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Kracht CL, Staiano AE, Harris M, Domangue K, Grantham-Caston M. Modification of childcare's outdoor setting for toddler physical activity and nature-based play: A mixed methods study. PLoS One 2024; 19:e0309113. [PMID: 39302934 PMCID: PMC11414991 DOI: 10.1371/journal.pone.0309113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 08/05/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Toddler physical activity is critical for child health, but little is known about its applications in early childhood education (ECE) centers. The aims of this study were 1) to determine if pragmatic and nature-based modifications to an ECE center's outdoor setting were feasible and acceptable, and 2) to identify barriers and facilitators of toddler physical activity at ECE centers. METHODS A multiphase mixed-methods study (QUANT+QUAL) was conducted. In the QUANT study, a stepped, sequential modification of the outdoor setting, using pragmatic and cost-effective nature-based elements, was conducted with a delayed control group over 10-weeks, with follow-up assessments 3-months later (week-20). Five elements (tree cookies, garden, teacher training, playground stencils, and nature table) were introduced individually. Feasibility was assessed using teacher surveys. Acceptability and engagement were assessed by direct observation of toddler use of outdoor elements. Accelerometers were used to assess toddlers' physical activity during outdoor sessions. The QUAL study included semi-structured interviews from ECE center directors (n = 27, 55.6% African American, 92.5% female) that were analyzed using content analysis for themes related to 1) toddler physical activity, 2) barriers and facilitators to toddler outdoor environment changes, 3) perspectives on nature-based elements, and 4) provider training. Member check focus groups (n = 2, 7-10/group) were conducted for additional interpretation. All three sources were reviewed for integration. RESULTS Toddlers engaged in physical activity for most of the outdoor sessions (>85%). This limited the effect of the intervention, but aligned with directors' and members' sentiments that toddlers were already quite active. Across directors, reported barriers to toddler outdoor environment changes were teacher turnover and finances. All nature-based elements, except the stencils, were feasible and acceptable, even at week-20. Directors and members identified additional age-appropriate elements, and desired pragmatic training with technical assistance and funding to implement these changes. Directors and members also desired a curriculum that could be used outdoors. CONCLUSIONS Nature-based elements were feasible and acceptable to toddlers. Directors were enthusiastic about nature-based elements, but barriers exist in linking directors with these elements. Opportunities to combine toddler-age curricula and pragmatic options for outdoor play may improve ECE centers' outdoor settings and ultimately toddler health.
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Affiliation(s)
- Chelsea L. Kracht
- Population and Public Health Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
- Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States of America
| | - Amanda E. Staiano
- Population and Public Health Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - Melissa Harris
- Population and Public Health Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - Kristin Domangue
- Population and Public Health Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
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Kracht CL, St Romain J, Hardee JC, Santoro N, Redman LM, Marlatt KL. "Weight loss is my goal and being healthy is my goal… I can get over the hot flashes": a qualitative exploration of menopausal transition experiences and preferences for weight management among White women. Menopause 2023; 30:1022-1032. [PMID: 37699233 PMCID: PMC10528173 DOI: 10.1097/gme.0000000000002248] [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: 09/14/2023]
Abstract
OBJECTIVES A qualitative research study design was used to (1) describe experiences of White women during the menopausal transition, and (2) identify barriers and facilitators for participating in a lifestyle program targeting weight management. METHODS Perimenopausal and postmenopausal White women who self-reported a desire to lose or maintain weight participated in focus groups. Women were queried about their past diet, exercise, and weight management practices; menopausal transition; and specific components and considerations for developing a lifestyle program for weight management. Thematic analysis was conducted on coded transcripts and four main themes emerged, each containing three to six subthemes. RESULTS Twenty-eight White women (age 54 ± 3 y, body mass index 31.4 ± 9.5 kg/m 2 ) were enrolled. Overall, women felt menopause was a major life event that coincided with weight gain and frustrating body changes. Women already engaged in many different types of exercises and diets to lose weight. Women also talked to healthcare professionals about menopause but were disappointed in the support they received. Women were interested in a lifestyle program that included menopause-specific education, which focused on results beyond weight, which was flexible to their busy lifestyle, and which provided opportunities to build camaraderie among other women experiencing menopause. CONCLUSIONS This cohort of White women were interested in receiving menopause information and improving their overall health as part of a lifestyle program targeting weight management during this transition. Building camaraderie with other women affected by menopause is important to women, as is creating a lifestyle program that is flexible with daily life.
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Affiliation(s)
| | | | - Julie C Hardee
- From the Pennington Biomedical Research Center, Baton Rouge, LA
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Leanne M Redman
- From the Pennington Biomedical Research Center, Baton Rouge, LA
| | - Kara L Marlatt
- From the Pennington Biomedical Research Center, Baton Rouge, LA
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Knight RL, Sharp CA, Hallingberg B, Mackintosh KA, McNarry MA. Mixed-Methods Systematic Review to Identify Facilitators and Barriers for Parents/Carers to Engage Pre-School Children in Community-Based Opportunities to Be Physically Active. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1727. [PMID: 36360455 PMCID: PMC9688361 DOI: 10.3390/children9111727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/05/2022] [Accepted: 11/06/2022] [Indexed: 09/08/2024]
Abstract
Background: Low physical activity levels in young children is a major concern. For children aged 0-5 years, engagement with opportunities to be physically active are often driven by the adults responsible for the child's care. This systematic review explores the barriers and facilitators to parents/caregivers engaging pre-school children in community-based opportunities for physical activity, within real-world settings, or as part of an intervention study. Methods: EBSCOhost Medline, CINHAL plus, EBSCOhost SPORTDiscus, Web of Science, ProQuest, and ASSIA were systematically searched for quantitative and qualitative studies published in English between 2015 and 16 May 2022. Data extracted from 16 articles (485 parents/carers; four countries) were quality-assessed using the Mixed Methods Assessment Tool and coded and themed via thematic analysis. Results: Nine themes (eight core, one minor) were identified and conceptualised into a socio-ecological model, illustrating factors over four levels: Individual-beliefs and knowledge (and parental parameters); Interpersonal-social benefits, social network, and family dynamic; Community-organisational factors and affordability; and Built and Physical Environment-infrastructure. Discussion: The findings provide valuable insights for practitioners and policy makers who commission, design, and deliver community-based physical activity opportunities for pre-school children. Developing strategies and opportunities that seek to address the barriers identified, as well as build on the facilitators highlighted by parents, particularly factors related to infrastructure and affordability, are imperative for physical activity promotion in pre-school children. The perspectives of fathers, socioeconomic and geographical differences, and the importance parents place on physical activity promotion all need to be explored further.
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Affiliation(s)
- Rachel L. Knight
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea SA1 8EN, UK
| | - Catherine A. Sharp
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea SA1 8EN, UK
| | - Britt Hallingberg
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF5 2YB, UK
| | - Kelly A. Mackintosh
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea SA1 8EN, UK
| | - Melitta A. McNarry
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea SA1 8EN, UK
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Risica PM, Karpowicz JM, von Ash T, Gans KM, Stowers KC, Tovar A. Feeding and Activity Environments for Infants and Toddlers in Childcare Centers and Family Childcare Homes in Southeastern New England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159702. [PMID: 35955058 PMCID: PMC9367851 DOI: 10.3390/ijerph19159702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/30/2022] [Accepted: 08/03/2022] [Indexed: 06/01/2023]
Abstract
Few studies have documented the food and physical activity (PA) environments of childcare settings caring for children <24 months of age, although they may be key contributors to developing child PA and diet patterns. We used an adapted Environment and Policy Assessment and Observation tool to assess the food and activity environments for infants and toddlers in childcare centers (n = 21) and family childcare homes (FCCH) (n = 20) and explored differences by childcare type. Many similarities were found between childcare site types; however, centers used more recommended feeding practices than FCCH (e.g., 100% of center providers talked with toddlers about feelings of hunger or fullness compared to 18% of family childcare providers (FCCP), p < 0.01). Differences in non-recommended feeding practices (e.g., spoon feeding, bottle propping and encouraging unhealthy foods) were mixed between childcare types. Toddlers in centers spent more time playing at higher PA levels than those in FCCH (61 vs. 13 min, p < 0.001). Screen time was observed in FCCH, but not in centers. Differences between childcare types may indicate differential influences on infant and toddler feeding and PA behaviors, which could predict disparate obesity risk. Future research should further observe these behaviors in a larger sample of centers and FCCH to inform childcare interventions and policies.
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Affiliation(s)
- Patricia Markham Risica
- Brown University School of Public Health, Providence, RI 02912, USA
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI 02912, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
| | | | - Tayla von Ash
- Brown University School of Public Health, Providence, RI 02912, USA
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI 02912, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
| | - Kim M. Gans
- Brown University School of Public Health, Providence, RI 02912, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT 06269, USA
- Institute for Collaboration in Health, Interventions and Policy, University of Connecticut, Storrs, CT 06269, USA
| | - Kristen Cooksey Stowers
- Institute for Collaboration in Health, Interventions and Policy, University of Connecticut, Storrs, CT 06269, USA
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT 06103, USA
| | - Alison Tovar
- Brown University School of Public Health, Providence, RI 02912, USA
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI 02912, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
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Hesketh KR, Janssen X. Movement behaviours and adherence to guidelines: perceptions of a sample of UK parents with children 0-18 months. Int J Behav Nutr Phys Act 2022; 19:58. [PMID: 35598015 PMCID: PMC9124375 DOI: 10.1186/s12966-022-01300-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Movement behaviours are important for infant (0-12 mo) and toddler (1-2 yrs) health and development, yet very little is known about adherence to the 24-hour movement behaviour guidelines and parents perception of these behaviours in these age groups. This study aimed to examine parental perceptions of movement behaviours and adherence to guidelines in a sample of UK parents with children 0-18 months. METHODS Participants were 216 parent-child dyads from the cross-sectional Movement Behaviour Assessment in Infants and Toddlers (M-BAIT) study. Tummy time, screen time, restraint time and sleep were measured using a parental questionnaire. A sub-sample of parents were asked about their priority areas for their child's health and development. Frequencies were used to describe the proportion of children meeting movement behaviour guidelines, the number of guidelines met and priority areas for parents. Mann-Whitney U-tests (continuous variables) and chi-square tests (categorical variables) were used to assess the differences between boys and girls. RESULTS For those under 12 months of age, just over 30% of children met tummy time recommendations, 41.3% met the screen time guidelines, 57.8% met restraint guidelines and 76.2% met sleep guidelines. For those 12 months and over, 24.1% met the screen time guidelines, 56.9% met restraint guidelines and 82.8% met sleep guidelines. Parents identified sleep and physical activity as top priorities for their child. Limiting screen time was deemed least important. CONCLUSION In this sample of UK infants and toddlers (0-18 months), few adhered to the sedentary behaviour and tummy time guidelines, whereas the majority meet sleep guidelines. This mirrors parental priorities; limiting screen time was seen as less important, with sleep and physical activity deemed most important. These findings suggest greater efforts are needed to raise awareness about screen and tummy time, supporting parents and care-providers to promote positive movement behaviours.
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Affiliation(s)
- Kathryn R Hesketh
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Xanne Janssen
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland, G1 1QN, UK.
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Dinkel D, Rasmussen M, Rech JP, Snyder K, Dev DA. A qualitative comparison of parent and childcare provider perceptions of communication and family engagement in children's healthy eating and physical activity. Child Care Health Dev 2022; 48:99-109. [PMID: 34391211 DOI: 10.1111/cch.12908] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 07/03/2021] [Accepted: 08/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parents and childcare providers play a substantial role in the development of health behaviours among the children they care for. In order to ensure the optimal growth and development of children, communication and family engagement in childcare is critical. Previous studies examining parent or provider perceptions about healthy eating or physical activity have explored these concepts individually and/or have only included only parents or providers. Therefore, the purpose of this study was to compare childcare provider and parent perceptions of communication regarding healthy eating and physical activity as well as use of best practice strategies on family engagement for these topics. METHODS Childcare providers (n = 12) in childcare centres or a family childcare home and a parent (n = 12) of a child they provide care for participated in a semi-structured interview guided by the Social Ecological Model. Interviews were transcribed verbatim and uploaded to NVivo for data analysis. Data were analysed using a directed content analysis. Three trained qualitative researchers developed a codebook and then compared responses between parents and providers. RESULTS Similarities in provider and parent responses included agreement on healthy eating; influences on child development; parents being the most influential on children's healthy eating; how they identified physical activity opportunities; and the use of family engagement principles. Differences that arose included parents' roles in promoting children's physical activity; challenges for parents in promoting healthy eating and physical activity; and providers' encouragement of physical activity. Importantly, few parents mentioned providers were top influences on their child's healthy eating or physical activity. Providers also mentioned having difficult conversations with parents was challenging. CONCLUSIONS Future efforts are needed to (1) help parents understand the providers' role in the development of their child's health behaviours and (2) strengthen efforts to engage families in healthy behaviours outside of childcare facilities.
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Affiliation(s)
- Danae Dinkel
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska, USA
| | - Maggie Rasmussen
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska, USA
| | - John P Rech
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska, USA
| | - Kailey Snyder
- Department of Physical Therapy, Creighton University, Omaha, Nebraska, USA
| | - Dipti A Dev
- Department of Child, Youth, and Family Studies, University of Nebraska at Lincoln, Lincoln, Nebraska, USA
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Children of Smoking and Non-Smoking Households' Perceptions of Physical Activity, Cardiorespiratory Fitness, and Exercise. CHILDREN-BASEL 2021; 8:children8070552. [PMID: 34206729 PMCID: PMC8307148 DOI: 10.3390/children8070552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/02/2022]
Abstract
Previous research has shown secondhand tobacco smoke to be detrimental to children’s health. This qualitative study aimed to explore children from low socioeconomic status (SES) families and their reasons for being physically active, attitudes towards physical activity (PA), fitness and exercise, perceived barriers and facilitators to PA, self-perceptions of fitness and physical ability, and how these differ for children from smoking and non-smoking households. A total of 38 children (9–11 years; 50% female; 42% smoking households) from the deprived areas of North West England participated in focus groups (n = 8), which were analysed by utilizing thematic analysis. The findings support hypothesised mediators of PA in children including self-efficacy, enjoyment, perceived benefit, and social support. Fewer than a quarter of all children were aware of the PA guidelines with varying explanations, while the majority of children perceived their own fitness to be high. Variances also emerged between important barriers (e.g., sedentary behaviour and environmental factors) and facilitators (e.g., psychological factors and PA opportunity) for children from smoking and non-smoking households. This unique study provided a voice to children from low SES and smoking households and these child perspectives could be used to create relevant and effective strategies for interventions to improve PA, fitness, and health.
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Venetsanou F, Emmanouilidou K, Kouli O, Bebetsos E, Comoutos N, Kambas A. Physical Activity and Sedentary Behaviors of Young Children: Trends from 2009 to 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1645. [PMID: 32138370 PMCID: PMC7084846 DOI: 10.3390/ijerph17051645] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/28/2020] [Accepted: 02/29/2020] [Indexed: 12/28/2022]
Abstract
Over the last decade, the lives of children in several countries, including Greece, have been affected by recession. The aim of the present study was (a) to examine time trends in physical activity (PA) and screen time (ST) of Greek preschool children, together with their family affluence (FA), from 2009 until 2018, and to explore the associations among them; and (b) to investigate the connections of parental educational level and children's BMIs to their achieving ST (<1h/day) and PA (11,500 steps/day) guidelines. A total of 652 children from four cross-sectional cohorts participated. PA was recorded with Omron HJ-720IT-E2 pedometers, whereas ST, family affluence (FA) and parental educational level were reported by participants' parents. The results of the one-way ANOVAs that were computed revealed statistically significant differences among cohorts, albeit of no practical importance, in PA, ST and FA. According to the regressions calculated, neither BMI nor the educational level was related to membership in ST and PA guidelines groups. ST was a significant predictor of children's PA in all week periods (school-time, leisure-time, weekend), whereas FA was not such a strong predictor. Multilevel interventions aiming at both ST and PA seem to be imperative for the benefit of young children's health.
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Affiliation(s)
- Fotini Venetsanou
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece;
| | - Kyriaki Emmanouilidou
- School of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece; (K.E.); (O.K.); (E.B.)
| | - Olga Kouli
- School of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece; (K.E.); (O.K.); (E.B.)
| | - Evangelos Bebetsos
- School of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece; (K.E.); (O.K.); (E.B.)
| | - Nikolaos Comoutos
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece;
| | - Antonis Kambas
- School of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece; (K.E.); (O.K.); (E.B.)
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