1. 1 “Policies and Practices to Enhance Children’s Physical Activity in Preschools” William H. Brown, PhD University of South Carolina Eleventh National Early Childhood Inclusion Institute: Innovations in Inclusion May 17, 2011 Chapel Hill, North Carolina

2. 2 Obesity: A National Problem  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)

3. increased LDL cholesterol decreased HDL cholesterol increased triglycerides atherosclerotic plaques hypertension increased type 2 diabetes sleep apnea orthopedic problems Health Implications for Children

4. 4 Preschoolers At Risk for Overweight & Obesity  Among 2- to 5-year-old children in the U. S., the prevalence of overweight is 24.4% (Ogden, Carroll, & Flegal, 2008)

5. 5 Putative Causes of Childhood Obesity  Researchers have hypothesized that increased rates of obesity are related to  decreases in physical activity  dietary changes  or both

6. CHILD Outside play time Nutrition Education Meals Opportunities for physical activity Role Modeling Built Environment THE HEALTH ENVIRONMENT OF A CHILD Food Rewards Parent Education No playtime punishments Candy fundraisers Snacks Parties Professional Development

7. Children’s Activity and Movement in Preschools Study  Interdisciplinary research team headed by Russ Pate in the Arnold School of Public Health and funded by NICHD  Cheryl Addy, Bill Brown, Marsha Dowda, Kerry McIver, Jennifer O’Neil, Karin Pfeiffer, and others

8. 8 OSRAC-P  At least 5 hours per child of observational data from 476 children in 24 community-based preschools in SC  childcare centers (n = 12)  church-affiliated preschools (n = 8)  Head Start programs (n = 4)

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10. Encourage Children’s Physical Activity

11. Outdoor Equipment Doesn’t Always Promote PA 11

12. 12 Physical Activity in Preschools  Preschools are sedentary in nature  Very limited adult encouragement and acknowledgement of physical activity in preschools, even during recess  Very restricted employment of intentional teaching to promote children’s physical activity

13. 13 Decrease “Screen Time”

14. 14 Three Evidence-Informed Recommendations for Outdoor Play  Increase the amount of time that children spend outdoors  Provide several shorter outdoor play activities to capture peak physical activity  Organize and directly encourage children’s vigorous activity during outdoor play

15. ABC Grow Healthy Pilot Initiative Collaborative Effort among Department of Social Services, Department of Health and Environmental Control, and Arnold School of Public Health at USC and funded by the U. S. Centers for Disease Control and Prevention Nutrition and physical activity standards being evaluated in a pilot test in 19 child care centers in South Carolina

16. Nutrition and Physical Activity Standards Nutrition Policy -- create and consistently implement written nutrition policies that address the 17 standards listed below (e.g., skim or 1% milk for children, do not serve sugar sweetened beverages, offer fruit (not juice) two times per day) Physical Activity Policy -- create and consistently implement written physical activity policies that address the 15 standards listed below (e.g., provide daily outdoor play for at least 30 minutes for every 4 hours in program, provide outdoor portable play equipment, provide space for physical activity in case of bad weather)

17. 17 Applied Interventions  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.

18. Teacher Enhanced Outdoor Physical Activity (Hannon & Brown, 2008)  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 18

19. Hannon and Brown (2008) Results  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 19

20. Teacher-Implemented Physical Activities  Activity-based intervention 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

21. “Plan, Do, and Review Process”  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”)

22. “Plan, Do, and Review Process” II mmediately after high-energy physical activity, employ a “COOL DOWN” strategy EE xamples: 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

23.  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

24. Main Messages 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

25. Main Messages 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

26. Questions and Discussion Thank You! 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/ 26