title: Physical activity and screen use policy and practices in childcare: results from a survey of early childhood education services in New Zealand.
abstract: OBJECTIVE
  To investigate written policies, equipment, strategies and barriers to children's activity in early childhood education settings, including participation in health promotion programs and reported time children spend in active play and using screens while in care.
  
  
  METHODS
  Cross-sectional online survey of licensed childcare services in Auckland and Waikato. Policies were scored using a validated tool (WellCCAT-NZ). Results were analysed using descriptive statistics and multivariate regression.
  
  
  RESULTS
  Managers, head teachers or similar from 237 services completed the survey (28% of invited services). Of these, 35% had a written activity policy; most policies scored low on the WellCCAT-NZ. Comprehensive and strongly worded policies were associated with a lower adult-to-child ratio (p=0.03, adjusted for ECE characteristics). No policies addressed screen use. Children were reported to have teacher-led activity 80 minutes/day, and child-led activity five hours/day (indoor and outdoor). Children watched television daily in 2% and weekly in 11% the services; and used computers daily in 11% and weekly in 22% of services. Fewer than half of services participated in health promotion programs with a physical activity component.
  
  
  CONCLUSIONS
  Childcare services reported having adequate equipment, space and time for physical activity of children; however, there are low participation rates in activity programs and a notable absence of written policy.
authors.affiliation: School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
authors.forename: Sarah
authors.initials: S
authors.lastname: Gerritsen
authors.affiliation: Centre for Longitudinal Research, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
authors.forename: Susan M B
authors.initials: SM
authors.lastname: Morton
authors.affiliation: Discipline of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
authors.forename: Clare R
authors.initials: CR
authors.lastname: Wall
mesh_terms: D002656:Child Day Care Centers / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003201:Computers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006293:Health Promotion / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009520:New Zealand; D010988:Play and Playthings; D011795:Surveys and Questionnaires; D013690:Television / Q000706:statistics & numerical data*
keywords: child obesity; day care; obesity prevention; physical activity environment; preschool