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Montague LA, Hespos S, Mackenzie E, Siette J. Parental acceptance of brain health programs for preschool children: a mixed-methods study exploring barriers, facilitators and future approaches. Front Public Health 2024; 12:1383270. [PMID: 38883200 PMCID: PMC11177877 DOI: 10.3389/fpubh.2024.1383270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 05/03/2024] [Indexed: 06/18/2024] Open
Abstract
Background Recent research proposes that as much as 40% of dementia risk is amendable. Promoting healthy lifestyle behaviors in early life through educational methods can cultivate habits that may decrease dementia risk in later life. This study explores parental acceptance of brain health programs tailored for preschool children, aiming to identify barriers and facilitators affecting parental and child engagement. Methods Mixed-methods cross-sectional study. Urban and suburban parents (N = 187, M age = 37.3 SD = 5.53, range = 29) of children aged three to five years across Australia. Parents participated in an online survey containing both open and closed questions exploring their personal views and opinions on brain health programs for their preschool children. Descriptive statistics, multiple linear regression analyses, and thematic analysis were used to explore sociodemographic factors associated with parental program acceptance. Results Most participants accepted a brain health program with over 98% agreeing a program would be useful for their child(ren). Participants with younger aged children were more likely to exhibit acceptance of a program (β = -0.209, p = 0.007). Three main categories emerged: dual home and preschool environments, the need for engaging brain health programs that were hands-on and screen-free, and addressing key barriers such as time and financial constraints to support implementation. Conclusion Participants valued educating their children for a healthy life and viewed brain health programs favorably. This study contributes to early childhood education discussions, offering guidance for future generations' brain health and wellbeing.
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Affiliation(s)
- Lily A Montague
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia
| | - Susan Hespos
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia
| | - Erin Mackenzie
- School of Education, Western Sydney University, Kingswood, NSW, Australia
| | - Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia
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Capio CM, Cheung SK, Fung SSW, Hu X. Integrating Fundamental Movement Skills and Mathematics in Early Childhood: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:457. [PMID: 38671674 PMCID: PMC11048741 DOI: 10.3390/children11040457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/04/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024]
Abstract
This project involved a co-design process involving researchers and kindergarten teachers to produce learning activities that integrated fundamental movement skills (FMS) and mathematics. We piloted the co-designed activities (i.e., motor-math program) in a local kindergarten and examined the effects on FMS proficiency, mathematics skills, and accrued physical activity (PA). The participants comprised pupils (N = 39) from two matched kindergarten classes, in which we compared the motor-math program with typical mathematics lessons. All participants wore pedometers to measure their number of steps during class, one day per week. FMS proficiency (i.e., locomotor, object control) and mathematics skills (numeracy, geometry, math problem solving) were measured before and after implementation. Significant improvements in locomotor and object control skills were found only in the pilot group (p < 0.001); there were no differences in the changes in mathematics skills between the pilot and comparison groups. During implementation days, the participants in the pilot group accrued significantly greater step counts (p < 0.001) than those in the comparison group. Participating in the motor-math program appears to have benefits associated with improvements in FMS proficiency and accrued PA time, suggesting a promising potential for integrated activities as a means of PA promotion in kindergarten settings. Future work that examines the effects of the integration of movement with mathematics should consider randomization, greater sample size, and a longer intervention period.
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Affiliation(s)
- Catherine M. Capio
- Department of Physiotherapy, Hong Kong Metropolitan University, Kowloon, Hong Kong SAR, China
| | - Sum Kwing Cheung
- Department of Early Childhood Education, The Education University of Hong Kong, Tai Po, Hong Kong SAR, China; (S.K.C.); (X.H.)
| | - Serena S. W. Fung
- School of Arts and Humanities, Tung Wah College, Kowloon, Hong Kong SAR, China;
| | - Xinyun Hu
- Department of Early Childhood Education, The Education University of Hong Kong, Tai Po, Hong Kong SAR, China; (S.K.C.); (X.H.)
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Padhani ZA, Das JK, Siddiqui FA, Salam RA, Lassi ZS, Khan DSA, Abbasi AMA, Keats EC, Soofi S, Black RE, Bhutta ZA. Optimal timing of introduction of complementary feeding: a systematic review and meta-analysis. Nutr Rev 2023; 81:1501-1524. [PMID: 37016953 DOI: 10.1093/nutrit/nuad019] [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] [Indexed: 04/06/2023] Open
Abstract
CONTEXT The timing of introducing complementary feeding (CF) is crucial because premature or delayed CF can be associated with adverse health outcomes in childhood and adulthood. OBJECTIVE This systematic review aims to evaluate the impact of the timing of CF introduction on health, nutrition, and developmental outcomes among normal-term infants. DATA SOURCES Electronic databases and trial registries were searched, along with the reference lists of the included studies and relevant systematic reviews. DATA EXTRACTION Two investigators independently extracted data from the included studies on a standardized data-extraction form. DATA ANALYSIS Data were meta-analyzed separately for randomized controlled trials (RCTs) and observational studies on the basis of early introduction of CF (< 3 months, < 4 months, < 6 months of age) or late introduction of CF (> 6 months, > 8 months of age). Evidence was summarized according to GRADE criteria. In total, 268 documents were included in the review, of which 7 were RCTs (from 24 articles) and 217 were observational studies (from 244 articles). Evidence from RCTs did not suggest an impact of early introduction, while low-certainty evidence from observational studies suggested that early introduction of CF (< 6 months) might increase body mass index (BMI) z score and overweight/obesity. Early introduction at < 3 months might increase BMI and odds of lower respiratory tract infection (LRTI), and early introduction at < 4 months might increase height, LRTI, and systolic and diastolic blood pressure (BP). For late introduction of CF, there was a lack of evidence from RCTs, but low-certainty evidence from observational studies suggests that late introduction of CF (> 6 months) might decrease height, BMI, and systolic and diastolic BP and might increase odds of intestinal helminth infection, while late introduction of CF (> 8 months) might increase height-for-age z score. CONCLUSION Insufficient evidence does suggest increased adiposity with early introduction of CF. Hence, the current recommendation of introduction of CF should stand, though more robust studies, especially from low- and middle-income settings, are needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42020218517.
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Affiliation(s)
- Zahra A Padhani
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Jai K Das
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Faareha A Siddiqui
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Rehana A Salam
- Centre of Research Excellence, Melanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australia
| | - Zohra S Lassi
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Ammaar M A Abbasi
- Division of Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
| | - Emily C Keats
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sajid Soofi
- Division of Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
| | - Robert E Black
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Zulfiqar A Bhutta
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
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Basterfield L, Machaira T, Jones D, Rapley T, Araujo-Soares V, Cameron N, Azevedo LB. Early Years Physical Activity and Motor Skills Intervention-A Feasibility Study to Evaluate an Existing Training Programme for Early Years Educators. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010145. [PMID: 36670695 PMCID: PMC9856565 DOI: 10.3390/children10010145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/21/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023]
Abstract
A lack of fundamental motor skills (FMS) in the early years can lead to lower engagement with physical activity (PA), and track into adulthood. This study aimed to test the feasibility of an existing intervention for Early Years Educators ("Educators") designed to increase knowledge, confidence and the ability to increase PA and FMS of children in a deprived area of England. Non-randomised design with wait-list control. Sixty-seven settings in Middlesbrough, North East England were invited. Recruitment target: 10 settings, 2 Educators per setting, four children per Educator. INTERVENTION one-day training course "Physical Literacy in the Early Years", an age-appropriate theoretical and practical training course to support the development of physical literacy. PRIMARY OUTCOMES recruitment, retention, acceptability of intervention and outcome measures. SECONDARY OUTCOMES change in Educators' knowledge, intentions and behaviour, and change in children's BMI z-score, PA and FMS. Eight settings were recruited; all Intervention Educators completed the training. Six settings participated at follow-up (four Intervention, two Control). The target for Educator recruitment was met (two per setting, total n = 16). Questionnaires were completed by 80% of Intervention Educators at baseline, 20% at follow-up. Control Educators completed zero questionnaires. No Educators took part in a process evaluation interview. Forty-eight children participated at baseline, 28 at follow-up. The intervention was deemed acceptable. The recruitment, retention and acceptability of measurements were insufficient to recommend proceeding. Additional qualitative work is needed to understand and surmount the challenges posed by the implementation of the trial.
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Affiliation(s)
- Laura Basterfield
- Human Nutrition and Exercise Research Centre, and Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Correspondence:
| | | | - Dan Jones
- SHLS Nursing & Midwifery, Teesside University, Middlesbrough TS1 3BX, UK
| | - Tim Rapley
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne NE7 7XA, UK
| | - Vera Araujo-Soares
- Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, D-68167 Mannheim, Germany
| | - Neil Cameron
- SportWorks (North East) Ltd., North Shields NE29 6DE, UK
| | - Liane B. Azevedo
- School of Human and Health Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
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Gago C, Aftosmes-Tobio A, Beckerman-Hsu JP, Oddleifson C, Garcia EA, Lansburg K, Figueroa R, Yu X, Kitos N, Torrico M, Leonard J, Jurkowski JK, Mattei J, Kenney EL, Haneuse S, Davison KK. Evaluation of a cluster-randomized controlled trial: Communities for Healthy Living, family-centered obesity prevention program for Head Start parents and children. Int J Behav Nutr Phys Act 2023; 20:4. [PMID: 36631869 PMCID: PMC9832428 DOI: 10.1186/s12966-022-01400-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/08/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND This study reports the outcomes of Communities for Healthy Living (CHL), a cluster randomized obesity prevention trial implemented in partnership with Head Start, a federally-funded preschool program for low-income families. METHODS Using a stepped wedge design, Head Start programs (n = 16; Boston, MA, USA) were randomly assigned to one of three intervention start times. CHL involved a media campaign and enhanced nutrition support. Parents were invited to join Parents Connect for Healthy Living (PConnect), a 10-week wellness program. At the beginning and end of each school year (2017-2019), data were collected on the primary outcome of child Body Mass Index z-score (BMIz) and modified BMIz, and secondary outcomes of child weight-related behaviors (diet, physical activity, sleep, media use) and parents' weight-related parenting practices and empowerment. Data from 2 years, rather than three, were utilized to evaluate CHL due to the COVID-19 pandemic. We used mixed effects linear regression to compare relative differences during intervention vs. control periods (n = 1274 vs. 2476 children) in (1) mean change in child BMIz and modified BMIz, (2) the odds of meeting child health behavior recommendations, (3) mean change in parenting practices, and (4) mean change in parent empowerment. We also compared outcomes among parents who chose post-randomization to participate in PConnect vs. not (n = 55 vs. 443). RESULTS During intervention periods (vs. control), children experienced greater increases in BMIz and modified BMIz (b = 0.06, 95% CI = 0.02,0.10; b = 0.07, 95% CI = 0.03, 0.12), yet were more likely to meet recommendations related to three of eight measured behaviors: sugar-sweetened beverage consumption (i.e., rarely consume; Odds Ratio (OR) = 1.5, 95% CI = 1.2,2.3), water consumption (i.e., multiple times per day; OR = 1.6, 95% CI = 1.2,2.3), and screen time (i.e., ≤1 hour/day; OR = 1.4, 95% CI = 1.0,1.8). No statistically significant differences for intervention (vs. control) periods were observed in parent empowerment or parenting practices. However, parents who enrolled in PConnect (vs. not) demonstrated greater increases in empowerment (b = 0.17, 95% CI = 0.04,0.31). CONCLUSIONS Interventions that emphasize parent engagement may increase parental empowerment. Intervention exposure was associated with statistically, but not clinically, significant increases in BMIz and increased odds of meeting recommendations for three child behaviors; premature trial suspension may explain mixed results. TRIAL REGISTRATION ClinicalTrials.gov, NCT03334669 , Registered October 2017.
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Affiliation(s)
- Cristina Gago
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Alyssa Aftosmes-Tobio
- School of Social Work, Boston College, 140 Commonwealth Ave, 115 McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Jacob P Beckerman-Hsu
- School of Social Work, Boston College, 140 Commonwealth Ave, 115 McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Carly Oddleifson
- School of Social Work, Boston College, 140 Commonwealth Ave, 115 McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Evelin A Garcia
- Department of Global Health & Population, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Kindra Lansburg
- Action for Boston Community Development (ABCD), Boston, MA, 02111, USA
| | - Roger Figueroa
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY, 14853, USA
| | - Xinting Yu
- School of Social Work, Boston College, 140 Commonwealth Ave, 115 McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Nicole Kitos
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Merieka Torrico
- Action for Boston Community Development (ABCD), Boston, MA, 02111, USA
| | - Jessie Leonard
- Community Action Agency of Somerville (CAAS), Somerville, MA, 02143, USA
| | - Janine K Jurkowski
- Department of Health Policy, Management, and Behavior, State University of New York, Albany, NY, 12222, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Erica L Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Kirsten K Davison
- School of Social Work, Boston College, 140 Commonwealth Ave, 115 McGuinn Hall, Chestnut Hill, MA, 02467, USA.
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Loebach J, Cox A. Playing in ' The Backyard': Environmental Features and Conditions of a Natural Playspace Which Support Diverse Outdoor Play Activities among Younger Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12661. [PMID: 36231961 PMCID: PMC9565111 DOI: 10.3390/ijerph191912661] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
Outdoor play in nature-rich spaces has been associated with healthy development among young children. The diverse play opportunities afforded to children by natural playspaces can scaffold health benefits, appreciation of nature, and pro-environmental behaviors into adulthood. Environmental features and conditions of outdoor playspaces significantly influence the diversity and quality of play opportunities. Understanding how the physical environment can support high-quality play experiences can inform the design of stimulating, health-promoting playscapes for children. An observational behavior mapping framework was utilized to examine the environmental features of The Backyard, a large natural playscape, associated with play activities among young children. The Tool for Observing Play Outdoors was used to capture outdoor play types OPT), along with associated behavioral and environmental data, during seven days of field observation. While the playspace supported most OPTs, Physical and Exploratory play were most prevalent. Associations with activity intensity and risk play are also presented. Loose parts, particularly natural loose parts, were highly involved in most OPTs, but especially associated with Exploratory play. Ground topography showed some association with several OPTs and warrants further investigation. The environmental features of The Backyard supported an abundant and diverse range of outdoor play activities for young children and families.
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Affiliation(s)
- Janet Loebach
- Department of Human Centered Design, Cornell University, Ithaca, NY 14853, USA
| | - Adina Cox
- Department of Landscape Architecture, Iowa State University, Ames, IA 50011, USA
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Prince SA, Lancione S, Lang JJ, Amankwah N, de Groh M, Jaramillo Garcia A, Merucci K, Geneau R. Examining the state, quality and strength of the evidence in the research on built environments and physical activity among children and youth: An overview of reviews from high income countries. Health Place 2022; 76:102828. [PMID: 35700605 DOI: 10.1016/j.healthplace.2022.102828] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Built environments have shown to be associated with health, with physical activity (PA) considered one of the critical pathways for achieving benefits. Navigating available evidence on the built environment and PA is challenging given the number of reviews. OBJECTIVE Examine the current state and quality of research looking at associations between built environments and total PA and domains of PA (i.e., leisure/recreation, transportation, school) among children and youth (1-18 years). METHODS We systematically searched the grey literature and six bibliographic databases from January 2000 to May 2020. Review quality was assessed using the AMSTAR2. Results by age group were synthesized using narrative syntheses and harvest plots, and certainty of the evidence was assessed using a modified GRADE approach. RESULTS This overview included 65 reviews. Most reviews were of very low-to-low quality. High certainty was found for positive associations between transportation PA and walking/cycling/active transportation (AT) infrastructure. There was high certainty for positive associations between streets/play streets and total PA, alongside lower certainty for transportation and leisure PA. Very low-to-moderate certainty supports schoolyards designed to promote PA were positively associated with total PA, but mixed for school PA (except children). Less consistent positive associations were found for forests/trees, greenspace/open space, recreation facilities, street lighting, traffic safety, population/residential density, proximity/access to destinations, neighbourhood characteristics, and home environments. There is very low-to-moderate certainty for negative associations between greater distance to school and traffic volume and domains of PA. Generally, null or mixed associations were observed for aesthetics, parks, AT comfort infrastructure, land-use mix, street connectivity, urban/rural status, and public transit. DISCUSSION There remains a need for high quality systematic reviews and studies to evaluate the effects of environmental changes across the pediatric age spectrum and using a PA domain approach. Given the global physical inactivity crisis the built environment remains and important means to promote PA among children/youth.
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Affiliation(s)
- Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Samantha Lancione
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Justin J Lang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; School of Mathematics and Statistics, Faculty of Science, Carleton University, Ottawa, Canada
| | - Nana Amankwah
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | - Margaret de Groh
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | | | | | - Robert Geneau
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
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8
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Bruijns BA, Johnson AM, Tucker P. Content development for a physical activity and sedentary behaviour e-learning module for early childhood education students: a Delphi study. BMC Public Health 2020; 20:1600. [PMID: 33097030 PMCID: PMC7584084 DOI: 10.1186/s12889-020-09670-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 10/09/2020] [Indexed: 12/03/2022] Open
Abstract
Background Early childhood educators play a prominent role in promoting healthy activity behaviours in childcare. However, they have expressed that they lack the appropriate pre-service training to confidently lead physical activity (PA), and minimize sedentary behaviour (SB), in childcare. As such, the purpose of this Delphi study was to generate and reach agreement on content areas for inclusion in a PA and SB e-Learning module for Early Childhood Education (ECE) students. Methods Purposeful sampling of Canadian/international researchers was used to form two expert panels: a PA/SB expert panel (n = 26), and a Canadian ECE panel (n = 35). The PA/SB experts suggested their top 12 PA/SB topics for the module via online survey. These topics were then pooled to generate a list of 19 content areas. In a second online survey, both panels of experts rated the importance of each content area (0 = unimportant to 5 = very important). Mean ratings (M) were ranked separately for each panel, and then ratings were pooled to create an overall ranking of the 19 content areas. Inter-panel agreement of importance rankings was visually represented as a scatterplot and quantified using Spearman’s rho (rs). Results The top-rated content area was Outdoor Play (M = 4.77 ± 0.64), followed by Benefits of PA in the Early Years (M = 4.75 ± 0.66), and Factors Influencing PA and SB in Childcare (M = 4.71 ± .74). Monitor PA and Sedentary Time Within Your Classroom had the lowest combined score (M = 3.77 ± 1.44). There was moderate-to strong inter-panel agreement for content area importance rankings (rs = 0.60, 95% CI: 0.20 to 0.83). The majority of the ECE expert panel considered this training important for ECE students (94.3%), aligning with ECE curriculum objectives (91.4%) and accreditation standards (78.8%), and complementary to the present ECE curriculum (88.6%). Conclusions Providing PA and SB training to ECE students is a proactive way to ensure healthy movement behaviours are prioritized in childcare programming. With the PA/SB expert-developed content areas, and endorsement by the ECE expert panel, implementing this training within ECE programs is a necessary next step. Supplementary information Supplementary information accompanies this paper at 10.1186/s12889-020-09670-w.
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Affiliation(s)
- Brianne A Bruijns
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada
| | - Andrew M Johnson
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada
| | - 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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9
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Almas A, Iqbal R, Sabir S, Ghani A, Kazmi K. School health education program in Pakistan (SHEPP)-a threefold health education feasibility trial in schoolchildren from a lower-middle-income country. Pilot Feasibility Stud 2020; 6:80. [PMID: 32523724 PMCID: PMC7278168 DOI: 10.1186/s40814-020-00625-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 05/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background The school environment plays an essential role in promoting health education and physical activity for children and adolescence, and they are more likely to adapt it into their adulthood. School health education program has been endorsed and emphasized by the World Health Organization has not been implemented in true spirit in Pakistan yet. We aim to test feasibility of threefold health education program in children and its potential efficacy on physical activity and diet and cardiometabolic risk factors by including BP, BMI, and waist circumference. Methods It is a parallel-group feasibility intervention trial. It is being conducted in two schools from lower to middle-income areas, at different locations but having the same school curriculum under the Aga Khan Education Service, Pakistan (AKESP). All children aged 9-11 years enrolled from the schools mentioned above were included. Children with any physical disability were excluded. One school received threefold intervention (focused on children, parents, and teachers) of school health education program in Pakistan (SHEPP) while the other school continued routine activity. Intervention of SHEPP is directed towards educating children, parents, and teachers about healthy behaviors. Children will receive interactive educational sessions and specially designed physical activity sessions. A 3-h health education session focusing on same healthy behaviors as for children will be conducted for both parents and teachers. Primary outcome is feasibility of SHEPP in terms of recruitment, retention, and treatment fidelity. Secondary outcomes are physical activity levels, dietary intake (of fruits, vegetable), and cardiometabolic risk factors (blood pressure, BMI, and waist circumference (WC)). The total number of children recruited were 982 (82.5 %); 505 from school A and 477 from school B and 496 (50.5) were boys. Conclusion SHEPP is a unique health education program for children as it focuses on children while involving the parents and teachers in the behavior change process. If found feasible and demonstrating potential efficacy on physical activity, dietary behaviors, and cardiometabolic parameters, we will be able to replicate this on a larger scale in public sector schools also. Trial registration NCT03303287
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Affiliation(s)
- Aysha Almas
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Romaina Iqbal
- Department of Medicine and Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Sania Sabir
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Abdul Ghani
- Department of Medicine and Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Khawar Kazmi
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
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10
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Saunders RP, Dowda M, Pfeiffer KA, Brown WH, Pate RR. Childcare Center Characteristics Moderate the Effects of a Physical Activity Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E101. [PMID: 31877840 PMCID: PMC6982193 DOI: 10.3390/ijerph17010101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 11/25/2022]
Abstract
Center-based early childhood education and care (ECEC) programs are well-positioned to create positive impacts on the health and development of large numbers of young children by promoting physical activity using evidence-based programs. Studies testing physical activity programs for young children should examine the circumstances under which programs are most effective by assessing the role of contextual factors on program outcomes. The purpose of this study was to examine the moderating effects of baseline ECEC center characteristics on the relationship between the Study of Health and Activity in Preschool Environments (SHAPES) intervention and moderate-to-vigorous physical activity (MVPA). MVPA was assessed via accelerometry; center characteristics, practices, and social and physical environments were assessed by director interview and observation; and center quality was assessed using the Early Childhood Environment Rating Scale-Revised Edition. Mixed-model analyses of covariance (ANCOVAs) examined intervention effects on MVPA during the school day; interactions between baseline center variables and group assignment (intervention vs. control) tested for moderation. Two center instructional practices, two social environment characteristics, and one physical environment characteristic at baseline moderated the effects of SHAPES on MVPA outcomes. Assessing baseline practices and center characteristics may aid efforts to match centers with interventions likely to increase physical activity as well as suggest additional intervention strategies to test.
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Affiliation(s)
- Ruth P. Saunders
- Department of Health Promotion, Education, and Behavior, Public Health Research Center, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC 29201, USA
| | - Marsha Dowda
- Department of Exercise Science, Public Health Research Center, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC 29201, USA; (M.D.); (R.R.P.)
| | - Karin A. Pfeiffer
- Department of Kinesiology, Michigan State University, 308 West Circle Drive, 27R Intramural Rec Sports-Circle, East Lansing, MI 48824, USA;
| | - William H. Brown
- Educational Studies, Wardlaw College, University of South Carolina, 820 Main Street, Columbia, SC 29208, USA;
| | - Russell R. Pate
- Department of Exercise Science, Public Health Research Center, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC 29201, USA; (M.D.); (R.R.P.)
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11
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Ray C, Kaukonen R, Lehto E, Vepsäläinen H, Sajaniemi N, Erkkola M, Roos E. Development of the DAGIS intervention study: a preschool-based family-involving study promoting preschoolers' energy balance-related behaviours and self-regulation skills. BMC Public Health 2019; 19:1670. [PMID: 31830926 PMCID: PMC6909522 DOI: 10.1186/s12889-019-7864-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 10/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background Preschoolers’ energy balance-related behaviours (EBRBs) and self-regulation skills are important for their later health. Few preschool-based interventions aiming to promote preschoolers’ EBRBs and self-regulation skills, simultaneously reducing differences in EBRBs, due to children’s socio-economic status (SES) background, have been conducted. This study will present the Increased Health and Wellbeing in Preschools (DAGIS) intervention development process applying the Intervention Mapping (IM) framework. Methods The development of the DAGIS intervention study, a preschool level clustered randomized controlled trial (RCT), was based on the IM framework. The protocol in IM guides the development process of an intervention through six steps: needs assessment and logic model of the problem, programme outcomes and objectives, design of the programme, production, implementation plan, and evaluation plan. Results The needs assessment, part of the step 1 in IM, yielded the base for the DAGIS logic model of change. The model includes objectives related to changes in children’s EBRBs, self-regulation skills, and in psychosocial and physical environment that is determined by parents and early educators. A 22-week programme was developed, and materials for preschools and families were produced. A feasibility study of the recruitment processes, acceptability of the materials and methods, and implementation was conducted. The DAGIS intervention study was conducted September 2017–May 2018 as a clustered RCT including a comprehensive effectiveness and process evaluation. The process evaluation was run throughout the intervention targeting preschools and families. Conclusion A preschool-based family-involving programme was developed in the DAGIS intervention study by applying the IM protocol. It was a time- and resource-consuming process. However, the systematic planning, development, and running of the programme have reinforced a comprehensive evaluation, which is a strength in the intervention. The results from the evaluation will enhance the knowledge of how to promote EBRBs and self-regulation skills among preschoolers, and diminish SES differences in them. Trial registration ISRCTN57165350 (Prospectively registered January the 8th, 2015).
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Affiliation(s)
- Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland. .,Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland.
| | - Riikka Kaukonen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland
| | - Elviira Lehto
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.,Department of Teacher Education, University of Helsinki, P.O. Box 9, 00014, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland
| | - Nina Sajaniemi
- Department of Teacher Education, University of Helsinki, P.O. Box 9, 00014, Helsinki, Finland.,Philosophical Faculty, School of Applied Educational Science and Teacher Education, University of Eastern Finland, P.O. Box 111, 80101 Joensuu, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland.,Department of Public Health, Clinicum, University of Helsinki, P.O. Box 63, 00014, Helsinki, Finland
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12
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Healthy Nutrition and Physical Activity in Childcare: Views from Childcare Managers, Childcare Workers and Parents on Influential Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122909. [PMID: 30572600 PMCID: PMC6313341 DOI: 10.3390/ijerph15122909] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 01/10/2023]
Abstract
Childhood obesity is an important public health issue influenced by both personal and environmental factors. The childcare setting plays an important role in children’s energy balance-related behaviours (EBRB), such as physical activity, sedentary behaviour and healthy nutrition. This study aimed to explore facilitators and barriers of healthy EBRB in childcare in a comprehensive way, from the perspective of three crucial stakeholders: childcare managers, childcare workers and parents. A qualitative study was performed using semi-structured interviews. Content analysis was performed using the ‘Environmental Research framework for weight Gain prevention’ (EnRG framework) to guide the analysis. Forty-eight interviews were held with a total of 65 participants (9 childcare managers, 23 childcare workers and 33 parents). Influential factors in all types of environment (physical, sociocultural, economic and political) were mentioned. Although a need for change was not always expressed, the interviews revealed opportunities for improvement of healthy EBRB in childcare. These opportunities were related to the sociocultural, physical and political environment. Childcare workers and managers expressed an influence of the home setting on the childcare setting, resulting in a need for more congruence between these settings. There are opportunities for improvement in the childcare setting to promote healthy EBRB in young children in the Netherlands. It appears important to align intervention components between the childcare and home setting.
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13
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Razak LA, Yoong SL, Wiggers J, Morgan PJ, Jones J, Finch M, Sutherland R, Lecathelnais C, Gillham K, Clinton-McHarg T, Wolfenden L. Impact of scheduling multiple outdoor free-play periods in childcare on child moderate-to-vigorous physical activity: a cluster randomised trial. Int J Behav Nutr Phys Act 2018; 15:34. [PMID: 29615061 PMCID: PMC5883422 DOI: 10.1186/s12966-018-0665-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background Increasing the frequency of periods of outdoor free-play in childcare may represent an opportunity to increase child physical activity. This study aimed to assess the efficacy of scheduling multiple periods of outdoor free-play in increasing the time children spend in moderate-to-vigorous physical activity (MVPA) while attending childcare. Methods The study employed a cluster randomised controlled trial design involving children aged 3 to 6 years, attending ten childcare services in the Hunter New England region of New South Wales, Australia. Five services were randomised to receive the intervention and five to a control condition. The intervention involved services scheduling three separate periods of outdoor free-play from 9 am to 3 pm per day, each at least 15 min in duration, with the total equivalent to their usual daily duration of outdoor play period. Control services implemented the usual single continuous period of outdoor free-play over this time. The primary outcome, children’s moderate-to-vigorous physical activity (MVPA) while in care per day, was measured over 5 days via accelerometers at baseline and at 3 months post baseline. Secondary outcomes included percentage of time spent in MVPA while in care per day, total physical activity while in care per day and documented child injury, a hypothesised potential unintended adverse event. Childcare services and data collectors were not blind to the experimental group allocation. Results Parents of 439 (71.6%) children attending participating childcare services consented for their child to participate in the trial. Of these, 316 (72.0%) children provided valid accelerometer data at both time points. Relative to children in control services, mean daily minutes of MVPA in care was significantly greater at follow-up among children attending intervention services (adjusted difference between groups 5.21 min, 95% CI 0.59–9.83 p = 0.03). Percentage of time spent in MVPA in care per day was also greater at follow-up among children in intervention services relative to control services (adjusted difference between groups 1.57, 95% CI 0.64–2.49 p < 0.001). Total physical activity while in care per day, assessed via counts per minute approached but did not reach significance (adjusted difference between groups 14.25, 95% CI 2.26–30.76 p = 0.09). There were no differences between groups in child injury nor subgroup interactions for the primary trial outcome by child age, sex, or baseline MVPA levels. Conclusion Scheduling multiple periods of outdoor free-play significantly increased the time children spent in MVPA while in attendance at childcare. This simple ecological intervention could be considered for broader dissemination as a strategy to increase child physical activity at a population level. Trial registration This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN1261000347460). Prospectively registered 17th March 2016. Electronic supplementary material The online version of this article (10.1186/s12966-018-0665-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lubna Abdul Razak
- Hunter New England Population Health, Wallsend, NSW, 2287, Australia. .,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia. .,Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia. .,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Sze Lin Yoong
- Hunter New England Population Health, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - John Wiggers
- Hunter New England Population Health, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Philip J Morgan
- School of Education, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia
| | - Jannah Jones
- Hunter New England Population Health, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Meghan Finch
- Hunter New England Population Health, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | | | - Karen Gillham
- Hunter New England Population Health, Wallsend, NSW, 2287, Australia
| | - Tara Clinton-McHarg
- School of Psychology, University of Newcastle, Newcastle, NSW, 2308, Australia.,Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, 2308, Australia
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14
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Xu C, Quan M, Zhang H, Zhou C, Chen P. Impact of parents' physical activity on preschool children's physical activity: a cross-sectional study. PeerJ 2018; 6:e4405. [PMID: 29503768 PMCID: PMC5833469 DOI: 10.7717/peerj.4405] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/02/2018] [Indexed: 11/29/2022] Open
Abstract
Purpose This study examined the associations of physical activity levels between parents and their pre-school children based on gender and weekday/weekend. Method A total of 247 parent-preschool child triads from Shanghai, China were analyzed. The children had a mean age of 57.5 ± 5.2 months. Both sedentary behavior and physical activity were measured in all participants using an ActiGraph GT3X+ accelerometer over seven consecutive days from Monday through the following Sunday. A multivariate regression model was derived to identify significant relationships between parental and child physical activity according to gender and weekday/weekend. Results There was a significant correlation between mothers’ and girls’ moderate-to-vigorous physical activity (MVPA) and total physical activity (TPA) on weekdays. Fathers’ MPVA levels correlated significantly with those of boys and girls, with paternal influence appearing to be stronger than maternal influence. However, there was not a significant correlation between fathers’ and children’s TPA. TPA levels of both mothers and fathers correlated with those of girls, but not with those of boys. Parental sedentary levels on the weekend correlated significantly with girls’ levels, but not with boys’ levels. Children’s physical activity levels on weekends were influenced more by fathers’ activity levels than by mothers’, while the opposite was observed on weekdays. Conclusion Sedentary behavior and physical activity levels of parents can strongly influence those of their preschool children, with maternal influence stronger during the weekdays and paternal influence stronger on the weekends. Parents’ activity levels influence girls’ levels more strongly than they influence boys’ levels.
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Affiliation(s)
- Chang Xu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Minghui Quan
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Hanbin Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China.,Health Promotion Center, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Chenglin Zhou
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - PeiJie Chen
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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15
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Sood D, Comer-Hagans D, Anderson D, Basmajian D, Bohlen A, Grome M, Imanova I, Martin K. Discovering Perspectives on Health and Well-Being from Parents and Teachers of Preschool- Aged Children. OPEN JOURNAL OF OCCUPATIONAL THERAPY 2018; 6. [PMID: 30854264 DOI: 10.15453/2168-6408.1365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background This study explores the concept of health and well-being as perceived by teachers and parents of preschool-aged children in the specific context of a child day care facility. The study also identifies the barriers parents and teachers encounter and the supports they require in promoting the health and well-being of preschool-aged children. Method A qualitative phenomenological research design combined with a projective technique of Photovoice was used for data collection. A total of eight participants, four teachers and four parents of preschool-aged children from a child day care facility, participated in the study. Results Several themes were identified related to barriers that parents and teachers face and the supports they require in promoting the health and well-being of preschool-aged children. Conclusions This study discusses a potential role for occupational therapy practitioners in collaborating with administrators and teachers and parents of preschool-aged children to develop a program to promote the health and well-being of preschool-aged children.
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16
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Research Foundations for Evidence-Informed Early Childhood Intervention Performance Checklists. EDUCATION SCIENCES 2017. [DOI: 10.3390/educsci7040078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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17
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Stacey FG, Finch M, Wolfenden L, Grady A, Jessop K, Wedesweiler T, Bartlem K, Jones J, Sutherland R, Vandevijvere S, Wu JHY, Yoong SL. Evidence of the Potential Effectiveness of Centre-Based Childcare Policies and Practices on Child Diet and Physical Activity: Consolidating Evidence from Systematic Reviews of Intervention Trials and Observational Studies. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0212-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Relationship between children's physical activity, sedentary behavior, and childcare environments: A cross sectional study. Prev Med Rep 2017; 6:171-176. [PMID: 28348946 PMCID: PMC5360221 DOI: 10.1016/j.pmedr.2017.02.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 02/15/2017] [Accepted: 02/18/2017] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to investigate the relationship between the childcare environment and physical activity and sedentary behavior of toddlers and preschoolers. A total of 68 toddlers (1.0–2.9 years) and 233 preschoolers (3.0–5.9 years) were recruited from 11 childcare services in 2013 within the Illawarra and Shoalhaven region of NSW, Australia. For this study analysis was conducted in 2016. The childcare environment was assessed using the Environment and Policy Assessment Observation (EPAO) instrument, and childcare services categorized as low, medium, or high based on their scores. Time spent in physical activity and sitting was assessed over one week using activPAL accelerometers. Relationship between EPAO and children's physical activity and sedentary behavior was assessed using multilevel mixed-effects linear regression. Toddlers who attended high EPAO services sat more (8.73 min [− 10.26, 27.73]) and stood less (− 13.64 min [− 29.27, 2.00]) than those who attended low EPAO services. Preschoolers who attended high EPAO services sat less than those in low and medium services (mean [95%CI] = − 7.81 min [− 26.64, 11.02]). Sub-categories of the EPAO that were associated with less time sitting were: sedentary environments for toddlers and portable play equipment for preschoolers. This study extends previous research by identifying differences between toddlers and preschooler's physical activity and sedentary behaviors in relation to childcare environments. A greater understanding of how the childcare environment relates to sitting time for both toddlers and preschool aged children is needed. More tailored physical activity interventions in childcare services are needed Childcare environmental factors differed between toddlers and preschoolers impacting physical activity Physical activity interventions for toddlers and preschoolers need to be holistic Quality and accessibility of staff training promoting physical activity is required
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19
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Ward DS, Welker E, Choate A, Henderson KE, Lott M, Tovar A, Wilson A, Sallis JF. Strength of obesity prevention interventions in early care and education settings: A systematic review. Prev Med 2017; 95 Suppl:S37-S52. [PMID: 27693295 DOI: 10.1016/j.ypmed.2016.09.033] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/20/2016] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
Abstract
2010-2015; INTERNATIONAL: Given the high levels of obesity in young children, numbers of children in out-of-home care, and data suggesting a link between early care and education (ECE) participation and overweight/obesity, obesity prevention in ECE settings is critical. As the field has progressed, a number of interventions have been reviewed yet there is a need to summarize the data using more sophisticated analyses to answer questions on the effectiveness of interventions. We conducted a systematic review of obesity prevention interventions in center-based ECE settings published between 2010 and 2015. Our goal was to identify promising intervention characteristics associated with successful behavioral and anthropometric outcomes. A rigorous search strategy resulted in 43 interventions that met inclusion criteria. We developed a coding strategy to assess intervention strength, used a validated study quality assessment tool, and presented detailed descriptive information about interventions (e.g., target behaviors, intervention strategies, and mode of delivery). Intervention strength was positively correlated with reporting of positive anthropometric outcomes for physical activity, diet, and combined interventions, and parent engagement components increased the strength of these relationships. Study quality was modestly related to percent successful healthy eating outcomes. Relationships between intervention strength and behavioral outcomes demonstrated negative relationships for all behavioral outcomes. Specific components of intervention strength (number of intervention strategies, potential impact of strategies, frequency of use, and duration of intervention) were correlated with some of the anthropometric and parent engagement outcomes. The review provided tentative evidence that multi-component, multi-level ECE interventions with parental engagement are most likely to be effective with anthropometric outcomes.
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Affiliation(s)
- Dianne S Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States.
| | - Emily Welker
- Healthy Eating Research, Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Ashley Choate
- Healthy Eating Research, Duke Global Health Institute, Duke University, Durham, NC, United States
| | | | - Megan Lott
- Healthy Eating Research, Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, South Kingstown, RI, United States
| | - Amanda Wilson
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, United States
| | - James F Sallis
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, United States
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20
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Wolfenden L, Wiggers J, Morgan P, Razak LA, Jones J, Finch M, Sutherland R, Lecathelinais C, Gillham K, Yoong SL. A randomised controlled trial of multiple periods of outdoor free-play to increase moderate-to-vigorous physical activity among 3 to 6 year old children attending childcare: study protocol. BMC Public Health 2016; 16:926. [PMID: 27590788 PMCID: PMC5010687 DOI: 10.1186/s12889-016-3604-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 08/27/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The implementation of physical activity interventions in centre-based childcare services has been recommended to improve child health. This study aims to evaluate the efficacy of scheduling multiple periods of outdoor free play in increasing the time children spend in moderate-to-vigorous physical activity (MVPA) during childcare. METHODS The study will employ a between group cluster randomised controlled trial design. Fourteen childcare services in the Hunter New England region of New South Wales, Australia, who currently implement a single session of free outdoor play between their core operational hours of 9 am to 3 pm will be recruited into the trial. Childcare services will be randomised to an intervention or a no intervention control group. Childcare services in the intervention group will be supported by an early childhood education specialist to provide three periods of outdoor free play for children between the hours of 9 am to 3 pm. Each period of outdoor free play will be at least 15 min in duration but must equate to their total usual duration of outdoor play. Services in the control group will continue to implement a single period of outdoor play. The primary trial outcome is minutes of time children spend in MVPA whilst in care assessed objectively via accelerometer over 5 days. Outcome assessment will occur at baseline and 3 months post baseline. Generalised Linear Mixed Models (GLMM) under an intention to treat framework will be used to compare differences between groups in the primary trial outcome at follow-up. Sensitivity analysis will be conducted to test assumptions of missing data. Per protocol analysis will be performed using services that implemented the intervention as intended and subgroup analysis undertaken by gender and baseline physical activity levels of children. DISCUSSION The study tests a simple ecological intervention that has the potential to increase child physical activity in care. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry 12616000347460 . Prospectively registered 17th March 2016.
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Affiliation(s)
- Luke Wolfenden
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia.
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - John Wiggers
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Philip Morgan
- School of Education, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Lubna Abdul Razak
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia
| | - Jannah Jones
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Meghan Finch
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia
| | | | - Karen Gillham
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
| | - Sze Lin Yoong
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, 2308, Australia
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21
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Yoong SL, Finch M, Nathan N, Wiggers J, Lecathelinais C, Jones J, Dodds P, Wolfenden L. A longitudinal study assessing childcare services' adoption of obesity prevention policies and practices. J Paediatr Child Health 2016; 52:765-70. [PMID: 27244222 DOI: 10.1111/jpc.13252] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2016] [Indexed: 12/18/2022]
Abstract
AIM Despite ongoing investments to improve the obesogenic environments of childcare settings, little is known regarding how these services have changed their physical activity and nutrition-promoting practices. This study aims to describe changes in the proportion of Australian childcare services that have adopted best-practice healthy eating and physical activity practices between 2006 and 2013 and to assess whether adoption varied by socio-economic status and locality. METHODS A randomly selected sample of nominated supervisors (n = 358) from childcare services located in New South Wales, Australia, participated in a telephone survey in 2006, 2009, 2010 and 2013. Supervisors reported on their service's adoption of six practices: (i) having written nutrition and physical activity policies; (ii) staff trained in physical activity and nutrition in the past year; (iii) scheduled time for fundamental movement skills and (iv) outdoor play; (v) weekly or less screen time opportunities; and (vi) serving only non-sweetened beverages. RESULTS A significant increase in the prevalence of services adopting all but one practice, between 2006 and 2013 was identified. Ninety one percent of services adopted four or more practices, a significant increase from 38% in 2006. There were no differences in the proportion of services adopting each practice by locality and socio-economic status. CONCLUSIONS Government investment in obesity prevention programmes can equitably improve childcare service's adoption of healthy eating and physical activity promoting practices on a jurisdiction-wide basis. The establishment of a routine system to monitor adoption of a broader range of practices by childcare services is warranted.
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Affiliation(s)
- Sze Lin Yoong
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, New South Wales, Australia
| | - Meghan Finch
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, New South Wales, Australia
| | - Nicole Nathan
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, New South Wales, Australia
| | - John Wiggers
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, New South Wales, Australia
| | - Christophe Lecathelinais
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, New South Wales, Australia
| | - Jannah Jones
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, New South Wales, Australia
| | - Pennie Dodds
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, New South Wales, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, New South Wales, Australia
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22
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Finch M, Jones J, Yoong S, Wiggers J, Wolfenden L. Effectiveness of centre-based childcare interventions in increasing child physical activity: a systematic review and meta-analysis for policymakers and practitioners. Obes Rev 2016; 17:412-28. [PMID: 27005942 DOI: 10.1111/obr.12392] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 01/27/2016] [Accepted: 01/28/2016] [Indexed: 11/29/2022]
Abstract
CONTEXT The review describes the effectiveness of physical activity interventions implemented in centre-based childcare services and (i) examines characteristics of interventions that may influence intervention effects; (ii) describes the effects of pragmatic interventions and non-pragmatic interventions; (iii) assesses adverse effects; and (iv) describes cost-effectiveness of interventions METHODS Data sources were Cochrane Central Register of Controlled trials, MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL, SCOPUS and SPORTDISCUS. Studies selected included randomized controlled trials conducted in centre-based childcare including an intervention to increase objectively measured physical activity in children aged less than 6 years. Data were converted into standardized mean difference (SMD) and analysed using a random effects model. RESULTS Overall interventions significantly improved child physical activity (SMD 0.44; 95% confidence interval [CI]: 0.12-0.76). Significant effects were found for interventions that included structured activity (SMD 0.53; 95% CI: 0.12-0.94), delivery by experts (SMD 1.26; 95% CI: 0.20-2.32) and used theory (SMD 0.76; 95% CI: 0.08-1.44). Non-pragmatic (SMD 0.80; 95% CI: 0.12-1.48) but not pragmatic interventions (SMD 0.10; 95% CI:-0.13-0.33) improved child physical activity. One trial reported adverse events, and no trials reported cost data. CONCLUSIONS Intervention effectiveness varied according to intervention and trial design characteristics. Pragmatic trials were not effective, and information on cost and adverse effects was lacking. Evidence gaps remain for policymakers and practitioners regarding the effectiveness and feasibility of childcare-based physical activity interventions.
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Affiliation(s)
- M Finch
- Hunter New England Population Health, Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - J Jones
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - S Yoong
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - J Wiggers
- Hunter New England Population Health, Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - L Wolfenden
- Hunter New England Population Health, Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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23
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Krombholz H. Untersuchung der Entwicklung und Förderung von Kindern mit unterschiedlichem motorischem Leistungsstand im Vorschulalter. ZEITSCHRIFT FUR SPORTPSYCHOLOGIE 2015. [DOI: 10.1026/1612-5010/a000142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In einer Längsschnittstudie (21 Monate) wurde die Entwicklung körperlicher Merkmale und motorischer und kognitiver Leistungen bei 281 Kindern (142 Jungen, 139 Mädchen, Alter zu Beginn 37 – 68 Monate) verglichen. Zusätzlich wurde geprüft, wie sich motorische Interventionsmaßnahmen im Kindergarten auswirken. Anhand ihrer Leistung in einer Motorik-Testbatterie (MoTB 3 – 7) zu Beginn der Studie wurden die Kinder in 3 Gruppen eingeteilt: Kinder mit geringer (N = 65, unterer Quartilbereich), durchschnittlicher (N = 145) oder hoher Leistungsfähigkeit (N = 71, oberer Quartilbereich). Kinder mit geringer motorischer Leistungsfähigkeit zu Beginn der Studie waren im Vergleich zu Kindern mit durchschnittlicher oder hoher Leistungsfähigkeit eher übergewichtig und erreichten im Untersuchungszeitraum niedrigere motorische und kognitive Leistungen. Alle Gruppen verbesserten sich in ihren motorischen Leistungen, die Leistungszuwächse waren bei Kindern mit geringer und durchschnittlicher Leistungsfähigkeit größer als bei Kindern mit hoher Leistungsfähigkeit. Interventionsmaßnahmen zur Steigerung der motorischen Leistungsfähigkeit hatten einen stärkeren Effekt in den Gruppen mit geringerer und durchschnittlicher Leistungsfähigkeit als in der mit hoher Leistungsfähigkeit.
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24
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Piercy KL, Dorn JM, Fulton JE, Janz KF, Lee SM, McKinnon RA, Pate RR, Pfeiffer KA, Young DR, Troiano RP, Lavizzo-Mourey R. Opportunities for public health to increase physical activity among youths. Am J Public Health 2015; 105:421-6. [PMID: 25602864 PMCID: PMC4330821 DOI: 10.2105/ajph.2014.302325] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2014] [Indexed: 11/04/2022]
Abstract
Despite the well-known benefits of youths engaging in 60 or more minutes of daily physical activity, physical inactivity remains a significant public health concern. The 2008 Physical Activity Guidelines for Americans (PAG) provides recommendations on the amount of physical activity needed for overall health; the PAG Midcourse Report (2013) describes effective strategies to help youths meet these recommendations. Public health professionals can be dynamic change agents where youths live, learn, and play by changing environments and policies to empower youths to develop regular physical activity habits to maintain throughout life. We have summarized key findings from the PAG Midcourse Report and outlined actions that public health professionals can take to ensure that all youths regularly engage in health-enhancing physical activity.
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Affiliation(s)
- Katrina L Piercy
- Katrina L. Piercy is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Joan M. Dorn, Janet E. Fulton, and Sarah M. Lee are with the US Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA. Kathleen F. Janz is with the Department of Health and Human Physiology, University of Iowa, Iowa City. Robin A. McKinnon and Richard P. Troiano are with the US Department of Health and Human Services, National Institutes of Health, Bethesda, MD. Russell R. Pate is with the Department of Exercise Science, University of South Carolina, Columbia. Karin A. Pfeiffer is with the Department of Kinesiology, Michigan State University, East Lansing. Deborah Rohm Young is with the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA. Risa Lavizzo-Mourey is with the Robert Wood Johnson Foundation, Princeton, NJ
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25
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Manios Y, Androutsos O, Katsarou C, Iotova V, Socha P, Geyer C, Moreno L, Koletzko B, De Bourdeaudhuij I. Designing and implementing a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study. Obes Rev 2014; 15 Suppl 3:5-13. [PMID: 25047374 DOI: 10.1111/obr.12175] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 04/08/2014] [Accepted: 04/08/2014] [Indexed: 11/28/2022]
Abstract
The development of the ToyBox-intervention was based on the outcomes of the preliminary phase of the ToyBox-study, aiming to identify young children's key behaviours and their determinants related to early childhood obesity. The ToyBox-intervention is a multi-component, kindergarten-based, family-involved intervention with a cluster-randomized design, focusing on the promotion of water consumption, healthy snacking, physical activity and the reduction/ breaking up of sedentary time in preschool children and their families. The intervention was implemented during the academic year 2012-2013 in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. Standardized protocols, methods, tools and material were used in all countries for the implementation of the intervention, as well as for the process, impact, outcome evaluation and the assessment of its cost-effectiveness. A total sample of 7,056 preschool children and their parents/caregivers, stratified by socioeconomic level, provided data during baseline measurements and participated in the intervention. The results of the ToyBox-study are expected to provide a better insight on behaviours associated with early childhood obesity and their determinants and identify effective strategies for its prevention. The aim of the current paper is to describe the design of the ToyBox-intervention and present the characteristics of the study sample as assessed at baseline, prior to the implementation of the intervention.
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Affiliation(s)
- Y Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
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26
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Duvinage K, Ibrügger S, Kreichauf S, Wildgruber A, De Craemer M, De Decker E, Androutsos O, Lateva M, Iotova V, Socha P, Zych K, Mouratidou T, Mesana Graffe MI, Manios Y, Koletzko B. Developing the intervention material to increase physical activity levels of European preschool children: the ToyBox-study. Obes Rev 2014; 15 Suppl 3:27-39. [PMID: 25047376 DOI: 10.1111/obr.12176] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 01/11/2023]
Abstract
Early childhood is an important period for adopting positive health-related behaviours. More than 95% of European preschool children attend kindergartens, making these settings ideal for the implementation of health promotion interventions. The ToyBox-intervention addressed preschool children, their parents/caregivers and teachers. The aim of the intervention was to improve four energy balance-related behaviours (i.e. healthy snacking, water consumption, physical activity and sedentary behaviour) by implementing a kindergarten-based, family-involved intervention in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). The intervention material was developed following the intervention mapping protocol, taking into account local and cultural differences among the intervention countries. The present paper focuses on the development of the physical activity component of the intervention. Parental involvement was addressed by providing parents/caregivers with two newsletters, two tip cards and a poster. Teachers received a handbook with guidance on environmental changes in the classroom, 26 physical education sessions and suggestions for fun, interactive classroom activities aiming at total class participation to increase preschoolers' physical activity levels. The ToyBox-intervention material was distributed according to a standard time frame. Teachers received their material prior to the start of the intervention and parents/caregivers received their material during the intervention when each energy balance-related behaviour was implemented.
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Affiliation(s)
- K Duvinage
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, München, Germany
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27
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Androutsos O, Katsarou C, Payr A, Birnbaum J, Geyer C, Wildgruber A, Kreichauf S, Lateva M, De Decker E, De Craemer M, Socha P, Moreno L, Iotova V, Koletzko BV, Manios Y. Designing and implementing teachers' training sessions in a kindergarten-based, family-involved intervention to prevent obesity in early childhood. The ToyBox-study. Obes Rev 2014; 15 Suppl 3:48-52. [PMID: 25047378 DOI: 10.1111/obr.12182] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 04/08/2014] [Accepted: 04/08/2014] [Indexed: 11/29/2022]
Abstract
Since school-based interventions are mainly delivered by the school staff, they need to be well-trained and familiarized with the programme's aims, procedures and tools. Therefore, the institute, research group, governmental or non-governmental body in charge of the coordination and implementation of the programme needs to devote time and resources to train the school staff before programme's implementation. This is particularly crucial in multi-centre studies where more than one research teams are involved. Both research teams and school staff need to be trained, using standard protocols and procedures, to ensure that the intervention will be delivered in a standardized manner throughout the intervention centres. The ToyBox-intervention, a multi-component, kindergarten-based, family-involved intervention, focusing on water consumption, snacking, physical activity and sedentary behaviours in preschool children, was implemented over the academic year 2012-2013 in six European countries. As part of this intervention, three teachers' training sessions were delivered to motivate and train teachers in implementing the intervention. The local researchers were trained centrally before delivering the training sessions for the teachers and followed a common protocol using standardized presentations and procedures. The aim of the current paper is to describe the protocol and methodological issues related to the teachers' training sessions conducted within the ToyBox-intervention.
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Affiliation(s)
- O Androutsos
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
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28
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Manios Y. Methodological procedures followed in a kindergarten-based, family-involved intervention implemented in six European countries to prevent obesity in early childhood: the ToyBox-study. Obes Rev 2014; 15 Suppl 3:1-4. [PMID: 25047373 DOI: 10.1111/obr.12178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 04/07/2014] [Accepted: 04/08/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Y Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
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29
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De Craemer M, De Decker E, De Bourdeaudhuij I, Verloigne M, Duvinage K, Koletzko B, Ibrügger S, Kreichauf S, Grammatikaki E, Moreno L, Iotova V, Socha P, Szott K, Manios Y, Cardon G. Applying the Intervention Mapping protocol to develop a kindergarten-based, family-involved intervention to increase European preschool children's physical activity levels: the ToyBox-study. Obes Rev 2014; 15 Suppl 3:14-26. [PMID: 25047375 DOI: 10.1111/obr.12180] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 04/08/2014] [Accepted: 04/08/2014] [Indexed: 11/28/2022]
Abstract
Although sufficient physical activity is beneficial for preschoolers' health, activity levels in most preschoolers are low. As preschoolers spend a considerable amount of time at home and at kindergarten, interventions should target both environments to increase their activity levels. The aim of the current paper was to describe the six different steps of the Intervention Mapping protocol towards the systematic development and implementation of the physical activity component of the ToyBox-intervention. This intervention is a kindergarten-based, family-involved intervention implemented across six European countries. Based on the results of literature reviews and focus groups with parents/caregivers and kindergarten teachers, matrices of change objectives were created. Then, theory-based methods and practical strategies were selected to develop intervention materials at three different levels: (i) individual level (preschoolers); (ii) interpersonal level (parents/caregivers) and (iii) organizational level (teachers). This resulted in a standardized intervention with room for local and cultural adaptations in each participating country. Although the Intervention Mapping protocol is a time-consuming process, using this systematic approach may lead to an increase in intervention effectiveness. The presented matrices of change objectives are useful for future programme planners to develop and implement an intervention based on the Intervention Mapping protocol to increase physical activity levels in preschoolers.
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Affiliation(s)
- M De Craemer
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
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30
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Payr A, Birnbaum J, Wildgruber A, Kreichauf S, Androutsos O, Lateva M, De Decker E, De Craemer M, Iotova V, Manios Y, Koletzko B. Concepts and strategies on how to train and motivate teachers to implement a kindergarten-based, family-involved intervention to prevent obesity in early childhood. The ToyBox-study. Obes Rev 2014; 15 Suppl 3:40-7. [PMID: 25047377 DOI: 10.1111/obr.12177] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 04/08/2014] [Indexed: 11/29/2022]
Abstract
The key person for the implementation of kindergarten-based behavioural interventions is the kindergarten teacher. When conducting intervention studies in kindergartens, training sessions are needed to train and motivate kindergarten teachers for programme implementation. This paper presents the systematic development of the teachers' trainings executed in the ToyBox-intervention - a kindergarten-based and family-involved obesity prevention programme for children aged 4-6. Based on concepts for the education of kindergarten teachers, on general strategies for successful programme implementation and on the ToyBox programme-specific requirements, the aims of the teachers' trainings were defined and an overall concept was deduced. Regarding the concept for the ToyBox teachers' training sessions, it is concluded that the training modules should focus on presenting information on the practical implementation of the intervention. Furthermore, these modules should also include self-efficacy enhancing components and should give kindergarten teachers opportunities to share experiences. Regarding the didactic methods applied in the ToyBox teachers' training sessions, constructivist learning approaches that facilitate active participation, reflective thinking and personal involvement were implemented. Emphasis was put not only on the content but especially on the didactic methods of teachers' trainings in order to enhance devotion to, and quality and sustainability of the ToyBox-intervention.
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Affiliation(s)
- A Payr
- Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
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31
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Sterdt E, Pape N, Kramer S, Liersch S, Urban M, Werning R, Walter U. Do children's health resources differ according to preschool physical activity programmes and parental behaviour? A mixed methods study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:2407-26. [PMID: 24577283 PMCID: PMC3986983 DOI: 10.3390/ijerph110302407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 01/20/2014] [Accepted: 02/13/2014] [Indexed: 11/16/2022]
Abstract
Preschool can have positive effects on the development of a healthy lifestyle. The present study analysed to what extent different conditions, structures and behavioural models in preschool and family—children’s central social microsystems—can lead to differences in children’s health resources. Using a cross-sectional mixed methods approach, contrast analyses of “preschools with systematic physical activity programmes” versus “preschools without physical activity programmes” were conducted to assess the extent to which children’s physical activity, quality of life and social behaviour differ between preschools with systematic and preschools without physical activity programmes. Differences in children’s physical activity according to parental behaviour were likewise assessed. Data on child-related outcomes and parent-related factors were collected via parent questionnaires and child interviews. A qualitative focused ethnographic study was performed to obtain deeper insight into the quantitative survey data. Two hundred and twenty seven (227) children were interviewed at 21 preschools with systematic physical activity programmes, and 190 at 25 preschools without physical activity programmes. There was no significant difference in children’s physical activity levels between the two preschool types (p = 0.709). However, the qualitative data showed differences in the design and quality of programmes to promote children’s physical activity. Data triangulation revealed a strong influence of parental behaviour. The triangulation of methods provided comprehensive insight into the nature and extent of physical activity programmes in preschools and made it possible to capture the associations between systematic physical activity promotion and children’s health resources in a differential manner.
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Affiliation(s)
- Elena Sterdt
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover 30625, Germany.
| | - Natalie Pape
- Institute of Education for Special Needs, Leibniz Universität Hannover, Hannover 30159, Germany.
| | - Silke Kramer
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover 30625, Germany.
| | - Sebastian Liersch
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover 30625, Germany.
| | - Michael Urban
- Faculty of Educational Science, Bielefeld University, Bielefeld 33501, Germany.
| | - Rolf Werning
- Institute of Education for Special Needs, Leibniz Universität Hannover, Hannover 30159, Germany.
| | - Ulla Walter
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover 30625, Germany.
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32
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Finch M, Wolfenden L, Morgan PJ, Freund M, Jones J, Wiggers J. A cluster randomized trial of a multi-level intervention, delivered by service staff, to increase physical activity of children attending center-based childcare. Prev Med 2014; 58:9-16. [PMID: 24145204 DOI: 10.1016/j.ypmed.2013.10.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 08/22/2013] [Accepted: 10/04/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the impact of a multi-level intervention on the physical activity levels of 3-5 year old children attending center-based childcare services. METHOD The trial was conducted in New South Wales Australia in 2010 in 20 centers with 459 children. The intervention, included: fundamental movement skill sessions; structured activities; staff role modelling; limiting small screen recreation and sedentary time; and anactivity promoting physical environment. Control services continued with usual routines. Physical activity during care was assessed using pedometers at baseline and at six months after baseline. Intervention implementation was assessed via observation of staff physical activity practices and audits of service environment and policy. RESULTS Mean step counts at baseline and follow-up were 17.20 (CI 15.94-18.46) and 16.12 (CI 14.86-17.30) in the intervention group and 13.78 (CI 12.76-14.80) and 13.87 (CI 12.57-15.17) in the control group (p=0.12). Intervention services showed significantly greater increases in the total minutes that teachers led structured activities, relative to control group services (p=0.02). CONCLUSION The intervention showed no significant effect on child step counts per minute despite increasing time that staff delivered structured activity which is likely to be attributable to difficulties experienced by service staff in delivering a number of intervention components.
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Affiliation(s)
- Meghan Finch
- Hunter New England Population Health, Newcastle, NSW, Australia; School of Medicine and Public Health University of Newcastle, Newcastle, NSW, Australia.
| | - Luke Wolfenden
- School of Medicine and Public Health University of Newcastle, Newcastle, NSW, Australia
| | - Philip J Morgan
- School of Education, University of Newcastle, Newcastle, NSW, Australia; Priority Research Center in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia
| | - Megan Freund
- Hunter New England Population Health, Newcastle, NSW, Australia; School of Medicine and Public Health University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Jannah Jones
- Hunter New England Population Health, Newcastle, NSW, Australia
| | - John Wiggers
- Hunter New England Population Health, Newcastle, NSW, Australia; School of Medicine and Public Health University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
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33
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Pate RR, O'Neill JR, Brown WH, McIver KL, Howie EK, Dowda M. Top 10 research questions related to physical activity in preschool children. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2013; 84:448-455. [PMID: 24592775 DOI: 10.1080/02701367.2013.844038] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this article was to highlight important research needs related to physical activity in 3- to 5-year-old children. We identified research needs in 3 major categories: health effects, patterns of physical activity, and interventions and policies. The top research needs include identifying the health effects of physical activity, the effects of physical activity on the development of healthy weight, the effects of physical activity on learning and behavior, and the health implications of sedentary behavior. Research questions concerning patterns of physical activity include determining the prevalence of 3- to 5-year-olds meeting the current physical activity guidelines; the social and environmental factors that influence physical activity in home, preschool, and community settings; and how physical activity tracks into later childhood, adolescence, and adulthood. Research questions about interventions and policies include identifying the most effective strategies to promote physical activity in home, child care, and community settings and to reach diverse populations of young children, identifying effective intervention implementation and dissemination strategies, and determining the effectiveness of national, state, local, and institutional policies for increasing physical activity. In conclusion, research is needed to establish a full understanding of the health implications of physical activity in 3- to 5-year-old children, to better understand the nature of physical activity behavior in this group, and to learn how to promote physical activity in young children.
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Affiliation(s)
- Russell R Pate
- Children's Physical Activity Research Group, University of South Carolina, Public Health Research Center, 921 Assembly, Suite 214, Columbia, SC 29208, USA.
| | - Jennifer R O'Neill
- Children's Physical Activity Research Group, University of South Carolina, Public Health Research Center, 921 Assembly, Suite 214, Columbia, SC 29208, USA
| | - William H Brown
- Children's Physical Activity Research Group, University of South Carolina, Public Health Research Center, 921 Assembly, Suite 214, Columbia, SC 29208, USA
| | - Kerry L McIver
- Children's Physical Activity Research Group, University of South Carolina, Public Health Research Center, 921 Assembly, Suite 214, Columbia, SC 29208, USA
| | - Erin K Howie
- Children's Physical Activity Research Group, University of South Carolina, Public Health Research Center, 921 Assembly, Suite 214, Columbia, SC 29208, USA
| | - Marsha Dowda
- Children's Physical Activity Research Group, University of South Carolina, Public Health Research Center, 921 Assembly, Suite 214, Columbia, SC 29208, USA
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Céspedes J, Briceño G, Farkouh ME, Vedanthan R, Baxter J, Leal M, Boffetta P, Hunn M, Dennis R, Fuster V. Promotion of cardiovascular health in preschool children: 36-month cohort follow-up. Am J Med 2013; 126:1122-6. [PMID: 24262725 PMCID: PMC4106297 DOI: 10.1016/j.amjmed.2013.06.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Educational interventions in preschool children could improve dietary behavior and physical activity, and prevent unhealthy body weights in low- and middle-income countries. Previously, we have reported the beneficial impact of an educational intervention in preschoolers in a 6-month trial. We now report extended results after 36 months. METHODS Evaluating the cohort of previously intervened children, baseline measurements were made in May 2009 in 14 preschool facilities in Usaquén (Bogotá, Colombia). Follow-up measurements were performed at 18 and 36 months. The primary outcome was the mean change in children's knowledge and attitudes scores regarding healthy eating and living an active lifestyle, including habits scores related to physical activity. Secondary outcomes were the change over time of children's nutritional status and the mean change in parent's knowledge, attitudes, and habits. RESULTS We included 1216 children, 3-5 years of age, and 928 parents. After adjusting by sex and age of children, socioeconomic status, age of parents, and age and education level of teachers, we found a significant increase in mean knowledge, attitudes, and habits scores at 36 months, compared with baseline: 87.94 vs 76.15 (P <.001); 86.39 vs 57.03 (P <.001); and 66.29 vs 48.72 (P <.001), respectively. We observed a similar increase in knowledge and attitude scores in parents: 73.45 vs 70.01 (P <.001); and 78.08 vs 74.65 (P <.001). The proportion of eutrophic children increased from 62.1% at baseline to 75.0% at 36 months (P <.0001). CONCLUSIONS After 36 months, the educational intervention maintained a beneficial trend toward a healthy lifestyle in children and their parents.
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Affiliation(s)
- Jaime Céspedes
- Fundación Cardioinfantil Instituto de Cardiología, Bogotá, Colombia
| | - German Briceño
- Fundación Cardioinfantil Instituto de Cardiología, Bogotá, Colombia
| | - Michael E. Farkouh
- Icahn School of Medicine at Mount Sinai, New York, NY
- Peter Munk Cardiac Centre and Li Ka Shing Knowledge Institute, University of Toronto, Ont, Canada
| | | | | | - Martha Leal
- Fundación Cardioinfantil Instituto de Cardiología, Bogotá, Colombia
| | | | - Marilyn Hunn
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - Rodolfo Dennis
- Fundación Cardioinfantil Instituto de Cardiología, Bogotá, Colombia
| | - Valentin Fuster
- Icahn School of Medicine at Mount Sinai, New York, NY
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
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van Sluijs EMF, McMinn AM, Inskip HM, Ekelund U, Godfrey KM, Harvey NC, Griffin SJ. Correlates of light and moderate-to-vigorous objectively measured physical activity in four-year-old children. PLoS One 2013; 8:e74934. [PMID: 24040365 PMCID: PMC3764204 DOI: 10.1371/journal.pone.0074934] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 08/07/2013] [Indexed: 12/31/2022] Open
Abstract
Background Correlates of physical activity (PA) are hypothesized to be context and behaviour specific, but there is limited evidence of this in young children. The aim of the current study is to investigate associations between personal, social and environmental factors and objectively measured light and moderate-to-vigorous PA (LPA and MVPA, respectively) in four-year-old children. Methods Cross-sectional data were used from the Southampton Women’s Survey, a UK population-based longitudinal study. Four-year old children (n = 487, 47.0% male) had valid PA data assessed using accelerometry (Actiheart) and exposure data collected with a validated maternal questionnaire (including data on child personality, family demographics, maternal behaviour, rules and restrictions, and perceived local environment). Linear regression modelling was used to analyse associations with LPA and MVPA separately, interactions with sex were explored. Results LPA minutes were greater in children whose mothers reported more PA (vs. inactive: regression coefficient±standard error: 6.70±2.94 minutes), and without other children in the neighbourhood to play with (−6.33±2.44). MVPA minutes were greater in children with older siblings (vs. none: 5.81±2.80) and those whose mothers used active transport for short trips (vs. inactive: 6.24±2.95). Children accumulated more MVPA in spring (vs. winter: 9.50±4.03) and, in boys only, less MVPA with availability of other children in the neighbourhood (−3.98±1.70). Discussion Young children’s LPA and MVPA have differing associations with a number of social and environmental variables. Interventions targeting PA promotion in young children outside of formal care settings should consider including intensity specific factors.
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Affiliation(s)
- Esther M. F. van Sluijs
- Medical Research Council Epidemiology Unit, Cambridge, United Kingdom
- UKCRC Centre for Diet and Activity Research (CEDAR), Cambridge, United Kingdom
- * E-mail:
| | - Alison M. McMinn
- Medical Research Council Epidemiology Unit, Cambridge, United Kingdom
- UKCRC Centre for Diet and Activity Research (CEDAR), Cambridge, United Kingdom
| | - Hazel M. Inskip
- Medical Research Council Lifecourse Epidemiology Unit, Southampton, United Kingdom
| | - Ulf Ekelund
- Medical Research Council Epidemiology Unit, Cambridge, United Kingdom
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Nicholas C. Harvey
- Medical Research Council Lifecourse Epidemiology Unit, Southampton, United Kingdom
| | - Simon J. Griffin
- Medical Research Council Epidemiology Unit, Cambridge, United Kingdom
- UKCRC Centre for Diet and Activity Research (CEDAR), Cambridge, United Kingdom
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36
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Do preschools differ in promoting children's physical activity? An instrument for the assessment of preschool physical activity programmes. BMC Public Health 2013; 13:795. [PMID: 24005037 PMCID: PMC3844298 DOI: 10.1186/1471-2458-13-795] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 08/29/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preschools offer high potential for preventive interventions. However, little is known about the structure of preschool programmes to promote physical activity (PA) in preschoolers although almost all children aged three to six years spend one third of the day at preschool. The aim of this study was to determine whether and to what extent preschools implement systematic PA promotion measures using an instrument specifically developed to assess and systematize preschool PA programmes. METHODS In the cross-sectional study a baseline survey of preschool education policies was conducted to identify and assess the type and extent of PA programmes and opportunities in preschools in the State of Lower Saxony, Germany. An assessment instrument was developed to identify preschools with systematic PA programmes (type 1) and those without PA programmes (type 2) based on the following quality criteria: A) written PA policy, B) structured weekly PA offerings for all children; C) at least one qualified physical education teacher; D) PA-friendly indoor and outdoor facilities (exercise room, situational PA opportunities, outdoor areas, play equipment etc.), and E) structured PA promotion in place for at least two years. A third type of preschool that promotes PA in children to some extent (i.e., that meets the criteria partially but not completely) was classified as "preschools with limited PA programmes". RESULTS 2415 preschools participated in the survey (response rate: 59%). The results show that 26% (n = 554) have a systematic PA programme while 3% (n = 64) have no PA programme. Most (71%, n = 1514) were classified as limited PA programme preschools. All three types of preschools differed significantly (p = .000) from each other in terms of size (small vs. large). Most of the preschools without PA programmes are small half-day preschools. CONCLUSIONS The study investigated an assessment-instrument providing extensive insight into the nature, extent and routine practical implementation of PA promotion in preschools. The criteria used to evaluate preschool PA programmes are well-suited to identify the different preschool PA programme types and target areas in the field of PA promotion in which specific measures (teacher education, structured PA offerings, etc.) can be implemented in future interventions.
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Escalante Y, García-Hermoso A, Backx K, Saavedra JM. Playground designs to increase physical activity levels during school recess: a systematic review. HEALTH EDUCATION & BEHAVIOR 2013; 41:138-44. [PMID: 23836828 DOI: 10.1177/1090198113490725] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
School recess provides a major opportunity to increase children's physical activity levels. Various studies have described strategies to increase levels of physical activity. The purpose of this systematic review is therefore to examine the interventions proposed as forms of increasing children's physical activity levels during recess. A systematic search of seven databases was made from the July 1 to July 5, 2012, leading to a final set of eight studies (a total of 2,383 subjects-599 "preschoolers" and 1,784 "schoolchildren") meeting the inclusion criteria. These studies were classified according to the intervention used: playground markings, game equipment, playground markings plus physical structures, and playground markings plus game equipment. The results of these studies indicate that the strategies analyzed do have the potential to increase physical activity levels during recess. The cumulative evidence was (a) that interventions based on playground markings, game equipment, or a combination of the two, do not seem to increase the physical activity of preschoolers and schoolchildren during recess and (ii) that interventions based on playground markings plus physical structures do increase the physical activity of schoolchildren during recess in the short to medium term.
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38
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Bonvin A, Barral J, Kakebeeke TH, Kriemler S, Longchamp A, Schindler C, Marques-Vidal P, Puder JJ. Effect of a governmentally-led physical activity program on motor skills in young children attending child care centers: a cluster randomized controlled trial. Int J Behav Nutr Phys Act 2013; 10:90. [PMID: 23835207 PMCID: PMC3724593 DOI: 10.1186/1479-5868-10-90] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 07/02/2013] [Indexed: 11/10/2022] Open
Abstract
Objective To assess the effect of a governmentally-led center based child care physical activity program (Youp’là Bouge) on child motor skills. Patients and methods We conducted a single blinded cluster randomized controlled trial in 58 Swiss child care centers. Centers were randomly selected and 1:1 assigned to a control or intervention group. The intervention lasted from September 2009 to June 2010 and included training of the educators, adaptation of the child care built environment, parental involvement and daily physical activity. Motor skill was the primary outcome and body mass index (BMI), physical activity and quality of life secondary outcomes. The intervention implementation was also assessed. Results At baseline, 648 children present on the motor test day were included (age 3.3 ± 0.6, BMI 16.3 ± 1.3 kg/m2, 13.2% overweight, 49% girls) and 313 received the intervention. Relative to children in the control group (n = 201), children in the intervention group (n = 187) showed no significant increase in motor skills (delta of mean change (95% confidence interval: -0.2 (−0.8 to 0.3), p = 0.43) or in any of the secondary outcomes. Not all child care centers implemented all the intervention components. Within the intervention group, several predictors were positively associated with trial outcomes: 1) free-access to a movement space and parental information session for motor skills 2) highly motivated and trained educators for BMI 3) free-access to a movement space and purchase of mobile equipment for physical activity (all p < 0.05). Conclusion This “real-life” physical activity program in child care centers confirms the complexity of implementing an intervention outside a study setting and identified potentially relevant predictors that could improve future programs. Trial registration Clinical trials.gov NCT00967460
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Lessard L, Williams Leng S, Brennan R. Consistency of compliance with nutrition-related regulations among Delaware child care centers. Child Obes 2013; 9:233-9. [PMID: 23675900 DOI: 10.1089/chi.2012.0126] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND As more calls are made in the literature for nutrition interventions to be delivered in child care settings, research on the implementation of these interventions becomes more important. This study examined compliance with Delaware's regulations related to nutrition in child care settings, which are designed to improve the nutrition-related environment in these settings. METHODS A stratified random sample of licensed child care centers (n=233) was created from the total population of eligible centers in Delaware (N=450). Study staff visited each center and distributed self-administered surveys to the director and two randomly selected teachers. Surveys contained items about classroom-level compliance with the regulations along with center-level characteristics. Bivariate analyses were conducted to explore relationships between consistent compliance with each regulation component and center-level characteristics. RESULTS A total of 179 of the 233 centers in the selected sample participated in the study. Compliance with the regulations varied within centers and across components; the highest levels of consistent compliance were reported for juice type (88.3%) and the lowest levels for whole grains (18.6%). Center characteristics, such as participation in the Child and Adult Care Food Program, were associated with consistent compliance for certain regulations components. CONCLUSIONS Our results suggest that these types of regulations can be implemented across a diversity of centers, but that certain components (e.g., those relating to whole grains and water) may need further clarification. Our results also suggest that there are certain types of centers on which to focus training efforts to maximize compliance.
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Affiliation(s)
- Laura Lessard
- College of Health Sciences, Arcadia University, Glenside, PA 19038, USA.
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Lakshman R, Mazarello Paes V, Hesketh K, O'Malley C, Moore H, Ong K, Griffin S, van Sluijs E, Summerbell C. Protocol for systematic reviews of determinants/correlates of obesity-related dietary and physical activity behaviors in young children (preschool 0 to 6 years): evidence mapping and syntheses. Syst Rev 2013; 2:28. [PMID: 23663239 PMCID: PMC3691606 DOI: 10.1186/2046-4053-2-28] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 04/22/2013] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The aim of these reviews is to inform the design and content of interventions to reduce obesity in young children. The behaviors that are associated with obesity/overweight have been studied extensively; however, the factors associated with these behaviors in young children (0 to 6 years) have not been systematically reviewed. Over the past few years the focus of obesity prevention has shifted to preschool children because of the high prevalence of obesity at school entry and recognition that habits formed in early life could track into adulthood. In order to develop effective interventions and change behavior, it is important to understand the factors that are associated with those behaviors. For example, we need to understand whether it would be more important to target the family, childcare settings or the wider environment and identify the most effective way of changing these energy balance related behaviors. METHODS/DESIGN Quantitative (intervention and observational) and qualitative literature on determinants/correlates of fruit and vegetable intake, sugar sweetened beverage and other unhealthy diet intake, and physical activity and sedentary behaviors in young children will be systematically identified, mapped and reviewed. A common search strategy (no language or period restrictions) will be used to identify papers from eight electronic databases and this will be supplemented by hand-searching. Next, studies in developed countries that examine the factors associated with these behaviors in children aged 0 to 6 years (at baseline) will be screened and mapped descriptively followed by in-depth data extraction, quality assessment and synthesis. Data from quantitative studies will be summarized using either forest plots or harvest plots and narrative synthesis, and qualitative studies using thematic analysis. Qualitative evidence will be integrated with the quantitative evidence, using a parallel synthesis approach, to provide a deeper understanding of effective strategies to influence these energy balance related behaviors. DISCUSSION In addition to updating and mapping current research, these reviews will be the first to comprehensively synthesize and integrate both the quantitative and qualitative evidence pertaining to determinants/correlates/barriers/facilitators of obesity related behaviors in this young age group (0 to 6 years) with the aim of informing future interventions. TRIAL REGISTRATION International Prospective Register for Systematic Reviews (PROSPERO) Registration number: CRD42012002881.
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Krombholz H. The impact of a 20-month physical activity intervention in child care centers on motor performance and weight in overweight and healthy-weight preschool children. Percept Mot Skills 2013; 115:919-32. [PMID: 23409603 DOI: 10.2466/06.10.25.pms.115.6.919-932] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A child-centered physical activity intervention was administered in child care centers over 20 months to promote motor performance and reduce weight in preschool children. The intervention group (N = 211) received at least one weekly 45-min. session of physical education and sessions of physical activities of at least 20 minutes on the other days. Control children (N = 217) experienced the regular curriculum, which consisted of one session of physical activities of 45 min. per week. At the end of the study, children in the intervention group surpassed children in the control group in motor performance (body coordination, physical fitness, and dexterity, measured by a motor test battery MoTB 3-7). Children in the top 20% by BMI at the beginning of the study ("high weight") had inferior motor performance. Children with higher BMIs in the intervention group had better motor scores than children with higher BMIs in the control group, but the intervention had no effect on body weight, BMI, or skinfold thickness.
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Affiliation(s)
- Heinz Krombholz
- State Institute of Early Childhood Research, Munich, Germany.
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Abstract
Gross and fine motor skills and cognitive performance in obese and overweight children were compared to healthy weight children. Participants were 1,543 children (797 boys and 746 girls) ages 43 to 84 months, attending child-care centers in Munich, Germany. According to German Body Mass Index (BMI) standards for age and sex, 4.6% of the children were classified as obese (percentile greater or equal 97), 6.8% as overweight (percentile greater or equal 90 and less than 97), 5.9% as underweight (percentile less than 10), and 83.1% as being of healthy weight. Dependent variables were physical characteristics (height, weight, skinfold thickness), physical fitness (standing broad jump, shuttle run, hanging), body coordination (balancing forward, balancing backward, lateral jump, hopping), manual dexterity (right and left hand), and cognitive performance (intelligence, verbal ability, concentration). Higher proportions of children from lower socioeconomic and immigrant backgrounds were overweight. There was no association between weight and sex. Overweight children showed lower performance on gross motor skills (coordination and fitness), manual dexterity, and intelligence compared to healthy weight children, even after controlling for the effects of social class and immigration status.
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Affiliation(s)
- Heinz Krombholz
- State Institute of Early Childhood Education and Research, Munich
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Goldfield GS, Harvey A, Grattan K, Adamo KB. Physical activity promotion in the preschool years: a critical period to intervene. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:1326-42. [PMID: 22690196 PMCID: PMC3366614 DOI: 10.3390/ijerph9041326] [Citation(s) in RCA: 144] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 03/13/2012] [Accepted: 03/22/2012] [Indexed: 12/22/2022]
Abstract
The primary aim of this paper is to provide a rationale for the necessity of intervening with a physical activity intervention in the preschool years and why the daycare environment is amenable to such intervention. We also review the prevalence of physical activity, sedentary behaviour and obesity in the preschool population and the impact that these lifestyle behaviours and conditions have on the health of preschool aged children, as secondary objectives. Moreover we discuss implications for intervention and research using a "lessons learned" model based on our research team's experience of conducting a randomized controlled trial aimed at increasing physical activity, reducing sedentary behaviour and improving motor skill development and body composition in preschoolers. Lastly, we make conclusions based on the literature and highlight issues and directions that need to be addressed in future research in order to maximize health promotion and chronic disease prevention in the pediatric population.
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Affiliation(s)
- Gary S. Goldfield
- Healthy Active Living & Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; (G.S.G.); (A.H.); (K.G.)
- Department of Pediatrics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Department of Psychology, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Alysha Harvey
- Healthy Active Living & Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; (G.S.G.); (A.H.); (K.G.)
| | - Kimberly Grattan
- Healthy Active Living & Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; (G.S.G.); (A.H.); (K.G.)
| | - Kristi B. Adamo
- Healthy Active Living & Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; (G.S.G.); (A.H.); (K.G.)
- Department of Pediatrics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
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Manios Y, Grammatikaki E, Androutsos O, Chinapaw MJM, Gibson EL, Buijs G, Iotova V, Socha P, Annemans L, Wildgruber A, Mouratidou T, Yngve A, Duvinage K, de Bourdeaudhuij I. A systematic approach for the development of a kindergarten-based intervention for the prevention of obesity in preschool age children: the ToyBox-study. Obes Rev 2012; 13 Suppl 1:3-12. [PMID: 22309061 DOI: 10.1111/j.1467-789x.2011.00974.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The increasing childhood obesity epidemic calls for appropriate measures and effective policies to be applied early in life. Large-scale socioecological frameworks providing a holistic multifactorial and cost-effective approach necessary to support obesity prevention initiatives in this age are however currently missing. To address this missing link, ToyBox-study aims to build and evaluate a cost-effective kindergarten-based, family-involved intervention scheme to prevent obesity in early childhood, which could potentially be expanded on a pan-European scale. A multidisciplinary team of researchers from 10 countries have joined forces and will work to realize this according to a systematic stepwise approach that combines the use of the PRECEDE-PROCEED model and intervention mapping protocol. ToyBox-study will conduct systematic and narrative reviews, secondary data analyses, focus group research and societal assessment to design, implement and evaluate outcome, impact, process and cost effectiveness of the intervention. This is the first time that such a holistic approach has been used on a pan-European scale to promote healthy weight and healthy energy balance-related behaviours for the prevention of early childhood obesity. The results of ToyBox-study will be disseminated among key stakeholders including researchers, policy makers, practitioners and the general population.
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Affiliation(s)
- Y Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
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