Slining Meghan M, Neelon Sara E Benjamin, Duffey Kiyah J
Department of Health Sciences, Furman University, 3300 Poinsett Highway, Greenville, SC, 29613, USA.
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA.
Int J Behav Nutr Phys Act. 2014 Nov 22;11:139. doi: 10.1186/s12966-014-0139-3.
The purpose of this study was to review state regulations promoting increased physical activity and decreased sedentary behaviors in infants in child care and to assess consistency with recent Institute of Medicine (IOM) recommendations.
We compared existing state and territory licensing and administrative regulations to recent IOM recommendations to promote physical activity and decrease sedentary time in very young children attending out-of-home child care (both child care centers and family child care homes). Three independent reviewers searched two sources (a publicly available website and WestlawNext™) and compared regulations with five IOM recommendations: 1) providing daily opportunities for infants to move, 2) engaging with infants on the ground, 3) providing daily tummy time for infants less than six months of age, 4) using cribs, car seats and high chairs for their primary purpose, and 5) limiting the use of restrictive equipment for holding infants while they are awake. We used Pearson chi-square tests to assess associations between geographic region, year of last update, and number of state regulations consistent with the IOM recommendations.
The mean (SD) number of regulations for states was 1.9 (1.3) for centers and 1.6 (1.2) for homes out of a possible 5.0. Two states had regulations for all five recommendations, Arizona for centers and Virginia for homes. Six states and territories had zero regulations for child care centers and seven states and territories had zero regulations for family child care homes. There were no significant associations between geographic region and number of regulations consistent with IOM recommendations.
Out-of-home child care settings are important targets for optimal early child health interventions. While most states had some regulations related to the promotion of physical activity among infants, few states had regulations for more than three of the five IOM recommendations. Enhancing state regulations in child care facilities could aid in early childhood obesity prevention efforts.
本研究旨在回顾各州促进婴幼儿在儿童保育机构中增加身体活动及减少久坐行为的相关规定，并评估其与美国医学研究所（IOM）近期建议的一致性。
我们将现有的州及领地许可和行政法规与IOM近期关于促进非家庭式儿童保育（包括儿童保育中心和家庭式儿童保育所）中幼儿身体活动及减少久坐时间的建议进行了比较。三名独立评审员检索了两个来源（一个公开网站和WestlawNext™），并将法规与IOM的五项建议进行了对比：1）为婴儿提供每日活动机会；2）在地面上与婴儿互动；3）为六个月以下婴儿提供每日趴卧时间；4）将婴儿床、汽车座椅和高脚椅用于其主要用途；5）限制在婴儿清醒时使用限制其活动的设备。我们使用Pearson卡方检验来评估地理区域、上次更新年份与符合IOM建议的州法规数量之间的关联。
各州针对儿童保育中心的法规平均（标准差）数量为1.9（1.3）条（满分5.0条），针对家庭式儿童保育所的为1.6（1.2）条。有两个州针对所有五项建议都制定了法规，亚利桑那州针对儿童保育中心，弗吉尼亚州针对家庭式儿童保育所。有六个州及领地针对儿童保育中心没有相关法规，七个州及领地针对家庭式儿童保育所没有相关法规。地理区域与符合IOM建议的法规数量之间没有显著关联。
非家庭式儿童保育环境是优化幼儿早期健康干预的重要目标。虽然大多数州都有一些与促进婴儿身体活动相关的法规，但很少有州针对IOM的五项建议中的三项以上制定法规。加强儿童保育设施方面的州法规有助于预防幼儿肥胖。
