Children's physical activity level and sedentary behaviour in Norwegian early childhood education and care: effects of a staff-led cluster-randomised controlled trial

Effects of eHealth Interventions on 24-Hour Movement Behaviors Among Preschoolers: Systematic Review and Meta-Analysis

BACKGROUND

The high prevalence of unhealthy movement behaviors among young children remains a global public health issue. eHealth is considered a cost-effective approach that holds great promise for enhancing health and related behaviors. However, previous research on eHealth interventions aimed at promoting behavior change has primarily focused on adolescents and adults, leaving a limited body of evidence specifically pertaining to preschoolers.

OBJECTIVE

This review aims to examine the effectiveness of eHealth interventions in promoting 24-hour movement behaviors, specifically focusing on improving physical activity (PA) and sleep duration and reducing sedentary behavior among preschoolers. In addition, we assessed the moderating effects of various study characteristics on intervention effectiveness.

METHODS

We searched 6 electronic databases (PubMed, Ovid, SPORTDiscus, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials) for experimental studies with a randomization procedure that examined the effectiveness of eHealth interventions on 24-hour movement behaviors among preschoolers aged 2 to 6 years in February 2023. The study outcomes included PA, sleep duration, and sedentary time. A meta-analysis was conducted to assess the pooled effect using a random-effects model, and subgroup analyses were conducted to explore the potential effects of moderating factors such as intervention duration, intervention type, and risk of bias (ROB). The included studies underwent a rigorous ROB assessment using the Cochrane ROB tool. Moreover, the certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment.

RESULTS

Of the 7191 identified records, 19 (0.26%) were included in the systematic review. The meta-analysis comprised a sample of 2971 preschoolers, which was derived from 13 included studies. Compared with the control group, eHealth interventions significantly increased moderate to vigorous PA (Hedges g=0.16, 95% CI 0.03-0.30; P=.02) and total PA (Hedges g=0.37, 95% CI 0.02-0.72; P=.04). In addition, eHealth interventions significantly reduced sedentary time (Hedges g=-0.15, 95% CI -0.27 to -0.02; P=.02) and increased sleep duration (Hedges g=0.47, 95% CI 0.18-0.75; P=.002) immediately after the intervention. However, no significant moderating effects were observed for any of the variables assessed (P>.05). The quality of evidence was rated as "moderate" for moderate to vigorous intensity PA and sedentary time outcomes and "low" for sleep outcomes.

CONCLUSIONS

eHealth interventions may be a promising strategy to increase PA, improve sleep, and reduce sedentary time among preschoolers. To effectively promote healthy behaviors in early childhood, it is imperative for future studies to prioritize the development of rigorous comparative trials with larger sample sizes. In addition, researchers should thoroughly examine the effects of potential moderators. There is also a pressing need to comprehensively explore the long-term effects resulting from these interventions.

TRIAL REGISTRATION

PROSPERO CRD42022365003; http://tinyurl.com/3nnfdwh3.

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

BACKGROUND

Insufficient physical activity (PA) is a significant risk factor that contributes to several health problems and there is a need to improve our understanding of how to increase PA, particularly among young children. This review (PROSPERO registration: CRD42022328841) investigated the relationship between behaviour change techniques (BCTs) and interventions that increased PA among pre-school children aged < 6 years old.

METHODS

Systematic searches of six databases were undertaken from inception to July 2022, updated in December 2022, to locate studies that evaluated interventions and reported a positive change in PA levels in children aged < 6 years old.

RESULTS

A total of 5,304 studies were screened, and 28 studies involving 10,605 subjects aged 2.5 to 5.9 years met the eligibility criteria. Each eligible study (n = 28) was independently appraised by two researchers using the Cochrane risk of bias tool. The BCT Taxonomy v1 and the Template for Intervention Description and Replication (TIDieR) guided the extraction and analysis of data, and this process led to the identification of 27 BCTs.

CONCLUSIONS

Potentially promising BCTs for increasing PA among young children included 'shaping knowledge,' 'antecedents,' 'goals and planning,' and 'comparison of behaviour.' Future PA interventions that target young children should consider integrating these promising BCTs into their programmes. However, such consideration needs to be tempered by the fact that most of the reviewed studies were deemed to have a high or unclear risk of bias and/or were limited with respect to the populations that they targeted. Further research using rigorous methodologies is required to establish a higher standard that addresses the needs of young children who are expected to have insufficient levels of physical activity.

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

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

Fundamental Movement Skills and Physical Activity of 3-4-Year-Old Children within Early Childhood Centers in New Zealand

We sought to describe and explore relationships between fundamental movement skills (FMS) and level of physical activity (PA; light-, medium-, vigorous, and kCal/hour) in preschool children, aged 3–4-years-old, across four early childhood education (ECE) settings. Children’s FMS were assessed using the Test for Gross Motor Development-2 (TGMD-2; n = 81) and PA via accelerometers (S = 53). Eighty-four children participated, with 50 in both assessments. The TGMD-2 showed as the children got older, their locomotor skills (p < 0.001, r = 0.512) and object control motor skills (p < 0.001, r = 0.383) improved. Accelerometry showed children were primarily inactive at ECE (78.3% of the time). There were significant correlations between kCal/hour and light (p < 0.001, r = −0.688), moderate (p < 0.001, r = 0.599) and vigorous (p < 0.001, r_s = 0.707) activity, and between gross motor quotient and locomotor (p < 0.001, r = 0.798) and object control (p < 0.001, r = 0.367) skills. No correlation was observed between gross motor quotient and kCal/hour. To conclude, children in this cohort were primarily inactive during ECE center hours. Moreover, gross motor quotient was significantly correlated to locomotor and object control skills.

Fitness Level Differences between Students in Kosovo and Montenegro

Geographical, cultural, and socio-economic factors create a different lifestyle. Accordingly, the aim of this research was to identify the differences in anthropometric and fitness characteristics among adolescents living in Montenegro and Kosovo in order to optimize the physical fitness as a consequence of the proactive behavior. Anthropometric characteristics and fitness level measures were assessed by Eurofit testing battery among 600 Kosovar and 600 Montenegrin students, equally distributed by gender. Differences between countries, gender, and age group (13, 14 and 15 years) were assessed with multivariate and univariate analysis of variance. The results showed that Montenegrin students are taller, heavier, and achieve better results in the sit-ups and 20-m endurance shuttle-run tests. Kosovar students achieve better results in the standing broad jump and 10 × 5 m shuttle-run tests. Males achieve significantly better results in all tests, excluding the sit-and-reach test. Statistically significant differences among age groups were found for all variables, regardless gender and country (except for the flamingo and sit-and reach tests). This study is of importance to physical education teachers and curriculum authors to optimize students’ proactive behavior based on the identified anthropometric and physical fitness differences between the two countries, age groups, and genders.