Activity and health prevention in preschools—contents of an activity-based intervention programme (PAKT—Prevention through Activity in Kindergarten Trial)

To determine if weight status modifies the relationship between motor skill (MS) performance and physical activity (PA) in preschoolers. Preschoolers (N = 227, age 3-5y) were recruited from 22 preschools. Preschoolers' MS (locomotor, object control, and total MS) were assessed with the Children's Activity and Movement in Preschool Study MS protocol. PA was measured by accelerometry. Mixed linear models were used to examine the relationship of MS performance and body mass index (BMI) z score to PA. Models were adjusted for age, race, sex, and parent education, with preschool as a random effect. There was a significant correlation between MS performance and PA (r = .14-.17, P < .05). A significant interaction was observed between BMI z score and object control, and between BMI z score and total MS score on PA (P = .03). Preschoolers with higher BMI z scores and high object control scores engaged in significantly (P = .03) more PA than preschoolers with lower BMI z scores and high object control scores (PA = 15.04min/h and 13.54min/h, respectively). Similarly, preschoolers with higher BMI z scores and high total MS scores spent significantly (P = .01) more time in PA compared with those with lower BMI z scores and high total MS scores (PA = 15.65min/h and 13.91min/h, respectively). Preschool children's MS performance is positively correlated with PA, and BMI z score modified the relationship between MS performance and PA.

The purpose of this article was to highlight important research needs related to physical activity in 3- to 5-year-old children. We identified research needs in 3 major categories: health effects, patterns of physical activity, and interventions and policies. The top research needs include identifying the health effects of physical activity, the effects of physical activity on the development of healthy weight, the effects of physical activity on learning and behavior, and the health implications of sedentary behavior. Research questions concerning patterns of physical activity include determining the prevalence of 3- to 5-year-olds meeting the current physical activity guidelines; the social and environmental factors that influence physical activity in home, preschool, and community settings; and how physical activity tracks into later childhood, adolescence, and adulthood. Research questions about interventions and policies include identifying the most effective strategies to promote physical activity in home, child care, and community settings and to reach diverse populations of young children, identifying effective intervention implementation and dissemination strategies, and determining the effectiveness of national, state, local, and institutional policies for increasing physical activity. In conclusion, research is needed to establish a full understanding of the health implications of physical activity in 3- to 5-year-old children, to better understand the nature of physical activity behavior in this group, and to learn how to promote physical activity in young children.

Little is known about the relationship between children's physical activity (PA) in preschool (in-school) and outside of preschool (out-of-school). This study described this relationship. Participants were 341 children (4.6 ± 0.3 years) in 16 preschools. Accelerometers measured moderate-to-vigorous physical activity (MVPA) and total physical activity (TPA) in-school and out-of-school. In the full sample, Pearson correlation was used to describe associations between in-school and out-of-school PA. In addition, children were categorized as meeting or not meeting a PA guideline during school. MVPA and TPA were compared between the 2 groups and in-school and out-of-school using 2-way repeated-measures analysis of variance. In the full sample, in-school and out-of-school PA were positively correlated for MVPA (r = .13, P = .02) and TPA (r = .15, P = .01). Children who met the guideline in-school remained comparably active out-of-school. However, those who did not meet the guideline were more active out-of-school than in-school. The groups were active at comparable levels while out-of-school. Identical patterns were seen for MVPA and TPA. Children's in-school PA was positively associated with out-of-school PA. Children who did not meet the guideline in-school were more active out-of-school than in-school, suggesting preschool and classroom factors may reduce some children's PA in-school.

ObjectivesThis study examined the relationship between environmental correlates and children’s sedentary time (ST), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) in preschool children.DesignCross-sectional studySettingA birth cohort in Drenthe,...

Preschool students are generally sedentary at school, and few interventions have addressed whether teacher-led activities can increase physical activity at preschools. The current study aimed to increase physical activity in preschool children enrolled in childcare centers by training childcare providers to deliver a physical activity curriculum. A within-group pre-test/post-test design was used including 32 children at 4 preschools. A teacher-led physical activity curriculum, the Coordinated Approach to Child Health Early Childhood Education Curriculum (CEC) was implemented in each childcare center for six weeks. Activity levels of participants were monitored through the use of accelerometers and direct observation for approximately five hours pre- and post-intervention. Time spent in moderate/vigorous physical activity in preschoolers in three of the four preschools suggested a positive trend increasing from 34.5% ± 13.2% baseline to 39.3% ± 15.4% at follow-up (p = 0.10). Teachers from all four centers reported spending 24.6 ± 13.0 minutes per activity session with up to two activity sessions completed per day. These results justify larger trials to determine the impact of a teacher-led physical activity curriculum on the intensity and duration of preschool students’ physical activity at school.

Background: Early childhood (05 years) is a critical neurodevelopment period, where physical activity is central to the development of motor, cognitive and psychosocial outcomes. Although the world has recommended a regular exercise among children, a significant percentage of children, especially in the low and middle-income-countries such as Pakistan do not follow these recommendations. There is little evidence on the relationship between social-emotional development and physical activity in preschool children. Objective: To evaluate the frequency of social-emotional development based on the physical activity level among preschool-aged children. Methods: The research was an analytical cross-sectional study carried out in Pediatric Outpatient Department of Fauji Foundation Hospital during December 2025 to March 2026. They enrolled 200 preschool children (3-5 years old) by non-probability consecutive sampling. A structured Preschool Physical Activity Questionnaire (based on NASPE guidelines) was used to measure physical activity, and the Ages and Stages Questionnaire: Social-Emotional, Second Edition (ASQ:SE-2) was used to measure social-emotional development. Daily time spent in activity levels were used to classify participants into high and low physical activity. The SPSS version 23 was used in statistical analysis. Chi-square tests and multivariable regression models were used to determine associations between variables. Results: There was a significant difference in the scores of social-emotional developments between children who were more physically active and those who were less physically active (p &lt; 0.001). A higher proportion of children in the low physical activity group fell into the “at-risk” and “delayed” categories. Developmental outcomes were negatively related to screen time and sedentary behavior. Conclusion: There is a close relationship between increased physical activity and social-emotional development in preschool children. These results emphasize the research that active lifestyles should be encouraged in early childhood through early interventions and parental awareness programs.

ObjectiveTo analyze physical activity and sedentary behavior in preschool children during their stay at school and the associated factors. Methods370 preschoolers, aged 4–6 years, stratified according to gender, age and school region in the city of Londrina, PR, participated in the study. A questionnaire was applied to principals of preschools to analyze the school infrastructure and environment. Physical activity and sedentary behavior were estimated using accelerometers for five consecutive days during the children's stay at school. The odds ratio (OR) was estimated through binary logistic regression. ResultsAt school, regardless of age, preschoolers spend relatively more time in sedentary behaviors (89.6–90.9%), followed by light (4.6–7.6%), moderate (1.3–3.0%) and vigorous (0.5–2.3%) physical activity. The indoor recreation room (OR 0.20, 95%CI 0.05–0.83) and the playground (OR 0.08, 95%CI 0.00–0.80) protect four-year-old schoolchildren from highly sedentary behavior. An inverse association was found between the indoor recreation room and physical activity (OR 0.20, 95%CI 0.00–0.93) in five-year-old children. The indoor recreation room (OR 1.54, 95%CI 1.35–1.77), the playground (OR 2.82, 95%CI 1.14–6.96) and the recess (OR 1.54, 95%CI 1.35–1.77) are factors that increase the chance of six-year-old schoolchildren to be active. ConclusionsThe school infrastructure and environment should be seen as strategies to promote physical activity and reduce sedentary behavior in preschool children.

To (i) validate a recently proposed questionnaire tool for the simple assessment of physical activity (PA) in pre-school children by comparison with accelerometry and heart-rate recordings; and (ii) extend the tool by adding more questions to improve validity and to refine the classification from two to three categories (PA low, medium, high). Baseline data of an intervention evaluation study. Pre-school children. Children were categorized as either physically active or non-active, based on their parents' answers to the five-item questionnaire. Activity and heart rate were recorded for 6 d (Actiheart device; CamNtech, Cambridge, UK). Nightly sleeping periods were removed and mean accelerometry counts (MACT), time spent in moderate-to-vigorous intensity physical activity (MVPA) and time spent in sedentary behaviour (SB) were computed. In a second step, additional questions that improved validity were added, resulting in an extended seven-item questionnaire. For 748 (90·4 %) of the participating children aged 2·3-6·7 years, the questionnaires were filled out sufficiently for classification. Children classified as physically active showed 9·6 % higher MACT (P < 0·0003), spent more time in MVPA and insignificantly less time in SB. Using the extended questionnaire, children with PA classified as medium (reference: low) showed 11·0 % more MACT, spent 11·8 % more time in MVPA and 4·8 % less time in SB. Children with PA classified as high showed 16·9 % more MACT, spent 20·2 % more time in MVPA and 7·2 % less time in SB. With validated PA questionnaires for pre-school children lacking, the proposed questionnaire might be a reasonable option to include for PA assessment in epidemiological studies where more elaborate measurements are unavailable.

Background:The purposes of this study were 1) to establish accelerometer count cutoffs to categorize activity intensity of 3 to 5-y old-children and 2) to evaluate the accelerometer as a measure of children’s physical activity in preschool settings.Methods:While wearing an ActiGraph accelerometer, 16 preschool children performed five, 3-min structured activities. Receiver Operating Characteristic (ROC) curve analyses identified count cutoffs for four physical activity intensities. In 9 preschools, 281 children wore an ActiGraph during observations performed by three trained observers (interobserver reliability = 0.91 to 0.98).Results:Separate count cutoffs for 3, 4, and 5-y olds were established. Sensitivity and specificity for the count cutoffs ranged from 86.7% to 100.0% and 66.7% to 100.0%, respectively. ActiGraph counts/15 s were different among all activities (P &lt; 0.05) except the two sitting activities. Correlations between observed and ActiGraph intensity categorizations at the preschools ranged from 0.46 to 0.70 (P &lt; 0.001).Conclusions:The ActiGraph count cutoffs established and validated in this study can be used to objectively categorize the time that preschool-age children spend in different physical activity intensity levels.

To validate parent-reported child habitual total physical activity against accelerometry and three existing step-count thresholds for classifying 3 h/day of total physical activity in pre-schoolers from 13 culturally and geographically diverse countries. Cross-sectional validation study. We used data involving 3- and 4-year-olds from 13 middle- and high-income countries who participated in the SUNRISE study. We used Spearman's rank-order correlation, Bland-Altman plots, and Kappa statistics to validate parent-reported child habitual total physical activity against activPAL™-measured total physical activity over 3 days. Additionally, we used Receiver Operating Characteristic Area Under the Curve analysis to validate existing step-count thresholds (Gabel, Vale, and De Craemer) using step-counts derived from activPAL™. Of the 352 pre-schoolers, 49.1 % were girls. There was a very weak but significant positive correlation and slight agreement between parent-reported total physical activity and accelerometer-measured total physical activity (r: 0.140; p = 0.009; Kappa: 0.030). Parents overestimated their child's total physical activity compared to accelerometry (mean bias: 69 min/day; standard deviation: 126; 95 % limits of agreement: -179, 316). Of the three step-count thresholds tested, the De Craemer threshold of 11,500 steps/day provided excellent classification of meeting the total physical activity guideline as measured by accelerometry (area under the ROC curve: 0.945; 95 % confidence interval: 0.928, 0.961; sensitivity: 100.0 %; specificity: 88.9 %). Parent reports may have limited validity for assessing pre-schoolers' level of total physical activity. Step-counting is a promising alternative - low-cost global surveillance initiatives could potentially use pedometers for assessing compliance with the physical activity guideline in early childhood.

The survey on physical activity in preschool children was accomplished in Lithuania. In the survey participated 512 preschool children (urban and rural). Chi-square test was used and the significance level p ≤0.05 was considered statistically significant. The study revealed that 21.7 % preschool children during leisure time are walking outside more than 1 hour per day, and 9.2 % preschool children are walking outside less than 15 minutes per day; no significant differences between boys and girls were observed. The rural preschool children are walking outside significantly longer compared with urban preschool children. Out of school, during leisure time everyday are taking physical exercises or go in for sports 22.5 % preschool children, and never exercise almost the same percent respondents (21.9 %). The survey showed that 36,1 % children exercise 2 and more times per week and 19.5 % preschool children exercise only few times per month. All investigated preschool children take physical exercises or go in for sports with almost the same rate, and there are no significant differences between boys and girls, and between urban and rural preschool children (p>0.05). The study revealed that the more than half of preschool children’s (57%) health is good. Only 1% respondents’ health is bad. The study showed that in Lithuania, preschool children physical activity is low, it is therefore necessary to implement measures for its promotion. Article in Lithuanian doi:10.5200/sm-hs.2012.075

BackgroundBoth individual socio-cultural determinants such as selected parental characteristics (migrant background, low educational level and workload) as well as the regional environment are related to childhood overweight and physical activity (PA). The purpose of the study was to compare the impact of distinct socio-cultural determinants such as the regional environment and selected parental characteristics on adiposity, PA and motor skills in preschool children.MethodsForty preschools (N = 542 children) of two culturally different urban regions (German and French speaking part of Switzerland) participated in the study (Ballabeina Study). Outcome measures included adiposity (BMI and skinfold thickness), objectively measured sedentary activities and PA (accelerometers) and agility performance (obstacle course). Parental characteristics (migrant status, educational level and workload) were assessed by questionnaire.ResultsChildren from the French speaking areas had higher adiposity, lower levels of total and of more intense PA, were more sedentary and less agile than children from the German speaking regions (percent differences for all outcome parameters except for BMI ≥10%; all p ≤ 0.04). Differences in skinfold thickness, sedentary activities and agility, but not in PA, were also found between children of Swiss and migrant parents, though they were ≤8% (p ≤ 0.02). While paternal workload had no effect, maternal workload and parental education resulted in differences in some PA measures and/or agility performance (percent differences in both: ≤9%, p ≤ 0.008), but not in adiposity or sedentary activities (p = NS). Regional differences in skinfold thickness, PA, sedentary activities and agility performance persisted after adjustment for parental socio-cultural characteristics, parental BMI and, where applicable, children's skinfolds (all p ≤ 0.01).ConclusionsThe regional environment, especially the broader social environment, plays a prominent role in determining adiposity, PA and motor skills of young children and should be implicated in the prevention of obesity and promotion of PA in children.Trial Registrationclinicaltrials.gov NCT00674544

Several studies have shown that children have sub-optimal physical activity levels. Since preschool children (4–6 years-old) spend most of their time awake in kindergarten on weekdays, physical activity level at kindergarten is crucial. The study examines preschool children's physical activity level at kindergarten. Preschool children's activity level at kindergarten is also investigated related to activity level at leisure, gender, and mothers' education level, income, and age. Two hundred and forty four children (125 boys and 119 girls) supplied valid accelerometer data, and mothers' education level, income, and age were measured using a questionnaire. One-way ANOVA and linear regression were utilized as statistical analyses. The results demonstrated that physical activity level during kindergarten is the main contributor to preschool children's physical activity level on weekdays. Furthermore, boys were more active than girls, and preschool children's physical activity level at both leisure and at kindergarten were not associated with mothers' age, education level, or income. However, a positive association was found between physical activity level at leisure and physical activity level at kindergarten, in which physical activity level at kindergarten increases when physical activity level at leisure increases. Physical activity level was also significantly different between kindergartens. The study indicated that kindergartens increase inequality according to physical activity level among preschool children—contributing to creating differences according to low-active and high-active children.

Background: Pre-school years are important for adopting health behaviours; however, today’s children seem to be overweight, present low physical activity (PA) levels and exceed screen time (ST) recommendations.Aim: To examine (a) time trends in PA in Greek pre-school children, (b) the associations among PA, body mass index (BMI) and ST and (c) potential PA differences between boys and girls.Subjects and methods: Data from five cross-sectional cohorts (2005 [n = 252]; 2008 [n = 212]; 2011 [n = 187]; 2014 [n = 194]; 2017 [n = 128]) were compared. PA was assessed using Omron HJ-720IT-E2 pedometers, whereas ST was reported by participants’ parents. A 4-way ANOVA was applied on children’s average week step counts.Results: A significant association (F = 828.90, p < 0.001, η2 = 0.638) between ST and PA was revealed, with children that had ST < 1 hour/day presenting the higher PA levels and being the only ones that met PA recommendations (11,500 steps/day). Statistically significant PA differences, though of no practical importance, were found among cohorts. There were no significant PA differences between boys and girls or among BMI categories. Nevertheless, obesity prevalence was found to exist at alarming levels (24.5% in 2008–41.4% in 2017), and a large percentage of children (23.6% in 2008–63.3% in 2017) presented excessive ST (> 2 hours/day).Conclusion: Effective interventions aiming at reducing ST and enhancing PA seem imperative if children’s health is to be safeguarded.

Policy-oriented, school-based physical activity intervention to prevent childhood obesity in China (the health legacy project of the second Summer Youth Olympic Games): a cluster randomised trial