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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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Olesen LG, Grøntved A, Brønd JC, Hestbæk L, Kristensen PL. Effectiveness of a Preschool Motor Skill Intervention on Body Mass Index and Movement Behavior: 6-, 18-, and 30-Month Findings From a Cluster Randomized Controlled Trial. Pediatr Exerc Sci 2024:1-16. [PMID: 38653455 DOI: 10.1123/pes.2023-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 01/29/2024] [Accepted: 02/12/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE To study the effectiveness of a preschool staff-delivered motor skills intervention on body composition and physical activity over a 2.5-year time frame. METHODS In this pragmatic parallel cluster randomized controlled trial (16 preschools), outcome data were collected after 6 (body composition only), 18, and 30 months of intervention. The main physical activity outcomes were accelerometer behavior measures summarizing the total percentage of child daily movement (walk, run, cycle, and standing that included minor movements) and preschool movement during preschool attendance. To estimate between-group mean differences in outcomes, mixed-linear regression analyses including baseline value of the selected outcome and a treatment × time interaction term as a fixed effect were applied. In addition, the baseline preschool and child were included as a random effect. RESULTS For body mass index, a total of 437 children (90%) had at least one valid baseline and one follow-up assessment. The corresponding numbers for preschool movement and daily movement were 163 (55%) and 146 (49%), respectively. No significant between-group mean difference was identified for body mass index, waist-to-height ratio, or any physical activity outcomes. CONCLUSION Overall, this preschool motor skills intervention had no effect on either child anthropometry or physical activity, consistent with previous studies.
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Affiliation(s)
- Line Grønholt Olesen
- Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense,Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital Skejby, Aarhus,Denmark
| | - Anders Grøntved
- Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense,Denmark
| | - Jan Christian Brønd
- Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense,Denmark
| | - Lise Hestbæk
- The Chiropractic Knowledge Hub and Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense,Denmark
| | - Peter Lund Kristensen
- Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense,Denmark
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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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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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Peng J, Yin L, Wang K, Zhang T, Liu H, Yang J, Luo J. A Study on the Relationship Between Adolescent Health Behavior, BMI, and Blood Physical and Chemical Properties. Front Public Health 2022; 10:766101. [PMID: 35372227 PMCID: PMC8964522 DOI: 10.3389/fpubh.2022.766101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 01/27/2022] [Indexed: 11/28/2022] Open
Abstract
In this study, the blood test index, demographic data, and health promotion behavior of adolescents were analyzed to provide a reference for early prevention and treatment of physical decline and abnormal biochemical indexes of adolescents. Using a cross-sectional study design, 1,436 valid samples were obtained by stratified random sampling, and the data were processed by SPSS21.0 statistical analysis software. The results showed that the overall health-promoting lifestyle of adolescents was good, and the interpersonal support behavior was the best, and the health responsibility and sports participation behavior were the worst; the interpersonal support and sports participation behavior of adolescents with normal weight were significantly better than those with overweight or light weight, while the overall health-promoting behavior of adolescents with high fasting blood glucose (FBG) before meals was poor, those with high glutamate pyruvate transaminase (GPT) had poor nutritional behavior and health responsibility behavior, while those with high uric acid (UA) had poor interpersonal support and stress coping behavior. The overweight rate and abnormal detection rate of UA and triglyceride (TG) in boys were significantly higher than those in girls, and the higher BMI of teenagers, the higher abnormal detection rate of GPT, UA, and TG, the better nutritional behavior, health responsibility behavior, and sports participation behavior, the lower abnormal detection rate of GPT, UA, and TG; the higher education level of parents, the better teenagers' sports participation and health responsibility behavior, the lower the incidence of overweight, the more time they spend playing online games and drinking sugary drinks on weekdays (or holidays), the higher the incidence of overweight.
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Affiliation(s)
- Jie Peng
- School of Physical Education, Liupanshui Normal University, Liupanshui, China
| | - Lian Yin
- Research Centre for Exercise Detoxification, College of Physical Education, Southwest University, Chongqing, China
| | - Kun Wang
- Research Centre for Exercise Detoxification, College of Physical Education, Southwest University, Chongqing, China
| | - Tingran Zhang
- Research Centre for Exercise Detoxification, College of Physical Education, Southwest University, Chongqing, China
| | - Hengxu Liu
- Research Centre for Exercise Detoxification, College of Physical Education, Southwest University, Chongqing, China
| | - Jinxin Yang
- Research Centre for Exercise Detoxification, College of Physical Education, Southwest University, Chongqing, China
| | - Jiong Luo
- Research Centre for Exercise Detoxification, College of Physical Education, Southwest University, Chongqing, China
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Bruijns BA, Vanderloo LM, Johnson AM, Adamo KB, Burke SM, Carson V, Heydon R, Irwin JD, Naylor PJ, Timmons BW, Tucker P. Implementation of an e-Learning course in physical activity and sedentary behavior for pre- and in-service early childhood educators: Evaluation of the TEACH pilot study. Pilot Feasibility Stud 2022; 8:64. [PMID: 35300723 PMCID: PMC8927755 DOI: 10.1186/s40814-022-01015-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Childcare-based physical activity (PA) and sedentary behavior (SB) interventions have traditionally used in-person training to supplement early childhood educators’ (ECEs) knowledge and confidence to facilitate physically active programming for the children in their care. However, this method of delivery is resource-intensive and unable to reach a high number of ECEs. The purpose of the Training pre-service EArly CHildhood educators in PA (TEACH) pilot study was to test the implementation (e.g., fidelity, feasibility, acceptability) of an e-Learning course targeting PA and SB among a sample of pre-service (i.e., post-secondary students) and in-service (i.e., practicing) ECEs in Canada. Methods A pre-/post-study design was adopted for this pilot study, and implementation outcomes were assessed cross-sectionally at post-intervention. Pre-service ECEs were purposefully recruited from three Canadian colleges and in-service ECEs were recruited via social media. Upon completing the e-Learning course, process evaluation surveys (n = 32 pre-service and 121 in-service ECEs) and interviews (n = 3 pre-service and 8 in-service ECEs) were completed to gather ECEs’ perspectives on the e-Learning course. Fidelity was measured via e-Learning course metrics retrieved from the web platform. Descriptive statistics were calculated for quantitative data, and thematic analysis was conducted to analyze qualitative data. Results Moderate-to-high fidelity to the TEACH study e-Learning course was exhibited by pre-service (68%) and in-service (63%) ECEs. Participants reported that the course was highly acceptable, compatible, effective, feasible, and appropriate in complexity; however, some ECEs experienced technical difficulties with the e-Learning platform and noted a longer than anticipated course duration. The most enjoyed content for pre- and in-service ECEs focused on outdoor play (87.5% and 91.7%, respectively) and risky play (84.4% and 88.4%, respectively). Conclusions These findings demonstrate the value of e-Learning for professional development interventions for ECEs. Participant feedback will be used to make improvements to the TEACH e-Learning course to improve scalability of this training. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01015-1.
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Affiliation(s)
- Brianne A Bruijns
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Leigh M Vanderloo
- ParticipACTION, Toronto, ON, Canada.,School of Occupational Therapy, Faculty of Health Sciences, Western University, 1201 Western Road, Elborn College, Room 2547, London, ON, N6G 1H1, Canada
| | - Andrew M Johnson
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Kristi B Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Shauna M Burke
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada.,Children's Health Research Institute, London, ON, Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Rachel Heydon
- Faculty of Education, Western University, London, ON, Canada
| | - Jennifer D Irwin
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Brian W Timmons
- Child Health and Exercise Medicine Program, McMaster University, Hamilton, ON, Canada
| | - Patricia Tucker
- School of Occupational Therapy, Faculty of Health Sciences, Western University, 1201 Western Road, Elborn College, Room 2547, London, ON, N6G 1H1, Canada. .,Children's Health Research Institute, London, ON, Canada.
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Beck F, Engel FA, Reimers AK. Compensation or Displacement of Physical Activity in Children and Adolescents: A Systematic Review of Empirical Studies. CHILDREN (BASEL, SWITZERLAND) 2022; 9:351. [PMID: 35327723 PMCID: PMC8947494 DOI: 10.3390/children9030351] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/16/2022] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
Regular physical activity during childhood and adolescence is associated with health benefits. Consequently, numerous health promotion programs for children and adolescents emphasize the enhancement of physical activity. However, the ActivityStat hypothesis states that increases in physical activity in one domain are compensated for by decreasing physical activity in another domain. Currently, little is known about how physical activity varies in children and adolescents within intervals of one day or multiple days. This systematic review provides an overview of studies that analyzed changes in (overall) physical activity, which were assessed with objective measurements, or compensatory mechanisms caused by increases or decreases in physical activity in a specific domain in children and adolescents. A systematic search of electronic databases (PubMed, Scopus, Web of Science, SportDiscus) was performed with a priori defined inclusion criteria. Two independent researchers screened the literature and identified and rated the methodological quality of the studies. A total of 77 peer-reviewed articles were included that analyzed changes in overall physical activity with multiple methodological approaches resulting in compensation or displacement. Of 40,829 participants, 16,265 indicated compensation associated with physical activity. Subgroup analyses separated by study design, participants, measurement instrument, physical activity context, and intervention duration also showed mixed results toward an indication of compensation. Quality assessment of the included studies revealed that they were of high quality (mean = 0.866). This review provides inconclusive results about compensation in relation to physical activity. A trend toward increased compensation in interventional studies and in interventions of longer duration have been observed.
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Affiliation(s)
- Franziska Beck
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123b, 91052 Erlangen, Germany;
| | - Florian A. Engel
- Institute of Sport Science, Julius-Maximilians-University Würzburg, Judenbühlweg 11, 97082 Würzburg, Germany;
| | - Anne Kerstin Reimers
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123b, 91052 Erlangen, Germany;
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Bruijns BA, Vanderloo LM, Johnson AM, Adamo KB, Burke SM, Carson V, Heydon R, Irwin JD, Naylor PJ, Timmons BW, Tucker P. Change in pre- and in-service early childhood educators’ knowledge, self-efficacy, and intentions following an e-learning course in physical activity and sedentary behaviour: a pilot study. BMC Public Health 2022; 22:244. [PMID: 35125100 PMCID: PMC8818368 DOI: 10.1186/s12889-022-12591-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Early childhood educators (ECEs) are the primary daytime role models for many young children, and are responsible for facilitating physical activity (PA) opportunities and minimizing sedentary behaviour (SB) in childcare. However, they have reportedly received little related education in their pre-service training. The purpose of the Training pre-service EArly CHildhood educators in physical activity (TEACH) pilot study was to explore changes in pre- and in-service ECEs’ knowledge, self-efficacy, behavioural intention, and perceived behavioural control following the TEACH e-Learning course in PA and SB. Methods Pre-service ECEs were purposefully recruited from three Canadian colleges, while in-service ECEs were recruited via social media. A pre-post study design was used. ECEs completed two online surveys; one prior to, and one immediately following the completion of the TEACH e-Learning course (~ 5 h). Descriptive statistics were reported, and McNemar Chi-Square tests and paired samples t-tests were used to examine changes in ECEs’ question-specific, and total knowledge scores, respectively. Wilcoxon Signed Ranks tests were employed to examine changes in self-efficacy, behavioural intention, and perceived behavioural control. Results Both pre- (n = 32) and in-service (n = 121) ECEs significantly increased their total knowledge scores from pre- to post-course completion (p < .05*). Significant positive changes in self-efficacy (p < .025*), behavioural intention (p < .007*), and perceived behavioural control (p < .007*) were demonstrated by in-service ECEs following course completion, while only select composite scores within these tools were significant among pre-service ECEs. Conclusions These findings provide preliminary evidence of the potential efficacy of the e-Learning course at improving ECEs’ knowledge, self-efficacy, behavioural intention, and perceived behavioural control to support PA and minimize SB in childcare. Following the success of the pilot study, testing the effectiveness of the TEACH e-Learning course on a larger scale, with a comparison group, is warranted prior to recommending broader dissemination of the training in pre-service ECE programs and for in-service ECE professional learning.
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Bruijns BA, Johnson AM, Irwin JD, Burke SM, Driediger M, Vanderloo LM, Tucker P. Training may enhance early childhood educators' self-efficacy to lead physical activity in childcare. BMC Public Health 2021; 21:386. [PMID: 33607984 PMCID: PMC7893737 DOI: 10.1186/s12889-021-10400-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 02/05/2021] [Indexed: 11/17/2022] Open
Abstract
Background Early childhood educators (ECEs) play a critical role in promoting physical activity (PA) among preschoolers in childcare; thus, PA-related training for ECEs is essential. The Supporting PA in the Childcare Environment (SPACE) intervention incorporated: 1. shorter, more frequent outdoor play sessions; 2. provision of portable play equipment; and, PA training for ECEs. An extension of the SPACE intervention (the SPACE-Extension) incorporated only the shorter, more frequent outdoor play periods component of the original SPACE intervention. The purpose of this study was to explore the individual impact of these interventions on ECEs’ PA-related self-efficacy and knowledge. Methods ECEs from the SPACE (n = 83) and SPACE-Extension (n = 31) were administered surveys at all intervention time-points to assess: self-efficacy to engage preschoolers in PA (n = 6 items; scale 0 to 100); self-efficacy to implement the intervention (n = 6 items); and, knowledge of preschooler-specific PA and screen-viewing guidelines (n = 2 items). A linear mixed effects model was used to analyze the impact of each intervention on ECEs’ self-efficacy and knowledge and controlled for multiple comparison bias. Results The SPACE intervention significantly impacted ECEs’ self-efficacy to engage preschoolers in PA for 180 min/day (main effect), and when outdoor playtime was not an option (interaction effect). Further, the interaction model for ECEs’ knowledge of the total PA guideline for preschoolers approached significance when compared to the main effects model. Participants within the SPACE-Extension did not demonstrate any significant changes in self-efficacy or knowledge variables. Conclusions Findings from this study highlight the benefit of ECE training in PA with regard to fostering their PA-related self-efficacy and knowledge. Future research should explore the impact of PA training for ECEs uniquely in order to determine if this intervention component, alone, can produce meaningful changes in children’s PA behaviours at childcare. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10400-z.
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Affiliation(s)
- Brianne A Bruijns
- Health and Rehabilitation Sciences, Western University, London, Canada
| | - Andrew M Johnson
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Jennifer D Irwin
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Shauna M Burke
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Molly Driediger
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Leigh M Vanderloo
- Child Health and Evaluative Science, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Patricia Tucker
- School of Occupational Therapy, Faculty of Health Sciences, Western University, 1201 Western Road, Elborn College, Room 2547, London, ON, N6G 1H1, Canada.
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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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Lerche AF, Vilhelmsen M, Schmidt KG, Kildedal R, Launbo N, Munch PK, Lidegaard M, Jacobsen SS, Rasmussen CL, Mathiassen SE, Straker L, Holtermann A. Can Childcare Work Be Designed to Promote High Intensity Physical Activity for Improved Fitness and Health? A Proof of Concept Study of the Goldilocks Principle. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207419. [PMID: 33053791 PMCID: PMC7600739 DOI: 10.3390/ijerph17207419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/18/2020] [Accepted: 10/04/2020] [Indexed: 12/12/2022]
Abstract
Childcare workers are reported to have high variation in physical activity during work hours, but also to sit for about half of the workday and have almost no high intensity physical activity (HIPA). No study has investigated if their work can be re-designed to introduce HIPA, thus promoting fitness and health according to the Goldilocks principle. This study investigated the feasibility of designing pedagogical games (‘Goldilocks-games’) intended to lead to more HIPA. Heart rate was measured in nineteen childcare workers during Goldilocks-games, and compared to measurements during a regular workday. Worker perceptions of feasibility, and researcher observations of contextual factors were also collected. The Goldilocks-games (33 min) elicited significantly more HIPA (18/33 min) compared to the most active period of equal length on a regular workday (0.5/33 min). Seventy-four-percent of the childcare workers reported that it was feasible to integrate the Goldilocks-games pedagogically, and seventy-two-percent could see themselves using them. Thus, we found it possible to re-design a work task in childcare according to the Goldilocks principle so that it leads to substantial time with HIPA. The sustainability of Goldilocks-games in childcare, and their effectiveness in improving fitness and health among childcare workers, needs to be tested in further studies.
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Affiliation(s)
- Anders Fritz Lerche
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark
- Correspondence:
| | - Maja Vilhelmsen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Kathrine Greby Schmidt
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Rasmus Kildedal
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Natja Launbo
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Pernille Kold Munch
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Mark Lidegaard
- Novo Nordisk Health & Safety, Novo Nordisk A/S, 2880 Bagsværd, Denmark;
| | - Sandra Schade Jacobsen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Charlotte Lund Rasmussen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
- Department of Public Health, Section of Social Medicine, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, 801 76 Gävle, Sweden;
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA 6102, Australia;
| | - Andreas Holtermann
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
- Department of Public Health, Section of Social Medicine, University of Copenhagen, 1165 Copenhagen, Denmark
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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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Herbert J, Matłosz P, Lenik J, Szybisty A, Baran J, Przednowek K, Wyszyńska J. Objectively Assessed Physical Activity of Preschool-Aged Children from Urban Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1375. [PMID: 32093361 PMCID: PMC7068295 DOI: 10.3390/ijerph17041375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/08/2020] [Accepted: 02/18/2020] [Indexed: 12/22/2022]
Abstract
Little is known about physical activity (PA) of preschool-age children in Poland through the course of the day. PA monitoring using an accelerometer increases the reliability of measuring daily PA levels and offers a reasonable compromise between accuracy and feasibility of measurement. The aim of the study was to determine the level of physical activity of preschool children (aged 5-6) on the basis of moderate to vigorous physical activity (MVPA) index and the number of steps. The physical activity of preschool children was assessed using accelerometery (ActiGraph) in 371 children for up to seven days. The normality of distribution was assessed using the Shapiro-Wilk test. The Mann-Whitney U-test and Kruskal-Wallis test were used to assess the significance of differences. The study group children had an average age of 5.4 years (± 0.6). Boys and girls showed a different level of MVPA index. The results significantly improve the current knowledge of PA in Europe. Promoting active lifestyles in children should be one of the health priorities in developed countries.
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Affiliation(s)
- Jarosław Herbert
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland; (P.M.); (J.L.); (A.S.); (K.P.)
| | - Piotr Matłosz
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland; (P.M.); (J.L.); (A.S.); (K.P.)
| | - Justyna Lenik
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland; (P.M.); (J.L.); (A.S.); (K.P.)
| | - Agnieszka Szybisty
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland; (P.M.); (J.L.); (A.S.); (K.P.)
| | - Joanna Baran
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland; (J.B.); (J.W.)
| | - Karolina Przednowek
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland; (P.M.); (J.L.); (A.S.); (K.P.)
| | - Justyna Wyszyńska
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland; (J.B.); (J.W.)
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14
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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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Morgan EH, Schoonees A, Sriram U, Faure M, Seguin‐Fowler RA. Caregiver involvement in interventions for improving children's dietary intake and physical activity behaviors. Cochrane Database Syst Rev 2020; 1:CD012547. [PMID: 31902132 PMCID: PMC6956675 DOI: 10.1002/14651858.cd012547.pub2] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Poor diet and insufficient physical activity are major risk factors for non-communicable diseases. Developing healthy diet and physical activity behaviors early in life is important as these behaviors track between childhood and adulthood. Parents and other adult caregivers have important influences on children's health behaviors, but whether their involvement in children's nutrition and physical activity interventions contributes to intervention effectiveness is not known. OBJECTIVES • To assess effects of caregiver involvement in interventions for improving children's dietary intake and physical activity behaviors, including those intended to prevent overweight and obesity • To describe intervention content and behavior change techniques employed, drawing from a behavior change technique taxonomy developed and advanced by Abraham, Michie, and colleagues (Abraham 2008; Michie 2011; Michie 2013; Michie 2015) • To identify content and techniques related to reported outcomes when such information was reported in included studies SEARCH METHODS: In January 2019, we searched CENTRAL, MEDLINE, Embase, 11 other databases, and three trials registers. We also searched the references lists of relevant reports and systematic reviews. SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs evaluating the effects of interventions to improve children's dietary intake or physical activity behavior, or both, with children aged 2 to 18 years as active participants and at least one component involving caregivers versus the same interventions but without the caregiver component(s). We excluded interventions meant as treatment or targeting children with pre-existing conditions, as well as caregiver-child units residing in orphanages and school hostel environments. DATA COLLECTION AND ANALYSIS We used standard methodological procedures outlined by Cochrane. MAIN RESULTS We included 23 trials with approximately 12,192 children in eligible intervention arms. With the exception of two studies, all were conducted in high-income countries, with more than half performed in North America. Most studies were school-based and involved the addition of healthy eating or physical education classes, or both, sometimes in tandem with other changes to the school environment. The specific intervention strategies used were not always reported completely. However, based on available reports, the behavior change techniques used most commonly in the child-only arm were "shaping knowledge," "comparison of behavior," "feedback and monitoring," and "repetition and substitution." In the child + caregiver arm, the strategies used most commonly included additional "shaping knowledge" or "feedback and monitoring" techniques, as well as "social support" and "natural consequences." We considered all trials to be at high risk of bias for at least one design factor. Seven trials did not contribute any data to analyses. The quality of reporting of intervention content varied between studies, and there was limited scope for meta-analysis. Both validated and non-validated instruments were used to measure outcomes of interest. Outcomes measured and reported differed between studies, with 16 studies contributing data to the meta-analyses. About three-quarters of studies reported their funding sources; no studies reported industry funding. We assessed the quality of evidence to be low or very low. Dietary behavior change interventions with a caregiver component versus interventions without a caregiver component Seven studies compared dietary behavior change interventions with and without a caregiver component. At the end of the intervention, we did not detect a difference between intervention arms in children's percentage of total energy intake from saturated fat (mean difference [MD] -0.42%, 95% confidence interval [CI] -1.25 to 0.41, 1 study, n = 207; low-quality evidence) or from sodium intake (MD -0.12 g/d, 95% CI -0.36 to 0.12, 1 study, n = 207; low-quality evidence). No trial in this comparison reported data for children's combined fruit and vegetable intake, sugar-sweetened beverage (SSB) intake, or physical activity levels, nor for adverse effects of interventions. Physical activity interventions with a caregiver component versus interventions without a caregiver component Six studies compared physical activity interventions with and without a caregiver component. At the end of the intervention, we did not detect a difference between intervention arms in children's total physical activity (MD 0.20 min/h, 95% CI -1.19 to 1.59, 1 study, n = 54; low-quality evidence) or moderate to vigorous physical activity (MVPA) (standard mean difference [SMD] 0.04, 95% CI -0.41 to 0.49, 2 studies, n = 80; moderate-quality evidence). No trial in this comparison reported data for percentage of children's total energy intake from saturated fat, sodium intake, fruit and vegetable intake, or SSB intake, nor for adverse effects of interventions. Combined dietary and physical activity interventions with a caregiver component versus interventions without a caregiver component Ten studies compared dietary and physical activity interventions with and without a caregiver component. At the end of the intervention, we detected a small positive impact of a caregiver component on children's SSB intake (SMD -0.28, 95% CI -0.44 to -0.12, 3 studies, n = 651; moderate-quality evidence). We did not detect a difference between intervention arms in children's percentage of total energy intake from saturated fat (MD 0.06%, 95% CI -0.67 to 0.80, 2 studies, n = 216; very low-quality evidence), sodium intake (MD 35.94 mg/d, 95% CI -322.60 to 394.47, 2 studies, n = 315; very low-quality evidence), fruit and vegetable intake (MD 0.38 servings/d, 95% CI -0.51 to 1.27, 1 study, n = 134; very low-quality evidence), total physical activity (MD 1.81 min/d, 95% CI -15.18 to 18.80, 2 studies, n = 573; low-quality evidence), or MVPA (MD -0.05 min/d, 95% CI -18.57 to 18.47, 1 study, n = 622; very low-quality evidence). One trial indicated that no adverse events were reported by study participants but did not provide data. AUTHORS' CONCLUSIONS Current evidence is insufficient to support the inclusion of caregiver involvement in interventions to improve children's dietary intake or physical activity behavior, or both. For most outcomes, the quality of the evidence is adversely impacted by the small number of studies with available data, limited effective sample sizes, risk of bias, and imprecision. To establish the value of caregiver involvement, additional studies measuring clinically important outcomes using valid and reliable measures, employing appropriate design and power, and following established reporting guidelines are needed, as is evidence on how such interventions might contribute to health equity.
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Affiliation(s)
- Emily H Morgan
- University of VermontDepartment of Nutrition and Food Sciences225B Marsh Life Science109 Carrigan DriveBurlingtonVTUSA05405
| | - Anel Schoonees
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownWestern CapeSouth Africa7505
| | - Urshila Sriram
- Cornell UniversityDivision of Nutritional Sciences2250 N Triphammer Rd, Apt E8IthacaNew YorkUSA14850
- Texas A&M AgriLife ResearchCollege StationTXUSA
| | - Marlyn Faure
- Stellenbosch UniversityDean's Division, Faculty of Medicine and Health SciencesFrancie van Zijl Drive, ParowCape TownWestern CapeSouth Africa14853
| | - Rebecca A Seguin‐Fowler
- Texas A&M AgriLife ResearchCollege StationTXUSA
- Texas A&M UniversityDepartment of Nutrition and Food Science, College of Agriculture and Life SciencesAgriculture and Life Sciences Building600 John Kimbrough Boulevard, Suite 512College StationTXUSA77843‐2142
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16
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Coe DP. Means of Optimizing Physical Activity in the Preschool Environment. Am J Lifestyle Med 2020; 14:16-23. [PMID: 31903074 PMCID: PMC6933560 DOI: 10.1177/1559827618818419] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 11/17/2018] [Accepted: 11/20/2018] [Indexed: 11/15/2022] Open
Abstract
During early childhood, the preschool years serve as a formative time for the development of movement skills and healthy, active behaviors. Currently, one fifth of children in this population are overweight or obese and only half of the children participate in sufficient activity to meet recommendations. Physical activity guidelines for preschool children include both structured and unstructured activities of various intensities, limitations on sedentary behaviors, fundamental motor skill competence, and the inclusion of caregivers to facilitate activity. The majority of US children are enrolled in preschool programs, so this environment has the potential to significantly influence young children's activity levels. Factors that have been associated with physical activity levels within the preschool setting include the influence of caregivers, the preschool environment, outdoor play, and motor skill development and competence. This review evaluated 16 publications in order to examine whether these factors had a significant impact on physical activity in the preschool setting. The findings from this review suggest the use of a multicomponent model, including the factors evaluated, may be the optimal strategy to increase activity levels in preschool children. Policy related to these factors should be created and implemented in order to facilitate optimal physical activity environments for preschool children.
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Affiliation(s)
- Dawn Podulka Coe
- Department of Kinesiology, Recreation, and Sport Studies,
University of Tennessee, Knoxville, Tennessee
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17
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van de Kolk I, Gerards SMPL, Harms LSE, Kremers SPJ, Gubbels JS. The Effects of a Comprehensive, Integrated Obesity Prevention Intervention Approach (SuperFIT) on Children's Physical Activity, Sedentary Behavior, and BMI Z-Score. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E5016. [PMID: 31835477 PMCID: PMC6950277 DOI: 10.3390/ijerph16245016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/25/2019] [Accepted: 12/04/2019] [Indexed: 01/28/2023]
Abstract
SuperFIT is a comprehensive, integrated intervention approach aimed at promoting healthy energy balance-related behaviors in 2- to 4-year-old children in the preschool and home settings. A quasi-experimental research design was adopted to evaluate the effects of SuperFIT on physical activity (PA), sedentary behavior (SB) and Body Mass Index (BMI) z-score. Children could participate in the preschool-based and family-based component (full intervention) or only in the preschool-based component (partial intervention). Children's PA levels and SB were assessed with accelerometers and observations, and height and weight were measured for the BMI z-score. Measurements were performed at baseline and two follow-up time points. Effectiveness was evaluated using linear mixed-model analyses, correcting for relevant covariates. Healthy changes in PA levels occurred within all study groups over time. No significant differences were found in overall PA levels between the intervention groups and control group at both follow-ups. Nevertheless, sedentary behavior decreased more in the full intervention group (effect size (ES): -0.62), and moderate-to-vigorous PA (ES: 0.85) and counts per minute (ES: 0.45) increased more compared to the control group on preschool days at the first follow-up. No effects were found for BMI z-score. The integrated approach of SuperFIT may induce changes in PA of young children, although the effects were small.
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Affiliation(s)
- Ilona van de Kolk
- Department of Health Promotion, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (S.M.P.L.G.); (L.S.E.H.); (S.P.J.K.); (J.S.G.)
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18
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van de Kolk I, Verjans-Janssen SRB, Gubbels JS, Kremers SPJ, Gerards SMPL. Systematic review of interventions in the childcare setting with direct parental involvement: effectiveness on child weight status and energy balance-related behaviours. Int J Behav Nutr Phys Act 2019; 16:110. [PMID: 31752917 PMCID: PMC6873502 DOI: 10.1186/s12966-019-0874-6] [Citation(s) in RCA: 35] [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: 05/10/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The early years are a crucial period to promote healthy energy balance-related behaviours in children and prevent overweight and obesity. The childcare setting is important for health-promoting interventions. Increasingly, attention has been paid to parental involvement in childcare-based interventions. The aim of this systematic review is to evaluate the effectiveness of these interventions with direct parental involvement on the children's weight status and behavioural outcomes. METHODS A systematic search was conducted in four electronic databases to include studies up until January 2019. Studies written in English, describing results on relevant outcomes (weight status, physical activity, sedentary behaviour and/or nutrition-related behaviour) of childcare-based interventions with direct parental involvement were included. Studies not adopting a pre-post-test design or reporting on pilot studies were excluded. To improve comparability, effect sizes (Cohen's d) were calculated. Information on different types of environment targeted (e.g., social, physical, political and economic) was extracted in order to narratively examine potential working principles of effective interventions. RESULTS A total of 22 studies, describing 17 different interventions, were included. With regard to the intervention group, 61.1% found some favourable results on weight status, 73.3% on physical activity, 88.9% on sedentary behaviour, and all on nutrition-related behaviour. There were studies that also showed unfavourable results. Only a small number of studies was able to show significant differences between the intervention and control group (22.2% weight status, 60.0% physical activity, 66.6% sedentary behaviour, 76.9% nutrition behaviour). Effect sizes, if available, were predominantly small to moderate, with some exceptions with large effect sizes. The interventions predominantly targeted the socio-cultural and physical environments in both the childcare and home settings. Including changes in the political environment in the intervention and a higher level of intensity of parental involvement appeared to positively impact intervention effectiveness. CONCLUSION Childcare-based interventions with direct parental involvement show promising effects on the children's energy balance-related behaviours. However, evidence on effectiveness is limited, particularly for weight-related outcomes. Better understanding of how to reach and involve parents may be essential for strengthening intervention effectiveness.
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Affiliation(s)
- I. van de Kolk
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - S. R. B. Verjans-Janssen
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - J. S. Gubbels
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - S. P. J. Kremers
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - S. M. P. L. Gerards
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
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19
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Azevedo LB, van Sluijs EMF, Moore HJ, Hesketh K. Determinants of change in accelerometer-assessed sedentary behaviour in children 0 to 6 years of age: A systematic review. Obes Rev 2019; 20:1441-1464. [PMID: 31243888 PMCID: PMC6772060 DOI: 10.1111/obr.12882] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 11/30/2022]
Abstract
Sedentary behaviour tracks from early to middle childhood, suggesting the need to intervene early. The aim of this systematic review was to identify determinants of change in accelerometer-assessed sedentary behaviour in young children, with a view to informing interventions. Ten electronic databases were searched. Longitudinal and intervention studies were included if they (a) targeted sedentary behaviour in young children (less than of equal to 6 years), (b) assessed change in accelerometer-assessed sedentary behaviour, and (c) reported on at least one determinant of change in sedentary behaviour. Intervention components were coded according to clusters of behaviour change technique (BCT) (ie, grouping similar BCTs components). Data synthesis was guided by the socioecological model. Sixteen studies (four longitudinal; 12 intervention) met the inclusion criteria. Two (out of five identified determinants) were associated with an increase in sedentary behaviour in longitudinal studies: the after childcare/school period and transition from childcare to school. Three (out of 21 identified determinants) were associated with a decrease in sedentary behaviour in intervention studies: "goals and planning" (ie, "behavioural contract"), "repetition and substitution" (ie, "graded tasks"), and "reward and treat" (ie, "incentives"). The environmental and interpersonal determinants identified in this review may help to inform behavioural strategies, timing, and settings for future interventions.
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Affiliation(s)
- Liane B Azevedo
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Esther M F van Sluijs
- MRC Epidemiology Unit and Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK
| | - Helen J Moore
- Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, UK
| | - Kathryn Hesketh
- MRC Epidemiology Unit and Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK.,UCL Great Ormond Street Institute of Child Health, London, UK
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20
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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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21
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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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22
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Lu C, Wiersma R, Shen T, Huang G, Corpeleijn E. Physical activity patterns by objective measurements in preschoolers from China. CHILD AND ADOLESCENT OBESITY 2019. [DOI: 10.1080/2574254x.2019.1585178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Congchao Lu
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Centre for International Collaborative Research on Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Rikstje Wiersma
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Center for Human Movement Sciences Groningen, University of Groningen, Groningen, the Netherlands
| | - Tong Shen
- Tianjin University kindergarten, Tianjin University, Tianjin, China
| | - Guowei Huang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Centre for International Collaborative Research on Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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23
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A Systematic Review of Data Collection Techniques Used to Measure Preschool Children's Knowledge of and Preference for Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060964. [PMID: 30889836 PMCID: PMC6466374 DOI: 10.3390/ijerph16060964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 11/27/2022]
Abstract
Background: Early childhood has been identified as a crucial period in which children develop physical activity preferences and behaviors. Both the knowledge of and preferences for physical activity are key proximal indicators of activity choices in children. Thus, accurate data collection tools are required to measure these variables. This review evaluates the data collection techniques that have been utilised to assess preschool children’s knowledge of and preference for physical activity, and examines the validity and reliability of existing techniques. Methods: A systematic search for relevant studies published from 1980 through to December 2017 was conducted via ProQuest, CINAHL, Embase, Scopus, ERIC, PubMed, MEDLINE, and ScienceDirect. Results: Fourteen studies were eligible for inclusion in the review. The identified studies employed a limited but disparate range of techniques to assess children’s physical activity knowledge and preferences. Findings reveal that four techniques were consistently used across the reviewed studies, including: interviews, structured play-based activities, questionnaires, and observations. Only four out of 14 included studies reported the assessment of the validity of the data collection tool used, and six reported testing the measures for at least one type of reliability. Conclusion: There is a need for validated and reliable measures to assess children’s knowledge of and preference for physical activity. Greater consideration is required to align data collection techniques with the characteristics, needs and abilities of this study population.
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24
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Bruijns BA, Adamo KB, Burke SM, Carson V, Irwin JD, Naylor PJ, Timmons BW, Vanderloo LM, Tucker P. Exploring the physical activity and screen-viewing-related knowledge, training, and self-efficacy of early childhood education candidates. BMC Pediatr 2019; 19:5. [PMID: 30611238 PMCID: PMC6320605 DOI: 10.1186/s12887-018-1358-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/27/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Early childhood educators greatly influence young children's physical activity and screen-viewing behaviours in childcare. However, educators have requested additional training in physical activity programming, and one logical place to provide this education is during their pre-service schooling. This study explored the physical activity and screen-viewing-related knowledge, training, and self-efficacy of early childhood education (ECE) candidates across Canada, to determine their confidence and ability to facilitate physical activity opportunities and limit screen-viewing among young children in childcare. METHODS Key program personnel at 61 (of 110) Canadian colleges/universities offering an ECE program agreed to participate in this cross-sectional study. An online survey (112 items; 9 domains), developed by experts using the Tailored Design Method, was administered via Qualtrics© to a sample of 1292 ECE candidates. Descriptive statistics, Mann-Whitney U-tests, and chi-square tests were used to report participant demographics and physical activity and screen-viewing-related knowledge (i.e., of physical activity and screen-viewing concepts), training (i.e., physical activity and screen-viewing courses/content received), and self-efficacy (i.e., to facilitate physical activity and limit screen-viewing in childcare) of candidates. RESULTS ECE candidates exhibited the least amount of knowledge regarding the impact of screen-viewing on physiological outcomes (i.e., blood pressure) in young children. Further, only 32.2 and 26.7% of candidates reported completing physical activity or screen-viewing courses during their post-secondary training, respectively. Candidates who completed one or more physical activity or screen-viewing courses exhibited significantly greater (p <.05) self-efficacy than those without such training related to ensuring children were engaging in adequate moderate-to-vigorous physical activity (MVPA). Confidence to limit screen time did not differ. Candidates reporting meeting national physical activity recommendations (i.e., 150+ minutes of MVPA/week) exhibited significantly greater (p <.05) physical activity-related self-efficacy than those not meeting these guidelines. CONCLUSIONS Findings from this work highlight both the need for and the potential of supplementary physical activity and screen-viewing content in post-secondary ECE programs to benefit candidates' knowledge and self-efficacy in these areas. Introducing this content at the post-secondary level will ensure that all early childhood educators are appropriately trained regarding physical activity and screen-viewing before entering a childcare-based profession, where they can positively influence young children's health behaviours.
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Affiliation(s)
- Brianne A. Bruijns
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, University of Western Ontario, London, Ontario Canada
| | - Kristi B. Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario Canada
| | - Shauna M. Burke
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, Ontario Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta Canada
| | - Jennifer D. Irwin
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, Ontario Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia Canada
| | - Brian W. Timmons
- Child Health and Exercise Medicine Program, McMaster University, Hamilton, Ontario Canada
| | - Leigh M. Vanderloo
- Child Health and Evaluative Science, Hospital for Sick Children, Toronto, Ontario Canada
| | - 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
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25
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Pereira JR, Cliff DP, Sousa-Sá E, Zhang Z, Santos R. Prevalence of objectively measured sedentary behavior in early years: Systematic review and meta-analysis. Scand J Med Sci Sports 2018; 29:308-328. [PMID: 30456827 DOI: 10.1111/sms.13339] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 10/28/2018] [Accepted: 11/12/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND The early years have been identified as a critical period during which sedentary habits may be established, as this behavior appears to track throughout life. OBJECTIVE The purpose of this systematic review and meta-analysis is to summarize the current literature on the prevalence of sedentary behavior in children aged 1-5.99 years, reporting differences between boys and girls, weekdays and weekend days, childcare hours and nonchildcare hours, and between time spent indoors and outdoors while children attended childcare. METHODS Five databases were searched until 26.10.2017 and meta-analyses were conducted to estimate prevalence and calculate mean differences in prevalence between groups. RESULTS Fifty studies representing 14 598 children (2-5.99 years) were included. Children spent 51.4% of their waking time in sedentary behaviors. Boys spent less time being sedentary than girls (estimate difference = -1.4%; 95%CI = -2.0: -0.7; P < .001). No significant differences were found between weekdays/weekend days (estimate difference = -0.4; 95%CI = -2.0: 1.2; P = .61) nor between childcare hours/nonchildcare hours (estimate difference = %; 95%CI = -0.9: 6.6; P = .136). While attending childcare centers, children were more sedentary indoors than outdoors (estimate difference = 14.4%; 95%CI = 11.8: 16.9; P < .001). CONCLUSIONS Our results suggest that young children spend a significant portion of their waking hours in sedentary behaviors. While at childcare, young children accumulated more sedentary behavior indoors than outdoors. Girls were more likely to be more sedentary than boys. No significant differences were found between weekdays and weekends, or between childcare and nonchildcare hours. There is a need for higher-quality studies with strong designs, using age and device appropriate cut-off points, to improve evidence-base and to better establish prevalence of sedentary behavior in young children.
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Affiliation(s)
- João Rafael Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia.,Research Unit for Sport and Physical Activity - CIDAF (uid/dtp/03213/2016) University of Coimbra, Coimbra, Portugal
| | - Dylan P Cliff
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Eduarda Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Zhiguang Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Rute Santos
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia.,Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.,Universidade Lusófona, Lisboa, Portugal
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26
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Byun W, Lau EY, Brusseau TA. Feasibility and Effectiveness of a Wearable Technology-Based Physical Activity Intervention in Preschoolers: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091821. [PMID: 30142911 PMCID: PMC6163401 DOI: 10.3390/ijerph15091821] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/09/2018] [Accepted: 08/16/2018] [Indexed: 02/07/2023]
Abstract
The purpose of this pilot study was to evaluate the feasibility and the effectiveness of an intervention that employed a technology-based physical activity (PA) monitoring system and teacher-regulated strategies to promote PA in preschoolers. A total of 93 preschoolers (53% girls, 4.7 years) from 5 child care centers were recruited for a one-week intervention and randomly assigned into control (2 centers, n = 45) or intervention (3 centers, n = 48) group. Key intervention components included: (1) wearable device-based, real-time monitoring of children’s PA by classroom teachers and (2) teacher-regulated strategies for providing more opportunities for PA. Sedentary behavior (SED) and PA were measured using accelerometers. Overall, children in the intervention group showed significantly lower level of SED (31.6 vs. 33.6 min/h) and higher level of total PA (28.4 vs. 26.4 min/h) than children in the control group, after adjusting for age, sex, race, parent education level, parent perception of their child’s PA, BMI, and childcare centers. Teachers in the intervention group reported that the intervention was highly feasible to be implemented in their current classroom settings. In conclusion, we observed high acceptability and initial effectiveness of the current intervention. Subsequent research at larger-scale is warranted to fully evaluate the effectiveness of the intervention strategies tested in this study.
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Affiliation(s)
- Wonwoo Byun
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
| | - Erica Y Lau
- School of Kinesiology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Timothy A Brusseau
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
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