Evaluation of a Massachusetts physical activity policy for child care

描述（由申请人提供）：肥胖可能是美国面临的最大健康威胁，基于政策的预防方法必须是解决方案的一部分。在学龄前儿童中，定期锻炼可以降低肥胖风险，提高运动技能，增强心血管功能。近四分之三的幼儿接受某种形式的非父母儿童保育，56%接受基于中心的儿童保育，儿童保育环境可能是扭转体育活动和肥胖令人不安的趋势的关键。马萨诸塞州（MA）最近实施了一项新政策，要求所有儿童每天进行60分钟的体育活动。现在存在一个狭窄的机会窗口来评估这项新政策，这将影响到2,000多个托儿中心照顾近40,000名儿童在马。我们打算利用这个自然的实验，以评估新政策的有效性，通过测量儿童参加托儿中心的政策生效之前和之后的身体活动，无论是在MA和罗得岛（RI），一个比较状态。儿童保育并不受联邦政府的监管，每个州都有责任管理自己的儿童保育中心。虽然特拉华州和阿拉斯加州最近颁布了新的政策，要求所有儿童每天进行60分钟的体育活动，但尚未对其有效性进行评估。拟议的研究提供了一个独特的机会来评估这一体育活动政策。这项研究的主要目的是确定在何种程度上的新政策在MA，与RI相比，增加体力活动在3至5岁的儿童在儿童保育。我们将采用准实验的两组前测/后测设计，以评估政策生效之前和之后的儿童参加幼儿园的样本的身体活动。这项评估已经在进行中。我们在1.5年的时间里（2008年秋季，2009年春季和2009年秋季）收集了三轮政策前的身体活动数据。我们将数据收集工作集中在马萨诸塞州的波士顿和罗德岛州的普罗维登斯，并测量了40个儿童保育中心（每个城市20个）的儿童样本的身体活动。我们收集了观察（n=360名儿童）和加速度计（n=41名儿童）数据，以评估儿童的身体活动水平，重点是儿童从事中度到剧烈身体活动的总分钟数。在这份提案中，我们寻求资金支持政策后的身体活动数据收集，以完成我们对这一自然实验的评估。 公共卫生相关性：在儿童保育环境中防治儿童肥胖症的政策方法可以具有广泛的影响范围，影响来自不同种族，民族和社会人口背景的儿童，并且实施成本低。通过这项研究，我们希望为政策制定者提供证据，证明国家体育活动政策对持牌儿童保育设施的有效性。如果有效的话，这项政策可以帮助扭转马萨诸塞州和全国儿童肥胖率的趋势。

DESCRIPTION (provided by applicant): Obesity is perhaps the greatest health threat facing the US, and policy-based prevention approaches must be part of the solution. In preschool-aged children, regular exercise decreases obesity risk, improves motor skills, and enhances cardiovascular function. With nearly three quarters of young children in some form of non- parental child care and 56% in center-based child care, the child care setting may be a key to reversing disturbing trends in physical activity and obesity. Massachusetts (MA) recently implemented a new policy requiring 60 minutes of daily physical activity for all children in child care. A narrow window of opportunity now exists to evaluate this new policy, which will affect over 2,000 child care centers caring for nearly 40,000 children in MA. We intend to leverage this natural experiment to assess the effectiveness of the new policy by measuring physical activity in children attending child care center before and after the policy takes effect, both in MA and Rhode Island (RI), a comparison state. Child care is not regulated by the federal government-each individual state is responsible for regulating its child care centers. Though 2 states, Delaware and Alaska, have recently enacted new policies requiring 60 minutes of daily physical activity for all children in child care, they have not been evaluated for effectiveness. The proposed study provides a unique opportunity to evaluate this physical activity policy. The primary aim of the study is to determine the extent to which the new policy in MA, compared with RI, increases physical activity in 3- to 5-year old children in child care. We will use a quasi-experimental two-group pre-test/post-test design to assess physical activity in a sample of children attending child care centers before and after the policy takes effect. This evaluation is already underway. We collected 3 rounds of pre-policy physical activity data over the course of 1.5 years (fall 2008, spring 2009, and fall 2009). We focused our data collection efforts on Boston, MA and Providence, RI and measured physical activity in a sample of children attending 40 child care centers (20 per city). We collected both observation (n=360 children) and accelerometer (n=41 children) data to assess the physical activity levels of children, focusing on total minutes children engage in moderate to vigorous physical activity. In this proposal, we seek funding to support post- policy physical activity data collection to complete our evaluation of this natural experiment. PUBLIC HEALTH RELEVANCE: Policy approaches to combat childhood obesity in the child care setting can have broad reach, affect children from varied racial, ethnic, and socio-demographic backgrounds, and be low-cost to implement. Through this study, we hope to provide evidence to policy-makers on the effectiveness of a state physical activity policy for licensed child care facilities. If effective, this policy could help reverse trends in rates of childhood obesity in Massachusetts and across the country.