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Jerebine A, Heering T, Barnett LM. Educator-Perceived Barriers and Facilitators to Structured-Physical Activity in Early Childhood Centres: A Systematic Review. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:243-262. [PMID: 37327492 DOI: 10.1080/02701367.2023.2193243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Purpose: Physical activity (PA) and motor competence development are vital for young children, yet many early childhood education and care (ECEC) centers struggle to successfully implement PA programs, particularly those organized and led by educators. This review aimed to synthesize qualitative literature to (1) identify educator-perceived barriers and facilitators to structured-PA in ECEC centers, and (2) map these to the COM-B model and Theoretical Domains Framework (TDF). Methods: Following PRISMA guidelines, a systematic search of five databases was conducted in April 2021 and updated in August 2022. Records were screened in Covidence software using predefined eligibility criteria. Using the framework synthesis method, data extraction and synthesis were conducted in coding forms in Excel and NVivo. Results: Of 2382 records identified, 35 studies were included, representing 2,365 educators across 268 ECEC centers in 10 countries. Using the COM-B model and TDF, an evidence-informed framework was developed. Findings revealed the greatest barriers concerned educator "opportunity" (e.g. competing time and priorities, policy tensions, indoor/outdoor space constraints) and "capability" (e.g. lack of PA knowledge and practical, hands-on skills) to implement structured-PA. Although fewer studies reported factors that influenced educator "motivation", several themes intersected across the three COM-B components illustrating the complexity of behavioral determinants in this setting. Conclusions: Interventions grounded in theory that utilize a systems approach to target multiple levels of influence on educator behavior, and are flexible and adaptable locally, are recommended. Future work should seek to address societal barriers, structural challenges in the sector, and the PA educational needs of educators. PROSPERO Registration: CRD42021247977.
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Nielsen JV, Koch S, Skovgaard T. Mind the gap: Danish school heads' ability to implement a national physical activity school requirement. Health Promot Int 2023; 38:7026244. [PMID: 36738453 DOI: 10.1093/heapro/daac193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
In 2014, the Danish government introduced a wide-ranging reform of primary and lower secondary education that applied to all public schools. A distinctive feature was that it became mandatory for schools to provide an average of 45 min of daily physical activity (PA). The capacity for change of local school heads and the schools overall are considered key to fulfilling such a policy-driven requirement. The aim of this study is therefore to explore local school heads' ability to implement the stated requirement of 45 min of daily PA within their local organizational capacity for change. Eleven semi-structured interviews were conducted across 11 schools. Respondents were school staff with management responsibilities (leading teachers with school management responsibilities, deputy heads and school heads). Results indicate that local school heads are central agents in converting the Danish school requirement of 45 min of daily PA into local action. This includes their ability to advance broad aims into concrete goals, secure supportive structures and organize the implementation strategy. Heads also need to support the staff in building sufficient knowledge capacity on how to arrange and incorporate PA into their daily practice, support the widespread dissemination of this knowledge across the school and reserve work hours for such activities. Assigning local PA ambassadors was particularly highlighted as important implementation support, as they can help build and disseminate knowledge while also broadcasting the school head's strategy and focus on integrating and upholding students' PA levels.
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Affiliation(s)
- Jonas Vestergaard Nielsen
- Centre for Primary and Lower Secondary Education Research, University of Southern Denmark, Odense M, Denmark.,Active Living, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Sofie Koch
- Active Living, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Thomas Skovgaard
- Centre for Primary and Lower Secondary Education Research, University of Southern Denmark, Odense M, Denmark.,Active Living, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
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Asada Y, Lin S, Siegel L, Kong A. Facilitators and Barriers to Implementation and Sustainability of Nutrition and Physical Activity Interventions in Early Childcare Settings: a Systematic Review. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:64-83. [PMID: 36198924 DOI: 10.1007/s11121-022-01436-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 02/01/2023]
Abstract
A stronger understanding of the factors influencing implementation of interventions in community-based early childcare settings is needed. The purpose of this systematic review was to synthesize existing research on facilitators and barriers to implementation and sustainability of nutrition and physical activity interventions in early childcare settings targeting 2-5-year-old children, including considerations for equitable implementation. This review adhered to PRISMA 2020 guidelines. Peer-reviewed literature was searched in PubMed, EMBASE, CINAHL, ERIC, and PsycINFO databases up to September 2020. Primary research studies that examined facilitators and barriers (or related synonyms) to the implementation and sustainability of nutrition and physical activity interventions in early childcare settings were eligible for inclusion. The search yielded 8092 records that were screened by four analysts in Covidence software with a final review of 24 studies. Two independent reviewers conducted study selection, data extraction, and quality appraisal (Mixed Methods Appraisal Tool). A "best fit" framework was applied using the Consolidated Framework for Implementation Research (CFIR) constructs to code barriers and facilitators. The most salient constructs were (1) "Available Resources," which was composed of time, staffing, space, and staff trainings; (2) adaptability; and (3) compatibility, the latter two indicating that easily modifiable interventions facilitated a smoother "fit" and were more likely to be successful, given adequate site-level resources. Only nine (28%) reported the use of a theory, model, or framework to guide evaluation; six studies (24%) included factors related to sustainability; and nine studies (38%) conducted their interventions with low-income or minoritized groups. The findings point to the need for intervention evaluations examining nutrition and physical activity to more consistently consider (a) sustainability factors early on in design and adoption phases; (b) use of theory, model, or framework to guide evaluation; and (c) equity-related frameworks and considerations for how equitable implementation.
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Affiliation(s)
- Yuka Asada
- School of Public Health, Community Health Sciences, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA.
| | - Shuhao Lin
- College of Applied Health Science, Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W Taylor St, Chicago, IL, 60612, USA
| | - Leilah Siegel
- 4-H Youth Development, University of Illinois Extension, 535 S. Randall Road, St., Charles, IL, 60174, USA
| | - Angela Kong
- Department of Pharmacy Systems, Outcomes, and Policy, College of Pharmacy, University of Illinois Chicago, 833 S. Wood St., Chicago, IL, 60612, USA
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Siegel L, Asada Y, Lin S, Fitzgibbon ML, Kong A. Perceived factors that influence adoption, implementation and sustainability of an evidence-based intervention promoting healthful eating and physical activity in childcare centers in an urban area in the United States serving children from low-income, racially/ethnically diverse families. FRONTIERS IN HEALTH SERVICES 2022; 2:980827. [PMID: 36925814 PMCID: PMC10012626 DOI: 10.3389/frhs.2022.980827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
Introduction Early childcare centers offer optimal settings to provide healthy built environments where preschool age children spend a majority of their week. Many evidence-based interventions (EBIs) promoting healthful eating and physical activity for early childcare settings exist, but there is a limited understanding of how best to support adoption, implementation and sustainability in community settings. This study examined how early childcare teachers and administrators from Chicago-area childcare centers serving children from low-income, racially/ethnically diverse communities viewed an EBI called Hip to Health (H3), and the factors they perceived as relevant for EBI adoption, implementation, and sustainability. Methods A multiple methods study including key informant interviews and a brief survey was conducted. Key informant interviews with teachers and administrators from childcare centers located in Chicago, IL were completed between December 2020 and May 2021. An interview guide and coding guide based on the Consolidated Framework for Implementation Research (CFIR) was developed. Interview transcripts were team coded in MAXQDA Qualitative Data Analysis software. Thematic analysis was used to identify findings specific to adoption, implementation, and sustainability. Participants were also asked to respond to survey measures about the acceptability, feasibility, and appropriateness of H3. Results Overall, teachers (n = 20) and administrators (n = 16) agreed that H3 was acceptable, appropriate, and feasible. Low start-up costs, ease-of-use, adaptability, trialability, compatibility, and leadership engagement were important to EBI adoption. Timely and flexible training was critical to implementation. Participants noted sustainability was tied to low ongoing costs, access to ongoing support, and positive observable benefits for children and positive feedback from parents. Conclusions These findings suggest that EBIs suitable for adoption, implementation, and sustainment in childcare centers serving racially/ethnically diverse, low-income families should be adaptable, easy to use, and low-cost (initial and ongoing). There is also some evidence from these findings of the heterogeneity that exists among childcare centers serving low-income families in that smaller, less resourced centers are often less aware of EBIs, and the preparation needed to implement EBIs. Future research should examine how to better support EBI dissemination and implementation to these settings.
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Affiliation(s)
- Leilah Siegel
- 4-H Youth Development, University of Illinois Extension, St. Charles, IL, United States
| | - Yuka Asada
- Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL, United States
| | - Shuhao Lin
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, United States
| | - Marian L. Fitzgibbon
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | - Angela Kong
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois Chicago, College of Pharmacy, Chicago, IL, United States
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Pate RR, Dishman RK, Dowda M, McIver KL, Pfeiffer KA, Porter DE, Saunders RP, Ward DS. A Summary of One Research Team's Contributions to Understanding Physical Activity Behavior in Children and Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14136. [PMID: 36361011 PMCID: PMC9655861 DOI: 10.3390/ijerph192114136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
Schools are well-positioned to provide physical activity opportunities to help youth achieve the recommended 60 or more daily minutes of moderate-to-vigorous physical activity. The Children's Physical Activity Research Group (CPARG) at the University of South Carolina has focused on understanding physical activity in school-aged youth for 30+ years. The purpose of this article was to critically review (CPARG) contributions to the field in school settings and school-age youth. We reviewed 127 published CPARG articles from six research projects conducted between 1993-2019. The review was guided by questions in five categories: measurement of physical activity and its determinants, characteristics of physical activity behavior, correlates/determinants of physical activity, physical activity interventions, and race/ethnicity and physical activity. Results were summarized by question and synthesized across categories. CPARG contributions included assessing physical activity levels, patterns, forms, and contexts; identifying and measuring physical activity correlates/determinants; and conducting school-based physical activity interventions. Identifying multiple domains of physical activity determinants enables researchers and practitioners to select/design age-appropriate, valid, and reliable instruments to assess determinants. Focusing on determinants enables them to create effective physical activity interventions, environments, programs, and policies in schools. These efforts must address race/ethnicity differences, ensuring that measurement instruments and intervention strategies are culturally appropriate.
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Affiliation(s)
- Russell R. Pate
- Public Health Research Center, Department of Exercise Science, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC 29208, USA
| | - Rod K. Dishman
- Department of Kinesiology, The University of Georgia Ramsey Student Center, 330 River Road, Athens, GA 30602, USA
| | - Marsha Dowda
- Public Health Research Center, Department of Exercise Science, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC 29208, USA
| | - Kerry L. McIver
- Public Health Research Center, Department of Exercise Science, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC 29208, USA
| | - Karin A. Pfeiffer
- Department of Kinesiology, Michigan State University, 308 West Circle Drive, 27R Intramural Rec Sports-Circle, East Lansing, MI 48824, USA
| | - Dwayne E. Porter
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, 915 Green Street, Suite 518, Columbia, SC 29208, USA
| | - Ruth P. Saunders
- Public Health Research Center, Department of Health Promotion, Education, and Behavior, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC 29208, USA
| | - Dianne S. Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB # 7461, Chapel Hill, NC 27599, USA
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Porter RR, McClelland P, Ewing A, Sonka V, Trilk JL. Design and implementation of a clinic-to-community, physical activity health promotion model for healthcare providers. Prev Med Rep 2022; 26:101697. [PMID: 35111567 PMCID: PMC8790628 DOI: 10.1016/j.pmedr.2022.101697] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/29/2021] [Accepted: 01/15/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Ryan R. Porter
- Texas Christian University, 2800 S. University Dr, Fort Worth, TX 76129, USA
| | - Patton McClelland
- University of South Carolina School of Medicine Greenville, Greenville, 701 Grove Road, Greenville, SC 29605, USA
| | - Alex Ewing
- Prisma Health, Greenville, 701 Grove Road, Greenville, SC 29605, USA
| | - Victoria Sonka
- Prisma Health, Greenville, 701 Grove Road, Greenville, SC 29605, USA
| | - Jennifer L. Trilk
- University of South Carolina School of Medicine Greenville, Greenville, 701 Grove Road, Greenville, SC 29605, USA
- Corresponding author.
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In It for the Long Haul: RE-AIM Evaluation of a Preschool Programme Implementing and Maintaining Adult-Initiated Motor Skill Development and Physical Activity across a Two-Year Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052544. [PMID: 35270237 PMCID: PMC8909496 DOI: 10.3390/ijerph19052544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/22/2022] [Accepted: 01/30/2022] [Indexed: 02/01/2023]
Abstract
Good motor skills (MS) are considered important for children's social, psychological and physical development and general physical activity (PA) levels. The Motor skill in Preschool study (MiPS) aimed to optimize children's MS through weekly PA sessions. The aim of this study is to use the RE-AIM framework to report the two-year implementation process of MiPS since the programme's initiation. Data were collected through a staff questionnaire based on the RE-AIM framework. Data were collected at three months, one year and two years after initiation. Results show that the pedagogical staff believes that the programme promotes MS in children. Implementation measures only showed medium to low fidelity concerning the core element of performing adult-initiated PA sessions with a duration of at least 45 min 4 days a week. The largest barrier was finding the time to plan these PA sessions. Still, the content of the PA sessions achieved high fidelity scores and the programme was deemed suitable for staff's everyday practice and in alignment with the stated pedagogical goals. The mandatory competence development course was highly valued as strong implementation support. It is notable that there is a large variation in the implementation among the preschools with some struggling more than others.
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The Role of Local Leaders in the Implementation of Adult-Initiated Motor Skill Development and Physical Activity in Preschool-A Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413119. [PMID: 34948728 PMCID: PMC8701091 DOI: 10.3390/ijerph182413119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/03/2021] [Accepted: 12/08/2021] [Indexed: 11/18/2022]
Abstract
Good motor skills (MS) and physical activity (PA) are considered important for children’s physical, social, and psychological development. The Motor skills in PreSchool (MiPS) study-Denmark aimed to optimize children’s MS through weekly PA sessions. The aim of this paper is to explore the role of local preschool leaders and their strategies in influencing the implementation of MiPS into daily practice. Leaders from all seven preschools in the project were interviewed. The results show that preschool leaders used communication (setting an agenda and dedicating speaking time to address the program at staff meetings) and reflective questioning about the pedagogic staff’s current practice in relation to the program (adding focus on MS and PA) as their main course of action. Through this form of communication and reflective questioning, the preschool leaders aimed to involve the staff and heighten their sensemaking in the existing practice while also ensuring that the implementation of the program was kept in progress. In sum, future implementation of an MS and PA initiative in preschools should put emphasis on a shared responsibility between leaders and staff combined with an adaptive approach in which the existing practice is reshaped rather than just increasing the workload of the pedagogic staff.
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Walter JK, Hill DL, Schall TE, Szymczak JE, Parikh S, DiDomenico C, Carroll KW, Nye RT, Feudtner C. An Interprofessional Team-Based Intervention to Address Barriers to Initiating Palliative Care in Pediatric Oncology: A Multiple-Method Evaluation of Feasibility, Acceptability, and Impact. J Pain Symptom Manage 2021; 62:1135-1144. [PMID: 34153461 PMCID: PMC8648922 DOI: 10.1016/j.jpainsymman.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/08/2021] [Accepted: 06/11/2021] [Indexed: 10/21/2022]
Abstract
CONTEXT Many children with advanced cancer are not referred to palliative care despite both professional recommendations to do so and bereaved parental preference for earlier support from sub-specialty palliative care. OBJECTIVES To assess the feasibility, acceptability, and impact of an adaptive intervention to address individual and team-level barriers to specialty palliative care referrals. METHODS A multiple-method approach assessed feasibility and acceptability among clinicians from pediatric oncology teams at a single institution. Quantitative measures of comfort with palliative care consultations, team cohesion, and team collaboration were conducted before and after the intervention. Number of palliative care consults were examined before, during, and after sessions. Intervention satisfaction surveys and qualitative interviews were conducted after the intervention. RESULTS Twenty-six team members (90% of consented) attended at least one intervention session with 20 (69%) participants completing 75% or more sessions. The intervention was modified in response to participant feedback. After the intervention, participants reported greater team cohesion, comfort discussing palliative care consultation, team collaboration, process satisfaction, and decision satisfaction. Participants agreed that the training was useful, effective, helpful, and worthwhile, that they would use the skills, and that they would recommend the training to other providers. The numbers of palliative care consults increased before intervention sessions were conducted, but did not significantly change during or after the sessions. In the interviews, participants reported overall favorably regarding the intervention with some participants reporting changes in practice. CONCLUSION An adaptive intervention to reduce barriers to initiating palliative care for pediatric oncology teams is feasible and acceptable.
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Affiliation(s)
- Jennifer K Walter
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA; Justin Ingerman Center for Palliative Care (J.K.W., S.P., C.F.), Philadelphia, Pennsylvania, USA
| | - Douglas L Hill
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA.
| | - Theodore E Schall
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA
| | - Julia E Szymczak
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania (J.E.S.), Philadelphia, Pennsylvania, USA
| | - Shefali Parikh
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA; Justin Ingerman Center for Palliative Care (J.K.W., S.P., C.F.), Philadelphia, Pennsylvania, USA
| | - Connie DiDomenico
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA; Division of Pediatric Oncology (C.D.), Philadelphia, Pennsylvania, USA
| | - Karen W Carroll
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA
| | - Russell T Nye
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA
| | - Chris Feudtner
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA; Justin Ingerman Center for Palliative Care (J.K.W., S.P., C.F.), Philadelphia, Pennsylvania, USA
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Bruijns BA, Johnson AM, Tucker P. Content development for a physical activity and sedentary behaviour e-learning module for early childhood education students: a Delphi study. BMC Public Health 2020; 20:1600. [PMID: 33097030 PMCID: PMC7584084 DOI: 10.1186/s12889-020-09670-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 10/09/2020] [Indexed: 12/03/2022] Open
Abstract
Background Early childhood educators play a prominent role in promoting healthy activity behaviours in childcare. However, they have expressed that they lack the appropriate pre-service training to confidently lead physical activity (PA), and minimize sedentary behaviour (SB), in childcare. As such, the purpose of this Delphi study was to generate and reach agreement on content areas for inclusion in a PA and SB e-Learning module for Early Childhood Education (ECE) students. Methods Purposeful sampling of Canadian/international researchers was used to form two expert panels: a PA/SB expert panel (n = 26), and a Canadian ECE panel (n = 35). The PA/SB experts suggested their top 12 PA/SB topics for the module via online survey. These topics were then pooled to generate a list of 19 content areas. In a second online survey, both panels of experts rated the importance of each content area (0 = unimportant to 5 = very important). Mean ratings (M) were ranked separately for each panel, and then ratings were pooled to create an overall ranking of the 19 content areas. Inter-panel agreement of importance rankings was visually represented as a scatterplot and quantified using Spearman’s rho (rs). Results The top-rated content area was Outdoor Play (M = 4.77 ± 0.64), followed by Benefits of PA in the Early Years (M = 4.75 ± 0.66), and Factors Influencing PA and SB in Childcare (M = 4.71 ± .74). Monitor PA and Sedentary Time Within Your Classroom had the lowest combined score (M = 3.77 ± 1.44). There was moderate-to strong inter-panel agreement for content area importance rankings (rs = 0.60, 95% CI: 0.20 to 0.83). The majority of the ECE expert panel considered this training important for ECE students (94.3%), aligning with ECE curriculum objectives (91.4%) and accreditation standards (78.8%), and complementary to the present ECE curriculum (88.6%). Conclusions Providing PA and SB training to ECE students is a proactive way to ensure healthy movement behaviours are prioritized in childcare programming. With the PA/SB expert-developed content areas, and endorsement by the ECE expert panel, implementing this training within ECE programs is a necessary next step. Supplementary information Supplementary information accompanies this paper at 10.1186/s12889-020-09670-w.
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Affiliation(s)
- Brianne A Bruijns
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada
| | - Andrew M Johnson
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada
| | - Patricia Tucker
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, 1201 Western Road, Elborn College, Room 2547, London, ON, N6G 1H1, Canada.
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11
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Saunders RP, Schenkelberg MA, Moyer C, Howie EK, Brown WH, Pate RR. The translation of an evidence-based preschool physical activity intervention from in-person to online delivery of professional development to preschool teachers. Transl Behav Med 2020; 9:1186-1196. [PMID: 31116392 DOI: 10.1093/tbm/ibz076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Study of Health and Activity in Preschool Environments (SHAPES) aimed to increase preschoolers' physical activity by engaging preschool teachers in professional development designed to modify instructional practices. SHAPES originated as a randomized controlled trial, tested in 16 preschools and disseminated to 4 control schools, and was shown to be effective in increasing preschool children's physical activity (Phase I, 2008-2012). This article describes the steps taken to translate an evidence-based physical activity intervention, SHAPES, from in-person delivery to online delivery of professional development to preschool teachers. In Phase II (2013-2016), professional development delivery was modified from an in-person to an online program for preschool teachers. Teacher implementation completeness and fidelity were examined in 10 pilot preschools and then replicated in 30 preschools. Large-scale dissemination of SHAPES began in Phase III (2017-2019), reaching 818 teachers from 228 unique centers after 2 years. The final SHAPES program consisted of six online modules, an accompanying guidebook, over 90 activities, self-assessment techniques, a video library, and an electronic community forum. The SHAPES core elements, defined in Phase I, were retained throughout all three phases. The Phase II change to online delivery was characterized by high levels of implementation completeness and fidelity. Results of Phase III statewide dissemination revealed comparable implementation completeness and fidelity. An intervention shown to be effective in a randomized controlled trial can be translated into an online professional development program and disseminated on a large scale in a timely manner.
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Affiliation(s)
- Ruth P Saunders
- Department of Health Promotion, Education, and Behavior, Public Health Research Center, University of South Carolina, Suite, Columbia, SC, USA
| | - Michaela A Schenkelberg
- Department of Health Promotion, University of Nebraska Medical Center, Maurer Center for Public Health, Nebraska Medical Center, Omaha, NE, USA.,Department of Exercise Science, Public Health Research Center, University of South Carolina, Columbia, SC, USA
| | - Christina Moyer
- Department of Exercise Science, Public Health Research Center, University of South Carolina, Columbia, SC, USA
| | - Erin K Howie
- Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - William H Brown
- Educational Studies, Wardlaw College, University of South Carolina, Columbia, USA
| | - Russell R Pate
- Department of Exercise Science, Public Health Research Center, University of South Carolina, Columbia, SC, USA
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Aadland E, Tjomsland HE, Johannessen K, Nilsen AKO, Resaland GK, Glosvik Ø, Lykkebø O, Stokke R, Andersen LB, Anderssen SA, Pfeiffer KA, Tomporowski PD, Størksen I, Bartholomew JB, Ommundsen Y, Howard SJ, Okely AD, Aadland KN. Active Learning Norwegian Preschool(er)s (ACTNOW) - Design of a Cluster Randomized Controlled Trial of Staff Professional Development to Promote Physical Activity, Motor Skills, and Cognition in Preschoolers. Front Psychol 2020; 11:1382. [PMID: 32719636 PMCID: PMC7350704 DOI: 10.3389/fpsyg.2020.01382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/25/2020] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION There is a dearth of high-quality evidence on effective, sustainable, and scalable interventions to increase physical activity (PA) and concomitant outcomes in preschoolers. Specifically, there is a need to better understand how the preschool context can be used to increase various types of physically active play to promote holistic child development. The implementation of such interventions requires highly competent preschool staffs, however, the competence in promoting PA is often low. The main aim of the ACTNOW study is therefore to investigate the effects of professional development for preschool staffs on child PA and developmental outcomes. METHODS The study will be conducted in Norway 2019-2022 and is designed as a two-arm (intervention, control) cluster randomized controlled trial (RCT) with 7- and 18-months follow-ups. We aim to recruit 60 preschools and 1,200 3- to 5-years-old children to provide sufficient power to detect effect sizes (ESs) between 0.20 and 0.30. The intervention is nested within two levels: the preschool and the child. Central to the ACTNOW intervention are opportunities for children to engage in a variety of "enriched," meaningful, and enjoyable physically active play that supports the development of the whole child. To this end, the main intervention is a 7-month professional development/education module for preschool staff, aimed to provide them with the necessary capacity to deliver four core PA components to the children (moderate-to-vigorous PA, motor-challenging PA, cognitively engaging play, and physically active learning). We will include a range of child-level outcomes, including PA, physical fitness, adiposity, motor skills, socioemotional health, self-regulation, executive function, and learning. At the preschool level, we will describe implementation and adaptation processes using quantitative and qualitative data. DISCUSSION Professional development of staff and a whole-child approach that integrates PA with cognitively engaging play and learning activities in the preschool setting may provide a feasible vehicle to enhance both physical and cognitive development in young children. ACTNOW is designed to test this hypothesis to provide a sustainable way to build human capital and provide an early solution to lifelong public health and developmental challenges. CLINICAL TRIAL REGISTRATION www.ClinicalTrials.gov identifier NCT04048967.
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Affiliation(s)
- Eivind Aadland
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Hege Eikeland Tjomsland
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Kjersti Johannessen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Ada Kristine Ofrim Nilsen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Geir Kåre Resaland
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Øyvind Glosvik
- Department of Pedagogy, Religion and Social Studies, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Osvald Lykkebø
- Department of Strategic Initiatives, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Rasmus Stokke
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Lars Bo Andersen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Sigmund Alfred Anderssen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Karin Allor Pfeiffer
- Department of Kinesiology, Michigan State University, East Lansing, MI, United States
| | | | - Ingunn Størksen
- Norwegian Centre for Learning Environment and Behavioural Research in Education, University of Stavanger, Stavanger, Norway
| | - John B. Bartholomew
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - Yngvar Ommundsen
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - Steven James Howard
- Early Start and School of Education, University of Wollongong, Wollongong, NSW, Australia
| | - Anthony D. Okely
- Early Start and School of Education, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Katrine Nyvoll Aadland
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
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Meyer LE, Hoza B, Martin CP, Shoulberg EK, Tompkins CL, Dennis M, Krasner A. CATs to Kiddie CATS: Transforming an Elementary Physical Activity Curriculum for Preschoolers. AMERICAN JOURNAL OF HEALTH EDUCATION 2020. [DOI: 10.1080/19325037.2020.1765905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Malden S, Reilly JJ, Hughes A, Bardid F, Summerbell C, De Craemer M, Cardon G, Androutsos O, Manios Y, Gibson AM. Assessing the acceptability of an adapted preschool obesity prevention programme: ToyBox-Scotland. Child Care Health Dev 2020; 46:213-222. [PMID: 31856335 DOI: 10.1111/cch.12736] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/14/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Childhood obesity is a global public health issue. Interventions to prevent the onset of obesity in the early years are often implemented in preschool settings. The ToyBox intervention was delivered across Europe and targeted energy balance-related behaviours in preschools and children's homes through teacher-led activities and parental education materials and was adapted for use in Scotland. This study assessed the acceptability of the 18-week adapted intervention to both parents and teachers. METHODS Mixed methods were employed to collect both qualitative and quantitative data. Preschool staff and children's parents/caregivers completed post-intervention feedback surveys, from which acceptability scores were calculated and presented as proportions. Focus groups were conducted with preschool staff, whereas parents/caregivers participated in semi-structured interviews. A thematic analysis was applied to qualitative data following the development of a coding framework. Quantitative and qualitative data were analysed using SPSS and NVivo 10, respectively. RESULTS Preschool staff rated the intervention as highly acceptable based on post-intervention feedback surveys (80%; mean score 8.8/11). Lower acceptability scores were observed for parents/caregivers (49%; 3.9/8). Nine preschool practitioners participated in focus groups (n = 3). User-friendliness of the intervention materials, integration of the intervention with the curriculum, and flexibility of the intervention were identified as facilitators to delivery. Barriers to delivery were time, insufficient space, and conflicting policies within preschools with regard to changing classroom layouts. Parental interviews (n = 4) revealed a lack of time to be a major barrier, which prevented parents from participating in home-based activities. Parents perceived the materials to be simple to understand and visually appealing. CONCLUSIONS This study identified a number of barriers and facilitators to the delivery and evaluation of the ToyBox Scotland preschool obesity prevention programme, which should be considered before any further scale-up of the intervention.
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Affiliation(s)
- Stephen Malden
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.,Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, UK
| | - John J Reilly
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Adrienne Hughes
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Farid Bardid
- School of Education, University of Strathclyde, Glasgow, UK.,Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Marieke De Craemer
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Ann-Marie Gibson
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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Barriers to and Facilitators of the Implementation of Environmental Recommendations to Encourage Physical Activity in Center-Based Childcare Services: A Systematic Review. J Phys Act Health 2019; 16:1175-1186. [PMID: 31624222 DOI: 10.1123/jpah.2019-0050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 07/16/2019] [Accepted: 08/13/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Identifying factors influencing the implementation of evidence-based environmental recommendations to promote physical activity in childcare services is required to develop effective implementation strategies. This systematic review aimed to: (1) identify barriers and facilitators reported by center-based childcare services impacting the implementation of environmental recommendations to increase physical activity among children, (2) synthesize these factors according to the 14 domains of the "Theoretical Domains Framework," and (3) report any associations between service or provider characteristics and the reported implementation of such recommendations. METHODS Electronic searches were conducted in 6 scientific databases (eg, MEDLINE) and Google Scholar to identify studies reporting data from childcare staff or other stakeholders responsible for childcare operations. Included studies were based on childcare settings and published in English. From 2164 identified citations, 19 articles met the inclusion criteria (11 qualitative, 4 quantitative, and 4 mixed methods). RESULTS Across all articles, the majority of factors impacting implementation fell into the "environmental context and resources" domain (eg, time, equipment, and space; n = 19) and the "social influences" domain (eg, support from parents, colleagues, supervisors; n = 11). CONCLUSION The current review provides guidance to improve the implementation of environmental recommendations in childcare services by addressing environmental, resource, and social barriers.
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Hnatiuk JA, Brown HE, Downing KL, Hinkley T, Salmon J, Hesketh KD. Interventions to increase physical activity in children 0-5 years old: a systematic review, meta-analysis and realist synthesis. Obes Rev 2019; 20:75-87. [PMID: 30257277 DOI: 10.1111/obr.12763] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 07/29/2018] [Accepted: 08/08/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective of the study is to evaluate the effectiveness of interventions to increase physical activity (PA) in 0-5 year olds and to determine what works, for whom, in what circumstances. DESIGN Systematic review, meta-analysis and realist synthesis. DATA SOURCES Embase and EBSCOhost (Academic Search Complete, CINAHL Complete, Global Health, MEDLINE Complete, PsycINFO, SPORTDiscus with full text), up to and including April 2017. ELIGIBILITY CRITERIA Published in a peer-reviewed English language journal; randomized or controlled trial design; aimed to increase children's PA levels; reported on objectively assessed PA in children between 0 and 5.9 years at baseline and post-intervention. RESULTS Thirty-four studies were included in the review, mostly conducted in the preschool/childcare setting. Meta-analyses showed an overall non-significant (Z = 0.04, p = 0.97) mean difference of 0.03 (95% CI = -1.57, 1.63) minutes/day for light-intensity PA (n = 11). The overall mean difference for moderate-intensity to vigorous-intensity PA (n = 21) was 2.88 (95% CI = 1.54, 4.23) minutes/day, indicating a small but significant overall positive effect (Z = 4.20, p < 0.001). The realist synthesis provided insights into the key contexts and mechanisms that appeared to be effective at changing children's PA. CONCLUSION Based on a quantitative and qualitative examination of the evidence, this review provides specific recommendations for effective early childhood PA interventions for practitioners and policymakers.
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Affiliation(s)
- J A Hnatiuk
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - H E Brown
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - K L Downing
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - T Hinkley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - J Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - K D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
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(Des) Valorização da atividade física na pré‐escola por professores. REVISTA BRASILEIRA DE CIÊNCIAS DO ESPORTE 2018. [DOI: 10.1016/j.rbce.2018.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Nielsen JV, Klakk H, Bugge A, Andreasen ML, Skovgaard T. Implementation of triple the time spent on physical education in pre-school to 6th grade: A qualitative study from the programme managers' perspective. EVALUATION AND PROGRAM PLANNING 2018; 70:51-60. [PMID: 29940411 DOI: 10.1016/j.evalprogplan.2018.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 06/04/2018] [Accepted: 06/13/2018] [Indexed: 06/08/2023]
Abstract
Schools constitute an important arena for promoting physical activity. However, school-based programmes often face implementation challenges, and the identification of factors influencing the implementation process is considered important in order to secure the effectiveness of future interventions. The aim of this study was to identify factors influencing the various implementation stages during the initial years of a programme tripling the amount of physical education at the primary school level. Document analysis of publicly available programme descriptions and meeting minutes, were conducted. Document analysis was complemented by two semi-structured group interviews with main programme managers to gather in-depth programme experiences and perspectives. Results show that early involvement of schools may ensure the best possible match between programmes and the needs and resources of schools, and that an ongoing shared partnership may help programme managers address program challenges in early stages. It seems that predetermined core elements in programmes are essential. At the same time programmes must be flexible enough for adaptation to individual school contexts. Finally, the implementation of triple the amount of physical education, is supported by teachers receiving a professional development course focusing on how to organise outdoor physical education in different seasons and weather conditions.
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Affiliation(s)
- Jonas Vestergaard Nielsen
- Research and Innovation Centre for Human Movement and Learning, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark.
| | - Heidi Klakk
- Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; University College Lillebaelt, Denmark
| | - Anna Bugge
- Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; Department of Physiotherapy and Occupational Therapy, University College Copenhagen, Copenhagen, Denmark
| | | | - Thomas Skovgaard
- Research and Innovation Centre for Human Movement and Learning, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; Active Living, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark
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Nielsen JV, Skovgaard T, Bredahl TVG, Bugge A, Wedderkopp N, Klakk H. Using the RE-AIM framework to evaluate a school-based municipal programme tripling time spent on PE. EVALUATION AND PROGRAM PLANNING 2018; 70:1-11. [PMID: 29890448 DOI: 10.1016/j.evalprogplan.2018.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/26/2018] [Accepted: 05/30/2018] [Indexed: 06/08/2023]
Abstract
Documenting the implementation of effective real-world programmes is considered an important step to support the translation of evidence into practice. Thus, the aim of this study was to identify factors influencing the adoption, implementation and maintenance of the Svendborgproject (SP) - an effective real-world programme comprising schools to implement triple the amount of physical education (PE) in pre-school to sixth grade in six primary schools in the municipality of Svendborg, Denmark. SP has been maintained for ten years and scaled up to all municipal schools since it was initiated in 2008. The Reach, Effectiveness, Adoption, Implementation and Maintenance framework (RE-AIM) was applied as an analytic tool through a convergent mixed method triangulation design. Results show that SP has been implemented with high fidelity and become an established part of the municipality and school identity. The successful implementation and dissemination of the programme has been enabled through the introduction of a predominantly bottom-up approach combined with simple non-negotiable requirements. The results show that this combination has led to a better fit of programmes to the individual school context while still obtaining high implementation fidelity. Finally, the early integration of research has legitimated and benefitted the programme.
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Affiliation(s)
- Jonas Vestergaard Nielsen
- Research and Innovation Centre for Human Movement and Learning, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark.
| | - Thomas Skovgaard
- Research and Innovation Centre for Human Movement and Learning, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | | | - Anna Bugge
- Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Niels Wedderkopp
- Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; The Orthopaedic department, Hospital of South-Western Denmark, Denmark; Institute of Regional Health Research, University of Southern Denmark, Denmark
| | - Heidi Klakk
- Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; University College Lillebaelt, Denmark
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Byun W, Lau EY, Brusseau TA. Feasibility and Effectiveness of a Wearable Technology-Based Physical Activity Intervention in Preschoolers: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091821. [PMID: 30142911 PMCID: PMC6163401 DOI: 10.3390/ijerph15091821] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/09/2018] [Accepted: 08/16/2018] [Indexed: 02/07/2023]
Abstract
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 randomly 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 settings. 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.
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Affiliation(s)
- Wonwoo Byun
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
| | - Erica Y Lau
- School of Kinesiology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Timothy A Brusseau
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
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Peden ME, Okely AD, Eady MJ, Jones RA. What is the impact of professional learning on physical activity interventions among preschool children? A systematic review. Clin Obes 2018; 8:285-299. [PMID: 29852538 DOI: 10.1111/cob.12253] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 02/25/2018] [Accepted: 03/30/2018] [Indexed: 11/30/2022]
Abstract
The purpose of this systematic review was to investigate professional learning models (length, mode, content) offered as part of objectively measured physical childcare-based interventions. A systematic review of eight electronic databases was conducted to June 2017. Only English, peer-reviewed studies that evaluated childcare-based physical activity interventions, incorporated professional learning and reported objectively measured physical activity were included. Study designs included randomized controlled trails, cluster randomized trials, experimental or pilot studies. The search identified 11 studies. Ten studies objectively measured physical activity using accelerometers; five studies used both accelerometer and direct observation tools and one study measured physical activity using direct observation only. Seven of these studies reported statistically significant intervention effects. Only six studies described all components of professional learning, but only two studies reported specific professional learning outcomes and physical activity outcomes. No patterns were identified between the length, mode and content of professional learning and children's physical activity outcomes in childcare settings. Educators play a critical role in modifying children's levels of physical activity in childcare settings. The findings of this review suggest that professional learning offered as part of a physical activity intervention that potentially impacts on children's physical activity outcomes remains under-reported.
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Affiliation(s)
- M E Peden
- Early Start, School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - A D Okely
- Early Start, School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - M J Eady
- School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - R A Jones
- Early Start, School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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Kennedy AB, Schenkelberg M, Moyer C, Pate R, Saunders RP. Process evaluation of a preschool physical activity intervention using web-based delivery. EVALUATION AND PROGRAM PLANNING 2017; 60:24-36. [PMID: 27669393 DOI: 10.1016/j.evalprogplan.2016.08.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/31/2016] [Accepted: 08/31/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND PURPOSE Preschool/childcare settings offer a practical target for physical activity interventions. Online learning programs have the potential for greater public health reach and impact. The SHAPES-Dissemination (SHAPES-D) project adapted the original SHAPES in-person intervention for online delivery to teachers. The purpose of this paper is to describe the implementation monitoring and process evaluation for the SHAPES-D project. METHODS Nine preschools with 26 classrooms participated. A total of 41 teachers were trained via online learning to implement the SHAPES-D program in their classrooms. The dose received, completeness, and fidelity of implementation were assessed through website metrics, teacher surveys and interviews, and classroom observations. RESULTS Dose received was adequate (73%). Observed completeness and physical activity enjoyment fidelity were high (100%), although moderate-to-vigorous physical activity fidelity and social environment fidelity were low (25% each). Overall implementation was high (91%). DISCUSSION Results indicate that the online method of delivery is viable for dissemination. The online delivery system provides an easy method of monitoring dose received. This may be the first structural intervention to monitor dose received through web metrics. CONCLUSION The adaptation of an in-person intervention to an online delivery system increases the potential for dissemination of a successful program to increase physical activity in preschool settings.
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Affiliation(s)
- Ann Blair Kennedy
- University of South Carolina School of Medicine Greenville, United States
| | | | - Christina Moyer
- University of South Carolina, Department of Exercise Science, United States
| | - Russ Pate
- University of South Carolina, Department of Exercise Science, United States
| | - Ruth P Saunders
- University of South Carolina, Department of Health Promotion, Education, and Behavior, United States.
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Saunders RP, Pfeiffer K, Brown WH, Howie EK, Dowda M, O'Neill JR, McIver K, Pate RR. Evaluating and Refining the Conceptual Model Used in the Study of Health and Activity in Preschool Environments (SHAPES) Intervention. HEALTH EDUCATION & BEHAVIOR 2017; 44:876-884. [PMID: 28052694 DOI: 10.1177/1090198116686334] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated the utility of the Study of Health and Activity in Preschool Environments (SHAPES) conceptual model, which targeted physical activity (PA) behavior in preschool children, by examining the relationship between implementation monitoring data and child PA during the school day. We monitored implementation completeness and fidelity based on multiple elements identified in the conceptual model. Comparing high-implementing, low-implementing, and control groups revealed no association between implementation and outcomes. We performed post hoc analyses, using process data, to refine our conceptual model's depiction of an effective preschool PA-promoting environment. Results suggest that a single component of the original four-component conceptual model, providing opportunities for moderate-to-vigorous physical activity through recess for 4-year-old children in preschool settings, may be a good starting place for increasing moderate-to-vigorous physical activity. Interventions that are implemented with optimal levels of completeness and fidelity are more likely to achieve behavior change if they are based on accurate conceptual models. Examining the mechanisms through which an intervention produces its effects, as articulated in the conceptual model that guides it, is particularly important for environmentally focused interventions because they are guided by emerging frameworks. The results of this study underscore the utility of using implementation monitoring data to examine the conceptual model on which the intervention is based.
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Affiliation(s)
| | | | | | - Erin K Howie
- 3 Curtin University, Perth, Western Australia, Australia
| | - Marsha Dowda
- 1 University of South Carolina, Columbia, SC, USA
| | | | - Kerry McIver
- 1 University of South Carolina, Columbia, SC, USA
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Howie EK, Brewer AE, Brown WH, Saunders RP, Pate RR. Systematic dissemination of a preschool physical activity intervention to the control preschools. EVALUATION AND PROGRAM PLANNING 2016; 57:1-7. [PMID: 27107302 PMCID: PMC4893903 DOI: 10.1016/j.evalprogplan.2016.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 03/15/2016] [Accepted: 03/23/2016] [Indexed: 06/05/2023]
Abstract
For public health interventions to have a meaningful impact on public health, they must be disseminated to the wider population. Systematic planning and evaluation of dissemination efforts can aid translation from experimental trials to larger dissemination programs. The Study of Health and Activity in Preschool Environments (SHAPES) was a group-randomized intervention trial conducted in 16 preschools that successfully increased the physical activity of preschool age children. Following the completion of the research study protocol, the intervention was abbreviated, modified and implemented in four preschools that participated as control preschools in the original research study. The purposes of the current study were to describe the process of refining the intervention for dissemination to the control preschools, and to assess the acceptability of the resulting abbreviated intervention delivery. Five overarching behavioral objectives, informed by process evaluation, data from the original trial and collaboration with intervention teachers, were used to guide the implementation. Teachers in the dissemination classrooms reported high levels of acceptability, potential for sustainability of the program, and positive results in knowledge, skills, and child outcomes. Researchers can include a systematic approach to dissemination of effective intervention elements to the control participants in experimental studies to inform future dissemination efforts and begin to bridge the dissemination gap.
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Affiliation(s)
- Erin K Howie
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly St, Suite 212, Columbia, SC 29208, United States.
| | - Alisa E Brewer
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly St, Suite 212, Columbia, SC 29208, United States.
| | - William H Brown
- Department of Educational Studies, College of Education, University of South Carolina, Wardlaw College, Columbia, SC 29208, United States.
| | - Ruth P Saunders
- Department of Health Promotion, Education and Behavior, University of South Carolina, 800 Sumter St, Columbia, SC 29208, United States.
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly St, Suite 212, Columbia, SC 29208, United States.
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An Intervention to Increase Physical Activity in Children: A Randomized Controlled Trial With 4-Year-Olds in Preschools. Am J Prev Med 2016; 51:12-22. [PMID: 26803357 PMCID: PMC4914452 DOI: 10.1016/j.amepre.2015.12.003] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 11/24/2015] [Accepted: 12/07/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION A majority of preschool-aged children spend a significant portion of every weekday in a preschool or child care setting, where they typically participate in limited physical activity. This study determined if an ecologic physical activity intervention in preschools increases children's moderate- to vigorous-intensity physical activity (MVPA). DESIGN RCT, with preschool as the unit of randomization and analysis. Child physical activity was measured by accelerometry. Mixed model analysis of covariance with preschool as a random variable was used to test the effects of the intervention on physical activity in the total group and in sex-specific subgroups. Data were collected in 2008-2010 and analyzed in 2012-2014. SETTING/PARTICIPANTS Children in 4-year-olds' classrooms in 16 preschools, pair matched and assigned to intervention or control groups. INTERVENTION The intervention focused on increasing children's physical activity by changing instructional practices. Researchers trained preschool teachers to engage children in physical activity during (1) structured, teacher-led physical activity opportunities in the classroom; (2) structured and unstructured physical activity opportunities at recess; and (3) physical activity integrated into pre-academic lessons. Research staff encouraged teachers to adapt the intervention to their classrooms. MAIN OUTCOME MEASURES Minutes/hour of MVPA during the preschool day. RESULTS In an analytic sample of 379 children (188 intervention, 191 control), those in the intervention schools engaged in significantly more MVPA than children in control schools (7.4 and 6.6 minutes/hour, respectively). This difference remained significant after adjusting for parent education and length of the school day (half versus full day). In the sex-specific analyses, the difference was significant for girls (6.8 vs 6.1 minutes/hour of MVPA, respectively) but not for boys (7.9 vs 7.2 minutes/hour, respectively). CONCLUSIONS A flexible ecologic physical activity intervention that trains teachers to provide children with opportunities to be active throughout the school day increased MVPA in preschool children.
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Vinci DM, Whitt-Glover MC, Wirth CK, Kraus C, Venezia AP. Let's Wiggle with 5-2-1-0: Curriculum Development for Training Childcare Providers to Promote Activity in Childcare Settings. J Obes 2016; 2016:8967092. [PMID: 27462468 PMCID: PMC4947646 DOI: 10.1155/2016/8967092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/03/2016] [Accepted: 05/09/2016] [Indexed: 11/21/2022] Open
Abstract
Overweight and obesity are increasing in preschool children in the US. Policy, systems, and environmental change interventions in childcare settings can improve obesity-related behaviors. The aim of this study was to develop and pilot an intervention to train childcare providers to promote physical activity (PA) in childcare classrooms. An evidence scan, key informant (n = 34) and focus group (n = 20) interviews with childcare directors and staff, and environmental self-assessment of childcare facilities (n = 22) informed the design of the training curriculum. Feedback from the interviews indicated that childcare providers believed in the importance of teaching children about PA and were supportive of training teachers to incorporate PA into classroom settings. The Promoting Physical Activity in Childcare Setting Curriculum was developed and training was implemented with 16 teachers. Participants reported a positive experience with the hands-on training and reported acquiring new knowledge that they intended to implement in their childcare settings. Our findings highlight the feasibility of working with childcare staff to develop PA training and curriculum. Next steps include evaluating the curriculum in additional childcare settings and childcare staff implementation of the curriculum to understand the effectiveness of the training on PA levels of children.
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Affiliation(s)
- Debra M. Vinci
- Health Promotion, Department of Exercise Science and Community Health, University of West Florida, 11000 University Parkway, Pensacola, FL 32514, USA
- *Debra M. Vinci:
| | | | - Christopher K. Wirth
- Physical Education, Department of Exercise Science and Community Health, University of West Florida, 11000 University Parkway, Pensacola, FL 32514, USA
| | - Caroline Kraus
- Gramercy Research Group, 7990 N. Point Boulevard, Suite 108, Winston-Salem, NC 27106, USA
| | - Alexandra P. Venezia
- Department of Exercise Science and Community Health, University of West Florida, 11000 University Parkway, Pensacola, FL 32514, USA
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Howie EK, Brewer AE, Dowda M, McIver KL, Saunders RP, Pate RR. A Tale of 2 Teachers: A Preschool Physical Activity Intervention Case Study. THE JOURNAL OF SCHOOL HEALTH 2016; 86:23-30. [PMID: 26645417 PMCID: PMC5069971 DOI: 10.1111/josh.12352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 04/15/2015] [Accepted: 05/08/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Preschool settings vary greatly, and research has shown that interventions are more successful when they can be adapted to individual settings. This is a descriptive case study of how 2 teachers successfully adapted and implemented a preschool physical activity intervention. METHODS The Study of Health and Activity in Preschool Environments (SHAPES) was a 3-year physical activity intervention. A detailed case study of 2 high-implementing teachers was conducted. Multiple data sources included accelerometry, direct observation, teacher surveys, and intervention staff field notes. RESULTS Teacher A focused on integrating physical activity into a wide range of activities, including parent and community events. Teacher B focused on high-intensity, structured activities. Both teachers supported the intervention, worked closely with intervention staff, and operated their classroom as an autonomous unit with support from their directors. Teacher A provided an average of 31.5, 78.0, and 67.5 min of physical activity opportunity per day of observation during years 1, 2, and 3. Teacher B provided an average of 2.7, 33.5, and 73.3 minutes of physical activity opportunity per day of observation. CONCLUSION Successful implementation of physical activity interventions may look different in different contexts; thus, interventions should allow for flexible implementation.
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Affiliation(s)
- Erin K Howie
- Department of Physiotherapy and Exercise Science, Curtin University, GPU Box U1987, Perth 6845, Western Australia.
| | - Alisa E Brewer
- Community Engagement & Outreach, Virginia Commonwealth University, Center on Health Disparities, PO Box 980501, Richmond, VA 232928.
| | - Marsha Dowda
- Department of Exercise Science, University of South Carolina, 921 Assembly St, Columbia, SC 29208.
| | - Kerry L McIver
- Department of Exercise Science, University of South Carolina, 921 Assembly St, Columbia, SC 29208.
| | - Ruth P Saunders
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Green Street, Room 529, Columbia, SC 29208.
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Suite 212, 921 Assembly St, Columbia, SC 29208.
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Norris E, Shelton N, Dunsmuir S, Duke-Williams O, Stamatakis E. Teacher and pupil perspectives on the use of Virtual Field Trips as physically active lessons. BMC Res Notes 2015; 8:719. [PMID: 26606892 PMCID: PMC4660659 DOI: 10.1186/s13104-015-1698-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 11/14/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Virtual Field Trips (VFTs) are emerging physically active lessons that combine curriculum content with globe-based movement using interactive whiteboards. No research has yet examined the acceptability of these sessions by target users. This study aimed to (1) assess current physically active lesson teaching practices, (2) assess teacher attitudes towards VFTs and (3) investigate pupil perceptions of VFTs. METHODS Data was collected from teaching staff interviews (n = 12) and three elementary school pupil focus groups (k = 3, n = 18), with all participants provided with a sample VFT session. Thematic analysis was used to analyse data. RESULTS Teachers described VFTs as a flexible teaching tool, allowing inclusive learning across abilities and a range of taught subjects. They stressed a packed curriculum may make delivering VFT sessions problematic and warned that some teachers may be resistant to their use of technology. Pupils enjoyed the ability to move in the classroom and the ability to share a new teaching experience with their peers. CONCLUSIONS This work suggests positive attitudes towards VFTs as novel, physically active lessons and identifies potential teacher concerns for consideration in forthcoming intervention planning. Future experimental work will assess if these attitudes persist during longitudinal exposure to VFTs.
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Affiliation(s)
- E Norris
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - N Shelton
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - S Dunsmuir
- Department of Clinical, Educational and Health Psychology, University College London, 26 Bedford Way, London, WC1H 0AP, UK.
| | - O Duke-Williams
- Department of Information Studies, University College London, Foster Court, London, WC1E 6BT, UK.
| | - E Stamatakis
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. .,Charles Perkins Centre, University of Sydney, Sydney, Australia. .,Exercise and Sport Sciences, Faculty of Health Sciences, University of Sydney, Sydney, Australia.
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