title: UK Preschool-aged children's physical activity levels in childcare and at home: a cross-sectional exploration.
abstract: BACKGROUND
  Young children are thought to be inactive in childcare, but little is known about location-specific activity levels. This observational study sought to describe the in-care and out-of-care activity patterns of preschool-aged children and explore differences in physical activity level by childcare attendance.
  
  
  METHODS
  Three to four-year-old children were recruited from 30 preschool and nursery 'settings' in Cambridgeshire, UK. Average minutes per hour (min/h) spent sedentary (SED), in light physical activity (LPA) and in moderate-to-vigorous PA (MVPA) were measured by accelerometry for up to 7 days (mean: 6.7 ± 1.1). Weekly childcare attendance patterns were reported by parents. The within-child association between childcare attendance and outcomes was assessed using two- and three-level hierarchical regression; sex by care (in/out) interactions were considered.
  
  
  RESULTS
  Two hundred and two children (51% female) had valid activity data for ≥2 days. Children, and particularly boys, were less sedentary and more active when in care compared to at home (SED: Boys: β (SE): -6.4 (0.5) min/h, Girls: -4.8 (0.5); LPA: Boys: 0.6 (0.4), Girls: 1.8 (0.4); MVPA: Boys: 5.7 (0.5); Girls: 3.0 (0.4)). Differences between in-care and at-home activity were largest in the (early) mornings and early evenings for boys; no compensation in at-home activity occurred later in the day. On days when children were in care part-time (1-5 h) or full-time (>5 h), they were significantly less sedentary and more active compared with non-care days.
  
  
  CONCLUSIONS
  Young children, and particularly boys, accumulate more MVPA in care compared to at home. Future research should identify factors accounting for this difference and consider targeting non-care time in intervention efforts to increase higher-intensity activity and decrease sedentary time in preschoolers.
authors.affiliation: MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, 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: MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.|Primary Care Unit, Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SR, UK.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Griffin
authors.affiliation: MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
authors.forename: Esther M F
authors.initials: EM
authors.lastname: van Sluijs
mesh_terms: D061725:Accelerometry; D002652:Child Behavior / Q000502:physiology*; D002654:Child Care / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D017678:Sex Distribution; D006113:United Kingdom