Abstract
OBJECTIVES: In order to improve healthy behaviours among rural children in their early years, a physical activity and healthy eating intervention (Healthy Start–Départ Santé) was implemented in rural childcare centres throughout Saskatchewan. The objective of the current study was to evaluate the impact of a multimodal physical activity and healthy eating intervention on educators’ provision of opportunities for children to improve their physical activity levels, fundamental movement skills and healthy eating behaviours.
SETTINGS: Six childcare centres (three Francophone and three Anglophone) located in five different rural and semi-rural communities in Saskatchewan participated in this intervention.
PARTICIPANTS: A total of 69 children with a mean age of 4 years 9 months, and 19 female early childhood educators.
INTERVENTION: Guided by an ecological framework, we implemented a population health controlled intervention, using a wait list control design (48 weeks delayed intervention), and evaluated its impact in rural childcare centres. Mixed methods were employed to determine the effectiveness of the intervention.
OUTCOMES: Overall, educators felt that the intervention supported the provision of physical activity and healthy eating opportunities for children. Increases in children’s physical activity levels were reported following the intervention.
CONCLUSION: The lessons learned in this study can be used to improve the Healthy Start–Départ Santé intervention so that its implementation can be effectively expanded to childcare centres within and outside Saskatchewan, in turn, supporting the healthy development of early years (0–5) children in the province and beyond.
Key Words: Child development, health promotion, early intervention, rural health
Résumé
OBJECTIFS : Afin de renforcer les comportements sains des enfants vivant en milieu rural au cours de leurs premières années de vie, on a mis en oeuvre une intervention d’activité physique et d’alimentation saine (Healthy Start–Départ Santé) dans les centres ruraux de la petite enfance de la Saskatchewan. L’objectif de notre étude était d’évaluer l’impact d’une intervention multimodale d’activité physique et d’alimentation saine sur les occasions offertes aux enfants par les éducatrices d’améliorer leurs niveaux d’activité physique, leurs habiletés motrices fondamentales et leurs comportements d’alimentation saine.
LIEUX : Six centres de la petite enfance (trois francophones et trois anglophones) situés dans cinq communautés rurales et semi-rurales de la Saskatchewan ont participé à cette intervention.
PARTICIPANTS : En tout, 69 enfants (âge moyen: 4 ans 9 mois) et 19 éducatrices de la petite enfance.
INTERVENTION : Avec un cadre de travail écologique pour guide, nous avons mis en oeuvre une intervention contrôlée en santé des populations, en utilisant des témoins placés sur une liste d’attente (intervention différée de 48 semaines), et nous en avons évalué l’impact dans les centres ruraux de la petite enfance. Nous avons employé des méthodes mixtes pour déterminer l’efficacité de l’intervention.
RÉSULTATS : Globalement, les éducatrices ont considéré que l’intervention soutenait l’offre d’occasions d’activité physique et d’alimentation saine aux enfants. Des hausses des niveaux d’activité physique des enfants ont été déclarées après l’intervention.
CONCLUSION : Les leçons de cette étude peuvent servir à améliorer l’intervention Healthy Start–Départ Santé pour que l’on puisse efficacement en étendre l’application aux centres de la petite enfance à l’intérieur et à l’extérieur des frontières de la Saskatchewan, pour ainsi soutenir en retour le développement sain des jeunes enfants (0 à 5 ans) dans la province et ailleurs.
Mots Clés: développement de l’enfant, promotion de la santé, intervention précoce, santé en zone rurale
Footnotes
Acknowledgements: We thank the participating childcare centres and our funders, Public Health and the Agricultural Rural Ecosystems. Without their participation and support, this pilot study would not have been possible.
Conflict of Interest: None to declare.
References
- 1.Temple VA, Naylor P-J, Rhodes RE, Higgins JW. Physical activity of children in family child care. Appl Physiol Nutr Metab. 2009;34(4):794–98. doi: 10.1139/H09-061. [DOI] [PubMed] [Google Scholar]
- 2.Pabayo R, Spence JC, Casey L, Storey K. Food consumption patterns in preschool children. Can J Diet Pract Res. 2012;73(2):66–71. doi: 10.3148/73.2.2012.66. [DOI] [PubMed] [Google Scholar]
- 3.Colley RC, Garriguet D, Adamo KB, Carson V, Janssen I, Timmons BW, et al. Physical activity and sedentary behavior during the early years in Canada: A cross-sectional study. Int J Behav Nutr Phys Act. 2013;10:54. doi: 10.1186/1479-5868-10-54. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS. The relation of childhood BMI to adult adiposity: The Bogalusa Heart Study. Pediatrics. 2005;115(1):22–27. doi: 10.1542/peds.2004-0220. [DOI] [PubMed] [Google Scholar]
- 5.Bushnik T. Child Care in Canada. Ottawa, ON: Statistics Canada; 2006. [Google Scholar]
- 6.Ward DS, Benjamin SE, Ammerman AS, Ball SC, Neelon BH, Bangdiwala SI. Nutrition and physical activity in child care: Results from an environmental intervention. Am J Prev Med. 2008;35(4):352–56. doi: 10.1016/j.amepre.2008.06.030. [DOI] [PubMed] [Google Scholar]
- 7.Larson N, Ward DS, Neelon SB, Story M. What role can child-care settings play in obesity prevention? A review of the evidence and call for research efforts. J Am Diet Assoc. 2011;111(9):1343–62. doi: 10.1016/j.jada.2011.06.007. [DOI] [PubMed] [Google Scholar]
- 8.Mikkelsen MV, Husby S, Skov LR, Perez-Cueto FJ. A systematic review of types of healthy eating interventions in preschools. Nutr J. 2014;13(1):56. doi: 10.1186/1475-2891-13-56. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Temple M, Robinson JC. A systematic review of interventions to promote physical activity in the preschool setting. J Spec Pediatr Nurs. 2014;19(4):274–84. doi: 10.1111/jspn.12081. [DOI] [PubMed] [Google Scholar]
- 10.Government of Saskatchewan. Licensed Childcare in Saskatchewan. 2015. [Google Scholar]
- 11.Beshiri R, Bollman RD. Definitions of “Rural.”. Stat Can Rural Small Town Can Anal Bull. 2002;3(21):1–43. [Google Scholar]
- 12.Froehlich Chow A, Humbert ML. Supporting the Healthy Development of Rural Children: An Ecologically Based Investigation of Barriers and Facilitators Identified by Early Years Caregivers in the Promotion of Physical Activity and Healthy Eating. 2010. [Google Scholar]
- 13.Vanderloo LM, Tucker P, Johnson AM, Holmes JD. Physical activity among preschoolers during indoor and outdoor childcare play periods. Appl Physiol Nutr Metab. 2013;38:1173–75. doi: 10.1139/apnm-2013-0137. [DOI] [PubMed] [Google Scholar]
- 14.Froehlich Chow A, Humbert ML. Perceptions of early childhood educators: Factors influencing the promotion of physical activity opportunities in Canadian rural care centers. Child Indic Res. 2013;7(1):57–73. doi: 10.1007/s12187-013-9202-x. [DOI] [Google Scholar]
- 15.Healthy Start–Départ Santé. Saskatoon, SK: Wordpress, 2013. Available at: http://www.healthystartkids.ca (Accessed June 8, 2015).
- 16.McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Behav. 1988;15(4):351–77. doi: 10.1177/109019818801500401. [DOI] [PubMed] [Google Scholar]
- 17.Public Health Agency of Canada. What is the Population Health Approach?—Population Health Approach. 2001. [Google Scholar]
- 18.Puyau M, Adolph A, Vohra F, Issa Z, Butte N. Prediction of activity energy expenditure using accelerometers in children. Med Sci Sport Exerc. 2004;36(9):1514–21. doi: 10.1249/01.MSS.0000139898.30804.60. [DOI] [PubMed] [Google Scholar]
- 19.Government of Saskatchewan. The Childcare Act. 2012. [Google Scholar]
- 20.Colley R, Gorber SC, Tremblay MS. Quality control and data reduction procedures for acelerometry-derived measures of physical activity. 2010. [PubMed] [Google Scholar]
- 21.Ryan GW, Bernard HR. Techniques to identify themes. Field Methods. 2003;15(1):85–109. doi: 10.1177/1525822X02239569. [DOI] [Google Scholar]
- 22.Gagné C, Harnois I. The contribution of psychosocial variables in explaining preschoolers’ physical activity. Health Psychol. 2013;32(6):657–65. doi: 10.1037/a0031638. [DOI] [PubMed] [Google Scholar]
- 23.Naylor P-J, Temple VA. Enhancing the capacity to facilitate physical activity in home-based child care settings. Health Promot Pract. 2013;14(1):30–37. doi: 10.1177/1524839910393280. [DOI] [PubMed] [Google Scholar]
- 24.Henderson KE, Grode GM, Connell MLO, Schwartz MB. Environmental factors associated with physical activity in childcare centers. Int J Behav Nutr Phys Act. 2015;12(43):1–9. doi: 10.1186/s12966-015-0198-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25.Tremblay L, Boudreau-Larivière C, Cimon-Lambert K. Promoting physical activity in preschoolers: A review of the guidelines, barriers, and facilitators for implementation of policies and practices. Can Psychol. 2012;53(4):280–90. doi: 10.1037/a0030210. [DOI] [Google Scholar]
- 26.Goldfield GS, Harvey A, Grattan K, Adamo KB. Physical activity promotion in the preschool years: A critical period to intervene. Int J Environ Res Public Health. 2012;9(4):1326–42. doi: 10.3390/ijerph9041326. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Nixon CA, Moore HJ, Douthwaite W, Gibson EL, Vogele C, Kreichauf S, et al. Identifying effective behavioural models and behaviour change strategies underpinning preschool- and school-based obesity prevention interventions aimed at 4–6-year-olds: A systematic review. Obes Rev. 2012;13:106–17. doi: 10.1111/j.1467-789X.2011.00962.x. [DOI] [PubMed] [Google Scholar]
- 28.Ward S, Bélanger M, Donovan D, Horsman A, Carrier N. Correlates, determinants, and effectiveness of childcare educators’ practices and behaviours on preschoolers’ physical activity and eating behaviours: A systematic review protocol. Syst Rev. 2015;4(10):18. doi: 10.1186/s13643-015-0011-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 29.Berk L. Child Development. 2nd, ed. Boston, MA: Allyn & Bacon; 2006. [Google Scholar]
- 30.FASEB J. 2014.