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Dianne Ward, Ed.D. - "Moving Kids at Preschool and at Home"

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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/YNCONF13

Published in: Education, Self Improvement
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Dianne Ward, Ed.D. - "Moving Kids at Preschool and at Home"

  1. 1. Moving Kids: at Preschool and Home Dianne S. Ward Youth-Nex Conference October 10-11, 2013
  2. 2. Guidelines for Physical Activity: Children 0-5 Years
  3. 3. 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)
  4. 4. International Recommendations Australia (2010) • Encourage supervised floor-based play from birth • 3hrs/day physical activity spread through the day UK (2011) • Encourage supervised floorbased play from birth • 3hrs/day physical activity spread through the day Slide from Dr. Anthony Okely, U. of Gollagoong Canada (2012) • Encourage supervised floorbased play from birth • 3hrs/day physical activity spread through the day
  5. 5. 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
  6. 6. What do we know? Moving Kids at Home
  7. 7. 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
  8. 8. 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
  9. 9. 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
  10. 10. Study Overview • Compared general parenting style and practices, physical activity-related practices, and child physical activity N=324 Parent Characteristics White African 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 Measured: •parenting style •parenting practice •physical activity Child Age 41.8 mo Child BMI %ile 59.1 %ile
  11. 11. CONTROLING PRACTICES Results Inside rules for active play (-0.515) Conditions on outside play - clean Conditions on outside play - weather Positive Parenting SUPPORTIVE PRACTICES Reward w/ PA (0.150) Modeling (0.247) Family activity (0.263) Encouragement (0.400) Education (0.206) CONTROLING PRACTICES Control over screen time (0.076, p=.162) Monitoring screen time SUPPORTIVE PRACTICES --- Positive assoc. --- Negative assoc. Reward w/ TV Modeling screen time
  12. 12. CONTROLING PRACTICES Results Inside rules for active play (0.167) Conditions on outside play – clean (0.121) Conditions on outside play – weather (0.102, p=.063) SUPPORTIVE PRACTICES Reward w/ PA Modeling (-0.132) Family activity (-0.213) Encouragement (-0.115) Education Punitive Parenting CONTROLING PRACTICES Control over screen time (-0.091, p=.104) Monitoring screen time (-0.201) SUPPORTIVE PRACTICES --- Positive assoc. --- Negative assoc. Reward w/ TV (0.109) Modeling screen time (0.201)
  13. 13. 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
  14. 14. 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
  15. 15. Which policies result in more physical activity? Child Care Policies, Practices & Environments for Physical Activity
  16. 16. 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 activity 5. Center’s written policies about physical activity McWilliams et al., Pediatrics, 2008
  17. 17. 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)
  18. 18. 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
  19. 19. Results
  20. 20. 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)
  21. 21. 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)
  22. 22. 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)
  23. 23. 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)
  24. 24. 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)
  25. 25. 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
  26. 26. 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
  27. 27. Go NAP SACC www.gonapsacc.org Online tools coming soon! @gonapsacc

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