Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada.
Faculty of Health Science, University of Ottawa, Ottawa, ON, Canada.
BMC Public Health. 2022 Mar 29;22(1):616. doi: 10.1186/s12889-022-12888-5.
A new physical activity and sedentary behaviour accreditation standard criterion for childcare settings was introduced by the provincial government in Alberta, Canada. The primary objective of this study was to examine if changes for in-care physical activity and sedentary time (ST) differed between centres in and around Edmonton, Alberta after implementing the new accreditation standards and non-accredited control centres in and around Ottawa, Ontario. Secondary objectives were to examine whether baseline age group (toddler, preschooler) or the childcare environment moderated any group differences in change of the primary outcomes. Furthermore, accreditation and control group differences in change of children's body mass index (BMI) Z-scores or cognitive development as well as educators' perceptions of the primary outcomes were explored.
Participants were 252 toddlers (19-35 months) and preschoolers (36-60 months) in childcare centres from Alberta (n = 11) and Ontario (n = 8) in the supporting Healthy physical AcTive CHildcare setting (HATCH) study. In-care ST, light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were accelerometer-derived before and 6 months after the implementation of the new standards. At both time points, cognitive development (working memory, expressive vocabulary), heights, and weights were measured, and BMI Z-scores were calculated. Additionally, the childcare environment was observed using the Environment and Policy Assessment and Observation (EPAO) and Movement Environment Rating Scale (MOVERS) tools. Demographic characteristics were parent-reported and weather variables were derived from Environment Canada data. Mixed models were conducted.
In adjusted models (n = 241), change in children's in-care ST (B = -0.07, 95%CI: - 1.43,1.29), LPA (B = 0.08, 95%CI: - 0.89,1.05), and log-transformed MVPA (B = 0.01, 95%CI: - 0.09,0.11) were not significantly different between accreditation and control groups. Age group and the childcare environment were not moderators. Significant increases in BMI Z-score (B = 0.19, 95%CI: 0.03,0.35) and high working memory (OR = 3.24, 95%CI: 1.32,7.97) were observed in the accreditation group and significant increases in expressive vocabulary (B = 3.18, 95%CI: 0.05,6.30) were observed in the control group.
The new accreditation criterion may not significantly change physical activity or ST in childcare settings and therefore may not explain findings for BMI Z-scores and cognitive development. Additional training and resources may be needed.
加拿大艾伯塔省的省政府引入了一项新的儿童保育环境体力活动和久坐行为认证标准准则。本研究的主要目的是检验在实施新的认证标准后，艾伯塔省埃德蒙顿及其周边地区的中心与安大略省渥太华及其周边地区的未经认证的对照中心之间，儿童在托育中心的体力活动和久坐时间（ST）是否有变化。次要目的是检验基线年龄组（幼儿、学龄前儿童）或儿童保育环境是否调节了主要结果变化的任何组间差异。此外，还探讨了认证和对照组之间儿童体重指数（BMI）Z 分数或认知发展变化的差异，以及教育工作者对主要结果的看法。
参与者为支持健康积极的儿童保育环境（HATCH）研究中来自艾伯塔省（n=11）和安大略省（n=8）的 252 名幼儿（19-35 个月）和学龄前儿童（36-60 个月）。在实施新标准之前和之后的 6 个月，使用加速度计分别测量儿童在托育中心的 ST、低强度体力活动（LPA）和中等到剧烈强度体力活动（MVPA）。在这两个时间点，还测量了认知发展（工作记忆、表达性词汇）、身高和体重，并计算了 BMI Z 分数。此外，使用环境和政策评估与观察（EPAO）和运动环境评分量表（MOVERS）工具观察儿童保育环境。人口统计学特征由家长报告，天气变量由加拿大环境部的数据得出。采用混合模型进行分析。
在调整后的模型中（n=241），儿童在托育中心的 ST（B=-0.07，95%CI：-1.43,1.29）、LPA（B=0.08，95%CI：-0.89,1.05）和 log 转换的 MVPA（B=0.01，95%CI：-0.09,0.11）的变化在认证组和对照组之间没有显著差异。年龄组和儿童保育环境不是调节因素。在认证组中，BMI Z 分数（B=0.19，95%CI：0.03,0.35）和高工作记忆（OR=3.24，95%CI：1.32,7.97）显著增加，而在对照组中，表达性词汇（B=3.18，95%CI：0.05,6.30）显著增加。
新的认证标准可能不会显著改变儿童保育环境中的体力活动或 ST，因此可能无法解释 BMI Z 分数和认知发展的结果。可能需要额外的培训和资源。
