested within two levels: the preschool and the child. Central to the ACTNOW intervention are opportunities for children to engage in a variety of "enriched," meaningful, and enjoyable physically active play that supports the development of the whole child. To this end, the main intervention is a 7-month professional development/education module for preschool staff, aimed to provide them with the necessary capacity to deliver four core PA components to the children (moderate-to-vigorous PA, motor-challenging PA, cognitively engaging play, and physically active learning). We will include a range of child-level outcomes, including PA, physical fitness, adiposity, motor skills, socioemotional health, self-regulation, executive function, and learning. At the preschool level, we will describe implementation and adaptation processes using quantitative and qualitative data. DISCUSSION Professional development of staff and a whole-child approach that integrates PA with cognitively engaging play and learning activities in the preschool setting may provide a feasible vehicle to enhance both physical and cognitive development in young children. ACTNOW is designed to test this hypothesis to provide a sustainable way to build human capital and provide an early solution to lifelong public health and developmental challenges. CLINICAL TRIAL REGISTRATION www.ClinicalTrials.gov identifier NCT04048967.
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Affiliation(s)
- Eivind Aadland
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Hege Eikeland Tjomsland
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Kjersti Johannessen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Ada Kristine Ofrim Nilsen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Geir Kåre Resaland
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Øyvind Glosvik
- Department of Pedagogy, Religion and Social Studies, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Osvald Lykkebø
- Department of Strategic Initiatives, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Rasmus Stokke
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Lars Bo Andersen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Sigmund Alfred Anderssen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Karin Allor Pfeiffer
- Department of Kinesiology, Michigan State University, East Lansing, MI, United States
| | | | - Ingunn Størksen
- Norwegian Centre for Learning Environment and Behavioural Research in Education, University of Stavanger, Stavanger, Norway
| | - John B. Bartholomew
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - Yngvar Ommundsen
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - Steven James Howard
- Early Start and School of Education, University of Wollongong, Wollongong, NSW, Australia
| | - Anthony D. Okely
- Early Start and School of Education, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Katrine Nyvoll Aadland
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
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Carson V, Adamo KB, Ogden N, Goldfield GS, Okely AD, Kuzik N, Crozier M, Hunter S, Predy M. Sedentary Time and Physical Activity Associations Between Child Care Educators and Children. Am J Prev Med 2020; 58:e105-e111. [PMID: 32005591 DOI: 10.1016/j.amepre.2019.11.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/18/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022]
Abstract
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.
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Affiliation(s)
- Valerie Carson
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada.
| | - Kristi B Adamo
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Nancy Ogden
- Faculty of Arts, Mount Royal University, Calgary, Alberta, Canada
| | - Gary S Goldfield
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Anthony D Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Nicholas Kuzik
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Mitchell Crozier
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Stephen Hunter
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Madison Predy
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
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Wolfenden L, Barnes C, Jones J, Finch M, Wyse RJ, Kingsland M, Tzelepis F, Grady A, Hodder RK, Booth D, Yoong SL. Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services. Cochrane Database Syst Rev 2020; 2:CD011779. [PMID: 32036618 PMCID: PMC7008062 DOI: 10.1002/14651858.cd011779.pub3] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement evidence-based policies, practices and programmes to promote child healthy eating, physical activity and prevent unhealthy weight gain, many services fail to do so. OBJECTIVES The primary aim of the review was to examine the effectiveness of strategies aimed at improving the implementation of policies, practices or programmes by childcare services that promote child healthy eating, physical activity and/or obesity prevention. The secondary aims of the review were to: 1. Examine the cost or cost-effectiveness of such strategies; 2. Examine any adverse effects of such strategies on childcare services, service staff or children; 3. Examine the effect of such strategies on child diet, physical activity or weight status. 4. Describe the acceptability, adoption, penetration, sustainability and appropriateness of such implementation strategies. SEARCH METHODS We searched the following electronic databases on February 22 2019: Cochrane Central Register of Controlled trials (CENTRAL), MEDLINE, MEDLINE In Process, Embase, PsycINFO, ERIC, CINAHL and SCOPUS for relevant studies. We searched reference lists of included studies, handsearched two international implementation science journals, the World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp/) and ClinicalTrials.gov (www.clinicaltrials.gov). SELECTION CRITERIA We included any study (randomised or nonrandomised) with a parallel control group that compared any strategy to improve the implementation of a healthy eating, physical activity or obesity prevention policy, practice or programme by staff of centre-based childcare services to no intervention, 'usual' practice or an alternative strategy. Centre-based childcare services included preschools, nurseries, long daycare services and kindergartens catering for children prior to compulsory schooling (typically up to the age of five to six years). DATA COLLECTION AND ANALYSIS Two review authors independently screened study titles and abstracts, extracted study data and assessed risk of bias; we resolved discrepancies via consensus. We performed meta-analysis using a random-effects model where studies with suitable data and homogeneity were identified; otherwise, findings were described narratively. MAIN RESULTS Twenty-one studies, including 16 randomised and five nonrandomised, were included in the review. The studies sought to improve the implementation of policies, practices or programmes targeting healthy eating (six studies), physical activity (three studies) or both healthy eating and physical activity (12 studies). Studies were conducted in the United States (n = 12), Australia (n = 8) and Ireland (n = 1). Collectively, the 21 studies included a total of 1945 childcare services examining a range of implementation strategies including educational materials, educational meetings, audit and feedback, opinion leaders, small incentives or grants, educational outreach visits or academic detailing, reminders and tailored interventions. Most studies (n = 19) examined implementation strategies versus usual practice or minimal support control, and two compared alternative implementation strategies. For implementation outcomes, six studies (one RCT) were judged to be at high risk of bias overall. The review findings suggest that implementation strategies probably improve the implementation of policies, practices or programmes that promote child healthy eating, physical activity and/or obesity prevention in childcare services. Of the 19 studies that compared a strategy to usual practice or minimal support control, 11 studies (nine RCTs) used score-based measures of implementation (e.g. childcare service nutrition environment score). Nine of these studies were included in pooled analysis, which found an improvement in implementation outcomes (SMD 0.49; 95% CI 0.19 to 0.79; participants = 495; moderate-certainty evidence). Ten studies (seven RCTs) used dichotomous measures of implementation (e.g. proportion of childcare services implementing a policy or specific practice), with seven of these included in pooled analysis (OR 1.83; 95% CI 0.81 to 4.11; participants = 391; low-certainty evidence). Findings suggest that such interventions probably lead to little or no difference in child physical activity (four RCTs; moderate-certainty evidence) or weight status (three RCTs; moderate-certainty evidence), and may lead to little or no difference in child diet (two RCTs; low-certainty evidence). None of the studies reported the cost or cost-effectiveness of the intervention. Three studies assessed the adverse effects of the intervention on childcare service staff, children and parents, with all studies suggesting they have little to no difference in adverse effects (e.g. child injury) between groups (three RCTs; low-certainty evidence). Inconsistent quality of the evidence was identified across review outcomes and study designs, ranging from very low to moderate. The primary limitation of the review was the lack of conventional terminology in implementation science, which may have resulted in potentially relevant studies failing to be identified based on the search terms used. AUTHORS' CONCLUSIONS Current research suggests that implementation strategies probably improve the implementation of policies, practices or programmes by childcare services, and may have little or no effect on measures of adverse effects. However such strategies appear to have little to no impact on measures of child diet, physical activity or weight status.
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Affiliation(s)
- Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Courtney Barnes
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Jannah Jones
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Meghan Finch
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Rebecca J Wyse
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Melanie Kingsland
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Flora Tzelepis
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Alice Grady
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Rebecca K Hodder
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Debbie Booth
- University of NewcastleAuchmuty LibraryUniversity DriveCallaghanNSWAustralia2308
| | - Sze Lin Yoong
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
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Factors That Influence Participation in Classroom-Based Physical Activity Breaks in Head Start Preschoolers. J Phys Act Health 2020; 17:162-168. [PMID: 31805537 DOI: 10.1123/jpah.2019-0060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 10/08/2019] [Accepted: 10/13/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Activity breaks are an established way physical activity may be incorporated into the preschool day. The purpose of this study was to examine what factors influenced moderate to vigorous physical activity (MVPA) during a teacher-implemented classroom-based activity break (CBAB) in a Head Start population. METHODS Ten-minute CBAB was conducted over 2 days in a quasi-experimental design; 99 preschoolers (mean age 3.80 [0.65] y; 49.5% male) from a convenience sample participated. Accelerometers measured MVPA, fundamental motor skill competency was assessed using the Test of Gross Motor Development-second edition, and weight classification status used body mass index percentiles. RESULTS A significant, moderate regression was found (r = .328, P = .001) between fundamental motor skill and MVPA. There was no significant correlation between body mass index percentile and MVPA during the CBAB. In addition, the locomotor subscale was the best predictor for MVPA for children during the CBAB (r = .32, β = 0.82, P < .001). CONCLUSIONS CBAB equally elicited MVPA for normal and overweight preschoolers. Fundamental motor skill competency was associated with MVPA during the CBAB; in particular, locomotor skills were the best predictor for physical activity. Structured activity opportunities that focus on locomotor skills may be a useful integration to prompt more MVPA in a preschool-age population.
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Distinct Methods for Assessing Compliance With a Physical Activity Guideline for Children in Preschools. J Phys Act Health 2019; 16:902-907. [PMID: 31454781 DOI: 10.1123/jpah.2018-0703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 05/24/2019] [Accepted: 06/21/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND According to the US Institute of Medicine guideline, preschool-aged children should participate in ≥15 minutes of physical activity (PA) per hour or 3 hours per day over 12 hours. Examinations of PA guideline compliance to date averaged time spent in PA over several days; however, children could exceed the guideline on some days and not on others. Therefore, this cross-sectional study examined PA guideline compliance in preschool children based on number of minutes per hour (average method) and percentage of days the guideline was met (everyday method). METHODS PA was measured by accelerometry during the preschool day for up to 10 days in 177 children (59.3% males, Mage = 4.23). Minutes per hour and percentage of time in light, moderate to vigorous, and total PAs were calculated. Percentage of days in compliance was determined by number of days in compliance (defined as the child active on average ≥15 min/h) divided by total accelerometer days. RESULTS Children engaged in PA, on average, 17.01 minutes per hour, suggesting that on average, children are meeting the guideline. However, children were only in compliance with the PA guideline 62.41% of assessment days. CONCLUSIONS Findings demonstrate the importance of examining compliance with both the average and everyday methods to more accurately portray level of Institute of Medicine PA guideline compliance.
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Brown T, Moore TH, Hooper L, Gao Y, Zayegh A, Ijaz S, Elwenspoek M, Foxen SC, Magee L, O'Malley C, Waters E, Summerbell CD. Interventions for preventing obesity in children. Cochrane Database Syst Rev 2019; 7:CD001871. [PMID: 31332776 PMCID: PMC6646867 DOI: 10.1002/14651858.cd001871.pub4] [Citation(s) in RCA: 275] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
EDITORIAL NOTE This Cochrane review is now out of date and should not be used for reference. It has been split into four age groups and updated. Please refer to the 5‐11 and 12‐18 age group Cochrane reviews which were published in May 2024: https://doi.org/10.1002/14651858.CD015328.pub2 https://doi.org/10.1002/14651858.CD015330.pub2 The 2‐4 age group Cochrane review is planned for publication in September 2024. BACKGROUND Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. The international evidence base for strategies to prevent obesity is very large and is accumulating rapidly. This is an update of a previous review. OBJECTIVES To determine the effectiveness of a range of interventions that include diet or physical activity components, or both, designed to prevent obesity in children. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsychINFO and CINAHL in June 2015. We re-ran the search from June 2015 to January 2018 and included a search of trial registers. SELECTION CRITERIA Randomised controlled trials (RCTs) of diet or physical activity interventions, or combined diet and physical activity interventions, for preventing overweight or obesity in children (0-17 years) that reported outcomes at a minimum of 12 weeks from baseline. DATA COLLECTION AND ANALYSIS Two authors independently extracted data, assessed risk-of-bias and evaluated overall certainty of the evidence using GRADE. We extracted data on adiposity outcomes, sociodemographic characteristics, adverse events, intervention process and costs. We meta-analysed data as guided by the Cochrane Handbook for Systematic Reviews of Interventions and presented separate meta-analyses by age group for child 0 to 5 years, 6 to 12 years, and 13 to 18 years for zBMI and BMI. MAIN RESULTS We included 153 RCTs, mostly from the USA or Europe. Thirteen studies were based in upper-middle-income countries (UMIC: Brazil, Ecuador, Lebanon, Mexico, Thailand, Turkey, US-Mexico border), and one was based in a lower middle-income country (LMIC: Egypt). The majority (85) targeted children aged 6 to 12 years.Children aged 0-5 years: There is moderate-certainty evidence from 16 RCTs (n = 6261) that diet combined with physical activity interventions, compared with control, reduced BMI (mean difference (MD) -0.07 kg/m2, 95% confidence interval (CI) -0.14 to -0.01), and had a similar effect (11 RCTs, n = 5536) on zBMI (MD -0.11, 95% CI -0.21 to 0.01). Neither diet (moderate-certainty evidence) nor physical activity interventions alone (high-certainty evidence) compared with control reduced BMI (physical activity alone: MD -0.22 kg/m2, 95% CI -0.44 to 0.01) or zBMI (diet alone: MD -0.14, 95% CI -0.32 to 0.04; physical activity alone: MD 0.01, 95% CI -0.10 to 0.13) in children aged 0-5 years.Children aged 6 to 12 years: There is moderate-certainty evidence from 14 RCTs (n = 16,410) that physical activity interventions, compared with control, reduced BMI (MD -0.10 kg/m2, 95% CI -0.14 to -0.05). However, there is moderate-certainty evidence that they had little or no effect on zBMI (MD -0.02, 95% CI -0.06 to 0.02). There is low-certainty evidence from 20 RCTs (n = 24,043) that diet combined with physical activity interventions, compared with control, reduced zBMI (MD -0.05 kg/m2, 95% CI -0.10 to -0.01). There is high-certainty evidence that diet interventions, compared with control, had little impact on zBMI (MD -0.03, 95% CI -0.06 to 0.01) or BMI (-0.02 kg/m2, 95% CI -0.11 to 0.06).Children aged 13 to 18 years: There is very low-certainty evidence that physical activity interventions, compared with control reduced BMI (MD -1.53 kg/m2, 95% CI -2.67 to -0.39; 4 RCTs; n = 720); and low-certainty evidence for a reduction in zBMI (MD -0.2, 95% CI -0.3 to -0.1; 1 RCT; n = 100). There is low-certainty evidence from eight RCTs (n = 16,583) that diet combined with physical activity interventions, compared with control, had no effect on BMI (MD -0.02 kg/m2, 95% CI -0.10 to 0.05); or zBMI (MD 0.01, 95% CI -0.05 to 0.07; 6 RCTs; n = 16,543). Evidence from two RCTs (low-certainty evidence; n = 294) found no effect of diet interventions on BMI.Direct comparisons of interventions: Two RCTs reported data directly comparing diet with either physical activity or diet combined with physical activity interventions for children aged 6 to 12 years and reported no differences.Heterogeneity was apparent in the results from all three age groups, which could not be entirely explained by setting or duration of the interventions. Where reported, interventions did not appear to result in adverse effects (16 RCTs) or increase health inequalities (gender: 30 RCTs; socioeconomic status: 18 RCTs), although relatively few studies examined these factors.Re-running the searches in January 2018 identified 315 records with potential relevance to this review, which will be synthesised in the next update. AUTHORS' CONCLUSIONS Interventions that include diet combined with physical activity interventions can reduce the risk of obesity (zBMI and BMI) in young children aged 0 to 5 years. There is weaker evidence from a single study that dietary interventions may be beneficial.However, interventions that focus only on physical activity do not appear to be effective in children of this age. In contrast, interventions that only focus on physical activity can reduce the risk of obesity (BMI) in children aged 6 to 12 years, and adolescents aged 13 to 18 years. In these age groups, there is no evidence that interventions that only focus on diet are effective, and some evidence that diet combined with physical activity interventions may be effective. Importantly, this updated review also suggests that interventions to prevent childhood obesity do not appear to result in adverse effects or health inequalities.The review will not be updated in its current form. To manage the growth in RCTs of child obesity prevention interventions, in future, this review will be split into three separate reviews based on child age.
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Affiliation(s)
- Tamara Brown
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
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Tortella P, Haga M, Ingebrigtsen JE, Fumagalli GF, Sigmundsson H. Comparing Free Play and Partly Structured Play in 4-5-Years-Old Children in an Outdoor Playground. Front Public Health 2019; 7:197. [PMID: 31380337 PMCID: PMC6646727 DOI: 10.3389/fpubh.2019.00197] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 07/02/2019] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to compare how the organization of a movement session as partly structured play or free play influenced the physical activity engagement in 4–5 years old pre-schoolers. The partly structured playgroup consisted of 46 children and the free playgroup consisted of 33 children. The playground activities consisted of 10 sessions each lasting 1 h, executed once per week in the period Mars to May 2017 at a specific playground setting. The partly structured playgroup conducted a movement activity session that included a combination of both structured- and free play activities. The free playgroup engaged in unstructured play, only. To detect the intensity of the physical activity each child carried an accelerometer 1 h the first week and last week of the intervention. Results indicate a significant difference in physical activity level between the two groups for the 5-year-old in the favor of the partly structured playgroup. There was a significant difference between the four-and 5-year-old in relation to physical activity level. No significant difference between the activity in March and May for the whole group was found.
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Affiliation(s)
| | - Monika Haga
- Section for Arts, Physical Education, and Sports, Department of Teacher Education, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan Erik Ingebrigtsen
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Guido Francesco Fumagalli
- Public Health and Community Medicine, Research Centre on Child Motor Development, University of Verona, Verona, Italy.,Associazione Onlus Laboratorio, Treviso, Italy
| | - Hermundur Sigmundsson
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.,Sports Science Department, Reykjavik University, Reykjavik, Iceland
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Houser NE, Cawley J, Kolen AM, Rainham D, Rehman L, Turner J, Kirk SFL, Stone MR. A Loose Parts Randomized Controlled Trial to Promote Active Outdoor Play in Preschool-aged Children: Physical Literacy in the Early Years (PLEY) Project. Methods Protoc 2019; 2:E27. [PMID: 31164608 PMCID: PMC6632144 DOI: 10.3390/mps2020027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/29/2019] [Accepted: 04/01/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The Physical Literacy in the Early Years (PLEY) intervention is a randomized mixed-methods controlled trial focused on embedding loose parts materials into the outdoor play spaces of regulated child care centres across Nova Scotia. The aim is to evaluate the efficacy of the PLEY intervention versus standard regulated childcare practice in influencing thoughts and behaviors of children, parents, and educators. METHODS Participating early child care centres (n = 19) were randomly assigned to intervention or control sites. Intervention sites received loose parts kits at the beginning of the project while control sites received kits upon project completion. The kits included items such as rocks, tree cookies, balls, wood planks, tubes, tires, ropes, and pulleys. Children (n = 183 at baseline) had their physical activity (accelerometers) and movement skills (TGMD-3 and PGMQ) measured before and after the intervention. All centres provided responses to environmental surveys (Go NAP SACC and Site Context Questionnaire), and educators in intervention sites participated in focus group and photovoice sessions. Educators were also provided with a full day professional development opportunity (plus ongoing mentoring) focused on physical activity, physical literacy, outdoor play, risk-taking, and loose parts. Parents participated in an interview addressing active outdoor play, physical literacy, and attitudes towards risk taking during play. DISCUSSION This study will provide a better understanding of how integrating loose parts materials into outdoor play spaces impacts children's health, and the impact on educator and parent attitudes, beliefs, and understanding around physical literacy, active outdoor play and risk-taking during play.
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Affiliation(s)
- Natalie E Houser
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK S7N 0W9, Canada.
- Healthy Populations Institute, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Jane Cawley
- Healthy Populations Institute, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Angela M Kolen
- Department of Human Kinetics, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada.
| | - Daniel Rainham
- Healthy Populations Institute, Dalhousie University, Halifax, NS B3H 4R2, Canada.
- Department of Earth and Environmental Sciences, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Laurene Rehman
- School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Joan Turner
- Child and Youth Study, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada.
| | - Sara F L Kirk
- Healthy Populations Institute, Dalhousie University, Halifax, NS B3H 4R2, Canada.
- School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Michelle R Stone
- Healthy Populations Institute, Dalhousie University, Halifax, NS B3H 4R2, Canada.
- School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 4R2, Canada.
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Johnstone A, Hughes AR, Bonnar L, Booth JN, Reilly JJ. An active play intervention to improve physical activity and fundamental movement skills in children of low socio-economic status: feasibility cluster randomised controlled trial. Pilot Feasibility Stud 2019; 5:45. [PMID: 30915229 PMCID: PMC6417079 DOI: 10.1186/s40814-019-0427-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 02/25/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction Active play is a novel approach to addressing low physical activity levels and fundamental movement skills (FMS) in childhood and new interventions must be developed and evaluated. Aim This study aimed to determine the feasibility of a 10-week school-based ‘active play’ intervention, and present preliminary findings on four outcomes: physical activity levels, FMS, inhibition, and maths fluency. Methods This was a feasibility cluster RCT in which eight schools (one primary three class per school) were paired and randomly allocated to either the 10-week intervention (n = 4) or waiting-list control (n = 4). The active play intervention consisted of a 1-h outdoor physical activity session per week, incorporating 30 min of facilitated games and 30 min of free play. Feasibility measures were gathered using appropriate methods and physical activity was measured using an ActiGraph GT3X accelerometer, FMS were assessed using the Test of Gross Motor Development-2 (TGMD-2), inhibition was measured using a Flanker Test and maths fluency was assessed using the One Minute Basic Number Facts Test. Results Sixty-six percent of eligible children (n = 137) agreed to participate in the research. No schools withdrew from the study and three participants were lost to follow-up. Compliance to the intervention was high—none of the participants missed more than two of the ten scheduled active play sessions. Data lost to follow-up were minimal; most were lost (14%) for school day physical activity. Active play sessions were shorter than planned on average by 10 min, and participants spent a mean of 39.4% (14.2) of the session time in moderate-to-vigorous intensity physical activity (MVPA). There was preliminary evidence of a small intervention effect on MVPA (d = 0.3), FMS score (d = 0.4), inhibition (fish trial: d = 0.1, arrow trial d = 0.1) and maths fluency (addition: d = 0.3, subtraction: d = 0.1). Conclusion The active play intervention was feasible and benefitted from a relatively high MVPA content; however, preliminary findings suggest the intervention had a small effect on the outcomes. Having more active play sessions per week and/or extending the duration of the intervention may increase the effects and these should be tested before a future definitive cluster RCT is undertaken. Trial registration This trial was registered on the International Standardised Randomised Controlled Trials Number register (ISRCTN) in August 2017 (ISRCTN11607781).
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Affiliation(s)
- Avril Johnstone
- 1Physical Activity for Health Group, University of Strathclyde, Glasgow, Scotland G1 1QE UK
| | - Adrienne R Hughes
- 1Physical Activity for Health Group, University of Strathclyde, Glasgow, Scotland G1 1QE UK
| | - Lizann Bonnar
- 2School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland G1 1QE UK
| | - Josie N Booth
- 3Moray House School of Education and Sport, University of Edinburgh, Edinburgh, EH8 8AQ UK
| | - John J Reilly
- 1Physical Activity for Health Group, University of Strathclyde, Glasgow, Scotland G1 1QE UK
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22
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Hnatiuk JA, Brown HE, Downing KL, Hinkley T, Salmon J, Hesketh KD. Interventions to increase physical activity in children 0-5 years old: a systematic review, meta-analysis and realist synthesis. Obes Rev 2019; 20:75-87. [PMID: 30257277 DOI: 10.1111/obr.12763] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 07/29/2018] [Accepted: 08/08/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective of the study is to evaluate the effectiveness of interventions to increase physical activity (PA) in 0-5 year olds and to determine what works, for whom, in what circumstances. DESIGN Systematic review, meta-analysis and realist synthesis. DATA SOURCES Embase and EBSCOhost (Academic Search Complete, CINAHL Complete, Global Health, MEDLINE Complete, PsycINFO, SPORTDiscus with full text), up to and including April 2017. ELIGIBILITY CRITERIA Published in a peer-reviewed English language journal; randomized or controlled trial design; aimed to increase children's PA levels; reported on objectively assessed PA in children between 0 and 5.9 years at baseline and post-intervention. RESULTS Thirty-four studies were included in the review, mostly conducted in the preschool/childcare setting. Meta-analyses showed an overall non-significant (Z = 0.04, p = 0.97) mean difference of 0.03 (95% CI = -1.57, 1.63) minutes/day for light-intensity PA (n = 11). The overall mean difference for moderate-intensity to vigorous-intensity PA (n = 21) was 2.88 (95% CI = 1.54, 4.23) minutes/day, indicating a small but significant overall positive effect (Z = 4.20, p < 0.001). The realist synthesis provided insights into the key contexts and mechanisms that appeared to be effective at changing children's PA. CONCLUSION Based on a quantitative and qualitative examination of the evidence, this review provides specific recommendations for effective early childhood PA interventions for practitioners and policymakers.
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Affiliation(s)
- J A Hnatiuk
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - H E Brown
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - K L Downing
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - T Hinkley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - J Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - K D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
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23
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Fossdal TS, Kippe K, Handegård BH, Lagestad P. "Oh oobe doo, I wanna be like you" associations between physical activity of preschool staff and preschool children. PLoS One 2018; 13:e0208001. [PMID: 30496229 PMCID: PMC6264855 DOI: 10.1371/journal.pone.0208001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 11/09/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Physical activity contributes to prevent serious diseases and ailments, and previous research indicates that lifestyle habits are likely to track from early childhood to adulthood. 90% of Norwegian children aged 1-5 are enrolled in preschools, and preschool staff can play an important role in children's activity levels. This study's aim was to identify whether any associations exist between preschool staff's characteristics (initiative, participation, attitudes, and activity levels) and children's activity in preschool. METHOD 289 children aged 4-6 and 72 preschool staff from 13 randomly selected preschools in a region of Nord-Troendelag, Norway, were enrolled in the study. All participants wore an Actigraph accelerometer for seven consecutive days. Questionnaires were also utilized to identify correlates between preschool staff's attitudes and initiative in relation to children's physical activity, in addition to their participation in children's physical activity. A multilevel analysis, the linear mixed model (LMM), was used to elucidate associations between preschool staff and children's activity levels. RESULTS A significant association was found between preschool staff's average activity levels during preschool hours and children's corresponding activity levels during preschool hours (t = 2.57; p = 0.021; f2 = 0.013). There were, however, no significant associations identified between the attitudes (t = -0.44; p = 0.67), initiative (t = -0.14; p = 0.89), and participation (t = 0.66; p = 0.52) variables among preschool staff and children's activity levels during preschool hours. CONCLUSION The study demonstrated that a significant association exists between preschool staff's aggregated activity levels and 4-6-year-olds' individual activity levels. However, an observational study is requisite in order to determine whether the association is based on preschool staff's impact on children's physical activity or if it is the children that affect the preschool staff's activity levels, or a combination thereof.
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Affiliation(s)
| | - Karin Kippe
- Faculty of Education and Arts, Nord University, Levanger, Norway
| | - Bjørn Helge Handegård
- Centre for Child and Adolescent Mental Health, UIT The Arctic University of Norway, Tromsø, Norway
| | - Pål Lagestad
- Faculty of Education and Arts, Nord University, Levanger, Norway
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O'Brien KT, Vanderloo LM, Bruijns BA, Truelove S, Tucker P. Physical activity and sedentary time among preschoolers in centre-based childcare: a systematic review. Int J Behav Nutr Phys Act 2018; 15:117. [PMID: 30463585 PMCID: PMC6249856 DOI: 10.1186/s12966-018-0745-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 10/30/2018] [Indexed: 12/31/2022] Open
Abstract
Background Many preschoolers spend a substantial portion of their day enrolled in centre-based childcare; the amounts of physical activity and sedentary time accumulated in this environment are critical to preschoolers’ ability to meet movement guidelines. The purpose of this systematic review was to provide a comprehensive overview of the objectively assessed physical activity and sedentary time of preschoolers in centre-based childcare (registration no. CRD42016033502). Methods Eight online databases were searched using terms related to physical activity, sedentary time, preschoolers and centre-based childcare. Published, peer-reviewed primary studies written in English that objectively assessed (via accelerometry) the physical activity and sedentary time of preschoolers (2-5 years) in centre-based childcare were included. Results Fifty-five studies (published 2004-2017) from 11 countries, representing 13,956 participants were included. Studies reported light physical activity (n=38) ranging from 2.94 to 29.96 mins/hr, moderate-to-vigorous physical activity (n=46) which ranged from 1.29 to 22.66 mins/hr, and total physical activity (n=42) ranging from 4.23 to 47.17 mins/hr. Sedentary time (n=47) ranged from 12.38 to 55.77 mins/hr. Conclusion Physical activity and sedentary time were highly varied and inconsistent between studies; therefore, it is difficult to determine preschoolers’ true amount of physical activity and sedentary time during childcare hours. Despite this variability, preschoolers were noted to participate in high rates of sedentary time in this setting. The lack of homogeneity is an important finding in and of itself as it highlights the lack of consistency in measuring, processing, and reporting paediatric physical activity data.
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Affiliation(s)
- Kathleen T O'Brien
- Department of French Studies, Faculty of Arts and Humanities, University of Western Ontario, London, Ontario, Canada
| | - Leigh M Vanderloo
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Brianne A Bruijns
- Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Stephanie Truelove
- Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Patricia Tucker
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, 1201 Western Road, Elborn College, Room 2547, London, N6G 1H1, Ontario, Canada.
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25
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Arhab A, Messerli-Bürgy N, Kakebeeke TH, Lanzi S, Stülb K, Zysset AE, Leeger-Aschmann CS, Schmutz EA, Meyer AH, Munsch S, Kriemler S, Jenni OG, Puder JJ. Childcare Correlates of Physical Activity, Sedentary Behavior, and Adiposity in Preschool Children: A Cross-Sectional Analysis of the SPLASHY Study. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2018; 2018:9157194. [PMID: 30651743 PMCID: PMC6311763 DOI: 10.1155/2018/9157194] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/25/2018] [Accepted: 10/25/2018] [Indexed: 01/08/2023]
Abstract
Background The childcare (CC) environment can influence young children's physical activity (PA), sedentary behavior (SB), and adiposity. The aim of the study was to identify a broad range of CC correlates of PA, SB, and adiposity in a large sample of preschoolers. Methods 476 preschool children (mean age 3.9 yrs; 47% girls) participated in the Swiss Preschoolers' Health Study (SPLASHY). PA and SB were measured by accelerometry. Outcome measures included total PA (TPA), moderate-to-vigorous PA (MVPA), SB, body mass index (BMI), and skinfold thickness (SF). PA measures consisted of both daily PA during CC attendance days and overall daily PA (CC and non-CC days). Results We identified the following CC correlates for higher TPA and/or higher MVPA or lower SB during CC attendance days: older age, sex (boys), more frequent child-initiated interactions during CC, mixing different ages within a group, and the presence of a written PA policy in the CC (all p ≤ 0.02). The CC correlates for overall TPA and/or MVPA or lower overall SB including both CC and non-CC days were the following: older age, sex (boys), more frequent child-initiated interactions during CC, mixing different ages within a group, less parental PA involvement in the CC, and having a larger surface area in CC (all p ≤ 0.046). Correlates for lower SF were sex (boys) and parental PA involvement in the CC (all p ≤ 0.02), and, for lower BMI, only increased age (p=0.001) was a correlate. Conclusions More frequent child-initiated interactions and mixing different ages in CC, the presence of a written PA policy, and a larger CC surface are correlates of PA and SB during CC attendance days and/or of overall PA. Parental involvement in CC PA projects was a correlate for reduced body fat. These novel factors are mostly modifiable and can be tackled/addressed in future interventions.
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Affiliation(s)
- Amar Arhab
- Obstetric Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Nadine Messerli-Bürgy
- Obstetric Service, Lausanne University Hospital, Lausanne, Switzerland
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland
| | - Tanja H. Kakebeeke
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Stefano Lanzi
- Obstetric Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Kerstin Stülb
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland
| | - Annina E. Zysset
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
| | | | - Einat A. Schmutz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Andrea H. Meyer
- Department of Psychology, University of Basel, Basel, Switzerland
| | - Simone Munsch
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Oskar G. Jenni
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Jardena J. Puder
- Obstetric Service, Lausanne University Hospital, Lausanne, Switzerland
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(Des) Valorização da atividade física na pré‐escola por professores. REVISTA BRASILEIRA DE CIÊNCIAS DO ESPORTE 2018. [DOI: 10.1016/j.rbce.2018.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Peden ME, Okely AD, Eady MJ, Jones RA. What is the impact of professional learning on physical activity interventions among preschool children? A systematic review. Clin Obes 2018; 8:285-299. [PMID: 29852538 DOI: 10.1111/cob.12253] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 02/25/2018] [Accepted: 03/30/2018] [Indexed: 11/30/2022]
Abstract
The purpose of this systematic review was to investigate professional learning models (length, mode, content) offered as part of objectively measured physical childcare-based interventions. A systematic review of eight electronic databases was conducted to June 2017. Only English, peer-reviewed studies that evaluated childcare-based physical activity interventions, incorporated professional learning and reported objectively measured physical activity were included. Study designs included randomized controlled trails, cluster randomized trials, experimental or pilot studies. The search identified 11 studies. Ten studies objectively measured physical activity using accelerometers; five studies used both accelerometer and direct observation tools and one study measured physical activity using direct observation only. Seven of these studies reported statistically significant intervention effects. Only six studies described all components of professional learning, but only two studies reported specific professional learning outcomes and physical activity outcomes. No patterns were identified between the length, mode and content of professional learning and children's physical activity outcomes in childcare settings. Educators play a critical role in modifying children's levels of physical activity in childcare settings. The findings of this review suggest that professional learning offered as part of a physical activity intervention that potentially impacts on children's physical activity outcomes remains under-reported.
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Affiliation(s)
- M E Peden
- Early Start, School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - A D Okely
- Early Start, School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - M J Eady
- School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - R A Jones
- Early Start, School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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Johnstone A, Hughes AR, Martin A, Reilly JJ. Utilising active play interventions to promote physical activity and improve fundamental movement skills in children: a systematic review and meta-analysis. BMC Public Health 2018; 18:789. [PMID: 29940923 PMCID: PMC6019649 DOI: 10.1186/s12889-018-5687-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 06/11/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Children's physical activity levels are low and efforts to improve their physical activity levels have proven difficult. Freely chosen and unstructured physical activity (active play) has the potential to be promoted in a variety of settings and potentially every day of the year in contrast to other physical activity domains, but active play interventions are an under-researched area. Therefore, the primary aim of this systematic review was to determine the effect of active play interventions on children's physical activity levels, particularly moderate-to-vigorous intensity physical activity (MVPA), and fundamental movement skills (FMS). METHODS Studies were included if they were solely or predominantly active play randomised, or cluster randomised controlled trials that targeted children aged 3-12 years. They had to report on at least one of the following outcomes: objectively measured physical activity, FMS, cognition and weight status. During December 2016, four databases (PE Index, SPORTDiscus, Medline and ERIC) were searched for relevant titles. Duplicates and irrelevant titles and abstracts were removed. The included studies had their quality assessed using the Effective Public Health Practice Project (EPHPP) tool. Suitable studies were combined in a meta-analysis using a random-effect model. A narrative synthesis was conducted for all outcomes. RESULTS Of the 4033 records, 91 studies were eligible for full text screening, of which 87 were removed, leaving four studies (representing five papers). The meta-analysis of two studies highlighted there was no significant effect of active play interventions on MVPA. However, the narrative synthesis suggested that active play interventions may increase total volume of physical activity. Only two studies examined the effect of active play interventions on children's FMS, one study examined effects on weight status and none examined effects on cognition. CONCLUSIONS Due to the small number of eligible studies and their heterogeneity, the review could not draw firm conclusions on the effect of active play interventions on children's physical activity levels. High-quality active play interventions, targeting different times of the day (school and after school) in different populations and settings, and with a wider range of outcomes, are required to determine the potential of active play.
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Affiliation(s)
- Avril Johnstone
- Physical Activity for Health Group, University of Strathclyde, Glasgow, Scotland
| | - Adrienne R. Hughes
- Physical Activity for Health Group, University of Strathclyde, Glasgow, Scotland
| | - Anne Martin
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - John J. Reilly
- Physical Activity for Health Group, University of Strathclyde, Glasgow, Scotland
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Driediger M, Vanderloo LM, Burke SM, Irwin JD, Gaston A, Timmons BW, Johnson AM, Tucker P. The Implementation and Feasibility of the Supporting Physical Activity in the Childcare Environment (SPACE) Intervention: A Process Evaluation. HEALTH EDUCATION & BEHAVIOR 2018; 45:935-944. [PMID: 29884067 DOI: 10.1177/1090198118775489] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study describes the process evaluation of the Supporting Physical Activity in the Childcare Environment (SPACE) intervention, consisting of educator physical activity training, provision of portable play equipment, and a modified outdoor schedule (i.e., 4 × 30-minute periods). Educators ( N = 49) from 11 childcare centers in London, Ontario, Canada, delivered the 8-week intervention to 200 preschoolers ( Mage = 3.38 years). Workshop attendance was documented while adherence to the outdoor schedule and number and timing of outdoor sessions offered (i.e., dose) were recorded in a daily log. Questionnaire-based program evaluation ( n = 41) and in-person group interviews ( n = 7) were completed postintervention to assess educator perspectives on the barriers and facilitators to implementation (i.e., context), the feasibility and perceived effectiveness of the intervention, educator and preschooler enjoyment, communication among researchers and childcare personnel, and the future implementation of the intervention. Descriptive statistics were calculated, and responses to open-ended questions were inductively coded. Educator workshop attendance was 96%, and 88% of classrooms adhered to the four daily outdoor periods. Educators delivered 90% of the scheduled outdoor sessions, and 87% of these met the 30-minute criteria. Educators expressed that the increase in number of transitions made the outdoor playtimes challenging to implement, yet rated the feasibility of the training and equipment as high. Educators perceived the intervention to be both enjoyable and effective at increasing preschoolers' physical activity. They indicated effective communication and revealed that they intended to continue to use their physical activity knowledge and to offer the play equipment once the intervention had concluded. These findings demonstrate that the SPACE intervention is viable in center-based childcare.
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Affiliation(s)
| | | | - Shauna M Burke
- 1 University of Western Ontario, London, Ontario, Canada
| | | | - Anca Gaston
- 1 University of Western Ontario, London, Ontario, Canada
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Tomayko EJ, Prince RJ, Hoiting J, Braun A, LaRowe TL, Adams AK. Evaluation of a multi-year policy-focused intervention to increase physical activity and related behaviors in lower-resourced early care and education settings: Active Early 2.0. Prev Med Rep 2017; 8:93-100. [PMID: 28936391 PMCID: PMC5602886 DOI: 10.1016/j.pmedr.2017.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/26/2017] [Accepted: 08/27/2017] [Indexed: 11/23/2022] Open
Abstract
Physical activity is a critical component of obesity prevention, but few interventions targeting early childhood have been described. The Active Early guide was designed to increase physical activity in early care and education (ECE) settings. The purpose of Active Early 2.0 was to evaluate the effectiveness of Active Early along with provider training, microgrant support, and technical assistance over 2 years (2012-2014) to increase physical activity and related behaviors (e.g., nutrition) in settings serving a high proportion of children from underserved groups in recognition of significant disparities in obesity and challenges meeting physical activity recommendations in low-resource settings. The physical activity and nutrition environment were assessed before and after the intervention in 15 ECE settings in Wisconsin using the Environment and Policy Observation Assessment tool, and interviews were conducted with providers and technical consultants. There was no significant change in Total Physical Activity Score or any EPAO subscale over the intervention period; however, significant improvements in the Total Nutrition Score and the several Nutrition subscales were observed. Additionally, the percentage of sites with written activity policies significantly increased. Overall minutes of teacher-led physical activity increased to 61.5 ± 29.0 min (p < 0.05). Interviews identified key benefits to children (i.e., more energy, better rest, improved behavior) and significant barriers, most notably care provider and child turnover and low parent engagement. Moderate policy and environmental improvements in physical activity and nutrition were achieved with this intervention, but more work is needed to understand and address barriers and to support sustained changes in lower-resource ECE settings.
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Affiliation(s)
- Emily J. Tomayko
- Nutrition, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, United States
| | - Ronald J. Prince
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53715, United States
| | - Jill Hoiting
- Supporting Families Together Association, Madison, WI 53711, United States
| | - Abbe Braun
- Supporting Families Together Association, Madison, WI 53711, United States
| | - Tara L. LaRowe
- Department of Nutritional Sciences, College of Agricultural and Life Sciences, University of Wisconsin, Madison, WI 53715, United States
| | - Alexandra K. Adams
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53715, United States
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Kuzik N, Poitras VJ, Tremblay MS, Lee EY, Hunter S, Carson V. Systematic review of the relationships between combinations of movement behaviours and health indicators in the early years (0-4 years). BMC Public Health 2017; 17:849. [PMID: 29219071 PMCID: PMC5773877 DOI: 10.1186/s12889-017-4851-1] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND A recent review highlighted important relationships between combinations of movement behaviours (i.e., sleep, sedentary behaviour, and physical activity) and health indicators among school-aged children and youth (aged 5-17 years). It is unclear whether similar relationships exist in younger children. Therefore, this review sought to examine the relationships between combinations of movement behaviours and health indicators in the early years (1.00 month to 4.99 years). METHODS Medline, EMBASE, PsycINFO, and SportDiscus were searched for relevant studies up to November 2016, with no date or study design limits. Included studies met the a priori-determined population (apparently healthy children aged 1.00 month to 4.99 years), intervention (combination of ≥2 movement behaviours [i.e., sleep and sedentary behaviour; sleep and physical activity; sedentary behaviour and physical activity; and sleep, sedentary behaviour, and physical activity]), comparator (various levels and combinations of movement behaviours), and health outcome/indicator (Critical: adiposity, motor development, psychosocial health/emotional regulation, cognitive development, fitness, and growth; Important: bone and skeletal health, cardiometabolic health, and risks). For each health indicator, quality of evidence was assessed by study design using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. RESULTS Ten articles (n = 7436 participants; n = 5 countries) were included. Across observational and experimental study designs, the most ideal combinations of sedentary behaviour and physical activity were: favourably associated with motor development and fitness among preschool-aged children (3.00 to 4.99 years); both favourably and not associated with adiposity among toddlers (1.10 to 2.99 years) and preschool-aged children; and not associated with growth among toddlers and preschool-aged children. The most ideal combinations of sleep and sedentary behaviour were favourably associated with adiposity among infants (1.00 month to 1.00 years) and toddlers. Quality of evidence ranged from "very low" to "moderate". CONCLUSIONS The most ideal combinations of movement behaviours (e.g., high sleep, low sedentary behaviour, high physical activity) may be important for optimal health in the early years. Findings can help inform movement behaviour guidelines for the early years. Given the limited evidence, future research is needed to determine the ideal distribution of daily movement behaviours for optimal health throughout the early years.
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Affiliation(s)
- Nicholas Kuzik
- Faculty of Physical Education and Recreation, University of Alberta, Van Vliet Complex, 8840-114 Street, Edmonton, AB T6G 2H9 Canada
| | - Veronica J. Poitras
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1 Canada
| | - Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1 Canada
| | - Eun-Young Lee
- Faculty of Physical Education and Recreation, University of Alberta, Van Vliet Complex, 8840-114 Street, Edmonton, AB T6G 2H9 Canada
| | - Stephen Hunter
- Faculty of Physical Education and Recreation, University of Alberta, Van Vliet Complex, 8840-114 Street, Edmonton, AB T6G 2H9 Canada
| | - Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Van Vliet Complex, 8840-114 Street, Edmonton, AB T6G 2H9 Canada
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Wasenius NS, Grattan KP, Harvey ALJ, Naylor PJ, Goldfield GS, Adamo KB. The effect of a physical activity intervention on preschoolers' fundamental motor skills - A cluster RCT. J Sci Med Sport 2017; 21:714-719. [PMID: 29150312 DOI: 10.1016/j.jsams.2017.11.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 10/31/2017] [Accepted: 11/05/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess the effect of a physical activity intervention delivered in the childcare centres (CC), with or without a parent-driven home physical activity component, on children's fundamental motor skills (FMS). DESIGN Six-month 3-arm cluster randomized controlled trial. METHODS Preschoolers were recruited from 18 licensed CC. CC were randomly assigned to a typical curriculum comparison group (COM), childcare intervention alone (CC), or childcare intervention with parental component (CC+HOME). FMS was measured with the Test of Gross Motor Development-2. Linear mixed models were performed at the level of the individual while accounting for clustering. RESULTS Raw locomotor skills score increased significantly in the CC group (mean difference=2.5 units, 95% Confidence Intervals, CI, 1.0-4.1, p<0.001) and the CC+HOME group (mean difference=2.4 units, 95% CI, 0.8-4.0, p<0.001) compared to the COM group. No significant (p>0.05) between group differences were observed in the raw object control skills, sum of raw scores, or gross motor quotient. No significant sex differences were found in any of the measured outcomes. CONCLUSIONS A physical activity intervention delivered in childcare with or without parents' involvement was effective in increasing locomotor skills in preschoolers.
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Affiliation(s)
- Niko S Wasenius
- Faculty of Health Sciences, University of Ottawa, 200 Lees Ave., Ottawa, ON K1N 6N5, Canada; Folkhälsan Research Center, Biomedicum Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland
| | - Kimberly P Grattan
- Faculty of Health Sciences, University of Ottawa, 200 Lees Ave., Ottawa, ON K1N 6N5, Canada
| | - Alysha L J Harvey
- Faculty of Health Sciences, University of Ottawa, 200 Lees Ave., Ottawa, ON K1N 6N5, Canada
| | - Patti-Jean Naylor
- University of Victoria, School of Exercise Science, Physical and Health Education, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada
| | - Gary S Goldfield
- Faculty of Health Sciences, University of Ottawa, 200 Lees Ave., Ottawa, ON K1N 6N5, Canada; Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON K1H 5B2, Canada
| | - Kristi B Adamo
- Faculty of Health Sciences, University of Ottawa, 200 Lees Ave., Ottawa, ON K1N 6N5, Canada; Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON K1H 5B2, Canada.
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Tucker P, Vanderloo LM, Johnson AM, Burke SM, Irwin JD, Gaston A, Driediger M, Timmons BW. Impact of the Supporting Physical Activity in the Childcare Environment (SPACE) intervention on preschoolers' physical activity levels and sedentary time: a single-blind cluster randomized controlled trial. Int J Behav Nutr Phys Act 2017; 14:120. [PMID: 28882152 PMCID: PMC5590124 DOI: 10.1186/s12966-017-0579-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/29/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Physical activity levels among preschoolers in childcare are low and sedentary time high. The Supporting Physical Activity in the Childcare Environment (SPACE) intervention had three components: 1. portable play equipment; 2. staff training; and, 3. modified outdoor playtime (i.e., shorter, more frequent periods). This study aimed to examine the effectiveness of the SPACE intervention on preschoolers' physical activity levels and sedentary time during childcare hours (compared to standard care). METHODS Via a single-blind cluster randomized controlled trial, 338 preschoolers (39.86 ± 7.33 months; 52% boys) from 22 centre-based childcare facilities (11 experimental, 11 control) were enrolled. Preschoolers wore an Actical™ accelerometer for 5 days during childcare hours at baseline, post-intervention, and 6- and 12-month follow-up, and were included in the analyses if they had a minimum of two valid days (5 h each day) at baseline and one additional time point. Intervention effectiveness was tested using a linear mixed effects model for each of the four outcome variables (i.e., sedentary time, light physical activity [LPA], moderate-to-vigorous physical activity [MVPA], and total physical activity [TPA]). Fixed effects were further evaluated with t-tests, for which degrees of freedom were estimated using a Satterthwaite approximation. RESULTS One hundred and ninety-five preschoolers were retained for analyses. The intervention did not significantly impact LPA. MVPA was significantly greater among children in the experimental group when comparing post-intervention to pre-intervention, t(318) = 3.50, p = .0005, but no intervention effects were evident at 6- or 12-month follow-up. TPA was significantly greater for children in the intervention group at post-intervention when compared to pre-intervention, t(321) = 2.70, p = .007, with no intervention effects evident at later time periods. Finally, sedentary time was significantly lower among preschoolers in the experimental group when comparing post-intervention to pre-intervention, t(322) = 2.63, p = .009, with no significant effects at follow-up. CONCLUSIONS The SPACE intervention was effective at increasing MVPA and TPA among preschoolers, while simultaneously decreasing sedentary time. The ability of the SPACE intervention to target higher intensity activity is promising, as MVPA levels have been documented to be low in centre-based childcare. The changes in physical activity were not sustained long term (6- or 12-month follow-up). TRIAL REGISTRATION ISRCTN70604107 (October 8, 2014).
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Affiliation(s)
- Patricia Tucker
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, 1201 Western Road, Elborn College, Room 2547, London, ON N6G 1H1 Canada
| | - Leigh M. Vanderloo
- Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, ON Canada
| | - Andrew M. Johnson
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON Canada
| | - Shauna M. Burke
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON Canada
| | - Jennifer D. Irwin
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON Canada
| | - Anca Gaston
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, ON Canada
| | - Molly Driediger
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, 1201 Western Road, Elborn College, Room 2547, London, ON N6G 1H1 Canada
| | - Brian W. Timmons
- Child Health & Exercise Medicine Program, McMaster University, Hamilton, Canada
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Adamo KB, Wasenius NS, Grattan KP, Harvey ALJ, Naylor PJ, Barrowman NJ, Goldfield GS. Effects of a Preschool Intervention on Physical Activity and Body Composition. J Pediatr 2017; 188:42-49.e2. [PMID: 28666535 DOI: 10.1016/j.jpeds.2017.05.082] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/04/2017] [Accepted: 05/31/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the effect of a preschool physical activity intervention program delivered in licensed childcare settings, with or without a parent-facilitated home component, on children's daily physical activity, sedentary time, and body composition. STUDY DESIGN For this cluster randomized controlled trial, 18 childcare centers were randomly allocated in equal numbers to the typical curriculum comparison group, childcare intervention alone (CC), or childcare intervention with parental involvement. Accelerometers were used to asses physical activity and sedentary time, and body composition was measured by bioelectrical impedance. RESULTS Linear mixed model regression analyses showed no differences between the CC, the childcare intervention with parental involvement, and the comparison groups in changes from baseline to 6 months in total physical activity (P for time × group interaction = .665) or moderate-to-vigorous physical activity (P for time × group interaction = .164) when adjusted for baseline physical activity levels. Furthermore, no group differences were found for changes in light physical activity, sedentary time, or anthropometric variables. CONCLUSIONS An affordable and easily scalable preschool intervention program delivered in licensed childcare settings, with or without the addition of a parent-driven home physical activity promotion, seems to have no significant effect on physical activity, sedentary time, or body composition. TRIAL REGISTRATION ISRCTN: ISRCTN94022291.
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Affiliation(s)
- Kristi Bree Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
| | - Niko Sebastian Wasenius
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Folkhälsan Research Center, Helsinki, Finland
| | - Kimberly Paige Grattan
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Alysha Leila Jean Harvey
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Nicolas James Barrowman
- Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Gary Scott Goldfield
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
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Wasenius NS, Grattan KP, Harvey ALJ, Barrowman N, Goldfield GS, Adamo KB. Maternal gestational weight gain and objectively measured physical activity among offspring. PLoS One 2017; 12:e0180249. [PMID: 28662129 PMCID: PMC5491154 DOI: 10.1371/journal.pone.0180249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 06/12/2017] [Indexed: 12/21/2022] Open
Abstract
Objective Animal studies have suggested that maternal weight-related factors during pregnancy can program offspring physical activity in a sex-dependent manner. However, there is limited evidence in humans. The purpose of this study was to investigate the association between maternal gestational weight gain (GWG) and offspring total physical activity (TPA) level and to determine whether these associations are moderated by sex of offspring or maternal pre-pregnancy weight status. Method We studied 56 boys (mean age = 3.7 years, standard deviation (SD) 0.5) and 57 girls (mean age = 3.5±0.5 years) enrolled in licensed childcare centers. TPA was objectively measured using Actical® accelerometers. Information on pre-pregnancy body mass index (BMI), GWG, and other maternal factors were collected with a maternal health questionnaire. Associations between GWG, as a continuous variable or categorically (inadequate, adequate, and excessive), and offspring TPA were analysed using linear mixed models to take into account the intraclass correlation between the clusters (childcare centers). Models were adjusted for gestational age, accelerometer weartime, socioeconomic status, and pre-pregnancy BMI status. Results We found a significant sex interaction (P-value = 0.009). In boys, greater GWG was associated with decreased offspring TPA (β = -3.2 counts⋅1000−1/d, 95% confidence intervals (CI) = -6.4–0.02, P-value = 0.049). In girls born to mothers categorized as overweight or obese, the association between the GWG and TPA followed an inverted U-shape curve (β for GWG squared = -0.1 counts⋅1000−1/d, 95% CI = (-0.2 –-0.04), P-value = 0.005). In contrast, a U-shaped curve was found in girls born to mothers classified as lean (pre-pregnancy BMI<25 kg/m2) (β for GWG squared = 0.7 counts⋅1000−1/d, 95% CI = 0.2–1.2, P-value = 0.011). In boys, TPA in offspring was higher among women with inadequate GWG compared to adequate GWG (P-value = 0.0137), whereas no significant differences were found in girls (P-value = 0.107). Conclusion Maternal GWG can be an important biological marker of offspring TPA. These findings support the sex-dependent early developmental programming influence of GWG on TPA.
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Affiliation(s)
- Niko S. Wasenius
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
- Folkhalsan Research Center, Helsinki, Finland
| | - Kimberly P. Grattan
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Alysha L. J. Harvey
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Nick Barrowman
- Clinical Research Unit, Children’s Hospital of Eastern Ontario Research Institute (CHEO RI), Ottawa, Canada
| | - Gary S. Goldfield
- Healthy Active Living and Obesity (HALO) Research Group, Ottawa, Canada
| | - Kristi B. Adamo
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
- Healthy Active Living and Obesity (HALO) Research Group, Ottawa, Canada
- * E-mail:
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Adamo KB, Wilson S, Harvey ALJ, Grattan KP, Naylor PJ, Temple VA, Goldfield GS. Response. Med Sci Sports Exerc 2016; 49:219-220. [PMID: 27984504 DOI: 10.1249/mss.0000000000001093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Kristi B Adamo
- School of Human Kinetics, Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Research Institute, Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, CANADA; Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Research Institute, Ottawa, CANADA; School of Human Kinetics, University of Ottawa, Ottawa, CANADA; School of Exercise Sciences, Physical & Health Education University of Victoria, Victoria, CANADA; School of Exercise Sciences, Physical & Health, University of Victoria, Victoria, CANADA; Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Research Institute Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, CANADA
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