The fundamental motor skill proficiency among Polish primary school-aged children: A nationally representative surveillance study

OBJECTIVES

With the premise that physical education classes should promote physical activity by teaching and learning fundamental motor skills, this study aimed to evaluate the fundamental motor skill proficiency of primary school students and determine the level of achievement of established learning outcomes for fundamental motor skills, as specified in the Polish National Physical Education Curriculum.

DESIGN AND METHODS

A cross-sectional design was used for this study. The sample consisted of 2605 children and adolescents enrolled in grades 1-3 (ages 7-9, n = 1165), 4-6 (ages 10-12, n = 837), and 7-8 (ages 13-14, n = 603), including 1353 boys and 1252 girls. The Fundamental Motor Skills in Sport test, a qualitative and process-oriented assessment tool, was used to evaluate fundamental motor skills. The Fundamental Motor Skills in Sport test evaluates the following movement skills: hurdles, jumping rope, forward roll, ball bouncing, ball throwing and catching, and kicking and stopping a ball.

RESULTS

The desired level of overall fundamental motor skill proficiency was achieved by only 2 % of students. An elementary level of fundamental motor skill proficiency was demonstrated by an additional 3.5 % of students. Further, the results showed that only 10-30 % of students had achieved mastery or were close to achieving mastery in a given fundamental motor skill. The skill with the lowest level of proficiency was jumping rope, which only 11 % of students had mastered or were near to mastering.

CONCLUSIONS

The present study of a large, nationally representative sample of primary school students in Poland indicates that the vast majority (approximately 94 %) of them demonstrated insufficient fundamental motor skill proficiency. This may greatly hinder effective, safe, and healthy participation in lifelong physical activity.

Associations among Motor Competence, Physical Activity, Perceived Motor Competence, and Aerobic Fitness in 10-15-Year-Old Youth

(1) Background: The developmental model describes possible mechanisms that could impact the trajectory of children and adolescents' health behaviors related to obesity; however, few data are available that support this model in the adolescent population. This study investigated the associations among motor competence (MC), moderate-to-vigorous physical activity (MVPA), perceived motor competence (PMC), and aerobic fitness in children and adolescents and the mediating and moderating effects of PMC, aerobic fitness, and weight status on the MC-MVPA relationship. (2) Methods: Participants included 47 adolescents (12.2 ± 1.6 y; 55% male) who completed the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition (MC), Harter's perceived self-competency questionnaire (PMC), and the PACER test (aerobic fitness) and whose MVPA was measured via accelerometry. The body mass index (BMI) was calculated from measured height and weight. (3) Results: There were positive correlations between MC and fitness [rs(47) = 0.469, p < 0.01], PMC and fitness [rs(47) = 0.682, p < 0.01], and PMC and MC [rs(47) = 0.416, p < 0.01]. There were no associations among MVPA and MC, PMC, or fitness (p > 0.05). There were inverse associations between BMI and both MVPA [rs(44) = -0.410, p < 0.01] and fitness [rs(47) = 0.295, p < 0.05]. The association between MC and MVPA was mediated by fitness (β = 0.3984; 95% CI (0.0564-0.7985)). (4) Conclusions: The associations among MC, PMC, and fitness highlight the critical role of MC in health and partially support the proposed developmental model concerning the relationships that exist among MC, MVPA, PMC, fitness, and BMI.

Motor Competence and Body Mass Index in the Preschool Years: A Pooled Cross-Sectional Analysis of 5545 Children from Eight Countries

BACKGROUND AND OBJECTIVE

One in five preschool children are overweight/obese, and increased weight status over time increases the risks of poorer future health. Motor skill competence may be a protective factor, giving children the ability to participate in health-enhancing physical activity. Yet, we do not know when the relationship between motor competence and weight status first emerges or whether it is evident across the body mass index (BMI) spectrum. This study examined the association between motor skill competence and BMI in a multi-country sample of 5545 preschoolers (54.36 ± 9.15 months of age; 50.5% boys) from eight countries.

METHODS

Quantile regression analyses were used to explore the associations between motor skill competence (assessed using the Test of Gross Motor Development, Second/Third Edition) and quantiles of BMI (15th; 50th; 85th; and 97th percentiles), adjusted for sex, age in months, and country.

RESULTS

Negative associations of locomotor skills, ball skills, and overall motor skill competence with BMI percentiles (p < 0.005) were seen, which became stronger at the higher end of the BMI distribution (97th percentile). Regardless of sex, for each raw score point increase in locomotor skills, ball skills, and overall motor skill competence scores, BMI is reduced by 8.9%, 6.8%, and 5.1%, respectively, for those preschoolers at the 97th BMI percentile onwards.

CONCLUSIONS

Public health policies should position motor skill competence as critical for children's obesity prevention from early childhood onwards. Robust longitudinal and experimental designs are encouraged to explore a possible causal pathway between motor skill competence and BMI from early childhood.

The fus test: a promising tool for evaluating fundamental motor skills in children and adolescents

Fundamental motor skills (FMS) are essential for enjoyable, confident and skillful participation in physical activity across the lifespan. Due to the alarming low level of FMS proficiency in children and adolescents worldwide, the development of motor competency is an urgent issue for physical education. The promotion and implementation of a systematic process of teaching and learning FMS should be a physical education priority. Accordingly, effective assessment tools for evaluating FMS should be adopted or developed. Because FMS assessment for both children and adolescents need further effective solutions, the primary aim of this study was to develop the new age-related test of FMS (Fundamental Motor Skills in Sport test, in Polish: Test Fundamentalnych Umiejętności Ruchowych w Sporcie, FUS). The secondary aim of this study was to establish validity and inter-rater, intra-rater, test-retest reliabilities and internal consistency of the FUS test. The FUS test involves six sport skill-based tasks: hurdling, jumping rope, forward roll, ball bouncing, throwing and catching a ball, and kicking and stopping a ball. Two hundred sixty-four Polish students in grades 1-3 (7-9 yrs; n = 81), 4-6 (10-12 yrs; n = 89) and 7-8 (13-14 yrs; n = 94), including 139 girls and 125 boys completed the FUS test. The content validity index for all items was notably high. Both inter-rater and intra-rater reliability showed substantial to almost perfect agreement, with observed agreements for FUS skills between 78.5 and 93.1%. Ball bouncing had a moderate correlation with the forward roll and throwing and catching, while other correlations were low or insignificant. ICC values, ranging from 0.95 to 0.97, confirmed excellent test-retest reliability. The results of our study provide evidence that the FUS test is valid, reliable, and feasible to administer in school settings. Therefore, this tool test has the potential to support deliberate practice and improve motor competence by providing a standardized and structured approach to measuring FMS among school-aged children and adolescents.

Painted playgrounds for preschoolers' physical activity and fundamental motor skill improvement: a randomized controlled pilot trial of effectiveness

BACKGROUND

Preschool children are not meeting recommended levels of physical activity (PA) nor are they proficient in fundamental motor skills (FMS), which are the foundation for PA. As such, interventions are needed to increase PA and FMS in young children. This trial examined the effects of an environmental ("painted playgrounds") and capacity-building (written toolkit) intervention on child FMS, PA, and sedentary behavior at early childhood education (ECE) centers and examined feasibility.

METHODS

In a randomized controlled trial, four ECE centers were randomly assigned to an intervention group or wait-list control. For intervention centers, stencils were spray painted adjacent to playgrounds and teachers were provided material for using stencils for FMS practice. Follow-up assessments were conducted six to eight weeks after baseline. Time spent in PA and sedentary behavior was assessed via accelerometry and FMS were evaluated using the Test of Gross Motor Development (TGMD-3) at baseline and follow-up. A repeated measures linear model was performed to test the effects of the painted playgrounds on the primary outcomes of interest. Feasibility was measured by stencil engagement via direct observation and satisfaction surveys.

RESULTS

A total of 51 preschoolers completed baseline assessments (4.3±0.6 years; 43.1% male). There were no significant changes in PA or sedentary behavior (all confidence intervals contain 0) between control and intervention groups. Intervention children significantly improved ball skill, locomotor, and overall TGMD-3 percentile scores at follow-up (all (all confidence intervals contain 0), which was not observed in control group. However, there was no significant change in FMS between the control and intervention groups (confidence intervals contain 0). For stencil use, boys and girls interacted with different stencils during their free play. Directors and teachers reported children incorporated academic concepts and initiated games, and teachers prompted more PA opportunities on the playground.

CONCLUSIONS

This intervention did not show statistically significant changes in children's PA, FMS, or sedentary behavior compared to a control group; however, small FMS improvements for the intervention group were found from baseline to follow-up. Further work should examine intervention fidelity as well as inexpensive supplies, teacher training, or other strategies to increase preschool children's PA and improve FMS at ECE centers.

Validation of remote assessment of preschool children's anthropometrics and motor skills

Introduction

Remotely delivered treatment and research procedures were rapidly adopted in response to the COVID-19 pandemic. However, it is unclear if these measures are valid. The purpose of this study was to compare the validity of anthropometry and motor skill proficiency measurements collected in a remote-setting to in-person setting among a sample of children ages 3-4 years.

Methods

Child anthropometry and motor skill performance were measured in-person by trained assessors and by parents at home with remote supervision via videoconference by trained assessors. The following measures from the National Institutes of Health Toolbox were collected: anthropometry (height and weight), manual dexterity/manipulation (9-hole pegboard), motor coordination and agility (supine timed up and go), lower body strength (standing long jump), and postural stability (one-leg standing balance). Differences in expert and parent-based measurements were assessed using Bland-Altman plots, paired samples t-tests, and Pearson correlations.

Results

A total of n = 14 children completed the assessments. No significant differences were observed between measurement locations for weight and motor skills (p > .05). Remote measurement of height (M = 101.1 cm, SD = 5.40) was significantly greater than in-person measurements (M = 98.2 cm, SD = 5.16); p < .0001.

Discussion

Remote measurements of motor skills and weight are valid assessments for researchers and clinicians to utilize in young children. Remote assessment with guidance offers comparable and valid estimates as in-person assessment, potentially offering a solution to resource-constricted barriers in research and access to care. There is an opportunity for researchers to fine-tune remote height and individual-level assessment strategies.

mHealth Intervention for Motor Skills: A Randomized Controlled Trial

BACKGROUND AND OBJECTIVES

Children's motor skills are a critical foundation for physical activity. The objective was to determine the effectiveness and feasibility of a mobile app-based intervention delivered to parents to improve preschoolers' motor skills.

METHODS

This randomized controlled trial randomly assigned children to : (1) Motor Skills, including instructional lessons, peer modeling videos, behavioral scaffolding, and structured activities or 2) Free Play. Both groups received a 12-week app-based intervention informed by social cognitive theory to deliver 12 hours (12-minutes per day, 5× per week) of instruction. The children were aged 3 to 5 y; parents and children had no mobility impairments. The primary outcome variables were children's motor skills percentile score assessed with the Test of Gross Motor Development, third edition (TGMD-3) at baseline, end-of-intervention (week 12), and follow-up (week 24); and feasibility and acceptability.

RESULTS

Seventy-two children (4.0 ± 0.8 y) participated. Between baseline and week 12, children in the Motor Skills condition significantly improved total TGMD-3 percentile (+13.7 Motor Skills vs -5.3 Free Play, P < .01), locomotor skills percentile (+15.5 Motor Skills vs -4.8 Free Play, P < .01), and ball skills percentile (+8.3 Motor Skills vs -7.3 Free Play, P < .01) compared with children in the comparator group. Significant differences were sustained at follow-up (week 24). Adherence did not significantly differ between conditions (71% for Motor Skills; 87% for Free Play). Parents in both arms reported high scores on satisfaction, helpfulness, and ease of use.

CONCLUSIONS

Clinicians and educators may encourage parents to enhance their child's motor skills through structured at-home programs.

Fundamental Motor Skill Delays in Preschool Children With Disabilities: 2012 National Youth Fitness Survey

Delays in fundamental motor skill (FMS) competency have been observed in a variety of children with disabilities. However, evidence of FMS delays is largely limited to small, geographically specific, limitedly diverse, and non-representative samples. The purpose of this study was to examine the association between FMS competency and reported disability status among pre-school children, ages 3–5 years, using the 2012 National Youth Fitness Survey (NYFS). In total, 329 preschool children (49% female; 4.00 ± 0.04 years of age) from the 2012 NYFS completed the Test of Gross Motor Development−2, including 43 preschoolers identified with a disability based on parental report (44% female; 4.20 ± 0.16 years). Associations were examined with logistic regression using sampling weights. Poor FMS competency, defined as gross motor quotient scores ≤ 79, was observed in significantly more children with disabilities (29%) than children without disabilities (10%, OR = 3.5, p = 0.04). While not statistically significant, there was a growing disparity in FMS competency at age 5 (41 vs. 11%) compared to age 3 (15 vs. 9%, OR = 1.80, p = 0.30). The results provide additional evidence for poor FMS competency among pre-school children with disabilities. FMS should be an early part of comprehensive assessments for all children suspected of disability or development delay as it is critical to identify and intervene upon FMS delays before discrepancies can widen.

Cross-sectional examination of 24-hour movement behaviours among 3- and 4-year-old children in urban and rural settings in low-income, middle-income and high-income countries: the SUNRISE study protocol

INTRODUCTION

24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap.

METHODS AND ANALYSIS

SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study.

ETHICS AND DISSEMINATION

The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminated via publications, conference presentations and may contribute to the development of local guidelines and public health interventions.

Associations between body composition and fundamental motor skill competency in children

Background

Evidence supports an inverse relationship between weight status and motor competence, but most work utilizes body mass index as the proxy for weight status. Body mass index fails to account for essential components of body composition, which may be critical for motor performance. The purpose of this investigation was to examine the relationship between fundamental motor skills competency and body composition (i.e., fat mass, fat percentage, and fatfree mass) as measured by bio-electrical impedance analysis and body mass index in children.

Methods

Two hundred forty-four children from the Southeastern portion of the United States participated in this project (6.05 ± 2.01 years, 53.3% male). Fundamental motor skills were measured using the Test of Gross Motor Development – 2nd edition and body composition was assessed with the Tanita SC-331S Body Composition Analyzer (bio-electrical impedance analysis). Body mass index was calculated using CDC normative growth charts.

Results

Bio-electrical impedance analysis measures accounted for 23.1%, F(3, 241) = 24.10, p < .001 and 2.7%, F(3, 241) = 2.22, p = .086 variance in locomotor and object control subscales, respectively; body mass index accounted for 8.4% (locomotor) and 0.1% (object control) variance. For the Test of Gross Motor Development -2nd edition total score, bio-electrical impedance analysis measures accounted for 24.4% F(3, 241) = 25.90, p < .001 compared to body mass index which accounted for 7.9% F(1, 244) = 20.86, p < .001 of the variance. Only fat free mass (p < .001) was a significant predictor for locomotor skills and total models for the Test of Gross Motor Development – 2nd edition; BMI was also a significant predictor (p < .001) in both the locomotor and total models.

Conclusions

Different components of body composition (i.e., fat free mass) were associated with different aspects of fundamental motor skills competency. Excess body fat may be a morphological constraint to proficient locomotor performance when transporting the body through space. In contrast, body composition did not significantly predict object manipulation performance. More work is needed to understand the causality and directionality of this relationship; however, bio-electrical impedance analysis accounts for more variance in fundamental motor skills performance than body mass index in a field-based setting.

Global effect of COVID-19 pandemic on physical activity, sedentary behaviour and sleep among 3- to 5-year-old children: a longitudinal study of 14 countries

BACKGROUND

The restrictions associated with the 2020 COVID-19 pandemic has resulted in changes to young children's daily routines and habits. The impact on their participation in movement behaviours (physical activity, sedentary screen time and sleep) is unknown. This international longitudinal study compared young children's movement behaviours before and during the COVID-19 pandemic.

METHODS

Parents of children aged 3-5 years, from 14 countries (8 low- and middle-income countries, LMICs) completed surveys to assess changes in movement behaviours and how these changes were associated with the COVID-19 pandemic. Surveys were completed in the 12 months up to March 2020 and again between May and June 2020 (at the height of restrictions). Physical activity (PA), sedentary screen time (SST) and sleep were assessed via parent survey. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Compliance with the World Health Organizations (WHO) Global guidelines for PA (180 min/day [≥60 min moderate- vigorous PA]), SST (≤1 h/day) and sleep (10-13 h/day) for children under 5 years of age, was determined.

RESULTS

Nine hundred- forty-eight parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (Adjusted Odds Ratio [AdjOR] = 2.0, 95%Confidence Interval [CI] 1.0,3.8) and SST (AdjOR = 2.2, 95%CI 1.2,3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO Global guidelines (AdjOR = 3.3, 95%CI 1.1,9.8) than those who were not. Children of parents with higher compared to lower stress were less likely to meet all three guidelines (AdjOR = 0.5, 95%CI 0.3,0.9).

CONCLUSION

PA and SST levels of children from LMICs have been less impacted by COVID-19 than in HICs. Ensuring children can access an outdoor space, and supporting parents' mental health are important prerequisites for enabling pre-schoolers to practice healthy movement behaviours and meet the Global guidelines.

Intervention to Improve Preschool Children's Fundamental Motor Skills: Protocol for a Parent-Focused, Mobile App-Based Comparative Effectiveness Trial

Background

Preschool age is an important time to master fundamental motor skills (FMS) through structured physical activity, yet many young children lag behind in motor skill development.

Objective

The Promoting Lifelong Activity in Youth (PLAY) study is a pilot comparative effectiveness trial to test the acceptability, feasibility, and preliminary effectiveness of a mobile app delivered to parents to promote FMS development in their preschool children (aged 3-5 years).

Methods

We conducted a 2-arm, parallel-design, randomized comparative effectiveness trial in 72 parent-child dyads from the southeastern United States. Experts in motor development and developmental psychology developed an app designed to deliver a 12-week program to parents of preschoolers using 1 of 2 curricula: an FMS program (intervention) that involved peer modeling, parent engagement, and structured skills-based activities and an unstructured physical activity (comparator) curriculum that provided suggestions for child-led physical activity (ie, free play). Primary outcomes are feasibility and acceptability of the app and child’s FMS measured at end of intervention (week 12). Exploratory outcomes are child’s objective physical activity, perceived movement competence, and parent report of self-regulation at the end of treatment (week 12) and sustained outcomes at follow-up (week 24).

Results

This project was funded in September 2018, with institutional review board approval in August 2018. Data collection took place from May 2019 through February 2020. To date, the project team has completed data collection on 69 preschool-age children, and results are expected to be published by 2021.

Conclusions

The PLAY study examines the feasibility and preliminary effectiveness of a mobile app, parent-led curricula to promote FMS proficiency for preschool children. If found to be effective, the app has the potential for wide-scale dissemination to parents of preschoolers and to provide a model for the utilization of mobile apps to promote young children’s motor skill development.

Trial Registration

ClinicalTrials.gov NCT03901300; https://clinicaltrials.gov/ct2/show/NCT03901300

International Registered Report Identifier (IRRID)

DERR1-10.2196/19943

Bifactor structure and model reliability of the Test of Gross Motor Development - 3rd edition

OBJECTIVES

This study investigated the structure of the Test of Gross Motor Development - 3rd edition (TGMD-3). Specifically, we examine bifactor structure, which simultaneously models a fundamental motor skills (FMS) general factor and specific factors for locomotor skills and ball skills, compared to other models.

DESIGN

Cross-sectional design using the TGMD-3 normative sample.

METHODS

The sample (N = 862) of children (Mage = 6.51, SD = 2.23) was matched based on United States census data, ensuring appropriate percentages of demographic representation and disability status. Confirmatory factor analyses, exploratory structural equation modeling, model-based reliability estimates including coefficient omega hierarchical, and coefficient omega hierarchical subscale, explained common variance estimates, and relative parameter bias were examined.

RESULTS

Findings revealed bifactor structure produced a better model fit compared to both one-factor and two-factor models. Furthermore, model reliability estimates that parceled true score variance for the general FMS factor, locomotor skills factor, and ball skills factor yielded high internal consistency for FMS (.797) but not locomotor skills (.168) and ball skills (.216). Finally, explained common variance (.852-.879) and relative parameter bias (.018-.072) estimates identified the strength of the run, skip, slide, and dribble skills tests to represent the FMS general factor.

CONCLUSIONS

Our findings demonstrate the advantages of using bifactor structure to examine the TGMD-3 compared to one-factor and two-factor models. Additionally, these results provide further evidence that using the TGMD-3 to examine an overall FMS general factor may explain more variance in performance and provide a better picture for evaluating children's current FMS levels compared to subscales independently.

Relationship between the 24-Hour Movement Guidelines and fundamental motor skills in preschoolers

OBJECTIVES

To examine the association among 24-Hour Movement Guidelines and fundamental motor skills (FMS) in preschoolers.

DESIGN

Prospective cohort study with one-year follow-up.

METHODS

Parents of 3-4-year-old children reported child age, sex, race, and time spent viewing screens (hours/day). Accelerometers measured preschooler physical activity (PA) and sleep. The 24-Hour Movement Guidelines were examined (≥3 h/day total PA including ≥1 h/day of moderate-to-vigorous [MVPA], 10-13 h/day of sleep, and ≤1 h/day of screen-time). Trained researchers administered the Test of Gross Motor Development-Third Edition (TGMD-3) to assess FMS. Linear regression was used to assess guidelines met and raw locomotor, ball skills, and total TGMD-3 scores with adjustment for covariates.

RESULTS

One hundred and seven preschoolers provided complete cross-sectional data, and 53 preschoolers provided complete longitudinal data. Of the 107 preschoolers, they were 3.4 ± 0.6 years of age, 44% were male, 50% were White, and the mean age-and-sex adjusted TGMD-3 total score percentile was below average (41 ± 22). Many preschoolers met the PA guideline (91%) and sleep guideline (83%), but few preschoolers met the screen-time guideline (8%) or all three guidelines (6%). MVPA was positively associated with locomotor and total TGMD-3 scores in cross-sectional analysis (p < 0.05 for all). Baseline PA, sleep, and screen-time were associated with total TGMD-3 score at follow-up (p < 0.05 for all). Meeting the screen-time guideline and all three guidelines at baseline were each positively associated with total TGMD-3 score at follow-up (p < 0.05 for all).

CONCLUSIONS

Each movement behavior contributed to later FMS. Promotion of adequate movement behaviors is warranted for child health.

A natural experiment of state-level physical activity and screen-time policy changes early childhood education (ECE) centers and child physical activity

BACKGROUND

Early childhood education (ECE) centers are an important place for preschool-aged children to obtain physical activity (PA). A U.S. state government (Louisiana) recently updated requirements for licensed centers' PA and screen-time policies, which allowed for assessment of 1) ECE center practices, environment, staff behaviors, and policies changes on child-level PA and 2) state level changes on the ECE center.

METHODS

ECE centers were assessed at the beginning of state licensing changes and 1-year later. The ECE centers were assessed via the Environmental Policy Assessment and Observation (EPAO) tool. The EPAO Sedentary Opportunities score, which primarily assesses television viewing time, was revised to reflect viewing non-television devices (e.g. tablets). Child-level PA was measured using accelerometry. For Aim 1, mixed models assessed ECE center changes and child PA with adjustment for demographic characteristics (fixed effects), baseline EPAO score (random effects), and clustering for center. For Aim 2, paired t-tests assessed ECE center environment differences between baseline and follow-up.

RESULTS

Nine ECE centers participated and 49 preschoolers provided complete measures at both time points. For Aim 1, increases in the EPAO revised-Sedentary Opportunities score (as in less non-television screen-time) resulted in increased child PA (p = 0.02). For Aim 2, ECE centers improved their EPAO Active Opportunities and Staff Behaviors score (p = 0.04 and p = 0.02 respectively).

CONCLUSIONS

ECE centers improved their environment after 1-year, resulting in additional child PA. Changes in ECE centers environment, possibly through policy, can positively influence children's PA.

Sociodemographic Differences in Young Children Meeting 24-Hour Movement Guidelines

BACKGROUND

Little is known about variation in meeting the 24-Hour Movement Guidelines (including physical activity [PA], sleep, and screen time [ST]) in early childhood. The aim was to evaluate sociodemographic differences in meeting the 24-Hour Movement Guidelines.

METHODS

Parents of 3-4 year old children reported sociodemographic information and ST. Sleep and PA were measured using accelerometry, and height and weight were objectively measured. The 24-Hour Movement Guidelines include daily PA (total PA: ≥3 h; including ≥1 h of moderate to vigorous), sleep (10-13 h), and ST (≤1 h). Meeting guidelines by age, sex, race, poverty level, and weight status were assessed using chi-square and linear regression models.

RESULTS

Of 107 children, 57% were white and 26% lived in households at or below the poverty level. Most children met the PA (91.5%) and sleep (86.9%) guidelines, but few met ST (14.0%) or all 3 (11.3%) guidelines. African American children and children who lived at or below the poverty level were less likely to meet the sleep, ST, and all 3 guidelines compared with others (P < .01 for all). There were no other differences.

CONCLUSION

These results suggest future interventions should focus on reducing differences in movement, namely in sleep and ST.

Fundamental motor skills, screen-time, and physical activity in preschoolers

PURPOSE

To examine the associations among preschoolers fundamental motor skills, screen-time, physical activity (PA), and sedentary behavior (SB).

METHODS

Children ages 3-4years were enrolled in a prospective observational trial of PA. Trained assessors conducted the Test of Gross Motor Development-3rdedition (TGMD-3), and the Movement Assessment Battery for Children-2nd edition, and parent-reported child screen-time and sociodemographic information. Children wore an accelerometer for 7days to examine SB and total PA (TPA). TPA was further characterized as moderate-to-vigorous PA (MVPA) or vigorous PA (VPA). Mixed linear models were calculated, controlling for age (for TGMD-3), sex, household income, and accelerometer wear time (for accelerometry models), with childcare center as a random effect. The primary analysis reported on the cross-sectional baseline data of 126 children with complete fundamental motor skill and screen-time data; a subanalysis included 88 children with complete accelerometry data.

RESULTS

Children were 3.4 ± 0.5years of age (54% girls; 46% white, 42% African American, 12% other). A total of 48% lived in households at or below the federal poverty level. Children engaged in 5.1 ± 3.6h/day of screen-time. Children's screen-time was inversely related to the Movement Assessment Battery for Children-2nd edition, manual dexterity skills percentile (β (SE) = -1.7 (0.8), p = 0.049). In the accelerometry subsample, children engaged in 5.9 ± 0.9h/day of TPA of which 1.7 ± 0.6h/day was MVPA. Boys engaged in more MVPA and VPA and less SB compared with girls (all p < 0.05). A higher TGMD-3, total score (β (SE) = 0.4 (0.2), p = 0.017) and locomotor score (β (SE) = 0.7 (0.3), p = 0.018) were associated with more VPA but not with TPA or MVPA. Screen-time and television in the bedroom were not related to SB, TPA, MVPA, or VPA.

CONCLUSION

Children's motor skills were positively related to VPA but inversely related to screen-time. Further inquiry into the implications of high exposure to screen-time in young children is needed.

A cross-sectional study on the relationship between the risk of hypertension and obesity status among pre-adolescent girls from rural areas of Southeastern region of the United States

This study investigated early indications of hypertension risk and the association of overweight and obesity in young girls from a low socioeconomic region of the rural South. 139 females (M age = 8.85 ± 1.67 years) from a rural school in the Southeastern region of the United States served as participants. Body mass index was calculated based on the child's height and weight measurements (kg/m2) and resting blood pressure measurements were taken with calibrated, automatic oscillations devices. Girls who were overweight or obese were 2.81 times more likely to have a systolic blood pressure indicative of being at-risk/hypertensive (i.e., pre-hypertension and/or hypertension stage 1) than girls who were not overweight/obese. In fact, the percentage of overweight/obese girls who were at-risk/hypertensive was double that of girls who were not overweight/obese (43.2% versus 21.3%), respectively. Being overweight or obese is associated with almost three times a higher risk of hypertension than girls who are not overweight or obese.

The Effect of CHAMP on Physical Activity and Lesson Context in Preschoolers: A Feasibility Study

PURPOSE

This feasibility study compared the effects of 2 movement programs, traditional and mastery climate (i.e., the Children's Health Activity Motor Program [CHAMP]), on lesson context and children's physical activity (PA) levels. A secondary aim was to examine sex differences in PA levels in both programs.

METHOD

Seventy-two preschoolers served as participants and were assigned to a movement program. Physical activity levels and lesson context were assessed with the System for Observing Fitness Instruction Time.

RESULTS

Preschoolers in CHAMP spent more time walking (p < .05, d = 3.3), more time in moderate-to-vigorous PA (MVPA; p < .05, d = 3.6), and less time standing (p < .05, d = 3.8) compared with those in a traditional movement program. Boys in both programs spent less time standing (p < .05, d = 4.8) and more time in vigorous activity (p < .05, d = 5.8) and MVPA (p < .05, d = 4.4) compared with girls. During CHAMP, children spent less time engaged in management and knowledge (p < .05, d = 1.4, and p < .001, d = 0.9, respectively) and more time in skill practice (p < .05, d = 1.5).

CONCLUSION

The findings support that participation in CHAMP elicits more MVPA in preschool-age children compared with a traditional movement program. The Children's Health Activity Motor Program provided children with more class time devoted to skill practice. The program appears to be an innovative approach that is beneficial for PA engagement and could contribute positively to children's health.

State Licensing Regulations on Screen Time in Childcare Centers: An Impetus for Participatory Action Research

BACKGROUND

New licensing regulations require Louisiana early care and education centers (ECEs) to limit children's screen time and increase physical activity. A community- academic partnership involving academic, community, government, and ECE stakeholders launched two initiatives: (1) an evaluation of the implementation of licensing regulations at the local level and (2) a statewide effort to develop technical assistance for ECE directors.

OBJECTIVES

To describe the methods and lessons learned and to establish recommendations based on this ongoing participatory action research.

METHODS

A case study approach was used to identify the lessons learned and recommendations thus far, based on partners' perspectives and ECE directors' participation.

LESSONS LEARNED

Recommendations include to share power and funding among stakeholders, to engage directors as partners to overcome recruitment challenges, and to start with the end in mind to ensure meaningful community engagement.

CONCLUSIONS

This participatory action approach is leading to innovative, feasible strategies to increase children's physical activity.

Effectiveness of pre-school- and school-based interventions to impact weight-related behaviours in African American children and youth: a literature review

This review assessed the effectiveness of pre-school- and school-based obesity prevention and/or treatment interventions targeting healthy eating, physical activity or obesity in African American children and adolescents. Systematic searches were conducted for English-printed research articles published between January 1980 and March 2013. Retained articles included experimental studies conducted in the United States that targeted ≥ 80% African American/black children and adolescents and/or studies whose results were stratified by race/ethnicity, and that were conducted in pre-schools/head start or schools (excluding after-school programmes). Of the 12,270 articles identified, 17 met the inclusion criteria (pre-school, n=2; elementary school, n=7; middle and secondary schools, n=8). Thirteen studies found significant improvements in nutrition (pre-school, n=1; elementary, n=7; secondary, n=5) and three found significant improvements in physical activity (pre-school, n=1; elementary, n=2) variables of interest. Two studies (pre-school, n=1; secondary, n=1) reported significant reductions in obesity in African American children. The evidence available suggests school-based interventions are effective in promoting healthy nutrition behaviours in African American children. Conclusions overall and, particularly, about effects on physical activity and obesity are limited due to the small number of studies, differences in assessment approaches and a lack of follow-up assessments.

School Reform: The Role of Physical Education Policy in Physical Activity of Elementary School Children in Alabama's Black Belt Region

Purpose.

To investigate the implementation of state- and school-mandated physical education (PE) and physical activity policies on students' school-day physical activity behaviors.

Design.

Observational, cross-sectional study.

Setting.

Five elementary schools in rural Alabama.

Subjects.

Six hundred and eighty-three school-age children.

Measures.

School-day physical activity behaviors were assessed with pedometer step count, the System for Observing Fitness Instruction Time (SOFIT), and the System for Observing Play and Leisure Activity in Youth (SOPLAY).

Analysis.

Descriptive statistics (means and standard deviations) were used to describe the current health and in-school physical activity behaviors of students.

Results.

Students accumulated a daily average of 4079.57 (± 1678.1) and 3473.44 (± 1073.37) steps for boys and girls, respectively, throughout the school day. SOFIT findings indicate that students spent an average of 23.80 ± 5.33 min/d in PE and that 14.33 ± 6.10 min/d were spent in moderate to vigorous physical activity (MVPA). This equates to 59.38% of PE time spent in MVPA. SOPLAY findings showed that recess and before/after school activity was not provided.

Conclusions.

It appears that schools were in compliance with the state-mandated PE policies on paper but not in actuality. Students did not attend PE for 30 min/d. The implementation of PE as the sole physical activity opportunity provides inadequate amounts of physical activity during the school day.