Tucker et al. BMC Public Health 2011, 11:168 http://www.biomedcentral.com/1471-2458/11/168 participate in organized physical activities outside of childcare, “...[t]here is quite a few that do those extra activities but there [are] also the ones that can’t afford it....” According to the childcare providers, many parents were supporting activity participation among their pre- schoolers by enrolling them in structured extracurricular sport and activities. Parents and the Home Environment as Barriers to Physical Activity Lack of Encouragement for Physical Activity. When asked about the barriers to engaging preschoolers in physical activity, in addition to the items related to the childcare setting (see van Zandvoort et al.) [20], many childcare providers indicated that several parents did not seem to encourage an active lifestyle among their children outside of childcare hours. For example, one provider explained, “...when children go home on the weekends there is no outdoor or active play.” Another elaborated, “...[i]t’s a vicious cycle [and] you see it more and more...[i]f the parents are inactive the kids are.” Yet another childcare provider stated, “I think there is defi- nitely a decrease in just spur-of-the-moment...activities outside with your family. I don’t think a lot of them do a lot of that kind of stuff....” A number of the childcare providers spoke of their perceptions of the impact that inactive home-lives have on preschoolers’ physical activity behaviours. One explained, “[on] Mondays they [the children] are very lethargic and [say] ‘I don’t want to. I’m bored.’ By the end of the week you can see the influences of the [child- care providers]...and the playing they’re doing [has] changed when they go home on the weekend. And [we] start all over again on Monday.” Another provider said, “[b]ecause they don’t do it [physical activity] at home... we hear ‘oh I’m tired,’ ‘I can’t do it,’ [or] ‘this is too much work.’” Screen-viewing Behaviours. Some providers felt that even the children who were enrolled in extracurricular activities may not be physically active outside of the time spent at childcare or organized activities. One childcare provider expressed, “...when they’re not at those [organized] activities all they do at home is play video games...it doesn’t sound like they do any gross motor [activities] at home really.” Another provider, lamenting on the challenge of time spent playing video games and watching television, said, “... the video games and the TV... they’re overly subjected to that and finding entertainment and enjoyment out of physical activity sometimes isn’t as exciting to them as the video games and the shows that they’re watching.” Another explained that children have become so enamoured by video games and television that they simply enjoy them more than they enjoy physical activity. She explained that she Page 4 of 7 often hears from both parents and the kids in her care that “[TV/video is] the privilege they get taken away now, it’s not like ‘oh you can’t go outside today, you didn’t have a good day...’ it’s always like ‘no video games, your computer is taken away, your movie or TV time is taken away.’” Suggestions for Improving Preschoolers’ Physical Activity Behaviours A number of childcare providers suggested that pre- schoolers’ physical activity levels might be increased through efforts to enhance parents’ awareness of–and involvement in–their children’s physical activity. Increasing Parent Awareness of the Benefits of Physical Activity. A few providers emphasized the importance of parental awareness about the benefits of physical activity and opportunities for activity in their neighbourhoods. For example, one said, “[j]ust like what you do with us as educators, like professional development for us...it’s kind of like for the families; if you could help to promote it or inform them [parents] then maybe they might go [to neighbourhood activities and programs]....” Another pro- vider shared, “[i]t’s all about education. I mean people say ‘oh, I don’t need that,’ [but] it’s ignorance, it’s lack of education. Any knowledge is good, is helpful, and I think it can stop that cycle [of inactivity] as far as being healthy and having a healthy family.” As a possible way to deliver this information to parents, one provider suggested they “...do a newsletter for the area. For... ‘at this arena this night is available and it’s free’...because maybe they [par- ents] don’t know and maybe sending something out might encourage knowing it’s free....” A different provider shared, “[w]e’ve done different [homework] things with more academic [subjects]... like reading...We could maybe do something along those lines in way of physical activ- ity... [for example, asking the children] ‘did you do 5 min- utes of skipping?’....” While it was suggested that workshops could be held at childcare centres to provide physical activity information to parents, one provider indicated (based on past experience) that this approach does not always target the parents in greatest need. The provider explained, “...a few years ago we did a workshop on media violence but again...you get the gung hoe par- ents who... want to know everything to make their child’s life as optimal as it can be and the ones who need to be there are not because they don’t want to come.” This childcare provider further highlighted that even when free babysitting and food was provided during the work- shop, often times parents didn’t come. Childcare Staff and Parental Partnerships to Support Physical Activity. A number of childcare providers also felt a valuable way to increase children’s activity behaviours was to engage parents in activities with their children. For example, one provider emphasized, “...[t]he biggest part of