Correlates of Physical Activity in Latino Preschool Children Attending Head Start

Exploring if Playground Quality Predicts Head Start Preschoolers' School Day Physical Activity

Physical activity (PA) engagement in Early Childcare and Education Centers (ECEC) supports preschoolers' ability to meet the national physical activity guidelines. However, the influence of Head Start playground quality, as assessed by the Head Start Body Start Play Space Assessment (PSA), on Head Start preschoolers' school day PA is under-researched. This study examined (1) the relationship between PSA quality scores and Head Start preschoolers' school day PA engagement and (2) the association between PSA quality scores and the likelihood of preschoolers' meeting the national PA guidelines during Head Start hours. Head Start preschoolers (N = 240, Mage = 3.9 years, 47% boys) from three centers participated in the study. Playground quality was assessed using the PSA, and preschoolers' PA during Head Start was measured using wrist-worn GTX3 Actigraph accelerometers. Approximately, 77% of preschoolers in this sample achieved the recommended amount of PA per hour (15 min), over 90% accumulated 60 min of MVPA, and half surpassed 180 min of total PA during Head Start hours, and preschoolers' PA engagement differed based on child sex and Head Start center attended. PSA playground quality scores were not significantly related to the amount or intensity of preschoolers' PA engagement or the likelihood of meeting the national PA guidelines during Head Start. However, our findings revealed unique PA patterns among Head Start boys' and girls' PA that should be probed in the future studies using the PSA.

Parental Acculturation and Its Effect on Preschool-Aged Children's Health Behaviors Among Latinos in Nevada: A Cross-Sectional Study

BACKGROUND

Latino children in the United States (US) have a higher prevalence of overweight/obesity compared to white children. Previous studies suggest that acculturation to the US is associated with health behaviors such as diet, body mass index (BMI), and physical activity. However, the role of parental acculturation remains understudied, particularly with the use of validated measures.

OBJECTIVE

The objective of this study was to evaluate parental acculturation and its association with parental interpersonal factors and health behaviors in the preschool-aged child.

METHODS

Data were analyzed from 187 Latino parents in Nevada. Parents completed a self-reported, cross-sectional survey. Acculturation was assessed using Norris' 4-item validated acculturation measure. The average age of the preschool-aged children was 45.5 months, and their mean BMI percentile was 96.4% (SD ± 18.7). The mean parental acculturation score was 2.1 (SD ± 1.2). Children were physically active an average of 4.9 (SD ± 2.0) days per week. After controlling for covariates, the results indicated that parental acculturation was positively associated with physical activity and sugar-sweetened beverage consumption. However, parental acculturation was not associated with child BMI percentile, or the consumption of fruits, vegetables, and sweet snacks.

CONCLUSIONS

These findings can inform future research on culturally tailored intervention strategies to boost physical activity and reduce sugar-sweetened beverage intake among Latino preschool-aged children.

Relation between Demographics and Physical Activity among Preschoolers Attending Head Start

Limited empirical evidence is available about preschoolers' sedentary behavior (SB) and physical activity (PA) patterns in Head Start programs, we explored (a) preschoolers' SB and PA patterns (ranging from SB to light-moderate-vigorous physical activity [LMVPA]) and (b) their relationships with sociodemographic factors, weight status, and motor development. Participants included 216 preschoolers (M age = 4.32 ± 0.63; girls 56.5%) from six Head Start centers in an urban area in the southwestern region of the United States, assessing Actical® activity monitor-based PA, weight status, and motor development. The findings revealed preschoolers who were female, Hispanic/Latinx, with an at risk weight level, and/or in the below average motor development group tended to engage in less MVPA/LMVPA and also had higher SB patterns while participating in the Head Start program (p < 0.05-0.001, d ranged from 0.23 to 0.62). Head Start stakeholders (e.g., policymakers, leaders, curriculum coordinators, health professionals, and teachers) need to acknowledge the PA and health disparities, and intervene in underserved preschoolers' health-promoting behaviors.

Compliance with Health-Related Behaviors Guidelines and Its Relationship with Multiple Factors in Preschool Children Aged 3–6 Years: A National Cross-Sectional Survey in China

Purpose: To investigate the compliance rates of health-related behaviors among Chinese preschool children, and to explore how supportive family environment, parental behavior, sociodemographic and community factors affect children’s health-related behavior comprehensively. Method: Preschool children aged 3 to 6 years were chosen from 5760 villages (residential) committees from 471 counties (districts) of 31 provinces by use of a stratified random sampling procedure, with 10,967 preschool children aged 3–6 years old included. The survey was conducted from September 2020 to November 2020. Results: The proportion of Chinese preschool children who met the moderate to vigorous physical activity (MVPA), screen time behavior (ST), and sleep behavior (SLP) guidelines were 62.3%, 52.8%, and 53.8%. Among the supportive family environment factors, parents’ time with their children on weekends had the most significant impact on children’s MVPA, ST, and SLP, with the odds ratio (OR) values of 2.18 (95%CI:1.97, 2.40), 0.69 (0.63, 0.76), and 1.62 (1.48, 1.79), respectively. Among the parental behavior factors, the mother’s exercise frequency had a strong association with the children’s MVPA and SLP, with OR values of 1.65 (1.50, 1.83) and 1.24 (1.13, 1.37), respectively; the mother’s screen time was inversely associated with the children’s ST with an OR value of 0.47 (0.44, 0.51). Conclusions: Different types of family environments were associated with the different levels of MVPA, ST and SLP among Chinese preschool children. In addition to the influence of parents’ education and family income, parents could also improve their children’s behaviors by providing a supportive family environment. The more of these factors presented in a family, the more likely it was for children to meet the guidelines. Therefore, for those families whose children’s health-related behaviors needed to be improved, the parents should create supportive family environments, such as by playing less on mobile phone and spending more time with children.

Measurement of screen time among young children aged 0-6 years: A systematic review

The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.

Levels, factors and interventions of preschool children physical activity: a systematic review

The goal of this study was to complete a systematic review of research on the occurrence the levels of physical activity (PA), forms of intervention and factors associated with this practice among preschool children. Studies published in the period between 2006 and 2016 were investigated, using the PubMed and SPORTDiscus databases. The search terms identified 177 articles, of which 41 met the inclusion criteria. Goals, methodologies and results were analysed. The studies used various cut-off points to establish the desired level of PA, along with different types of interventions. Overall, the problem of low level of PA among preschool children appears to be increasing. Involvement and participation of parents and teachers, guidance from booklets and other information sources, parent instruction and availability of extracurricular activities were considered positive factors that tended to increase children's PA levels, whereas parental obesity was a negative factor. New studies to define sedentary behaviour in preschool children are required to clarify the nature of this problem, along with the establishment of prevention programmes with ecological design aimed at schools, families and other sectors of society.

Physical activity and sedentary time of youth in structured settings: a systematic review and meta-analysis

BACKGROUND

Structured settings, such as school, childcare, afterschool programs, summer camps, and physical activity/sport programs are crucial to promoting physical activity (PA) opportunities and reducing sedentary (ST) for children and adolescents. However, little is known about how much PA and ST children and adolescents accumulate in structured settings. The aim of this study is to conduct a systematic review and meta-analysis of the absolute amount of time youth spend physically active and sedentary in different structured settings (Prospero number: 42018111804).

METHODS

Observational and experimental/quasi-experimental studies (baseline data only) with full-text available, written in English and published in a peer-reviewed journal, reporting the total amount of objectively measured PA (light, moderate, vigorous, and/or total physical activity) and/or time spent ST during structured settings among youth (3 to 18 years) were eligible. Adjusted meta-analysis was conducted to estimate the pooled mean of time spent in PA and ST, by settings and sex.

RESULTS

A total of 187 studies (childcare n=60; school n=91; afterschool programs n=14; summer camp n=4; and Physical activity/ sport programs n=18) from 30 countries (47.9% United States), representing 74,870 youth (mean age 8.6 years old) were included. Overall, there was a high variation between studies in outcomes and settings. The meta-analyses revealed, on average, youth spend 221.8 minutes (36.7 min/hour) in ST and 32.1 minutes (5.1 min/hour) in MVPA during childcare hours, and 223.9 minutes (36.7min/hour) in ST and 27.8 min (4.4 min/hour) in MVPA at school. Relatively, youth are engaged in more MVPA in afterschool programs (11.7 min/hour), PA/ sport programs (20.9 min/hour), and summer camps (6.4 min/hour), when compared to childcare and school.

CONCLUSION

Total PA accumulated during childcare and MVPA accumulated during schools hours were close to recommendations, despite high proportion of ST. Afterschool programs, summer camp and PA/ sport programs are important settings that can contribute to daily PA and reduced ST. Ensuring all youth have access to these structured settings may be an important step forward for public health.

Clusters of diet, physical activity, television exposure and sleep habits and their association with adiposity in preschool children: the EDEN mother-child cohort

Background

Despite the growing interest in the relation between adiposity in children and different lifestyle clusters, few studies used a longitudinal design to examine a large range of behaviors in various contexts, in particular eating- and sleep-related routines, and few studies have examined these factors in young children. The objectives of this study were to identify clusters of boys and girls based on diet, sleep and activity-related behaviors and their family environment at 2 and 5 years of age, and to assess whether the clusters identified varied across maternal education levels and were associated with body fat at age 5.

Methods

At 2 and 5 years, respectively, 1436 and 1195 parents from the EDEN mother-child cohort completed a questionnaire including behavioral data. A latent class analysis aimed to uncover gender-specific behavioral clusters. Body fat percentage was estimated by anthropometric and bioelectrical impedance measurements. Association between cluster membership and body fat was assessed with mutivariable linear regression models.

Results

At 2 years, two clusters emerged that were essentially characterized by opposite eating habits. At 5 years, TV exposure was the most distinguishing feature, but the numbers and types of clusters differed by gender. An association between cluster membership and body fat was found only in girls at 5 years of age, with girls in the cluster defined by very high TV exposure and unfavorable mealtime habits (despite high outdoor playing and walking time) having the highest body fat. Girls whose mother had low educational attainment were more likely to be in this high-risk cluster. Girls who were on a cluster evolution path corresponding to the highest TV viewing time and the least favorable mealtime habits from 2 to 5 years of age had higher body fat at 5 years.

Conclusions

Efforts to decrease TV time and improve mealtime routines may hold promise for preventing overweight in young children, especially girls growing up in disadvantaged families. These preventive efforts should start as early in life as possible, ideally before the age of two, and should be sustained over the preschool years.

Unravelling the association between accelerometer-derived physical activity and adiposity among preschool children: A systematic review and meta-analyses

Evidence on the association between physical activity (PA) and adiposity in young children is inconclusive. A systematic review and meta-analyses were conducted to examine associations between accelerometer-derived PA and varying adiposity outcomes in preschool children. Searches were conducted in Embase, MEDLINE and Web of Science to identify studies on the association between total PA, sedentary behaviour or different PA intensities and adiposity in children aged 2 to 7 years. Separate random effects meta-analyses were performed for varying PA intensities and adiposity outcomes. Fifty-six articles were included in the review and 48 in the meta-analyses. There was substantial evidence of an inverse association between moderate-to-vigorous- or vigorous PA and body fat percentage (stdβ [SE] = -0.162[0.041]; 5 studies), weight status (r = -0.120, P<.001; 11 studies), fat mass (stdβ [SE] = -0.103[0.051]; 5 studies), fat mass index (stdβ [SE] = -0.121[0.036]; 2 studies) and skinfold thickness (stdβ [SE] = -0.145[0.036]; 4 studies). However, total PA, sedentary behaviour, and different PA intensities were not associated with body mass index (BMI) or waist circumference. Adiposity levels were lower among preschool children engaged in more (moderate-to-) vigorous PA compared with their peers, but no associations between PA and BMI or waist circumference were found.

Objectively measured physical activity in one-year-old children from a Brazilian cohort: levels, patterns and determinants

Background

The aim of this study is to describe objectively measured physical activity (PA) and its correlates in one-year-old children.

Methods

The current study includes participants from the 2015 Pelotas (Brazil) birth cohort. At age one, PA was assessed in a 24-h protocol during 4 days with a wrist-attached accelerometer (ActiGraph, wGT3X-BT), from which two complete days of data were analyzed, with 5-s epochs.

Results

A total of 2974 individuals provided valid accelerometry data. Infants able to walk independently spent on average 19 h per day below 50 mg of acceleration (including sleep time), and those who could not walk spent on average 21 h in this intensity category. Girls spent approximately 10 min more than boys below 50 mg daily in both walking status categories, and less activity than boys on higher intensity categories. Boys and infants whose mothers were more physically active during pregnancy presented more acceleration, regardless of walking status. Among infants who could walk by themselves, those with mothers with one to eight schooling years; adequate length-for-age (z-score); not attending daycare; and more physically active fathers also showed higher levels of acceleration.

Conclusions

Our findings demonstrate higher levels of PA among boys and those children with higher maternal PA during pregnancy, regardless of walking status. Also, among infants able to independently walk, 1–8 years of maternal schooling, adequate length-for-age (z-score), no daycare attendance and higher paternal PA are positive correlates of objectively measured PA early in life.

Physical activity and sedentary time among preschoolers in centre-based childcare: a systematic review

Background

Many preschoolers spend a substantial portion of their day enrolled in centre-based childcare; the amounts of physical activity and sedentary time accumulated in this environment are critical to preschoolers’ ability to meet movement guidelines. The purpose of this systematic review was to provide a comprehensive overview of the objectively assessed physical activity and sedentary time of preschoolers in centre-based childcare (registration no. CRD42016033502).

Methods

Eight online databases were searched using terms related to physical activity, sedentary time, preschoolers and centre-based childcare. Published, peer-reviewed primary studies written in English that objectively assessed (via accelerometry) the physical activity and sedentary time of preschoolers (2-5 years) in centre-based childcare were included.

Results

Fifty-five studies (published 2004-2017) from 11 countries, representing 13,956 participants were included. Studies reported light physical activity (n=38) ranging from 2.94 to 29.96 mins/hr, moderate-to-vigorous physical activity (n=46) which ranged from 1.29 to 22.66 mins/hr, and total physical activity (n=42) ranging from 4.23 to 47.17 mins/hr. Sedentary time (n=47) ranged from 12.38 to 55.77 mins/hr.

Conclusion

Physical activity and sedentary time were highly varied and inconsistent between studies; therefore, it is difficult to determine preschoolers’ true amount of physical activity and sedentary time during childcare hours. Despite this variability, preschoolers were noted to participate in high rates of sedentary time in this setting. The lack of homogeneity is an important finding in and of itself as it highlights the lack of consistency in measuring, processing, and reporting paediatric physical activity data.

A review of early influences on physical activity and sedentary behaviors of preschool-age children in high-income countries

PURPOSE

Promoting physical activity (PA) is a key component of preventing and controlling childhood obesity. Despite well-documented benefits of PA, globally, rates of PA among young children have declined over the past decades, and most children are not accruing sufficient PA daily. Helping children develop the foundation for PA habits early in life is critical for the promotion of health in childhood and prevention of chronic diseases later in life, and will ultimately promote longer and healthier lives for individuals and the general population. The purpose of this review is to provide a synthesis of current evidence on influences on PA and sedentary behaviors of preschool-age children in high-income countries.

DESIGN AND METHODS

A systematic review of three databases was performed. Studies conducted in high-income countries and published from 2000 onward that addressed influences on PA and sedentary behaviors of preschool-age children were identified and reviewed. Additionally, reference lists of identified articles and relevant published reviews were reviewed. Studies that met the following inclusion criteria were considered: (a) sample included preschoolers (age ≤5 years); (b) PA and/or sedentary behaviors or factors associated with PA and/or sedentary behaviors was assessed; (c) published in English; (d) used either quantitative or qualitative methods; and (e) conducted in a high-income country. Data were extracted from selected studies to identify influences on PA and sedentary behaviors of preschool-age children and organized using the social-ecological model according to multiple levels of influence.

RESULTS

Results from included studies identify multiple factors that influence PA and sedentary behaviors of young children in high-income countries at the various levels of the social-ecological model including intrapersonal, interpersonal, environmental, organizational, and policy.

PRACTICE IMPLICATIONS

Given pediatric nurses' role as primary care providers, and their frequent and continued contact with parents and their children throughout childhood through well-child visits, immunization, and minor acute illnesses, they are well positioned to promote and support the development of early healthful PA habits of children starting in early childhood.

Parent's Physical Activity Associated With Preschooler Activity in Underserved Populations

INTRODUCTION

In the U.S., children from low-income families are more likely to be obese. The impact of parent modeling of physical activity (PA) and sedentary behaviors in low-income American ethnic minorities is unclear, and studies examining objective measures of preschooler and parent PA are sparse.

METHODS

This cross-sectional study examined 1,003 parent-child pairs who were of low income, largely Latino and African American, and living in one of two geographically disparate metropolitan areas in the U.S. Parents and children wore GT3X/GT3X+ accelerometers for an average of >12 hours/day (7:00am-9:00pm) for 1 week (September 2012 to May 2014). Analysis occurred in 2015-2016.

RESULTS

About 75% of children were Latino and >10% were African American. Mean child age was 3.9 years. The majority of children (60%) were normal weight (BMI ≥50th and <85th percentiles), and more than a third were overweight/obese. Children's total PA was 6.03 hours/day, with 1.5 hours spent in moderate to vigorous PA (MVPA). Covariate-adjusted models showed a monotonic, positive association between parent and child minutes of sedentary behavior (β=0.10, 95% CI=0.06, 0.15) and light PA (β=0.06; 95% CI=0.03, 0.09). Child and parent MVPA were positively associated up to 40 minutes/day of parent MVPA, but an inverse association was observed when parental MVPA was beyond 40 minutes/day (p=0.002).

CONCLUSIONS

Increasing parental PA and reducing sedentary behavior correlate with increased PA-related behaviors in children. However, more work is needed to understand the impact of high levels of parental MVPA on the MVPA levels of their children.

Hispanic Mothers' Views of the Fathers' Role in Promoting Healthy Behaviors at Home: Focus Group Findings

BACKGROUND

Overweight and obesity prevention interventions rarely take into account the unique role of fathers in promoting healthy home environments.

OBJECTIVE

To use qualitative methodology to examine the views of Hispanic mothers of children aged 2 to 5 years regarding fathers' roles in promoting healthy behaviors at home.

DESIGN

Nine focus groups were conducted in Spanish with Hispanic mothers of preschool-aged children (N=55) from October to December 2015.

PARTICIPANTS/SETTINGS

Hispanic mothers were recruited from churches, community agencies, and preschools located in five Zip codes in the southwest part of Oklahoma City, OK.

ANALYSIS

Questions examined the views of Hispanic mothers regarding fathers' roles in promoting healthy behaviors at home. Focus groups were audiorecorded, transcribed in Spanish, translated into English, and coded and analyzed for themes by two coders using NVivo version 10 software.

RESULTS

Four themes were identified: fathers' disagreement with mothers about food preferences and preparation, fathers' support for child's healthy eating, fathers' support for child's physical activity, and fathers' lack of support for a healthy home food environment. Fathers' traditional expectations about the type of foods and portion sizes adults should eat conflicted with mothers' meal preparations. Mothers reported that, although they favored eating low-calorie meals, the meals fathers preferred eating were high-calorie meals (eg, quesadillas). In general, fathers supported healthy eating and physical activity behaviors for their children. Supportive behaviors for children included preparing healthy meals, using healthier cooking methods, grocery shopping with their children for healthy foods, and asking the child to participate in household chores and/or play sports. Fathers' unsupportive behaviors included bringing high-calorie foods, such as pizza, and sugary drinks into the home, using sweets and savory foods for emotion regulation, and displaying an indulgent parental feeding style.

CONCLUSIONS

Mothers' views of fathers' perceived roles in child eating and physical activity, and maintaining a healthy eating environment, have important implications for the success of promoting healthy behaviors in the homes of Hispanic families.

Places where preschoolers are (in)active: an observational study on Latino preschoolers and their parents using objective measures

BACKGROUND

To combat the disproportionately higher risk of childhood obesity in Latino preschool-aged children, multilevel interventions targeting physical (in) activity are needed. These require the identification of environmental and psychosocial determinants of physical (in) activity for this ethnic group. The objectives were to examine differences in objectively-measured physical activity and sedentary behavior across objectively-determined types of locations in Latino preschool-aged children; and determine whether the differences in physical activity by location were greater in children of parents with higher neighborhood-safety perceptions and physical activity-supportive parenting practices.

METHODS

An observational field study was conducted in Houston (Texas, USA) from August 2011 to April 2012. A purposive sample of Latino children aged 3-5 years and one of their parents (n = 84) were recruited from Census block groups in Houston (Texas) stratified by objectively-assessed high vs. low traffic and crime safety. Seventy-three children provided valid data. Time spent outdoors/indoors tagged with geographic locations was coded into location types based on objective data collected using Global Positioning Systems units that children wore >8 hr/day for a week. Physical activity parenting practices, perceived neighborhood-safety, and demographics were reported by parents. Time spent in sedentary behavior and moderate-to-vigorous physical activity was measured based on objective data collected using accelerometers (motion sensors) that children wore >8 hr/day for a week.

RESULTS

The odds of children engaging in moderate-to-vigorous physical activity were 43% higher when outdoors than indoors (95% confidence interval: 1.30, 1.58), and the odds of being sedentary were 14% lower when outdoors compared to indoors (95% confidence intervals: 0.81, 0.91). This difference depended on parental neighborhood-safety perceptions and parenting practices. Children were most active in parks/playgrounds (30% of the time spent in moderate-to-vigorous physical activity) and least active in childcare/school settings (8% of the time spent in moderate-to-vigorous physical activity).

CONCLUSIONS

Objectively-assessed time spent in specific locations is correlated with physical activity and sedentary behavior in Latino preschoolers. Interventions and policies should identify ways to engage Latino preschool-aged children in more physical activity and less sedentary behavior while in childcare, and encourage parents to spend more time with their young children in parks/playgrounds and other safe outdoor places.