Children's physical activity level and sedentary behaviour in Norwegian early childhood education and care: effects of a staff-led cluster-randomised controlled trial

Eivind Andersen, Steinar Øvreås, Kari Anne Jørgensen, Janne Borch-Jenssen, Thomas Moser, Eivind Andersen, Steinar Øvreås, Kari Anne Jørgensen, Janne Borch-Jenssen, Thomas Moser

Abstract

Background: A growing body of evidence suggest that the children's physical activity (PA) level in early childhood education and care (ECEC) settings are insufficient. Since most children attend ECEC settings for many hours on most days of the week, and these institutions reach children across the socioeconomic spectrum, the ECEC settings may serve as an ideal avenue for increasing physical activity level, reduce sedentary time and enhance the overall health of young children. This paper investigates the effectiveness of the "Active Kindergarten - Active Children" study to increase children's PA level and reduce sedentary time within the ECEC setting.

Methods: Accelerometers were used to asses PA and sedentary time. A total of 116 three to four-year olds took part in a randomised controlled trial in 11 ECEC settings. Participants were cluster-randomised, by ECEC setting, to either a 12 week staff-led and expert-supported intervention or a waiting list control group.

Results: The intervention group increased time spent in moderate- and vigorous intensity PA by 10 min/day (95% CI = 3, 18; P = 0.01), took 1909 more steps per day (95% CI = 1130, 2688; P < 0.01) and reduced sedentary time with 14 min/day (95% CI = - 27, - 1; P = 0.04) compared to the control group. The intervention group had a 2.4 higher odds (95% CI = 1.05, 5.7; P = 0.04) of meeting the PA recommendations compared to the control group at follow-up.

Conclusions: Our results show that a flexible staff-led and expert-supported multicomponent PA intervention can increase total PA level, moderate- and vigorous intensity PA and reduce time spent sedentary in three to four-year old children during their stay in ECEC settings.

Trial registration: The trial was retrospectively registered on September 19, 2020 and available online at ClinicalTrials.gov: No. NCT04555746 .

Keywords: Children; ECEC; Physical activity; RCT; Sedentary time.

Conflict of interest statement

The authors have no conflict of interest to disclose.

Figures

Fig. 1
Fig. 1
Flow of participants through the trial
Fig. 2
Fig. 2
Percentage of children in the two groups meeting PA recommendations at baseline and follow-up
Fig. 3
Fig. 3
Delta (follow-up – baseline) physical activity level hour-by-hour for both groups
Fig. 4
Fig. 4
Delta differences (follow-up – baseline) for MVPA and sedentary time for the 50% least active and 50% most active at baseline in the intervention group (left) and control group (right)

References

    1. Temple VA, et al. Physical activity of children in family child care. Appl Physiol Nutr Metab. 2009;34(4):794–798. doi: 10.1139/H09-061.
    1. Vanderloo LM, et al. Environmental influences on Preschoolers' physical activity levels in various early-learning facilities. Res Q Exerc Sport. 2015;86(4):360–370. doi: 10.1080/02701367.2015.1053105.
    1. Tremblay MS, et al. Sedentary behavior research network (SBRN) - terminology consensus project process and outcome. Int J Behav Nutr Phys Act. 2017;14(1):75. doi: 10.1186/s12966-017-0525-8.
    1. Reilly JJ, et al. Total energy expenditure and physical activity in young Scottish children: mixed longitudinal study. Lancet. 2004;363(9404):211–212. doi: 10.1016/S0140-6736(03)15331-7.
    1. LeBlanc AG, et al. Systematic review of sedentary behaviour and health indicators in the early years (aged 0-4 years) Appl Physiol Nutr Metab. 2012;37(4):753–772. doi: 10.1139/h2012-063.
    1. Andersen E, et al. Objectively measured physical activity level and sedentary behavior in Norwegian children during a week in preschool. Prev Med Rep. 2017;7:130–135. doi: 10.1016/j.pmedr.2017.06.003.
    1. Pietilainen KH, et al. Physical inactivity and obesity: a vicious circle. Obesity (Silver Spring) 2008;16(2):409–414. doi: 10.1038/oby.2007.72.
    1. Biddle SJ, et al. Tracking of sedentary behaviours of young people: a systematic review. Prev Med. 2010;51(5):345–351. doi: 10.1016/j.ypmed.2010.07.018.
    1. Jones RA, et al. Tracking physical activity and sedentary behavior in childhood: a systematic review. Am J Prev Med. 2013;44(6):651–658. doi: 10.1016/j.amepre.2013.03.001.
    1. Burgi F, et al. Relationship of physical activity with motor skills, aerobic fitness and body fat in preschool children: a cross-sectional and longitudinal study (Ballabeina) Int J Obes. 2011;35(7):937–944. doi: 10.1038/ijo.2011.54.
    1. Jimenez-Pavon D, et al. Physical activity and clustered cardiovascular disease risk factors in young children: a cross-sectional study (the IDEFICS study) BMC Med. 2013;11:172. doi: 10.1186/1741-7015-11-172.
    1. Timmons BW, et al. Systematic review of physical activity and health in the early years (aged 0-4 years) Appl Physiol Nutr Metab. 2012;37(4):773–792. doi: 10.1139/h2012-070.
    1. Becker DR, et al. Physical activity, self-regulation, and early academic achievement in preschool children. Early Educ Dev. 2014;25(1):56–70. doi: 10.1080/10409289.2013.780505.
    1. Finn K, Johannsen N, Specker B. Factors associated with physical activity in preschool children. J Pediatr. 2002;140(1):81–85. doi: 10.1067/mpd.2002.120693.
    1. Pate RR, et al. Physical activity among children attending preschools. Pediatrics. 2004;114(5):1258–1263. doi: 10.1542/peds.2003-1088-L.
    1. Norway, S. Statistics Norway; kindergartens. 2019; Available from: . Accessed 15 Oct 2019.
    1. Wilke S, et al. Factors influencing childcare workers promotion of physical activity in children aged 0-4 years: a qualitative study. Early Years. 2013;33(3):226–238. doi: 10.1080/09575146.2013.810592.
    1. Derschied B, et al. Early childhood teachers and staff members perceptions of nutrition and physical activity practicies for preschoolers. J Res Child Educ. 2010;24:248–265. doi: 10.1080/02568543.2010.487405.
    1. Van Cauwenberghe E, et al. The impact of a teacher-led structured physical activity session on preschoolers' sedentary and physical activity levels. J Sci Med Sport. 2013;16(5):422–426. doi: 10.1016/j.jsams.2012.11.883.
    1. Mehtala MA, et al. A socio-ecological approach to physical activity interventions in childcare: a systematic review. Int J Behav Nutr Phys Act. 2014;11:22. doi: 10.1186/1479-5868-11-22.
    1. Temple M, Robinson JC. A systematic review of interventions to promote physical activity in the preschool setting. J Spec Pediatr Nurs. 2014;19(4):274–284.
    1. Gordon ES, et al. Effectiveness of physical activity interventions for preschoolers: a meta-analysis. Res Q Exerc Sport. 2013;84(3):287–294. doi: 10.1080/02701367.2013.813894.
    1. Johnstone A, et al. Utilising active play interventions to promote physical activity and improve fundamental movement skills in children: a systematic review and meta-analysis. BMC Public Health. 2018;18(1):789. doi: 10.1186/s12889-018-5687-z.
    1. Ward DS, et al. Interventions for increasing physical activity at child care. Med Sci Sports Exerc. 2010;42(3):526–534. doi: 10.1249/MSS.0b013e3181cea406.
    1. Finch M, et al. A cluster randomized trial of a multi-level intervention, delivered by service staff, to increase physical activity of children attending center-based childcare. Prev Med. 2014;58:9–16. doi: 10.1016/j.ypmed.2013.10.004.
    1. Wick K, et al. Interventions to promote fundamental movement skills in childcare and kindergarten: a systematic review and meta-analysis. Sports Med. 2017;47(10):2045–2068. doi: 10.1007/s40279-017-0723-1.
    1. Finch M, et al. Effectiveness of Centre-based childcare interventions in increasing child physical activity: a systematic review and meta-analysis for policymakers and practitioners. Obes Rev. 2016;17(5):412–428. doi: 10.1111/obr.12392.
    1. Jones RA, et al. Childcare physical activity interventions: a discussion of similarities and differences and trends, issues, and recommendations. Int J Environ Res Public Health. 2019;16(23):4836. doi: 10.3390/ijerph16234836.
    1. Costa S, et al. Relationship between early childhood non-parental childcare and diet, physical activity, sedentary behaviour, and sleep: a systematic review of longitudinal studies. Int J Environ Res Public Health. 2019;16(23):4652. doi: 10.3390/ijerph16234652.
    1. Hnatiuk JA, et al. Interventions to increase physical activity in children 0–5 years old: a systematic review, meta-analysis and realist synthesis. Obes Rev. 2019;20(1):75–87. doi: 10.1111/obr.12763.
    1. Jones RA, et al. Enhancing the effectiveness of early childhood educators and researchers working together to achieve common aims. Australas J Early Childhood. 2017;42(1):81–84. doi: 10.23965/AJEC.42.1.09.
    1. Sharmahd, N., et al., Transforming European ECEC Services and Primary Schools Into Professional Learning Communities: Drivers, Barriers and Ways Forward: NESET II: Analytical Report. 2017: Publications Office of the European Union.
    1. Wang W-T, Hou Y-P. Motivations of employees’ knowledge sharing behaviors: a self-determination perspective. Inf Organ. 2015;25(1):1–26. doi: 10.1016/j.infoandorg.2014.11.001.
    1. MacDonald MA, Green LW. Reconciling concept and context: the dilemma of implementation in school-based health promotion. Health Educ Behav. 2001;28(6):749–768. doi: 10.1177/109019810102800607.
    1. Wenger, E., Communities of practice Learning, Meaning, and Identity. Cambridge: Cambridge University press; 1999. .
    1. Cliff DP, Reilly JJ, Okely AD. Methodological considerations in using accelerometers to assess habitual physical activity in children aged 0-5 years. J Sci Med Sport. 2009;12(5):557–567. doi: 10.1016/j.jsams.2008.10.008.
    1. Butte NF, et al. Prediction of energy expenditure and physical activity in preschoolers. Med Sci Sports Exerc. 2014;46(6):1216–1226. doi: 10.1249/MSS.0000000000000209.
    1. Cooper AR, et al. Objectively measured physical activity and sedentary time in youth: the International children's accelerometry database (ICAD) Int J Behav Nutr Phys Act. 2015;12:113. doi: 10.1186/s12966-015-0274-5.
    1. World_Health_Organization, Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children under 5 Years of Age. 2019. . Accessed 1 Nov 2019.
    1. Tucker P. The physical activity levels of preschool-aged children: a systematic review. Early Child Res Q. 2008;23(4):547–558. doi: 10.1016/j.ecresq.2008.08.005.
    1. Donnelly JE, et al. Physical activity, fitness, cognitive function, and academic achievement in children: a systematic review. Med Sci Sports Exerc. 2016;48(6):1197–1222. doi: 10.1249/MSS.0000000000000901.
    1. Miguel-Berges ML, et al. Associations between pedometer-determined physical activity and adiposity in children and adolescents: systematic review. Clin J Sport Med. 2018;28(1):64–75. doi: 10.1097/JSM.0000000000000419.
    1. Knowles G, et al. Physical activity and blood pressure in primary school children: a longitudinal study. Hypertension. 2013;61(1):70–75. doi: 10.1161/HYPERTENSIONAHA.112.201277.
    1. Kriemler S, et al. Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomised controlled trial. BMJ. 2010;340:c785. doi: 10.1136/bmj.c785.
    1. Griffiths LJ, et al. Objectively measured physical activity and sedentary time: cross-sectional and prospective associations with adiposity in the millennium cohort study. BMJ Open. 2016;6(4):e010366. doi: 10.1136/bmjopen-2015-010366.
    1. Bonvin A, et al. Effect of a governmentally-led physical activity program on motor skills in young children attending child care centers: a cluster randomized controlled trial. Int J Behav Nutr Phys Act. 2013;10:90. doi: 10.1186/1479-5868-10-90.
    1. Bufdir. The Norwegian Directorate for Children, Youth and Family Affairs (2018). Ansatte i barnehage og skole [Employees in kindergarten and school]. . Available from: . Accessed 15 Nov 2019.
    1. Education, M.o. Forskrift om rammeplan for barnehagelærerutdanning [Regulations on the framework plan for kindergarten teacher education]. Available from: . Accessed 15 Nov 2019.
    1. Bølstad, J. and V. Glaser, eds. Moderne oppvekst. Nye tider, nye krav. 2008, Universitetsforlaget: Oslo. 205 s.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren