title: Features of the UK childcare environment and associations with preschooler's in-care physical activity.
abstract: OBJECTIVE
  Features of the childcare environment may influence children's in-care physical activity (PA). We assessed the association between UK preschool care-provider, environmental and policy factors and 3-4-year-olds' average daily in-care sedentary behaviour (SED) and PA.
  
  
  METHODS
  In 2013, we used accelerometers to measure the in-care SED/ PA of 201 3-4-year-old children (51% female) in 30 preschools in Cambridgeshire, UK, (average wear time: (mean ± SD) 4.2 ± 1.3 week-days). We assessed the childcare environment using the Environment and Policy Assessment and Observation tool; demographic and carer information was taken from questionnaires. We used three-level mixed-effects regression analyses (adjusted for sex, in-care time and travel mode to care) to determine the association between childcare factors and children's in-care average daily minutes/hour spent SED, in light PA (LPA) and in moderate-to-vigorous PA (MVPA).
  
  
  RESULTS
  Children spent 5.6 ± 2.5 h in care per day on average; clustering of PA within preschools was limited (ICCs: 0.003-0.05). Fully adjusted models showed that active opportunities were positively associated with children's in-care SED. No associations with in-care LPA and MVPA were observed.
  
  
  CONCLUSIONS
  Few care-provider, environmental and policy factors were associated with children's in-care activity. UK childcare policies advocating child-driven play, moving freely indoors and outdoors, may be more conducive to individual children's PA.
authors: 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, United Kingdom.
authors: Kathryn R
authors: KR
authors: Hesketh
authors: 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, United Kingdom.
authors: Esther M F
authors: EM
authors: van Sluijs
keywords: Childcare; EPAO, Environment Policy Assessment and Observation; Environment; ICC, Intra-class correlation co-efficient; IMD, Index of Multiple Deprivation; LPA, Light physical activity; MVPA, Moderate-to-vigorous physical activity; Ofsted, Office for Standards in Education; PA, Physical activity; Physical activity; Policy; Preschool-aged children; SED, Sedentary; SPACE, Studying Physical Activity in preschool-aged Children and their Environment Study; Sedentary