A socio-ecological approach to physical activity interventions in childcare: a systematic review
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REVIEW
Open Access
A socio-ecological approach to physical activity interventions in childcare: a systematic review Marjo Anette Kristiina Mehtälä1*, Arja Kaarina Sääkslahti2, Mari Elina Inkinen1 and Marita Eija Helena Poskiparta1
Abstract The promotion of physical activity (PA) in young children requires effective interventions. This article reviews the evidence on PA interventions in childcare by applying a socio-ecological approach. A computer-based literature search for intervention studies aimed at increasing children’s PA levels was run across four databases: SPORTDiscus, ISI Web of Science, PsycINFO and ERIC. The participants had to be in childcare, aged 2-6-year-old, and their pre- and post- intervention PA levels measured. Selection was restricted to peer-reviewed publications and to studies conducted in childcare settings. Twenty-three studies met the inclusion criteria and their methodological quality was assessed. Seven studies exhibited high methodological quality; twelve were rated as moderate and four low. The effectiveness of the interventions was determined according to the post-intervention behavioral changes reported in children’s PA. Fourteen studies found increases in PA levels or reductions in sedentary time, although the changes were modest. The data remain too limited to allow firm conclusions to be drawn on the effectiveness of the components mediating PA interventions, although PA-specific in-service teacher training seems a potential strategy. The findings of this review indicate that children’s PA remained low and did not approach the 180 min/day criteria. It may be that more intensive multilevel and multicomponent interventions based on a comprehensive model are needed. Keywords: Physical activity, Intervention, Children, Childcare, Socio-ecological model
Introduction Physical activity (PA) guidelines for childcare children (2– 6 year olds) vary, stipulating between at least 2 hours and, more recently, at least 3 hours of PA daily [1-4]. Most children do not meet any of the current guidelines, and their PA levels have been reported to be very low [5,6]. Health behavior habits in childhood tend to track into adulthood. Findings of reviews have indicated evidence of moderate tracking during early childhood and from early childhood to middle childhood, and low to moderate tracking from childhood to adulthood for PA [7,8]. Increased or higher PA in early childhood reduces the risk for being overweight and is associated with improved motor skill development, psychosocial health, and cardiometabolic health indicators [9,10]. In contrast, a sedentary lifestyle is associated with greater risk factors for chronic diseases such as diabetes mellitus * Correspondence: [email protected] 1 Department of Health Sciences, University of Jyväskylä, Keskussairaalantie 4, Jyväskylä 40014, Finland Full list of author information is available at the end of the article
and coronary heart disease [1]. Therefore promotion of PA should begin already during early childhood. Studies have reported low levels
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