title: Effects of a New State Policy on Physical Activity Practices in Child Care Centers in South Carolina.
abstract: OBJECTIVE
  We sought to determine the extent to which child care centers in South Carolina improved physical activity practices after a new policy took effect.
  
  
  METHODS
  In 2012, South Carolina adopted new mandatory physical activity standards within its child care quality enhancement program. This quasi-experimental study used North Carolina, a state not making policy changes, as the comparison. Participants were 34 child care centers in South Carolina and 30 centers in North Carolina. Researchers used the Environment and Policy Assessment and Observation (EPAO) tool to conduct center observations before and after policy implementation and then conducted repeated-measures linear regression with interaction between state and time for the Physical Activity Environment Total Score and the 8 subscale scores.
  
  
  RESULTS
  Compared with centers in North Carolina, EPAO subscale scores in South Carolina centers increased significantly for the Fixed Play Environment (P < .001) and Physical Activity Training and Education (P = .015). The state-by-time interaction of Physical Activity Environment Total Score approached statistical significance (P = .06).
  
  
  CONCLUSIONS
  Adoption of new physical activity standards in South Carolina child care centers was associated with improvements in practices aimed at increasing children's physical activity.
authors.affiliation: Jennifer R. O'Neill, Marsha Dowda, and Russell R. Pate are with the Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia. Sara E. Benjamin Neelon is with the Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD. Brian Neelon is with the Department of Public Health Sciences, Medical University of South Carolina, Charleston.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: O'Neill
authors.affiliation: Jennifer R. O'Neill, Marsha Dowda, and Russell R. Pate are with the Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia. Sara E. Benjamin Neelon is with the Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD. Brian Neelon is with the Department of Public Health Sciences, Medical University of South Carolina, Charleston.
authors.forename: Marsha
authors.initials: M
authors.lastname: Dowda
authors.affiliation: Jennifer R. O'Neill, Marsha Dowda, and Russell R. Pate are with the Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia. Sara E. Benjamin Neelon is with the Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD. Brian Neelon is with the Department of Public Health Sciences, Medical University of South Carolina, Charleston.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Benjamin Neelon
authors.affiliation: Jennifer R. O'Neill, Marsha Dowda, and Russell R. Pate are with the Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia. Sara E. Benjamin Neelon is with the Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD. Brian Neelon is with the Department of Public Health Sciences, Medical University of South Carolina, Charleston.
authors.forename: Brian
authors.initials: B
authors.lastname: Neelon
authors.affiliation: Jennifer R. O'Neill, Marsha Dowda, and Russell R. Pate are with the Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia. Sara E. Benjamin Neelon is with the Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD. Brian Neelon is with the Department of Public Health Sciences, Medical University of South Carolina, Charleston.
authors.forename: Russell R
authors.initials: RR
authors.lastname: Pate
mesh_terms: D002656:Child Day Care Centers / Q000592:standards*; D002675:Child, Preschool; D015444:Exercise; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010988:Play and Playthings; D011640:Public Policy; D058996:Quality Improvement; D013022:South Carolina; D013219:State Government