Multi-component intervention to increase physical activity in preschool children

描述(申请人提供)：近几十年来，美国3-5岁儿童的肥胖率急剧上升。与这一令人震惊的趋势同时，幼儿在学龄前环境中花费的时间增加了，他们花在非结构化游戏上的时间减少了。最近的研究表明，学龄前儿童主要从事久坐不动的活动。然而，很少有旨在增加PA或减少学龄前儿童久坐行为的干预措施被评估。这项拟议的调查将测试旨在增加3-5岁儿童体力活动能量消耗(PAEE)的多组分干预措施。12所幼儿园将被随机分配到干预组或对照组。360名儿童，在两次每年180名儿童的浪潮中，将在基线和接受干预9个月后参加测量方案。儿童水平的测量将包括中等到剧烈的PA、久坐行为和通过加速计测量的PAEE；身高、体重和腰围；以及人口统计数据。干预措施将由八个部分组成：高质量的体育课，每天两次积极的课间休息，PA课堂教学，减少在学校的久坐时间，减少在家看电视，改善促进PA的物理环境，改善促进PA的社会环境，以及确保通过与PA相关的组织政策。这项研究的干预协调员将与幼儿园主任、教师和助理教师合作，通过提供培训、材料以及持续的支持和反馈来促进干预的实施。广泛的过程评估将记录干预措施的实施程度。将确定干预对PA、久坐行为、PAEE和体重状况的影响。此外，这项研究还将检查与学龄前儿童在一个学年中体力活动、久坐行为、体力活动能量消耗和身体质量指数变化相关的因素。 公共卫生相关性：这项研究将通过在数百万儿童就读的学龄前儿童类型中测试体力活动干预，来解决一个关键的公共健康问题--儿童肥胖。从这项研究中获得的信息可能会导致采取学龄前政策和教学实践，增加学龄前儿童的体力活动，降低肥胖的风险。

DESCRIPTION (provided by applicant): Obesity rates in 3-5 year-old American children have increased dramatically in recent decades. Concurrent with this alarming trend, time spent by young children in preschool settings has increased and their time spent in unstructured play has decreased. Recent studies have shown that children in preschools are engaged primarily in sedentary activities. Nonetheless, few interventions designed to increase PA or decrease sedentary behavior have been evaluated in preschool children. The proposed investigation will test a multi- component intervention designed to increase physical activity energy expenditure (PAEE) in 3-5 year-old children. Twelve preschools will be randomly assigned to intervention or control groups. 360 children, in two annual waves of 180 children, will participate in the measurement protocol at baseline and after exposure to the intervention for 9 months. Child-level measures will include moderate-to-vigorous PA, sedentary behavior, and PAEE measured by accelerometry; height, weight and waist circumference; and demographics. The intervention will consist of eight components: high-quality physical education, two active recess periods per day, PA in classroom lessons, reduced sedentary time in school, reduced TV watching at home, enhancing the physical environment to promote PA, enhancing the social environment to promote PA, and ensuring adoption of organizational policies related to PA. The study's intervention coordinator will work with the preschool directors, teachers, and assistant teachers to facilitate intervention implementation by providing training, materials, and ongoing support and feedback. An extensive process evaluation will document the extent to which the intervention was implemented. Effects of the intervention on PA, sedentary behavior, PAEE, and weight status will be determined. In addition, the study will examine factors that associate with change in physical activity, sedentary behavior, physical activity energy expenditure and body mass index during a school year in preschool children. Public Health Relevance: The study will address a critical public health problem, childhood obesity, by testing a physical activity intervention in the types of preschools that millions of children attend. Information gained in this study may lead to adoption of preschool policies and instructional practices that increase physical activity and reduce the risk of obesity in preschool children.