Societal values and policies may curtail preschool children's physical activity in child care centers.
OBJECTIVE
Three-fourths of US preschool-age children are in child care centers. Children are primarily sedentary in these settings, and are not meeting recommended levels of physical activity. Our objective was to identify potential barriers to children's physical activity in child care centers.


METHODS
Nine focus groups with 49 child care providers (55% African American) were assembled from 34 centers (inner-city, suburban, Head Start, and Montessori) in Cincinnati, Ohio. Three coders independently analyzed verbatim transcripts for themes. Data analysis and interpretation of findings were verified through triangulation of methods.


RESULTS
We identified 3 main barriers to children's physical activity in child care: (1) injury concerns, (2) financial, and (3) a focus on "academics." Stricter licensing codes intended to reduce children's injuries on playgrounds rendered playgrounds less physically challenging and interesting. In addition, some parents concerned about potential injury, requested staff to restrict playground participation for their children. Small operating margins of most child care centers limited their ability to install abundant playground equipment. Child care providers felt pressure from state mandates and parents to focus on academics at the expense of gross motor play. Because children spend long hours in care and many lack a safe place to play near their home, these barriers may limit children's only opportunity to engage in physical activity.


CONCLUSIONS
Societal priorities for young children--safety and school readiness--may be hindering children's physical development. In designing environments that optimally promote children's health and development, child advocates should think holistically about potential unintended consequences of policies.
Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. kristen.copeland@cchmc.org
Kristen A
KA
Copeland
Susan N
SN
Sherman
Cassandra A
CA
Kendeigh
Heidi J
HJ
Kalkwarf
Brian E
BE
Saelens
D002656:Child Day Care Centers; D002675:Child, Preschool; D005260:Female; D017144:Focus Groups; D006306:Health Surveys; D006801:Humans; D008297:Male; D009043:Motor Activity; D009820:Ohio; D010988:Play and Playthings; D011640:Public Policy; D017751:Safety Management; D057185:Sedentary Behavior; D012945:Social Values; D014947:Wounds and Injuries / Q000209:etiology / Q000517:prevention & control