Multi-component intervention to increase physical activity in preschool children

描述（由申请人提供）：近几十年来，3-5岁美国儿童的肥胖率急剧上升。与这一令人担忧的趋势同时发生的是，幼儿在学前环境中度过的时间增加了，而他们在非结构化游戏中度过的时间减少了。最近的研究表明，学龄前儿童主要从事久坐的活动。然而，在学龄前儿童中，很少有旨在增加PA或减少久坐行为的干预措施得到评估。提出的调查将测试一种多成分干预，旨在增加3-5岁儿童的身体活动能量消耗（PAEE）。12个学龄前儿童将被随机分配到干预组或对照组。360名儿童，每年两波180名儿童，将在基线和接触干预措施9个月后参加测量方案。儿童水平的测量将包括中度至剧烈的PA、久坐行为和通过加速度计测量的PAEE；身高、体重、腰围；和人口统计数据。干预将包括八个组成部分：高质量的体育教育，每天两次积极的休息时间，课堂上的PA，减少在学校久坐的时间，减少在家看电视，改善物理环境以促进PA，改善社会环境以促进PA，并确保采用与PA相关的组织政策。该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。广泛的过程评价将记录干预措施实施的程度。将确定干预对PA、久坐行为、PAEE和体重状况的影响。此外，该研究还将调查学龄前儿童一学年期间身体活动、久坐行为、身体活动能量消耗和体重指数变化的相关因素。

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.