Early childhood education and care (ECEC) services are a key setting to support improvements in the physical activity of young children. This umbrella review gathered and synthesised systematic review evidence of the effectiveness of interventions in the ECEC setting on the physical activity levels of children aged 0–6. We also mapped the current evidence to the existing ECEC sector-specific physical activity practice recommendations. Five electronic databases were searched to identify systematic reviews that evaluated the impact of any ECEC-based interventions on the physical activity levels (e.g., moderate-to-vigorous physical activity, total physical activity) of children aged 0–6. One reviewer extracted data on intervention effectiveness and quality of the reviews, checked by a second reviewer. Ten reviews were included. Overall, the majority of the reviews found interventions delivered in ECEC improved child physical activity. Across reviews, the impact of six intervention strategies were identified, mapped to four (of eight) broad recommendations (i.e., providing opportunity, offering educator training, educators promoting the benefits of physical activity, creating a physical activity-promoting environment). The impact of the majority of recommendations, however, did not have systematic review evidence. Further investigation of the effectiveness of ECEC-based physical activity strategies is required to demonstrate support for the existing recommended practices.
As a strategy for early childhood obesity prevention, a variety of dietary behavior and physical activity policies and guidelines published by leading health agencies and early childhood education and care (ECEC) licensing and accreditation bodies exist. Given the potential diversity in recommendations from these policies, this narrative review sought to synthesize, appraise and describe the various policies and guidelines made by organizational and professional bodies to highlight consistent recommendations and identify opportunities to strengthen such policies. An electronic bibliographic search of seven online databases and grey literature sources was undertaken. Records were included if they were policies or guidelines with specific recommendations addressing dietary behavior and/or physical activity practice implementation within the ECEC setting; included children aged >12 months and <6 years and were developed for high income countries. Recommended dietary behavior and physical activity policies and practices were synthesized into broad themes using the Analysis Grid for Environments Linked to Obesity framework, and the quality of included guidelines appraised. Our search identified 38 eligible publications mostly from the US and Australia. Identified guidelines were largely consistent in their recommendation and frequently addressed the physical and sociocultural environment and were well-aligned with research evidence. Broader consideration of policy and economic environments may be needed to increase the impact of such policies and guidelines within the ECEC setting.
Objective: To (i) identify and synthesise findings from interventions to improve the dietary intake, physical activity and weight status of children aged 0–6 years attending family day care services; and (ii) assess the impact of interventions on family day care environments, intervention cost and adverse outcomes.Design: Medline in Process, PsycINFO, ERIC, Embase, CINAHL, CENTRAL and Scopus databases were searched in March 2019. Studies were included if they (i) evaluated an intervention to improve the diet, physical activity and/or weight of children aged 0–6 years; (ii) were delivered in family day care services; (iii) targeted child diet, physical activity and/or weight; and (iv) used a parallel control group design. Screening was undertaken by two reviewers with disagreements resolved by a third reviewer.Setting: Family day care services, also known as family childcare homes.Participants: Children aged 0–6 years attending family day care services.Results: In total, 8977 titles were retrieved, and 199 full-texts reviewed. No studies met the inclusion criteria for the primary outcome; however, two studies reporting on the secondary outcome of family day care environments were included. The 4-year community-wide obesity prevention programme and the 12-month train-the-trainer programme both reported statistically significant improvements in the healthy eating and physical activity environments of family day care, compared to cross-sectional state-average control groups.Conclusions: Findings highlight few existing interventions in family day care services and a need for high-quality controlled trials to identify effective interventions to improve children’s diet, activity and weight in this setting.
Family day care (FDC) services provide care to young children typically within the carer's own home and represents a unique setting to deliver public health programs to improve child health. To support the implementation of programs targeting healthy eating, physical activity and obesity prevention in the FDC setting, an understanding of the factors influencing their implementation is required. This mixed methods systematic review aimed to describe the barriers and facilitators to the implementation of healthy eating, physical activity or obesity prevention policies, practices and programs (hereafter referred to as programs) in the FDC setting, and synthesise these according to the Theoretical Domains Framework (TDF). Electronic searches were conducted in 7 databases up to July 2020 to identify studies reporting the barriers and/or facilitators to program implementation in the FDC setting. Methodological quality assessments of included studies were conducted using the Mixed Methods Appraisal Tool (MMAT). Twenty studies met the review inclusion criteria (12 qualitative, 6 quantitative, 2 mixed methods). Of the 20 included studies, 16 reported barriers and facilitators mapped to the 'environmental contexts and resources' TDF domain; 10 reported barriers mapped to the 'social influences' TDF domain. Ten of the 12 qualitative studies and none of the quantitative or mixed method studies met all relevant MMAT criteria. This review comprehensively describes barriers and facilitators that need to be addressed to improve the implementation of healthy eating, physical activity and obesity prevention programs in FDC to ensure the expected health benefits of such programs reach children attending FDC.
Background: Workplaces are an important setting to deliver programs to reduce risk factors for noncommunicable diseases (NCDs). To help decision makers understand the most current and relevant evidence regarding effectiveness of workplace programs, we conducted an umbrella review to present a comprehensive synthesis of the large volume of literature. Methods: Systematic reviews of workplace interventions targeting primary risk factors for NCDs—unhealthy diet, insufficient physical activity, overweight/obesity, tobacco use, and/or excessive alcohol use—published since 2010 were sourced. For each risk factor, reviews were categorized by intervention type and quality. The most recent, high-quality review was included for each intervention type. Evidence for the effectiveness of each intervention type was then broadly classified based on the review summary findings. Results: Twenty-one reviews were included. Most reviews focused on diet (n = 5), physical activity (n = 7), or obesity (n = 9) interventions, with fewer targeting alcohol (n = 2) or tobacco (n = 2) use. Reviews of interventions focusing on individual behavior (such as education or counseling) were most common. Across diet, obesity, physical activity, and tobacco use, multicomponent interventions were consistently likely to be classified as “likely effective.” Motivational interviewing and broad health promotion interventions were identified as “promising” for alcohol use. Conclusion: This umbrella review identified that multicomponent workplace interventions were effective to reduce NCD risk factors. There is a gap around interventions targeting alcohol use as most syntheses lacked enough studies to draw conclusions about effectiveness. Exploring the impact of interventions that utilize policy and/or environmental strategies is a critical gap for future research.
17 September 2020 in Health Promotion Journal of Australia