What is the impact of professional learning on physical activity interventions among preschool children? A systematic review

Effects of a staff physical activity professional development intervention on preschoolers' mental health and self-regulation: The active learning Norwegian Preschool(er)s (ACTNOW) cluster randomised controlled trial

BACKGROUND AND AIM

Physical activity may have positive effects on preschoolers' mental health and self-regulation. The preschool setting provides children with opportunities to meet physical activity guidelines and could improve with staff training in delivering physical activity. This study examined the effect of physical activity professional development for preschool staff on preschoolers' proxy-measured mental health and self-regulation.

METHODS

In total, 1265 children from 46 preschools were cluster randomised to either the intervention or the control group. The intervention was nested within two levels implemented concurrently: the preschool level, formed as a professional development where preschools conducted development work, and the child level, with whom the staff implemented physical activity with four core components. Data were analysed using an ANCOVA model through structural equation modelling with latent outcome factors of: emotional problems, peer problems, hyperactivity, and prosocial behaviour from the Strength and Difficulties Questionnaire; and cognitive, emotional, and behavioural self-regulation from the Child Self-regulation and Behaviour Questionnaire.

RESULTS

No effects of the intervention (standardised effect sizes -0.195-0.145, p-values 0.118-0.893) were observed. Secondary analysis showed that children with initially high prosocial behaviour and behavioural self-regulation positively benefited from the intervention (p = 0.035 and p = 0.047, respectively).

CONCLUSION

The ACTNOW intervention had no effects on preschoolers' mental health or self-regulation after 18 months, besides effects for children with initially the highest prosocial behaviour and behavioural self-regulation. Although the professional development was more extensive than previous studies it may have been insufficient to change the preschools physical activity practices.

CLINICAL TRIAL REGISTRATION

www.

CLINICALTRIALS

gov identifier NCT04048967.

Assessing the implementation of healthy eating and physical activity policies and practices in Early Childhood Education and Care in New South Wales, Australia: A cross-sectional study

ISSUE ADDRESSED

Australian children are not meeting the recommended physical activity (PA) and healthy eating (HE) guidelines. Health behaviour practices implemented in community settings such as early education services can improve child's health outcomes and are therefore key to help meet guidelines. This study aimed to measure the implementation of HE and PA policies and practices in Early Childhood Education and Care (ECEC) services in New South Wales (NSW), Australia, and to examine their association with service characteristics.

METHODS

A random sample of 1122 centre-based ECEC services were invited to a cross-sectional survey measuring HE and PA policy and practice implementation. Regression analyses were conducted to assess the relationship between the service characteristics and implementation of policies/practices.

RESULTS

In total, 565 ECEC services completed the survey. Results show that while some practices are implemented, the implementation of practices promoting HE and PA education is low. Practices related to educator training for HE (18%) and PA (13%) were poorly implemented. The implementation of practices such as 'providing educator training around child PA', 'engaging families in activities to increase child PA' and 'encouraging supportive feeding practices' were significantly higher in services located in major cities than regional/remote services. 'Having a PA policy' and the practice of 'limiting the use of screen time' was significantly higher in long day care services than in preschools. The implementation of 'providing educator-led PA', 'providing free play opportunities' and 'having a PA policy' was significantly lower in private not-for-profit community managed services than in private for-profit services.

CONCLUSIONS

Implementation of various HE and PA policies and practices in regional/remote services, private not-for-profit services and preschools across NSW could be improved. SO WHAT?: Future research should be prioritised towards identifying factors influencing the implementation of these policies and practices to best tailor implementation support efforts for those who need it the most.

Effects of a staff-led multicomponent physical activity intervention on preschooler's fundamental motor skills and physical fitness: The ACTNOW cluster-randomized controlled trial

BACKGROUND

Fundamental motor skills (FMS) and physical fitness (FIT) play important roles in child development and provide a foundation for lifelong participation in physical activity (PA). Unfortunately, many children have suboptimal levels of PA, FMS, and FIT. The Active Learning Norwegian Preschool(er)s (ACTNOW) study investigated the effects of a staff-led PA intervention on FMS, FIT, and PA in 3-5-year-old children.

METHODS

Preschools in Western Norway having ≥ six 3-4-year-old children were invited (n = 56). Of these, 46 agreed to participate and were cluster-randomized into an intervention (n = 23 preschools [381 children, 3.8 yrs., 55% boys]) or a control group (n = 23 [438, 3.7 yrs., 52% boys]). Intervention preschools participated in an 18-month PA intervention involving a 7-month staff professional development between 2019 and 2022, amounting to 50 h, including face-to-face seminars, webinars, and digital lectures. Primary outcomes in ACTNOW were cognition variables, whereas this study investigated effects on secondary outcomes. FMS was measured through 9 items covering locomotor, object control, and balance skills. FIT was assessed as motor fitness (4 × 10 shuttle-run test) and upper and lower muscular strength (handgrip and standing long jump). PA was measured with accelerometers (ActiGraph GT3X +). All measures took place at baseline, 7-, and 18-month follow-up. Effects were analysed using a repeated measures linear mixed model with child and preschool as random effects and with adjustment for baseline scores.

RESULTS

Participants in the intervention preschools showed positive, significant effects for object control skills at 7 months (standardized effect size (ES) = 0.17) and locomotor skills at 18 months (ES = 0.21) relative to controls. A negative effect was found for handgrip strength (ES = -0.16) at 7 months. No effects were found for balance skills, standing long jump, or motor fitness. During preschool hours, sedentary time decreased (ES = -0.18), and light (ES = 0.14) and moderate-to-vigorous PA (ES = 0.16) increased at 7 months, whereas light PA decreased at 18 months (ES = -0.15), for intervention vs control. No effects were found for other intensities or full day PA.

CONCLUSIONS

The ACTNOW intervention improved some FMS outcomes and increased PA short-term. Further research is needed to investigate how to improve effectiveness of staff-led PA interventions and achieve sustainable improvements in children's PA, FMS, and FIT.

TRIAL REGISTRATION

Clinicaltrials.gov, identifier NCT04048967 , registered August 7, 2019.

FUNDING

ACTNOW was supported by the Research Council of Norway (grant number 287903), the County Governor of Sogn og Fjordane, the Sparebanken Sogn og Fjordane Foundation, and the Western Norway University of Applied Sciences.

An updated systematic review of correlates of children's physical activity and sedentary time in early childhood education services

BACKGROUND

Early childhood education services (ECE) continue to be a key setting to promote physical activity and limit sedentary behaviour. Thus, the aim of this study was to (1) provide an updated systematic review of correlates of physical activity and sedentary behaviour among children in ECE settings and (2) discuss changes in physical activity and sedentary behaviour correlates among children in ECEC settings over time.

METHODS

A systematic search of eight databases identified 40 studies published between 2015 and 2023 that met the inclusion criteria. The variables were categorized into four domains (child, educator, physical environmental and organizational). Fifty-eight variables were identified.

RESULTS

For data from 2015 to 2023, strong associations were identified in all domains (child, educator, physical environmental and organizational) for physical activity, yet no strong associations for sedentary behaviour were identified. Aggregated data (i.e., combining data from previous review and this review) showed strong associations with children's physical activity and age, motor coordination and sex (child), educator behaviour and presence (educator), presence and size of outdoor environments (physical environmental) and active opportunities and service quality (organizational). For sedentary behaviour, sex, outdoor environments and active opportunities were strongly associated in the combined data.

CONCLUSION

The correlates of physical activity and sedentary behaviour in ECE settings continue to be multi-dimensional and span different domains. Variables such as educator behaviours and intentionality, provision of active opportunities, use of outdoor space and service quality should be the key focus area for improving physical activity and sedentary behaviour levels of young children.

Educator-Perceived Barriers and Facilitators to Structured-Physical Activity in Early Childhood Centres: A Systematic Review

Purpose: Physical activity (PA) and motor competence development are vital for young children, yet many early childhood education and care (ECEC) centers struggle to successfully implement PA programs, particularly those organized and led by educators. This review aimed to synthesize qualitative literature to (1) identify educator-perceived barriers and facilitators to structured-PA in ECEC centers, and (2) map these to the COM-B model and Theoretical Domains Framework (TDF). Methods: Following PRISMA guidelines, a systematic search of five databases was conducted in April 2021 and updated in August 2022. Records were screened in Covidence software using predefined eligibility criteria. Using the framework synthesis method, data extraction and synthesis were conducted in coding forms in Excel and NVivo. Results: Of 2382 records identified, 35 studies were included, representing 2,365 educators across 268 ECEC centers in 10 countries. Using the COM-B model and TDF, an evidence-informed framework was developed. Findings revealed the greatest barriers concerned educator "opportunity" (e.g. competing time and priorities, policy tensions, indoor/outdoor space constraints) and "capability" (e.g. lack of PA knowledge and practical, hands-on skills) to implement structured-PA. Although fewer studies reported factors that influenced educator "motivation", several themes intersected across the three COM-B components illustrating the complexity of behavioral determinants in this setting. Conclusions: Interventions grounded in theory that utilize a systems approach to target multiple levels of influence on educator behavior, and are flexible and adaptable locally, are recommended. Future work should seek to address societal barriers, structural challenges in the sector, and the PA educational needs of educators. PROSPERO Registration: CRD42021247977.

Barriers, enablers and motivators of the "I'm an active Hero" physical activity intervention for preschool children: a qualitative study

Background

Insufficient physical activity (PA) in early childhood is linked to adverse health outcomes and a heightened risk of obesity. Successful PA programmes often require input from key stakeholders, such as parents and educators. However, research on stakeholders' perspectives regarding PA programmes for preschool children is limited, impeding effective programme design and implementation.

Objectives

This study aims to explore the perspectives of key stakeholders to gain insights into the challenges, facilitators, and motivators that influence the planning, execution, and sustainability of the "I'm an Active Hero (IAAH) intervention component," a preschool-based initiative designed to promote PA among young children.

Methods

Semi-structured interviews were conducted in Saudi Arabia with individual preschool principals (n = 2), and focus group discussions were held, respectively, with preschool staff members (n = 4, all female) and parents (4 mothers, 5 fathers).

Results

A thematic analysis identified four main themes: (1) Barriers to parental involvement in preschool PA interventions, such as time constraints, lack of flexibility, limited space, and a shortage of trained staff; (2) Risks and benefits of children's programme participation; (3) Motivators including rewards, non-financial incentives, and concerns about childhood obesity and a sedentary lifestyle; (4) Facilitating factors for overcoming barriers, including staff training, time reallocation, staff coordination, space optimization, non-financial incentives, and sustaining partnerships.

Conclusion

This study's findings are crucial for childcare professionals, preschools, education authorities, and policymakers, offering valuable insights for future research. However, further collaboration with key stakeholders is essential to enhance individual attitudes and preschool policies for effective intervention implementation.

Which behaviour change techniques are associated with interventions that increase physical activity in pre-school children? A systematic review

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.

Early childhood educator outcomes from online professional development for physical literacy: A randomised controlled trial

INTRODUCTION

Early childhood is recognised as a critical window of opportunity for physical literacy development, however early childhood educators typically lack the training required to effectively provide appropriate physical literacy opportunities for children. We examined the effects of an online physical literacy professional development program-relative to continuing with 'standard' practice-on early childhood educators' physical literacy knowledge and application.

METHODS

We conducted a parallel two-arm randomised controlled trial, in which 88 early childhood educators were randomly assigned to an online professional development program designed to support educators' physical literacy instructional skills (intervention arm; n = 37), or a 'standard practice' control condition (n = 51). Data were collected prior to and after the four-week intervention period. We measured educators' physical literacy knowledge and application (our primary outcome) through independent coding of open-ended survey responses, and educators' self-reported perceptions of values, confidence, behaviours, and barriers (secondary outcomes). Between-group differences were assessed through analysis of covariance.

RESULTS

One intervention arm participant withdrew from the study, resulting in 87 participants included in analysis. Educators in the intervention arm scored significantly higher on post-intervention physical literacy knowledge (d = 0.62) and application (d = 0.33) than those in the control arm. Educators in the intervention arm also scored significantly higher than controls on confidence in teaching physical activity (d = 0.42) and significantly lower than controls on perceived personal barriers to physical activity (d = 0.53). Thirteen participants in the intervention arm (36%) did not begin the online professional development program.

CONCLUSION

Improvements in physical literacy instructional outcomes indicate the potential for further investigation into broader implementation of online professional development programs of this nature in the future.

A Systematic Review of Educator-Led Physical Literacy and Activity Interventions

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.

A blended professional learning intervention for early childhood educators to target the promotion of physical activity and healthy eating: the HOPPEL cluster randomized stepped-wedge trial

BACKGROUND

Childcare centres are important environments for promoting physical activity and healthy eating. Blended approaches to professional learning may help overcome existing challenges for educators in promoting these behaviours. This study aimed to test the effect of a blended professional learning program on healthy eating and physical activity in childcare.

METHODS

Cluster randomized stepped-wedge trial in 15 childcare centres in Tasmania, Australia. Children aged 2-5y who attended at least two days per week were eligible to participate. Random assignment occurred at the centre level. Centre names were drawn out of a hat and then subsequently allocated to one of the three steps. The intervention comprised a 12-week blended professional learning program for educators. The main outcome was centre-level physical activity and healthy eating, assessed using the Environment and Policy Assessment Observation System (EPAO). All data collectors were blinded to step allocation. Analyses were according to intention to treat. The trial was registered with the Australian New Zealand Clinical Trial Registry (ACTRN12618000346279, date registered: 07/03/2018).

RESULTS

Centres were recruited between January 2016 and February 2016. All centres were retained for the duration of the study. A total of 313 children were recruited with 291 analysed at the completion of the study (93%). The difference between groups for the EPAO total score was significant at the end of the maintenance period (adjusted difference = 14.63, 95% CI [1.33, 27.92], p = 0.03). Significant differences were found for the percentage of time children spent in light-intensity physical activity at the end of the intervention (adjusted difference = 0.01, 95% CI [0.00,0.01], p = 0.02) and maintenance periods (adjusted difference = 0.01, 95% CI [0.00,0.02], p = 0.04). To the best of the authors knowledge, there were no adverse events.

CONCLUSION

This intervention achieved a sustained improvement in physical activity and healthy eating in childcare centres. Further, it can be easily integrated into existing service provision, especially among centres with limited access to professional learning.

TRIAL REGISTRATION

The study was registered with the Australian and New Zealand Clinical Trials Registry ( ACTRN12618000346279 , date registered: 07/03/2018).

Training Pre-Service Early Childhood Educators in Physical Activity (TEACH): Protocol for a Quasi-Experimental Study

Background: Early childhood educators (ECEs) influence young children’s early uptake of positive health behaviours in childcare settings and serve as important daytime role models. As such, it is imperative that post-secondary early childhood education programs provide students with the foundational knowledge and professional training required to confidently facilitate quality active play opportunities for young children. The primary objective of the Training pre-service EArly CHildhood educators in physical activity (TEACH) study is to develop and implement an e-Learning course in physical activity and sedentary behaviour to facilitate improvements in: pre-service ECEs’ self-efficacy and knowledge to lead physical activity and outdoor play opportunities and minimize sedentary behaviours in childcare. This study will also explore pre-service ECEs’ behavioural intention and perceived control to promote physical activity and outdoor play, and minimize sedentary behaviour in childcare, and the implementation of the e-Learning course. Methods/Design: A mixed-methods quasi-experimental design with three data collection time points (baseline, post-course completion, 3-month follow-up) will be employed to test the e-Learning course in early childhood education programs (n = 18; 9 experimental, 9 comparison) across Canada. Pre-service ECEs enrolled in colleges/universities assigned to the experimental group will be required to complete a 4-module e-Learning course, while programs in the comparison group will maintain their typical curriculum. Pre-service ECEs’ self-efficacy, knowledge, as well as behavioural intention and perceived behavioural control will be assessed via online surveys and module completion rates will be documented using website metrics. Group differences across timepoints will be assessed using linear mixed effects modelling and common themes will be identified through thematic analysis. Discussion: The TEACH study represents a novel, evidence-informed approach to address the existing gap in physical activity and sedentary behaviour-related education in Canadian post-secondary early childhood education programs. Moreover, e-Learning platforms, can be employed as an innovative, standardized, and scalable way to provide ECEs with consistent training across jurisdictions.

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

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.

Interventions to Improve Child Physical Activity in the Early Childhood Education and Care Setting: An Umbrella Review

Early childhood education and care (ECEC) services are a key setting to support improvements in the physical activity of young children. This umbrella review gathered and synthesised systematic review evidence of the effectiveness of interventions in the ECEC setting on the physical activity levels of children aged 0-6. We also mapped the current evidence to the existing ECEC sector-specific physical activity practice recommendations. Five electronic databases were searched to identify systematic reviews that evaluated the impact of any ECEC-based interventions on the physical activity levels (e.g., moderate-to-vigorous physical activity, total physical activity) of children aged 0-6. One reviewer extracted data on intervention effectiveness and quality of the reviews, checked by a second reviewer. Ten reviews were included. Overall, the majority of the reviews found interventions delivered in ECEC improved child physical activity. Across reviews, the impact of six intervention strategies were identified, mapped to four (of eight) broad recommendations (i.e., providing opportunity, offering educator training, educators promoting the benefits of physical activity, creating a physical activity-promoting environment). The impact of the majority of recommendations, however, did not have systematic review evidence. Further investigation of the effectiveness of ECEC-based physical activity strategies is required to demonstrate support for the existing recommended practices.

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

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.

Measuring Early Childhood Educators' Physical Activity and Sedentary Behavior-Related Self-Efficacy: A Systematic Review of Tools

Early childhood educators’ (ECEs) self-efficacy is often predictive of their ability and likelihood of promoting healthy activity behaviors in childcare settings. To date, ECEs’ physical activity and sedentary behavior–related self-efficacy has been measured in a variety of ways in childcare-based research, creating difficulty when comparing across studies. To identify the different approaches ECEs’ self-efficacy is assessed, the current study aimed to compare all existing tools that quantitatively measure physical activity and sedentary behavior–related self-efficacy of pre- and in-service ECEs. Seven online databases were searched for original, peer-reviewed, English-written journal articles. Articles were deemed eligible if they employed a tool which measured physical activity and/or sedentary behavior–related self-efficacy of pre- or in-service ECEs. A total of 16 studies were included in this review, and 13 unique tools were identified. All tools measured task self-efficacy (n = 13), while only 1 tool measured barrier self-efficacy, and approximately half of the tools (n = 7; 54%) reported on the validity and reliability. Great variability existed among the self-efficacy items included in the tools; however, common constructs included: teaching/leading physical activity, fundamental movement skill development, and physical activity programming. Very few tools mentioned sedentary behavior (n = 2) and outdoor/risky play (n = 2). Given the low number of studies that tested validity and reliability of their self-efficacy tools, the lack of consideration for barrier self-efficacy, and the paucity of tools that fully encompassed physical activity, sedentary behavior, and outdoor play considerations for ECEs, future research is needed to validate a new, reliable tool.

A peer coach intervention in childcare centres enhances early childhood physical activity: The Active Early Learning (AEL) cluster randomised controlled trial

Background

As numbers of children and time spent in childcare centres increase, so does the potential influence of these centres on early childhood physical activity (PA). However, previous reports indicate little success of interventions aimed at improving PA. The Active Early Learning (AEL) program is a multi-component pragmatic intervention designed to imbed PA into the daily curriculum. Delivered by childcare centre staff, it is directed and supported by a peer coach who works across a network of centres. The objective of the study is to investigate the effect of the AEL program on children’s PA.

Methods

Fifteen childcare centres (8 intervention, 7 control centres; 314 children, 180 boys, 4.3y ± 0.4) participated in a 22-week stratified cluster randomised controlled trial. To be eligible to participate, centres needed to have ≥15 preschool children aged 3 to 5-years. The primary outcome was PA measured by accelerometer (Actigraph GT3X) during childcare centre hours over a 3-day period, calculated in min/h of Total PA and moderate-to-vigorous PA (MVPA). The effect of the intervention was evaluated using linear mixed models adjusted for age, sex, accelerometer wear time and centre clustering.

Results

There was an intervention effect for Total PA (+ 4.06 min/h, 95% CI [2.66 to 5.47], p < .001) and MVPA (+ 2.33 min/h, 95% CI [1.31 to 3.34] p < .001). On average, a child taking part in the intervention attending a childcare centre from 8 am to 3 pm performed 28 min more Total PA and 16 min more MVPA per day than children receiving usual practice care.

Conclusion

In contrast with the findings of previous pragmatic trials in early childcare centres, this study shows that a peer-coach facilitated program, focussed on integrating PA into the daily childcare routine, can elicit increases in preschool children’s PA of practical as well as statistical significance.

Trial registration

Australian New Zealand Clinical Trials registry: ACTRN12619000638134. Registered 30/04/2019.

Training may enhance early childhood educators' self-efficacy to lead physical activity in childcare

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.

Comparison between the Healthy Start-Départ Santé online and in-person training of childcare educators to improve healthy eating and physical activity practices and knowledge of physical activity and fundamental movement skills: A controlled trial

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Healthy Start Départ Santé online training improved educators’ practices.

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Healthy eating and physical activity practices improved with online training.

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Knowledge gains of FMS and physical activity did not differ across groups.

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Online training is a sustainable way of reaching a greater number of educators.

Online training may be a more effective and sustainable way to reach educators in early childcare centres (ECCs). This study compared the effectiveness of an online version of the Healthy Start-Départ Santé (HSDS) training to the traditional in-person version of the training as well as to the usual practice condition on ECC educators’ healthy eating (HE) and physical activity (PA) practices and knowledge of PA and fundamental movement skills (FMS). Seventy-eight ECCs were randomly chosen across the provinces of New Brunswick and Saskatchewan, Canada and were allocated to either the online training, the in-person training or the usual practice groups between 2013 and 2018. Educators in each group completed a self-administered questionnaire before and nine months after the intervention, which included questions regarding their HE and PA practices in the ECC, as well as their knowledge of children’s FMS and PA. Group differences were assessed with mixed-effect models. Compared to educators in the usual practice group, educators in the online training group reported a greater improvement in scores for HE and PA practices (p = 0.03 and 0.03, respectively), but change for educators in the in-person training group were not different (p = 0.8 and 0.56, respectively). The rate of improvement in FMS and PA knowledge did not differ across all three groups (p = 0.9). The HSDS online training is an effective method of improving educators’ HE and PA practices in ECCs.

Trial registration: ClinicalTrials.gov (NCT02375490)

Multisector Approach to Improve Healthy Eating and Physical Activity Policies and Practices in Early Care and Education Programs: The National Early Care and Education Learning Collaboratives Project, 2013-2017

Purpose and Objectives

Embedding healthy eating and physical activity best practices in early care and education settings is important for instilling healthy behaviors early in life. A collaborative partnership between Nemours Children’s Health System and the Centers for Disease Control and Prevention was created to implement the National Early Care and Education Learning Collaboratives Project (ECELC) in childcare settings in 10 states. We measured improvement at the program level by the self-reported number of best practices implemented related to healthy eating and physical activity.

Intervention Approach

The ECELC implemented a collaborative model with state-level partners (eg, child care resource and referral networks) and early care and education programs. Intervention components received by program directors and lead teachers included 1) self-assessment, 2) in-person learning and training sessions, 3) action planning and implementation, 4) technical assistance, and 5) post-reassessment.

Evaluation Methods

A pre–post design assessed self-reported policies and practices related to breastfeeding and infant feeding, child nutrition, infant and child physical activity, screen time, and outdoor play and learning as measured by the validated Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) best practices instrument. The sample included 1,173 early care and education programs.

Results

The number of best practices met for each of the 5 NAP SACC areas increased from pre-assessment to post-assessment approximately 6 months later and ranged from 1.5 to 4.7 best practices (P < .001). Almost all increases occurred regardless of participation in the Child and Adult Care Food Program, Quality Rating Improvement System, Head Start/Early Head Start, and/or accreditation status.

Implications for Public Health

The innovative and collaborative partnerships led to broad implementation of healthy eating and physical activity–based practices in early care and education settings. Development, implementation, and evaluation of policy and practice-based partnerships to promote healthy eating and physical activity among children attending early care and education programs may contribute to obesity prevention in the United States.

Physical Activity and Mobile Phone Apps in the Preschool Age: Perceptions of Teachers and Parents

BACKGROUND

Physical activity (PA) is already beneficial at the preschool age. In many countries, young children spend most of their days in the preschool setting, making it a common arena for PA interventions. Mobile health tools are becoming increasingly popular to promote PA in different populations; however, little is known about the interest for and how the preschool setting could incorporate such a tool.

OBJECTIVE

This study aimed to examine how teachers and parents perceive PA in preschool-aged children in general and their perceptions of how a mobile phone app could be used to promote PA in the preschool setting.

METHODS

Semistructured interviews were conducted with 15 teachers (93%, [14/15] women, mean age 43.5 years, 47%, [7/15] with a university degree and 10 parents [91%, 9/10] women, mean age 38.9 years, all with a university degree) recruited from 2 urban preschools in central Sweden. The interviews were recorded, fully transcribed, coded, and analyzed using thematic analysis by means of an inductive approach.

RESULTS

The analysis revealed 4 themes: (1) children are physically active by nature, (2) the environment as a facilitator or a barrier, (3) prerequisites of the adult world, and (4) an app in the preschool setting-challenges and possibilities. Parents and teachers perceived preschoolers as being spontaneously physically active; however, high-intensity PA was perceived as low. The PA was specifically performed during the day in the preschool. Identified facilitators of PA were access to safe and engaging outdoor environments such as forests, spacious indoor areas, and adult involvement. Adult involvement was considered especially important for children preferring sedentary activities. Identified barriers for PA were restricted indoor and outdoor space, rules for indoor activities, and lack of adult involvement because of time constraints. The teachers perceived that they had limited skills and experiences using apps in general, although they also acknowledged the increasing role of technological tools in the curriculum. Thus, the teachers expressed an interest for an app designed as a support tool for them, especially for situations when PA was limited because of perceived barriers. They suggested the app to include accessible information regarding the health benefits of PA in children linked to a library of activities for different settings and seasons. Parents suggested interactive app features including problem-solving tasks and music and dance, but not video clips as they made children passive.

CONCLUSIONS

Vigorous PA was perceived as low in preschool-aged children. Future tailoring of interventions in the preschool setting should work around barriers and support facilitators to PA, especially PA of high intensity. In such work, an app could serve as a source of inspiration for PA in different ages, settings, and seasons and thus reduce environmental and structural inequalities in the preschool setting.

Exploring the physical activity and screen-viewing-related knowledge, training, and self-efficacy of early childhood education candidates

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.