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Lane C, Naylor PJ, Predy M, Kurtzhals M, Rhodes RE, Morton K, Hunter S, Carson V. Exploring a parent-focused physical literacy intervention for early childhood: a pragmatic controlled trial of the PLAYshop. BMC Public Health 2022; 22:659. [PMID: 35382793 PMCID: PMC8982907 DOI: 10.1186/s12889-022-13048-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/22/2022] [Indexed: 12/05/2022] Open
Abstract
Background Parents play a key role in young children’s physical activity and physical literacy development. Little research has explored parent-focused interventions to improve young children’s physical literacy. We examined if a theory-based, feasible physical literacy training workshop (PLAYshop) for parents could improve their physical literacy knowledge and confidence and improve parenting practices related to facilitating the physical literacy development of their preschool-aged child (3-5 years). The secondary objective was to explore implementation facilitators and barriers. Methods We conducted a pragmatic controlled trial in two Canadian cities (Edmonton and Victoria) from November 2019 – March 2020. A total of 143/151 parents were eligible and assigned to intervention (n = 71) or control group (n = 72). The PLAYshop included: (i) a 75-min in-person workshop with interactive activities and physical literacy educational messages, (ii) educational materials, (iii) an equipment pack, and (iv) two post-workshop booster emails. Surveys measured parents’ knowledge and confidence at baseline and follow-up. Application of PLAYshop concepts and implementation facilitators and barriers were explored with interviews of parents and workshop leaders. Repeated measures ANOVAs and thematic analyses were completed. Results Parents’ knowledge and confidence improved significantly over time; intervention group changes were significantly greater than control group changes (p < 0.001; ɳ2 = .32). Parents applied PLAYshop concepts at-home, including child-led play, making activities fun, and promoting child manipulative and locomotor skills. Time was a key parental implementation barrier. Program implementation issues varied by context (location and participants). Conclusions PLAYshop participation changed parents’ physical literacy knowledge and confidence and physical literacy enhancing play with their children. Implementation feasibility was high. The findings from this real-world trial highlight an efficacious and scalable intervention that warrants further testing. Trial registration ClinicalTrials.gov: NCT04394312. Registered 19/05/2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13048-5.
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Affiliation(s)
- Cassandra Lane
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Madison Predy
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 8840 114 St., Van Vliet Complex, University Hall, Edmonton, Alberta, T6G 2H9, Canada
| | - Mette Kurtzhals
- Center for Clinical Research and Prevention, Frederiksberg Hospital DK, Frederiksberg, Denmark
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Kayla Morton
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Stephen Hunter
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 8840 114 St., Van Vliet Complex, University Hall, Edmonton, Alberta, T6G 2H9, Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 8840 114 St., Van Vliet Complex, University Hall, Edmonton, Alberta, T6G 2H9, Canada.
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Grady A, Jackson JK, Lum M, Delaney T, Jones J, Kerr J, Falkiner M, Yoong S. Barriers and facilitators to the implementation of healthy eating, physical activity and obesity prevention policies, practices or programs in family day care: A mixed method systematic review. Prev Med 2022; 157:107011. [PMID: 35248680 DOI: 10.1016/j.ypmed.2022.107011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/14/2022] [Accepted: 02/26/2022] [Indexed: 10/18/2022]
Abstract
Family day care (FDC) services provide care to young children typically within the carer's own home and represents a unique setting to deliver public health programs to improve child health. To support the implementation of programs targeting healthy eating, physical activity and obesity prevention in the FDC setting, an understanding of the factors influencing their implementation is required. This mixed methods systematic review aimed to describe the barriers and facilitators to the implementation of healthy eating, physical activity or obesity prevention policies, practices and programs (hereafter referred to as programs) in the FDC setting, and synthesise these according to the Theoretical Domains Framework (TDF). Electronic searches were conducted in 7 databases up to July 2020 to identify studies reporting the barriers and/or facilitators to program implementation in the FDC setting. Methodological quality assessments of included studies were conducted using the Mixed Methods Appraisal Tool (MMAT). Twenty studies met the review inclusion criteria (12 qualitative, 6 quantitative, 2 mixed methods). Of the 20 included studies, 16 reported barriers and facilitators mapped to the 'environmental contexts and resources' TDF domain; 10 reported barriers mapped to the 'social influences' TDF domain. Ten of the 12 qualitative studies and none of the quantitative or mixed method studies met all relevant MMAT criteria. This review comprehensively describes barriers and facilitators that need to be addressed to improve the implementation of healthy eating, physical activity and obesity prevention programs in FDC to ensure the expected health benefits of such programs reach children attending FDC.
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Affiliation(s)
- Alice Grady
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia; Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia; Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia.
| | - Jacklyn Kay Jackson
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia; Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Melanie Lum
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia; Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia; Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia.
| | - Tessa Delaney
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia; Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia; Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia.
| | - Jannah Jones
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia; Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia; Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia.
| | - Jayde Kerr
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia.
| | - Maryann Falkiner
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia.
| | - Serene Yoong
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia; Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia; Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia; School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia.
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The effects of intervening with physical activity in the early years (ages 3-5) on health-related quality of life: a secondary analysis of the Activity Begins in Childhood (ABC) trial. Qual Life Res 2020; 30:221-227. [PMID: 32700186 DOI: 10.1007/s11136-020-02587-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Limited research has measured the effect of physical activity (PA) interventions on health-related quality of life (HRQoL) among pre-school-aged children. This study evaluates the effect of the Activity Begins in Childhood (ABC) cluster-randomized controlled trial designed to increase PA in the ages 3-5 years on HRQoL. METHODS This was a cluster-randomized controlled trial where the intervention group included PA education delivered to daycare providers only, or daycare providers and parents. In the current study, the two PA intervention groups were combined. The comparator group received standard daycare curriculum (COM). A total of 215 children were included (PA n = 161, COM n = 54). Parents completed the proxy Pediatric Quality of Life Inventory Generic Core Scale (PedsQL™ 4.0) to measure HRQoL at baseline and the end of the 6-month trial. HRQoL scores were analyzed as physical, psychosocial, and total domains. Baseline and 6-months measurements were compared for PA and COM groups, and mean changes in scores (95% confidence intervals) were measured using absolute values. RESULTS No between-group differences were observed for the physical (p = 0.17), psychosocial (p = 0.95) or total scores (p = 0.20). Paired comparisons showed that only the PA group improved psychosocial- (PA mean difference = 2.18 (0.20, 4.15), p = 0.03; COM mean difference = 2.05 (- 1.03, 5.13), p = 0.19) and total-HRQoL scores (PA mean difference = 2.83 (1.83, 3.84), p < 0.001; COM mean difference = 0.19 (- 1.78, 2.16), p = 0.84) after 6 months. CONCLUSION Although the within-PA group analysis showed an improvement in psychosocial and total HRQoL scores from baseline, no between-group differences were observed in the HRQoL over time among children aged 3-5 years.
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A Pragmatic Feasibility Trial Examining the Effect of Job Embedded Professional Development on Teachers' Capacity to Provide Physical Literacy Enriched Physical Education in Elementary Schools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124386. [PMID: 32570863 PMCID: PMC7345283 DOI: 10.3390/ijerph17124386] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/27/2022]
Abstract
A gap in physical literacy (PL) oriented professional development (PD) for generalist teachers exists and thus their capacity to develop PL and maximize student health is potentially limited. We explored the feasibility of a novel job-embedded professional development (JEPD) program (10 weeks) and its impact on teachers’ capacity to deliver PL-enriched physical education (PE) and student PL. A pragmatic feasibility trial with mixed methods included quantitative measurements of teacher PL, knowledge and confidence (pre), and knowledge, confidence, satisfaction and intention (post), as well as self-reported change, to evaluate the impact on teacher capacity and practices. A pre–post comparison of student PL outcomes (motor skills using PLAYbasic, Sport for Life, Victoria, BC, Canada) during the JEPD and teacher implementation phase explored the impact on student PL. In total, 15/44 teachers participated in surveys and 11/44 completed interviews (87% female, mean age bracket = 25–44 years). Confidence to deliver PL enhancing PE increased significantly after JEPD (p < 0.0001). Teachers were highly satisfied with the JEPD (X = 4.67/5) and intended to change their practices (X = 4.09/5). At three months, teachers reported changes including enhanced lesson planning, increased activity variety (often from the JEPD), intentional skill development, student-focused discussions, introductory, transition, and closing activities, and more equipment adaptations. During JEPD, with the exception of throwing (p < 0.0001), children’s (47% female, mean age = 7.9 (1.7)) change in running, jumping, kicking and balance walking backwards did not differ from usual practice (UP). During teacher implementation, motor skill competence regressed; confounding factors could not be ruled out. JEPD appears feasible and effective for changing teacher capacity to deliver PL and enhancing PE; however, post-JEPD teacher implementation and outcomes need further exploration.
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A systematic review of interventions to improve the dietary intake, physical activity and weight status of children attending family day care services. Public Health Nutr 2020; 23:2211-2220. [PMID: 32383429 DOI: 10.1017/s1368980019005275] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To (i) identify and synthesise findings from interventions to improve the dietary intake, physical activity and weight status of children aged 0-6 years attending family day care services; and (ii) assess the impact of interventions on family day care environments, intervention cost and adverse outcomes. DESIGN Medline in Process, PsycINFO, ERIC, Embase, CINAHL, CENTRAL and Scopus databases were searched in March 2019. Studies were included if they (i) evaluated an intervention to improve the diet, physical activity and/or weight of children aged 0-6 years; (ii) were delivered in family day care services; (iii) targeted child diet, physical activity and/or weight; and (iv) used a parallel control group design. Screening was undertaken by two reviewers with disagreements resolved by a third reviewer. SETTING Family day care services, also known as family childcare homes. PARTICIPANTS Children aged 0-6 years attending family day care services. RESULTS In total, 8977 titles were retrieved, and 199 full-texts reviewed. No studies met the inclusion criteria for the primary outcome; however, two studies reporting on the secondary outcome of family day care environments were included. The 4-year community-wide obesity prevention programme and the 12-month train-the-trainer programme both reported statistically significant improvements in the healthy eating and physical activity environments of family day care, compared to cross-sectional state-average control groups. CONCLUSIONS Findings highlight few existing interventions in family day care services and a need for high-quality controlled trials to identify effective interventions to improve children's diet, activity and weight in this setting.
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Implementing Appetite to Play at scale in British Columbia: Evaluation of a Capacity-Building Intervention to Promote Physical Activity in the Early Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041132. [PMID: 32053916 PMCID: PMC7068589 DOI: 10.3390/ijerph17041132] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/31/2020] [Accepted: 02/08/2020] [Indexed: 11/17/2022]
Abstract
Childcare is a critical target for promoting children’s physical activity (PA) and physical literacy (PL). With emerging evidence about the efficacy of policy and capacity-building strategies, more information about how to bring these strategies to scale is needed. This paper describes implementation at scale of Appetite to Play (ATP), a capacity-building intervention for childcare providers, and examines the implementation and impact on early years providers’ capacity to address PA. The ATP implementation evaluation was a natural experiment that utilized a mixed methods concurrent parallel design framed within the Reach, Effectiveness, Adoption, Implementation, Maintenance framework (RE-AIM). Workshop and website tracking assessed reach and adoption. Surveys and interviews with workshop participants and stakeholders assessed satisfaction, implementation, and maintenance. Training reached 60% of British Columbia municipalities and 2700 early years providers. Significant changes in participants’ knowledge and confidence to promote PA and PL were achieved (p > 0.01–0.001). Childcare level implementation facilitators as reported by early years providers included appropriate resources, planning, indoor space, and equipment, whereas weather and space were reported barriers. The stakeholder advisory group viewed the stakeholder network and Active Play policy as facilitators and adjustments to recent shifts in childcare funding and previous initiatives as barriers to implementation. ATP was scalable and impacted provider knowledge, confidence, and intentions. The impact on actual policies and practices, and children’s PA needs to be assessed along with sustainability.
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McConnell-Nzunga J, Mâsse LC, Buckler EJ, Carson V, Faulkner GE, Lau EY, McKay HA, Temple VA, Wolfenden L, Naylor PJ. Prevalence and Relationships among Physical Activity Policy, Environment, and Practices in Licensed Childcare Centers from a Manager and Staff Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1064. [PMID: 32046187 PMCID: PMC7037996 DOI: 10.3390/ijerph17031064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/24/2020] [Accepted: 02/05/2020] [Indexed: 11/17/2022]
Abstract
Physical activity (PA) is critical to early childhood health and development, and childcare is a key setting for establishing physically active play. In British Columbia (BC), a provincial standard for active play in childcare was enacted, identified here as the Active Play (AP) standard. Pragmatic constraints limit real-world data collection for evaluating policy impact. We explored whether information about policies, practices, and the environment varied when it was collected from managers or staff. Surveys were distributed to BC childcare centers before AP standard enactment to ascertain current PA and fundamental movement skill policies and practices. The full sample (n = 1037 from 625 facilities) and a subsample of paired managers and staff (n = 261 centers) were used to explore agreement across managers and staff in reported prevalence and relationships among indicators. The policy prevalence and relationships for active play and outdoor play variables were relatively similar for manager and staff data, although the matched data had modest agreement and less than optimal intraclass correlations. The prevalence of manager-reported PA policies ranged from 47% for screen-time limits to 77% for fundamental movement skill activities. The manager and staff data highlighted indoor and outdoor space as a primary factor in AP standard adherence. With reliance on sampling staff unfeasible, it appears that the manager data may adequately describe the policies and practices of childcare providers with some notable issues.
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Affiliation(s)
- Jennifer McConnell-Nzunga
- Child Health BC, 4088 Cambie St #305, Vancouver, BC V5Z 2X8, Canada;
- School of Exercise Science, Physical and Health Education, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada;
| | - Louise C. Mâsse
- School of Population and Public Health, University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4, Canada; (L.C.M.); (E.J.B.)
- British Columbia Children’s Hospital Research Institute, 4480 Oak St., Vancouver, BC V6H 3N1, Canada
| | - E. Jean Buckler
- School of Population and Public Health, University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4, Canada; (L.C.M.); (E.J.B.)
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, 3-100 University Hall, Van Vliet Complex, University of Alberta, Edmonton, AB T6G 2H9, Canada;
| | - Guy E. Faulkner
- School of Kinesiology, University of British Columbia, 6081 University Boulevard, Vancouver, BC V6T 1Z1, Canada;
| | - Erica Y. Lau
- Department of Family Practice, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada; (E.Y.L.); (H.A.M.)
| | - Heather A. McKay
- Department of Family Practice, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada; (E.Y.L.); (H.A.M.)
| | - Viviene A. Temple
- School of Exercise Science, Physical and Health Education, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada;
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia;
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada;
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Adamo KB, Wasenius NS, Grattan KP, Harvey ALJ, Naylor PJ, Barrowman NJ, Goldfield GS. Effects of a Preschool Intervention on Physical Activity and Body Composition. J Pediatr 2017; 188:42-49.e2. [PMID: 28666535 DOI: 10.1016/j.jpeds.2017.05.082] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/04/2017] [Accepted: 05/31/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the effect of a preschool physical activity intervention program delivered in licensed childcare settings, with or without a parent-facilitated home component, on children's daily physical activity, sedentary time, and body composition. STUDY DESIGN For this cluster randomized controlled trial, 18 childcare centers were randomly allocated in equal numbers to the typical curriculum comparison group, childcare intervention alone (CC), or childcare intervention with parental involvement. Accelerometers were used to asses physical activity and sedentary time, and body composition was measured by bioelectrical impedance. RESULTS Linear mixed model regression analyses showed no differences between the CC, the childcare intervention with parental involvement, and the comparison groups in changes from baseline to 6 months in total physical activity (P for time × group interaction = .665) or moderate-to-vigorous physical activity (P for time × group interaction = .164) when adjusted for baseline physical activity levels. Furthermore, no group differences were found for changes in light physical activity, sedentary time, or anthropometric variables. CONCLUSIONS An affordable and easily scalable preschool intervention program delivered in licensed childcare settings, with or without the addition of a parent-driven home physical activity promotion, seems to have no significant effect on physical activity, sedentary time, or body composition. TRIAL REGISTRATION ISRCTN: ISRCTN94022291.
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Affiliation(s)
- Kristi Bree Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
| | - Niko Sebastian Wasenius
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Folkhälsan Research Center, Helsinki, Finland
| | - Kimberly Paige Grattan
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Alysha Leila Jean Harvey
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Nicolas James Barrowman
- Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Gary Scott Goldfield
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
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Goldfield GS, Harvey ALJ, Grattan KP, Temple V, Naylor PJ, Alberga AS, Ferraro ZM, Wilson S, Cameron JD, Barrowman N, Adamo KB. Effects of Child Care Intervention on Physical Activity and Body Composition. Am J Prev Med 2016; 51:225-231. [PMID: 27180030 DOI: 10.1016/j.amepre.2016.03.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 03/14/2016] [Accepted: 03/14/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study evaluated whether intervening with child care providers would increase physical activity (PA) and reduce adiposity in preschoolers. METHODS This was a two-arm, parallel group, cluster RCT whereby six child care centers were randomly assigned in equal numbers to intervention (n=40 children) or control (n=43 children). Participants were aged 3-5 years and attended licensed child care centers. Child care providers received two 3-hour train-the-trainer workshops and a training manual at program initiation aimed at increasing structured and unstructured PA through active play. Control child care centers implemented their standard curriculum. PA and sedentary behavior were measured by accelerometry, and body composition was measured using bioelectrical impedance at baseline and 6 months. Data were collected in 2011-2012 and analyzed in April 2015. RESULTS Linear mixed-effects modeling showed that at 6 months, children in the intervention group demonstrated greater increases in minutes per preschool day spent in overall PA (22.5 minutes, 95% CI=8.9, 36.1, p=0.002), and light-intensity PA (16.1 minutes, 95% CI=5.2, 26.7, p=0.004), but changes between groups in moderate to vigorous PA did not differ. The intervention group showed greater reductions in body fat percentage (-1.9%, 95% CI=-3.5, -0.3, p=0.023) and fat mass (-0.3 kg, 95% CI=-0.7, -0.1, p=0.018), but groups did not differ on fat-free mass, BMI, or z-BMI. CONCLUSIONS Provider-led intervention in child care centers increased preschoolers' PA and reduced adiposity, therefore may represent a viable approach to promoting PA and related health benefits in preschool-aged children. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT02293278.
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Affiliation(s)
- Gary S Goldfield
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Paediatrics, University of Ottawa, Ottawa, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada; School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Department of Psychology, Carleton University, Ottawa, Ontario, Canada.
| | - Alysha L J Harvey
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Kimberly P Grattan
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Viviene Temple
- School of Exercise Science, Health and Physical Education, University of Victoria, Victoria, British Columbia, Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Health and Physical Education, University of Victoria, Victoria, British Columbia, Canada
| | - Angela S Alberga
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
| | - Zachary M Ferraro
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Division of Maternal-Fetal Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Shanna Wilson
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Jameason D Cameron
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Nicholas Barrowman
- Department of Paediatrics, University of Ottawa, Ottawa, Ontario, Canada; Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Kristi B Adamo
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Paediatrics, University of Ottawa, Ottawa, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
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Chow AF, Leis A, Humbert L, Muhajarine N, Engler-Stringer R. Healthy Start-Départ Santé: A pilot study of a multilevel intervention to increase physical activity, fundamental movement skills and healthy eating in rural childcare centres. Canadian Journal of Public Health 2016; 107:e312-e318. [PMID: 31820321 DOI: 10.17269/cjph.107.5279] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 02/21/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES In order to improve healthy behaviours among rural children in their early years, a physical activity and healthy eating intervention (Healthy Start-Départ Santé) was implemented in rural childcare centres throughout Saskatchewan. The objective of the current study was to evaluate the impact of a multimodal physical activity and healthy eating intervention on educators' provision of opportunities for children to improve their physical activity levels, fundamental movement skills and healthy eating behaviours. SETTINGS Six childcare centres (three Francophone and three Anglophone) located in five different rural and semi-rural communities in Saskatchewan participated in this intervention. PARTICIPANTS A total of 69 children with a mean age of 4 years 9 months, and 19 female early childhood educators. INTERVENTION Guided by an ecological framework, we implemented a population health controlled intervention, using a wait list control design (48 weeks delayed intervention), and evaluated its impact in rural childcare centres. Mixed methods were employed to determine the effectiveness of the intervention. OUTCOMES Overall, educators felt that the intervention supported the provision of physical activity and healthy eating opportunities for children. Increases in children's physical activity levels were reported following the intervention. CONCLUSION The lessons learned in this study can be used to improve the Healthy Start-Départ Santé intervention so that its implementation can be effectively expanded to childcare centres within and outside Saskatchewan, in turn, supporting the healthy development of early years (0-5) children in the province and beyond.
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Affiliation(s)
- Amanda Froehlich Chow
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7N 5B2, Canada.
| | - Anne Leis
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Louise Humbert
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7N 5B2, Canada
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Rachel Engler-Stringer
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
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