Impact of the Supporting Physical Activity in the Childcare Environment (SPACE) intervention on preschoolers’ physical activity levels and sedentary time: a single-blind cluster randomized controlled trial Supporting Physical Activity in the Childcare Environment (SPACE): rationale and study protocol for a cluster randomized controlled trial A comparison of parent and childcare provider's attitudes and perceptions about preschoolers' physical activity and outdoor time. Effects of a Preschool Intervention on Physical Activity and Body Composition Association between childcare educators’ practices and preschoolers’ physical activity and dietary intake: a cross-sectional analysis Objectively measured physical activity in four-year-old British children: a cross-sectional analysis of activity patterns segmented across the day Preschoolers' health-related quality of life following the implementation of a childcare physical activity intervention. Effect of a school-based active play intervention on sedentary time and physical activity in preschool children. Protocol for systematic reviews of determinants/correlates of obesity-related dietary and physical activity behaviors in young children (preschool 0 to 6 years): evidence mapping and syntheses Activity Begins in Childhood (ABC) – inspiring healthy active behaviour in preschoolers: study protocol for a cluster randomized controlled trial Impact of a population based intervention to increase the adoption of multiple physical activity practices in centre based childcare services: a quasi experimental, effectiveness study A pragmatic randomised controlled trial of an implementation intervention to increase healthy eating and physical activity-promoting policies, and practices in centre-based childcare services: study protocol The effect of a physical activity intervention on preschoolers' fundamental motor skills - A cluster RCT. Feasibility and Effectiveness of a Wearable Technology-Based Physical Activity Intervention in Preschoolers: A Pilot Study Effect of a family focused active play intervention on sedentary time and physical activity in preschool children The effect of a movement-to-music video program on the objectively measured sedentary time and physical activity of preschool-aged children and their mothers: A randomized controlled trial Objectively measured physical activity level and sedentary behavior in Norwegian children during a week in preschool☆ The effect of a cluster randomised control trial on objectively measured sedentary time and parental reports of time spent in sedentary activities in Belgian preschoolers: the ToyBox-study A participatory physical activity intervention in preschools: a cluster randomized controlled trial. Acute exercise enhances preschoolers' ability to sustain attention. Design and baseline characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study Healthy caregivers-healthy children (HC2) phase 2: Integrating culturally sensitive childhood obesity prevention strategies into childcare center policies. A cluster randomised trial to evaluate a physical activity intervention among 3-5 year old children attending long day care services: study protocol
Background Physical activity levels among preschoolers in childcare are low and sedentary time high . The Supporting Physical Activity in the Childcare Environment ( SPACE ) intervention had three components : 1 . portable play equipment ; 2 . staff training ; and , 3 . modified outdoor playtime ( i.e. , shorter , more frequent periods ) . This study aim ed to examine the effectiveness of the SPACE intervention on preschoolers ’ physical activity levels and sedentary time during childcare hours ( compared to st and ard care ) . Methods Via a single-blind cluster r and omized controlled trial , 338 preschoolers ( 39.86 ± 7.33 months ; 52 % boys ) from 22 centre-based childcare facilities ( 11 experimental , 11 control ) were enrolled . Preschoolers wore an Actical ™ accelerometer for 5 days during childcare hours at baseline , post-intervention , and 6- and 12-month follow-up , and were included in the analyses if they had a minimum of two valid days ( 5 h each day ) at baseline and one additional time point . Intervention effectiveness was tested using a linear mixed effects model for each of the four outcome variables ( i.e. , sedentary time , light physical activity [ LPA ] , moderate-to-vigorous physical activity [ MVPA ] , and total physical activity [ TPA ] ) . Fixed effects were further evaluated with t-tests , for which degrees of freedom were estimated using a Satterthwaite approximation . Results One hundred and ninety-five preschoolers were retained for analyses .  The intervention did not significantly impact LPA . MVPA was significantly greater among children in the experimental group when comparing post-intervention to pre-intervention , t(318 ) = 3.50 , p = .0005 , but no intervention effects were evident at 6- or 12-month follow-up . TPA was significantly greater for children in the intervention group at post-intervention when compared to pre-intervention , t(321 ) = 2.70 , p = .007 , with no intervention effects evident at later time periods . Finally , sedentary time was significantly lower among preschoolers in the experimental group when comparing post-intervention to pre-intervention , t(322 ) = 2.63 , p = .009 , with no significant effects at follow-up . Conclusions The SPACE intervention was effective at increasing MVPA and TPA among preschoolers , while simultaneously decreasing sedentary time . The ability of the SPACE intervention to target higher intensity activity is promising , as MVPA levels have been documented to be low in centre-based childcare . The changes in physical activity were not sustained long term ( 6- or 12-month follow-up).Trial registration IS RCT N70604107 ( October 8 , 2014 ) Background Young children are prone to low levels of physical activity in childcare . Research ers have identified that preschoolers tend to be more active outdoors than indoors , with higher activity levels occurring during the first 10 minutes of outdoor playtime . Additionally , interventions incorporating either staff training or the inclusion of play equipment have been effective at increasing children ’s activity in this setting . As such , the overarching objective of the Supporting Physical Activity in the Childcare Environment ( SPACE ) intervention is to improve the physical activity levels of preschoolers during childcare hours , utilizing a combination of the above components . The purpose of this manuscript is to provide a detailed account of the protocol , innovative methods , and evaluation plans used in the implementation of the SPACE study ; in an effort to support the development of further research in this field . Methods / Design The SPACE study , a cluster r and omized controlled trial , involves 22 childcare centres r and omly allocated to either the experimental ( n = 11 ) or the control ( n = 11 ) group . Childcare centres receiving the intervention will adopt an 8-week physical activity intervention with the following components : 1 . shorter , more frequent bouts of outdoor playtime ( 4 × 30 min periods rather than 2 × 60 min periods ) ; 2 . new portable play equipment ( e.g. , obstacle course , balls ) ; and , 3 . staff training ( 1 × 4 hr workshop ) . Actical accelerometers will be used to assess total physical activity with measurements taken at baseline ( i.e. , week 0 ) , immediately post-intervention ( i.e. , week 8) , and at 6- and 12-month follow-up . As secondary objectives , we aim to evaluate the effectiveness of the intervention on  preschoolers ’ : a ) sedentary time ; b ) st and ardized body mass index scores ( percentiles ) ; c ) health-related quality of life ; and childcare providers ’ physical activity-related knowledge and self-efficacy to implement physical activity . Discussion The SPACE study aims to increase the low levels of physical activity observed within childcare centres . The findings of this work may be useful to policy makers and childcare providers to consider modifications to the current childcare curriculum and associated outdoor play time . Trial registration IS RCT N70604107 ( October 8 , 2014 BACKGROUND Young children depend on  adult caregivers  to provide opportunities for physical activity . Research has focused on barriers and facilitators to children 's physical activity while in childcare , but parental influences remain largely unknown . This study examines parent 's attitudes about preschoolers ' physical activity and outdoor time , compares them with those of childcare providers and determines the association between parental attitudes and preschoolers ' measured activity . METHODS Parents and childcare providers from 30 childcare centres were surveyed regarding attitudes towards  preschoolers ' physical activity and outdoor time . Children 's moderate-to-vigorous physical activity was determined by using 24-h accelerometry . Parent and childcare providers ' responses were compared . Mixed-effect linear regression examined moderate-to-vigorous physical activity and sedentary time as outcomes with parental attitudes as predictors , family demographics as covariates and centre as a r and om effect . RESULTS Three hundred eighty-eight parents and 151 childcare providers participated . On average , children were 4.3 ( 0.7 ) years old . Parents and childcare providers both considered daily physical activity important for preschoolers , but providers rated the importance of daily outdoor time higher on a 10-point scale ( 8.9 vs. 7.6 , P < 0.001 ) . More parents than providers believed that children would get sick by playing outside in the cold ( 25 vs. 11 % , P < 0.05 ) . Parents were more comfortable with their child playing outside at childcare compared with outside at home ( 8.9 vs. 6.9 , P < 0.001 ) . Lower income parents felt less comfortable than higher income parents with their child playing outside either near home or at childcare . Neither home nor total child activity levels were associated with most parental attitudes queried . CONCLUSIONS While parents and childcare providers value daily physical activity for children , some parents expressed discomfort about their young children engaging in outdoor play , especially around home and in cold weather . These findings highlight the importance of childcare-based interventions to promote preschoolers ' physical activity and outdoor play Objective To investigate the effect of a  preschool physical activity intervention program delivered in licensed childcare setting s , with or without a parent‐facilitated home component , on  children 's daily physical activity , sedentary time , and body composition . Study design For this cluster r and omized controlled trial , 18 childcare centers were r and omly allocated in equal numbers to the typical curriculum comparison group , childcare intervention alone ( CC ) , or childcare intervention with parental involvement . Accelerometers  were used to asses physical activity and sedentary time , and body composition was measured by bioelectrical impedance . Results Linear mixed model regression analyses showed no differences between the CC , the childcare intervention with parental involvement , and the comparison groups in changes from baseline to 6 months in total physical activity ( P for time × group interaction = .665 ) or moderate‐to‐vigorous physical activity ( P for time × group interaction = .164 ) when adjusted for baseline physical activity levels . Furthermore , no group differences were found for changes in light physical activity , sedentary time , or anthropometric variables . Conclusions An affordable and easily scalable preschool intervention program delivered in licensed childcare setting s , with or without the addition of a parent‐driven home physical activity promotion , seems to have no significant effect on physical activity , sedentary time , or body composition . Trial registration IS RCT N : IS RCT N94022291 Introduction Childcare educators may be role models for healthy eating and physical activity ( PA ) behaviours among young children . This study aim ed to identify which childcare educators ’ practice s are associated with preschoolers ’ dietary intake and PA levels . Methods This cross-sectional analysis included 723 preschoolers from 50 r and omly selected childcare centres in two Canadian provinces . All data were collected in the fall of 2013 and 2014 and analysed in the fall of 2015 .  PA was assessed using Actical accelerometers during childcare hours for 5 consecutive days .  Children ’s dietary intake  was measured at lunch on 2 consecutive days using weighed plate waste and digital photography . Childcare educators ’ nutrition practice s ( modelling , nutrition education , satiety recognition , verbal encouragement and not using food as rewards ) and PA practice s ( informal and formal PA promotion ) were assessed by direct observation over the course of 2 days , using the Nutrition and Physical Activity Self- Assessment for Child Care tool . Associations between educators ’ practice s and preschoolers ’ PA and dietary intake were examined using multilevel linear regressions . Results Overall , modelling of healthy eating was positively associated with children ’s intake of sugar ( β=0.141 , 95 % CI 0.03 to 0.27 ) , while calorie ( β=−0.456 , 95 % CI −1.46 to –0.02 ) and fibre intake ( β=−0.066 , 95 % CI −0.12 to –0.01 ) were negatively associated with providing nutrition education . Not using food as rewards was also negatively associated with fat intake ( β=−0.144 , 95 % CI −0.52 to –0.002 ) . None of the educators ’ PA practice s were associated with children ’s participation in PA  . Conclusions Modelling healthy eating , providing nutrition education and not using food as rewards are associated with children ’s dietary intake at lunch in childcare centres , highlighting the role that educators play in shaping preschoolers ’ eating behaviours . Although PA practice s were not associated with  children ’s PA levels , there is a need to reduce sedentary time in childcare centres Background Little is known about preschool-aged children ’s levels of  physical activity ( PA ) over the course of the day . Using time-stamped data , we describe the levels and patterns of PA in a population -based sample of four-year-old British children . Methods Within the Southampton Women ’s Survey the PA levels of 593 4-year-old children ( 51 % female ) were measured using ( Actiheart ) accelerometry for up to 7 days . Three outcome measures : minutes spent sedentary ( < 20 cpm ) ; in light ( LPA : ≥20 – 399 cpm ) and in moderate-to-vigorous activity ( MVPA : ≥400 cpm ) were derived . Average daily activity levels were calculated and then segmented across the day ( morning , afternoon and evening ) . MVPA was log-transformed . Two-level r and om intercept models were used to analyse associations between activity level and temporal and demographic factors . Results Children were active for 67 % ( mean 568.5 SD 79.5 minutes ) of their daily registered time on average , with 88 % of active time spent in LPA . All children met current UK guidelines of 180 minutes of daily activity . There were no differences in children ’s average daily levels of sedentary activity and LPA by temporal and demographic factors : differences did emerge when activity was segmented across the day . Sex differences were largest in the morning , with girls being more sedentary , spending fewer minutes in LPA and 18 % less time in MVPA than boys . Children were more sedentary and less active ( LPA and MVPA ) in the morning if they attended childcare full-time compared to part-time , and on weekend mornings compared to weekdays . The reverse was true for weekend afternoons and evenings . Children with more educated mothers were less active in the evenings . Children were less sedentary and did more MVPA on summer evenings compared to winter evenings . Conclusions Preschool-aged children meet current physical activity guidelines , but with the majority of their active time spent in LPA , investigation of the importance of activity intensity in younger children is needed . Activity levels over the day differed by demographic and temporal factors , highlighting the need to consider temporality in future interventions . Increasing girls ’ morning activity and providing opportunities for daytime activity in winter months may be worthwhile Being active offers many physical and emotional benefits contributing to a higher health-related quality of life ( HRQoL ) ; however , this relationship remains unexplored among preschoolers ( aged 2.5 - 5 years ) . This study examined the impact of the Supporting Physical Activity in the Childcare Environment ( SPACE ) , which was an intervention implemented using a cluster r and omized controlled trial on preschoolers ' HRQoL. Childcare centres were r and omly allocated to the experimental ( n = 11 ) or control ( n = 11 ) conditions , and preschoolers ' HRQoL was measured using the parent-report Pediatric Quality of Life Inventory 4.0 ( 3 subscales : physical , psychosocial , and total HRQoL ) at baseline , post-intervention ( i.e. , week 8) , and 6- and 12-month follow-up . A linear mixed-effects model was used to determine if preschoolers in the experimental condition displayed an increased HRQoL post-intervention and at follow-up compared with preschoolers in the control condition . Preschoolers ( n = 234 ) with HRQoL data at baseline and one additional time-point were retained for analyses .  Body mass index was not found to impact significantly on the intervention , and no statistically significant interaction effects were found for any of the 3 HRQoL variables . In conclusion , the SPACE intervention had no impact on  preschoolers ' HRQoL. Given the scarcity of research in this population , additional exploration is necessary to better underst and the potential impact of physical activity participation on preschoolers ' Early childhood is a critical time for promoting physical activity . Few studies have investigated the effect of interventions in this population . The aim of this study was to investigate the effect of a school-based active play intervention on preschool children 's sedentary time and physical activity .  Preschool children were recruited from r and omly selected preschools . Schools were r and omly assigned to an intervention or comparison group . One teacher per intervention school received training from active play professionals in the delivery of a 6-week active play programme . Comparison schools continued their usual practice . Children wore a  uni-axial accelerometer  for 7 days at baseline , immediately after and at 6-month post-intervention . No significant intervention effects were observed for sedentary time or physical activity . However , sex and hours spent at school were significant predictors of physical activity . Children who spent fewer hours ( half-day children ) at school were significantly more active than their full-day counterparts . Physical activity during the intervention classes was high even though neither daily physical activity nor sedentary time changed . Notably children who spent more time at preschool were less active suggesting that preschool was not as conducive to physical activity engagement as other environments Background The aim of these review s is to inform the design and content of interventions to reduce obesity in young children . The behaviors that are associated with obesity/overweight have been studied extensively ; however , the factors associated with these behaviors in young children ( 0 to 6 years ) have not been systematic ally review ed . Over the past few years the focus of obesity prevention has shifted to preschool children because of the high prevalence of obesity at school entry and recognition that habits formed in early life could track into adulthood . In order to develop effective interventions and change behavior , it is important to underst and the factors that are associated with those behaviors . For example , we need to underst and whether it would be more important to target the family , childcare setting s or the wider environment and identify the most effective way of changing these energy balance related behaviors . Methods / Design Quantitative ( intervention and observational ) and qualitative literature on determinants/correlates of fruit and vegetable intake , sugar sweetened beverage and other unhealthy diet intake , and physical activity and sedentary behaviors in young children will be systematic ally identified , mapped and review ed . A common search strategy ( no language or period restrictions ) will be used to identify papers from eight electronic data bases and this will be supplemented by h and - search ing . Next , studies in developed countries that examine the factors associated with these behaviors in children aged 0 to 6 years ( at baseline ) will be screened and mapped descriptively followed by in-depth data extraction , quality assessment and synthesis . Data from quantitative studies will be summarized using either forest plots or harvest plots and narrative synthesis , and qualitative studies using thematic analysis . Qualitative evidence will be integrated with the quantitative evidence , using a parallel synthesis approach , to provide a deeper underst and ing of effective strategies to influence these energy balance related behaviors . Discussion In addition to updating and mapping current research , these review s will be the first to comprehensively synthesize and integrate both the quantitative and qualitative evidence pertaining to determinants/correlates/barriers/facilitators of obesity related behaviors in this young age group ( 0 to 6 years ) with the aim of informing future interventions . Systematic review registration International Prospect i ve Register for Systematic Review s ( PROSPERO ) Registration number : Background Today ’s children are more overweight than previous generations and physical inactivity is a contributing factor . Modelling and promoting positive behaviour in the early years is imperative for the development of lifelong health habits . The social and physical environments where children spend their time have a powerful influence on behaviour . Since the majority of preschool children spend time in care outside of the home , this provides an ideal setting to examine the ability of an intervention to enhance movement skills and modify physical activity behaviour . This study aims to evaluate the efficacy of the Activity Begins in Childhood ( ABC ) intervention delivered in licensed daycare setting s alone or in combination with a parent-driven home physical activity-promotion component to increase preschoolers ’  overall physical activity levels and , specifically , the time spent in moderate to vigorous physical activity . Methods / design This study is a single site , three-arm , cluster-r and omized controlled trial design with a daycare centre as the unit of measurement ( clusters ) . All daycare centres in the National Capital region that serve children between the ages of 3 and 5 , expressing an interest in receiving the ABC intervention will be invited to participate . Those who agree will be r and omly assigned to one of three groups : i ) ABC program delivered at a daycare centre only , ii ) ABC program delivered at daycare with a home/parental education component , or iii ) regular daycare curriculum . This study will recruit 18 daycare centres , 6 in each of the three groups . The intervention will last approximately 6 months , with baseline assessment prior to ABC implementation and follow-up assessment s at 3 and 6 months . Discussion Physical activity is an acknowledged component of a healthy lifestyle and childhood experiences as it has an important impact on lifelong behaviour and health . Opportunities for physical activity and motor development in early childhood may , over the lifespan , influence the maintenance of a healthy body weight and reduce cardiovascular disease risk . If successful , the ABC program may be implemented in daycare centres as an effective way of increasing healthy activity behaviours of preschoolers . Trial registration Current Controlled Trials : IS RCT N94022291 . Registered in December 2012 , first cluster r and omized in April 2013 Background There is considerable scope to improve the delivery of practice s that increase the physical activity of children in centre based childcare services . Few studies have reported the effectiveness of interventions to address this , particularly at a population level . The primary aim of this study was to describe the impact of an intervention to increase the adoption of multiple policies and practice s to promote physical activity in centre based childcare services . Methods A quasi experimental study was conducted in centre based childcare services ( n = 228 ) in New South Wales ( NSW ) , Australia and involved a three month intervention to increase the adoption of eight practice s within childcare services that have been suggested to promote child physical activity . Intervention strategies to support the adoption of practice s included staff training , re sources , incentives , follow-up support and performance monitoring and feedback .  R and omly selected childcare services in the remainder of NSW acted as a comparison group ( n = 164 ) and did not receive the intervention but may have been exposed to a concurrent NSW government healthy eating and physical activity initiative . Self reported information on physical activity policies , fundamental movement skills sessions , structured physical activity opportunities , staff involvement in active play and provision of verbal prompts to encourage physical activity , small screen recreation opportunities , sedentary time , and staff trained in physical activity were collected by telephone survey with childcare service managers at baseline and 18 months later . Results Compared with the comparison area , the study found significantly greater increases in the prevalence of intervention services with a written physical activity policy , with policy referring to placing limits on small screen recreation , and with staff trained in physical activity . In addition , non-significant trends towards a greater increase in the proportion of intervention services conducting daily fundamental movement skill sessions , and such services having a physical activity policy supporting physical activity training for staff were also evident . Conclusion The intervention was effective in improving a number of centre based childcare service policies and practice s associated with promoting child physical activity . Adoption of a broader range of practice s may require more intensive and prolonged intervention support Background Promotion of healthy eating and physical activity in early childhood is recommended as a global chronic disease prevention strategy . Centre-based childcare services represent a promising setting to provide children with opportunities to improve healthy eating and physical activity . Evidence to inform implementation of childcare obesity prevention guidelines into routine practice in childcare , however , is lacking . This study aims to assess the effectiveness of an intervention , delivered to childcare staff , aim ing to increasing service implementation of healthy eating and physical activity-promoting policies and practice s. Methods and analysis A pragmatic parallel group r and omised controlled trial will be undertaken with 165 childcare services in the Hunter New Engl and region of New South Wales , Australia . Services will be r and omised to receive either a 10-month evidence -based performance review intervention with other re sources to support practice change , or to a waitlist control group . The primary trial outcome is the proportion of services implementing all of the following recommended healthy eating and physical activity promoting practice s : written nutrition , physical activity and small screen recreation policies ; providing information to families regarding healthy eating ( including breastfeeding ) , physical activity and small screen time ; providing twice weekly healthy eating learning experiences to children ; providing water and only plain milk to children ; providing fundamental movement skills activities for children every day ; and limiting and using electronic screen time more for educational purpose s and learning experiences . Effectiveness will be assessed using a telephone interview of practice implementation with childcare staff at baseline and 12 months following baseline . Ethics and dissemination The study was approved by the Hunter New Engl and Human Research Ethics Committee and the University of Newcastle Human Research Ethics Committee . Study findings will be disseminated widely through peer- review ed publications and conference presentations . Trial registration number Australian New Zeal and Clinical Trials Registry ACTRN12614000972628 OBJECTIVES To assess the effect of a physical activity intervention delivered in the childcare centres ( CC ) , with or without a parent-driven home physical activity component , on children 's fundamental motor skills ( FMS ) . DESIGN Six-month 3-arm cluster r and omized controlled trial . METHODS Preschoolers were recruited from 18 licensed CC . CC were r and omly assigned to a typical curriculum comparison group ( COM ) , childcare intervention alone ( CC ) , or childcare intervention with parental component ( CC+HOME ) . FMS was measured with the Test of Gross Motor Development-2 . Linear mixed models were performed at the level of the individual while accounting for clustering . RESULTS Raw locomotor skills score increased significantly in the CC group ( mean difference=2.5 units , 95 % Confidence Intervals , CI , 1.0 - 4.1 , p<0.001 ) and the CC+HOME group ( mean difference=2.4 units , 95 % CI , 0.8 - 4.0 , p<0.001 ) compared to the COM group . No significant ( p>0.05 ) between group differences were observed in the raw object control skills , sum of raw scores , or gross motor quotient . No significant sex differences were found in any of the measured outcomes . CONCLUSIONS A physical activity intervention delivered in childcare with or without parents ' involvement was effective in increasing locomotor skills in preschoolers The purpose of this pilot study was to evaluate the feasibility and the effectiveness of an intervention that employed a technology-based physical activity ( PA ) monitoring system and teacher-regulated strategies to promote PA  in preschoolers . A total of 93 preschoolers ( 53 % girls , 4.7 years ) from 5 child care centers were recruited for a one-week intervention and r and omly assigned into control ( 2 centers , n = 45 ) or intervention ( 3 centers , n = 48 ) group . Key intervention components included : ( 1 ) wearable device-based , real-time monitoring of children ’s PA by classroom teachers and ( 2 ) teacher-regulated strategies for providing more opportunities for PA . Sedentary behavior ( SED ) and PA were measured using accelerometers . Overall , children in the intervention group showed significantly lower level of SED ( 31.6 vs. 33.6 min/h ) and higher level of total PA ( 28.4 vs. 26.4 min/h ) than children in the control group , after adjusting for age , sex , race , parent education level , parent perception of their child ’s PA , BMI , and childcare centers . Teachers in the intervention group reported that the intervention was highly feasible to be implemented in their current classroom setting s. In conclusion , we observed high acceptability and initial effectiveness of the current intervention . Subsequent research at larger-scale is warranted to fully evaluate the effectiveness of the intervention strategies tested in this study Background Early childhood provides a window of opportunity for the promotion of physical activity . Given the limited effectiveness of interventions to date , new approaches are needed . Socio-ecological models suggest that involving parents as intervention targets may be effective in fostering healthier lifestyles in children . This study describes the effectiveness of a family-focused ‘ Active Play ’ intervention in decreasing sedentary time and increasing total physical activity in preschool children . MethodS eventy-seven families were recruited from 8 r and omly selected SureStart children ’s centres in the North West of Engl and . Centres were r and omly assigned to either an intervention ( n = 4 ) or a comparison group ( n = 4 ) . Parents and children in the intervention group received a 10-week active play programme delivered by trained active play professionals ; this included an activity and educational component . Families in the comparison group were asked to maintain their usual routine . Each participating parent and child wore a  uni-axial accelerometer  for 7 days at baseline and post-test . Week and weekend day sedentary time and total physical activity adjusted for child- and home- level covariates were analysed using multilevel analyses . Results Significant intervention effects were observed for sedentary time and physical activity for both week and weekend days . Children in the intervention group engaged in 1.5 % and 4.3 % less sedentary time during week and weekend days , respectively and 4.5 % and 13.1 % more physical activity during week and weekend days , respectively than children in the comparison group . Parent ’s participation in sport and their physical activity levels , child ’s sex , availability of media in the home and attendance at organised activities were significant predictors of sedentary time and physical activity in this age group . Conclusion A 10-week family focused active play intervention produced positive changes in sedentary time and total physical activity levels in preschool children . Specific covariates were identified as having a significant effect on the outcome measures . Moreover , children whose parents were active engaged in less sedentary time and more physical activity suggesting that parent ’s activity habits are mediators of physical activity engagement in this age group Regular physical activity ( PA ) and the avoidance of prolonged sitting are essential for children ’s healthy growth , and for the physical and mental wellbeing of both children and adults . In the context of exercise , music may promote behavioral change through increased exercise adherence and participation . The purpose of this study was to determine whether a movement-to-music video program could reduce sedentary behavior ( SB ) and increase PA in mother-child pairs in the home environment . A r and omized controlled trial was conducted in the Pirkanmaa region , Finl and , in 2014–2016 . The participants consisted of 228 mother-child pairs ( child age 5–7 years ) . The primary outcomes of interest were tri-axial accelerometer-derived SB and PA , which were measured in weeks one ( baseline ) , two , and eight in both the intervention and control groups . Further , the mothers and children in the intervention group used a movement-to-music video program from the beginning of week two to the end of week eight . Secondary outcomes included self-reported screen time . The statistical methods employed comprised an intention-to-treat and linear mixed effects model design . No statistically significant differences between groups were found in primary or secondary outcomes . Among the children in the control group  , light PA  decreased significantly over time and screen time increased from 89 ( st and ard deviation , SD 37 ) to 99 ( SD 41 ) min/d . Among mothers and children in the intervention group , no statistical differences were found . In supplementary analysis , the children who stayed at home instead of attending daycare/preschool had on average 25 ( 95 % confidence interval , CI 19–30 ) min/d more sedentary time and 11 ( 95 % CI 8–14 ) min/d less moderate-to-vigorous PA than those who were at daycare/preschool . The higher body mass index of mothers was related with 5 ( 95 % CI 2–7 ) min/d more sedentary time and 1 ( 95 % CI 0–2 ) min/d less moderate-to-vigorous PA . The movement-to-music video program did not change the objective ly measured SB or PA of the mother-child pairs . However , mothers and children seemed to be more sedentary at home , and therefore interventions for decreasing SB and increasing PA should be targeted in the home environment Although many studies have reported on  physical activity ( PA ) levels using accelerometers , a thorough description of the PA pattern in preschool children during their stay in the preschool , is lacking in the current literature . Furthermore , there remains a lack of underst and ing of the PA level and pattern in children in the lower end of the PA continuum . The first aim of this study was therefore to describe the PA pattern during a week-long stay in a preschool in all children born in 2011 ( either three or four-year-olds ) attending public preschools in a municipality in Norway . The second aim was to describe the PA level and pattern of the children who are the least physically active . This cross-sectional study included baseline data from 95 % of children ( N = 111 ) participating in a r and omized controlled physical activity intervention ( Active Kindergarten – Active Children study ) . The participants wore an Actigraph accelerometer , in week 39 in 2015 , from when they arrived at the preschool on Monday morning and throughout their stay of five consecutive days . The amount of moderate- to vigorous-intensity PA ( MVPA ) per day ranged from 16 min to 116 min , and sedentary time ranged from 2.7 h to 6.5 h per day in the least and most sedentary child , respectively . The least physically active 25 % of children were less active throughout the entire day , and only a few of them managed to achieve the recommended level of MVPA on any weekday . The physical activity levels and patterns among the least active children described in this study may help to inform interventions targeting this group Background In preschoolers , high levels of sedentary behaviour are associated with several adverse health outcomes . The purpose of this study is to report the effects of the ToyBox-intervention ( a European 24-week cluster r and omised controlled trial ) on sedentary behaviour  in preschoolers . Methods In Belgium , 859 preschoolers from 27 kindergartens ( 15 intervention and 12 control ) wore an accelerometer  to objective ly measure  their  sedentary time  and 1715 parents/caregivers completed a question naire to assess sedentary activities in which preschoolers participate at home . Main outcomes were objective ly measured sedentary time , time spent watching TV , using the computer and time spent in quiet play . Multilevel repeated measures analyses were conducted to take clustering into account . Intention to treat analysis was used to h and le missing data . Results A sample of 859 ( 29.5 % of all contacted children ) preschoolers ( 4.4 ± 0.6 years , 54.4 % boys ) provided valid accelerometer data at either baseline or follow-up and parents of 1715 ( 58.9 % of all contacted children ) preschoolers ( 4.4 ± 0.5 years , 52.5 % boys ) completed a question naire at either baseline or follow-up . No intervention effects were found on objective ly and subjectively measured total sedentary time in the total sample . However , some effects on objective ly and subjectively measured sedentary time were found in specific subgroups . Preschoolers from the intervention group from high SES kindergartens and preschoolers with high levels of sedentary time at baseline decreased their sedentary time , while preschoolers from the control group increased their sedentary time . Girls in the intervention group decreased their TV viewing time during weekend days ( -5.83 min/day ) , while girls ’ & TV viewing in the control group increased ( + 4.15 min/day ) . In low SES kindergartens , a smaller increase for computer time during weekend days was found in preschoolers in intervention kindergartens ( + 6.06 min/day ) than in control kindergartens ( + 12.49 min/day ) . Conclusion While some small positive effects were found in some sub-groups , the ToyBox-intervention had no effect on objective ly and subjectively measured sedentary time in the total sample . A longer period to implement the intervention and a more active involvement of parents/caregivers might enhance intervention effects . The ToyBox- study is registered with the clinical trials registry clinical trials.gov , ID : NCT02116296 BACKGROUND Previous studies on physical activity interventions in preschools have reported limited effectiveness . Participatory community-based approaches hold promise for increasing intervention effectiveness and involving parents as key stakeholders in a sustainable way . PURPOSE To assess whether a  participatory parent-focused approach using parents as agents of behavioral change enhances the efficacy of a  preschool physical activity ( PA ) intervention . DESIGN Two-armed , cluster- RCT with preschool as unit of r and omization and children as unit of analysis . SETTING / PARTICIPANTS 39 South German preschools applying for an existing state-sponsored PA program with 826 children ( 52 % boys , aged 5.0±0.2 years ) , with 441 allocated to the intervention arm .  INTERVENTION Control preschools received a state-sponsored program consisting of twice-weekly gym classes over 6 months . In intervention preschools , this program was augmented by motivating parents to develop and implement their own project ideas for promoting children 's PA . MAIN OUTCOME MEASURES Primary outcomes included mean accelerometry counts and time spent in moderate- to vigorous-intensity PA or sedentary behavior . Secondary outcomes were BMI , percentage body fat , quality of life , sleep quality , and general health . Outcomes were measured at baseline and at 6 and 12 months in both study arms ( time period : 2008 - 2010 ) . Using an intention-to-treat- analysis , linear multilevel regression models assessed change over time and across study arms , adjusted for age , gender , season , and preschool location . Analysis was conducted in 2011 . RESULTS In 15 intervention preschools , parents implemented 25 PA projects . Compared with controls , intervention arm children were 11 minutes less sedentary per day ( 95 % CI=5.39 , 17.01 , p=0.014 ) ; had significantly more mean accelerometry counts ( 1.4 counts/15 seconds [ 95 % CI=0.22 , 2.54 ] , p=0.019 ) ; and showed benefits in perceived general health and quality of life . All other outcomes showed no difference between study arms . CONCLUSIONS A participatory preschool intervention focusing on parents as agents of behavioral change may be able to promote PA and reduce sedentary behavior in preschoolers . These benefits may go beyond the effects of existing nonparticipatory interventions . TRIAL REGISTRATION This study is registered at clinical trials.gov NCT00987532 A growing body of research has illuminated beneficial effects of a single bout of physical activity ( i.e. , acute exercise ) on cognitive function in school-age children . However , the influence of acute exercise on preschoolers ' cognitive function has not been reported . To address this shortcoming , the current study examined the effects of a 30-min bout of exercise on preschoolers '  cognitive function .  Preschoolers ' cognitive function was assessed following a single bout of exercise and a single sedentary period . Results revealed that , after engaging in a bout of exercise , preschoolers exhibited markedly better ability to sustain attention , relative to after being sedentary ( p = .006 , partial eta square = .400 ) . Based on these findings , providing exercise opportunities appears to enhance preschoolers ' cognitive function Background Most preschool centers provide two 30-min sessions of gross-motor/outdoor playtime per preschool day . Within this time frame , children accumulate most of their activity within the first 10 min . This paper describes the design and baseline participant characteristics of the Short bouTs of Exercise for Preschoolers ( STEP ) study . The STEP study is a cluster r and omized controlled study design ed to examine the effects of short bouts of structured physical activity ( SBS-PA ) implemented within the classroom setting as part of design ated gross-motor playtime on during-school physical activity ( PA ) in preschoolers . Methods / Design Ten preschool centers serving low-income families were r and omized into  SBS-PA versus unstructured PA ( UPA ) . SBS-PA schools were asked to implement age-appropriate 10 min structured PA routines within the classroom setting , twice daily , followed by 20 min of usual unstructured playtime . UPA intervention consisted of 30 min of supervised unstructured free playtime twice daily . Interventions were implemented during the morning and afternoon design ated gross-motor playtime for 30 min/session , five days/week for six months . Outcome measures were between group difference in during-preschool PA ( accelerometers and direct observation ) over six-months . Ten preschool centers , representing 34 classrooms and 315 children , enrolled in the study . The average age and BMI percentile for the participants was 4.1 ± 0.8 years and 69th percentile , respectively . Participants spent 74 % and 6 % of their preschool day engaged in sedentary and MVPA , respectively . Discussion Results from the STEP intervention could provide evidence that a PA policy that exposes preschoolers to shorter bouts of structured PA throughout the preschool day could potentially increase preschoolers ’ PA levels . Trial registration Clinical trials.gov , OBJECTIVE Despite the high prevalence of obesity among preschool-aged children , most states lack childcare center ( CCC ) nutrition and physical activity policies . The Healthy Caregivers , Healthy Children ( HC ) Phase 2 project is examining the relationship between the CCC nutrition and physical activity environment and child dietary intake/physical activity patterns and body mass index ( BMI ) . PARTICIPANTS A total of 24 " Quality Counts " ( Miami Dade County , Florida 's Quality Rating Improvement System [ QRIS ) ] ) CCCs serving low re source families with ≥50 2-to-5year olds attending have been r and omized to either intervention ( n=12 ) or control ( n=12 ) . INTERVENTION The HC2 intervention arm CCCs receive implementation of a daily curricula for ( 1 ) teachers/parents ; ( 2 ) children ; ( 3 ) snack , beverage , physical activity , and screen time policies ; and ( 4 ) technical assistance with menu modifications . Control arm schools receive an attention control safety curriculum . HC2 is delivered once a month in year 1 , quarterly in year 2 and will be disseminated throughout the Quality Counts network in year 3 . MAIN OUTCOME MEASURES Primary outcome measures include the Environment and Policy Assessment and Observation tool ( EPAO ) , st and ardized dietary intake and physical activity patterns surveys , and child BMI . The ' Reach , Effectiveness , Adoption , Implementation , and Maintenance ( RE- AIM ) ' framework will guide the interpretation of outcome measures . CONCLUSIONS CCCs are in need of evidence -based st and ardized nutrition and physical activity policies . The intersection of RE- AIM and early childhood obesity prevention in the childcare setting could generate robust and new information to the field about potential barriers , facilitators , adoption , and sustainability in this setting Background Young children are not participating in recommended levels of physical activity and exhibit high levels of sedentary behaviour . Childcare services provide access to large numbers of young children for prolonged periods , yet there is limited experimental evidence regarding the effectiveness of physical activity interventions implemented in this setting . The aim of this study is to assess the effectiveness and acceptability of a multi-component physical activity intervention , delivered by childcare service staff , in increasing the physical activity levels of children attending long day care services . Methods / Design The study will employ a cluster r and omised controlled trial design . Three hundred children aged between 3 - 5 years from twenty r and omly selected long day care services in the Hunter Region of New South Wales , Australia will be invited to participate in the trial . Ten of the 20 long day care services will be r and omly allocated to deliver the intervention with the remaining ten services allocated to a wait list control group . The physical activity intervention will consist of a number of strategies including : delivering structured fundamental movement skill activities , increasing physical activity opportunities , increasing staff role modelling , providing children with a physical activity promoting indoor and outdoor environment and limiting children 's small screen recreation and sedentary behaviours . Intervention effectiveness will be measured via child physical activity levels during attendance at long day care . The study also seeks to determine the acceptability and extent of implementation of the intervention by services and their staff participating in the study . Discussion The trial will address current gaps in the research evidence base and contribute to the design and delivery of future interventions promoting physical activity for young children in long day care setting s . Trial registration Australian New Zeal and Clinical Trials Registry
Conclusion Physical activity and sedentary time were highly varied and inconsistent between studies ; therefore , it is difficult to determine preschoolers ’ true amount of physical activity and sedentary time during childcare hours .
Despite this variability , preschoolers were noted to participate in high rates of sedentary time in this setting .
The lack of homogeneity is an important finding in and of itself as it highlights the lack of consistency in measuring , processing , and reporting paediatric physical activity data
Background Many preschoolers spend a substantial portion of their day enrolled in centre-based childcare ; the amounts of physical activity and sedentary time accumulated in this environment are critical to preschoolers ’ ability to meet movement guidelines .
The purpose of this systematic review was to provide a comprehensive overview of the objective ly assessed physical activity  and  sedentary time  of preschoolers in centre-based childcare ( registration no. CRD42016033502 ) .