Purpose: Public health authorities recommend children ≤ 5 y accumulate 180 min/d in a variety of physical activity (PA) types and intensities. Given the large proportion of children attending childcare, quantitative guidelines for PA accumulated while in care are needed. The current study analysed accelerometer data from four Australian studies to establish population-based reference values for PA while attending childcare.

Methods: 3,374 accelerometer records were available, providing 11,404 childcare monitoring days for analysis.  Of this number, 3,893 monitoring days from 2,185 children met the strict inclusion criteria (aged 2 to 5 y; childcare attendance ≥ 4 and < 12 hrs; accelerometer wear time ≥ 95% of attendance). Raw accelerometer signal was processed into PA metrics using a random forest (RF) PA classification algorithm for children ≤ 5 y (Ahmadi et al., 2020). The RF uses 20 features in the vector magnitude (VM) of the tri-axial acceleration signal to classify movement as: sedentary (SED), light-intensity activities and games (L_ACT_G), walking (WALK), running (RUN), or moderate-to-vigorous activities and games (MV_ACT_G). Non-wear periods were defined as 30 consecutive mins in which the SD for the VM was < 13 mg. Total PA (TPA) was the sum of L_ACT_G, WALK, RUN, and MV_ACT_G. Energetic Play (EP) was the sum of WALK, RUN, and MV_ACT_G.  TPA and EP values were standardised to an 8-hr day. Percentiles were calculated after transforming TPA and EP values to a normal distribution using the bestNormalize package in R.

Results: Boys percentiles for TPA were: 200 (5^th), 252 (25^th), 292 (50^th), 326 (75^th), and 377 (95^th) min/d. In girls, the corresponding values were 182, 234, 276, 314, and 363 min/d. Boys percentiles for EP were: 8 (5^th), 15 (25^th), 25 (50^th), 37 (75^th), and 65 (95^th) min/d. In girls, the corresponding values were 6, 12, 20, 30, and 51 min/d.

Conclusions: On an average childcare day, Australian children accumulate 276 to 292 min of TPA and 20 to 25 min of EP. Nearly all children meet the 180 min TPA recommendation if they attend childcare for a full day, but only a small percentage meet the daily guideline for energetic play.

Purpose: Australian 24-hour movement guidelines for the early years provide recommendations on daily physical activity, sedentary leisure screen time and sleep, for children 0-5 years. We used a large representative sample to examine the association between meeting 24-hour movement guidelines and pre-schooler social-emotional development.

Methods: PLAYCE study data were collected for 1368 children 2-5 years from 122 Perth, Western Australian childcare centres. Centres were recruited based on size and socio-economic status. Physical activity was assessed using 7 day accelerometry. Parent-report screen time and sleep were determined using established reliable items. The Strengths and Difficulties Questionnaire was used to measure social-emotional development.

Results/findings: Only 7.7% of pre-schoolers met all three 24-hour movement guidelines and 7.1% met none. Meeting screen time guidelines (compared with none) was associated with lower mean emotional difficulties (p=0.013), conduct problems (p=0.026), hyperactivity (p=0.029) and peer problems (p=0.046) scores as well as lower overall difficulties score (adjusted mean difference -2.39, p<0.001). Meeting the sleep guideline vs. none (p=0.029), as well as meeting all three guidelines vs. none (p=0.033) was associated with better overall social-emotional development.

Conclusions: Pre-schoolers who met screen time guidelines had on average a lower total difficulties score of 2.4. These findings are important considering existing population level data shows that the odds of children developing a clinically significant mental health disorder increases by 14-28% for each one point increase in the total difficulties score. Our findings provide stronger evidence that meeting 24-hour movement guidelines, particularly screen time guidelines, supports young children’s social-emotional development. Effective scalable integrated intervention strategies targeting multiple movement behaviours are required to support all aspects of young children’s health and development.

Purpose:

Preschool children spend a significant amount of their time in the childcare centre environment, however studies of the childcare physical environmental influences on preschool children’s physical activity behaviours are sparse and limited by the lack of use of device measured physical activity and objectively measured physical environment data. The use of device measured physical activity and spatial data can provide objective information on how spaces are used and the types of physical activity preschool children do in the childcare outdoor environment. This study aims to investigate where preschool children are most and least active in the childcare outdoor environment using device measured physical activity and objectively measured physical environment data.

Methods:

Participants included 399 preschool children aged 2-5 years from 30 childcare centres taking part in the part in the Play Spaces & Environment for Children's Physical Activity (PLAYCE) Study in Perth, Western Australia. Participant wore an accelerometer (Actigraph GT3X) and a Global Positioning System (GPS) device (Qstarz Q-1000XT) for 7 days. Optimized hot-spot analysis was performed using ArcGISpro to identify the statistically significant spatial clusters of GPS points with high or low physical activity levels in every childcare centre.

Results:

Clusters of hot spots were found to be gathered in childcare open areas (24 out of 30 childcare centres) and sometimes also found in their adjacent outdoor play areas if children can freely move between these areas. Overall, there was no significant difference in preschool children’s physical activity levels by sex or childcare centre socioeconomic status.

Conclusions:  

The amount of free running space in nature play, sand play and dramatic play areas and their connection to the open areas was important for facilitating active play in preschool children. These findings provide preliminary evidence to help identify where preschool children are physically active or inactive in the childcare environment, and will help to inform the planning, design, building of childcare centres that are sensitive to children’s needs.

Purpose

Essential to optimal child health and development in early childhood education and care (ECEC) is responsive infant and young child feeding. Research investigated the environments that supported responsive infant feeding and views of Australian educators on responsive feeding implementation.  

Methods

Long day care and family day care services (n=19) in the state of Queensland from metropolitan/regional and varied socio-economic areas participated in the study. This included 124 educators contributing through professional conversations, semi-structured interviews with service leaders and environmental audits utilising images and the NAP SAAC survey tool. Analysis was guided by the Framework method, incorporating both inductive thematic, and deductive analysis utilising Bronfenbrenner’s Ecological model.

Results

Three main themes were identified through qualitative analysis 1. Educator knowledge, efficacy and agency, 2. Environment and 3. Monitoring/surveillance as being significant factors for collective supportive responsive infant feeding, vital to agency. Fundamentally this illuminates the crucial need for supporting service leadership, knowledge of educators for infant and young child feeding and collective efficacy to overcome system barriers to enable supportive ECEC environments for responsive feeding.

Conclusions

Research outcomes describe the necessity for national visibility of infant and young child feeding policies and policy leadership and training on responsive feeding. Results highlight the importance of developing educator efficacy around parents to support responsive feeding impacting infant and young child agency.

Purpose: Web-based modalities provide a potentially effective and less costly approach to implementing healthy eating interventions at scale. This study sought to collect feasibility and pilot data to inform the design of a web-based intervention to improve the implementation of healthy eating practices within the childcare setting. Specifically, the aim of this pilot implementation trial was to: (1) Collect data to inform processes to undertake a fully-powered implementation trial; (2) Examine the uptake of the implementation strategies; (3) Examine the acceptability of intervention and implementation strategies; and (4) Understand the cost to deliver the implementation support strategies.

Methods: A 6-month pilot implementation trial employing a cluster randomised controlled trial design was conducted in childcare centres within New South Wales, Australia. Intervention centres received implementation strategies embedded within a web-based program and provided by health promotion officers. Feasibility of the intervention was assessed through study consent rates and completion of data collection. Uptake of the implementation strategies were captured via analytics and internal records. Acceptability of the intervention and implementation strategies were assessed through surveys with centre staff. Cost to deliver implementation strategies was assessed via internal records.

Results: A 47% consent rate was achieved. Twenty-two centres (100%) consented to participate in all data collection components. All intervention centres (n=11) received audit with feedback and developed a formal implementation blueprint via the web-based program. All intervention centres received the educational outreach visit and 91% received a support call (n=10). One hundred percent of centre managers (n=11) reported the web-based program as being an acceptable method for assessing implementation of healthy eating practices. All implementation strategies were deemed highly acceptable by 100% of centre managers. The total cost to deliver the implementation strategies was $1351 ($122 per centre).

Conclusions: As this study is one of few examining the potential impact of a web-based intervention within the childcare setting, a fully-powered implementation trial is warranted to establish the true effects and examine the impact of the intervention on the implementation of healthy eating practices at scale.