title: Active play opportunities at child care.
abstract: OBJECTIVE
  Physical activity (PA) is important for children's health and development, yet preschoolers are not meeting PA recommendations. The objective of this study was to examine different PA opportunities at child care and how variation in indoor versus outdoor and free versus teacher-led opportunities relate to children's PA.
  
  
  METHODS
  An observational study of 98 children (mean age 4.5 years, 49% girls) from 10 child care centers. Classrooms were observed for at least 4 full days per center (total 50 days) to categorize time into (1) not an active play opportunity (APO); (2) naptime; (3) APO, outdoor free play; (4) APO, outdoor teacher-led; (5) APO, indoor free play; and (6) APO, indoor teacher-led. Children wore accelerometers during observations. Linear regression models examined the influence of APO categories on moderate-vigorous physical activity (MVPA) and sedentary time.
  
  
  RESULTS
  Children's activity was 73% sedentary, 13% light, and 14% MVPA. For 88% of time children did not have APOs, including 26% time as naptime. On average, 48 minutes per day were APOs (41% sedentary, 18% light, and 41% MVPA), 33 minutes per day were outdoors. The most frequent APO was outdoor free play (8% of time); outdoor teacher-led time was <1%. Children were more active and less sedentary outdoors versus indoors and during the child-initiated APOs (indoors and outdoors) versus teacher-led APOs.
  
  
  CONCLUSIONS
  Preschoolers were presented with significantly fewer than recommended opportunities for PA at child care. More APOs are needed for children to meet recommendations, particularly those that encourage more outdoor time, more teacher-led and child-initiated active play, and flexibility in naptime for preschoolers.
authors.affiliation: Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington; and Department of Pediatrics, University of Washington, Seattle, Washington pooja@uw.edu.
authors.forename: Pooja S
authors.initials: PS
authors.lastname: Tandon
authors.affiliation: Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington; and Department of Pediatrics, University of Washington, Seattle, Washington.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Saelens
authors.affiliation: Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington; and Department of Pediatrics, University of Washington, Seattle, Washington.
authors.forename: Dimitri A
authors.initials: DA
authors.lastname: Christakis
mesh_terms: D002654:Child Care / Q000592:standards*; D002656:Child Day Care Centers; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D010988:Play and Playthings