Influence of the day care, home and neighbourhood environment on young children's physical activity and health: protocol for the PLAYCE observational study

Longitudinal effects of dog ownership, dog acquisition, and dog loss on children's movement behaviours: findings from the PLAYCE cohort study

INTRODUCTION

Regular physical activity is important for children's physical and mental health, yet many children do not achieve recommended amounts of physical activity. Dog ownership has been associated with increased physical activity in children, however, there have been no longitudinal studies examining this relationship. This study used data from the Play Spaces and Environments for Children's Physical Activity (PLAYCE) cohort study to examine the longitudinal effects of dog ownership status on children's movement behaviours.

METHODS

Change in dog ownership from preschool (wave 1, age 2-5) to fulltime school (wave 2, age 5-7) was used as a natural experiment with four distinct dog ownership groups: continuing non-dog owners (n = 307), continuing dog owners (n = 204), dog acquired (n = 58), and dog loss (n = 31; total n = 600). Daily movement behaviours, including physical activity, sedentary time, sleep, and screen time, were measured using accelerometry and parent-report surveys. Differences between groups over time and by sex were tested using linear mixed effects regression models.

RESULTS

Girls who acquired a dog increased their light intensity activities and games by 52.0 min/day (95%CI 7.9, 96.0) and girls who lost a dog decreased their light intensity activities and games by 62.1 min/day (95%CI -119.3, -4.9) compared to no change among non-dog owners. Girls and boys who acquired a dog increased their unstructured physical activity by 6.8 (95%CI 3.2, 10.3) and 7.1 (95%CI 3.9, 10.3) occasions/week, compared to no changes among non-dog owners. Girls and boys who lost a dog reduced their unstructured physical activity by 10.2 (95%CI -15.0, -5.3) and 7.7 (95%CI -12.0, -3.5) occasions/week. Girls who lost a dog decreased their total physical activity by 46.3 min/day (95%CI -107.5, 14.8) compared to no change among non-dog owners. Continuing dog ownership was typically not associated with movement behaviours. Dog ownership group was not associated with changes in sleep and had mixed associations with screen time.

CONCLUSION

The positive influence of dog ownership on children's physical activity begins in early childhood and differs by child sex. Further research should examine the specific contributions dog-facilitated physical activity makes to children's overall physical activity, including the intensity and duration of dog walking and play.

Association between preschooler outdoor play and home yard vegetation as measured by high resolution imagery: Findings from the PLAYCE study

Outdoor play in the home yard is an important source of physical activity for many preschoolers. This study investigated if home yard size and vegetation are related to preschooler outdoor play time. High-resolution remotely sensed data were used to distinguish between types of vegetation coverage in the home yard. Shrub and tree cover, and yard size, were positively associated with outdoor play. Following stratification by socio-economic status (SES - parent education), only tree cover was positively associated with preschooler outdoor play in low SES households. All types of vegetation cover were positively associated with preschooler outdoor play in higher SES households. This study highlights the importance of larger yard sizes and higher levels of vegetation for facilitating outdoor play in preschoolers.

Neighborhood Places for Preschool Children's Physical Activity: A Mixed-Methods Study Using Global Positioning System, Geographic Information Systems, and Accelerometry Data

BACKGROUND

This study adds to the current literature by using a novel device-based method to explore where preschool children are physically active outside of home and childcare settings. This study combined accelerometry with geospatial data to explore the influence of the environment on preschool children's physical activity by objectively identifying the locations where preschool children engage in moderate to vigorous physical activity (MVPA) within and outside of their neighborhood.

METHODS

Accelerometry, Global Positioning System, and Geographic Information Systems data from 168 preschool children aged 2-5 years were processed in ArcGIS Pro to identify locations (per 25 × 25-m fishnet cell) with high MVPA counts. Locations with high MVPA counts were defined as those with the top 20% of MVPA counts per fishnet cell. The land use for high MVPA count location was determined for 3 domains: <500 m from home, 500 to 1600 m from home, and >1600 m from home.

RESULTS

Locations with high MVPA counts <500 m from home were playgrounds (66.6%), schools (16.7%), and parks (16.7%). Locations with high MVPA counts 500 to 1600 m from home included playgrounds (33.3%), nonhome residential (29.6%), childcare centers (11.1%), and parks (3.7%). Locations with high MVPA counts >1600 m from home included nonhome residential (54.7%), sports and recreation centers (11.1%), playgrounds (6.8%), and parks (5.3%).

CONCLUSIONS

Our findings highlight that local parks and playgrounds provide physical activity opportunities for preschool children, yet beyond the local neighborhood, the homes of others are important locations for preschool children to accumulate MVPA. These findings can be used to inform the design of current and future neighborhood places to better accommodate preschool children's MVPA.

The moderating role of parent perceptions in relationships between objectively measured neighbourhood environment attributes and pre-schooler's physical activity: Findings from the PLAYCE study

We examined the moderating effects of parent perceptions of the neighbourhood environment on associations between objectively measured neighbourhood environment attributes and physical activity among pre-schoolers. The number of neighbourhood parks was positively associated with pre-schooler energetic play when parents had above average perceptions of access to services. Objectively measured street connectivity was associated with fewer minutes of energetic play when pedestrian and traffic safety was perceived to be below average by parents. Greater understanding of the role played by parents in pre-schooler's exposure to physically active supportive environments is needed to inform environmental interventions for specific age groups.

Correlates of Sedentary Time Among Children and Adolescents in Ethiopia: A Cross-Sectional Study

PURPOSE

To assess the correlates of sedentary time among children and adolescents in Ethiopia.

METHODS

The study was conducted in representative samples of children and adolescents in the capital city of Ethiopia, Addis Ababa. Multivariable logistic regression models were used to determine associations of sedentary time and predictor variables.

RESULTS

The mean sedentary time was 4.61 (95% confidence interval [CI], 4.35-4.86) hours per day. Overall, the prevalence of high sedentary time (>3 h/d) was 68.2% (95% CI, 64.2-72.2). Results of multivariable logistic regression analyses showed a statistically significant association between high sedentary time and female household head (adjusted odds ratio [AOR] = 0.50; 95% CI, 0.32-0.80), literate mothers (AOR = 1.98; 95% CI, 1.26-3.11), child attending public school (AOR = 1.79; 95% CI, 1.12-2.85), children who belonged to the poor and rich household wealth tertiles compared with medium wealth tertile (AOR = 2.30; 95% CI, 1.42-3.72 and AOR = 2.04; 95% CI, 1.14-3.65, respectively), and those families that did not have adequate indoor play space for children (AOR = 0.45; 95% CI, 0.29-0.72).

CONCLUSION

The study found that time spent sedentary was high in the study area as compared with other studies of similar settings. Several modifiable factors were identified that can be targeted in interventions to reduce sedentary time in the study setting.

Built Environments And Child Health in WalEs and AuStralia (BEACHES): a study protocol

INTRODUCTION

Childhood obesity and physical inactivity are two of the most significant modifiable risk factors for the prevention of non-communicable diseases (NCDs). Yet, a third of children in Wales and Australia are overweight or obese, and only 20% of UK and Australian children are sufficiently active. The purpose of the Built Environments And Child Health in WalEs and AuStralia (BEACHES) study is to identify and understand how complex and interacting factors in the built environment influence modifiable risk factors for NCDs across childhood.

METHODS AND ANALYSIS

This is an observational study using data from five established cohorts from Wales and Australia: (1) Wales Electronic Cohort for Children; (2) Millennium Cohort Study; (3) PLAY Spaces and Environments for Children's Physical Activity study; (4) The ORIGINS Project; and (5) Growing Up in Australia: the Longitudinal Study of Australian Children. The study will incorporate a comprehensive suite of longitudinal quantitative data (surveys, anthropometry, accelerometry, and Geographic Information Systems data) to understand how the built environment influences children's modifiable risk factors for NCDs (body mass index, physical activity, sedentary behaviour and diet).

ETHICS AND DISSEMINATION

This study has received the following approvals: University of Western Australia Human Research Ethics Committee (2020/ET000353), Ramsay Human Research Ethics Committee (under review) and Swansea University Information Governance Review Panel (Project ID: 1001). Findings will be reported to the following: (1) funding bodies, research institutes and hospitals supporting the BEACHES project; (2) parents and children; (3) school management teams; (4) existing and new industry partner networks; (5) federal, state and local governments to inform policy; as well as (6) presented at local, national and international conferences; and (7) disseminated by peer-reviewed publications.

Meeting the Australian 24-Hour Movement Guidelines for the Early Years is associated with better social-emotional development in preschool boys

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Only 8% of preschool children meet all three 24-hour movement guidelines.

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Meeting 24-hour movement guidelines associated with boy’s social-emotional development.

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Dose–response evidence needed to identify guideline thresholds for health outcomes.

24-hour Movement Guidelines for the Early Years promote that achieving all three-movement behaviour (sleep, sedentary behaviour and physical activity) recommendations is important for child health and development. We examined the association between meeting all, none and combinations of the Australian 24-Hour Movement Guidelines for the Early Years and social-emotional development in 1363 preschool (2–5 years) boys (52%) and girls. The PLAYCE study (Perth, Western Australia) parent survey collected data on children’s social-emotional development (Strengths & Difficulties Questionnaire), screen time, sleep and socio-demographic factors. Physical activity was measured using seven-day accelerometry. Only 8% of preschoolers met all three guidelines (5% met none). A higher proportion of boys than girls met physical activity-related guideline combinations (physical activity only, physical activity plus screen, physical activity plus sleep, all), while more girls than boys met sleep only guidelines (all p < 0.05). In boys, meeting all guidelines, compared with none, was associated with a lower total difficulties score (adjusted difference in means −1.90; 95%CI: −3.88, −0.10). Meeting the screen only guideline or the screen plus sleep guidelines, compared with none, were associated with lower total difficulties, conduct problems and hyperactivity scores in boys (all p < 0.05). Meeting the physical activity plus sleep guidelines, compared with none, were associated with lower total difficulties and conduct problems scores in boys (all p < 0.05). No significant associations were found for girls. These findings highlight the positive impact for boys social-emotional development in meeting all guidelines. Future guideline development should consider dose–response evidence to identify guideline thresholds for specific health and developmental outcomes for boys and girls.

Parents' Perceptions of the Neighbourhood Built Environment Are Associated with the Social and Emotional Development of Young Children

The influence of the neighbourhood built environment on young children’s physical development has been well-documented; however, there is limited empirical evidence of an association with social and emotional development. Parental perceptions of the neighbourhood built environment may act as facilitators or barriers to young children’s play and interactions in their local environment. The aim of this study was to examine the associations between parents’ perceptions of the neighbourhood built environment and the social-emotional development of children aged two-to-five years. Parents’ positive perceptions of traffic safety (OR 0.74; 95% CI 0.55, 0.98), crime safety (OR 0.79; 95% CI 0.64, 0.99) and land use mix–access (OR 0.74; 95% CI 0.56, 0.98) were associated with lower odds of social-emotional difficulties, while positive perceptions of walking and cycling facilities were associated with higher odds of difficulties (OR 1.26; 95% CI 1.02, 1.55). Positive perceptions of land use mix–access (OR 1.32; 95% CI 1.03, 1.69), street connectivity (OR 1.35; 95% CI 1.10, 1.66) and neighbourhood aesthetics (OR 1.27; 95% CI 1.01, 1.60) were associated with higher odds of prosocial behaviours. Interventions to improve parents’ perceptions of built environment features may facilitate opportunities for play and interactions which contribute to healthy social-emotional development.

A mobile health intervention to encourage physical activity in children: a randomised controlled trial

Background

Despite immense benefits of physical activity on health and developmental outcomes, few children achieve recommended daily levels of physical activity. Given more than half of families with children own a dog, we investigated the effect of a mobile health (mHealth) intervention to encourage dog-facilitated physical activity through increased family dog walking and children’s active play with their dog.

Methods

The PLAYCE PAWS study was a three-armed randomised pilot trial conducted in Perth, Western Australia. Children aged 5-10 years with a family dog were randomised to 4 weeks of either 1) SMS-only intervention, 2) ‘SMS + pedometer’ intervention or 3) ‘usual care’ control. The mHealth intervention involved SMS messages to parents; the ‘SMS + pedometer’ group also received a dog pedometer and personalised dog steps diary. Parent-reported measures were collected at baseline, 1- and 3-months post intervention. The primary outcome was weekly frequency of family dog walking and dog play; secondary outcomes were child attachment to the dog and feasibility of the intervention.

Results

A total of 150 children were randomised in staggered blocks to SMS-only (n = 50), ‘SMS + pedometer’ (n = 50) or usual care (n = 50). No differences were observed in family dog walking and dog play at 1-month. SMS-only children (OR 2.6, 95% CI 1.17, 5.83, P = 0.019) and all intervention children (OR 1.97, 95% CI 1.01, 3.86, P = 0.048) were more likely to increase total dog-facilitated physical activity (sum of family dog walking and dog play responses) at 3-months. The positive associations with total dog-facilitated physical activity disappeared (all P > 0.05) after adjusting for socio-demographic factors.

Conclusions

The PLAYCE PAWS mHealth intervention did not significantly affect dog-facilitated physical activity in children. Given high levels of dog ownership in the community, SMS prompts could be a low-cost intervention to encourage more physical activity in children. Further research is needed to understand how increased interaction with the family dog impacts on children’s overall physical activity and other health and development outcomes.

Trial registration

ANZCTR, ACTRN12620000288921, retrospectively registered on 4/3/2020.

Association between preschooler movement behaviours, family dog ownership, dog play and dog walking: Findings from the PLAYCE study

Physical inactivity in childhood is a major public health issue. Dog ownership has been widely reported to lead to greater physical activity in adults and school-aged children. We examined if dog ownership and dog-facilitated physical activity were associated with higher physical activity in preschoolers. Secondary analysis of the 'Play Spaces & Environments for Children's Physical Activity' (PLAYCE, 2015-2018) study involving 1366, 2-5-year-olds from 122 long day-care centres in Perth, Australia was conducted. Socio-demographics and movement behaviours (physical activity, screen time, sleep) were examined by dog ownership, dog play and dog walking. Dog-owning preschoolers did physical activity 8 times/week more but 6 min/day less park play than non-dog owners (all p < 0.05). Dog-owning preschoolers who played with their dog ≥ 3 times/week did more physical activity, outdoor play and had 16 min/day more sleep (all p < 0.05). For dog-owners, family dog walking ≥ 3 times/week was positively associated with preschooler physical activity, outdoor play and negatively associated with screen time (all p < 0.05). Our findings suggest that the physical activity-related benefits from having a family dog may be realised when preschoolers spend time playing and walking their dog. Dog walking and play, not dog ownership alone, may be an important source of physical activity for preschoolers.

Physical environmental opportunities for active play and physical activity level in preschoolers: a multicriteria analysis

Background

Active play opportunities seems to influence the level of physical activity during childhood. However, a gap remains about which environmental opportunities including the daycare physical environment could have a positive impact on the level of physical activity in preschoolers.

Objectives

(1) To develop an index to measure the environmental opportunities of free active play for preschoolers of middle-income countries; (2) to check the relationship and contribution of the index to explain objectively the level of physical activity.

Methods

A quantitative, cross-sectional, exploratory study with 51 preschool children. The established criteria for the index according to the literature were: (1) Outdoor time on typical days of the week. (2) Outdoor time on a typical weekend day. (3) The presence of internal space and external environment in the child’s home that allows playing. (4) Presence of patio with space for games at the school. (5) Presence of a playground with a toy at the school. We applied multi-attribute utility theory for the determination of the multicriteria index of physical environmental opportunities. Pearson’s correlation analysis and simple linear regression were used to verify the association between the index and the physical activity level.

Results

The index showed a positive correlation with the level of physical activity, e.g., the average time of MVPA (r = 0.408, p = 0.003). The univariate linear regression demonstrated that the quality of physical environmental opportunities for physical activity explained 20% of the preschooler’s classification as active and 16% of the time in moderate to vigorous physical activity (p < 0.001).

Conclusion

Physical environmental opportunities for active play have a positive effect on physical activity in preschoolers and should be encouraged in different social segments.

Evaluating the effectiveness of the Play Active policy intervention and implementation support in early childhood education and care: a pragmatic cluster randomised trial protocol

BACKGROUND

Daily physical activity is critical during the early years of life for facilitating children's health and development. A large proportion of preschool children do not achieve the recommended 3 h of daily physical activity. Early childhood education and care (ECEC) services are a key setting to intervene to increase physical activity. There is a significant need for ECEC specific physical activity policy, including clearer guidelines on the amount of physical activity children should do during care, and strategies for implementation of these guidelines.

METHODS

This study is a pragmatic cluster randomised trial to evaluate the effectiveness of the Play Active physical activity policy intervention to improve early childhood education and care educator's physical activity-related practices. The central component of Play Active is an evidence-informed physical activity policy template which includes 25 practices to support nine age-specific recommendations on the amount of physical activity and sedentary time, including screen time, young children should do while in care. There are six implementation support strategies to facilitate physical activity policy implementation: (i) personalise policy (services select at least five of the 25 practices to focus on initially); (ii) policy review and approval; (iii) a resource guide; (iv) a brief assessment tool for monitoring children's energetic play; (v) professional development; and (vi) Project Officer implementation support (phone calls). A total of 60 early childhood education and care services will be recruited from metropolitan Perth, Western Australia. After baseline assessment, services will be randomly allocated to either intervention or wait-listed comparison conditions. Primary (educator-reported frequency and amount of daily time provided for children's physical activity, sedentary and screen time) and secondary (educator physical activity-related practices, self-efficacy, motivation, attitudes and beliefs, social support, and supportive physical environment) outcomes will be assessed at baseline and post-intervention, after intervention services have had a minimum 3 months of policy implementation within their service.

DISCUSSION

The Play Active trial will rigorously evaluate a novel physical activity policy intervention with implementation support that promotes positive physical activity behaviours in educators and children attending ECEC. If effective, the program could be adapted, scaled-up and delivered in ECEC services nationally.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12620001206910 (date of registration 13/11/2020).

Is vegetation cover in key behaviour settings important for early childhood socioemotional function? A preregistered, cross-sectional study

The environmental influences on early childhood development are understudied. The association between vegetation cover (i.e., trees, shrubs, grassed areas) in four key behaviour settings and socioemotional functioning was investigated in 1196 young children (2-5 years). Emotional difficulties were inversely associated with vegetation cover in the home yard (OR: 0.81 [0.69-0.96]) and neighbourhood (OR: 0.79 [0.67-0.94]), but not in early childhood education and care (ECEC) centre outdoor areas or the ECEC neighbourhood. The higher odds of emotional difficulties associated with lower levels of maternal education was reduced with higher percentages of home yard vegetation cover. There was no evidence of mediation of the relationship between emotional difficulties and vegetation cover by time spent playing outside the home, day or nighttime sleep duration, or physical activity. We found no associations between vegetation cover and conduct, hyperactivity and inattention, peer difficulties, or prosocial behaviours. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=J3HeEiIjVZc.

Traffic exposure, air pollution and children's physical activity at early childhood education and care

BACKGROUND

A significant number of children attend Early Childhood Education and Care (ECEC). ECEC is an important environment and behaviour setting for young children. Time spent outdoors is positively associated with children's physical activity levels, yet increased time spent physically active outdoors may expose young children to traffic-related air pollution, particularly in ECEC centres located in high traffic areas.

METHODS

This study was part of the Play Spaces and Environments for Children's Physical Activity (PLAYCE) study, Perth, Western Australia. Data from 22 ECEC centres and 478 children were collected. Continuous measures of indoor and outdoor fine particulate matter (PM_2.5) were conducted for 48-72 h in each ECEC. Children wore ActiGraph GT3X + accelerometers to measure their physical activity at ECEC. The total length of high traffic roads within a 300m road network service area buffer around each ECEC was used to identify high and low traffic centres.

RESULTS

Outdoor PM_2.5 concentrations peaked in the afternoon (1pm, 2pm and 6pm) at ECEC centres. Outdoor and indoor PM_2.5 concentrations were significantly higher for centres located in high compared with low traffic areas (both p < 0.05). There was no significant association between a centre being located in a high or low traffic area and the time preschoolers spent outdoors or their physical activity levels.

DISCUSSION

Time periods when air pollution concentrations in ECECs are highest correspond with times when preschoolers are likely to be physically active outdoors. Children's potential exposure to traffic-related air pollutants is occurring during a period of rapid lung development. Given there is no evidence of a safe level of exposure to PM_2.5 or a threshold below which no adverse health effects occur, careful planning should be a consideration to avoid locating ECEC centres in high traffic areas.

The Relationship between Physical Activity, Self-Regulation and Cognitive School Readiness in Preschool Children

(1) Background: Limited research exists on the pathways through which physical activity influences cognitive development in the early years. This study examined the direct and indirect relationships between physical activity, self-regulation, and cognitive school readiness in preschool children. (2) Method: Participants (n = 56) aged 3–5 years were recruited from the PLAYCE study, Perth, Western Australia. Physical activity was measured using 7-day accelerometry. Self-regulation was measured using the Head Toes Knees and Shoulders task and cognitive school readiness was assessed using the Bracken School Readiness Assessment. Baron and Kenny’s method was used for mediation analysis. (3) Results: After adjustment for socio-demographic factors, total physical activity was positively and significantly associated with cognitive school readiness (B = 0.16, SE = 0.07, p ≤ 0.05). Moderate-vigorous physical activity (MVPA) was positively and significantly associated with self-regulation (B = 0.3, SE = 0.13, p ≤ 0.05) and cognitive school readiness score (B = 0.20, SE = 0.09, p ≤ 0.05). Self-regulation was found to be a partial mediator of the relationship between MVPA and cognitive school readiness. (4) Conclusion: These findings highlight the direct and indirect association between preschool children’s physical activity, self-regulation, and cognitive school readiness. Further research is needed to determine the causal relationships between young children’s physical activity and cognitive development, over time.

The Association Between Preschooler Physical Activity Duration and Intensity and Social Emotional Development: Findings From the PLAYCE Study

BACKGROUND

Social emotional development is imperative to young children's long-term psychological and physical health. Physical activity (PA) may be important for young children's social emotional development. The association between preschooler PA duration and intensity and social emotional development was investigated.

METHODS

Data from six hundred and fifty-one 2- to 4-year-olds in the Play Spaces and Environments for Children's Physical Activity (PLAYCE) study were analyzed. PA was measured using ActiGraph-GT3X accelerometers worn over 7 days. Social emotional development was measured using the parent-completed Strengths and Difficulties Questionnaire. Multilevel linear regression models examined the association between PA duration and intensity and Strengths and Difficulties Questionnaire subscales.

RESULTS

Preschoolers did 158.2 (SD = 40.2) minutes per day of PA with 27% meeting the Australian Physical Activity Guidelines for the Early Years. There was a 1.74 point decrease in the total Strengths and Difficulties Questionnaire score for each additional hour of moderate-intensity PA per day (P < .05). Similar significant associations were found across all domains of social emotional development except hyperactivity, and were consistent across different intensities of light, moderate, and vigorous PA.

CONCLUSIONS

These findings highlight the potential importance of PA, especially moderate-intensity play-based PA, for different aspects of preschool children's social emotional development. Longitudinal and intervention research is required to confirm whether promoting PA in the early years provides developmental benefit.

The reliability and validity of a physical activity and sedentary behaviour home audit tool for children aged 2-5 years

OBJECTIVES

To test the reliability and validity of a physical activity and sedentary behaviour home environment audit tool for young children (2-5 years old).

DESIGN

Cross-sectional.

METHODS

Parents of children aged 2-5 years were recruited through online methods (i.e., social media and blogs). Reliability of the SPACES home audit tool was assessed using self-reported surveys (n = 55) completed on two separate occasions, approximately 12 days apart. Validity of the home audit tool was assessed in a separate sample via home observations by researchers conducted after parents completed the self-report survey (n = 21). The audit tool measured indoor and outdoor home environment characteristics hypothesised to influence young children's physical activity and sedentary behaviour. Data were analysed using intraclass correlations (ICCs) and Kappas.

RESULTS

The majority of items demonstrated acceptable reliability and validity (80.4% and 53.4%, respectively). Size of the child's bedroom showed substantial agreement for reliability (ICC = 0.85), and slight agreement for validity (ICC = 0.23). Physical activity equipment items within the indoor environment showed slight to moderate agreement for reliability (ICC = 0.32-0.68) and slight agreement for validity (ICC = 0.15-0.35). Screen time equipment showed substantial agreement for reliability (ICC = 0.83) and fair for validity (ICC = 0.38). Outdoor items (e.g., backyard size, availability and condition of physical activity equipment, outdoor features) showed substantial agreement for reliability and validity (ICC = 0.84-0.95).

CONCLUSIONS

The home audit tool was found to be reliable and valid for many items. This tool could be used in future research to understand the impact of the home environment on young children's physical activity and sedentary behaviour.

Barriers and motivators for preschoolers playing and walking with their dog: Results from qualitative research

ISSUES ADDRESSED

A large proportion of preschoolers do not meet the recommended three hours of daily physical activity. A potential source of daily physical activity could be that provided via the family dog. This qualitative study aimed to explore the barriers and motivators to preschoolers playing with their dog and participating in family dog walks.

METHODS

Twelve in-depth interviews were conducted with parents of preschoolers who owned a dog. A semistructured interview guide was used, and transcripts were analysed thematically.

RESULTS

Factors influencing preschoolers playing with their dog and participating in family dog walks included parents' level of attachment to their dog, parental history of dog ownership, parent modelling of safe dog play, type of play the family dog enjoys and proximity to dog- and child-friendly destinations. Other factors such as the size, level of socialisation and perceived exercise requirements of the dog, physical environment factors such as backyard size and individual factors such as time and existing commitments were also reported.

CONCLUSIONS

A number of dog, individual and physical environment specific factors should be considered when promoting preschooler physical activity through dog walking and play. SO WHAT?: A large proportion of preschoolers do not meet the recommended three hours of daily physical activity. In Australia, 43% of Australian households with children aged four to five own a dog. Dog-facilitated physical activity through family dog walks and active play could be an effective strategy for increasing preschooler physical activity.

Impact of COVID-19 Restrictions on Western Australian Children's Physical Activity and Screen Time

Physical activity is essential for children's healthy development, yet COVID-19 physical distancing restrictions such as school closures and staying at home, playground closures, and the cancelling of organised community sport have dramatically altered children's opportunities to be physically active. This study describes changes in levels of physical activity and screen time from February 2020 (i.e., before COVID-19 restrictions were introduced in Western Australia) to May 2020 (i.e., when COVID-19 restrictions were in place). Parents of children aged 5 to 9 years from Western Australia were eligible to participate and recruited through convenience sampling. An online survey instrument that included validated measures of their children's physical activity (unstructured, organized, home-based, indoor/outdoor active play, dog play/walking), sociodemographic, and other potential confounders was administered to parents. Paired t-tests and mixed ANOVA models assessed changes in physical activity outcomes. The analytic sample comprised parents of 157 children who were 6.9 years of age (SD = 1.7) on average. Overall, weekly minutes of total physical activity (PA) did not change from before to during COVID-19. However, frequency and duration (total and home-based) of unstructured physical activity significantly increased. Outdoor play in the yard or street around the house, outdoor play in the park or playground or outdoor recreation area, and active indoor play at home all significantly increased. Frequency and total duration of organised physical activity significantly declined during COVID-19 distancing. During Western Australian COVID-19 restrictions, there was an increase in young children's unstructured physical activity and outdoor play and a decrease in organised physical activity. It remains to be seen whether children's increased physical activity has been sustained with the easing of physical distancing restrictions.

The relationship between dog ownership, dog play, family dog walking, and pre-schooler social-emotional development: findings from the PLAYCE observational study

BACKGROUND

Regular physical activity provides children with health and developmental benefits. This study investigated if active play and walking with the family dog was associated with better social-emotional development in young children.

METHODS

We surveyed 1646 parents to ascertain if families with pre-schoolers owned a dog, and the frequency per week their child went on family dog walks or actively played with their dog. The parent-report version of the Strengths and Difficulties Questionnaire (SDQ) was used to measure children's social-emotional development.

RESULTS

Children from dog-owning households had reduced likelihood of conduct problems (odds ratio (OR) = 0.70; 95% confidence interval (CI): 0.54, 0.90), peer problems (OR = 0.60; 95% CI: 0.46, 0.79), and total difficulties (OR = 0.77; 95% CI: 0.59, 0.99) and increased likelihood of prosocial behavior (OR = 1.34; 95% CI: 1.06, 1.68) compared with children without a dog. Within dog-owning households, family dog walking at least once/week (OR = 1.45; 95% CI: 1.02, 2.08) and active play with the family dog three or more times/week (OR = 1.74; 95% CI: 1.16, 2.59) increased the likelihood of prosocial behaviors. Family dog walking at least once/week also reduced the likelihood of total difficulties (OR = 0.64; 95% CI: 0.42, 0.96).

CONCLUSIONS

Our findings highlight the possible physical activity and social-emotional developmental benefits of family dog ownership for pre-schoolers, and that these benefits may present in early childhood.

IMPACT

Young children from dog-owning families had lower peer problems and conduct problems, and higher prosocial behaviors than children from non-dog-owning families. Children of dog-owning families who walked or played with their dog more often also had better prosocial behaviors. Positive social-emotional development was associated with dog ownership, family dog walking, and dog play in young children. Highlights that the social-emotional benefits of owning a dog may begin early in childhood. Due to the high level of pet ownership in households with children, these findings suggest having a dog and interacting with it through play and walking may be important mechanisms for facilitating young children's social-emotional development.

A study protocol for a randomised controlled trial to evaluate the effectiveness of a dog-facilitated physical activity minimal intervention on young children's physical activity, health and development: the PLAYCE PAWS trial

BACKGROUND

Pet ownership brings many health benefits to individuals. In children developmental benefits can extend to improved self-esteem, better social competence and decreased loneliness. The majority of households with children own a dog, however only a small proportion of children gain the benefits of dog ownership through dog walking and play. There are few intervention studies investigating the impact of dog-facilitated physical activity in children. The PLAYCE PAWS study aims to test a minimal-contact intervention through the use of mobile health ("mhealth") strategies, i.e. text (SMS) messages, to parents to encourage their children to walk and play with their dog more, and evaluate the impact on children's overall physical activity and development.

METHODS/DESIGN

The PLAYCE PAWS intervention study will target parents in dog-owning families with children aged 5 to 8 years in Perth, Western Australia. Approximately 150 dog-owning parents and children will be randomly allocated into either one of two intervention groups or a 'usual care' control group. The first intervention group will receive SMS messages over 4 weeks to encourage and prompt parents to undertake dog walking and dog play with their child. The second intervention group will receive the same text messages, plus a dog pedometer and personalised 'dog steps' diary for their child to complete. Parent-reported outcome measures include changes in children's dog walking and play, overall physical activity, socio-emotional development, self-regulation, self-esteem, empathy, and level of attachment to their dog.

DISCUSSION

The PLAYCE PAWS study appears to be the first to examine the effectiveness of a low-cost, mhealth intervention for increasing young children's physical activity through dog walking and play. Given the high prevalence of dogs as family pets, this study presents a valuable opportunity to investigate if mHealth interventions encourage children to walk and play with their dog more, and if there are any associated impact on children's overall physical activity and socio-emotional well-being. If effective, a larger trial or program could be implemented at low-cost and with wide reach in the community.

TRIAL REGISTRATION

ANZCTR, ACTRN12620000288921 . Registered 4th March 2020 - Retrospectively registered.

The Influence of the Early Childhood Education and Care Environment on Young Children's Physical Activity: Development and Reliability of the PLAYCE Study Environmental Audit and Educator Survey

(1) Background: Participation in physical activity is crucial for the healthy growth and development of young children. More robust measurement of environmental influences on children’s physical activity in early childhood education and care (ECEC) settings may help resolve inconsistencies in the literature. This study evaluated the reliability of an environmental audit and educator practice survey for assessing ECEC physical, policy, and social environments related to young children’s physical activity. (2) Methods: A convenience sample of 20 ECEC centres participated in this PLAYCE (Play Spaces and Environments for Children’s Physical Activity) sub-study. Trained auditors conducted audits and educators completed surveys, two weeks apart. Test-retest reliability of the survey (n = 32), inter-rater (n = 20 pairs) and intra-rater reliability (n = 38) of the audit was assessed using intra-class correlation coefficients (ICCs), Kappa statistics and percent agreement. (3) Results: Intra-rater and inter-rater reliability ICCs for outdoor equipment, spaces and features were good to excellent (ICC = 0.70–0.94), while ratings for indoor equipment, media and spaces varied from fair to excellent (ICC = 0.46–0.78). The majority of items were rated by Kappa as moderate or above for intra-rater, inter-rater and survey test-retest reliability. (4) Conclusions: The PLAYCE Study instruments provide reliable measures of ECEC physical activity environments which can help to better understand influences on young children’s physical activity.

The Effect of Upgrades to Childcare Outdoor Spaces on Preschoolers' Physical Activity: Findings from a Natural Experiment

Physical inactivity is a significant risk factor for childhood obesity. Preventing obesity in the early years reduces the risk of developing chronic health conditions later. Early childhood education and care (ECEC) services are important settings to establish good preschooler physical activity behaviors. This natural experiment investigated the influence of ECEC outdoor physical environment upgrade on preschoolers' physical activity (aged 2-5 years). Centers implemented upgrades without researcher input. Physical activity was measured by 7-day accelerometry for intervention (n = 159; 6 centers) and control (n = 138; 5 centers) groups. ECEC outdoor space was assessed using a modified Environment and Policy Assessment and Observation (EPAO) Instrument. Key outcomes were measured at baseline and 6-12 months follow-up. Fixed sandboxes, balls, portable slides, portable floor play equipment (e.g., tumbling mats), and natural grassed areas were positively associated with activity levels; fixed tunnels and twirling equipment were negatively associated with activity levels (all p < 0.05). Post-upgrade portable play equipment (balls, twirling equipment, slides, floor play equipment) increased intervention preschoolers' moderate-vigorous physical activity (MVPA) levels compared to control (p < 0.05). Intervention preschoolers were more active than control at follow-up (58.09 vs. 42.13 min/day increase in total physical activity; 30.46 vs. 19.16 min/day increase in MVPA (all p < 0.001)). Since few preschoolers meet daily activity recommendations while at ECEC, the findings may help ECEC providers to optimize outdoor physical environments and encourage more active play among preschoolers.

Nature Play and Fundamental Movement Skills Training Programs Improve Childcare Educator Supportive Physical Activity Behavior

Background: Physical activity professional development programs for Early Childhood Education and Care (ECEC) educators are a viable strategy for improving preschool children’s physical activity behavior. This pilot intervention evaluated the effectiveness of ‘nature play’ and ‘fundamental movement skills’ (FMS) professional development programs on ECEC educators’ practices on physical activity. Methods: 148 ECEC educators from 20 ECEC centers took part in either the Nature play or FMS professional development programs in Perth, Western Australia. Educators self-reported their physical activity related practices at baseline and three months post-professional development training, using established items. Wilcoxon’s test and adjusted models using Mann–Whitney U tests were run at the individual educator level to examine the change between baseline and post-professional development educator physical activity behavior. Results: Educators’ self-efficacy to engage children to be active significantly increased in both the Nature play and FMS professional development programs (p < 0.05). In the Nature play professional development program, ECEC educators’ perceived time set aside for children to participate in nature-based play increased by 9.2%, and their perceived behavioral control for supporting general and nature-based play activities for preschool children increased by 5% and 10.3%, respectively (p < 0.05). However, these results were no longer significant after adjusting for educator socio-demographics. Conclusion: Both the Nature play and FMS professional development programs were effective in improving educators’ self-efficacy to engage children to be active in Nature play or FMS activities. Larger pragmatic trials are required to confirm the impact of these professional development programs on educator perceived physical activity behavior.

Shade coverage, ultraviolet radiation and children's physical activity in early childhood education and care

OBJECTIVE

To investigate the association between shade coverage in early childhood education and care (ECEC) centres and pre-school children's physical activity, outdoor time and ultraviolet radiation (UVR) exposure.

METHODS

A total of 48 ECEC centres (678 children) in the Western Australian Play Spaces and Environments for Children's Physical Activity (PLAYCE) study took part. Physical activity at ECEC was measured using 7-day accelerometry. UVR exposure was measured using polysulphone film attached to children's shoulders. Educators reported time spent outdoors. The Shade Factor and remote sensing imagery captured shade coverage.

RESULTS

Centre vegetation but not Shade Factor was significantly negatively associated with children's UVR exposure (p < 0.001). Higher levels of vegetation were associated with increased time outdoors, but higher levels of the Shade Factor were associated with decreased time outdoors (all p < 0.001). Neither shade measure was significantly associated with physical activity. Outdoor time moderated the relationships between shade measures, physical activity and UVR exposure.

CONCLUSIONS

The provision of shade, particularly through natural forms such as tree canopy, is an important sun protection strategy and enabler of outdoor time in children attending ECEC.

A retrospective qualitative evaluation of barriers and facilitators to the implementation of a school-based running programme

BACKGROUND

There is growing interest in school-based interventions which deliver opportunities for additional physical activity time outside of physical education (PE). A practical and cost-effective approach may be school running programmes. Consequently, many school-based running initiatives are currently being implemented in a grass-roots style movement across the UK. However, research on the implementation of physical activity programmes in schools is notably underdeveloped. Therefore, this qualitative study aimed to better understand the barriers and facilitators to the implementation of a running programme, Marathon Kids (MK), within primary schools in England.

METHODS

Two sets of semi-structured interviews were conducted, the first with each of the three core members of staff responsible for MK, and the second with each of the MK school staff Champions from 20 primary schools. Also, nine focus groups were conducted with 55 pupils (6-10 years) from five of the schools; all were analysed using thematic analysis.

RESULTS

Three themes were identified surrounding the barriers and facilitators to implementation: features of the programme (e.g. ethos and resources), school climate (e.g. culture; whole school engagement; PE and physical activity policies and goals; and physical environment) and programme implementation decisions (e.g. aspirations and planning and sustainability).

CONCLUSION

Findings suggest that the barriers and facilitators to implementation are wide-ranging and include programme, organisational and system-level factors. Collectively pointing towards the need for a preparation period before implementation to understand schools' readiness to implement and context-specific factors, both regarding organisational capacity and programme specific capacity.

Impact of scheduling multiple outdoor free-play periods in childcare on child moderate-to-vigorous physical activity: a cluster randomised trial

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.