Abstract
BackgroundThe prevalence of obesity increased while certain measures of physical fitness deteriorated in preschool children in China over the past decade. This study tested the effectiveness of a multifaceted intervention that integrated childcare center, families, and community to promote healthy growth and physical fitness in preschool Chinese children.MethodsThis 12-month study was conducted using a quasi-experimental pretest/posttest design with comparison group. The participants were 357 children (mean age = 4.5 year) enrolled in three grade levels in two childcare centers in Beijing, China. The intervention included: 1) childcare center intervention (physical activity policy changes, teacher training, physical education curriculum and food services training), 2) family intervention (parent education, internet website for support, and family events), and 3) community intervention (playground renovation and community health promotion events). The study outcome measures included body composition (percent body fat, fat mass, and muscle mass), Body Mass Index (BMI) and BMI z-score and physical fitness scores in 20-meter agility run (20M-AR), broad jump for distance (BJ), timed 10-jumps, tennis ball throwing (TBT), sit and reach (SR), balance beam walk (BBW), 20-meter crawl (20M-C)), 30-meter sprint (30M-S)) from a norm referenced test. Measures of process evaluation included monitoring of children’s physical activity (activity time and intensity) and food preparation records, and fidelity of intervention protocol implementation.ResultsChildren in the intervention center significantly lowered their body fat percent (−1.2%, p < 0.0001), fat mass (−0.55 kg, p <0.0001), and body weight (0.36 kg, p <0.02) and increased muscle mass (0.48 kg, p <0.0001), compared to children in the control center. They also improved all measures of physical fitness except timed 10-jumps (20M-AR: −0.74 seconds, p < 0.0001; BJ: 8.09 cm, p < 0.0001; TBT: 0.52 meters, p < 0.006; SR: 0.88 cm, p < 0.03; BBW: −2.02 seconds, p <0.0001; 30M-S: −0.45 seconds, p < 0.02; 20M-C: −3.36 seconds, p < 0.0001). Process evaluation data showed that the intervention protocol was implemented with high fidelity.ConclusionsThe study demonstrated that a policy-driven multi-faceted intervention can improve preschool children’s body composition and physical fitness. Program efficacy should be tested in a randomized trial.Trial registrationChiCTR-ONRC-14004143.
Highlights
The prevalence of obesity increased while certain measures of physical fitness deteriorated in preschool children in China over the past decade
We presented the findings of a multifaceted intervention study conducted in childcare centers for preschool children
Findings from this study demonstrated that a multifaceted intervention can improve preschool children’s body composition and physical fitness
Summary
The prevalence of obesity increased while certain measures of physical fitness deteriorated in preschool children in China over the past decade. One study of children in nine large Chinese cities found that the prevalence of obesity in 5 years-old increased from 0.84% in 1986 to 6.05% in 2006, a rate of annual absolute increase at 0.26 percentage point [3]. According to the 2010 Chinese National Fitness Survey, weight and height of Chinese children aged 3 to 6 years old increased significantly from 2005 to 2010. The survey revealed that the average National Physical Fitness Index decreased 0.36 percentage points from 2005 to 2010. This trend was reflected in preschool children with declines in some physical fitness measures (e.g. 20-meter agility run, broad jump, walking on balance beam) [9]
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