# Exercise as it relates to Disease/An Intervention to Increase Physical Activity in Children
## What is the background to this research?

Obesity rates in American children have increased exponentially since the 1960s with this trend being evident in all levels of schooling, including pre-schools. Whilst the specific cause of this marked increase in cases of childhood obesity have yet to be identified, a significant decrease in physical activity is widely accepted as a significant factor. Physical activity guidelines exist in a number of states within the U.S to promote physical activity in children of all ages, however data shows that the majority of children, particularly between the ages of 3–5 years do not meet these guidelines.
As well as this more than 50% of American children attend a pre-school or child care centre, where the majority of the children’s time is spent performing sedentary activities. There is a strong belief that there is a correlation between the prevalence of childhood obesity and the proportion of children attending pre-school and child care centres where they remain sedentary for a number of hours every weekday.
Due to the importance of physical activity in children’s heathy development and growth it is important to understand ways in which to increase the amount of physical activity performed. Due to the structured nature of child care and pre-school settings they provide a sufficient setting to examine ways in which to promote and increase physical activity among the selected population which is 4 year old children. (7)

## Where is the research from?

The research is from a study completed by the American Journal of Preventative Medicine, which collected data between 2008 and 2010 and subsequently analysed said data between 2012 and 2014. The journal itself was published in July 2016. The data was acquired from a total of 16 different pre-schools with hundreds of children of all races and backgrounds between the ages of 3–5 years providing data.

## What kind of research was this?

The research was a quantitative study utilising self applied accelerometers within both a control and intervention group. The research was based on an analytical sample of 379 children (188 interventions, 191 control) whereby the Study of Health and Activity in Preschool Environments (SHAPES) used a randomised group design, with preschools as the unit of randomisation and analysis. The interventions themselves were guided by a social ecological model that indicates that healthy behaviour is influenced by factors operating at multiple levels, including individual, institutional, social, physical and environmental. The children providing data also provided pre-intervention information including baseline BMI, race and parents education.

## What did the research involve?

Physical activity was measured by ActiGraph GT1M and GT3X accelerometers over 5 days during each data collection period. The children involved wore a monitor on their right hip during the entirety of these data acquisition periods, except when engaging in water based activities or during sleep. The data was collected and stored in 15 second intervals to capture the sporadic activity patterns that are characteristic of children aged 3–5 years. Three mixed-model ANCOVA’s were calculated to determine the effects of the intervention on the children’s moderate to vigorous physical activity each day.

## What were the basic results?

A total of 407 children provided 3 or more days worth of accelerometer data, and after deletions for missing race, baseline BMI or parent education (which were all required) there was 379 children whose data was adequate for analysis. Of the 379 an estimated 49% attended intervention schools. At baseline, children involved in the intervention schools were not significantly different in total physical activity, moderate to vigorous physical activity, time spent sedentary, and estimated physical activity energy expenditure.
Children in the control schools spent significantly more time in light physical activity than those involved in the interventions and the children of the control group were found to wear the accelerometers for longer durations and than those involved in the intervention group.
However, when considering the total sample of children it was found that those in the intervention group spent more tome performing moderate to vigorous activity during their time at the preschools or child-care centres. The children’s estimated energy expenditure due to physical activity was therefore greater as well.

## What conclusions can we take from this research?

The major findings from this study indicate that an ecological intervention performed by pre-school teachers in a flexible and adaptive manner can increase the amount of moderate to vigorous physical activity performed by children between the ages of 3–5 years.
This is particularly important due to the prevalence of obesity within this age group as well as the limited amount of exercise performed by this age group within the selected environment. It is estimated that children will spend 10 hours a day, 4 days a week within these settings and due to this it is imperative that exercise be promoted and monitored. (8)
Interventions that utilise this time spent at pre-school or child care to promote physical activity are therefore considered a success and worthwhile. While the exercise is regimented, monitored and controlled the teachers or carers are therefore capable of providing the children with the numerous health benefits of regular physical activity without impacting on their social, emotional or intellectual development.

## Further information/resources

For information regarding the health benefits of exercise for children visit: http://link.springer.com/article/10.1007/s10212-012-0148-z (The academic and psychological benefits of exercise in healthy children and adolescents)
For information regarding physical activity guidelines for Americans visit: Office of Disease Prevention and Health Promotion. 2008. 2008 Physical Activity Guidelines for Americans . [ONLINE] Available at: https://health.gov/paguidelines/guidelines/summary.aspx.
For information regarding physical activity and sedentary behaviour in child care visit: Physical Activity at Child Care Settings: Review and Research Recommendations, 3, 6, 474-488. [ONLINE] Available at: http://ajl.sagepub.com/content/3/6/474.abstract

## References

* ↑ Commonwealth of Australia, C.A, 2010. National Physical Activity Recommendations for Children 0-5 Years. Commonwealth of Australia, Department of Health and Ageing, 1, 1-6.
* ↑ Hesketh, Campbell, K.H, K.C, 2010. Obesity (Silver Spring). Interventions to prevent obesity in 0-5 year olds: an updated systematic review of the literature., 1, 27-35.
* ↑ Kids Health. 1995. Benefits of Exercise for Children. [ONLINE] Available at: http://kidshealth.org/en/parents/exercise.html. [Accessed 22 September 2016].
* ↑ MedLine Plus. 2015. Exercise For Children. [ONLINE] Available at: https://medlineplus.gov/exerciseforchildren.html. [Accessed 22 September 2016].
* ↑ Office of Disease Prevention and Health Promotion. 2008. 2008 Physical Activity Guidelines for Americans . [ONLINE] Available at: https://health.gov/paguidelines/guidelines/summary.aspx. [Accessed 25 September 2016].
* ↑ Rasmussen, Laumann, M.R, K.L, 2012. European Journal of Psychology of Education. The academic and psychological benefits of exercise in healthy children and adolescents, 28, 3, 945-962.
* ↑ Russell R. Pate, PhD, William H. Brown, PhD, Karin A. Pfeiffer, PhD, Erin K. Howie, PhD, Ruth P. Saunders, PhD, Cheryl L. Addy, PhD, Marsha Dowda, DrPH, 2016. An Intervention to Increase Physical Activity in Children. American Journal of Preventative Medicine, Volume 1, Issue 1, 12-22.
* ↑ Ward, Vaughn, McWilliams, Hales, D.W, A.V, C.M, D.H, 2015. American Journal of Lifestyle Medicine. Physical Activity at Child Care Settings: Review and Research Recommendations, 3, 6, 474-488.