Moving Kids: at Preschool and

HomeDianne S. Ward

Youth-Nex ConferenceOctober 10-11, 2013

Guidelines for Physical Activity: Children 0-5 Years

NASPE Guidelines (2002)

• Infants:– Should interact with parents and/or caregivers in daily

physical activities and in settings that encourage activity and do not restrict

• Toddlers and Preschoolers:– Should engage in at least 60 minutes – up to several

hours per day– of unstructured activity– Should accumulate 30 – 60 minutes of structured PA

each day (Toddlers-30 min; Preschool-60 min)

International Recommendations

Australia (2010) UK (2011) Canada (2012)

• Encourage supervised floor-based play from birth

• 3hrs/day physical activity spread through the day

• Encourage supervised floor-based play from birth

• 3hrs/day physical activity spread through the day

• Encourage supervised floor-based play from birth

• 3hrs/day physical activity spread through the day

Slide from Dr. Anthony Okely, U. of Gollagoong

Institute of Medicine. Early childhood obesity prevention policies: Goals, recommendations, and potential actions. Washington: Institute of Medicine; 2011.

Slide from Dr. Anthony Okely, U. of Gollagoong

Moving Kids at Home

What do we know?

Challenges Working with Parents

• Parents of young children mostly young adults • Time is a premium• Often both parents work outside of home• Demands related to caring for a younger child

are great (e.g., closer oversight, less independence, safety issues, less structured approaches available)

• Need to find strategies for engagement

Parenting for Activity or “Physical Activity Parenting”

• A recent conference focused on “Measuring Parenting” (ISBNPA Pre-Conference, 2011)

• Identified concept of “PA Parenting”• Work by Davison and other tried to identify

and conceptualize parent actions for PA• Found research lacking including absence of

quality measurements of PA parenting• More research work needed

See 2 papers by Davison et al. and Trost et al. Childhood Obesity, 2013

Parents have different “styles” of managing children

• Parenting “style” is described as how parents respond to their children based on control (demandingness) and warmth (responsiveness)

• Positive parenting refers the a balance between warmth and control

• Greater control, less warmth results in “punitive” or authoritarian parenting

• Concerns for safety and protection may favor control over warmth

Study Overview

• Compared general parenting style and practices, physical activity-related practices, and child physical activity

N=324

Parent Characteristics

WhiteAfrican Amer

51.4%39.8%

Parent Age 34.9 y

Parent BMI 30.1 kg/m2

Income <$50K 36.6%

Education≥ College 75.3%

Child Characteristics

Child Age 41.8 mo

Child BMI %ile 59.1 %ile

Measured: •parenting style•parenting practice•physical activity

CONTROLING PRACTICESResults

SUPPORTIVE PRACTICES

Inside rules for active play (-0.515)

Reward w/ PA (0.150)

Conditions on outside play - weather

Conditions on outside play - clean

Modeling (0.247)

Family activity (0.263)

Education (0.206)

Encouragement (0.400)

CONTROLING PRACTICES

Control over screen time (0.076, p=.162)

Monitoring screen time

SUPPORTIVE PRACTICES

Modeling screen time

Reward w/ TV--- Positive assoc.--- Negative assoc.

Positive Parenting

CONTROLING PRACTICES

Results

SUPPORTIVE PRACTICES

Inside rules for active play (0.167)

Reward w/ PA

Conditions on outside play – weather (0.102, p=.063)

Conditions on outside play – clean (0.121)

Modeling (-0.132)

Family activity (-0.213)

Education

Encouragement (-0.115)

CONTROLING PRACTICES

Control over screen time (-0.091, p=.104)

Monitoring screen time (-0.201)

SUPPORTIVE PRACTICES

Modeling screen time (0.201)

Reward w/ TV (0.109)--- Positive assoc.--- Negative assoc.

Punitive Parenting

Parenting Style-Parenting Practice

• What works positively for one parenting style may not work as well for another– Positive parenting works well with supportive PA

practices but not with controlling practices– Inconsistent parenting style using supportive PA

practices did not increase kids’ PA – Punitive parenting style can use controlling

practices effectively but long-term impacts of style-practice interaction unknown

Conclusions

• Model explains a small but significant amount of variance in child activity (16. 5% MVPA & 12.8 % sed.)– Positive parenting supportive practices child MVPA– Punitive parenting controlling practices– Associations with inconsistent parenting somewhat

unexpected (some positive, some not)

• Similarities and differences with feeding literature• Much more work in needed in this area

Child Care Policies, Practices & Environments for Physical Activity

Which policies result in more physical activity?

Best Practice Guidelines

1. Amount of play time (minutes) provided (both inside & outside): 120 minutes

2. Occasions (#) of teacher-led physical activity: 2 or more per day

3. Staff joining in activity with children: regularly

4. Staff trained on physical activity5. Center’s written policies about physical

activity

McWilliams et al., Pediatrics, 2008

Procedures

• 50 child-care centers in North Carolina– 45 centers were rated 3-5 stars; others 2-3 stars– 23 centers participated in the Child and Adult Care

Food Program (CACFP)• Data collected during 4 days at the centers• 4 day of observation at each center (full day)• Children’s activity assessed by accelerometers – About 10 children measured per day at each

center (~500 total)

Measures

Physical Activity• GT1M worn for 4 days while

at child-care center • Average wear time was 7

hours/day• 15 second epochs

– Cut-points • Sedentary = <25 counts per

15 seconds• MVPA = >500 counts per 15

seconds

Child Care Practices

Results

Amount of PA time at centers with ≥120 min/day of active play

At centers providing ≥120 min/day of active play, children spent

More minutes/hour in MVPA (p=0.04)

Fewer minutes/hour in sedentary activities (p=0.11, ES = -0.81)

PA time at centers providing ≥2 occasions of teacher-led activity

At centers providing≥2 occasions of teacher-led PA, children spent

More minutes/hr. in MVPA (p=0.03)

Fewer minutes/hr. in sedentary activities (p=0.02)

PA time at centers where staff joined in active play on >1day

At centers where staff joined children in active play on >1 day, children spent

More minutes/hr. in MVPA (p=0.01)

Fewer minutes/hr. in sedentary activity (p=0.14, ES=-0.48)

PA time at centers where staff received PA training

At centers where at least 1 staff had received PA training, children spent

No effect on minutes of MVPA/hr. (p=0.07, ES=0.04)

More minutes in sedentary activity (p=0.18, ES =0.43)

PA time at centers with ≥4 Written Physical Activity Policies

No policy effect on time spent in MVPA (p=0.08, ES= -0.32) or sedentary activity (p=0.49, ES=0.13)

Summary

• Found a positive effect of:– Providing 120 min/day of activity time– Teachers who lead activities at least twice per day – Teachers joining in active play

• Found no effect of:– PA training (at least 1 staff)– written policies had no effect

• Lack of finding for training and policy may be related to type training; non-specific policies

Overall Conclusions and Future Directions

• Settings (home & child care) and caregivers (parents & providers) influence the amount of physical activity children

• Parents can influence child activity, but new strategies may be needed to engage parents and modifying PA parenting practices

• Child care centers can increase children’s PA through their policies and practices; efforts to improve are needed

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