Abstract
BackgroundThree-quarters of 3-6 year-old children in the U.S. spend time in childcare; many spend most of their waking hours in these settings. Daily physical activity offers numerous health benefits, but activity levels vary widely across centers. This study was undertaken to explore reasons why physical activity levels may vary. The purpose of this paper is to summarize an unexpected finding that child-care providers cited was a key barrier to children's physical activity.MethodsNine focus groups with 49 child-care providers (55% black) from 34 centers (including inner-city, suburban, Head Start and Montessori) were conducted in Cincinnati, OH. Three independent raters analyzed verbatim transcripts for themes. Several techniques were used to increase credibility of findings, including interviews with 13 caregivers.ResultsTwo major themes about clothing were: 1) children's clothing was a barrier to children's physical activity in child-care, and 2) clothing choices were a significant source of conflict between parents and child-care providers. Inappropriate clothing items included: no coat/hat/gloves in the wintertime, flip flops or sandals, dress/expensive clothes, jewelry, and clothes that were either too loose or too tight. Child-care providers explained that unless there were enough extra coats at the center, a single child without a coat could prevent the entire class from going outside. Caregivers suggested several reasons why parents may dress their child inappropriately, including forgetfulness, a rushed morning routine, limited income to buy clothes, a child's preference for a favorite item, and parents not understanding the importance of outdoor play. Several child-care providers favored specific policies prohibiting inappropriate clothing, as many reported limited success with verbal or written reminders to bring appropriate clothing.ConclusionInappropriate clothing may be an important barrier to children's physical activity in child-care settings, particularly if the clothing of a few children preclude physical activity for the remaining children. Center directors and policy makers should consider devising clear and specific policies for the types of clothing that will be permitted in these settings so that children's active play opportunities are not curtailed. To enhance compliance, parents may need education about the importance and benefits of active play for children's development.
Highlights
Three-quarters of 3-6 year-old children in the U.S spend time in childcare; many spend most of their waking hours in these settings
The purpose of this paper is to describe two major themes from our findings that that were unexpected based on our review of the relevant literature: 1) that child care providers cited children's clothing as an important barrier to children's physical activity, and 2) children's clothing contributes to considerable conflict between parents and child-care providers
Child-care providers in these focus groups reported that children commonly wear inappropriate clothing such as flip flops, no coat/hat/gloves in winter, and dress clothes with instructions not to get them dirty
Summary
Three-quarters of 3-6 year-old children in the U.S spend time in childcare; many spend most of their waking hours in these settings. Physical activity offers numerous health benefits, but activity levels vary widely across centers. Physical activity is essential for healthy childhood growth and development [3,4,5,6], and confers numerous health, cognitive, and mood benefits to young children [7,8,9]. Many children in child care are not meeting daily recommendations[10] for physical activity as recent studies found that children spend most of their time in child care being sedentary [11,12]. The amount of physical activity that children obtain in child-care varies widely across different centers [11,12,13]. Given the large number of children in child-care and the numerous benefits to physical activity, policy-makers and researchers in physical activity and public health have turned their attention towards child-care centers as a potential venue for health promotion and childhood obesity prevention [14,15] These reports called for more detail about the problems and potential solutions in order to inform strategies to increase children's physical activity in child care
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