University of South Carolina Physical Activity in Preschool - PowerPoint PPT Presentation

William H. Brown, PhD South Carolina Education Policy Fellow University of South Carolina

 Physical Activity in Preschool Children. National Institutes of Health (2003-2007). (Pate, PI with Addy & Brown, Investigators).  Multi-component Intervention to Increase Physical Activity in Preschool Children. National Institutes of Health (2008-2013). (Pate, PI with Brown, Saunders, & Addy, Co-PIs)  ABC Grow Healthy Project. U. S. Centers for Disease Control and Prevention and the South Carolina Departments of Health and Environmental Control (DEC) and Social Services (DS) (2010-2013). (Pate, PI & Brown, Co-PI).

 Overweight and Obesity a National Challenge  What We Know about Young Children’s Physical Activity  How t o Enhance Young Children’s Physical Activity in Community-based Preschools  A “Thought Experiment” about Children with Developmental Delays 4

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Weight of the Nation (HBO Documentary) Super Size Me: A Film of Epic Portions (Mockumentary) 7

 Healthy People 2020 (United States Department of Health and Human Services, 2010)  “The Epidemic of Childhood Obesity: Review of Research and Implications for Policy” Social Policy Report: Society for Research in Child Development (Krishnamoorthy, Hart, & Jelalian, 2006) 8

“Lack of activity destroys the good condition of every human being, while movement and methodical physical exercise save it and preserve it.” (Fox & Haskell, 1968) 9

 The data shown in these maps were collected through CDC’s Behavioral Risk Factor Surveillance System (BRFSS). • Mokdad AH, et al. The spread of the obesity epidemic in the United States, 1991 – 1998. JAMA 1999;282:16:1519 – 22. • Mokdad AH, et al. The continuing epidemics of obesity and diabetes in the United States. JAMA 2001;286:10:1519 – 22. • Mokdad AH, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003;289:1:76 – 9. • CDC. State-specific prevalence of obesity among adults — United States, 2005. MMWR 2006;55(36):985 – 8. • CDC. State-specific prevalence of obesity among adults — United States, 2007. MMWR 2008;57(28):765 – 8. • CDC. Vital signs: State-specific prevalence of obesity among adults — United States, 2009. MMWR 2010;59:1 – 5. 10

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10% – 14% 11

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10% – 14% 15% – 19% 12

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10% – 14% 15% – 19% ≥20% 13

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10% – 14% 15% – 19% 20% – 24% 25% –29% ≥30% 14

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10% – 14% 15% – 19% 20% – 24% 25% –29% ≥30% 15

 In 2010, no state had a prevalence of obesity less than 20%;  Thirty-six (36) states had a prevalence equal to or greater than 25%; and  Twelve (12) of these states (almost all Southeastern states, including S. C.) had a prevalence equal to or greater than 30%. 16

 Among 2- to 5-year-old children in the U.S., the prevalence of overweight is 26.7%  Among 6- to 11-year-old children, the prevalence of overweight is 32.6%  Overweight is both those at-risk for overweight (BMI ≥ 85 th percentile) and overweight (BMI ≥ 95 th percentile) (Ogden, Carroll, Kit, & Flegal, 2012 ) 17

 increased LDL cholesterol  decreased HDL cholesterol  increased triglycerides  atherosclerotic plaques  hypertension  increased type 2 diabetes  sleep apnea  orthopedic problems 18

 Obesity has been associated with multiple health problems  coronary heart disease  hypertension  type II diabetes  osteoporosis  several types of cancer 19

 Researchers have hypothesized that increased rates of obesity are related to  decreases in physical activity  dietary changes  or both 20

Energy Out Energy In 21

Ecological Theory of Development A Powerful Paradigm Work Place Extended Family Economy School Culture Social Network Government 22 22

Snacks Role Modeling Opportunities for Outside play time physical activity Built Environment Candy fundraisers CHILD Nutrition Education Professional Development Parent Education Parties Food Rewards No playtime punishments Meals

Let’s Move! Child Care is a very recent effort to promote children’s health by encouraging and supporting healthier physical activity and nutrition practices for children in all child care settings. 25

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 Office of the First Lady  White House Domestic Policy Council  U. S. Department of Health & Human Services  Administration for Children and Families  Centers for Disease Control & Prevention  Health Resources and Services Administration 27

Screen Time - No screen time for children under 2 years. For children age 2 and older, strive to limit screen time to no more than 30 minutes per week in child care, and work with parents and caregivers to ensure children have no more than 1-2 hours of quality screen time per day (recommended by AAP) 28

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Physical Activity - Provide 1-2 hours of physical activity throughout the day including outside play when possible. Nutrition - Serve fruits or vegetables at every meal, eat meals family-style whenever possible, and don’t serve fried foods. 30

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Beverages - Provide access to water during meals and throughout the day, and don’t serve sugar-sweetened drinks. For children age 2 and older, serve low-fat (1%) or non- fat milk, and no more than one 4- to 6- ounce serving of 100% juice per day. 34

Infant feeding - For mothers who want to continue breastfeeding, provide their milk to their infants and welcome them to breastfeed during the child care day. 35

Conventional wisdom is that preschoolers are naturally active and have a lot of outdoor playtime in community-based programs. 36

 The National Association of Sport and Physical Education (NASPE) recommends that preschool aged children participate in 60 minutes of structured activity and 60 minutes of unstructured activity each day  A recent Institute of Medicine (IOM) report suggests that preschoolers should participate in 15 minutes per hour of physical activity (light + MVPA) 37

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 Interdisciplinary research team headed by Russ Pate in the Arnold School of Public Health  Cheryl Addy, Bill Brown, Marsha Dowda, Kerry McIver, Jennifer O’Neill, Karin Pfeiffer, Kristen Swaney, and Harriet Williams  To obtain multi-measure and multi-source descriptive information to inform policies and practices related to preschoolers’ physical activity in community programs 41

W. H. Brown, PhD National Early Childhoo d Inclusion Institute (2012) 42

 Moderate Physical Activity  Translocation (moving a body from one location to another at a moderate pace) (e.g., walking at a brisk or rapid pace, walking up stairs or uphill, climbing on monkey bars, jungle gym, fence, hanging from bar with legs swinging).  Vigorous Physical Activity  Translocation (moving body from one location to another at a fast of very fast pace) (e.g., running, walking up 3 or more stairs or an incline fast or with vigorous arm movement, three repetitions or more of skipping, hopping, jumping, leaping, kicking, or galloping). Definitions from Brown et al. (2003) 43

Outside Sedentary Light MVPA 44

100 90 80 70 Percent of Intervals 60 Sedentary 50 Light MVPA 40 30 20 10 0 Males Females Figure 2. Percent of Intervals coded as Sedentary, Light and MVPA using Direct Observation with the OSRAC-P from Pate, R. R., McIver, K., Dowda, M., Brown, W. H., & Addy, C. (2008). Directly observed physical activity levels in preschool children. Journal of School Health, 78 (8), 438-444.

 Of over 300,000 observed intervals, only 61 intervals (0.01%) included a teacher prompt to increase activity Of over 300,000 observed intervals, only 61 intervals (0.01%) included a teacher prompt to increase activity 46

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 Hannon, J. C., & Brown, B. B. (2008). Increasing preschoolers' physical activity intensities: An activity-friendly preschool playground intervention. Preventive Medicine, 46, 532-536.  Brown, W. H., Googe, H. S., McIver, K. L., & Rathel, J. M. (2009). Effects of teacher- encouraged physical activity on preschool playgrounds. Journal of Early Intervention, 31 (2), 126-145. 49

 Addition of portable materials related to running, jumping, and crawling (e.g., playground balls, hoops, target toss sets, tunnels)  New materials were arranged into activity stations around the playground 50