Systematic review of the relationships between physical activity and health indicators in the early years (0-4 years)

It is Feasible for 3 to 5-Year-Old Children to Use Smartwatch Activity Trackers: A Systematic Review

AIM

This review aimed to summarise the evidence related to the feasibility, efficacy for increasing physical activity, and implications of smartwatch activity tracker use in preschool-aged children.

METHODS

In November 2023, we searched Medline, PsycINFO, CINAHL, Web of Science, ProQuest Central and SPORTDiscus. From an initial 7449 studies, we included 15 studies that explored the use of smartwatch activity trackers in preschool children aged three to 5 years. Data were extracted on feasibility, efficacy, and reported advantages and disadvantages of use. We used the preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

Studies that reported adherence to wear indicate good feasibility. No studies evaluated the efficacy of activity trackers for influencing physical activity and sedentary behaviours. Potential limitations of activity tracker use by preschool children include discomfort and a loss of interest.

CONCLUSION

Smartwatch activity trackers may be feasible for use by preschool children, but no studies have explored whether these devices can increase physical activity in this age group. Short-term use of these devices may encourage physical activity by promoting family discussions and increasing awareness of physical activity, but discomfort and a loss of interest over time may be barriers to long-term use by young children.

Reallocating 24-hour movement behaviors and its impact on mental health in preschool children: a compositional data and dose-response analysis

BACKGROUND

Mental health issues in preschool children are a significant public health concern with long-term developmental implications. Understanding how reallocations of time among different 24-hour movement behaviors-moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SED), and sleep (SLP)-affect various dimensions of mental health is essential for designing effective interventions.

METHODS

In this cross-sectional study, 828 Chinese preschool children aged 3 to 6 years were assessed. Physical activity and sleep were objectively measured using accelerometers to capture MVPA, LPA, SED, and SLP. Mental health was evaluated using the Strengths and Difficulties Questionnaire (SDQ), assessing Total Difficulties, Internalizing Problems, Externalizing Problems, and Prosocial Behavior. Compositional data analysis was conducted using isometric log-ratio (ilr) transformation, followed by multivariate linear regression to assess associations. Additionally, isotemporal substitution modeling and dose-response analysis were applied to examine the effects of reallocating time between behaviors on mental health outcomes, adjusting for age, gender, BMI, parental education, and parental attitudes toward physical activity.

RESULTS

Increased MVPA was significantly associated with lower Total Difficulties (ßMVPA= - 1.587; P < 0.001) and Internalizing Problems (ßMVPA= - 0.663; P = 0.017). Increased SED was associated with higher Total Difficulties (ßSED= 1.512; P < 0.05), while increased SLP was linked to improved Externalizing Problems (ßLPA= - 1.792; P = 0.008). Reallocating as little as 1 min from LPA or SED to MVPA or SLP significantly reduced Total Difficulties and Internalizing Problems (P < 0.05). Conversely, replacing SED or SLP with LPA increased Externalizing Problems, particularly Conduct Problems and Hyperactivity/Inattention (P < 0.05). A critical threshold at 30 min was identified, beyond which the effects on mental health outcomes became more pronounced.

CONCLUSIONS

Reallocating time from LPA or SED to MVPA or SLP significantly improves Total Difficulties and Internalizing Problems in preschool children, even with brief substitutions. However, increasing LPA at the expense of SED or SLP exacerbates Externalizing Problems, especially Conduct Problems and Hyperactivity/Inattention. Interventions should promote MVPA and adequate sleep while considering the critical 30-minute threshold where effects become more pronounced to enhance emotional and behavioral well-being.

Children's and Adolescents' Actual Motor Competence, Perceived Physical Competence and Physical Activity: A Structural Equation Modelling Meta-Analysis

BACKGROUND

Perceived physical competence (e.g. perceived motor skills, perceived athletic competence) is hypothesised to mediate the association between actual motor competence and physical activity in children, and this mediated association is expected to be stronger in older children and adolescents. However, no meta-analyses to date have synthesised the hypothesised mediation effect.

OBJECTIVES

The purpose of this study was to systematically identify and synthesise the existing literature on the hypothesised mediation model between actual motor competence, perceived physical competence and physical activity in children and adolescents using structural equation modelling meta-analysis.

METHODS

Five electronic databases were searched from inception to December 2023 using a range of keywords for actual motor competence, perceived physical competence, physical activity and children/adolescents. Machine learning assisted screening was used to identify studies which reported the association between at least two of the variables in the hypothesised model in children and adolescents aged 4-18 years. One-stage structural equation modelling meta-analysis was used to test the hypothesised model. Moderation analysis was conducted to determine whether any of the model parameters differed as a function of children's age.

RESULTS

A total of 218 reports that reported on 213 studies met the inclusion criteria and were included in the meta-analysis. Results from studies which examined the concurrent association between actual motor competence (gross motor, locomotion, object control), perceived physical competence, and physical activity demonstrated that perceived physical competence only had a small absolute (0.029 ≤ r ≤ 0.034) and relative (16.7-20.6% of total effect) mediating effect on the association between actual motor competence and physical activity. Results from studies which examined lagged associations (11% of included studies) also demonstrated a small bidirectional mediation effect of perceived physical competence. The moderation model demonstrated the mediation effect was significantly stronger in adolescents than children, albeit still weak.

CONCLUSIONS

Perceived physical competence is not a strong mediator of the association between actual motor competence and physical activity in children and adolescents. Given that the association between perceived physical competence and actual motor competence with physical activity are largely independent, there may be benefits to targeting both motor skills and perceived physical competence to increase engagement in physical activity.

The Associations Between Parental-Reported and Device-Based Measured Outdoor Play and Health Indicators of Physical, Cognitive, and Social-Emotional Development in Preschool-Aged Children

PURPOSE

Examine in preschool-aged children: (1) the associations between parental-reported and device-measured outdoor play (OP) and health indicators of physical, cognitive, and social-emotional development and (2) whether associations were independent of outdoor moderate- to vigorous-intensity physical activity (MVPA).

METHODS

This cross-sectional study included 107 participants. Children's OP was measured via a parental questionnaire and the lux feature of accelerometers. Children's growth, adiposity, and motor skills were assessed as physical development indicators. Visual-spatial working memory, response inhibition, and expressive language were assessed as cognitive development indicators. Sociability, prosocial behavior, internalizing, externalizing, and self-regulation were assessed as social-emotional development indicators. Regression models were conducted that adjusted for relevant covariates. Additional models further adjusted for outdoor MVPA.

RESULTS

Parental-reported total OP, OP in summer/fall months, and OP on weekdays were negatively associated (small effect sizes) with response inhibition and working memory. After adjusting for outdoor MVPA, these associations were no longer statistically significant. OP on weekdays was negatively associated with externalizing (B = -0.04; 95% confidence interval, -0.08 to -0.00; P = .03) after adjusting for outdoor MVPA. A similar pattern was observed for device-based measured total OP (B = -0.49; 95% confidence interval, -1.05 to 0.07; P = .09).

CONCLUSIONS

Future research in preschool-aged children should take into account MVPA and contextual factors when examining the association between OP and health-related indicators.

Reviewing the association between motor competence and physical activity from a behavioral genetic perspective

A much-cited model by Stodden and colleagues has proposed motor competence to be a 17 promising target for intervention to increase childhood physical activity. Motor competence is thought to influence future physical activity through bidirectional causal effects that are partly direct, and partly mediated by perceived motor competence and physical fitness. Here, we argue that the model is incomplete by ignoring potential confounding effects of age-specific and age-invariant factors related to genetics and the shared family environment. We examined 106 systematic reviews and/or meta-analyses on the Stodden model for the mention of familial confounding. These reviews summarized data from 1,344 primary studies on children in the age range 0-18 on the associations in five bidirectional pathways: motor competence-physical activity, motor competence-perceived motor competence, perceived motor competence-physical activity, motor competence-physical fitness, and physical fitness-physical activity. We show that a behavioral genetic perspective has been completely lacking from this vast literature, despite repeated evidence for a substantial contribution of genetic and shared environmental factors to motor competence (h 2 = ♂55%-♀58%; c2 = ♂31%-♀29%), physical fitness (h 2 = ♂65%-♀67%; c 2 = ♂3%-♀2%), and physical activity (h 2 = ♂37%-♀29%; c 2 = ♂33%-♀49%). Focusing on the alleged causal path from motor competence to physical activity, we find that the systematic reviews provide strong evidence for an association in cross-sectional studies, but weak evidence of prediction of physical activity by motor competence in longitudinal studies, and indeterminate effects of interventions on motor competence. Reviews on interventions on physical activity, in contrast, provide strong evidence for an effect on motor competence. We conclude that reverse causality with familial confounding are the main sources of the observed association between motor competence and physical activity in youth. There is an unabated need studies on the interplay between motor competence, perceived motor competence, physical fitness, and physical activity across early childhood and into adolescence, but such studies need to be done in genetically informative samples.

Hyperactive-impulsive behavior does not moderate the association between executive function and physical activity in preschoolers

Experimental research suggests a positive association between executive function (EF) and physical activity (PA). Observational research examining PA in everyday life does not consistently support this positive association, with findings yielding negative or no associations. Hyperactive-impulsive behavior could act as a possible moderator, explaining inconsistent findings. In this observational study, we examined the relation between EF and everyday PA as well as hyperactive-impulsive behavior as a potential moderator in a sample of 68 German preschoolers (3-5 yrs). As performance-based measured of EF and PA, participants performed a computerized EF test battery in two sessions and wore an accelerometer for 7 days. Parental questionnaires of EF, PA, and hyperactive-impulsive behavior were further implemented. Accelerometer-assessed moderate-to-vigorous PA was negatively related to EF performance, and hyperactive-impulsive behavior did not moderate this association. Neither time spent in any other PA intensity nor parental PA reports were related to EF. The present study represents the first study to investigate if hyperactive-impulsive behavior moderates the association between everyday PA and preschoolers' EF. Thus, the findings yield new insight into the relation between PA in everyday life and preschoolers' EF, as the unexpected negative relation could not be explained through hyperactive-impulsive behavior.

Profile of the PLAY spaces & environments for children's physical activity, sedentary behaviour and sleep (PLAYCE) cohort study, Western Australia

BACKGROUND

Childhood is a critical period for the development of movement behaviours such as physical activity, sleep and sedentary behaviour. The PLAYCE Cohort was established to investigate how movement behaviours change over early to middle childhood, across key behaviour settings and relationships with health and development. An overview of the PLAYCE cohort, summary of key findings to date, and future research opportunities are presented.

METHODS

Children were recruited at 2-5 years of age (preschool; Wave 1) via early childhood education and care (ECEC) services and were followed up in junior primary school (5-7 years; Wave 2) at 8-10 years (Wave 3) and again at 11-13 years (Wave 4; in progress). Children's movement behaviours were measured via parent-report and accelerometry. Social-emotional development, motor development, weight status, diet, and child and family socio-demographics were parent-reported. Physical environmental features of children's key behaviour settings (home, neighbourhood, ECEC and school) were collected using geo-spatial and audit data.

RESULTS TO DATE

At wave 1 (2-5 years), only 8% of children met all three recommendations of the Australian 24-hour Movement Guidelines for the Early Years. Meeting all recommendations (8%) was positively associated with boys social-emotional development. Physical environment features of the home yard (size, play equipment, natural features) were positively associated with preschool children's physical activity. Tree canopy and more portable play equipment in ECEC outdoor areas was also positively associated with children's outdoor time and physical activity.

CONCLUSIONS

Wave 4 (11-13 years) data collection will be completed in early 2026. Traditional longitudinal and compositional data analysis of the PLAYCE cohort will be undertaken. Four waves of data will provide detailed patterns of movement behaviours and their effect on child health and development as well as the environmental influences on children's movement behaviours across early to middle childhood. The findings can be used to inform national and international 24-Hour Movement Guidelines and behaviour setting-specific as well as population-level interventions to benefit child health and wellbeing across early to middle childhood.

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.

Development and Testing of the Observational System for Recording Physical Activity in Children-Toddlers

Background: Direct observation (DO) tools developed for preschoolers have been used to describe toddler physical activity (PA). No DO system created to assess PA levels and the childcare environment of toddlers exists. The purpose of this study was to develop the Observational System for Recording Physical Activity in Children-Toddlers (OSRAC-T) and assess the inter- and intra-rater reliability. Methods: This tool is an extension of the Observational System for Recording Physical Activity in Children-Preschool and uses the same focal child, time sampling system (5-second observation and 25-second recording). Tool content was established through identifying similar research, consulting with experts, and conducting informal observations. A sample of toddlers (12-36 months) was observed and video recorded during childcare. In-person observations were compared to video observations from one coder (intrarater reliability). Video observations (39% of intervals) were coded by two raters to determine interrater reliability. Results: The final instrument included nine categories that described PA level and type, social and environmental contexts, and transition support relevant to toddlers. Observers completed 124 observation sessions (n = 31; 25.5 ± 6.0 months) resulting in 7,757 30-second observation intervals. Interval-by-interval agreement was moderate to high (58.90%-95.30%) for all categories, and interrater reliability was low to moderate (k = 0.28-0.69). Conclusion: The OSRAC-T is a reliable observation system to assess several PA-related behaviors of toddlers. It may be used to better inform early childcare center design, future intervention studies, or to assess correlates or relationships between PA behavior and health outcomes in toddlers.

Assessing the implementation of healthy eating and physical activity policies and practices in Early Childhood Education and Care in New South Wales, Australia: A cross-sectional study

ISSUE ADDRESSED

Australian children are not meeting the recommended physical activity (PA) and healthy eating (HE) guidelines. Health behaviour practices implemented in community settings such as early education services can improve child's health outcomes and are therefore key to help meet guidelines. This study aimed to measure the implementation of HE and PA policies and practices in Early Childhood Education and Care (ECEC) services in New South Wales (NSW), Australia, and to examine their association with service characteristics.

METHODS

A random sample of 1122 centre-based ECEC services were invited to a cross-sectional survey measuring HE and PA policy and practice implementation. Regression analyses were conducted to assess the relationship between the service characteristics and implementation of policies/practices.

RESULTS

In total, 565 ECEC services completed the survey. Results show that while some practices are implemented, the implementation of practices promoting HE and PA education is low. Practices related to educator training for HE (18%) and PA (13%) were poorly implemented. The implementation of practices such as 'providing educator training around child PA', 'engaging families in activities to increase child PA' and 'encouraging supportive feeding practices' were significantly higher in services located in major cities than regional/remote services. 'Having a PA policy' and the practice of 'limiting the use of screen time' was significantly higher in long day care services than in preschools. The implementation of 'providing educator-led PA', 'providing free play opportunities' and 'having a PA policy' was significantly lower in private not-for-profit community managed services than in private for-profit services.

CONCLUSIONS

Implementation of various HE and PA policies and practices in regional/remote services, private not-for-profit services and preschools across NSW could be improved. SO WHAT?: Future research should be prioritised towards identifying factors influencing the implementation of these policies and practices to best tailor implementation support efforts for those who need it the most.

Jarjums Connections: Connecting Aboriginal Culture With Yoga in Early Childhood Education and Care Services-A Partnership Story

ISSUE ADDRESSED

There remains a wide health disparity between Indigenous and non-Indigenous Australians. Effective health promotion programs and partnerships between Aboriginal and non-Aboriginal services are vital to improving Aboriginal health outcomes, closing the gap of inequality and working towards reconciliation.

DISCUSSION

The Jarjums Connections program promotes Aboriginal culture through storytelling, yoga-inspired movements and mindfulness, in Early Childhood Education and Care Services (ECECS). The program was developed in collaboration between the Aboriginal Health Unit and the Health Promotion Unit in Sydney Local Health District (SLHD) and is based on Aboriginal significant animals of SLHD. The principles of yoga and its philosophies merging with Aboriginal culture have been complementary, and this synergy was harnessed to develop the program. The program has had positive feedback to date and shows promise.

CONCLUSION

The accomplishments and lessons learned so far from the program can inform future practice and scale-up of the program. As it moves towards a digital platform, it has the potential to be adapted and tailored to suit other Aboriginal Nations, LHDs and ECECS across the state and beyond. SO WHAT?: Rolling the program out digitally would be a low-cost and equitable way to embed Aboriginal cultural learning into mainstream education and potentially positively affect the physical, mental and emotional well-being of children more broadly.

Tracking Physical Activity and Nutrition Policies and Practices in Early Childhood Education and Care: Five Years Post-Implementation of a Provincial-Level Active Play Standard

Background: Early childhood education and care (ECEC) settings are key for improving health behaviors, including physical activity (PA) and nutrition. In 2017, the province of British Columbia (BC) implemented a provincial-level Active Play policy supported by a capacity-building intervention. Significant improvements in all PA policies and practices and the majority of nutrition policies were observed post-implementation. The purpose of this study was to understand if PA and nutrition policies and practices were maintained at 5+ years post-provincial policy implementation. Methods: This study employed a repeated cross-sectional design to distribute surveys querying about PA and nutrition policies and practices to ECEC centers across BC at three time points: time 1, prior to implementation of the Active Play standard (2016-2017) and capacity-building intervention, time 2, 1-2 years post-implementation (2018-2019), and time 3, 5+ years post-implementation (2022-2023). Results: The majority of PA and all nutrition policies were maintained from time 2 (n = 378) to time 3 (n = 639). Prevalence of policies related to the provision of activities that address fundamental movement skills (odds ratio [OR] = 0.30) and total amount of active play (OR = 0.56) significantly decreased from time 2 to time 3. All reported PA practice prevalence levels decreased to time 1 levels. Conclusions: Center-level health behavior policies were largely maintained 5 years post-implementation, except some PA policies and practices returned to pre-implementation levels. Staff capacity and turnover as well as change in implementation support may explain these changes. Ongoing implementation support is needed to ensure maintenance of health promoting policies and practices in ECEC.

Associations Between Movement Behaviors, Cognition, and Academic Achievement in Children and Adolescents: A Systematic Review

OBJECTIVE

This systematic review summarizes the literature on the associations between movement behaviors (eg, sleep, sedentary behavior, and physical activity [PA]) and cognition, and academic achievement (AA) in children and adolescents.

METHODS

Four electronic databases (PubMed, Embase, PsycINFO, and SPORTDiscus) were searched from inception until October 2023.

RESULTS

This systematic review included 24 reports, representing 48,558 youth aged 6-17.9 years. Ten reports (46%) showed a high risk of bias, and overall quality of evidence ranged from very low to moderate. No reports assessed the associations between sleep and cognition; 1 cross-sectional report showed beneficial associations between sleep and AA. Sedentary behaviors showed null associations with AA in 43% of the reports; however, screen time was detrimentally associated with AA in all reports. Overall, 57% of the reports looking at the associations between PA and cognition showed beneficial associations; 53% showed beneficial associations between PA and AA; 56% of the randomized controlled trials showed beneficial impacts on cognition (3 out of 5) or on AA (2 out of 4).

CONCLUSIONS

Overall, this systematic review showed evidence of beneficial associations between PA and cognition and AA, as well as detrimental effects of screen time. Due to the many inconsistent results found for sedentary behavior, together with scarce data on associations between sleep duration and cognition, and AA in children and adolescents, more research is needed so researchers can draw strong and evidence-based conclusions.

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

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

Effects of preschool staff professional development in physical activity on self-regulation, executive function and early academic learning in 3-5-year-old children: The active learning Norwegian preschool(er)s (ACTNOW) cluster-randomized controlled trial

We aimed to investigate the effects of preschool staff physical activity (PA) professional development on self-regulation, executive function and early academic learning in 3-5-year-old children. A total of 1265 children from 46 preschools in Norway were randomized to a 7-month intervention or control. Main analyses included 816 3-4-year-olds who provided data at baseline, 7- and 18-month follow-ups. We measured children's self-regulation (Head-Toes-Knees-Shoulders task), inhibition, cognitive flexibility, working memory, early expressive vocabulary, early mathematical skills (Early Years Toolbox) and physical activity (accelerometry). Linear mixed models were used to analyze the data. Results showed no effect of the intervention on cognitive or learning outcomes in the primary analyses. We found small positive effects on sedentary time (standardized effect size (ES)=-0.17, p = 0.014) and moderate to vigorous-intensity PA (ES = 0.15, p = 0.048) at 7 months, and a negative effect on low-intensity PA at 18 months (EF = -0.15, p = 0.021). Boys had a small positive effect on vocabulary at 7 months (ES = 0.23, p = 0.006), and girls a small negative effect at 18 months (ES = -0.23, p = 0.004). This cluster RCT in preschoolers supports the notion that pragmatic trials within educational settings have difficulties in providing changes to the PA practice and to impact young children's cognitive development and learning.

A meta-analysis of the effect of physical activity programs on fundamental movement skills in 3-7-year-old children

Introduction

This study aimed to systematically review the effects of different physical activity programs on the fundamental movement skills of 3 - 7-year-old children.

Methods

For this review, the databases of CNKI, Web of Science, and PubMed were searched to collect relevant literature on the effects of different physical activity program interventions on fundamental movement skills, and a total of 10 articles with 1,121 subjects were included. The Cochrane Risk of Bias Assessment Tool was used to assess the quality of the literature, and meta-analysis was performed using Review Manager 5.4 software.

Results

Physical activity significantly influenced children's running ability, horizontal jump, dribbling the ball, kicking ability, catching ability, overhand throwing, striking a stationary ball, and dynamic balance. However, the intervention effect was insignificant for the hop and underhand throwing abilities. The intervention effects for running ability, horizontal jump, kicking ability, and catching ability were better at less than 12 weeks than at 12 weeks and above. In addition, an intervention duration of 90 min or more was better than less than 90 min for running ability and horizontal jump.

Conclusion

Future research is recommended to focus on the common factors of the intervention effects of physical activity programs to develop more precise and effective intervention practices to further improve children's fundamental movement skill levels.

How strong is the evidence supporting the WHO guidelines on physical activity, sedentary behaviour and sleep in early childhood?

BACKGROUND

The WHO issued recommendations about the ideal amount of physical activity, sedentary behaviour and sleep in infants, toddlers and preschool children. To facilitate their interpretation and translation into public health policies, we analysed the quantity and quality of the evidence that supported the development of each WHO recommendation.

METHODS

All data for each exposure-outcome pair analysed in the studies informing WHO guidelines were extracted, and predefined criteria, based upon GRADE methodology, were used to classify each outcome and study result.

RESULTS

Among the 237 studies that could be included, 37 were experimental and 200 were observational, yielding 920 analyses of exposure-outcome associations. Sixty-two analyses used a relevant outcome, with or without significant results. Five of the 10 WHO recommendations were based upon zero analyses with significant results on relevant health outcomes. The remaining recommendations were mostly based upon analyses evaluating obesity-related outcomes. Eight of the 10 GLs thresholds were not supported by any significant analysis on clinically relevant outcomes.

CONCLUSION

While these findings should not be interpreted as an attempt to disprove the benefits of healthy lifestyle habits in early childhood, neither to minimize the work of the experts in this complex research field, very limited evidence currently supports the adoption of recommended thresholds as behavioural surveillance and public health interventions targets. Therefore, until further data are available, public health interventions should be developed balancing whether to focus on the achievement of specific targets that are still not supported by high-quality evidence or on the general promotion of healthy behaviours.

24-hour movement components, cardiorespiratory fitness and cardiometabolic risk in children: a network perspective

This study to examine associations between cardiorespiratory fitness (CRF), 24-hour movement components, and cardiometabolic risk factors in children from southern Brazil, emphasizing the critical variables in these relationships. The sample included 186 schoolchildren (6-11 years, 8.57±1.56). Waist circumference (WC) and CRF were assessed using PROESP-Br protocols, while physical activity (moderate to vigorous - MVPA, and light - LPA) was measured via accelerometers. Sleep and screen time were reported by parents, and fasting blood samples provided data on triglycerides, HDL cholesterol, glucose, insulin, and HOMA-IR. Network analysis highlight WC, systolic blood pressure, and MVPA as central variables with significant connectivity. MVPA emerged as central among 24-hour movement behaviors, with CRF playing an intermediary role. Results underscore WC and MVPA's relationship on cardiometabolic health, supporting interventions targeting MVPA to prevent early cardiometabolic risks in children.

Identifying data gaps in early childhood physical activity evidence

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

Associations between adherence to 24-hour movement guidelines and socio-emotional competence among preschool children: A cross-sectional study

BACKGROUND

This study investigated the association between adherence to 24-h movement guidelines and socioemotional competence among Chinese preschool children.

METHODS

A total of 1288 parents of Chinese preschoolers (54.64 % boys, 45.36 % girls; Mage = 4.48, SD = 0.97) reported the time their children spent on physical activity (PA), screen time (ST), and sleep duration (SD), and completed questionnaires measuring socioemotional competence. Multiple logistic regression analyses were used to explore the associations between individual and combined measures of PA, ST, and SD, and the risk of low socioemotional competence.

RESULTS

The risk of low socioemotional competence was significantly lower for children aged 4 (odds ratio [OR] = 0.47, 95 % CI: 0.31-0.71), 5 (OR = 0.23, 95 % CI: 0.15-0.35), and 6 (OR = 0.16, 95 % CI: 0.10-0.25) compared to 3-year-olds. Children with a family income level higher than 20,000CNY had a significantly lower risk of low socioemotional competence than those with a family income level not higher than 3000CNY (OR = 0.21, 95 % CI: 0.08-0.59). Urban residency was associated with significantly lower odds of low socioemotional competence than rural residency (OR = 0.41, 95 % CI: 0.21-0.82). Adherence to the PA-only guidelines (OR = 0.45, 95 % CI: 0.22-0.94), SD-only guidelines (OR = 0.25, 95 % CI: 0.08-0.72), ST + SD guidelines (OR = 0.33, 95 % CI: 0.16-0.67), and PA + ST + SD guidelines (OR = 0.36, 95 % CI: 0.18-0.70) were associated with a lower risk of low socioemotional competence. In addition, among boys, only adherence to the PA + ST + SD guidelines (OR = 0.36, 95 % CI: 0.14-0.90) was associated with a lower risk of low socioemotional competence. Among girls, adherence to SD guidelines only (OR = 0.22, 95 % CI: 0.04-0.90), ST + SD guidelines (OR = 0.17, 95 % CI: 0.06-0.49), and PA + ST + SD guidelines (OR = 0.37, 95 % CI: 0.14-0.91) were all associated with a lower risk of low socioemotional competence.

CONCLUSIONS

Adhering to 24-h movement guidelines is crucial for enhancing socioemotional competence in preschool children, especially girls. Interventions should focus on promoting physical activity, reducing screen time, and ensuring adequate sleep.

Understanding variations in the built environment over time to inform longitudinal studies of young children's physical activity behaviour - The BEACHES project

We know relatively little about the role the neighbourhood built environment plays in promoting young children's physical activity, particularly its longitudinal effect either through repeated exposure to the same environment or through change in exposure by moving from one neighbourhood to another. This study characterised the neighbourhood environment of young children in the PLAYCE cohort study over three timepoints from 2015 to 2023. There were statistically significant differences in built environment attributes between timepoints and across socio-economic status, however they did not represent practically significant differences. These findings inform the analysis approach of subsequent research in the BEACHES Project, an international study examining the role of the built environment on child physical activity and obesity using multiple cohorts.

Associations between family factors and physical activity clustering in preschool children: a cross-sectional study

Objective

This study aimed to examine the association between family factors and physical activity (PA) clustering in preschool children.

Methods

Preschoolers' PA and sedentary behavior (SB) were assessed consecutively for 7 days using ActiGraph accelerometers based on the cutoff counts developed by Pate et al. Information about children, their parents, and their families was collected using questionnaires. We developed a two-step approach to clustering PA both inside and outside of kindergarten. The Euclidean distance metric was utilized to distinguish between groups, while the Schwarz-Bayesian criterion was applied to identify the most optimal sub-group model. A one-way ANOVA was used to assess the clustering effect, and logistic regression was used to analyze the influencing factors of different clustering.

Results

We collected data from 291 preschool children aged 3 to 6 years and divided them into three clusters-Inactive (50.2%), Active in kindergarten (26.8%), and Active outside kindergarten (23.0%)-with significant differences in PA and SB, revealing distinct temporal and spatial clustering patterns (silhouette coefficient = 0.3, p < 0.05). Furthermore, preschooler activity levels correlated significantly with factors including gender (OR = 0.35, 95% CI: 0.19-0.66), age (OR = 1.05, 95% CI: 1.00-1.10), birth weight (OR = 1.79, 95% CI: 1.16-2.76), paternal age (OR = 1.01, 95% CI: 1.00-1.02), and maternal income (OR = 0.68, 95% CI: 0.48-0.96).

Conclusion

This study shows that the family environment or parents significantly influence the PA of preschool children. Older fathers may promote preschool children's PA through greater educational focus and financial stability, while higher maternal income can provide more opportunities and resources for preschool children to engage in active lifestyles. Thus, it is suggested that families providing more attention and exercise opportunities for preschool children's education can help improve their PA levels in the future.

Associations Between Combinations of 24-Hour Movement Behaviors and Dietary Outcomes in Children and Adolescents: A Systematic Review

Background/Objectives: Twenty-four-hour movement behaviors, including physical activity, sedentary time, and sleep, are associated with a range of health outcomes. However, the relationship between the combinations of these behaviors and dietary outcomes in young populations remains unclear. We conducted a systematic review to explore how combined movement behaviors are linked to dietary outcomes in children and adolescents. Methods: We searched MEDLINE, Embase, and PsycINFO from January 2017 to July 2024, including studies that were (1) written in English, (2) published in peer-reviewed journals, (3) quantitatively analyzed two or three movement behaviors with dietary outcomes, and (4) focused on populations aged between 0 and 18 years. Results: Ten cross-sectional studies met these criteria. The majority of studies (6 out of 10) assessed all three movement behaviors, although sleep was less frequently examined, appearing in only 4 of the studies. Our findings indicated that adhering to all movement recommendations was consistently associated with healthier dietary patterns, including a higher consumption of fruits, vegetables, nuts, fish, and cereals, and a lower intake of sweets and pastries. Additionally, adhering to physical activity and sedentary time guidelines was linked to improved dietary habits in children, including more fruit and vegetable intake and less sugary drink and snack consumption. Conversely, higher sedentary time and inadequate sleep were linked to poorer dietary outcomes, particularly lower fruit intake and hydration. Conclusions: This review suggests that meeting movement behavior guidelines correlates with healthier dietary outcomes in children and adolescents. However, given the limited number of studies and their cross-sectional design, further high-quality research, including longitudinal and intervention studies, is needed to clarify causal relationships.

Associations between physical activity and development in preschool-aged children born <30 weeks' gestation: a cohort study

OBJECTIVE

To investigate the effect of physical activity (PA) on development (motor, cognitive, social-emotional) in children 4-5 years old born <30 weeks' gestation, and to describe subgroups of children at risk of low PA in this cohort.

DESIGN

Longitudinal cohort study.

PATIENTS

123 children born <30 weeks were recruited at birth and assessed between 4 and 5 years' corrected age.

MAIN OUTCOME MEASURES

Development was assessed using the Movement Assessment Battery for Children, Second Edition (MABC-2), Little Developmental Coordination Disorder Questionnaire (L-DCDQ), Wechsler Preschool and Primary Scale of Intelligence (Fourth Edition; WPPSI-IV), and Strengths and Difficulties Questionnaire (SDQ). To measure PA, children wore an accelerometer and parents completed a diary for 7 days. Effects of PA on developmental outcomes, and associations between perinatal risk factors and PA, were estimated using linear regression.

RESULTS

More accelerometer-measured PA was associated with better MABC-2 aiming and catching scores (average standard score increase per hour increase in PA: 0.54, 95% CI 0.11, 0.96; p=0.013), and lower WPPSI-IV processing speed index scores (average composite score decrease per hour increase in PA: -2.36, 95% CI -4.19 to -0.53; p=0.012). Higher accelerometer-measured PA was associated with better SDQ prosocial scores. Major brain injury in the neonatal period was associated with less moderate-vigorous and less unstructured PA at 4-5 years.

CONCLUSIONS

Higher levels of PA are associated with aspects of motor, cognitive and social-emotional skill development in children 4-5 years old born <30 weeks. Those with major brain injury in the neonatal period may be more vulnerable to low PA at preschool age.

Prevention Strategies in Obesity Management: A Systematic Review Comparing Canadian and American Guidelines for Adults

The fast-increasing obesity prevalence rates in children, youths, and adults in the last decade have made obesity prevention a global public health priority. The primary objective of this study is to evaluate the various obesity prevention strategies and guidelines implemented in the United States and Canada. Thus, for this study, a systematic review was performed on various online databases including PubMed, Scopus, Google Scholar, and MEDLINE. The decision to study the obesity prevention strategies in Canada and the United States is a result of the high prevalence rates of obesity in the two countries, alongside the numerous prevention interventions that have been executed to prevent obesity. Additionally, the systematic review used robust methodology that followed the Cochrane guidance and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only studies published between 2014 and 2024, drawn from listed databases, were included in this systematic review. The quality of the included studies was evaluated using the appraisal tool for cross-sectional studies, with the studies being rated moderate to high quality. Therefore, a total of 15 studies met the inclusion criteria and were reviewed. The findings indicate that various obesity prevention interventions have been implemented across the United States and Canada, with diverse degrees of success in obesity prevention and management. Food labeling, regular exercises, portion size regulation, school-based intervention strategies, early childhood Intervention programs, and sugar-sweetened beverage taxation were found to be effective interventions for preventing obesity in children and adults. Based on the findings, there is a need to ensure full execution of the different interventions to ensure significant reduction in obesity prevalence, as well as prevention of obesity in different populations.

Validity of the PROMIS® Early Childhood Physical Activity Scale among toddlers

BACKGROUND

The PROMIS® Early Childhood Physical Activity (PROMIS EC PA) scale is a recently developed PROMIS Early Childhood measure to assess PA among children aged 1-5 years. The purpose of this study was to examine test-retest reliability and convergent validity of the PROMIS EC PA scale among toddlers.

METHOD

An ancillary study was conducted in the toddler-mother dyad sample of the Child and Mother Physical Activity Study. Mothers completed the 7-item PROMIS EC PA scale twice: during a study visit (test) and on the last day when their child's wore an ActiGraph accelerometer on the hip for 7 days (retest). The PROMIS EC PA summed score was calculated by totaling scores from items 1-5. Test-retest reliability was assessed using intraclass correlation coefficient (ICC) for test and retest PROMIS EC PA. Convergent validity was assessed using rank correlation coefficients (rho) between PROMIS EC PA scores and accelerometer-measured moderate- and vigorous-intensity PA (MVPA).

RESULTS

Among 74 participants (56% female; 19 ± 4 months of mean age with range of 12-30 months), average accelerometer-measured MVPA was 76 ± 24 min/day. The median number of days between PROMIS EC PA test and retest was 8 days (IQR = 6 to 8), with an average PROMIS EC PA summed score of 11.0 ± 3.5 at test and 10.5 ± 3.4 at retest. ICC for the test-retest PROMIS EC PA summed scores was 0.72 (95% CI = 0.59-0.82). The rank correlation between the PROMIS EC PA summed score and accelerometer-measured MVPA was 0.13 (95% CI=-0.10 to 0.35; p = 0.28).

CONCLUSION

In a sample of children aged 12-30 months, test-retest reliability for the PROMIS EC PA scale was moderate and its convergent validity against accelerometer-measured MVPA was poor. Prior to a widespread use of the PROMIS EC PA scale in large-scale research and clinical practice, the tool should be further refined and validated to elucidate how young children's lived PA experience as measured in the PROMIS EC PA scale is relevant to their health and wellbeing outcomes.

Effectiveness of a parent-focused intervention targeting 24-hour movement behaviours in preschool-aged children: a randomised controlled trial

BACKGROUND

Interventions focusing on individual behaviours (physical activity, sedentary behaviour, sleep) of preschool-aged children have been widely studied. However, there is a lack of understanding about integrated interventions that target all three 24-hour movement behaviours. This is the first study to assess the effectiveness of an intervention aimed at improving all three 24-hour movement behaviours among preschoolers in Hong Kong.

METHODS

A 12-week randomised controlled trial with a 12-week follow-up was conducted. Parent-child pairs were randomised to integrated approach (targeting all three behaviours), dyadic approach (targeting physical activity and sedentary behaviour including screen time), or wait-list control group. Utilising the Internet-based delivery, this intervention consisted of education materials, workshops, and interactive questionnaires and reminders. Two intervention groups employed the same strategies, with the only difference being that the integrated approach targeted sleep in addition to physical activity and sedentary behaviour. The outcomes were preschoolers' overall 24-hour movement behaviours which were assessed by the Activity Sleep Index (ASI), movement behaviour composition, and absolute duration of movement behaviours. Generalised estimating equations were conducted to evaluate the intervention.

RESULTS

A total of 147 preschoolers (4.8 ± 0.9 years old, 56.5% boys) and their parents were included. Preschoolers in all groups had a lower ASI at follow-up compared with baseline. Preschoolers in the integrated approach had a smaller decline in ASI at follow-up, compared to that in the control group (3.41; 95% confidence interval [CI] = 0.07, 6.76). Preschoolers in both intervention groups had a smaller reduction of the composition of time spent in physical activity at follow-up, and a decreased screen time at postintervention and follow-up. No significant differences were found for the sleep subcomponent. Furthermore, preschoolers in the dyadic approach had a smaller increase in the sedentary behaviour subcomponent (vs.

CONTROL

- 0.21; 95% CI = - 0.37, - 0.05) at follow-up.

CONCLUSIONS

Both intervention groups showed a decrease in screen time at postintervention, but there were no significant changes in other behaviours. The favourable changes observed at follow-up demonstrated the effectiveness of both intervention approaches on alleviating the decline in the composition of time spent in physical activity and reducing screen time and revealed the possible effectiveness of the integrated approach in promoting overall movement behaviours among preschoolers.

TRIAL REGISTRATION

The study is prospectively registered at the Chinese Clinical Trial Registry (ChiCTR2200055958).

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

The impact of an early childhood educator e-Learning course on young children's fundamental movement skills: A cluster randomized controlled trial

Early childhood educators (ECEs) are ideally positioned to support the development of children's fundamental movement skills (FMS). However, ECEs have little specialised training to support the development of FMS in young children. This study aimed to assess the impact of an e-Learning course on the FMS of preschool-aged children. 145 Preschool-aged children and 42 ECEs from 12 childcare centres participated in the study. ECEs in the experimental group were asked to complete the e-Learning course. A subsample of children (n = 48) was objectively assessed using the Test of Gross Motor Development 3rd Edition (TGMD-3). Additionally, parents of all participating children reported perceptions of their child's FMS to understand if they knew how well their child was progressing. Findings showed a significant increase in TGMD-3 assessed locomotor skills from baseline to follow-up in the intervention group compared to the control group and total FMS but not objective control skills. Parent-reported FMS increased in the intervention group for all locomotor, object control skills, and total FMS. However, the intervention effect for all three measurements was not significant. The results from this study highlight the potential utility of online professional development for ECEs as an approach to improving young children's FMS.

A Comprehensive Planning Framework for Designing Effective Physical Activity Interventions in Youth

BACKGROUND

Effective physical activity (PA) interventions are needed to counter the insufficient and declining levels of PA in youth. These require an updated, comprehensive planning framework that consolidates recent decades of progress in promoting PA in young children, children, and adolescents. Effective PA interventions require program planning and conceptual model development that target a coordinated and multilevel set of age-specific PA determinants. Accordingly, this paper presents a comprehensive planning framework that researchers can use to design intervention research to promote PA in youth.

METHODS

The first author conducted targeted searches through Google Scholar to compile PA models/frameworks/guides applicable to youth, a comprehensive set of PA determinants, and determinant-linked strategies to promote PA focusing on review articles. The information was summarized in tables, synthesized, and used to create a planning framework, all of which were reviewed by coauthors.

RESULTS

The APPLE Framework for Planning PA Opportunities for Youth (APPLE = Age, PA focus, Place and time, Leverage relevant influences and strategies, and ensure Enjoyable PA opportunities) incorporated all core elements from targeted reviews to create a comprehensive planning framework. The APPLE Planning Framework has a set of questions/prompts that guide the intervention planning process and conceptual model templates to organize planning efforts for designing intervention research.

CONCLUSIONS

The APPLE Framework for Planning PA Opportunities for Youth will enable researchers to develop comprehensive conceptual models to guide the design of PA interventions for youth. Future research should refine the model and its components to enable PA intervention research in youth to move forward.

Compliance with the 24-hour movement behavior guidelines and the impact of sleep methods among toddler, preschool, and school-aged children enrolled in the Guelph Family Health Study

Canadian movement guidelines focused on physical activity (PA), sleep, and screen time support childhood development and reduce the risk of chronic disease. Accelerometers are often used to capture these behaviors; however, they are limited in their ability to record daytime sleep due to potential misclassification.

OBJECTIVES

The objectives of this study were to 1) determine the prevalence of children enrolled in the Guelph Family Health Study who met the guidelines and to 2) compare the impact of different sleep measurement methods.

DESIGN/METHODS

Toddlers (1.5-<3 years; n = 128; valid data for all movement behaviors, n = 70), preschoolers (3-<5 years; n = 143; valid data for all movement behaviors, n = 104), and school-aged (5-<6 years; n = 49; valid data for all movement behaviors, n = 31) children were included. Screen time and sleep habits were obtained through parental report and published normative data. PA and sleep were recorded using accelerometers (wGT3X-BT ActiGraph; right hip).

RESULTS

It was found that 66 % of toddler, 44 % of preschool, and 63 % of school-aged children met the screen time guidelines. Further, 63 % of toddler, 98 % of preschooler, and 80 % of school-aged children met PA guidelines. Sleep guideline compliance ranged from 3 % to 83 % in toddler, 27 % to 92 % in preschooler, and 32 % to 90 % in school-aged children. These proportions were found to be significantly different (Cochran's Q and McNemar's tests).

CONCLUSIONS

Nearly all children met PA guidelines. In contrast, less than half to two-thirds met screen time guidelines. Compliance with sleep guidelines varied substantially with measurement method, highlighting the need for standardization.

Teachers' perception on physical activity promotion in kindergarten children in China: a qualitative study connecting social-ecological model

BACKGROUND

Globally, the majority of kindergarten-aged children face obesity issues and insufficient physical activity (PA) engagement. Regular PA participation can provide various health benefits, including obesity reduction, for kindergarten-aged children. However, limited studies have investigated the factors influencing kindergarten-aged children's PA engagement from the perspective of their teachers. This qualitative study aimed to identify factors that could help promote PA among kindergarten-aged children from teachers' perspectives, including facilitators, barriers, and teachers' recommendations.

METHODS

Fifteen kindergarten teachers (age range: 28-50 years; mean age: 38.53 years) with teaching experience ranging from 2 to 31 years (mean: 16.27 years) were recruited from Shanghai municipality, Henan, and Jiangsu provinces in China. One-on-one semi-structured interviews were conducted via face-to-face (n = 7) or telephone (n = 8) to gather insights into factors influencing PA promotion among kindergarten-aged children. The interviews were audio-recorded, transcribed, and analyzed using a constant comparison approach based on grounded theory, which involved open, axial, and selective coding processes.

RESULTS

The study revealed mutual theoretical support between themes and the social-ecological model (SEM), as factors identified in the study are distributed at various levels of the SEM. Twelve factors were identified at four levels of the SEM: (1) intrapersonal level (children's personality and skills), (2) interpersonal level (family, peers, and teachers influence), (3) organizational level (school environment and resources, opportunities for kindergarten teachers' training and children's PA, design and organization of PA, and PA that children need), (4) community level (family-school partnerships).

CONCLUSION

Various factors at different levels can influence kindergarten-aged children's PA. The study's findings revealed that these factors are distributed across the first four levels of SEM, with the majority being at the organizational level. These multilevel findings are expected to assist in developing and implementing more effective PA interventions for kindergarten-aged children. Future research is warranted to identify strategies for promoting PA among kindergarten-aged children at the policy level of the SEM.

Efficacy of a Physical Activity e-Learning Course Delivered to Early Childhood Educators on Preschoolers' Physical Activity and Sedentary Behaviors: A Cluster Randomized Controlled Trial

PURPOSE

This study examined the effectiveness of an early childhood educator (ECE)-focused physical activity e-Learning course on children's physical activity and sedentary time in childcare.

METHODS

A cluster randomized controlled trial was conducted in 12 childcare centers in London, Ontario, Canada. A total of 145 preschoolers and 42 ECEs participated in this study. ECEs in the intervention condition completed a 5-hour e-Learning course related to physical activity. Outcomes were preschoolers' minutes of moderate- to vigorous-intensity physical activity, light-intensity physical activity, and sedentary time assessed using accelerometers.

RESULTS

The intervention did not have a significant effect on moderate- to vigorous-intensity physical activity (d < 0.01, P = .984), light-intensity physical activity (d = -0.17, P = .386), or sedentary time (d = 0.07, P = .717) from baseline to postintervention. There was also no significant intervention effect on moderate- to vigorous-intensity physical activity (d = 0.27, P = .260), light-intensity physical activity (d = -0.08, P = .740), or sedentary time (d = -0.15, P = .520) from baseline to follow-up.

CONCLUSIONS

Providing ECEs with online training in physical activity through an e-Learning course may not be sufficient to increase physical activity levels among young children in their care. It may be essential to deliver multicomponent interventions to increase preschoolers' engagement in physical activity in childcare.

Prevalence and Correlates of Adherence to the Global Total Physical Activity Guideline Based on Step Counting Among 3- to 4-Year-Olds: Evidence From SUNRISE Pilot Studies From 17 Countries

BACKGROUND

There is limited evidence from globally diverse samples on the prevalence and correlates of meeting the global guideline of 180 minutes per day of total physical activity (TPA) among 3- to 4-year-olds.

METHODS

Cross-sectional study involving 797 (49.2% girls) 3- to 4-year-olds from 17 middle- and high-income countries who participated in the pilot phases 1 and 2 of the SUNRISE International Study of Movement Behaviours in the Early Years. Daily step count was measured using thigh-worn activPAL accelerometers. Children wore the accelerometers for at least one 24-hour period. Children were categorized as meeting the TPA guideline based on achieving ≥11,500 steps per day. Descriptive analyses were conducted to describe the proportion of meeting the TPA guideline for the overall sample and each of the sociodemographic variables, and 95% CIs were calculated. Multivariable logistic regression was used to determine the sociodemographic correlates of meeting the TPA guideline.

RESULTS

Mean daily step count was 10,295 steps per day (SD = 4084). Approximately one-third of the sample (30.9%, 95% CI, 27.6-34.2) met the TPA guideline. The proportion meeting the guideline was significantly lower among girls (adjusted OR [aOR] = 0.70, 95% CI, 0.51-0.96) and 4-year-olds (aOR = 0.50, 95% CI, 0.34-0.75) and higher among rural residents (aOR = 1.78, 95% CI, 1.27-2.49) and those from lower middle-income countries (aOR = 1.35, 95% CI, 0.89-2.04).

CONCLUSIONS

The findings suggest that a minority of children might meet the TPA guideline globally, and the risk of not meeting the guideline differed by sociodemographic indicators. These findings suggest the need for more surveillance of TPA in young children globally and, possibly, interventions to improve childhood health and development.

Associations Between Sedentary Time, Physical Activity, and Cardiovascular Health in 6-Year-Old Children Born to Mothers With Increased Cardiometabolic Risk

PURPOSE

To assess associations between sedentary time (ST), physical activity (PA), and cardiovascular health in early childhood.

METHOD

Cross-sectional study including 160 children (age 6.1 y [SD 0.5], 86 boys, 93 maternal body mass index ≥ 30 kg/m2, and 73 gestational diabetes) assessed for pulse wave velocity, echocardiography, ultra-high frequency 48-70 MHz vascular ultrasound, and accelerometery.

RESULTS

Boys had 385 (SD 53) minutes per day ST, 305 (SD 44) minutes per day light PA, and 81 (SD 22) minutes per day moderate to vigorous PA (MVPA). Girls had 415 (SD 50) minutes per day ST, 283 (SD 40) minutes per day light PA, and 66 (SD 19) minutes per day MVPA. In adjusted analyses, MVPA was inversely associated with resting heart rate (β = -6.6; 95% confidence interval, -12.5 to -0.7) and positively associated with left ventricular mass (β = 6.8; 1.4-12.3), radial intima-media thickness (β = 11.4; 5.4-17.5), brachial intima-media thickness (β = 8.0; 2.0-14.0), and femoral intima-media thickness (β = 1.3; 0.2-2.3). MVPA was inversely associated with body fat percentage (β = -3.4; -6.6 to -0.2), diastolic blood pressure (β = -0.05; -0.8 to -0.1), and femoral (β = -18.1; -32.4 to -0.8) and radial (β = -13.4; -24.0 to -2.9) circumferential wall stress in boys only. ST and pulse wave velocity showed no significant associations.

CONCLUSIONS

In young at-risk children, MVPA is associated with cardiovascular remodeling, partly in a sex-dependant way, likely representing physiological adaptation, but ST shows no association with cardiovascular health in early childhood.

The efficacy of the TEACH e-Learning course at improving early childhood educators' physical activity and sedentary behaviour self-efficacy, knowledge, intentions, and perceived behavioural control: a randomized controlled trial

BACKGROUND

Early childhood educators play a critical role in promoting physical activity and reducing sedentary time in childcare centres. However, early childhood educators receive limited specialised pre- and in-service learning opportunities relating to these behaviours and may lack the capacity to effectively engage children in healthy movement behaviours. This study aimed to examine the efficacy of an e-Learning course on increasing early childhood educators' physical activity and sedentary behaviour-related capacities.

METHODS

A two-group parallel randomized controlled trial was conducted with early childhood educators in Canada (Mage = 41.78, 97% female). Participants randomized to the intervention group were asked to complete a physical activity and sedentary behaviour e-Learning course within a 4-week period. Participants randomized to the waitlist control condition were assigned to a waitlist to receive the intervention after the testing period. Participants reported on their self-efficacy, knowledge, intentions, and perceived behavioural control relating to physical activity and sedentary behaviours at baseline, post-intervention, and 3 months follow-up. Linear mixed effects models were estimated to determine difference in changes in outcomes from baseline to post-intervention, and follow-up.

RESULTS

A total of 209 early childhood educators participated in the study (intervention n = 98; control n = 111). The TEACH e-Learning course was found to be efficacious at improving all of the examined outcomes, with standardized effect sizes ranging from d = 0.58 to d = 0.65 for self-efficacy outcomes, d = 0.66 to d = 1.20 for knowledge outcomes, d = 0.50 to d = 0.65 for intention outcomes, and d = 0.33 to d = 0.69 for perceived behavioural control outcomes post-intervention. The intervention effects were sustained at follow-up for all outcomes apart from perceived behavioural control to limit screen time. Additionally, the magnitude of the effect for knowledge outcomes decreased at follow-up, with standardized effect sizes ranging from d = 0.49 to d = 0.67.

CONCLUSIONS

The e-Learning course was highly successful at improving early childhood educators' capacity pertaining to physical activity and sedentary behaviours. Providing training content through e-Learning may be an efficacious approach to providing continual professional learning opportunities relating to physical activity and sedentary time to early childhood educators on a large scale.

Effects of a staff-led multicomponent physical activity intervention on preschooler's fundamental motor skills and physical fitness: The ACTNOW cluster-randomized controlled trial

BACKGROUND

Fundamental motor skills (FMS) and physical fitness (FIT) play important roles in child development and provide a foundation for lifelong participation in physical activity (PA). Unfortunately, many children have suboptimal levels of PA, FMS, and FIT. The Active Learning Norwegian Preschool(er)s (ACTNOW) study investigated the effects of a staff-led PA intervention on FMS, FIT, and PA in 3-5-year-old children.

METHODS

Preschools in Western Norway having ≥ six 3-4-year-old children were invited (n = 56). Of these, 46 agreed to participate and were cluster-randomized into an intervention (n = 23 preschools [381 children, 3.8 yrs., 55% boys]) or a control group (n = 23 [438, 3.7 yrs., 52% boys]). Intervention preschools participated in an 18-month PA intervention involving a 7-month staff professional development between 2019 and 2022, amounting to 50 h, including face-to-face seminars, webinars, and digital lectures. Primary outcomes in ACTNOW were cognition variables, whereas this study investigated effects on secondary outcomes. FMS was measured through 9 items covering locomotor, object control, and balance skills. FIT was assessed as motor fitness (4 × 10 shuttle-run test) and upper and lower muscular strength (handgrip and standing long jump). PA was measured with accelerometers (ActiGraph GT3X +). All measures took place at baseline, 7-, and 18-month follow-up. Effects were analysed using a repeated measures linear mixed model with child and preschool as random effects and with adjustment for baseline scores.

RESULTS

Participants in the intervention preschools showed positive, significant effects for object control skills at 7 months (standardized effect size (ES) = 0.17) and locomotor skills at 18 months (ES = 0.21) relative to controls. A negative effect was found for handgrip strength (ES = -0.16) at 7 months. No effects were found for balance skills, standing long jump, or motor fitness. During preschool hours, sedentary time decreased (ES = -0.18), and light (ES = 0.14) and moderate-to-vigorous PA (ES = 0.16) increased at 7 months, whereas light PA decreased at 18 months (ES = -0.15), for intervention vs control. No effects were found for other intensities or full day PA.

CONCLUSIONS

The ACTNOW intervention improved some FMS outcomes and increased PA short-term. Further research is needed to investigate how to improve effectiveness of staff-led PA interventions and achieve sustainable improvements in children's PA, FMS, and FIT.

TRIAL REGISTRATION

Clinicaltrials.gov, identifier NCT04048967 , registered August 7, 2019.

FUNDING

ACTNOW was supported by the Research Council of Norway (grant number 287903), the County Governor of Sogn og Fjordane, the Sparebanken Sogn og Fjordane Foundation, and the Western Norway University of Applied Sciences.

Study on the relationship and related factors between physical fitness and health behavior of preschool children in southwest China

OBJECTIVE

To investigate the physical fitness level and health behavior status of preschool children in China, explore the relationship between physical fitness and health behavior, and further reveal the main factors affecting health behavior, to provide a reference for improving the physical fitness level of preschool children and maintaining healthy behavior.

METHODS

A total of 755 preschool children (394 boys and 361 girls, aged 4.52 ± 1.11 years) were selected from Chongqing and Liupanshui in China by cluster random sampling method for questionnaire survey and physical monitoring, and SPSS21.0 software was used to process and analyze the data.

RESULTS

(1) Heart rate (p = 0.015), protein content (p < 0.001), and time spent on the balance beam (p < 0.001) were significantly lower in boys than in girls, while BMI (p = 0.012), muscle mass (p < 0.001), and distance of standing long jump (p < 0.001) were significantly higher in boys than in girls. Meanwhile, systolic blood pressure (p = 0.004) and diastolic blood pressure (p = 0.001) of rural children were significantly higher than those of urban children, while BMI (p < 0.001) and sitting forward flexion (p = 0.019) were significantly lower than those of urban children. (2) The light-intensity physical activity (LPA) and moderate to vigorous physical activity (MVPA) of boys were significantly higher than that of girls (p < 0.001), and the MVPA of urban children was significantly higher than that of rural children (p = 0.001), and the former participated in sports classes more frequently (p < 0.001). (3) There was a significant correlation between physical activity (PA) and physical fitness indicators of preschoolers. Participating in sports interest classes was only significantly correlated with systolic blood pressure (r = 0.08) and sitting forward flexion (r = 0.09). (4) The PA level of preschool children was related to gender, household registration, kindergarten nature, age, residence environment, parental support, and participation degree. Participation in sports interest classes was related to gender, the nature of the kindergarten, household registration, age, and parent participation. Daily screen time was related to household registration, the nature of the kindergarten, the environment of residence, and the value perception of parents.

CONCLUSIONS

There were different degrees of correlation between preschool children's physical fitness and health behaviors, and children's health behaviors were closely related to gender, environment, parents, and other factors. Therefore, how to increase the protective factors of children's health behaviors and controlling the risk factors may be crucial to promoting the development of good health behaviors and improving the physical fitness of preschool children.

Tummy Time Tracking: Examining Agreement Between Parent Recall and Direct Observation in Infants

IMPORTANCE

Parent recall is the primary method for measuring positioning practices such as tummy time in infants. Concerns regarding the accuracy of parent recall have been raised in the literature. To date, no study has examined the agreement of tummy time recall measures with gold-standard methods.

OBJECTIVE

To assess the agreement between parental recall versus direct observation of tummy time in infants, and to explore the impact of prematurity on this relationship.

DESIGN

Cross-sectional observational study, spanning 1 yr.

SETTING

Participants' homes Participants: Thirty-two infant-parent dyads (19 full-term, 13 preterm), with infants ages 3 to 6 mo and caregivers ages older than 18 yr.

OUTCOME AND MEASURES

Home-recorded videos of infant play across 3 days were used as a proxy for direct observation of tummy time and compared with a 12-item parent recall survey.

RESULTS

Parent recall had a significant moderate correlation (ρ = .54, p = .002) with direct observation in full-term infants but was not correlated (p = .23) with direct observation in preterm infants. On average, parents of preterm infants overestimated tummy time by 2.5 times per day compared with direct observation.

CONCLUSIONS AND RELEVANCE

For full-term infants, parent recall measures of tummy time exhibit an acceptable level of agreement with direct observation and can be reliably used over shorter periods. Parents of preterm infants may display a bias in recalling tummy time, leading to overestimations. To accurately assess tummy time in this population, a combination of subjective and objective measures should be explored. Plain-Language Summary: Tummy time is an essential movement experience for infants, especially for preterm infants, who are at a higher risk for motor delays. The most common way to track tummy time is through parent reports, or recall, versus a practitioner directly observing tummy time in the home. Despite the widespread use of parent recall to track tummy time, no study has examined the accuracy of parent recall versus direct observation in the home. Accurately assessing tummy time is crucial for improving and supporting health outcomes for infants. This study found that prematurity may affect the accuracy of parent recall for assessing tummy time in young infants. The authors discuss the implications of this finding and provide suggestions to guide the selection of appropriate methods to measure tummy time in clinical practice and research studies.

Prevalence of meeting 24-hour movement guidelines and its associations with health indicators in people with disabilities: A systematic review and meta-analysis

BACKGROUND

Meeting the 24-h movement guidelines (i.e., physical activity, sedentary behavior, sleep) could generate health benefits to people with disabilities. However, no systematic reviews or meta-analyses have examined the prevalence of meeting these guidelines and associations with health indicators in this group.

OBJECTIVE

This systematic review and meta-analysis aimed to examine the prevalence of meeting the 24-h movement guidelines and associations with health indicators among people with disabilities.

METHODS

Six electronic databases were searched for studies published in English from inception to May 31, 2023. Meta-analyses with the random-effects model were used to determine the prevalence of meeting the 24-h movement guidelines. Qualitative syntheses were employed to describe the associations between meeting the guidelines and health indicators.

RESULTS

Twenty-four studies comprising 77510 participants (41.6% females) with disabilities aged 6-65 years from eight countries were identified. Overall, 6.97% of the participants with disabilities met all 24-h movement guidelines, and 16.65% met none of the guidelines. Significant age (P = 0.006) and disability type (P = 0.001) differences were found in meeting all guidelines. Participants with disabilities who met all guidelines reported better psychosocial health indicators (9/9 studies) than those met none or only one of the guidelines. There was limited evidence or research for other health indicators.

CONCLUSION

There is some evidence showing that the prevalence of meeting all 24-h movement guidelines in people with disabilities is low. Meanwhile, there is preliminary evidence suggesting that meeting all guidelines is associated with better psychosocial health than meeting none of the guidelines.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Acquisition and Retention Effects of Fundamental Movement Skills on Physical Activity and Health-Related Fitness of Children with Autism Spectrum Disorder

This study adopted a quasi-experimental design to explore the effects of fundamental movement skill intervention on the acquisition and retention of physical activity levels and health-related fitness in children with autism spectrum disorder (ASD). In the experiments, 11 children received fundamental motor skill training (12 weeks, 60 min/session, 4 times/week), and 10 children maintained traditional physical activity. Assessments were performed using an ActiGraph GT3X+ accelerometer, health-related fitness pre-post intervention, and 1-month follow-up tests. The sedentary time during physical activity was significantly decreased (p = 0.01), and there were large changes in health-related physical fitness indicators, including significantly improved body composition (body mass index, F(1,19) = 8.631, p = 0.03, partial η2 = 0.312), muscle strength and endurance (sit-ups, F(1,19) = 3.376, p = 0.02, partial η2 = 0.151 and vertical jumps, F(1,19) = 5.309, p = 0.04, partial η2 = 0.218), and flexibility (sit and reach, F(1,19) = 36.228, p = 0.02, partial η2 = 0.656). Moreover, the follow-up tests showed that the children's sedentary time continued to reduce, and the muscle strength and endurance (sit-ups, F(1,19) = 4.215, p = 0.01, partial η2 = 0.426) improved continuously after the intervention. Based on this study, actionable and regular fundamental movement skill programs can be provided in the future as an effective way to achieve the healthy development goals of children with ASD.

Compliance with the 24-h movement behaviors guidelines among urban and rural Brazilian preschoolers

BACKGROUND

The importance of movement behaviors for health is well-known, although few studies have examined the compliance with movement guidelines in preschoolers from different living contexts. This study reported the compliance with the 24-h movement behaviors guidelines among low-income Brazilian preschoolers from rural and urban areas, according to age.

METHODS

A total of 453 preschoolers (n = 222 urban), aged between 3 and 5 years, provided physical activity (PA) data (Actigraph wGT3X). Sleep duration, and screen time were parent-reported. Preschoolers were classified as compliant/non- compliant with the 24-h movement guidelines, according to age. The association between prevalence of compliance with the recommendations and the children's living setting were estimated (SPSS; 27.0).

RESULTS

Preschoolers were active (mean = 299.19 ± 76.42; and 369.76 ± 95.56 min/day in urban and rural areas, respectively), though moderate-to-vigorous physical activity (MVPA) time was below the 60 daily minutes recommended in both urban and rural settings (mean = 38.39 ± 21.36; and 47.32 ± 24.28, respectively). None of the urban children complied with the three recommendations simultaneously, while in the rural area, only 2.6% were compliant. Single movement behaviors compliances in the urban setting were 6.8%, 28.8% and 5.4% for PA, sleep, and screen time, respectively; while for rural settings were 16.5%, 21.2%, and 7.4%. Living in the rural area was related to the compliance with PA recommendation for the 5-year-old preschoolers.

CONCLUSION

In both urban and rural Brazilian areas, very few preschoolers are compliant with the guidelines, and more than one third of the children do not comply with any of the recommendations. Strategies and programs to promote compliance with movement behaviors guidelines should consider children's living setting and their age groups.

The Effectiveness of Physical Activity Policies in Center-Based Childcare: A Systematic Review and Meta-Analysis

Purpose: Many young children spend a significant portion of time in center-based childcare settings; however, these children are often not sufficiently active during care. Promoting physical activity through policy implementation is one mechanism which has the potential to increase physical activity. The purpose of this systematic review and meta-analysis was to provide an overview of physical activity policies implemented in childcare centers and determine their effect on children's physical activity. Methods: Electronic searches were conducted in CINAHL, Medline, PsycINFO, EMBASE, Scopus, SPORTDiscus, and Sports Medicine and Education Database. Two reviewers independently examined 3,286 articles to find peer-reviewed, original studies that assessed the impact of physical activity policies on children's physical activity. Random effects meta-analyses were used to determine the impact of policies. Results: A total of 13 articles met the inclusion criteria; in which 12 unique policies were implemented. Results of the meta-analyses suggest that introducing new physical activity policies did not increase children's moderate-to-vigorous physical activity (MVPA); however, compared to centers without a formalized physical activity policy, children in centers with a formalized policy engaged in significantly more MVPA and total physical activity. Conclusions: Introducing new physical activity policies alone may not be sufficient to increase children's engagement in physical activity, and it may be important to combine with capacity-building initiatives for childcare staff and early childhood educators. Results reinforce the value of childcare centers implementing their own formalized physical activity policies to support children's physical activity, which highlights the importance of regulating physical activity practices in childcare. Registration: CRD42022326037.

Effect of capacity building interventions on classroom teacher and early childhood educator perceived capabilities, knowledge, and attitudes relating to physical activity and fundamental movement skills: a systematic review and meta-analysis

BACKGROUND

Capacity building may play an important role in improving classroom teachers' and early childhood educators' (ECE) capacity to implement physical activity and FMS interventions. Capacity building is the development of knowledge, skills, and structures to improve the capability of individuals and organisations to achieve effective health promotion. This review aimed to determine the efficacy of capacity building interventions on teachers' and ECEs' perceived capabilities, knowledge, and attitudes relating to physical activity and fundamental movement skills.

METHODS

An exhaustive literature search of six electronic databases was conducted. Controlled, single-group pre-post studies were included if they measured the effect of a capacity building intervention on in-service or pre-service classroom teachers' (primary or secondary) or ECEs' physical activity or fundamental skills related perceived capabilities, knowledge, or attitudes. The effects of interventions were synthesised using random effects meta-analysis. Subgroup analysis and meta-regression was conducted to determine if the effects differed based on study design, type of teacher (ECE vs. primary school), or teacher level (pre-service vs. in-service).

RESULTS

A total of 22 studies reporting on 25 unique samples were included in the meta-analyses. Only studies reporting on ECEs and primary school teachers were identified. Interventions most commonly included training/professional development, resources and toolkits, communities of practice, mentorships, and ongoing support. Results showed that capacity building interventions significantly improved teachers' and ECEs' perceived capabilities (g = 0.614, 95% CI = 0.442, 0.786), knowledge (g = 0.792 95% CI = 0.459, 1.125), and attitudes (g = 0.376 95% CI = 0.181, 0.571). The effects did not differ significantly as a function of any of the moderators examined.

CONCLUSION

Findings from this review provide strong support that capacity building interventions are efficacious at improving teachers' and ECEs' perceived capabilities, knowledge, and attitudes related to promoting physical activity and teaching fundamental movement skills. Pre-service teachers and ECEs should be provided training in physical activity and fundamental movement skills as part of their degrees, and continual professional development and capacity building should be offered to in-service teachers and ECEs to promote physical activity and fundamental movement skills in children.

Differences and Relationship between Body Composition and Motor Coordination in Children Aged 6-7 Years

BACKGROUND

The primary goal of this study was to investigate the relationship between body composition and motor coordination performance, and the secondary goal was to determine sex differences in body composition and motor coordination of preschool children.

METHODS

Forty-eight children (23 boys and 25 girls) underwent assessments for body composition and motor coordination using the Köperkoordinationstest für Kinder (KTK).

RESULTS

Linear regression analysis revealed significant associations between body composition and motor coordination in boys (p < 0.05) but not in girls. In boys, Body height (p = 0.01), Total muscle mass (p = 0.03), Total fat (p = 0.03), and Total water (p = 0.02) show statistically significant influence on single-leg jumps. Similar results were obtained for lateral jumps where there was a statistically significant influence of Body height (p = 0.01), Total muscle mass (p = 0.03), and Total water (p = 0.02). Interestingly, predictive variables showed no statistically significant influence on KTK overall score in boys (p = 0.42) nor in girls (p = 0.90).

CONCLUSIONS

The predictive system of morphological variables demonstrated significance only among boys in this age group and sample. Girls outperformed boys due to early maturation, resulting in better average KTK scores.

Physical activity, sedentary behaviour, and sleep knowledge and self-efficacy among parents of young children in Canada

Background

Engaging in healthy movement behaviours in early childhood is beneficial for children's development, and parents play a critical role in shaping movement habits during these formative years. This study aimed to explore parents' knowledge of the Canadian 24-Hour Movement Guidelines for the Early Years (The Guidelines) and their perceived knowledge and self-efficacy of movement behaviour concepts in early childhood. The influence of sociodemographic characteristics on these variables was also examined.

Methods

Via a cross-sectional online survey with parents/guardians (n = 576) of young children in Canada, participants' knowledge of The Guidelines (11 items), and perceived knowledge (11 items; 5-point scale) and self-efficacy (11 items; 11-point scale) of movement behaviour concepts in early childhood were examined. Descriptive statistics were calculated for independent variables and multivariate regression models were estimated to examine sociodemographic factors that were associated with participants' knowledge and self-efficacy.

Results

Few participants (11.9%) reported to be familiar with The Guidelines. Parents were most knowledgeable about the screen time guideline for children under 2 years (75.0% correctly identified the guideline) and least familiar with the recommendation for toddler/preschooler total physical activity (14.7% correctly identified the guideline). Parents/guardians perceived they were the most knowledgeable about safe sleep practices (65.9% very/extremely knowledgeable) and least knowledgeable about muscle- and bone-strengthening activities (71.8% not at all/somewhat knowledgeable). Overall, parents/guardians were moderately confident in promoting healthy movement behaviours (M = 6.01; SD = 1.73). Participants with higher levels of education reported significantly higher perceived knowledge compared to those who were less educated (p = .004), and parents/guardians identifying as White reported significantly higher levels of self-efficacy compared to parents/guardians from minority ethnic groups (p = .028). Finally, parents/guardians who were more physically active reported both higher perceived knowledge (p < .001) and self-efficacy (p < .001) than those who were less active.

Conclusion

These findings shed light on the need to raise awareness of The Guidelines among parents of young children and highlight specific movement behaviour concepts in need of focus in future training for this population. Targeted education for parents/guardians from lower socioeconomic groups is also needed to address equity concerns.

Supplementary Information

The online version contains supplementary material available at 10.1186/s44167-024-00051-x.

A lifestyle screening tool for young children in the community: needs and wishes of parents and youth healthcare professionals

BACKGROUND

Youth healthcare has an important role in promoting a healthy lifestyle in young children in order to prevent lifestyle-related health problems. To aid youth healthcare in this task, a new lifestyle screening tool will be developed. The aim of this study was to explore how youth healthcare professionals (YHCP) could best support parents in improving their children's lifestyle using a new lifestyle screening tool for young children.

METHODS

We conducted four and seven focus groups among parents (N = 25) and YHCP (N = 25), respectively. Two main topics were addressed: the experiences with current practice of youth healthcare regarding lifestyle in young children, and the requirements for the lifestyle screening tool to be developed. The focus groups were recorded, transcribed verbatim and analysed using an inductive approach.

RESULTS

Both parents and YHCP indicated that young children's lifestyles are often discussed during youth healthcare appointments. While parents felt that this discussion could be more in-depth, YHCP mainly needed clues to continue the discussion. According to parents and YHCP, a new lifestyle screening tool for young children should be easy to use, take little time and provide courses of action. Moreover, it should be attractive to complete and align with the family concerned.

CONCLUSIONS

According to parents and YHCP, a new lifestyle screening tool for young children could be useful to discuss specific lifestyle topics in more detail and to provide targeted advice.

Exploring Factors Associated With Accelerometer Validity Among Ethnically Diverse Toddlers

PURPOSE

Studying physical activity in toddlers using accelerometers is challenging due to noncompliance with wear time (WT) and activity log (AL) instructions. The aims of this study are to examine relationships between WT and AL completion and (1) demographic and socioeconomic variables, (2) parenting style, and (3) whether sedentary time differs by AL completion.

METHODS

Secondary analysis was performed using baseline data from a community wellness program randomized controlled trial for parents with toddlers (12-35 mo). Parents had toddlers wear ActiGraph wGT3x accelerometers and completed ALs. Valid days included ≥600-minute WT. Analysis of variance and chi-square analyses were used.

RESULTS

The sample (n = 50) comprised racial and ethnically diverse toddlers (mean age = 27 mo, 58% male) and parents (mean age = 31.7 y, 84% female). Twenty-eight families (56%) returned valid accelerometer data with ALs. Participants in relationships were more likely to complete ALs (P < .05). Toddler sedentary time did not differ between those with ALs and those without.

CONCLUSIONS

We found varied compliance with WT instructions and AL completion. Returned AL quality was poor, presenting challenges in correctly characterizing low-activity counts to improve internal validity of WT and physical activity measures. Support from marital partners may be important for adherence to study protocols.