1. Physical activity play and sport in young children: implications for pedagogy Professor Anthony D Okely National Heart Foundation of Australia Career Development Fellow Director, Early Start Research Institute Faculty of Social Sciences University of Wollongong, Australia tokely@uow.edu.au

2. Outline 1.Behavioural epidemiology framework to provide rationale for promoting physical activity play 2.What are the recommendations around physical activity play? 3.Evidence-based strategies for incorporating physical activity play into early childhood settings?

3. Physical activity play Contains characteristics of general play (unstructured, imaginary, child-directed, sometimes spontaneous) but involves movement of large muscles so that there is an appreciable increase in energy expenditure compared with sitting down/resting. Examples include moving to music, ball activities, water games, rough and tumble play, running and locomotor activities

6. Health Benefits of Physical Activity Play for Children aged 0-5 Cardiometabolic Blood pressure lipids Insulin resistance Psychosocial Social and emotional development Motor development Musculoskeletal Bone mineral density Reduced plantar pressure Adiposity Cognitive Executive function 1. Timmons et al. Appl. Physiol. Nutr. Metab. 2012;37: 773–792. 2. Okely et al. J Sci Med Sport (under review)

7. Hnatuik J, Salmon J, Hinkley T, Okely AD, Trost SG, (in press) A review of preschool children’s physical activity and sedentary time using objective measures. Am J Prev Med. Percent of time spent in MVPA 6% = 47mins

8. Hnatuik J, Salmon J, Hinkley T, Okely AD, Trost SG, (in press) A review of preschool children’s physical activity and sedentary time using objective measures. Am J Prev Med. Percent of time spent in LPA 17% = 132mins

9. 1.ABS. Australian Health Survey: Physical Activity, 2011-2012. 4364.0.55.004. Accessed 24/7/13. Prevalence of PA in 2-4 year-olds (Australian Recs; ≥3hrs LMVPA/d)

10. Tracking of physical activity play Jones RA, Hinkley T, Okely AD, Salmon J. Am J Prev Med 2013;44(6):651–658

11. Correlates of physical activity play Hinkley T, et al. Am J Prev Med 2008;34(5):435–441 SexParent PATime outdoorsGross motor skills Lubans DR, et al. Sports Med 2010; 40 (12): 1019-1035

12. Efficacy of PA interventions in early years 9 studies; 7 RCTS 3 RCTs no sig diff between groups Results for other 4, all INT>CON Alhassan (2007): 13.1 CPM Binkley & Specker (2004): 2500CPD; 1.5% time in MVPA Eliakim (2007): 1438 steps/day Trost (2008) Ward DS, Vaughn A,McWilliams C, Hales D. Physical Activity at Child Care Settings: Review and Research Recommendations. Am J Lifestyle Med 2009;3:474.

13. What are the recommendations around physical activity? Australia (2010)UK (2011)Canada (2012) Encourage supervised floor- based play from birth 3hrs/day physical activity spread through the day Should not be sedentary for >1hr at a time, except for sleeping Encourage supervised floor- based play from birth 3hrs/day physical activity spread through the day Minimise the amount of time spent being sedentary Encourage supervised floor- based play from birth 3hrs/day physical activity spread through the day Minimize the spent being sedentary during waking hours. This includes prolonged sitting or being restrained for more than 1hr at a time

14. National physical activity recommendations

15. Companion statements 1.Mobile infants should be encouraged to be as active as possible in a safe, supervised, minimally structured and nurturing play environment. 2.For toddlers and preschoolers, physical activity should occur primarily through physically active play 3.In selecting activities for children, the emphasis should be on fun and on engaging their interests through exploration, guided-discovery, and unstructured play and developing an enjoyment of outdoor activity. 4.For children 0-5, competitive sport is developmentally inappropriate and should not be encouraged.

16. Evidence-based tips on promoting PA Play in ECEC services Employ highly trained educators Use indoor space for gross motor activities Provide access to fixed equipment Consider layout of outdoor spaces

17. Cosco N, Moore R. Preventing Obesity by Design (POD). North Carolina State University. May 2014.

18. Evidence-based tips on promoting PA Play in ECEC services Employ highly trained educators Use indoor space for gross motor activities Provide access to fixed equipment Consider layout of outdoor spaces Supplement structured/intentional learning with opportunities for related unstructured play

19. Jump Start 20-week 2-arm cluster pilot RCT 2 long day care services 91 Children aged 3-5 years Three components, Implemented by setting staff  Ongoing professional development (PD) for staff (4 x 30 min PD sessions + 16 demonstration lessons)  Control over how program was implemented  Sense of accomplishment  Structured lessons (20 min each, 3 per week)  Fun activities  Increased competence in motor skills  Pleasing adults (social approval)  Unstructured activity sessions  Choice for both educators and children in what to participate in Funded by UOW Small Grant

20. 3. Unstructured activities

21. Results: Physical Activity During intervention Adjusted Difference (95% CI) P valueEffect size Counts per minute 110.48 (33.62, 187.33) 0.010.40 % SB-0.97 (-5.76, 3.82)0.690.08 % LPA-0.06 (-3.15, 3.02)0.970.01 % MPA-0.24 (-1.68, 1.21)0.740.07 % VPA0.56 (-0.90, 2.02)0.160.15 %MVPA0.26 (-2.07, 2.60)0.820.04 Jones RA et al. Pediatric Exercise Science. 2011;23:600-615. = approx 26 min/day more activity

22. Acknowledgements Marijka Batterham David Lubans Tom Robinson

23. Thank you Early Start Research Institute, Faculty of Social Sciences University of Wollongong, Australia tokely@uow.edu.au