Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.
University of Connecticut Institution for Collaboration in Health, Interventions and Policy, Storrs, CT, USA.
Child Obes. 2022 Jun;18(4):281-290. doi: 10.1089/chi.2021.0094. Epub 2021 Dec 1.
Child care settings significantly influence children's physical activity (PA) and screen time (ST) behaviors, yet less research has been conducted in family child care homes (FCCHs) than in child care centers. While a few studies have measured family child care providers' (FCCPs') PA practices, none have used observation to assess which specific evidence-based, best practice guidelines FCCPs met or did not meet, and no previous studies have included Latinx providers. This article examines FCCPs' adherence to PA and ST best practice guidelines using primarily observational methods with diverse FCCPs (including Latinx). We examined baseline data from a cluster randomized trial including surveys and observational data collected at the FCCH to assess whether providers met specific PA and ST best practices from the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) and the American Academy of Pediatrics. Providers completed a telephone survey and participated in two full-day observations ( = 127; 72% Hispanic). Overall, only 4 of 14 PA and ST best practices were met by >50% of providers including: leading a planned PA class more than once a week; no ST during meal or snack; not modeling sedentary behavior; and providing families with information about children's ST. Best practices least likely to be met (<20% of providers) include: providing children with >60 minutes of outdoor play daily; providing children with >45 minutes of adult-led PA each day; participating in outdoor PA with children; participating in indoor PA with children; prompting and praising children for being active; and talking with children informally about the importance of PA. While FCCPs engage in some positive PA and ST practices, many providers do not meet best practice guidelines. There is a need for more research about how to overcome providers' personal and environmental barriers for meeting these guidelines as well as interventions and supports to overcome these barriers. Clinical Trial Registration Number NCT0245645.
儿童保育环境对儿童的身体活动 (PA) 和屏幕时间 (ST) 行为有重大影响,但在家庭儿童保育中心 (FCCH) 开展的研究比在儿童保育中心开展的研究要少。虽然有一些研究测量了家庭儿童保育提供者 (FCCP) 的 PA 实践,但没有一项研究使用观察来评估 FCCP 符合或不符合哪些具体的基于证据的最佳实践指南,也没有以前的研究包括拉丁裔提供者。本文主要使用观察方法研究 FCCP 对 PA 和 ST 最佳实践指南的遵守情况,研究对象为不同的 FCCP(包括拉丁裔)。我们检查了一项包括调查和在 FCCH 收集的观察数据的整群随机试验的基线数据,以评估提供者是否符合来自儿童保育营养和身体活动自我评估 (NAP SACC) 和美国儿科学会的特定 PA 和 ST 最佳实践。提供者完成了一项电话调查,并参加了为期两天的观察 ( = 127;72%为西班牙裔)。总体而言,只有 14 项 PA 和 ST 最佳实践中的 4 项被 >50%的提供者遵守,包括:每周至少开展一次有计划的 PA 课程;在用餐或吃零食时不看屏幕;不模仿久坐行为;并向家庭提供有关儿童 ST 的信息。最不可能遵守的最佳实践 (<20%的提供者)包括:每天为儿童提供 >60 分钟的户外活动;每天为儿童提供 >45 分钟的成人主导的 PA;与儿童一起进行户外活动;与儿童一起进行室内 PA;鼓励和表扬孩子积极活动;以及与孩子非正式地谈论 PA 的重要性。虽然 FCCP 从事一些积极的 PA 和 ST 实践,但许多提供者不符合最佳实践指南。需要进一步研究如何克服提供者在遵守这些指南方面的个人和环境障碍,以及克服这些障碍的干预措施和支持。临床试验注册号 NCT0245645。