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Angie L.I. Cradock, Emily M. O'Donnell, Sara E. Benjamin, Elizabeth Walker and Meghan Slining

Background:

As interventions increasingly emphasize early child care settings, it is necessary to understand the state regulatory context that provides guidelines for outdoor physical activity and safety and sets standards for child care environments.

Methods:

Researchers reviewed regulations for child care facilities for 50 states, the District of Columbia and the Virgin Islands. We compared state regulations with national standards for 17 physical activity- and safety-related items for outdoor playground settings outlined in Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs (CFOC). State regulations were coded as fully, partially or not addressing the CFOC standard and state-level summary scores were calculated.

Results:

On average, state regulations fully addressed one-third of 17 CFOC standards in regulations for centers (34%) and family child care homes (27%). Data suggest insufficient attention to outdoor play area proximity and size, equipment height, surfacing, and inspections.

Conclusions:

Considerable variation exists among state regulations related to physical activity promotion and injury prevention within outdoor play areas. Many states' regulations do not comply with published national health and safety standards. Enhancing regulations is one component of a policy approach to promoting safe, physically active child care settings.

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Sarah C. Ball, Matthew W. Gillman, Meghan Mayhew, Rebecca J. Namenek Brouwer and Sara E. Benjamin Neelon

Background:

Young children’s physical activity (PA) is influenced by their child care environment. This study assessed PA practices in centers from Massachusetts (MA) and Rhode Island (RI), compared them to best practice recommendations, and assessed differences between states and center profit status. We also assessed weather-related practices.

Methods:

Sixty percent of MA and 54% of RI directors returned a survey, for a total of 254. Recommendations were 1) daily outdoor play, 2) providing outdoor play area, 3) limiting fixed play structures, 4) variety of portable play equipment, and 5) providing indoor play area. We fit multivariable linear regression models to examine adjusted associations between state, profit status, PA, and weather-related practices.

Results:

MA did not differ from RI in meeting PA recommendations (β = 0.03; 0.15, 0.21; P = .72), but MA centers scored higher on weather-related practices (β = 0.47; 0.16, 0.79; P = .004). For-profit centers had lower PA scores compared with nonprofits (β = −0.20; 95% CI: −0.38, −0.02; P = .03), but they did not differ for weather (β = 0.12; −0.19, 0.44; P = .44).

Conclusions:

More MA centers allowed children outside in light rain or snow. For-profit centers had more equipment—both fixed and portable. Results from this study may help inform interventions to increase PA in children.