Assessment of physical activity and sedentary behavior at preschools in Cape Town, South Africa.

Abstract

Overweight and obesity among young South African (SA) children have reached concerning levels. Preschool interventions to promote physical activity (PA) and reduce sedentary behavior (SB) could help curb these trends. However, research has not been conducted to assess these behaviors in SA preschools and how these might differ across income settings. This study aimed to (1) assess, by direct observation, PA and SB patterns of children in a range of preschool settings; (2) determine the influence of socioeconomic status on PA and SB; and (3) identify contextual and individual-level factors associated with PA. Eighty children (4-5 years old) from four low-income and four mid-/high-income preschools in Cape Town were observed using the Observational System for Recording Physical Activity in Children-Preschool Version. Children spent 73% of their time engaged in SB. Low-income children spent 93% of their time indoors, compared to 79% among mid-/high-income children (p<0.001). Low-income children spent 11% of their time in moderate-to-vigorous PA (MVPA), compared to 8% among mid-/high-income children (p<0.05). Children across all settings were significantly more likely to engage in light PA (LPA) and MVPA if they were outside (relative risk ratio [RRR]=2.48 for LPA; RRR=6.95 for MVPA) and if their activity was adult-initiated (RRR=1.74 for LPA; RRR=1.66 for MVPA). Obese children were significantly less likely to do LPA (RRR=0.47); underweight children were significantly less likely to do LPA (RRR=0.63) and MVPA (RRR=0.26). These findings provide information useful for the development of interventions to address PA and SB in SA preschool children.