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Behbehani F, Kowalski AJ, Selam H, Dombrowski E, Black MM. Childcare centre attendance and health, growth, and development among children aged 0-3 years in low- and middle-income countries: A systematic review. J Glob Health 2024; 14:04028. [PMID: 38385435 PMCID: PMC10882641 DOI: 10.7189/jogh.14.04028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
Background Lack of childcare for children aged 0-3 years has emerged as a global crisis, accentuated by women's increasing workforce participation and recognition that young children require nurturing care. Through this systematic review, we sought to examine associations between childcare centre attendance in low- and middle-income countries (LMICs) and children's health, growth, and development, and to generate childcare centre programmatic and research recommendations for children aged 0-3 years. Methods We systematically searched PsycINFO, MEDLINE, PubMed, and Cochrane for articles on centre-based childcare for children aged 0-3 years in LMICs, published between 2000 and 2021 in English (or which were translated into English). We excluded articles on specialised subgroups or interventions. We imported the retrieved articles into Covidence for review and assessed them for bias using the National Institutes of Health (NIH) quality assessment tool. Results Twenty-two articles (24 studies) met the inclusion criteria, encompassing 36 927 children from 10 countries across Mexico and South America (n = 12), Africa (n = 5), and Asia (n = 5). Outcomes included health (n = 12), growth/nutrition (n = 6), and development (n = 6). Study quality assessments were low; 41% exceeded 50% of quality criteria and 45% adjusted for confounders. Associations between childcare attendance and outcome measures were primarily negative for health (n/N = 7/12) and positive for growth/nutrition (n/N = 5/6) and development (n/N = 4/6). Childcare centre programmatic recommendations for children aged 0-3 years included: age-specific policies; program quality, including safety, hygiene, nutrition, and curriculum; access and affordability; parent engagement; financial support; and workforce development. Research recommendations included: study design, including enrolment age, frequency, duration, childcare type, home and childcare sociodemographic and cultural environments, child and caregiver outcomes, and analytical approaches; longitudinal studies; and implementation research. Conclusions Rigorous primary research in global childcare for young children is urgently needed. Policies, programmes, and investments in high-quality childcare can promote nurturing care for young children, enabling mothers to participate in the workforce. Registration PROSPERO: CRD42018105576.
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Affiliation(s)
- Farah Behbehani
- Department of Public Health Practice, Kuwait University College of Public Health, Kuwait City, Kuwait
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alysse J Kowalski
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Helina Selam
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Vermont Oxford Network, Burlington, Vermont, USA
| | | | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- RTI International, Research Triangle Park, North Carolina, USA
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Wendt A, Knuth AG, Nunes BP, de Azevedo MR, Gonçalves H, Hallal PC, Crochemore-Silva I. Leisure-Time Physical Activity in a Southern Brazilian City (2004-2021): Applying an Equity Lens to Time-Trend Analyses. J Phys Act Health 2024; 21:94-102. [PMID: 37922898 DOI: 10.1123/jpah.2023-0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/18/2023] [Accepted: 09/25/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND This study aimed to verify leisure-time physical activity trends over 15 years and monitor inequalities according to gender, self-reported skin color, and socioeconomic position in a Southern Brazilian city. A secondary aim is to evaluate intersectionalities in physical activity. METHODS Trend analysis using 3 population-based surveys carried out in 2004, 2010, and 2021. Main outcome assessed was the prevalence of physical activity according to recommendations (150 min/wk). Inequalities dimensions measured were sex, self-reported skin color, and wealth. Intersectionalities were evaluated using Jeopardy index combining all inequality dimensions. Trend analysis was performed using least-squares weighted regression. RESULTS We included data from 3090, 2656, and 5696 adults in 2004, 2010, and 2021, respectively. Prevalence of physical activity remains stable around 25% in the 3 years. In the 3 periods evaluated, men presented a prevalence in average 10 percentage points higher than women (SII2004 = -11.1 [95% confidence interval, CI, -14.4 to -7.8], SII2021 = -10.7 [95% CI, -13.7 to -7.7]). Skin color inequalities did not present a clear pattern. Richest individuals, in general presented a prevalence of leisure-time physical activity level 20pp higher than poorest ones (SII2004 = 20.5 [95% CI, 13.7 to 27.4]; SII2021 = 16.7 [95% CI, 11.3 to 22.0]). Inequalities were widely marked, comparing the most privileged group (represented by men, the wealthiest, and White) and the most socially vulnerable group (represented by women, the poorest, and Black/Brown). The Slope Index of Inequality for intersectionalities was -24.5 (95% CI, -31.1 to -17.9) in 2004 and -18.8 in 2021 (95% CI, -24.2 to -13.4). CONCLUSIONS Our analysis shows that women, Black/Brown, and poor present lower leisure-time physical activity level. This group is often neglected regarding other health and social outcomes.
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Affiliation(s)
- Andrea Wendt
- Programa de Pós-Graduação em Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
| | - Alan G Knuth
- Post-Graduate program in Public Health, Federal University of Rio Grande, Rio Grande, RS, Brazil
| | - Bruno P Nunes
- Post-Graduate program in Nursing, Federal University of Pelotas, Pelotas, RS, Brazil
- Post-Graduate program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Mario Renato de Azevedo
- Post-Graduate program in Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Helen Gonçalves
- Post-Graduate program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Pedro C Hallal
- Post-Graduate program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Post-Graduate program in Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
- College of Applied Health Sciences, Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA
| | - Inácio Crochemore-Silva
- Post-Graduate program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Post-Graduate program in Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
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Tornquist D, Crochemore-Silva I, Tornquist L, Mielke GI, Ekelund U, Murray J, Domingues MR. Trajectories of Device-Measured Physical Activity During Early Childhood and Its Determinants: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study. J Phys Act Health 2023; 20:840-849. [PMID: 37451685 DOI: 10.1123/jpah.2022-0608] [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] [Received: 11/14/2022] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The objective was to describe trajectories of physical activity (PA) measured by accelerometry during early childhood and to test associations with sociodemographic, gestational, maternal, and perinatal determinants. METHODS Data from 1798 children from the 2015 Pelotas (Brazil) Birth Cohort were analyzed. PA was measured with wrist accelerometers at 1, 2, and 4 years. PA trajectories were estimated using group-based trajectory modeling, and associations with determinants were tested using Poisson regression with robust variance. RESULTS Two trajectories were identified: Moderate and high PA, both showing a linear increase in PA in the first years but differing in volume. Girls (prevalence ratio [PR]: 0.91; 95% confidence interval [CI], 0.88-0.94), highly educated mothers (PR: 0.93; 95% CI, 0.88-0.97), and high birth weight children (PR: 0.91; 95% CI, 0.85-0.97) showed less probability of high PA trajectory. Birth order ≥3 (PR: 1.06; 95% CI, 1.01-1.11) was associated with higher likelihood of high PA trajectory. CONCLUSIONS Children showed an increase in PA during the first years, with 2 trajectories that differ in PA levels. Female sex, high maternal schooling, and high birth weight reduced the probability of having a high PA trajectory, while higher birth order increased this probability. These characteristics should be considered when planning PA interventions for children in early childhood.
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Affiliation(s)
- Debora Tornquist
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Inácio Crochemore-Silva
- Postgraduate Program in Physical Education and Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Luciana Tornquist
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Grégore I Mielke
- School of Public Health, University of Queensland, Brisbane, QLD,Australia
| | - Ulf Ekelund
- Norwegian School of Sport Sciences, Oslo,Norway
| | - Joseph Murray
- Human Development and Violence Research Centre (DOVE), Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Marlos R Domingues
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS,Brazil
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Wanderley Júnior RDS, Queiroz DDR, Guerra PH, Martins CL, Hardman CM, Umpierre D, da Silva LR, Souza Filho AND, Azevedo Cavalcante FVS, Sandreschi PF, Barros MVGD. Correlatos de atividade física e comportamento sedentário em crianças pré-escolares sul-americanas: revisão de escopo. Rev Panam Salud Publica 2022. [PMID: 34131427 PMCID: PMC9168416 DOI: 10.26633/rpsp.2022.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objetivo.
Sintetizar os achados sobre correlatos da atividade física (AF) e do comportamento sedentário (CS) em crianças sul-americanas.
Método.
Realizou-se uma busca dos artigos no período de 24 de junho até 27 de outubro de 2020, nas bases de dados LILACS, PubMed, SciELO, Scopus e Web of Science. Para ampliar a busca, foram examinadas as referências dos artigos de revisão identificados e realizada uma consulta a um painel de especialistas. Foram incluídos estudos com delineamentos observacional e de intervenção com foco em crianças sul-americanas de zero a 5 anos de idade.
Resultados.
Dos 3 111 artigos inicialmente identificados, 18 foram elegíveis: 14 com delineamento observacional, 12 realizados no Brasil e 17 conduzidos com pré-escolares (3 a 5 anos de idade). Além do Brasil, os únicos países representados foram o Chile e o Equador. A AF e o CS foram medidos por acelerômetros em sete estudos, porém houve alta variabilidade nos instrumentos e pontos de corte usados. Embora as crianças tenham sido consideradas fisicamente ativas em 12 estudos, seis estudos mostraram que elas despendiam muito tempo em CS. Os domínios de influência mais avaliados foram o individual (14 estudos) e o interpessoal (11 estudos), seguidos pelo ambiental (oito estudos) e o político (um estudo). As intervenções no contexto escolar (quatro estudos) aumentaram os níveis de AF e diminuíram o tempo em CS. Entretanto, as evidências dos estudos transversais e de intervenção apresentaram alto risco de viés.
Conclusão.
Diante das lacunas identificadas, recomendam-se estudos com delineamentos robustos que incluam mais países sul-americanos, com foco em bebês e crianças com menos de 3 anos de idade e que investiguem correlatos dos domínios ambiental e político.
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Affiliation(s)
| | - Daniel da Rocha Queiroz
- Universidade Federal de Pernambuco (UFPE), Departamento de Educação Física, Recife (PE), Brasil
| | | | - Clarice Lucena Martins
- Universidade Federal da Paraíba (UFPB), Departamento de Educação Física, João Pessoa (PB), Brasil
| | - Carla Menêses Hardman
- Universidade Federal de Pernambuco (UFPE), Departamento de Educação Física, Recife (PE), Brasil
| | - Daniel Umpierre
- Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Saúde Coletiva, Porto Alegre (RS), Brasil
| | - Larissa Rosa da Silva
- Universidade Estadual do Oeste do Paraná (Unioeste), Departamento de Educação Física, Marechal Candido Rondon (PR), Brasil
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Longitudinal Associations Between Device-Measured Physical Activity and Early Childhood Neurodevelopment. J Phys Act Health 2022; 19:80-88. [PMID: 34983024 DOI: 10.1123/jpah.2021-0587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of this study was to investigate longitudinal associations between physical activity and early childhood neurodevelopment. METHODS Data from 1673 children from the 2015 Pelotas (Brazil) birth cohort study were analyzed. Physical activity was measured using accelerometers on the wrist at ages 1, 2, and 4 years. Neurodevelopment was measured using the Battelle Development Inventory at age 4 years. Linear regression models were used to test trajectories and cumulative associations of physical activity with child neurodevelopment. RESULTS Of the 3 physical activity trajectories observed, children in the medium (β = 1.17; 95% confidence interval, 0.25 to 2.10) and high (β = 2.22; 95% confidence interval, 0.61 to 3.82) trajectories showed higher neurodevelopment scores than children in the lower activity trajectory. Cumulative analyses showed that children in the highest tertile of physical activity in all follow-ups presented a mean neurodevelopment score 4.57 (95% confidence interval, 2.63 to 6.51) higher than children in the lowest tertile in all follow-ups. All analyses showed a dose-response characteristic of association, with higher physical activity indicating higher neurodevelopment scores. CONCLUSIONS Physical activity may be an important predictor of neurodevelopment through early childhood.
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Sehn AP, Tornquist D, Tornquist L, Brazo-Sayavera J, Reuter CP. Biological and socioeconomic factors as moderator in relationship between leisure-time physical activity and cardiometabolic risk in adolescents from southern Brazil. Environ Health Prev Med 2021; 26:90. [PMID: 34521350 PMCID: PMC8442526 DOI: 10.1186/s12199-021-01012-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Given the important repercussions that sociodemographic factors can have on physical activity, especially in the field of leisure, and cardiometabolic risk, it seems relevant to analyze the implications of these variables on the relationship between physical activity in leisure time (LTPA) and cardiometabolic risk. In this sense, the present study aims to verify the moderating role of biologic and socioeconomic factors in the relationship between LTPA and cardiometabolic risk in adolescents in southern Brazil. METHODS Cross-sectional study that included 1596 adolescents selected at random (58.2% girls), aged between 10 and 17 years. LTPA, biological and socioeconomic factors were assessed using a self-reported questionnaire and the cardiometabolic risk score (total cholesterol/HDL-c ratio, triglycerides, fasting glucose, systolic blood pressure, and waist circumference, considering the participant's age and sex) was included as an outcome. Associations and moderations were tested by multiple linear regression models. RESULTS It was observed a positive interaction of LTPA and sex (p = 0.048) and LTPA and school system (p = 0.037), and negative interaction of LTPA and skin color (p = 0.040), indicating that these factors were moderators in the relationship between LTPA and clustered cardiometabolic risk score (cMetS) in adolescents. A reduction in cardiometabolic risk was observed according to the increase in weekly minutes of LTPA among boys, non-white adolescents, and students from municipal schools. CONCLUSIONS The association between LTPA and cardiometabolic risk was moderated by sex, skin color, and school system in adolescents from southern Brazil.
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Affiliation(s)
- Ana Paula Sehn
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Av. Independência, 2293, Universitário, Santa Cruz do Sul, Rio Grande do Sul 96815-900 Brazil
| | - Debora Tornquist
- Graduate Program in Physical Education, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul Brazil
| | - Luciana Tornquist
- Graduate Program in Physical Education, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul Brazil
| | - Javier Brazo-Sayavera
- Department of Sports and Computer Sciences, Universidad Pablo de Olavide, Seville, Spain
| | - Cézane Priscila Reuter
- Graduate Program in Health Promotion, Department of Health Sciences, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Rio Grande do Sul Brazil
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