Barriers and facilitators to structured physical activity interventions in early childhood education and care centres: a systematic review

Abstract

Introduction: Despite the importance of physical activity and motor competence for young children, many early childhood education and care (ECEC) centres struggle to successfully implement and sustain physical activity programs, especially those delivered by educators rather than physical education specialists. This review aimed to identify factors (barriers and facilitators) reported by educators that may influence their implementation of structured physical activity interventions in ECEC and synthesise these factors according to the 14 domains of the “Theoretical Domains Framework” (TDF). Methods: A systematic search in five scientific databases was undertaken for articles published between 2009 and July 2019 that investigated educator reported barriers and/ or facilitators to implementing structured physical activity programs in ECEC centres. Duplicate abstracts were removed, and selection criteria applied. Data from included studies was extracted and coded in two stages. Extracted factors were mapped and synthesised using the TDF. Results: Of the 1903 identified citations, 12 studies met the inclusion criteria (4 qualitative, 8 mixed methods). Across studies, barriers and facilitators were identified in 11 of the 14 domains of the TDF, with the most frequently reported domains for both barriers and facilitators being “knowledge”, “skills”, and “environmental context and resources”. Within these domains, common themes were educator training, organisational policies and readiness, physical environment and space, supporting resources and time. Relatively few factors were identified in the remaining domains and none were reported for three domains: “intentions”, “memory, attention and decision processes” and “behavioural regulation”. Discussion: This evidence synthesis may help guide development of policy, programs, and implementation strategies that improve uptake and sustainability of structured physical activity interventions in ECEC settings. Greater investigation and reporting of training to build educator knowledge, skills and confidence is warranted. Implementation science frameworks may provide a means to improve intervention design, including involving educators in co-design, whereby potential organisational and educator-level implementation barriers are identified and addressed. Additionally, use of theoretical frameworks in evaluating program implementation may identify a wider range of factors that influence educator behaviour than is currently reported in the literature. Conflict of interest statement: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract.