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Many young children in child care centers do not have the opportunity to get the recommended length of active playtime and little research has been done to find ways to improve physical activity in preschool children, according to two studies published in November.

A study published in Pediatrics online November 16 found only 13.7% of child care centers offered 120 minutes of active playtime during the school day. Researchers at the UNC Center for Health Promotion and Disease Prevention (HPDP) observed and reviewed practices and policies about physical activity and playtime in 96 centers in North Carolina. An earlier study by the same group developed best practice guidelines for healthy weight in young children by reviewing recommendations from several expert organizations.


“Basically, we think that our best practices are a starting point for researchers and for the development of physical activity policies for the child care setting,” said Christina McWilliams, the lead author of the Pediatrics article. “Unfortunately, a lot of the best- practice guidelines are not being met in North Carolina.”

However, the study also showed positive signs. In 82% of the centers, children were not sitting for more than 30 minutes at a time and about 56% of the centers had a written policy on physical activity.

Another study published by the same group in the American Journal of Lifestyle Medicine revealed that only nine studies, all conducted since 2003, have tested ways to help young children in child care centers become more physically active. Dianne Ward, EdD, an HPDP Research Fellow and Professor of Nutrition at the UNC Gillings School of Global Public Health and her colleagues were the first to systematically review research databases for studies about physical activity for young children in child care.

Ward’s team found that research into physical activity for young children in child care centers is a new field and there is much to learn about effective ways to increase physical activity in child care centers. They recommend future researchers target six areas to promote physical activity at preschools including active opportunities, sedentary opportunities, physical environment, staff training and behavior, physical activity policies and physical activity outreach..

Ward and her team also recently completed the Nutrition and Physical Activity Self-Assessment in Child Care (NAPSACC) study, which developed the best-practice guidelines based in part on the findings from these recent publications. The guidelines specify recommendations for eight unique components of the child care environment, including the six recommended target areas from the systematic review and adding staff behavior and physical activity education/training for staff.

The investigators began studying physical activity in the child care setting in response to the rapidly increasing rates of childhood obesity. Nationwide data show that the percentage of obese children aged 2 to 5 years increased more than 30% between 2001 and 2004.

“The child care center is a very important indicator of preschoolers’ physical activity levels since children spend on average 25 hours a week in child care centers, and physical activity protects against obesity during the preschool-age period,” said McWilliams, who also served as project director for NAPSACC. “More specific physical activity recommendations for child care centers will be a positive step in fighting against childhood obesity.”

The UNC Center for Health Promotion and Disease Prevention addresses pressing health problems by collaborating with communities to conduct research, provide training, and translate research findings into policy and practice. The Center seeks to reduce health disparities through an emphasis on community-based participatory research to ensure that the community is involved in every stage of research. The CDC selected HPDP to be one of its first three Prevention Research Centers in 1985. Now comprised of 33 academic institutions, the PRC program is an interdependent network of community, academic, and public health partners that conduct prevention research and promote practices proven to promote good health.

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