Preschools' friendliness toward physical activity: item battery and two scores developed by mixed methods.
BACKGROUND
Previous work suggests that many context-level characteristics of preschools are associated with increased physical activity (PA) in children.


OBJECTIVE
To facilitate assessment of preschools' friendliness toward PA, an item battery as well as comprehensive and short rating scores were developed based on mixed methods with validity and reliability tested.


METHODS
Organizational and contextual characteristics of 24 German preschools were assessed by direct observation and semi-structured interviews (September 2008 to April 2009; analyzed in 2012). Twenty-seven items across seven domains of friendliness toward PA were rated independently by two researchers as being limited (0); adequate (1); or extraordinarily (2) friendly toward PA. Values were summed to a comprehensive rating score value (RS-c). To increase feasibility, a short score (RS-s) was developed using an item subset identified by both item-item correlations and positive association with moderate to vigorous PA. Validity of items and scores was tested by their association with preschoolers' accelerometer-measured PA (n=405) in covariate-adjusted multilevel models. Reliability was tested by inter-rater reliability coefficients.


RESULTS
Nine of 27 items were included in the RS-s. In the multilevel model, four single items and both the RS-c and RS-s were positively associated with children's moderate to vigorous PA (RS-c: β=0.5 minutes, p=0.003, explained variance=9%; RS-s: β=1.3 minutes, p<0.001, variance=23%), but not with light activity or sedentary behavior. Inter-rater reliability was 0.80 (RS-c) and 0.88 (RS-s).


CONCLUSIONS
There is potential value for mixed methods in assessing preschools' friendliness toward PA.
Mannheim Institute of Public Health, Social and Preventive Medicine (Dörr, Bock, Fischer, De Bock), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Claudia S
CS
Dörr
Mannheim Institute of Public Health, Social and Preventive Medicine (Dörr, Bock, Fischer, De Bock), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Christina
C
Bock
Mannheim Institute of Public Health, Social and Preventive Medicine (Dörr, Bock, Fischer, De Bock), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Joachim E
JE
Fischer
Mannheim Institute of Public Health, Social and Preventive Medicine (Dörr, Bock, Fischer, De Bock), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Children's Hospital (De Bock), University Medicine Mannheim, Heidelberg University, Mannheim, Germany. Electronic address: freia.debock@medma.uni-heidelberg.de.
Freia
F
De Bock
D061725:Accelerometry; D002675:Child, Preschool; D003625:Data Collection; D005858:Germany; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009043:Motor Activity; D015588:Observer Variation; D015203:Reproducibility of Results; D012574:Schools / Q000706:statistics & numerical data*