title: Assessing care providers' perceptions and beliefs about physical activity in infants and toddlers: baseline findings from the Baby NAP SACC study.
abstract: BACKGROUND
  As children now spend increasing amounts of time in out-of-home care, care providers play an important role in promoting positive health behaviors. Little is currently known about providers' perceptions and beliefs about physical activity, particularly for very young children. This study describes providers' perceptions and beliefs about infants' and toddlers' physical activity, and assesses their knowledge of physical activity guidelines, to establish if and where providers may need support to promote physical activity in child care settings.
  
  
  METHODS
  We analyzed baseline data from a pilot randomized-controlled trial conducted in 32 child care centers in Massachusetts, USA. Providers completed physical activity-related questionnaires from which we compared twenty perception and belief questions for infant and toddler care providers.
  
  
  RESULTS
  203 care providers (96% female, mean ± SD age: 32.7 ± 11.2 years) from 29 centers completed questionnaires. A large proportion of providers (n = 114 (61.9%)) believed that infants should be active for 45 minutes or less each day, and only 56 providers (29.7%) perceived toddlers to require more than 90 minutes of activity per day. 97% of providers perceived it was their job to ensure children engaged in a healthy amount of physical activity and most (94.1%) perceived physical activity to be important to own their health, despite 13.3% finding it hard to find the energy to be physically active.
  
  
  CONCLUSIONS
  This study is the first to assess the physical activity perceptions and attitudes of providers caring for infants and toddlers. Though all providers believed toddlers should engage in more physical activity than infants, most providers believed that young children require only a short amount of physical activity each day, below recommended guidelines. How provider perceptions influence children's physical activity behavior requires investigation.
authors.affiliation: Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. kathryn.hesketh@ucl.ac.uk.|UCL Institute of Child Health, 30 Guilford Street, London, WC1N1EH, UK. kathryn.hesketh@ucl.ac.uk.
authors.forename: Kathryn R
authors.initials: KR
authors.lastname: Hesketh
authors.affiliation: Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. ev234@medschl.cam.ac.uk.
authors.forename: Esther M F
authors.initials: EM
authors.lastname: van Sluijs
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA. rblaine@mail.harvard.edu.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Blaine
authors.affiliation: Division of General Pediatrics, Pediatric Population Health Management, Mass General Hospital for Children, Boston, MA, USA. elsie.taveras@mgh.harvard.edu.
authors.forename: Elsie M
authors.initials: EM
authors.lastname: Taveras
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. matthew_gillman@harvardpilgrim.org.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
authors.affiliation: Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. sara.benjamin@duke.edu.|Department of Community and Family Medicine, Duke University Medical Center and Duke Global Health Institute, Durham, NC, USA. sara.benjamin@duke.edu.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Benjamin Neelon
mesh_terms: D000328:Adult; D002654:Child Care / Q000706:statistics & numerical data*; D002656:Child Day Care Centers / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015444:Exercise; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008297:Male; D008404:Massachusetts; D010988:Play and Playthings; D011795:Surveys and Questionnaires