William H. Brown, PhD South Carolina Education Policy Fellow University of South Carolina

Physical Activity in Preschool Children. National Institutes of Health (2003-2007). (Pate, PI with Addy & Brown, Investigators).

Multi-component Intervention to Increase Physical Activity in Preschool Children. National Institutes of Health (2008-2013). (Pate, PI with Brown, Saunders, & Addy, Co-PIs)

ABC Grow Healthy Project. U. S. Centers for Disease Control and Prevention and the South Carolina Departments of Health and Environmental Control (DEC) and Social Services (DS) (2010-2013). (Pate, PI & Brown, Co-PI).

Overweight and Obesity a National Challenge What We Know about Young Children’s Physical

Activity

How to Enhance Young Children’s Physical Activity in Community-based Preschools

A “Thought Experiment” about Children with Developmental Delays

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Weight of the Nation (HBO Documentary) Super Size Me: A Film of Epic Portions (Mockumentary)

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Healthy People 2020 (United States Department of

Health and Human Services, 2010)

“The Epidemic of Childhood Obesity: Review of Research and Implications for Policy” Social Policy Report: Society for Research in Child Development (Krishnamoorthy, Hart, & Jelalian, 2006)

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“Lack of activity destroys the good condition of every human being, while movement and methodical physical exercise save it and preserve it.” (Fox & Haskell, 1968)

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The data shown in these maps were collected through CDC’s Behavioral Risk Factor Surveillance System (BRFSS).

• Mokdad AH, et al. The spread of the obesity epidemic in the United States, 1991–

1998. JAMA 1999;282:16:1519–22.

• Mokdad AH, et al. The continuing epidemics of obesity and diabetes in the United States. JAMA 2001;286:10:1519–22.

• Mokdad AH, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003;289:1:76–9.

• CDC. State-specific prevalence of obesity among adults — United States, 2005. MMWR 2006;55(36):985–8.

• CDC. State-specific prevalence of obesity among adults — United States, 2007. MMWR 2008;57(28):765–8.

• CDC. Vital signs: State-specific prevalence of obesity among adults — United States, 2009. MMWR 2010;59:1–5.

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(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

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(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

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(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

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(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

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(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

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In 2010, no state had a prevalence of obesity less than 20%;

Thirty-six (36) states had a prevalence

equal to or greater than 25%; and Twelve (12) of these states (almost all

Southeastern states, including S. C.) had a prevalence equal to or greater than 30%.

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Among 2- to 5-year-old children in the U.S., the prevalence of overweight is 26.7%

Among 6- to 11-year-old children, the prevalence of overweight is 32.6%

Overweight is both those at-risk for overweight (BMI ≥ 85th percentile) and overweight (BMI ≥ 95th percentile) (Ogden, Carroll, Kit, & Flegal, 2012)

increased LDL cholesterol

decreased HDL cholesterol

increased triglycerides

atherosclerotic plaques

hypertension

increased type 2 diabetes

sleep apnea

orthopedic problems

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Obesity has been associated with multiple health problems

coronary heart disease

hypertension

type II diabetes

osteoporosis

several types of cancer

Researchers have hypothesized that increased rates of obesity are related to

decreases in physical activity

dietary changes

or both

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Energy Out

Energy In

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Ecological Theory of Development

Culture

Economy

Government

Work Place

Extended Family

Social Network

School

A P

ow

erfu

l P

ara

dig

m

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CHILD

Outside play time

Nutrition Education

Meals

Opportunities for

physical activity

Role Modeling

Built Environment

Food Rewards

Parent Education

No playtime punishments

Candy fundraisers

Snacks

Parties

Professional Development

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Let’s Move! Child Care is a very recent effort to promote children’s health by encouraging and supporting healthier physical activity and nutrition practices for children in all child care settings.

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Office of the First Lady White House Domestic Policy Council U. S. Department of Health & Human

Services

Administration for Children and Families

Centers for Disease Control & Prevention

Health Resources and Services Administration

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Screen Time - No screen time for children under 2 years. For children age 2 and older, strive to limit screen time to no more than 30 minutes per week in child care, and work with parents and caregivers to ensure children have no more than 1-2 hours of quality screen time per day (recommended by AAP)

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Physical Activity - Provide 1-2 hours of physical activity throughout the day including outside play when possible.

Nutrition - Serve fruits or vegetables at every meal, eat meals family-style whenever possible, and don’t serve fried foods.

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Beverages - Provide access to water during meals and throughout the day, and don’t serve sugar-sweetened drinks. For children age 2 and older, serve low-fat (1%) or non-fat milk, and no more than one 4- to 6- ounce serving of 100% juice per day.

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Infant feeding - For mothers who want to continue breastfeeding, provide their milk to their infants and welcome them to breastfeed during the child care day.

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Conventional wisdom is that preschoolers are

naturally active and have a lot of outdoor playtime in community-based programs.

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The National Association of Sport and Physical Education (NASPE) recommends that preschool aged children participate in 60 minutes of structured activity and 60 minutes of unstructured activity each day

A recent Institute of Medicine (IOM) report suggests that preschoolers should participate in 15 minutes per hour of physical activity (light + MVPA) 37

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Interdisciplinary research team headed by Russ Pate in the Arnold School of Public Health Cheryl Addy, Bill Brown, Marsha Dowda, Kerry McIver,

Jennifer O’Neill, Karin Pfeiffer, Kristen Swaney, and Harriet Williams

To obtain multi-measure and multi-source descriptive information to inform policies and practices related to preschoolers’ physical activity in community programs

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W. H.

Brown,

PhD

National

Early

Childhoo

d

Inclusion

Institute

(2012) 42

Moderate Physical Activity

Translocation (moving a body from one location to another at a moderate pace) (e.g., walking at a brisk or rapid pace, walking up stairs or uphill, climbing on monkey bars, jungle gym, fence, hanging from bar with legs swinging).

Vigorous Physical Activity

Translocation (moving body from one location to another at a fast of very fast pace) (e.g., running, walking up 3 or more stairs or an incline fast or with vigorous arm movement, three repetitions or more of skipping, hopping, jumping, leaping, kicking, or galloping).

Definitions from Brown et al. (2003) 43

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Outside

Sedentary

Light

MVPA

0

10

20

30

40

50

60

70

80

90

100

Males Females

Per

cen

t o

f In

terv

als

Sedentary

Light

MVPA

Figure 2. Percent of Intervals coded as Sedentary, Light and MVPA using Direct

Observation with the OSRAC-P from Pate, R. R., McIver, K., Dowda, M., Brown, W. H., &

Addy, C. (2008). Directly observed physical activity levels in preschool children. Journal of

School Health, 78(8), 438-444.

Of over 300,000 observed intervals, only 61

intervals (0.01%) included a teacher

prompt to increase activity

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Of over 300,000 observed intervals, only 61 intervals (0.01%) included a teacher prompt to increase activity

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Hannon, J. C., & Brown, B. B. (2008). Increasing preschoolers' physical activity intensities: An activity-friendly preschool playground intervention. Preventive Medicine, 46, 532-536.

Brown, W. H., Googe, H. S., McIver, K. L., & Rathel, J. M. (2009). Effects of teacher-encouraged physical activity on preschool playgrounds. Journal of Early Intervention, 31(2), 126-145.

Addition of portable materials related to

running, jumping, and crawling (e.g.,

playground balls, hoops, target toss sets,

tunnels)

New materials were arranged into activity

stations around the playground

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Three- to five-year-old girls and boys

decreased sedentary behavior when

materials present

Three- to five-year-old girls and boys

increased light, moderate, and vigorous

activity when materials present

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Activity-based approach with a focus on children’s physical activity (cf. Bricker)

Modified “Plan, Do, and Review Process” (cf. High

Scope) that focuses on encouraging MVPA during group activities at outdoor playtime

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Initial teacher discussion allows the teacher to “set the stage” for an activity (“PLANNING PHASE”)

Teacher participation with modeling PA or at least monitoring and careful supervision, increases the likelihood of children’s active engagement (“DOING PHASE”)

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Teacher discussion and feedback creates a classroom atmosphere that promotes healthy behaviors (“REVIEWING PHASE”)

Debriefing with children will also be a “teaching context” for preschoolers’ self-evaluation and development of their self-regulation

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Immediately after high-energy physical

activity, employ a “COOL DOWN” strategy

Examples: talking in soft relaxed voice, modeling deep

breathing to slowly relax participants, and providing a

clear signal for the end of the high-energy activity

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Preschools are sedentary in nature

Limited adult encouragement and acknowledgement of physical activity in preschools, even during recess

Restricted employment of intentional teaching to promote children’s physical activity

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1. Preschool children need more physical

activity during appropriate times of the

school day

2. Preschool teachers are on the “front lines”

of prevention in promoting healthy habits,

dispositions, and lifestyles for young

children’s physical activity

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3. Preschool teachers “ought” to be proactive in implementing high-interest and high-energy activities that are embedded at appropriate times during the school day

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National and local policies and practices Expectations and resources (policies, space, &

supplies) Encouraging adults (teachers, school partners, &

volunteers)

Integrated physical activities Indoor breaks with vigorous activities Outdoor play opportunities with appropriate

materials Teacher-led activities to intentionally encourage

sustained physical activities

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Outdoors Indoors

Video from SHAPESTM

Teacher-led

Integrated Physical Activity

Fast or slow

Full body movement

“I’ve learned that once they get up and move around, they’re ready to work. Whereas if we just sat, they’re not as calm. They have to get their energy out before they do their work.” – SHAPES School Teacher

A nutrition and physical activity quality improvement initiative designed to impact childhood obesity by improving the quality of the childcare environment

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Working Together to Grow Healthy…..

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Funded by NIH to increase preschool physical activity.

Goals and class activity developed by USC & preschools (researchers, teachers and staff).

3-year intervention resulted in activity and

training to best fit the preschool day, existing curriculum, and professional development for effective physical activity.

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Preschool is the perfect place to learn healthy habits for a physically active life.

Early childhood educators are natural experts for the enhancing preschoolers’ physical activity.

Physical activity is not just for the playground. Physical activity is full-day compatible benefit to child and teacher.

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“SHAPES made me even more aware that it’s not just having a break time, it’s getting

enough physical activity throughout the day. SHAPES has taught me a lot about what

children need and how to motivate them to do more.” – SHAPES School Teacher

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Outdoors Indoors

Video from SHAPESTM

Teacher-led

Integrated Physical Activity

Fast or slow

Full body movement

“I’ve learned that once they get up and move around, they’re ready to work. Whereas if we just sat, they’re not as calm. They have to get their energy out before they do their work.” – SHAPES School Teacher

1. Incorporate various types of physical activity 2. Increase time that children spend outdoors 3. Directly encourage child activity (verbal and

physical) 4. Provide active learning environments 5. Provide activity breaks within the classroom

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Increase physical activity throughout the day

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Identify time of day. What are class objectives at this time?

Select an activity. Use examples and experience. Why is the chosen

activity most appropriate for this time?

Describe your activity. Name it. Share summary or game rules. Which

physical activity enhancements will you include?

Make-Your-Own Physical Activity Checklist

The kids did things I really did not believe that they would be able to do so fast – like take turns and think of different moves and things like that, but they did. Sometimes we underestimate the kids. – SHAPES School Teacher

1. Share your time and activity name.

2. Describe your activity. How is it done (demo)? How does it fit your time of day?

3. What physical activity enhancements did you choose? Why?

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Make-Your-Own Physical Activity

Presentations

For the overwhelming majority of young children significant modifications are not needed

Teaching and supporting access and participation may need to be

Some small group of children with significant medical problems (e.g. breathing tubes) might have only restricted or passive watching to be a part of a game (time keeper, score keeper)

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Mark Twain

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William H. Brown

College of Education

University of South Carolina

bbrown@mailbox.sc.edu

Children’s Physical Activity

Research Group

http://www.sph.sc.edu/USC_

CPARG/

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