title: Effects of Child Care Intervention on Physical Activity and Body Composition.
abstract: This study evaluated whether intervening with child care providers would increase physical activity (PA) and reduce adiposity in preschoolers.
  
  
  
  This was a two-arm, parallel group, cluster RCT whereby six child care centers were randomly assigned in equal numbers to intervention (n=40 children) or control (n=43 children). Participants were aged 3-5 years and attended licensed child care centers. Child care providers received two 3-hour train-the-trainer workshops and a training manual at program initiation aimed at increasing structured and unstructured PA through active play. Control child care centers implemented their standard curriculum. PA and sedentary behavior were measured by accelerometry, and body composition was measured using bioelectrical impedance at baseline and 6 months. Data were collected in 2011-2012 and analyzed in April 2015.
  
  
  
  Linear mixed-effects modeling showed that at 6 months, children in the intervention group demonstrated greater increases in minutes per preschool day spent in overall PA (22.5 minutes, 95% CI=8.9, 36.1, p=0.002), and light-intensity PA (16.1 minutes, 95% CI=5.2, 26.7, p=0.004), but changes between groups in moderate to vigorous PA did not differ. The intervention group showed greater reductions in body fat percentage (-1.9%, 95% CI=-3.5, -0.3, p=0.023) and fat mass (-0.3 kg, 95% CI=-0.7, -0.1, p=0.018), but groups did not differ on fat-free mass, BMI, or z-BMI.
  
  
  
  Provider-led intervention in child care centers increased preschoolers' PA and reduced adiposity, therefore may represent a viable approach to promoting PA and related health benefits in preschool-aged children.
  
  
  
  This study is registered at www.clinicaltrials.gov NCT02293278.
authors.affiliation: Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Paediatrics, University of Ottawa, Ottawa, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada; School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Department of Psychology, Carleton University, Ottawa, Ontario, Canada. Electronic address: ggoldfield@cheo.on.ca.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Goldfield
authors.affiliation: Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Alysha L J
authors.initials: ALJ
authors.lastname: Harvey
authors.affiliation: Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Kimberly P
authors.initials: KP
authors.lastname: Grattan
authors.affiliation: School of Exercise Science, Health and Physical Education, University of Victoria, Victoria, British Columbia, Canada.
authors.forename: Viviene
authors.initials: V
authors.lastname: Temple
authors.affiliation: School of Exercise Science, Health and Physical Education, University of Victoria, Victoria, British Columbia, Canada.
authors.forename: Patti-Jean
authors.initials: PJ
authors.lastname: Naylor
authors.affiliation: Werklund School of Education, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Angela S
authors.initials: AS
authors.lastname: Alberga
authors.affiliation: Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Division of Maternal-Fetal Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Ferraro
authors.affiliation: Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Shanna
authors.initials: S
authors.lastname: Wilson
authors.affiliation: Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Jameason D
authors.initials: JD
authors.lastname: Cameron
authors.affiliation: Department of Paediatrics, University of Ottawa, Ottawa, Ontario, Canada; Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Barrowman
authors.affiliation: Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Paediatrics, University of Ottawa, Ottawa, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Kristi B
authors.initials: KB
authors.lastname: Adamo
mesh_terms: D061725:Accelerometry / Q000379:methods; D050154:Adiposity / Q000502:physiology; D001823:Body Composition / Q000502:physiology*; D002654:Child Care / Q000458:organization & administration*; D002675:Child, Preschool; D015444:Exercise / Q000502:physiology*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male