title: Child physical activity levels and associations with modifiable characteristics in centre-based childcare.
abstract: OBJECTIVE
  To describe children's physical activity levels during childcare and associations with modifiable characteristics.
  
  
  METHODS
  A cross-sectional study of 328 preschool children (43% girls; age 3-5 years) and 145 staff from 20 long day care centres in the Hunter Region of NSW, Australia. Pedometers assessed child physical activity levels. Centre characteristics and staff attitudes and behaviours towards children's physical activity were assessed using surveys, interviews and observational audit. Results were analysed using descriptive statistics and linear regression.
  
  
  RESULTS
  Over the measurement period, average step count of children was 15.8 (SD=6.8) steps/minute. Four-year-olds had the highest step counts (16.4, SD=7.1, p=0.03) with no differences by sex. Step counts were significantly higher in centres that had a written physical activity policy (+3.8 steps/minute, p=0.03) and where staff led structured physical activity (+3.7 steps/minute, p<0.001) and joined in active play (+2.9 steps/minute, p=0.06).
  
  
  CONCLUSIONS
  Written physical activity policy, structured staff-led physical activity and staff joining in active play were associated with higher levels of physical activity.
  
  
  CONCLUSIONS
  Childcare physical activity interventions should consider including strategies to encourage written physical activity policies and support structured staff led physical activities.
authors.affiliation: School of Medicine and Public Health, University of Newcastle, New South Wales.|School of Education, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, New South Wales.|School of Medicine, Deakin University, Victoria.
authors.forename: A Colin
authors.initials: AC
authors.lastname: Bell
authors.affiliation: School of Medicine and Public Health, University of Newcastle, New South Wales.|Hunter New England Population Health, New South Wales.
authors.forename: Meghan
authors.initials: M
authors.lastname: Finch
authors.affiliation: School of Medicine and Public Health, University of Newcastle, New South Wales.|Hunter New England Population Health, New South Wales.
authors.forename: Luke
authors.initials: L
authors.lastname: Wolfenden
authors.affiliation: School of Medicine and Public Health, University of Newcastle, New South Wales.
authors.forename: Michael
authors.initials: M
authors.lastname: Fitzgerald
authors.affiliation: School of Education, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, New South Wales.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Morgan
authors.affiliation: Hunter New England Population Health, New South Wales.
authors.forename: Jannah
authors.initials: J
authors.lastname: Jones
authors.affiliation: School of Medicine and Public Health, University of Newcastle, New South Wales.|Hunter New England Population Health, New South Wales.|Hunter Medical Research Institute, New South Wales.
authors.forename: Megan
authors.initials: M
authors.lastname: Freund
authors.affiliation: School of Medicine and Public Health, University of Newcastle, New South Wales.|Hunter New England Population Health, New South Wales.|Hunter Medical Research Institute, New South Wales.
authors.forename: John
authors.initials: J
authors.lastname: Wiggers
mesh_terms: D061725:Accelerometry; D000328:Adult; D001315:Australia; D002656:Child Day Care Centers; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009043:Motor Activity; D017063:Outcome Assessment, Health Care; D010988:Play and Playthings; D057185:Sedentary Behavior; D012931:Social Environment; D011795:Surveys and Questionnaires
keywords: childcare; observation; pedometer; physical activity; preschool children