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Al-walah MA, Donnelly M, Alhusaini AA, Heron N. Pre-school-based behaviour change intervention to increase physical activity levels amongst young children: a feasibility cluster randomised controlled trial. Front Public Health 2024; 12:1379582. [PMID: 38756888 PMCID: PMC11096494 DOI: 10.3389/fpubh.2024.1379582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
Background A significant rise in childhood obesity worldwide over the past three decades highlights the urgent need for early interventions, especially in preschools as key settings for child development. This study aimed to assess the feasibility and fidelity of a randomised controlled trial of "I'm an Active Hero" (IAAH), a theory- and evidence-based multi-component behaviour change intervention targeting physical activity and sedentary behaviour amongst preschool-aged children. Methods Two preschools in Taif city, Saudi Arabia were randomly assigned to either the intervention (n = 3 classrooms) or the usual curriculum control group (n = 3 classrooms). The intervention ran for 10 weeks from February to April 2023 and consisted of teacher-led physical activity and sedentary behaviour sessions in preschools, with an additional interactive home component. Primary outcome measures included intervention fidelity, recruitment rates, attrition rates, and compliance with trial procedures. Secondary outcomes included body mass index (BMI), objectively measured physical activity, and sedentary time via the ActiGraph GT3X accelerometer. Outcomes were measured at baseline and at 10 weeks in both study arms. Results The preschool intervention component had high fidelity (93.3%), but the home component fidelity was lower (74%). A cluster-level recruitment rate of 12% (13/112 centres) was attained, whilst the individual-level recruitment rate stood at 36% (52/143 children, mean age of 4.16 years; 23 girls). Attrition was 10%. Compliance varied with 90% for BMI, 71% for accelerometery, and 45% for questionnaires. The intervention group showed small decreases in BMI, slight increases in physical activity, and decreases in sedentary time at follow-up compared to the control group. Parents, facilitators, and assistant teachers considered the intervention to be feasible and beneficial. Conclusion The IAAH intervention was feasible to implement in Saudi Arabian preschools. Facilitators showed high fidelity in delivering it. However, preliminary data did not demonstrate effectiveness. A more comprehensive evaluation across a broader population is warranted. The intervention could be revised to optimise recruitment, compliance, and fidelity of the home-based component. Successful elements from this pilot should be retained whilst adaptations to implementation are made to strengthen key areas.Clinical trial registration: ClinicalTrials.gov, NCT05754359.
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Affiliation(s)
- Mosfer A. Al-walah
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Adel A. Alhusaini
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Neil Heron
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- School of Medicine, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
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Tonge KL, Mavilidi M, Jones RA. An updated systematic review of correlates of children's physical activity and sedentary time in early childhood education services. Child Care Health Dev 2024; 50:e13265. [PMID: 38657131 DOI: 10.1111/cch.13265] [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: 06/15/2023] [Revised: 02/06/2024] [Accepted: 03/24/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Early childhood education services (ECE) continue to be a key setting to promote physical activity and limit sedentary behaviour. Thus, the aim of this study was to (1) provide an updated systematic review of correlates of physical activity and sedentary behaviour among children in ECE settings and (2) discuss changes in physical activity and sedentary behaviour correlates among children in ECEC settings over time. METHODS A systematic search of eight databases identified 40 studies published between 2015 and 2023 that met the inclusion criteria. The variables were categorized into four domains (child, educator, physical environmental and organizational). Fifty-eight variables were identified. RESULTS For data from 2015 to 2023, strong associations were identified in all domains (child, educator, physical environmental and organizational) for physical activity, yet no strong associations for sedentary behaviour were identified. Aggregated data (i.e., combining data from previous review and this review) showed strong associations with children's physical activity and age, motor coordination and sex (child), educator behaviour and presence (educator), presence and size of outdoor environments (physical environmental) and active opportunities and service quality (organizational). For sedentary behaviour, sex, outdoor environments and active opportunities were strongly associated in the combined data. CONCLUSION The correlates of physical activity and sedentary behaviour in ECE settings continue to be multi-dimensional and span different domains. Variables such as educator behaviours and intentionality, provision of active opportunities, use of outdoor space and service quality should be the key focus area for improving physical activity and sedentary behaviour levels of young children.
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Affiliation(s)
- Karen L Tonge
- Early Start, Faculty of the Arts, Humanities and Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- School of Education, Faculty of The Arts, Humanities and Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Myrto Mavilidi
- Early Start, Faculty of the Arts, Humanities and Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- School of Education, Faculty of The Arts, Humanities and Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Rachel A Jones
- Early Start, Faculty of the Arts, Humanities and Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- School of Education, Faculty of The Arts, Humanities and Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
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Christiansen LB, Ekberg JE, Soini A, Larsen R, Kristjánsdóttir G, Froberg K, Sollerhed AC, Sääkslahti A, Fjørtoft I, Vilhjálmsson R, Olesen LG. A comparative analysis of movement and physical activity in early childhood teacher education policy in five Nordic countries. Front Sports Act Living 2024; 6:1352520. [PMID: 38645724 PMCID: PMC11026603 DOI: 10.3389/fspor.2024.1352520] [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: 12/08/2023] [Accepted: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction The aim of this study is to investigate the integration of movement and physical activity (MoPA) within Early Childhood Teacher Education (ECTE) policies across Denmark, Finland, Iceland, Norway, and Sweden. This knowledge can inform the development of ECTE policies and practices that promote MoPA in Early Childhood Education and Care (ECEC) in Nordic countries and other countries worldwide. Methods In this study, a Nordic cross-national network of researchers collaborated in investigating policy documents at the national and university levels, which govern the education of ECEC teachers. This study was inspired by the Non-affirmative Theory of Education, which provides a framework for understanding the various influences on curricular development in higher education. Based on this, a four-step comparative analytical process of national and university documents across the Nordic countries was conducted. It included keyword search for MoPA related courses and a qualitative description of MoPA in ECTE. Thus, a combination of investigations of policy documents at the national and university level and expert knowledge set a solid foundation for international comparison. Results The comparative analysis of MoPA in ECTE reveals diverse approaches influenced by national and university policies. A central theme is the variability in MoPA integration across these nations. Finland and Norway prioritize MoPA with independent mandatory courses. In Iceland, compulsory MoPA courses exist at one of two universities, and in Sweden at three out of 19. All university colleges in Denmark offer an elective course. Furthermore, learning objectives related to MoPA are, to varying degrees, part of the internships in the countries, with Sweden being an exception. In the participating countries, the teachers decide the content of the MoPA courses with little guidance, support, and agreement on essential MoPA content within and across the ECTE's. Norway has established guidelines, and in Finland, there is a network of ECTE Physical Education (PE) educators, which, to some degree, increases the consistency and quality of MoPA in education. Discussion The Nordic countries present diverse MoPA integration approaches rooted in national policies and educational traditions. The findings emphasize the necessity of independent and mandatory MoPA courses, integration of MoPA into internships and promoting networks across the educational and academic sectors to equip future early childhood educators with competencies for fostering physical activity, motor development and children's well-being.
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Affiliation(s)
- Lars Breum Christiansen
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jan-Eric Ekberg
- Department of Sport Sciences, Malmö University, Malmö, Sweden
| | - Anne Soini
- Department of Education, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Robert Larsen
- Department of Sports, Physical Education and Outdoor Studies, Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Notodden, Norway
| | - Gudrún Kristjánsdóttir
- Faculty of Nursing and Midwifery, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Karsten Froberg
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | | | - Arja Sääkslahti
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyväskylä, Finland
| | - Ingunn Fjørtoft
- Department of Sports, Physical Education and Outdoor Studies, Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Notodden, Norway
| | - Rúnar Vilhjálmsson
- Faculty of Nursing and Midwifery, School of Health Sciences, University of Iceland, Reykjavik, Iceland
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Byambaa A, Dechinjamts O, Jambaldorj B, Jones RA, Chong KH, Okely AD. Prevalence and Health Associations of Meeting the World Health Organization Guidelines for Physical Activity, Sedentary Behavior, and Sleep in Preschool-Aged Children: The SUNRISE Mongolia Pilot and Feasibility Study. J Phys Act Health 2024; 21:283-293. [PMID: 38242111 DOI: 10.1123/jpah.2023-0511] [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: 09/12/2023] [Revised: 11/17/2023] [Accepted: 12/06/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND There is a lack of evidence regarding 24-hour movement behaviors of young children from low- and middle-income countries. This study examined Mongolian preschoolers' adherence to the World Health Organization's guidelines for physical activity, sedentary behavior, and sleep; their associations with health indicators, and the feasibility of the SUNRISE International study in Mongolia. METHODS Preschool-aged children were recruited from 5 kindergartens in urban and rural areas of Ulaanbaatar city and Tuv province in Mongolia. Physical activity and sedentary behavior were measured by an ActiGraph accelerometer worn for 5 consecutive days. Screen time and sleep were reported by parents. The National Institute of Health and Early Years Toolboxes were used to assess motor skills and executive function, respectively. RESULTS One hundred and one children participated in the study (mean age = 4.82 y, boys = 58), with 88% (n = 89) having complete data for analysis. The proportion of children who met the recommendations for physical activity, sedentary screen time, and sleep was 61%, 23%, and 82%, respectively. Only 7% met all recommendations. Meeting the sleep recommendation individually (P = .032) and in combination with the physical activity recommendation was associated with better gross (P = .019) and fine (P = .042) motor skills. Spending more time in physical activity was positively correlated with motor development. Results confirmed that the SUNRISE study protocol was feasible, age-appropriate, and enjoyable for children. CONCLUSIONS The results of the SUNRISE pilot study will help inform the SUNRISE Mongolia main study and lay the groundwork for future research into children's 24-hour movement behaviors in Mongolia.
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Affiliation(s)
- Ankhmaa Byambaa
- Early Start, University of Wollongong, Wollongong, NSW, Australia
- School of Health & Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
- National Center for Public Health, Ulaanbaatar, Mongolia
| | | | | | - Rachel A Jones
- Early Start, University of Wollongong, Wollongong, NSW, Australia
- School of Education, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Kar Hau Chong
- Early Start, University of Wollongong, Wollongong, NSW, Australia
- School of Health & Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Anthony D Okely
- Early Start, University of Wollongong, Wollongong, NSW, Australia
- School of Health & Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
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Wadsworth DD, Spring KE. The Impact of an Acute Active Reading Intervention on Physical Activity Levels in Preschoolers: A Comparative Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:183. [PMID: 38397295 PMCID: PMC10887753 DOI: 10.3390/children11020183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 02/25/2024]
Abstract
The purpose of this study was to examine the acute effects of an active reading intervention on physical activity (PA) levels in preschoolers. Participants were recruited from the 3-5-year-old classes at two preschools. A total of six classrooms and 37 children participated in three conditions: an active reading book read by a researcher (Act_R) trained in active play techniques, an active reading book read by a preschool classroom teacher (Act_T), and a book about health behavior read by both the researcher and the teacher (Sed_H). The order in which classes received each condition was randomized. The Actigraph accelerometer assessed PA. Motor skills were assessed with the Peabody Motor Development Scale, 2nd Edition. Participants spent significantly more time in sedentary behavior during the Sed_H condition compared to Act_R (p < 0.000) and Act_T (p < 0.008). Participants spent significantly more time in MVPA during Act_R compared to Act_T (p = 0.030), Act_T compared to Sed_H (p < 0.001), and Act_R compared to Sed_H (p < 0.001). The amount of MVPA participation within the active reading sessions was not dependent upon the level of fundamental motor skill competence. Active reading books may provide a feasible method to incorporate physical activity and active play into the preschool day.
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Affiliation(s)
- Danielle D. Wadsworth
- Exercise Adherence and Obesity Prevention Laboratory, School of Kinesiology, Auburn University, Auburn, AL 36849, USA;
| | - Katherine E. Spring
- Exercise Adherence and Obesity Prevention Laboratory, School of Kinesiology, Auburn University, Auburn, AL 36849, USA;
- Pediatric Obesity and Health Behavior Laboratory, Division of Population and Public Health Science, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
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Webster EK, Kepper MM, Saha S, Beyl RA, Kracht CL, Romain JS, Staiano AE. Painted playgrounds for preschoolers' physical activity and fundamental motor skill improvement: a randomized controlled pilot trial of effectiveness. BMC Pediatr 2023; 23:455. [PMID: 37689622 PMCID: PMC10492343 DOI: 10.1186/s12887-023-04260-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 08/21/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Preschool children are not meeting recommended levels of physical activity (PA) nor are they proficient in fundamental motor skills (FMS), which are the foundation for PA. As such, interventions are needed to increase PA and FMS in young children. This trial examined the effects of an environmental ("painted playgrounds") and capacity-building (written toolkit) intervention on child FMS, PA, and sedentary behavior at early childhood education (ECE) centers and examined feasibility. METHODS In a randomized controlled trial, four ECE centers were randomly assigned to an intervention group or wait-list control. For intervention centers, stencils were spray painted adjacent to playgrounds and teachers were provided material for using stencils for FMS practice. Follow-up assessments were conducted six to eight weeks after baseline. Time spent in PA and sedentary behavior was assessed via accelerometry and FMS were evaluated using the Test of Gross Motor Development (TGMD-3) at baseline and follow-up. A repeated measures linear model was performed to test the effects of the painted playgrounds on the primary outcomes of interest. Feasibility was measured by stencil engagement via direct observation and satisfaction surveys. RESULTS A total of 51 preschoolers completed baseline assessments (4.3±0.6 years; 43.1% male). There were no significant changes in PA or sedentary behavior (all confidence intervals contain 0) between control and intervention groups. Intervention children significantly improved ball skill, locomotor, and overall TGMD-3 percentile scores at follow-up (all (all confidence intervals contain 0), which was not observed in control group. However, there was no significant change in FMS between the control and intervention groups (confidence intervals contain 0). For stencil use, boys and girls interacted with different stencils during their free play. Directors and teachers reported children incorporated academic concepts and initiated games, and teachers prompted more PA opportunities on the playground. CONCLUSIONS This intervention did not show statistically significant changes in children's PA, FMS, or sedentary behavior compared to a control group; however, small FMS improvements for the intervention group were found from baseline to follow-up. Further work should examine intervention fidelity as well as inexpensive supplies, teacher training, or other strategies to increase preschool children's PA and improve FMS at ECE centers.
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Affiliation(s)
- E Kipling Webster
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, 1914 Andy Holt Ave, Knoxville, TN, 37996, USA.
| | - Maura M Kepper
- Washington University of St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Sanjoy Saha
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Robbie A Beyl
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Chelsea L Kracht
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Jessica St Romain
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
- Virginia Commonwealth University Health, Sanger Hall 1101 E. Marshall, Richmond, VA, 23298, USA
| | - Amanda E Staiano
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
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Neshteruk C, Burkart S, Flanagan EW, Melnick E, Luecking C, Kracht CL. Policy, systems, and environmental interventions addressing physical activity in early childhood education settings: A systematic review. Prev Med 2023; 173:107606. [PMID: 37414226 PMCID: PMC10699121 DOI: 10.1016/j.ypmed.2023.107606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/30/2023] [Accepted: 07/02/2023] [Indexed: 07/08/2023]
Abstract
Policy, systems, and environmental (PSE) approaches can facilitate physical activity in priority populations (e.g., racial and ethnic minority, low wealth groups) within early childhood education (ECE) settings. The purpose of this review was to 1) characterize the inclusion of priority populations within ECE physical activity interventions containing PSE approaches and 2) identify and describe interventions within these populations. Seven databases were systematically searched (January 2000-Febrary 2022) for ECE-based interventions focusing on children (0-6 years) that utilized at least one PSE approach. Eligible studies included a child physical activity or physical activity environment outcome and child or center-level population characteristics. Forty-four studies, representing 42 interventions were identified. For Aim 1, half of interventions included one PSE approach (21/42), with only 11/42 including three or more approaches. Physical environment changes [e.g., adding play equipment, modifying space (25/42)] were the most used PSE approaches followed by system [e.g., integrating activity into routines, (21/42)] and policy [e.g., outdoor time (20/42)] approaches. Nearly half of interventions were conducted in predominantly priority populations (18/42). Studies were primarily rated as good (51%) or fair (38%) methodological quality using the Downs and Black checklist. In Aim 2, of the 12 interventions assessing child physical activity in priority populations, 9/12 reported at least one physical activity outcome in the expected direction. Of the 11 interventions assessing the physical activity environment, 9/11 reported an effect in the expected direction. Findings indicate clear opportunities exist to target priority populations by incorporating PSE approaches in ECE physical activity interventions.
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Affiliation(s)
- Cody Neshteruk
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States of America.
| | - Sarah Burkart
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Emily W Flanagan
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, United States of America
| | - Emily Melnick
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America
| | - Courtney Luecking
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, United States of America
| | - Chelsea L Kracht
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, United States of America
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Ullevig SL, Parra-Medina D, Liang Y, Howard J, Sosa E, Estrada-Coats VM, Errisuriz V, Li S, Yin Z. Impact of ¡Míranos! on parent-reported home-based healthy energy balance-related behaviors in low-income Latino preschool children: a clustered randomized controlled trial. Int J Behav Nutr Phys Act 2023; 20:33. [PMID: 36944986 PMCID: PMC10029790 DOI: 10.1186/s12966-023-01427-z] [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: 03/17/2022] [Accepted: 02/19/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Widespread establishment of home-based healthy energy balance-related behaviors (EBRBs), like diet, physical activity, sedentary behavior, screen time, and sleep, among low-income preschool-aged children could curb the childhood obesity epidemic. We examined the effect of an 8-month multicomponent intervention on changes in EBRBs among preschool children enrolled in 12 Head Start centers. METHODS The Head Start (HS) centers were randomly assigned to one of three treatment arms: center-based intervention group (CBI), center-based plus home-based intervention group (CBI + HBI), or control. Before and following the intervention, parents of 3-year-olds enrolled in participating HS centers completed questionnaires about their child's at-home EBRBs. Adult-facilitated physical activity (PA) was measured by an index based on questions assessing the child's level of PA participation at home, with or facilitated by an adult. Fruit, vegetable, and added sugar intake were measured via a short food frequency questionnaire, and sleep time and screen time were measured using 7-day logs. A linear mixed effects model examined the intervention's effect on post-intervention changes in PA, intake of fruit, vegetable, and added sugar, sleep time, and screen time from baseline to post-intervention. RESULTS A total of 325 parents participated in the study (CBI n = 101; CBI + HBI n = 101; and control n = 123). Compared to control children, CBI and CBI + HBI parents reported decreases in children's intake of added sugar from sugar-sweetened beverages. Both CBI and CBI + HBI parents also reported smaller increases in children's average weekday screen time relative to controls. In addition, CBI + HBI parents reported CBI + HBI parents reported increases in children's adult-facilitated PA, fruit and vegetable intake, and daily sleep time during weekdays (excluding weekends) and the total week from baseline to post-intervention, while children in the CBI increased sleep time over the total week compared to the children in the control group. CONCLUSIONS Parent engagement strengthened the improvement in parent-reported EBRBs at home in young children participating in an evidence-based obesity prevention program in a childcare setting. Future studies should investigate equity-related contextual factors that influence the impact of obesity prevention in health-disparity populations. TRIAL REGISTRATION ClinicalTrials.gov, NCT03590834. Registered July 18, 2018, https://clinicaltrials.gov/ct2/show/NCT03590834.
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Affiliation(s)
- Sarah L Ullevig
- College for Health, Community and Policy, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA
| | - Deborah Parra-Medina
- Latino Research Institute, University of Texas at Austin, 210 W. 24th Street, GWB 1.102, Austin, TX, 78712, USA.
| | - Yuanyuan Liang
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 W. Redwood Street, Baltimore, MD, USA
| | - Jeffrey Howard
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA
| | - Erica Sosa
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA
| | - Vanessa M Estrada-Coats
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA
| | - Vanessa Errisuriz
- Latino Research Institute, University of Texas at Austin, 210 W. 24th Street, GWB 1.102, Austin, TX, 78712, USA
| | - Shiyu Li
- School of Nursing, UT Health San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, USA
| | - Zenong Yin
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA
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Wenden EJ, Virgara R, Pearce N, Budgeon C, Christian HE. Movement behavior policies in the early childhood education and care setting: An international scoping review. Front Public Health 2023; 11:1077977. [PMID: 37113169 PMCID: PMC10126357 DOI: 10.3389/fpubh.2023.1077977] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 03/20/2023] [Indexed: 04/29/2023] Open
Abstract
Background Meeting 24-h movement behavior guidelines for the early years is associated with better health and development outcomes in young children. Early childhood education and care (ECEC) is a key intervention setting however little is known about the content and implementation of movement behavior polices in this context. To inform policy development this international scoping review examined the prevalence, content, development and implementation of ECEC-specific movement behavior policies. Methods A systematic literature search of published and gray literature since 2010 was conducted. Academic databases (EMBASE, Cinahl, Web of Science, Proquest, Scopus, EBSCO, PubMed) were searched. A Google search was undertaken and limited to the first 200 results. The Comprehensive Analysis of Policy on Physical Activity framework informed data charting. Results Forty-three ECEC policy documents met inclusion criteria. Most policies originated in the United States, were subnational and developed with government, non-government organizations and ECEC end-users. Physical activity was specified in 59% (30-180 min/day), sedentary time in 51% (15-60 min/day) and sleep in 20% (30-120 min/day) of policies. Daily outdoor physical activity was recommended (30-160 min/day) in most policies. No policy permitted screen time for children <2 years, with 20-120 min/day for children >2 years. Most policies (80%) had accompanying resources but few provided evaluation tools (e.g., checklists; action plan templates). Many policies had not been reviewed since the publication of 24-h movement guidelines. Conclusion Movement behavior policies in the ECEC setting are often vaguely worded, missing a comprehensive evidence base, siloed in development and often not tailored for the 'real world.' A focus on evidence informed ECEC-specific movement behavior policies proportionally aligned with national/international 24-h Movement Behaviors Guidelines for the Early Years is needed.
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Affiliation(s)
- Elizabeth J. Wenden
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
- *Correspondence: Elizabeth J. Wenden,
| | - Rosa Virgara
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Natasha Pearce
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Charley Budgeon
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Hayley E. Christian
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
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Wenden EJ, Pearce N, George P, Christian HE. Educators' Barriers and Facilitators to Physical Activity Policy Implementation in the Childcare Setting: Qualitative Findings From the Play Active Project. Am J Health Promot 2022; 36:1326-1334. [PMID: 35612922 DOI: 10.1177/08901171221105052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE We explored childcare educators' perceived barriers and facilitators to policy implementation in order to inform the development and implementation of an early childhood education and care (ECEC) specific physical activity policy. This study was part of the Play Active (2019-2023) project which aimed to develop, implement and evaluate evidence-based physical activity policy to improve physical activity levels in children attending ECEC. APPROACH Stakeholder focus groups. Setting: ECEC centers in Perth, Western Australia. Sample: Educators (n=66) from 11 ECEC centers participated in 13 focus groups (August-September 2019). METHODS Semi-structured questions explored educators' perceptions of barriers and facilitators to implementing a new physical activity policy. A qualitative descriptive approach within a naturalistic framework informed data analysis. Focus group data were reviewed and grouped through several iterations to produce core themes. RESULTS Four core themes resulted from focus groups: (1) leadership; (2) educator mindset: (3) parent engagement; and (4) organisational and educator capacity. Educators needed supportive leadership and a commitment of resources for physical activity policy implementation. Educators acknowledged physical activity practices can be influenced by knowledge, attitudes, beliefs and change capacity and stressed the need for parent engagement for successful implementation. CONCLUSIONS Educators' voices are important for informing implementation of physical activity policy and practices leading to improvements in children's physical activity levels.
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Affiliation(s)
- Elizabeth J Wenden
- Telethon Kids Institute, 117610University of Western Australia, Crawley, WA, Australia.,School of Population and Global Health, 85075University of Western Australia, Crawley, WA, Australia
| | - Natasha Pearce
- Telethon Kids Institute, 117610University of Western Australia, Crawley, WA, Australia
| | - Phoebe George
- Telethon Kids Institute, 117610University of Western Australia, Crawley, WA, Australia
| | - Hayley E Christian
- Telethon Kids Institute, 117610University of Western Australia, Crawley, WA, Australia.,School of Population and Global Health, 85075University of Western Australia, Crawley, WA, Australia
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11
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Me P, Mj E, Ad O, K P, M B, Ra J. A blended professional learning intervention for early childhood educators to target the promotion of physical activity and healthy eating: the HOPPEL cluster randomized stepped-wedge trial. BMC Public Health 2022; 22:1353. [PMID: 35841084 PMCID: PMC9284697 DOI: 10.1186/s12889-022-13542-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childcare centres are important environments for promoting physical activity and healthy eating. Blended approaches to professional learning may help overcome existing challenges for educators in promoting these behaviours. This study aimed to test the effect of a blended professional learning program on healthy eating and physical activity in childcare. METHODS Cluster randomized stepped-wedge trial in 15 childcare centres in Tasmania, Australia. Children aged 2-5y who attended at least two days per week were eligible to participate. Random assignment occurred at the centre level. Centre names were drawn out of a hat and then subsequently allocated to one of the three steps. The intervention comprised a 12-week blended professional learning program for educators. The main outcome was centre-level physical activity and healthy eating, assessed using the Environment and Policy Assessment Observation System (EPAO). All data collectors were blinded to step allocation. Analyses were according to intention to treat. The trial was registered with the Australian New Zealand Clinical Trial Registry (ACTRN12618000346279, date registered: 07/03/2018). RESULTS Centres were recruited between January 2016 and February 2016. All centres were retained for the duration of the study. A total of 313 children were recruited with 291 analysed at the completion of the study (93%). The difference between groups for the EPAO total score was significant at the end of the maintenance period (adjusted difference = 14.63, 95% CI [1.33, 27.92], p = 0.03). Significant differences were found for the percentage of time children spent in light-intensity physical activity at the end of the intervention (adjusted difference = 0.01, 95% CI [0.00,0.01], p = 0.02) and maintenance periods (adjusted difference = 0.01, 95% CI [0.00,0.02], p = 0.04). To the best of the authors knowledge, there were no adverse events. CONCLUSION This intervention achieved a sustained improvement in physical activity and healthy eating in childcare centres. Further, it can be easily integrated into existing service provision, especially among centres with limited access to professional learning. TRIAL REGISTRATION The study was registered with the Australian and New Zealand Clinical Trials Registry ( ACTRN12618000346279 , date registered: 07/03/2018).
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Affiliation(s)
- Peden Me
- Early Start, School of Education, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Eady Mj
- School of Education, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Okely Ad
- School of Health and Society, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Patterson K
- Faculty of Education, University of Tasmania, Tasmania, 7005, Australia
| | - Batterham M
- School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Jones Ra
- Early Start, School of Education, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia.
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12
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Gans KM, Jiang Q, Tovar A, Kang A, McCardle M, Risica PM. Physical Activity and Screen Time Practices of Family Child Care Providers: Do They Meet Best Practice Guidelines? Child Obes 2022; 18:281-290. [PMID: 34851731 PMCID: PMC9145567 DOI: 10.1089/chi.2021.0094] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Child care settings significantly influence children's physical activity (PA) and screen time (ST) behaviors, yet less research has been conducted in family child care homes (FCCHs) than in child care centers. While a few studies have measured family child care providers' (FCCPs') PA practices, none have used observation to assess which specific evidence-based, best practice guidelines FCCPs met or did not meet, and no previous studies have included Latinx providers. This article examines FCCPs' adherence to PA and ST best practice guidelines using primarily observational methods with diverse FCCPs (including Latinx). Methods: We examined baseline data from a cluster randomized trial including surveys and observational data collected at the FCCH to assess whether providers met specific PA and ST best practices from the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) and the American Academy of Pediatrics. Results: Providers completed a telephone survey and participated in two full-day observations (n = 127; 72% Hispanic). Overall, only 4 of 14 PA and ST best practices were met by >50% of providers including: leading a planned PA class more than once a week; no ST during meal or snack; not modeling sedentary behavior; and providing families with information about children's ST. Best practices least likely to be met (<20% of providers) include: providing children with >60 minutes of outdoor play daily; providing children with >45 minutes of adult-led PA each day; participating in outdoor PA with children; participating in indoor PA with children; prompting and praising children for being active; and talking with children informally about the importance of PA. Conclusions: While FCCPs engage in some positive PA and ST practices, many providers do not meet best practice guidelines. There is a need for more research about how to overcome providers' personal and environmental barriers for meeting these guidelines as well as interventions and supports to overcome these barriers. Clinical Trial Registration Number NCT0245645.
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Affiliation(s)
- Kim M. Gans
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.,University of Connecticut Institution for Collaboration in Health, Interventions and Policy, Storrs, CT, USA.,Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA.,Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, USA.,Address correspondence to: Kim M. Gans, PhD, MPH, Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Qianxia Jiang
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.,University of Connecticut Institution for Collaboration in Health, Interventions and Policy, Storrs, CT, USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Augustine Kang
- Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Meagan McCardle
- Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Patricia M. Risica
- Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA.,Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, USA
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13
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Thinking inside the box: The future of young children's physical activity and the home environment. Soc Sci Med 2022; 301:114930. [PMID: 35344777 PMCID: PMC9350970 DOI: 10.1016/j.socscimed.2022.114930] [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: 11/15/2021] [Revised: 02/07/2022] [Accepted: 03/15/2022] [Indexed: 11/20/2022]
Abstract
Parrish et al.'s (2021) investigation of caregiver perceptions of preschoolers' physical activity (PA) within the home environment posits important opportunities for public policy to consider space and available opportunities for PA for preschoolers. This study uncovered qualitative themes on preschoolers' PA in the home, referencing the use of indoor and outdoor spaces, adaptations within the home, interplay between space and caregiving, and variability in child's PA. This work sparks a discussion into the current understanding of the home environment for preschooler PA and future research directions. We propose three main areas to bring forward physical activity and public health research, including 1) role of policies and community (e.g., societal norms) on the home environment and child physical activity, 2) reimagination of the home environment beyond the physical components as a complex system, and 3) advanced measurement of child physical activity using modern technology. Merging these new opportunities with past efforts may help design and facilitate healthier PA and movement patterns for preschoolers now and into the future.
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14
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Gans KM, Tovar A, Kang A, Ward DS, Stowers KC, von Ash T, Dionne L, Papandonatos GD, Mena N, Jiang Q, Risica PM. A multi-component tailored intervention in family childcare homes improves diet quality and sedentary behavior of preschool children compared to an attention control: results from the Healthy Start-Comienzos Sanos cluster randomized trial. Int J Behav Nutr Phys Act 2022; 19:45. [PMID: 35428298 PMCID: PMC9013065 DOI: 10.1186/s12966-022-01272-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background Childcare settings are important environments for influencing child eating and physical activity (PA). Family childcare homes (FCCH) care for many children of low-income and diverse racial/ethnic backgrounds who are at greater risk for poor diet quality, low PA, and obesity, but few interventions have targeted this setting. The aim of this study was to assess the efficacy of a multicomponent intervention conducted in FCCH on the diet quality and PA of 2–5 year old children in their care. Trial design Cluster randomized trial. Methods The cluster-randomized trial, Healthy Start/Comienzos Sanos (2015–2019) evaluated an 8-month nutrition and PA intervention that included four components: (1) monthly telephone calls from a support coach using brief motivational interviewing, (2) tailored reports, newsletters and videos, (3) group support meetings, and (4) active play toys. After completing baseline measurement, FCCH were randomized into intervention or comparison groups in matched pairs. Both groups received the same intervention components but on different topics (intervention: nutrition/PA vs. comparison: reading readiness/literacy). Evaluation staff were blinded to group assignment. Child primary outcome measures collected at baseline and 8-months included: 1) Healthy Eating Index (HEI-2015) scores calculated from diet observation, and 2) accelerometer measurement of PA. Process measures were collected from field data and provider surveys. Generalized Estimating Equation Models assessed changes in HEI-2015 scores and PA over time by experimental condition. Results Ethnically diverse FCCH providers (n = 119) and 2-to-5-year-old children in their care (n = 377) were included in the final analysis. Process evaluation showed high participation in all intervention components except for group meetings. Compared to children in comparison group FCCH, children in intervention FCCH increased total HEI-2015 scores by 7.2 points (p < .001) including improvement in component scores for vegetables (0.84 points, p = .025) and added sugar (0.94 points, p = .025). For PA, compared to children in the comparison group, children in intervention FCCH decreased sedentary time by 5.7% (p = .021). Conclusions The multicomponent Healthy Start intervention was effective in improving diet quality and sedentary behavior of children in FCCH, which demonstrates the promise of obesity prevention interventions in this setting. Future research could include enhancing the Healthy Start intervention to strengthen the PA component, considering virtual peer support, and determining how to best translate and disseminate the intervention into FCCH nationally. Trial registration National Institutes of Health, NCT02452645. Registered 5 May 2015. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01272-6.
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15
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Lessons Learned From 10 Years of Preschool Intervention for Health Promotion. J Am Coll Cardiol 2022; 79:283-298. [DOI: 10.1016/j.jacc.2021.10.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 12/20/2022]
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16
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Telford RM, Olive LS, Telford RD. A peer coach intervention in childcare centres enhances early childhood physical activity: The Active Early Learning (AEL) cluster randomised controlled trial. Int J Behav Nutr Phys Act 2021; 18:37. [PMID: 33726777 PMCID: PMC7962250 DOI: 10.1186/s12966-021-01101-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background As numbers of children and time spent in childcare centres increase, so does the potential influence of these centres on early childhood physical activity (PA). However, previous reports indicate little success of interventions aimed at improving PA. The Active Early Learning (AEL) program is a multi-component pragmatic intervention designed to imbed PA into the daily curriculum. Delivered by childcare centre staff, it is directed and supported by a peer coach who works across a network of centres. The objective of the study is to investigate the effect of the AEL program on children’s PA. Methods Fifteen childcare centres (8 intervention, 7 control centres; 314 children, 180 boys, 4.3y ± 0.4) participated in a 22-week stratified cluster randomised controlled trial. To be eligible to participate, centres needed to have ≥15 preschool children aged 3 to 5-years. The primary outcome was PA measured by accelerometer (Actigraph GT3X) during childcare centre hours over a 3-day period, calculated in min/h of Total PA and moderate-to-vigorous PA (MVPA). The effect of the intervention was evaluated using linear mixed models adjusted for age, sex, accelerometer wear time and centre clustering. Results There was an intervention effect for Total PA (+ 4.06 min/h, 95% CI [2.66 to 5.47], p < .001) and MVPA (+ 2.33 min/h, 95% CI [1.31 to 3.34] p < .001). On average, a child taking part in the intervention attending a childcare centre from 8 am to 3 pm performed 28 min more Total PA and 16 min more MVPA per day than children receiving usual practice care. Conclusion In contrast with the findings of previous pragmatic trials in early childcare centres, this study shows that a peer-coach facilitated program, focussed on integrating PA into the daily childcare routine, can elicit increases in preschool children’s PA of practical as well as statistical significance. Trial registration Australian New Zealand Clinical Trials registry: ACTRN12619000638134. Registered 30/04/2019.
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Affiliation(s)
- R M Telford
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - L S Olive
- School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Social and Early Emotional Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - R D Telford
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.
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17
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Andersen E, Øvreås S, Jørgensen KA, Borch-Jenssen J, Moser T. Children's physical activity level and sedentary behaviour in Norwegian early childhood education and care: effects of a staff-led cluster-randomised controlled trial. BMC Public Health 2020; 20:1651. [PMID: 33148218 PMCID: PMC7640688 DOI: 10.1186/s12889-020-09725-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 10/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A growing body of evidence suggest that the children's physical activity (PA) level in early childhood education and care (ECEC) settings are insufficient. Since most children attend ECEC settings for many hours on most days of the week, and these institutions reach children across the socioeconomic spectrum, the ECEC settings may serve as an ideal avenue for increasing physical activity level, reduce sedentary time and enhance the overall health of young children. This paper investigates the effectiveness of the "Active Kindergarten - Active Children" study to increase children's PA level and reduce sedentary time within the ECEC setting. METHODS Accelerometers were used to asses PA and sedentary time. A total of 116 three to four-year olds took part in a randomised controlled trial in 11 ECEC settings. Participants were cluster-randomised, by ECEC setting, to either a 12 week staff-led and expert-supported intervention or a waiting list control group. RESULTS The intervention group increased time spent in moderate- and vigorous intensity PA by 10 min/day (95% CI = 3, 18; P = 0.01), took 1909 more steps per day (95% CI = 1130, 2688; P < 0.01) and reduced sedentary time with 14 min/day (95% CI = - 27, - 1; P = 0.04) compared to the control group. The intervention group had a 2.4 higher odds (95% CI = 1.05, 5.7; P = 0.04) of meeting the PA recommendations compared to the control group at follow-up. CONCLUSIONS Our results show that a flexible staff-led and expert-supported multicomponent PA intervention can increase total PA level, moderate- and vigorous intensity PA and reduce time spent sedentary in three to four-year old children during their stay in ECEC settings. TRIAL REGISTRATION The trial was retrospectively registered on September 19, 2020 and available online at ClinicalTrials.gov: No. NCT04555746 .
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Affiliation(s)
- Eivind Andersen
- Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Horten, Norway.
| | - Steinar Øvreås
- Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Horten, Norway
| | - Kari Anne Jørgensen
- Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Horten, Norway
| | | | - Thomas Moser
- Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Horten, Norway
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18
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Christian HE, Cross D, Rosenberg M, Schipperijn J, Shilton T, Trapp G, Trost SG, Nathan A, Maitland C, Thornton A, Wenden EJ, George P. Development of physical activity policy and implementation strategies for early childhood education and care settings using the Delphi process. Int J Behav Nutr Phys Act 2020; 17:131. [PMID: 33066798 PMCID: PMC7566154 DOI: 10.1186/s12966-020-01034-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 10/05/2020] [Indexed: 01/26/2023] Open
Abstract
Background The aim of this study was to gain consensus on an evidence informed physical activity policy template for early childhood education and care (ECEC) and determine best-practice dissemination and implementation strategies using the Delphi process. Methods Three-round modified Delphi methodology. During round one an expert working group developed an evidence informed ECEC specific physical activity policy template. Rounds two and three involved national online surveys to seek insight from a group of experts on the draft physical activity policy template. Results Ninety per cent of experts reported ECEC services are fully responsible for having a physical activity policy. There was consensus on the components of the policy and key physical activity and sedentary behaviour statements and recommendations. The most effective methods for disseminating a physical activity policy to ECEC providers included online (websites, social and electronic media), ECEC targeted launch events, direct mail outs and via professional associations. Twenty five key strategies related to management, supervisors and educators; the ECEC physical environment; communicating with families; and accreditation, monitoring and review, were identified as necessary for the successful implementation of physical activity policy in ECEC. Experts reached consensus on nine of these strategies indicating they were both easy to implement and likely to have a high level of influence. Key barriers and enablers to implementing ECEC-specific physical activity were also identified. Conclusions This evidence informed physical activity policy template for ECEC provides recommendations on the amount of physical activity and sedentary time (including screen time) children should have whilst attending ECEC and aligns with national/international guidelines. A number of effective physical activity policy implementation strategies for ECEC were identified. An important next step is advocating for the introduction of legislative requirements for services to have and implement a physical activity policy.
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Affiliation(s)
- Hayley E Christian
- Telethon Kids Institute, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. .,School of Population and Global Health, University of Western Australia, Perth, Australia.
| | - Donna Cross
- Telethon Kids Institute, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Michael Rosenberg
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Jasper Schipperijn
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Trevor Shilton
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Georgina Trapp
- Telethon Kids Institute, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.,School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation - Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Andrea Nathan
- Telethon Kids Institute, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Clover Maitland
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia.,Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia
| | - Ashleigh Thornton
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Elizabeth J Wenden
- Telethon Kids Institute, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.,School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Phoebe George
- Telethon Kids Institute, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
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Müller C, Hassel H. [Childcare Center Characteristics Associated with Children's MVPA: A Multilevel Analysis with Cross-Sectional Data from the QueB 2 Project]. DAS GESUNDHEITSWESEN 2020; 83:903-909. [PMID: 32869241 DOI: 10.1055/a-1205-0917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Characteristics of childcare centers influence the daily time spent on moderate-to-vigorous physical activity (MVPA) by children younger than 6 years. The study explores the characteristics of childcare centers and the behavior of staff that influence children's MVPA levels. METHODS We used cross-sectional data from 8 childcare centers in the research project QueB 2. MVPA per day was measured with ActiGraph GT3X+accelerometers. Independent variables included were age, sex, staff MVPA levels and 8 items from a self-assessment-checklist for childcare centers. Hierarchical linear regression models were run with SAS. RESULTS Valid accelerometer data on 126 children (51.59% girls) were available. Girls spent a mean of 33.01, boys of 49.11 min per day in MVPA. Childcare centers accounted for only 1.72% of variance. Indoor space, rules concerning physical activity and staff participating in activities were significantly associated with children's MVPA. CONCLUSIONS Individual variables (age, sex) seem to have a greater influence on children's daily time spent on MVPA than childcare center characteristics and should be taken into account when implementing interventions to promote physical activity.
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Affiliation(s)
- Christina Müller
- Institut für angewandte Gesundheitswissenschaften, Hochschule für angewandte Wissenschaften Coburg, Coburg
| | - Holger Hassel
- Institut für angewandte Gesundheitswissenschaften, Hochschule für angewandte Wissenschaften Coburg, Coburg
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