Characteristics of the physical childcare environment are associated with children’s sedentary behavior (SB) and physical activity (PA) levels. This study examines whether these associations are moderated by child characteristics. A total of 152 1- to 3-year-old children from 22 Dutch childcare centers participated in the study. Trained research assistants observed the physical childcare environment, using the Environment and Policy Assessment Observation (EPAO) protocol. Child characteristics (age, gender, temperament and weight status) were assessed using parental questionnaires. Child SB and PA was assessed using Actigraph GT3X+ accelerometers. Linear regression analyses including interaction terms were used to examine moderation of associations between the childcare environment and child SB and PA. Natural elements and portable outdoor equipment were associated with less SB and more PA. In addition, older children, boys and heavier children were less sedentary and more active, while more use of childcare and an anxious temperament were associated with more SB. There were various interactions between environmental factors and child characteristics. Specific physical elements (e.g., natural elements) were especially beneficial for vulnerable children (i.e., anxious, overactive, depressive/withdrawn, overweight). The current study shows the importance of the physical childcare environment in lowering SB and promoting PA in very young children in general, and vulnerable children specifically. Moderation by child characteristics shows the urgency of shaping childcare centers that promote PA in all children, increasing equity in PA promotion in childcare.
Background and aimsThe aim of this study was to gain insight in the effect of a preschool-based intervention for Early Childhood Education and Care (ECEC) teachers on promoting healthy eating and physical activity in toddlers.MethodsIn a cluster randomized controlled trial, 37 preschools of child care organization Impuls in Amsterdam Nieuw-West, the Netherlands, were randomly allocated to an intervention or control group. In total, 115 female ECEC teachers (mean age 42 ± 9 years) participated. The intervention for ECEC teachers consisted of two existing Dutch programs: ‘A Healthy Start’ and ‘PLAYgrounds’. The practices and knowledge of ECEC teachers concerning healthy eating and physical activity and the level of confidence in promoting healthy eating and physical activity in toddlers was assessed at baseline and 9 months of follow-up. To examine the effect of the intervention linear mixed models were used.ResultsPreliminary analyses of the practices indicated that Activity-related-Teaching/Autonomy-Support was increased in the intervention group (mean difference: 0.181), but not in the control group (mean difference: -0.048; p-value group*time: 0.025). Food-related-Pressure-to-Eat was decreased in the intervention group (mean difference: -0.580), but not in the control group (mean difference: -0.158; p-value group*time: 0.014). No effect of the intervention was found on knowledge (p-value group*time: 0.24) and the level of confidence (p-value group*time: 0.98) of ECEC teachers. ConclusionsThe preschool-based intervention seems to increase Activity-related-Teaching/Autonomy-Support and to decrease Food-related-Pressure-to-Eat. No effects were seen on knowledge and level of confidence of ECEC teachers in promoting healthy eating and physical activity in toddlers.
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BackgroundEarly Childhood Education and Care (ECEC) teachers at urban preschools are potential key figures to promote healthy behaviours in disadvantaged young children and to engage parents in lifestyle-related topics. An ECEC teacher-parent partnership regarding healthy behaviours may support parents and stimulate their children’s development. However, it is not an easy task to establish such a collaboration and ECEC teachers need tools to communicate with parents about lifestyle-related topics. This paper describes the study protocol of a preschool-based intervention (CO-HEALTHY) to promote an ECEC teacher-parent partnership regarding healthy eating, physical (in)activity and sleeping behaviours in young children.MethodsA cluster randomised controlled trial will be performed at preschools in Amsterdam, the Netherlands. Preschools will be randomly allocated to an intervention or control group. The intervention consists of a toolkit with 10 parent-child activities and associated training for ECEC teachers. The activities were composed using the Intervention Mapping protocol. At intervention preschools, ECEC teachers will carry out the activities during standard contact moments. Parents will receive associated intervention materials and will be encouraged to perform similar parent-child activities at home. At control preschools, the toolkit and training will not be implemented. The primary outcome will be the teacher- and parent-reported partnership regarding healthy eating, physical (in)activity and sleeping behaviours in young children. The perceived partnership will be assessed by a questionnaire at baseline and at 6 months. In addition, short interviews with ECEC teachers will be held. Secondary outcomes include the knowledge, attitude, food- and activity-related practices of ECEC teachers and parents. Furthermore, children’s eating, physical (in)activity and sleeping behaviours, and weight development will be assessed. A process evaluation of the intervention will be made.DiscussionThe intervention aims to provide a practical tool for ECEC teachers at urban preschools to promote an ECEC teacher-parent partnership regarding a healthy lifestyle in young children.Trial registrationNetherlands Trial Register (NTR): NL8883. Date registered: September 8, 2020.
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