Graduate Thesis Or Dissertation
 

Physical activity in children attending family child care homes

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  • Family Child Care Homes (FCCHs) are the second largest provider of non-relative care in the U.S. However, despite providing care for nearly 1.9 million children under the age of 5, little is known about the physical activity levels of children attending FCCHs. This dissertation sought to provide new information with regards to physical activity in children attending FCCHs. The purpose of the first study was to objectively measure physical activity in children attending FCCHs. 114 children (60 boys and 54 girls) 3.7 ± 1.1 years of age from 47 FCCHs wore an ActiGraph GT1M accelerometer for the duration of child care attendance during a randomly selected week. Counts were classified as sedentary (SED), light (LPA), or moderate-to-vigorous (MVPA) using the cut-points developed by Pate et al. (2006). Total physical activity was calculated by summing time spent in LPA and MVPA. Non-wear time was estimated by summing the number of consecutive zero counts accumulated in strings of 10 minutes or longer. Children were included in the analyses if they had 2 or more monitoring days in which wear time was ≥75% of the attendance time. On average, children accumulated 25.9 ± 5.7 min of SED, 10.1 ± 4.2 min of MVPA, and 34.1 ± 5.7 min of total physical activity per hour of attendance. Further analysis revealed that among healthy weight children, 4 year-olds exhibited significantly lower levels of SED and significantly higher levels of MVPA and total physical activity than 2- and 3- year-olds. Among 4-year-olds, overweight and obese children exhibited significantly higher levels of SED and significantly lower levels of MVPA and total PHYSICAL ACTIVITY than healthy weight counterparts. The results from this study indicated that preschool-aged children attending FCCHs are mostly sedentary and accumulate low levels of MVPA during the child care day. The purpose of the second study was to assess the validity of two proxy report instruments designed to measure physical activity in children attending FCCHs. Valid self-report measures are needed for large scale intervention studies and/or population-based surveillance studies in which more burdensome objective measures are not feasible. In Year 1 of the study, FCCH Providers (N=37) completed the Burdette parent proxy report, modified for the family child care setting, for 107 children aged 3.4 ± 1.2 years. In Year 2, 42 Providers completed the Harro parent and teacher proxy report, modified for the family child care setting, for 131 children aged 3.8 ± 1.3 years. Both proxy-reports were assessed for validity using objectively measured physical activity as a criterion measure (accelerometry). Significant positive correlations were observed between scores from the modified Burdette proxy report and objectively measured total physical activity (r = 0.31, p < 0.01) and MVPA (r = 0.33, p < 0.01). Across levels of Provider-reported activity, both total physical activity and MVPA increased significantly in a linear dose-response fashion. Provider-reported MVPA scores from modified Harro proxy report were not associated with objectively measured physical activity. These findings suggested that the modified Burdette proxy report may be a useful measurement tool in larger-scale physical activity studies involving FCCHs in which objective measures, such as direct observation or accelerometry, are not practical. The purpose of the third study was to evaluate the effects of two strategies to increase the use of portable play equipment in FCCHs – a community-based train-the-trainer physical activity intervention (INT), and the same trainer-the-trainer intervention supplemented with monthly emails promoting the use of portable play equipment (INT+). We hypothesized that Providers completing the standard train-the-trainer intervention would report significantly greater portable play equipment use than Providers completing the food allergy control training (CON). We further hypothesized that Providers completing the supplementary email intervention would report significantly greater portable play equipment use than Providers completing standard train-the-trainer intervention or the food allergy control training. A total of 50 FCCH Providers from Marion, Linn, Benton, Washington, and Lane County, Oregon were randomized to the INT or CON conditions. Twelve Providers from Lincoln County were assigned to the (INT+). The type, variety, and frequency of portable play equipment use was measured by means of self-report via a checklist and two items from the previously validated NAP-SACC Self-Assessment instrument. FCCH Providers who completed the INT reported significantly greater use of portable play equipment than Providers completing the CON training. However, portable play equipment use among Providers completing the INT+ was not significantly different from that reported by Providers in the INT or CON. Notably, neither intervention had a significant impact on the amount or variety of portable play equipment. The results showed that a comprehensive trainer-the-trainer intervention to increase physical activity in FCCHs could successfully increase the use of portable play equipment in the home. However, supplementing the intervention with monthly emails encouraging the use of PPE was not effective.
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