Leigh M. Vanderloo

The Influence of Centre-Based Childcare on Preschoolers' Physical Activity Levels: A Cross-Sectional Study

The childcare environment represents an appropriate avenue to support physical activity among preschoolers. The aim of this study was two-fold: (1) to measure the physical activity levels of a sample of preschoolers during childcare hours; and (2) to assess which attributes (e.g., space, equipment, policies) within centre-based childcare environments influenced physical activity. Thirty-one preschoolers from 5 childcare centres across London, Canada participated. Actical accelerometers were worn by participants for one day during childcare hours to assess activity levels using a 15 second epoch length. The Environment and Policy Assessment and Observation instrument was used to conduct a full-day evaluation of the childcare environment. On average, participants engaged in 1.54 min/h of moderate-to-vigorous physical activity and 17.42 min/h of total physical activity. Sedentary opportunities, portable and fixed play equipment, and staff behaviour accounted for 49.3% of the variability in moderate-to-vigorous physical activity and 14.1% of the variability in total physical activity, with sedentary opportunities, fixed play equipment, and staff behaviours displaying an inverse relationship. Results emphasize the critical role the childcare environment plays in supporting physical activity among preschoolers.

Learning environments’ activity potential for preschoolers (LEAPP): study rationale and design

Background The purpose of this paper is to provide an overview of the study protocol for the Learning Environments’ Activity Potential for Preschoolers (LEAPP) study, the goal of which is to describe the activity levels of preschoolers attending various early learning venues and explore which attributes of these facilities (e.g. curriculum, policies, equipment, etc.) support activity participation. Design and methods This cross-sectional study aimed to recruit approximately 30 early learning environments requesting participation from preschoolers aged 2.5-5 years. Data collection included: Actical accelerometers (MiniMitter, Oregon, USA) to measure the activity levels of children for five consecutive days (15-second epoch length) while in care; the Environment and Policy Assessment and Observation tool to explore the early learning environment’s impact on activity; anthropometric data; the Child Temperament Questionnaire to assess the influence of preschoolers’ temperament on physical activity; and demographic information from parents/guardians and early learning staff. ANOVA and linear regression analyses will be conducted to assess variances in activity levels among preschoolers attending different early learning types and to explore the impact of early learning environments on their activity levels. Independent sample t-tests will be used to examine differences in activity levels based on sex and weight status. Expected impact of the study for public health This research will provide the first Canadian data to address environmental influences on preschoolers’ activity levels in differing early learning environments. Additionally, this work will highlight the extent to which activity levels vary among preschoolers enrolled in full-day kindergarten, centre-, and home-based childcare. Significance for public health This study represents the first examination of the differences in physical activity levels among preschoolers attending various early learning environments. As such, it is important that the methodology undertaken be shared in the event that other researchers doing comparable work want to adopt a similar approach. Results of this research may inform the work of health promotion, public health, and early learning stakeholders. Specifically this work may impact early learning curricula, policies, and practices in service of helping Canada’s preschool cohort become sufficiently physically active.

Defining and Measuring Active Play Among Young Children: A Systematic Review

BACKGROUND Many young children are not meeting the Canadian physical activity guidelines. In an effort to change this, the term active play has been used to promote increased physical activity levels. Among young children, physical activity is typically achieved in the form of active play behavior. The current study aimed to review and synthesize the literature to identify key concepts used to define and describe active play among young children. A secondary objective was to explore the various methods adopted for measuring active play. METHODS A systematic review was conducted by searching seven online databases for English-language, original research or reports, and were eligible for inclusion if they defined or measured active play among young children (ie, 2 to 6 years). RESULTS Nine studies provided a definition or description of active play, six measured active play, and 13 included both outcomes. While variability in active play definitions did exist, common themes included: increased energy exerted, rough and tumble, gross motor movement, unstructured, freely chosen, and fun. Alternatively, many researchers described active play as physical activity (n = 13) and the majority of studies used a questionnaire (n = 16) to assess active play among young children. CONCLUSION Much variability in the types of active play, methods of assessing active play, and locations where active play can transpire were noted in this review. As such, an accepted and consistent definition is necessary, which we provide herein.

Exploring the Nexus Between Health Promotion and Occupational Therapy: Synergies and Similarities

Background. The similarities between health promotion and occupational therapy have been recognized. Both are based on perspectives that share a goal of enabling individuals and populations to improve control over their health. Consequently, it is logical that the principles of health promotion complement the practice of occupational therapy. Purpose. This paper highlights the affinity between occupational therapy and health promotion, and discusses ways in which health promotion principles can be incorporated into occupational therapy practice. Key Issues. Some Canadian occupational therapists may be unaware of the current discourse in health promotion and, thus, may not be incorporating its principles into practice. Steps are warranted to expand the current knowledge and practice of therapists to include health promotion, with specific attention to providing services for the population. Implications. Incorporating health promotion principles into occupational therapy perspectives will facilitate the implementation of the domains of practice within the occupational therapy profile. This paper highlights how the principles of health promotion can impact practice at the individual and community level. Description. Les similarités entre la promotion de la santé et l’ergothérapie ont été reconnues. En effet, la promotion de la santé et l’ergothérapie sont basées sur des perspectives ayant le même but, soit celui d’aider les individus et les populations à avoir une meilleure emprise sur leur santé. Par conséquent, il est logique que les principes de la promotion de la santé soient complémentaires à la pratique de l’ergothérapie. But. Cet article met en relief les affinités entre l’ergothérapie et la promotion de la santé et discute des façons d’incorporer les principes de la promotion de la santé dans la pratique de l’ergothérapie. Questions clés. Certains ergothérapeutes canadiens ne sont peut-être pas au courant du discours actuel sur la promotion de la santé et n’incorporent peut-être pas ses principes dans la pratique. Des mesures doivent être prises pour rehausser les connaissances actuelles et la pratique des ergothérapeutes, en vue d’incorporer la promotion de la santé et d’accorder une attention spécifique à la prestation de services à la population. Conséquences. L’incorporation des principes de la promotion de la santé dans les perspectives ergothérapiques facilitera la mise en œuvre des champs d’intervention définis dans le profil de l’ergothérapie. Cet article met en relief les différentes façons dont les principes de la promotion de la santé peuvent influer sur la pratique, à l’échelle de l’individu et de la communauté.

Weekly Trends in Preschoolers’ Physical Activity and Sedentary Time in Childcare

This study sought to examine how the physical activity levels and sedentary time of preschoolers attending center-based childcare varied across the week. Sex differences were also explored. Participants (n = 101) wore Actical™ accelerometers (15 s epoch) for five consecutive days during childcare hours only. A multivariate repeated measures analysis of variance was used to evaluate levels of sedentary, light, and moderate-to-vigorous (MVPA) physical activity across the five weekdays. Total physical activity (TPA) was analyzed separately in a univariate repeated measures ANOVA. Sex was entered as an additional between-subjects factor. Levels of sedentary time, LPA, and TPA across the week were found to be statistically significant, and can best be described by quadratic effects. Participants’ activity levels and sedentary time typically peaked mid-week. Levels of physical activity and sedentary time were not found to significantly differ based on sex. Childcare centers may benefit from the introduction and/or modification of active play-based programming and curricula, particularly at the start and end of the week where preschoolers’ activity levels tend to be lower. Additional investigations are required to confirm these findings.

Physical activity and sedentary time during childcare outdoor play sessions: A systematic review and meta-analysis

Outdoor playtime has been highly correlated with moderate-to vigorous-intensity physical activity (MVPA), while also being associated with decreased sedentary time. This systematic review and meta-analysis sought to examine the physical activity levels and sedentary time of young children (2-5years) during outdoor play periods at centre-based childcare. Eight online databases were searched for peer-reviewed, English-language, original research. Two reviewers independently extracted data (study design, participants, method of measurement, and physical activity and/or sedentary time of participants). Time spent in outdoor activity intensities were converted to percentage of time, and averaged across the two measurement types: accelerometry and observational. Of the 26 included articles, 11 used accelerometry, 13 employed direct observation, and 2 adopted a combination of both measurement methods. Average percentage of time engaged in MVPA and sedentary pursuits ranged from 6.7% to 43% and 23.2% to 63.5% by accelerometry, and 2% to 53.9% and 46.1% to 80.2% by observation, respectively. Total physical activity (only measured by accelerometry) ranged from 23.2% to 63.5% of outdoor playtime. Meta-analysis of 11 accelerometer studies found that children spent a mean (95% CI) of: 13.99% (10.35-17.63) of outdoor playtime in MVPA, 43.77% (32.95-54.58) in TPA, and 52.81% (44.1-61.51) in sedentary time. Overall, young children have the potential to be highly active during outdoor play sessions at centre-based childcare; however, many children still engage in substantial amounts of sedentary time. Future research should explore the frequency and/or duration of outdoor time which best support young childrens physical activity and limits sedentary time in childcare.

Comparing the nutrition environment and practices of home- and centre-based child-care facilities

OBJECTIVE To assess and compare the nutrition environment and practices (as they relate to pre-schoolers) of centre- and home-based child-care facilities. DESIGN Using a cross-sectional study design, nineteen child-care facilities (ten centre-based, nine home-based) were assessed for one full day using the Environment and Policy Assessment and Observation (EPAO) tool (consisting of a day-long observation/review of the nutrition environment, practices and related documents). Specifically, eight nutrition-related subscales were considered. SETTING Child-care facilities in London, Ontario, Canada. SUBJECTS Child-care facilities were recruited through directors at centre-based programmes and the providers of home-based programmes. RESULTS The mean total nutrition environment EPAO scores for centre- and home-based facilities were 12·3 (sd 1·94) and 10·8 (sd 0·78) out of 20 (where a higher score indicates a more supportive environment with regard to nutrition), respectively. The difference between the total nutrition environment EPAO score for centre- and home-based facilities was approaching significance (P=0·055). For both types of facilities, the highest nutrition subscale score (out of 20) was achieved in the staff behaviours domain (centre mean=17·4; home mean=17·0) and the lowest was in the nutrition training and education domain (centre mean=3·6; home mean=2·0). CONCLUSIONS Additional research is needed to confirm these findings. In order to better support child-care staff and enhance the overall nutrition environment in child care, modifications to food practices could be adopted. Specifically, the nutritional quality of foods/beverages provided to pre-schoolers could be improved, nutrition-related training for child-care staff could be provided, and a nutrition curriculum could be created to educate pre-schoolers about healthy food choices.

Physical activity and sedentary time among young children in full-day kindergarten: Comparing traditional and balanced day schedules

Objective: To compare physical activity and sedentary time among young children whose schools adhere to traditional (i.e. three outdoor playtimes = 70 minutes) versus balanced day (i.e. two outdoor playtimes = ~55 minutes) schedules in Ontario full-day kindergarten classrooms. Design: The project was part of a larger, 2-year cross-sectional study. Setting: Full-day kindergarten classrooms across London, Ontario, Canada. Methods: Participants included 113 young children (mean age = 4.69 years; standard deviation [SD] = 0.66 years) from eligible full-day kindergarten programmes. Participants’ physical activity and sedentary data were collected using Actical accelerometers worn for five consecutive days during school hours only. Type of school schedule and periods of outdoor play were captured using the Environment and Policy Assessment and Observation tool. Results: Participants mean activity rates (i.e. sedentary time, light physical activity, moderate-to-vigorous physical activity [MVPA] and total physical activity [TPA]) during school hours were similar across both formats. Participants’ overall daily physical activity and sedentary time did not significantly differ across school schedule type (p > .05); however, participants adhering to the traditional schedule accumulated significantly more TPA outdoors than those following the balanced day schedule. Conclusion: Neither schedule format appeared to be superior with regard to supporting overall daily physical activity nor minimising sedentary time in school, although children adhering to the traditional schedule format did accumulate more physical activity during periods of outdoor play. Regardless of schedule type, steps are warranted to encourage additional movement (and minimise sedentary behaviours) in the school setting by school and public health officials.

From crawling to running: A provincial/territorial review of physical activity legislation in childcare centres across Canada

| 199 supplementaire pour l’etat qui serait reinvesti en prevention. approche : Il serait interessant de taxer les boissons gazeuses et energisantes afin de contrebalancer les couts associes a leur impact sur la sante. resultats : La taxe proposee aurait deux objectifs : « denormaliser » la consommation des boissons gazeuses et energisantes tout en generant des revenus supplementaires pour l’etat qui seraient reinvestis en prevention. Discussion : Les acteurs du sport, de la recherche et de la medecine se mobilisent autour de ce phenomene.

Encouraging kids to hop, skip, and jump: Emphasizing the need for higher-intensity physical activity in childcare

Daily physical activity (PA) participation is crucial to the health and well-being of young children. Along with total physical activity (TPA; all-intensity), moderate-to-vigorous physical activity (MVPA), or energetic play, is associated with greater health benefits, particularly for preschoolers (3–4 years), including but not limited to improved bone and skeletal properties and cognitive and psychosocial health.1 Centered on this, both Canada and Australia have recently established 24-Hour Movement Guidelines for the Early Years, recommending that children 2–4 years engage in at least 180 min of any-intensity activity per day, with children 3 years and older spending a minimum of 60 min of this time in higher-intensity energetic play.2, 3 To date, activity promotion among this cohort has focused on increasing movement at any intensity. In light of the recent shift in focus to higher-intensity activity, steps are warranted to augment time spent in developmentally appropriate energetic play, focusing on a variety of unstructured (e.g., active free play)4 and structured aerobic activities (e.g., dance) for optimal health.1 Introducing regular, higher-intensity activity from a young age will set children on the right track to meeting PA guidelines across the lifespan.