dianne ward, ed.d. - "moving kids at preschool and at home"
DESCRIPTION
The Youth-Nex Conference on Physical Health and Well-Being for Youth, Oct 10 & 11, 2013, University of Virginia Ward is Professor of Nutrition in the Gillings School of Global Public Health at the University of North Carolina. Panel 2 - How can we increase physical activity in children and adolescents? The presentations in this panel will describe programs that have successfully increased physical activity at preschool, in the home, at school, in communities, and in the private sector. Website: http://bit.ly/YNCONF13TRANSCRIPT
Moving Kids: at Preschool and
HomeDianne S. Ward
Youth-Nex ConferenceOctober 10-11, 2013
Guidelines for Physical Activity: Children 0-5 Years
NASPE Guidelines (2002)
• Infants:– Should interact with parents and/or caregivers in daily
physical activities and in settings that encourage activity and do not restrict
• Toddlers and Preschoolers:– Should engage in at least 60 minutes – up to several
hours per day– of unstructured activity– Should accumulate 30 – 60 minutes of structured PA
each day (Toddlers-30 min; Preschool-60 min)
International Recommendations
Australia (2010) UK (2011) Canada (2012)
• Encourage supervised floor-based play from birth
• 3hrs/day physical activity spread through the day
• Encourage supervised floor-based play from birth
• 3hrs/day physical activity spread through the day
• Encourage supervised floor-based play from birth
• 3hrs/day physical activity spread through the day
Slide from Dr. Anthony Okely, U. of Gollagoong
Institute of Medicine. Early childhood obesity prevention policies: Goals, recommendations, and potential actions. Washington: Institute of Medicine; 2011.
Slide from Dr. Anthony Okely, U. of Gollagoong
Moving Kids at Home
What do we know?
Challenges Working with Parents
• Parents of young children mostly young adults • Time is a premium• Often both parents work outside of home• Demands related to caring for a younger child
are great (e.g., closer oversight, less independence, safety issues, less structured approaches available)
• Need to find strategies for engagement
Parenting for Activity or “Physical Activity Parenting”
• A recent conference focused on “Measuring Parenting” (ISBNPA Pre-Conference, 2011)
• Identified concept of “PA Parenting”• Work by Davison and other tried to identify
and conceptualize parent actions for PA• Found research lacking including absence of
quality measurements of PA parenting• More research work needed
See 2 papers by Davison et al. and Trost et al. Childhood Obesity, 2013
Parents have different “styles” of managing children
• Parenting “style” is described as how parents respond to their children based on control (demandingness) and warmth (responsiveness)
• Positive parenting refers the a balance between warmth and control
• Greater control, less warmth results in “punitive” or authoritarian parenting
• Concerns for safety and protection may favor control over warmth
Study Overview
• Compared general parenting style and practices, physical activity-related practices, and child physical activity
N=324
Parent Characteristics
WhiteAfrican Amer
51.4%39.8%
Parent Age 34.9 y
Parent BMI 30.1 kg/m2
Income <$50K 36.6%
Education≥ College 75.3%
Child Characteristics
Child Age 41.8 mo
Child BMI %ile 59.1 %ile
Measured: •parenting style•parenting practice•physical activity
CONTROLING PRACTICESResults
SUPPORTIVE PRACTICES
Inside rules for active play (-0.515)
Reward w/ PA (0.150)
Conditions on outside play - weather
Conditions on outside play - clean
Modeling (0.247)
Family activity (0.263)
Education (0.206)
Encouragement (0.400)
CONTROLING PRACTICES
Control over screen time (0.076, p=.162)
Monitoring screen time
SUPPORTIVE PRACTICES
Modeling screen time
Reward w/ TV--- Positive assoc.--- Negative assoc.
Positive Parenting
CONTROLING PRACTICES
Results
SUPPORTIVE PRACTICES
Inside rules for active play (0.167)
Reward w/ PA
Conditions on outside play – weather (0.102, p=.063)
Conditions on outside play – clean (0.121)
Modeling (-0.132)
Family activity (-0.213)
Education
Encouragement (-0.115)
CONTROLING PRACTICES
Control over screen time (-0.091, p=.104)
Monitoring screen time (-0.201)
SUPPORTIVE PRACTICES
Modeling screen time (0.201)
Reward w/ TV (0.109)--- Positive assoc.--- Negative assoc.
Punitive Parenting
Parenting Style-Parenting Practice
• What works positively for one parenting style may not work as well for another– Positive parenting works well with supportive PA
practices but not with controlling practices– Inconsistent parenting style using supportive PA
practices did not increase kids’ PA – Punitive parenting style can use controlling
practices effectively but long-term impacts of style-practice interaction unknown
Conclusions
• Model explains a small but significant amount of variance in child activity (16. 5% MVPA & 12.8 % sed.)– Positive parenting supportive practices child MVPA– Punitive parenting controlling practices– Associations with inconsistent parenting somewhat
unexpected (some positive, some not)
• Similarities and differences with feeding literature• Much more work in needed in this area
Child Care Policies, Practices & Environments for Physical Activity
Which policies result in more physical activity?
Best Practice Guidelines
1. Amount of play time (minutes) provided (both inside & outside): 120 minutes
2. Occasions (#) of teacher-led physical activity: 2 or more per day
3. Staff joining in activity with children: regularly
4. Staff trained on physical activity5. Center’s written policies about physical
activity
McWilliams et al., Pediatrics, 2008
Procedures
• 50 child-care centers in North Carolina– 45 centers were rated 3-5 stars; others 2-3 stars– 23 centers participated in the Child and Adult Care
Food Program (CACFP)• Data collected during 4 days at the centers• 4 day of observation at each center (full day)• Children’s activity assessed by accelerometers – About 10 children measured per day at each
center (~500 total)
Measures
Physical Activity• GT1M worn for 4 days while
at child-care center • Average wear time was 7
hours/day• 15 second epochs
– Cut-points • Sedentary = <25 counts per
15 seconds• MVPA = >500 counts per 15
seconds
Child Care Practices
Results
Amount of PA time at centers with ≥120 min/day of active play
At centers providing ≥120 min/day of active play, children spent
More minutes/hour in MVPA (p=0.04)
Fewer minutes/hour in sedentary activities (p=0.11, ES = -0.81)
PA time at centers providing ≥2 occasions of teacher-led activity
At centers providing≥2 occasions of teacher-led PA, children spent
More minutes/hr. in MVPA (p=0.03)
Fewer minutes/hr. in sedentary activities (p=0.02)
PA time at centers where staff joined in active play on >1day
At centers where staff joined children in active play on >1 day, children spent
More minutes/hr. in MVPA (p=0.01)
Fewer minutes/hr. in sedentary activity (p=0.14, ES=-0.48)
PA time at centers where staff received PA training
At centers where at least 1 staff had received PA training, children spent
No effect on minutes of MVPA/hr. (p=0.07, ES=0.04)
More minutes in sedentary activity (p=0.18, ES =0.43)
PA time at centers with ≥4 Written Physical Activity Policies
No policy effect on time spent in MVPA (p=0.08, ES= -0.32) or sedentary activity (p=0.49, ES=0.13)
Summary
• Found a positive effect of:– Providing 120 min/day of activity time– Teachers who lead activities at least twice per day – Teachers joining in active play
• Found no effect of:– PA training (at least 1 staff)– written policies had no effect
• Lack of finding for training and policy may be related to type training; non-specific policies
Overall Conclusions and Future Directions
• Settings (home & child care) and caregivers (parents & providers) influence the amount of physical activity children
• Parents can influence child activity, but new strategies may be needed to engage parents and modifying PA parenting practices
• Child care centers can increase children’s PA through their policies and practices; efforts to improve are needed
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