Correlates of Physical Activity in 0- to 5-year-olds: A Systematic Umbrella Review and Consultation of International Researchers

Child-, Family-, and Community-Level Correlates of 24-Hour Movement Behaviors in Ethiopian Young Children: The SUNRISE Study

BACKGROUND

Understanding the factors influencing 24-hour movement behaviors is important for designing appropriate health promotion strategies. We examined the multidimensional correlates of physical activity, sedentary behavior, screen time, and sleep among children under 5 years of age in Ethiopia.

METHODS

Cross-sectional study conducted in Adama and Lume district, Ethiopia. Children were recruited from urban kindergartens and rural villages. Physical activity, sedentary time, and sleep were assessed using accelerometry. Screen time and correlates were parent reported. Variables were selected a priori, using the social ecological model and considering country context. Linear mixed models were used to test associations between child-, family-, and community-level correlates and time spent in 24-hour movement behaviors, accounting for clustering effect.

RESULTS

Four hundred and thirty children participated (mean age 4.2 [0.6] y). Girls spent less time in total of physical activity (TPA) and moderate- to vigorous-intensity physical activity (MVPA) and more time sedentary than boys. Children who spent more time outdoors had higher TPA and MVPA, longer sleep duration, and shorter sedentary and screen time. Children of educated parents had lower TPA and MVPA and higher sedentary time than those with no formal education. Children of parents who reported using a screen device with their child for educational purposes spent less time in MVPA, had shorter sleep, and had more screen time than those who did not. Rural children had higher TPA and MVPA, longer sleep, and shorter sedentary and screen time than urban children.

CONCLUSION

We identified key correlates of 24-hour movement behaviors in Ethiopian children. Designing tailored health promotion strategies to support healthy levels of movement behaviors, particularly in urban areas, is needed.

Raising active children: how family and school shape health-promoting physical activity-findings from the FAMIPASS study

This study investigated the combined impact of family dynamics and school environments on physical activity levels in children aged 3-9 years across distinct segments of the school day. Conducted as part of the FAMIPASS project in the Czech Republic, the study collected data in 2022 and 2023 from 502 families affiliated with 36 preschools and primary schools. The device-based monitoring of movement behaviors in children and their parents was conducted over a one-week period using ActiGraph accelerometers, complemented by detailed family questionnaires. Regression analysis revealed that parental physical activity, BMI, and education level significantly influenced children's moderate-to-vigorous physical activity, with educated parents more likely to raise active children. Active transport to school emerged as a key factor associated with higher child activity levels specifically in the time segment before school. This research underscores the role of family and school as critical arenas for promoting health and physical activity. These insights highlight the need for integrated family-school strategies to foster healthy activity habits in children, thereby laying the groundwork for a more active generation.

Association Between Maternal Physical Activity From Pre-pregnancy to Child-rearing and Their Children's Physical Activity in Early Childhood Among Japanese

INTRODUCTION

This study aimed to determine the association between cumulative maternal physical activity level and their children's physical activity in early childhood. We also compared the influence of each maternal physical activity on children's physical activity in early childhood.

METHODS

We analyzed the data from 1,067 Japanese mother-child pairs. Maternal physical activity was assessed using the International Physical Activity Questionnaire. Cumulative physical activity level in mothers was computed based on the categories (low, moderate, and high) of physical activity from five time points (pre-pregnancy, during pregnancy, 1.5, 3.5, and 5.5 years postpartum). Children's physical activity level was measured at age 5.5 years using the WHO Health Behaviour School-aged Children questionnaire and defined as engaging in physical activity for at least 60 minutes per day for more than 5 days. Logistic regression analysis was used to determine the association between maternal and children's physical activity levels.

RESULTS

The results showed the positive association between cumulative maternal physical activity and children's physical activity level (P for trend < 0.001). Furthermore, maternal physical activity during pregnancy (P for trend = 0.031) and 5.5 years postpartum (P for trend < 0.001) was positively associated with children's physical activity.

CONCLUSION

A positive association was observed between the cumulative maternal physical activity level and the physical activity level of their children at 5.5 years of age. Furthermore, maternal physical activity during pregnancy and at 5.5 years postpartum were positively associated with the level of children's physical activity.

Longitudinal Change in Physical Activity in Children 6 to 36 Months of Age

OBJECTIVE

To describe the developmental pattern for physical activity (PA) in children 6-36 months of age and to identify factors that are longitudinally associated with PA as children transition from infancy to preschool age.

STUDY DESIGN

The study employed a prospective longitudinal design with baseline data collected when children were approximately 6 months of age. Mothers and infants (n = 124) were recruited through community and educational settings in South Carolina. Data were collected at 6-month intervals from 6 to 36 months. PA was measured via accelerometry. Mothers completed questionnaires that assessed independent variables, including parent characteristics, the child's sex, race, and ethnicity, birth/delivery type, motor milestones, sleep habits, dietary practices, childcare setting, and home environmental factors. Trained research staff administered anthropometric measures and assessed motor developmental status. Growth curve models described the age-related pattern for PA and evaluated relationships between independent variables and change in PA.

RESULTS

PA increased by approximately 45% between 6 and 36 months of age and followed a curvilinear pattern, with most of the increase occurring between 6 and 24 months. The child's exposure to television/electronic media was negatively associated with change in PA, and the presence of older siblings in the home was positively associated with change in PA.

CONCLUSIONS

As children develop from infancy to early childhood, their PA increases substantially, with most of the increase occurring by 24 months of age.

Identifying data gaps in early childhood physical activity evidence

Childhood physical activity sets the foundation for health. While we know many factors that contribute to physical activity, there are limitations in our knowledge, especially in early childhood. Through our review, we identify gaps in existing datasets to guide future research.

Effectiveness of a movement and music programme on activity, sedentary, and sleep behaviours and motor and musical skills in young children: protocol for the MoviMusi cluster randomised controlled trial

The early childhood education and care (ECEC) environment is an important setting for providing children with daily opportunities for movement and music, supporting holistic child development in the early years. To date, there are no studies evaluating the implementation of a holistic programme in the ECEC context in the areas of movement behaviour and motor and musical skills. The main aim is to examine the effectiveness of a holistic movement and music programme on physical activity (PA), sedentary behaviour and sleep, motor skills and musical skills in young children (1-3 years). The secondary aims are to examine the impact of the movement and music programme on the perceptions of the educational community, as well as the barriers and facilitators they perceive in the process of baseline assessment, construction, and implementation of the movement and music programme in their own ECEC community. This cluster-randomised controlled trial (intervention and control groups) with public ECEC centres will be performed over a 24-month period. Baseline measurements will be taken in the first year of the project, and assessments to examine the effectiveness of the programme will take place 12 months after the baseline assessment. For young children the main outcome variables will be: (a) PA, sedentary time, and sleep time; (b) gross and fine motor skills; and (c) musical skills. The secondary outcomes will be: (a) PA and sedentary time during outdoor play and structured PA sessions; (b) play patterns during outdoor free play; and (c) movement and music behaviours after ECEC hours. For families, secondary outcomes will be: (a) perceived barriers and facilitators to PA in young children; (b) perceived barriers and facilitators to the inclusion of music at home; and (c) the means of transport to ECEC settings and barriers to active commuting. For ECEC educators, the secondary will be: (a) perceived barriers and facilitators for the inclusion of movement and music as curricular practices in the ECEC institution; (b) perceived impact of the implementation of the movement and music programme. This research project aims to fill a knowledge gap during a period of childhood that has rarely been explored, either nationally or internationally (1-3 years), and to position movement and music teaching practices as key contexts in the curriculum development of infant and toddler education.

Developmental trends in young children's device-measured physical activity and sedentary behaviour

BACKGROUND

Knowledge of developmental trends in meeting age-specific 24-hour movement behaviour guidelines is lacking. This study describes developmental trends in device-measured physical activity and sedentary time over a three-year period among Western Australian children aged two to seven years, including differences between boys and girls. The proportion of children meeting age-specific physical activity guidelines before and after they transition to full-time school was also examined.

METHODS

Data from waves 1 and 2 of the Play Spaces and Environments for Children's Physical Activity (PLAYCE) cohort study were used (analysis n = 1217). Physical activity and sedentary time were measured by accelerometry at ages two to five (preschool, wave 1) and ages five to seven (commenced full-time school, wave 2). Accelerometer data were processed using a validated machine-learning physical activity classification model. Daily time spent in sedentary behaviour, energetic play (moderate-to-vigorous physical activity (MVPA)), total physical activity, and meeting physical activity guidelines were analysed using linear and generalised linear mixed-effects models with age by sex interaction terms.

RESULTS

All movement behaviours changed significantly with increasing age, and trends were similar in boys and girls. Total daily physical activity increased from age two to five then declined to age seven. Mean daily total physical activity exceeded 180 min/day from ages two to five. Daily energetic play increased significantly from age two to seven, however, was below 60 min/day at all ages except for seven-year-old boys. Daily sedentary time decreased to age five then increased to age seven but remained lower than at age two. All two-year-olds met their age-specific physical activity guideline, decreasing to 5% of girls and 6% of boys at age four. At age seven, 46% of boys and 35% of girls met their age-specific physical activity guideline.

CONCLUSIONS

Young children's energetic play and total physical activity increased with age, but few children aged three to seven met the energetic play (MVPA) guideline. Interventions should focus on increasing children's energetic play in early childhood. Clearer guidance and strategies are needed to support young children as they change developmentally and as they transition from one age-specific movement guideline to the next.

Sex differences in physical activity of US children at age 13 months: child and Mother Physical Activity Study (CAMPAS)

BACKGROUND

Lower physical activity (PA) has been observed in females compared to males among preschool-aged and older children. However, the timing of when the sex gap emerges is unclear. The purpose of this study was to investigate whether females have lower PA levels than males in the early toddler age and to explore whether gross motor competency and PA parenting practices might explain a sex difference in PA.

METHODS

The study design was cross-sectional. Participants were a community-based sample of 137 children aged 10-16 months residing in US Midwest urban/suburban area. Participants' mothers completed a survey that contained a demographic questionnaire, the Ages and Stages Questionnaire gross motor competency subscale, and a PA parenting practices questionnaire. Participating children wore an ActiGraph accelerometer on their hip for 7 days. Accelerometer-measured time spent in moderate- and vigorous intensity PA (MVPA; minutes/day) and in total PA (minutes/day) were calculated. Multivariable linear regression analysis was conducted to predict MVPA and total PA by sex, gross motor competency, PA parenting practices, and socioeconomic status.

RESULTS

Among 137 participants (54.0% female), average age was 13.6 months (SD = 1.7). MVPA was 72 ± 25 and 79 ± 26 min/day for females and males, respectively (p = 0.14). Total PA was 221 ± 48 and 238 ± 47 min/day for females and males, respectively (p = 0.04). Both gross motor competency and PA-encouraging parenting practices were positively associated MVPA (p = 0.01 and p = 0.02, respectively) and total PA (p = 0.02 and p = 0.01, respectively); however, these relationships did not differ by sex (p = 0.11 and p = 0.89, respectively). After accounting for gross motor competency and PA parenting practices, total PA was 15 min/day lower among females than males (p = 0.04).

CONCLUSIONS

This cross-sectional study of US children observed a sex gap in total PA at 10-16 months of age. Gross motor development and PA parenting practices did not differ by child sex nor explain the sex difference in PA. A longitudinal investigation should follow to further narrow down when sex differences in PA emerge and to determine the factors that lead to this difference.

Children's physical activity in family child care homes: Influence of quality status, environment and policy features, and child characteristics

BACKGROUND

About half of preschool-age children are not meeting recommendations of 15 min/h of physical activity (PA), and nearly one out of seven children between the ages of 2-5 years are living with obesity. Furthermore, children attending family child care homes (FCCHs), compared with larger child care centers, engage in lower levels of PA and appear to be at a higher risk of obesity. Therefore, examining PA and multi-level factors that influence PA in children who attend FCCHs is essential.

METHODS

The Childcare Home Eating and Exercise Study (CHEER) examined PA behaviors of 184 children enrolled in 56 FCCHs and FCCH quality status, environment and policy features, and child characteristics. PA was assessed by accelerometer, and FCCH environment and policy was assessed via structured observation. Multiple linear regression was used to model associations between school day total PA and FCCH quality status, environment and policy features, and child characteristics.

RESULTS

Child participants were on average 3.1 years old; participants were non-Hispanic Black (47.3%), Non-Hispanic White (42.9%), other race/ethnicity (7.1%), and Hispanic/Latin (2.7%). Children in FCCH settings participated in 11.2 min/h of total PA, which is below the recommended 15 min per hour. The PA environment and policy observation yielded a score of 11.8 out of a possible 30, which is not supportive of child PA. There were no associations between total child PA and FCCH quality status, environment and policy features, and child characteristics in these FCCH settings.

CONCLUSIONS

This study was unique in its examination of PA and a comprehensive set of factors that may influence PA at the individual, organizational, environmental, and policy levels in a diverse sample of children attending FCCHs in South Carolina. Additional research is needed to better understand how to increase children's physical activity while they are in the FCCH setting. This research should use multi-level frameworks and apply longitudinal study designs.

Sex Differences in Physical Activity of US children at age 13 months: Child and Mother Physical Activity Study (CAMPAS)

Background

Lower physical activity (PA) has been observed in females compared to males among preschool-aged and older children. However, the timing of when the sex gap emerges is unclear. The purpose of this study was to investigate whether females have lower PA levels than males in the early toddler age and to explore whether gross motor competency and PA parenting practices might explain a sex difference in PA.

Methods

The study design was cross-sectional. Participants were a community-based sample of 137 children aged 10-16 months residing in US Midwest urban/suburban area. Participants' mothers completed a survey that contained a demographic questionnaire, the Ages and Stages Questionnaire gross motor competency subscale, and a PA parenting practices questionnaire. Participating children wore an ActiGraph accelerometer on their hip for 7 days. Accelerometer-measured time spent in moderate- and vigorous intensity PA (MVPA; minutes/day) and in total PA (minutes/day) were calculated. Multivariable linear regression analysis was conducted to predict MVPA and total PA by sex, gross motor competency, PA parenting practices, and socioeconomic status.

Results

Among 137 participants (54.0% female), average age was 13.6 months (SD = 1.7). MVPA was 72 ± 25 and 79 ± 26 minutes/day for females and males, respectively (p = 0.14). Total PA was 221 ± 48 and 238 ± 47 minutes/day for females and males, respectively (p = 0.04). Both gross motor competency and PA-encouraging parenting practices were positively associated MVPA (p = 0.01 and p = 0.02, respectively) and total PA (p = 0.02 and p = 0.01, respectively); however, these relationships did not differ by sex (p = 0.11 and p = 0.89, respectively). After accounting for gross motor competency and PA parenting practices, total PA was 15 minutes/day lower among females than males (p = 0.04).

Conclusions

This cross-sectional study of US children observed a sex gap in total PA at 10-16 months of age. Gross motor development and PA parenting practices did not differ by child sex nor explain the sex difference in PA. A longitudinal investigation should follow to further narrow down when sex differences in PA emerge and to determine the factors that lead to this difference.

Investigating young children's physical activity through time and place

BACKGROUND

Previous research indicates the start of primary school (4-5-year-old) as an essential period for the development of children's physical activity (PA) patterns, as from this point, the age-related decline of PA is most often observed. During this period, young children are exposed to a wider variety of environmental- and social contexts and therefore their PA is influenced by more diverse factors. However, in order to understand children's daily PA patterns and identify relevant opportunities for PA promotion, it is important to further unravel in which (social) contexts throughout the day, PA of young children takes place.

METHODS

We included a cross-national sample of 21 primary schools from the Startvaardig study. In total, 248 children provided valid accelerometer and global positioning (GPS) data. Geospatial analyses were conducted to quantify PA in (social) environments based on their school and home. Transport-related PA was evaluated using GPS speed-algorithms. PA was analysed at different environments, time-periods and for week- and weekend days separately.

RESULTS

Children accumulated an average of 60 min of moderate-to-vigorous PA (MVPA), both during week- and weekend days. Schools contributed to approximately half of daily MVPA during weekdays. During weekends, environments within 100 m from home were important, as well as locations outside the home-school neighbourhood. Pedestrian trips contributed to almost half of the daily MVPA.

CONCLUSIONS

We identified several social contexts relevant for children's daily MVPA. Schools have the potential to significantly contribute to young children's PA patterns and are therefore encouraged to systematically evaluate and implement parts of the school-system that stimulate PA and potentially also learning processes. Pedestrian trips also have substantial contribution to daily MVPA of young children, which highlights the importance of daily active transport in school- and parental routines.

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

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.

Are low-income preschoolers physically active at preschool settings? A cross-sectional study

BACKGROUND

Preschools may provide opportunities for children to engage in physical activity (PA), to benefit their health, although little is known when concerning low-income preschoolers. This study aimed (1) to describe time spent in PA among low-income children during preschool hours and (2) to analyse how many children meet the PA recommendations during preschool hours.

METHODS

A total of 204 low-income preschoolers (4.51 ± 0.79 years) from João Pessoa/Brazil provided valid accelerometer (Actigraph, WGT3-X) data during the preschool period. Children were grouped in quartiles of PA in counts per minute, according to sex and age. The General Linear Model Univariate was used to examine the differences in PA intensities between the quartiles and the time spent in total PA (TPA) and moderate-to-vigorous PA (MVPA) by quartiles, according to age. An hour-by-hour description of children's PA was presented.

RESULTS

TPA during preschool hours ranged from 68.33% to 113.89% of the recommended and from 28.34% to 81.68% of the MVPA recommendations. Among 5-year-old children, those in the highest quartile met the PA recommendations. All children were more active outdoors than indoors. For the less actives, preschool time corresponded to 30% of the recommended daily MVPA.

CONCLUSION

The current results reinforce the importance of preschool settings for promoting preschoolers' PA and provide particularly important and useful information for tailoring preschool-based interventions focused on those who need it most. Strategies to increase children's MVPA should be prioritized during free-play time.

Longitudinal effects of dog ownership, dog acquisition, and dog loss on children's movement behaviours: findings from the PLAYCE cohort study

INTRODUCTION

Regular physical activity is important for children's physical and mental health, yet many children do not achieve recommended amounts of physical activity. Dog ownership has been associated with increased physical activity in children, however, there have been no longitudinal studies examining this relationship. This study used data from the Play Spaces and Environments for Children's Physical Activity (PLAYCE) cohort study to examine the longitudinal effects of dog ownership status on children's movement behaviours.

METHODS

Change in dog ownership from preschool (wave 1, age 2-5) to fulltime school (wave 2, age 5-7) was used as a natural experiment with four distinct dog ownership groups: continuing non-dog owners (n = 307), continuing dog owners (n = 204), dog acquired (n = 58), and dog loss (n = 31; total n = 600). Daily movement behaviours, including physical activity, sedentary time, sleep, and screen time, were measured using accelerometry and parent-report surveys. Differences between groups over time and by sex were tested using linear mixed effects regression models.

RESULTS

Girls who acquired a dog increased their light intensity activities and games by 52.0 min/day (95%CI 7.9, 96.0) and girls who lost a dog decreased their light intensity activities and games by 62.1 min/day (95%CI -119.3, -4.9) compared to no change among non-dog owners. Girls and boys who acquired a dog increased their unstructured physical activity by 6.8 (95%CI 3.2, 10.3) and 7.1 (95%CI 3.9, 10.3) occasions/week, compared to no changes among non-dog owners. Girls and boys who lost a dog reduced their unstructured physical activity by 10.2 (95%CI -15.0, -5.3) and 7.7 (95%CI -12.0, -3.5) occasions/week. Girls who lost a dog decreased their total physical activity by 46.3 min/day (95%CI -107.5, 14.8) compared to no change among non-dog owners. Continuing dog ownership was typically not associated with movement behaviours. Dog ownership group was not associated with changes in sleep and had mixed associations with screen time.

CONCLUSION

The positive influence of dog ownership on children's physical activity begins in early childhood and differs by child sex. Further research should examine the specific contributions dog-facilitated physical activity makes to children's overall physical activity, including the intensity and duration of dog walking and play.

Trajectories of Device-Measured Physical Activity During Early Childhood and Its Determinants: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study

BACKGROUND

The objective was to describe trajectories of physical activity (PA) measured by accelerometry during early childhood and to test associations with sociodemographic, gestational, maternal, and perinatal determinants.

METHODS

Data from 1798 children from the 2015 Pelotas (Brazil) Birth Cohort were analyzed. PA was measured with wrist accelerometers at 1, 2, and 4 years. PA trajectories were estimated using group-based trajectory modeling, and associations with determinants were tested using Poisson regression with robust variance.

RESULTS

Two trajectories were identified: Moderate and high PA, both showing a linear increase in PA in the first years but differing in volume. Girls (prevalence ratio [PR]: 0.91; 95% confidence interval [CI], 0.88-0.94), highly educated mothers (PR: 0.93; 95% CI, 0.88-0.97), and high birth weight children (PR: 0.91; 95% CI, 0.85-0.97) showed less probability of high PA trajectory. Birth order ≥3 (PR: 1.06; 95% CI, 1.01-1.11) was associated with higher likelihood of high PA trajectory.

CONCLUSIONS

Children showed an increase in PA during the first years, with 2 trajectories that differ in PA levels. Female sex, high maternal schooling, and high birth weight reduced the probability of having a high PA trajectory, while higher birth order increased this probability. These characteristics should be considered when planning PA interventions for children in early childhood.

Physical activity in infancy and early childhood: a narrative review of interventions for prevention of obesity and associated health outcomes

In the context of the childhood obesity epidemic, this narrative review aims to explore opportunities to promote physical activity (PA) between birth and age 5 years as well as the health outcomes associated with PA in early childhood. Although early childhood is an ideal time to promote healthy habits, guidelines for PA have often ignored early childhood given the limited evidence for children <5 years old. Herein we discuss and highlight infant, toddler and preschool age interventions to promote PA and prevent obesity both in the short and long-term. We describe novel and modified interventions to promote improved early childhood health outcomes, encompassing cardiorespiratory, muscle, and bone strengthening components necessary for short-term motor development and long-term health. We call for new research aimed at developing and testing innovative early childhood interventions that may be performed in home or childcare settings, monitored by parents or caregivers.

The moderating role of parent perceptions in relationships between objectively measured neighbourhood environment attributes and pre-schooler's physical activity: Findings from the PLAYCE study

We examined the moderating effects of parent perceptions of the neighbourhood environment on associations between objectively measured neighbourhood environment attributes and physical activity among pre-schoolers. The number of neighbourhood parks was positively associated with pre-schooler energetic play when parents had above average perceptions of access to services. Objectively measured street connectivity was associated with fewer minutes of energetic play when pedestrian and traffic safety was perceived to be below average by parents. Greater understanding of the role played by parents in pre-schooler's exposure to physically active supportive environments is needed to inform environmental interventions for specific age groups.