Preschoolers Activity Trial - a Pilot Randomized Controlled to Increase Physical Activity and Reduce Sedentary Behaviour

Background & Significance:

Objective measures of physical activity (PA) using accelerometers (motion sensors worn at the hip) reveal that preschoolers level of sedentary behaviour are high, and levels of moderate to vigorous physical activity (MVPA) are low (Pate et al., 2004, Reilly et al., 2004, 2006). Inquiry into preschoolers daily levels of PA suggest that 2.6% to 4% of waking hours are spent in MVPA (Reilly, 2004, 2006;Montgomery et al. 2004), and, during pre-school hours, Pate and colleagues found that 3 to 5 year old children engaged in 7.7 minutes of MVPA. A recent study of Canadian preschoolers found remarkably similar levels of MVPA (Temple et al., 2009), that include 12.3 minutes of MVPA per day and 39.5 minutes of sedentary behaviour per hour. Although Pate et al. 2004 found that boys had higher levels of MVPA than girls, they did not detect differences in levels of sedentary behaviour, which constituted the vast majority of time for boys and girls. The findings suggest that young children are very inactive and therefore may be at risk for adverse health consequences related to physical inactivity.

Opportunities for PA and motor development in early childhood may, over the lifespan, influence health behaviours and the potential to maintain a healthy body weight. Fundamental movement skills (e.g., catching, throwing, jumping, running, etc.) are the essential building blocks for the acquisition of more refined and complicated skills that can be applied later in life, such as sporting, recreational and physical activities (Gallahue et al. 2002; Carson 1994; Seefeldt, 1979). However, movement skills will not develop to their potential without opportunities to practice in environments that are stimulating and supportive (Kelly et al., 1989; Taggart & Keegan, 1997). Butcher & Eaton found that preschoolers movement competence already influenced their PA choices and levels. It is the mastery of motor skills and the ability of children to incorporate these skills into games, dances, and sports of one's culture that provides the stimulus for movement which contributes to long-term health (Seefeldt & Vogel, 1987).

There is a paucity of information on current trends in PA of preschool aged children, and on the relationship between the ability of children to perform fundamental movement skills and prediction of PA (Mackenzie et al 2003). The few studies noted above indicate that preschool aged children do not come close to being physically active enough to accrue health benefits. In fact, although the evidence of how much and what type of PA is necessary to optimize health and development of preschool-aged children is somewhat unclear (Timmons et al., 2007), expert consensus suggests that preschool-aged children should not be sedentary for more than 60 minutes at a time, except when sleeping, and they should engage in at least 60 minutes (and up to several hours) of structured (facilitated by day care providers, parents, etc. ) and 60 minutes of unstructured PA daily, as well as 180 mins of total PA (National Association for Sport & Physical Education, NASPE, 2002).

In keeping with the settings-based approach to health promotion, which acknowledges the influence of place on behaviour (Dooris et al. 2007), it is believed that powerful influences on children's PA levels are the social and physical environments in which they spend time (Bower et al., 2008; Dowda et al., 2004; Finn eta l., 2002). Over half of all Canadian children aged 6 months to 5 years were in some form of nonparental/guardian care in 2002-2003, and children spent an average of 29 hours a week in these day care settings (Bushnik , 2006; Silver 2000). The majority of Canadian children in both two parent and single parent families fall into this category as 77% of two parent families and 75% of single parent families rely on day care for their children. As such, the paid child day care setting provides an ideal opportunity to examine and enhance the movement skills and PA behaviours of preschool-aged children. There is a small body of evidence that suggests that group preschool and child care settings, policies and practices strongly influence children's PA (Finn et al., 2002; Pate et al., 2004; Bower et al., 2008), but the efficacy of interventions in day care centre settings on preschool children's PA and inactivity behaviours has not yet been determined.