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Environmental Influences on Children’s Physical Activity in Early Childhood Education and Care

Karen Tonge, Rachel A. Jones, and Anthony D. Okely

Background: To examine the relationship between attributes of early childhood education and care (ECEC) settings and children’s physical activity and sedentary behavior. Methods: Cross-sectional study involving 490 children aged 2–5 years from 11 ECECs. The ECEC routine, size of the outdoor environment, and time spent in the outdoor environment were calculated for each center. Children’s physical activity and sedentary time were measured using accelerometers. Multivariate linear regressions were used to examine associations of the attributes of ECEC centers with the outcome variables, adjusting for the effects of center clustering and gender. Results: Children in ECECs that offered free routines (where children can move freely between indoor and outdoor environments) had lower levels of sedentary time (28.27 min/h vs 33.15 min/h; P = .001) and spent more time in total physical activity (7.99 min/h vs 6.57 min/h; P = .008) and moderate- to vigorous-intensity physical activity (9.49 min/h vs 7.31 min/h; P = .008). Children in ECECs with an outdoor environment >400 m2 had less sedentary time (28.94 min/h vs 32.42 min/h; P = .012) than those with areas <400 m2. Conclusion: Modifiable practices such as offering a free routine and increasing time spent in outdoor environments could potentially offer an easy and sustainable way for ECEC centers to promote physical activity and reduce sedentary time among children.

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Body Mass Index, Physical Activity, Sedentary Behavior, Sleep, and Gross Motor Skill Proficiency in Preschool Children From a Low- to Middle-Income Urban Setting

Simone A. Tomaz, Alessandra Prioreschi, Estelle D. Watson, Joanne A. McVeigh, Dale E. Rae, Rachel A. Jones, and Catherine E. Draper

Background: Limited research reports on the relationship between body mass index (BMI) and physical activity (PA), sedentary behavior (SB), sleep, and gross motor skills (GMS) in low- and middle-income countries. The aim of this study was to (1) describe BMI, PA, SB, sleep duration, and GMS proficiency in South African preschool children and (2) identify relationships between variables. Methods: BMI, including z scores for height, weight, and BMI were determined. Seven-day PA, SB, and sleep were measured using accelerometry. GMS were assessed using the Test of Gross Motor Development (second edition). Associations were explored by comparing sleep, PA, SB, and GMS between BMI tertiles using the Kruskal–Wallis test. Results: Most (86%) children (n = 78, 50% boys) had a healthy BMI (15.7 [1.3] kg/m2). Children spent 560.5 (52.9) minutes per day in light- to vigorous-intensity PA and 90.9 (30.0) minutes per day in moderate- to vigorous-intensity PA; most (83%) met the current PA guideline. Nocturnal sleep duration was low (9.28 [0.80] h/d). Although daytime naps increased 24-hour sleep duration (10.17 [0.71] h/d), 38% were classified as short sleepers. Around half (54.9%) of participants complied with both PA and sleep guidelines. No associations between variables were found. Conclusion: Despite being lean, sufficiently active, and having adequate GMS, many children were short sleepers, highlighting a possible area for intervention.

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Are South African Mothers Moving? Patterns and Correlates of Physical Activity and Sedentary Behavior in Pregnant Black South African Women

Estelle D. Watson, Mireille N. M. Van Poppel, Rachel A. Jones, Shane A Norris, and Lisa K. Micklesfield

Background:

Although physical activity during pregnancy may be beneficial, the prenatal period is a vulnerable time for decreasing physical activity levels and increasing sedentary time.

Methods:

This longitudinal cohort study measured physical activity using the Global Physical Activity Questionnaire (GPAQ) in singleton, pregnant women in the second (14–18 wk gestation; n = 332) and third trimester (29–33 wk; n = 256).

Results:

There was a significant decrease in total MVPA (MET mins/wk) between the second and third trimester (P = .01). The majority of physical activity time was spent in walking for transport (80%), and less than 2% in recreational activities. In both trimesters, being married was inversely associated with walking for transport (second trimester: β = –0.12 95% CI = –0.31 to –0.02, third trimester: β = –0.17 95% CI = –0.47 to –0.07) and owning a car was positively associated with recreational physical activity (second trimester: β = 0.16 95% CI = 0.02 to 0.32, third trimester: β = 0.17 95% CI = 0.04 to 0.27). The women spent an average of 5 hours per day sitting.

Conclusions:

The low and declining levels of physical activity during pregnancy in this population are a concern. Interventions that include lifestyle education and provision of accessible recreational physical activity programs for pregnant women are needed.

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Prevalence and Health Associations of Meeting the World Health Organization Guidelines for Physical Activity, Sedentary Behavior, and Sleep in Preschool-Aged Children: The SUNRISE Mongolia Pilot and Feasibility Study

Ankhmaa Byambaa, Oyundelger Dechinjamts, Bayasgalan Jambaldorj, Rachel A. Jones, Kar Hau Chong, and Anthony D. Okely

Background: There is a lack of evidence regarding 24-hour movement behaviors of young children from low- and middle-income countries. This study examined Mongolian preschoolers’ adherence to the World Health Organization’s guidelines for physical activity, sedentary behavior, and sleep; their associations with health indicators, and the feasibility of the SUNRISE International study in Mongolia. Methods: Preschool-aged children were recruited from 5 kindergartens in urban and rural areas of Ulaanbaatar city and Tuv province in Mongolia. Physical activity and sedentary behavior were measured by an ActiGraph accelerometer worn for 5 consecutive days. Screen time and sleep were reported by parents. The National Institute of Health and Early Years Toolboxes were used to assess motor skills and executive function, respectively. Results: One hundred and one children participated in the study (mean age = 4.82 y, boys = 58), with 88% (n = 89) having complete data for analysis. The proportion of children who met the recommendations for physical activity, sedentary screen time, and sleep was 61%, 23%, and 82%, respectively. Only 7% met all recommendations. Meeting the sleep recommendation individually (P = .032) and in combination with the physical activity recommendation was associated with better gross (P = .019) and fine (P = .042) motor skills. Spending more time in physical activity was positively correlated with motor development. Results confirmed that the SUNRISE study protocol was feasible, age-appropriate, and enjoyable for children. Conclusions: The results of the SUNRISE pilot study will help inform the SUNRISE Mongolia main study and lay the groundwork for future research into children’s 24-hour movement behaviors in Mongolia.

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Promoting Physical Activity and Executive Functions Among Children: A Cluster Randomized Controlled Trial of an After-School Program in Australia

Sanne L.C. Veldman, Rachel A. Jones, Rebecca M. Stanley, Dylan P. Cliff, Stewart A. Vella, Steven J. Howard, Anne-Maree Parrish, and Anthony D. Okely

Background: The aim of this study was to examine the efficacy of an embedded after-school intervention, on promoting physical activity and academic achievement in primary-school-aged children. Methods: This 6-month, 2-arm cluster randomized controlled trial involved 4 after-school centers. Two centers were randomly assigned to the intervention, which involved training the center staff on and implementing structured physical activity (team sports and physical activity sessions for 75 min) and academic enrichment activities (45 min). The activities were implemented 3 afternoons per week for 2.5 hours. The control centers continued their usual after-school care practice. After-school physical activity (accelerometry) and executive functions (working memory, inhibition, and cognitive flexibility) were assessed pre- and postintervention. Results: A total of 60 children were assessed (7.7 [1.8] y; 50% girls) preintervention and postintervention (77% retention rate). Children in the intervention centers spent significantly more time in moderate to vigorous physical activity (adjusted difference = 2.4%; 95% confidence interval, 0.6 to 4.2; P = .026) and scored higher on cognitive flexibility (adjusted difference = 1.9 units; 95% confidence interval, 0.9 to 3.0; P = .009). About 92% of the intervention sessions were implemented. The participation rates varied between 51% and 94%. Conclusion: This after-school intervention was successful at increasing moderate to vigorous physical activity and enhancing cognitive flexibility in children. As the intervention was implemented by the center staff and local university students, further testing for effectiveness and scalability in a larger trial is required.