Research article
The Childcare Environment and Children’s Physical Activity

https://doi.org/10.1016/j.amepre.2007.09.022Get rights and content

Background

With increased numbers of children attending child care, this setting presents an ideal opportunity to promote physical activity and the early development of healthy behaviors. The purpose of this study was to examine the relationships between the childcare environment and physical activity behavior of preschool children.

Methods

Aspects of the environment hypothesized to influence children’s physical activity were assessed in 20 childcare centers using the Environment and Policy Assessment and Observation (EPAO) instrument. Physical activity behavior was assessed over 2 days using direct observation.

Results

Children in centers with supportive environments achieved more moderate-to-vigorous physical activity (15% of observations vs 9%; effect size [ES]=1.17), spent less time in sedentary activities (50% vs 61%; ES=–1.52), and had higher mean physical activity levels (2.68 vs 2.43; ES=1.41) compared to centers with less supportive environments. Facets of the physical and social environment related to physical activity behavior included active opportunities, portable play equipment, fixed play equipment, sedentary environment, and physical activity training and education.

Conclusions

Previous research indicates that the childcare center that children attend significantly affects physical activity behavior. The current findings extend this evidence by identifying aspects of the childcare environment that relate to the physical activity behavior of children. These factors should be considered when identifying determinants of physical activity and designing interventions.

Introduction

Fifty-seven percent of children aged 3 to 5 years were enrolled in center-based child care in 2005.1 With a large proportion of young children spending all or part of their day outside of home, the childcare environment presents an ideal opportunity to promote physical activity and aid in the early development of healthy behaviors. The increasing prevalence and earlier onset of childhood overweight further underscores the importance of intervening at the preschool level.2, 3, 4

Despite growing evidence supporting environmental determinants of physical activity behavior5, 6, 7 and studies suggesting that nearly 50% of the variation in physical activity during preschool hours can be attributed to the childcare center,8, 9 research focused on understanding the unique aspects of the childcare environment that influence physical activity behavior is lacking.10, 11, 12, 13, 14 This may be due, in part, to the need for appropriate measures to assess the healthy-weight environment in the childcare setting. The unique social and physical aspects of childcare settings that may influence weight status are not adequately covered by instruments designed to assess the home, school, and built environments.

Recently, a new instrument has been developed that attempts to quantify both social and physical environmental factors thought to affect dietary and physical activity behaviors of children in child care. The Environment and Policy Assessment and Observation (EPAO) was created to evaluate the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) program, an environmental nutrition and physical activity intervention in child care. The EPAO is an expansion of the self-assessment component of the NAP SACC program created following an extensive review of the nutrition and physical activity literature, recommendations and standards from credible organizations, as well as input from a number of experts in the fields of measurement, nutrition, physical activity, and child care. Details of the literature review and documentation of the components used for the self-assessment and the EPAO can be found elsewhere.15, 16

Improving our understanding of physical activity determinants in the childcare setting will ultimately lead to the development of more effective strategies for promoting physical activity among preschool children. Therefore, the purpose of this study was to determine the relationship between the social and physical activity environment in childcare centers, measured by the physical activity component of the EPAO, and physical activity behavior of children while in child care. The findings are also presented as validity evidence for the EPAO physical activity subscales.

Section snippets

Methods

Each childcare center received a 1-day assessment of the physical and social environmental factors hypothesized to influence healthy weight. In addition, an evaluation of the physical activity behavior of children attending centers was conducted on 2 additional days. During the 3-day assessment, children aged 3 to 5 years were observed. In centers with more than one eligible classroom, a single class was randomly selected for observation. Additional data were gathered through interviews and a

Results

Data from the EPAO and modified OSRAP are summarized in Table 3. Overall, 12% of physical activity observations were classified as MVPA (rated 4 or 5), while 55% were classified as sedentary activity (rated 1 or 2). The mean activity rating over all observation periods was 2.55, indicating that the average intensity across all centers was between seated play and slow/easy movement.

The average EPAO physical activity environment total score (±SD) was 10.15±2.80 (median=10.59). Mean subscale

Discussion

The purpose of the present study was to examine associations between physical activity behavior and the physical activity environment in childcare centers. A key finding was that centers with higher physical activity environment scores had children who were more physically active and less inactive while in child care. Previous research indicates that the childcare center accounts for a significant proportion of the variability in physical activity behavior of children while in care.8, 9, 10, 12

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