Providing Time in the Schedule is Insufficient for Increasing Physical Activity in Childcare

ABSTRACT The purpose of this study was to describe differences in children’s sedentary behavior and physical activity (PA) when their early care and education center met the recommended PA practices. Up to 4 d of Environment and Policy Assessment and Observation was collected on 80 centers and 150 classrooms along with corresponding accelerometer (ActiGraph GT3X+) data on 472 children. Linear mixed models were used to examine children’s PA outcomes based on compliance with the recommended PA practices (≥60 min·d−1 of outdoor play, ≥120 min·d−1 of indoor/outdoor play, and <60 min·d−1 of sedentary time). Meeting outdoor play recommendation was associated with a significant difference in centers’ time use: +56.7 min·d−1 of outdoor play and −38.5 min·d−1 of indoor play, resulting in an approximately 9 min·d−1 increase in children’s total PA while at childcare. Meeting indoor/outdoor play recommendation was associated with differences in centers’ time use: +66.9 min·d−1 of indoor/outdoor play, −29.7 min·d−1 of screen/sitting, −11.4 min·d−1 for circle time, and −19.2 min·d−1 of nonclassified activities, resulting in an approximately 14 min·d−1 increase in children’s total PA while at childcare. Meeting recommendation for limiting sedentary time was associated with −55.0 min·d−1 of screen/sitting, +24.4 min·d−1 of indoor play, +15.1 min·d−1 of outdoor play, and +8.4 min·d−1 for circle time, resulting in an approximately 7.0 min·d−1 increase in children’s light activity only while at childcare. Classroom compliance with the recommended practices at childcare had minimal association with children’s total daily or at home PA levels. These results suggest that providing time for play alone leads to minimal increases in total PA. These findings suggest the need for more quality play opportunities (e.g., provider-led PA) rather than allocating time alone to improve daily PA.