Encouraging “Active Learning”: Assessing Implementation of Head Start’s Physical Activity Requirements Within the Teaching and Learning Environment

in Journal of Physical Activity and Health
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Background: Head Start serves over 1 million diverse low-income preschool children and is an ideal setting for developing and implementing obesity prevention efforts, which is expected to have positive impacts on behavior as youth age. This study examined how regional- and state-level Head Start offices have supported implementation of the recently updated physical activity (PA) requirement within the teaching and learning environment Head Start Program Performance Standard (1302.31). Methods: Key informant telephone interviews were conducted with 8 regional- and 36 state-level Head Start representatives. Interviews were recorded and professionally transcribed. Data were coded and analyzed using constant comparative methods in ATLAS.ti (version 8). Audit trails were maintained, and disagreements in codes were discussed and resolved among coders. Results: The following 3 overarching themes emerged: communication, resources and technical assistance, and challenges. Results showed variation in respondent knowledge regarding the Standards. Although regional contacts provide technical assistance, state-level contacts have many information sharing strategies for programs. Implementation challenges included the need for frequent professional development opportunities given staff turnover and low PA competency, and additional PA curricula. Conclusion: Findings can help identify existing or potential strategies that could be adopted more widely or developed to assist Head Start programs incorporate PA into daily activities.

Slater is with the School of Pharmacy, Concordia University Wisconsin, Mequon, WI, USA. Sanghera, Herrera, and Chriqui are with the Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA. Chriqui is also with the Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.

Slater (Sandra.Slater@cuw.edu) is corresponding author.

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    • Supplementary Material (pdf 301 KB)
  • 1.

    Pan L, Park S, Slayton R, Goodman AB, Blanck HM. Trends in severe obesity among children aged 2 to 4 years enrolled in special supplemental nutrition program for women, infants, and children from 2000 to 2014. JAMA Pediatr. 2018;172(3):232238. PubMed ID: 29309485 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Hills AP, Dengel DR, Lubans DR. Supporting public health priorities: recommendations for physical education and physical activity promotion in schools. Prog Cardiovasc Dis. 2015;57(4):368374. PubMed ID: 25269062 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Pate RR, O’Neill JR, Brown WH, Pfeiffer KA, Dowda M, Addy CL. Prevalence of compliance with a new physical activity guideline for preschool-age children. Child Obes. 2015;11(4):415. PubMed ID: 26121562 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Piercy KL, Troiano RP, Ballard RM, et al. The physical activity guidelines for Americans. JAMA. 2018;320(19):20202028. PubMed ID: 30418471 doi:

  • 5.

    Tremblay MS, Barnes JD, González SA, et al. Global matrix 2.0: report card grades on the physical activity of children and youth comparing 38 countries. J Phys Act Health. 2016;13(s2):S343S366. doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Skinner AC, Ravanbakht SN, Skelton JA, Perrin EM, Armstrong SC. Prevalence of obesity and severe obesity in US children, 1999–2016. Pediatrics. 2018;141(3):e20173459. PubMed ID: 29483202 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014;311(8):806. PubMed ID: 24570244 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Händel MN, Larsen SC, Rohde JF, Stougaard M, Olsen NJ, Heitmann BL. Effects of the Healthy Start randomized intervention trial on physical activity among normal weight preschool children predisposed to overweight and obesity. PLoS One. 2017;12(10):e0185266. doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Waters E, de Silva‐Sanigorski A, Burford BJ, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2011(12):CD001871.

    • Search Google Scholar
    • Export Citation
  • 10.

    Sisson SB, Krampe M, Anundson K, Castle S. Obesity prevention and obesogenic behavior interventions in child care: a systematic review. Prev. Med. 2016;87:5769. PubMed ID: 26876631 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Ward DS, Welker E, Choate A, et al. Strength of obesity prevention interventions in early care and education settings: a systematic review. Prev Med. 2017;95:S37S52. PubMed ID: 27693295 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Services USDoHaH. Head Start program facts, fiscal year 2017. 2017. https://eclkc.ohs.acf.hhs.gov/about-us/article/head-start-program-facts-fiscal-year-2017. Accessed November 30, 2018.

    • Export Citation
  • 13.

    Services USDoHaH. Head Start Program Performance Standards. 2016. https://eclkc.ohs.acf.hhs.gov/policy/45-cfr-chap-xiii

    • Export Citation
  • 14.

    Bellows LL, Davies PL, Anderson J, Kennedy C. Effectiveness of a physical activity intervention for Head Start preschoolers: a randomized intervention study. Am J Occup Ther. 2013;67(1):28. PubMed ID: 23245780 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Pate RR, McIver K, Dowda M, Brown WH, Addy C. Directly observed physical activity levels in preschool children. J School Health. 2008;78(8):438444. PubMed ID: 18651931 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Sandelowski M. Whatever happened to qualitative description? Res Nurs Health. 2000;23(4):334340. PubMed ID: 10940958 doi:

  • 17.

    Flick U. Designing Qualitative Research. Thousand Oaks, CASage; 2018.

  • 18.

    Gill P, Stewart K, Treasure E, Chadwick B. Methods of data collection in qualitative research: interviews and focus groups. Br Dent J. 2008;204(6):291. doi:

  • 19.

    Miles MB, Huberman A, Saldana J. Qualitative Data Analysis: A Methods Sourcebook. 3rd ed. Thousand Oaks: Sage Publications; 2014.

  • 20.

    Colorafi KJ, Evans B. Qualitative descriptive methods in health science research. HERD. 2016;9(4):1625. PubMed ID: 26791375 doi:

  • 21.

    Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013;15(3):398405. PubMed ID: 23480423 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Glaser BG. The constant comparative method of qualitative analysis. Soc Prob. 1965;12(4):436445. doi:

  • 23.

    Glaser BG, Strauss AL. Theoretical Sampling the Discovery of Grounded Theory: Strategies for Qualitative Research. New Brunswick, NJ: Aldine Publishing Company; 1999.

    • Search Google Scholar
    • Export Citation
  • 24.

    Rodgers BL, Cowles KV. The qualitative research audit trail: a complex collection of documentation. Res Nurs Health. 1993;16(3):219226. PubMed ID: 8497674 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Agee J. Developing qualitative research questions: a reflective process. Int J Qual Stud Educ. 2009;22(4):431447. doi:

  • 26.

    Administration for Children and Families. I Am Moving I Am Learning Curriculum Enhancement. https://eclkc.ohs.acf.hhs.gov/physical-health/article/i-am-moving-i-am-learning-early-findings-implementation-obesity-prevention. Accessed March 25, 2019.

    • Export Citation
  • 27.

    Byrd-Williams C, Dooley EE, Sharma SV, Chuang R-J, Butte N, Hoelscher DM. Peer reviewed: best practices and barriers to obesity prevention in head start: differences between director and teacher perceptions. Prev Chronic Dis. 2017;14:E139. PubMed ID: 29267155 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Derscheid LE, Umoren J, Kim S-Y, Henry BW, Zittel LL. Early childhood teachers’ and staff members’ perceptions of nutrition and physical activity practices for preschoolers. J Res Child Educ. 2010;24(3):248265. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Lu C, Montague B. Move to learn, learn to move: prioritizing physical activity in early childhood education programming. Early Child Educ J. 2016;44(5):409417. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Breslin CM, Morton JR, Rudisill ME. Implementing a physical activity curriculum into the school day: helping early childhood teachers meet the challenge. Early Child Educ J. 2008;35(5):429437. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Hughes CC, Gooze RA, Finkelstein DM, Whitaker RC. Barriers to obesity prevention in Head Start. Health Aff. 2010;29(3):454462. doi:

  • 32.

    Otten JJ, Bradford VA, Stover B, et al. The culture of health in early care and education: workers’ wages, health, and job characteristics. Health Aff. 2019;38(5):709720. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Linnan L, Arandia G, Bateman L, Vaughn A, Smith N, Ward D. The health and working conditions of women employed in child care. Int J Environ Res Public Health. 2017;14(3):283. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Chriqui JF, Leider J, Schermbeck RM. Early childhood education centers’ reported readiness to implement the updated child and adult care food program meal pattern standards in the United States, 2017. Child Obes. 2018;14(6):412420. PubMed ID: 30199290 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    usa.childcareaware.org. The US and the high price of child care: an examination of a broken system. 2019. https://cdn2.hubspot.net/hubfs/3957809/2019%20Price%20of%20Care%20State%20Sheets/Final-TheUSandtheHighPriceofChildCare-AnExaminationofaBrokenSystem.pdf. Accessed June 9, 2020.

    • Export Citation
  • 36.

    Bullough RV, Hall-Kenyon KM, MacKay KL. Head Start teacher well-being: implications for policy and practice. Early Child Educ J. 2012;40(6):323331. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37.

    Administration for Children and Families, Fox MK, Hallgren K, Boller K, Turner A. Efforts to Meet Children’s Physical Activity and Nutritional Needs: Findings From the I Am Moving, I am Learning Implementation Evaluation. Washington, DC: U.S. Department of Health and Human Services; 2010.

    • Search Google Scholar
    • Export Citation
  • 38.

    Pianta R, Downer J, Hamre B. Quality in early education classrooms: definitions, gaps, and systems. Future Child. 2016;26(2):119137. doi:

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