title: The Preschool Activity, Technology, Health, Adiposity, Behaviour and Cognition (PATH-ABC) cohort study: rationale and design.
abstract: Prevalence estimates internationally suggest that many preschool-aged children (3-5 years) are insufficiently physically active and engage in high levels of screen-based entertainment. Early childhood is the developmental period for which we know the least about the effects of physical activity on development and health. Likewise, rapid technological advancements in mobile electronic media have made screen-based forms of entertainment for young children ubiquitous, and research demonstrating the impacts on cognition, psychosocial well-being, and health has lagged behind the rate of adoption of these technologies. The purpose of the Preschool Activity, Technology, Health, Adiposity, Behaviour and Cognition (PATH-ABC) study is to investigate if physical activity and screen-based entertainment are independently associated with cognitive and psychosocial development, and health outcomes in young children, and if so, how much and which types of these behaviours might be most influential.
  
  
  
  The PATH-ABC study is a prospective cohort, aiming to recruit 430 3-5 year-old children. Children are recruited through and complete initial assessments at their Early Childhood Education and Care (ECEC) centre, and then 12-months later at their centre or school. Direct assessments are made of children's habitual physical activity using accelerometry, cognitive (executive function) and language development (expressive vocabulary), psychosocial development (emotional understanding, Theory of Mind, empathy, and heart rate variability), adiposity (body mass index and waist circumference), and cardiovascular health (blood pressure and retinal micro- vasculature). Educators report on children's psychological strengths and difficulties and self-regulation. Parents report on children's habitual use of electronic media and other child, parent and household characteristics.
  
  
  
  The PATH-ABC study aims to provide evidence to enhance understanding of how much and which types of physical activity and screen-based media influence development and health in preschool-aged children. This information would benefit parents, educators, health professionals and governments seeking to develop strategies and policies to give young children the best start in life by promoting healthy levels of physical activity and electronic media use.
authors.affiliation: Early Start Research Institute, School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia. dylanc@uow.edu.au.|Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia. dylanc@uow.edu.au.
authors.forename: Dylan P
authors.initials: DP
authors.lastname: Cliff
authors.affiliation: Early Start Research Institute, School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia.|Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.
authors.forename: Jade
authors.initials: J
authors.lastname: McNeill
authors.affiliation: Early Start Research Institute, School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.
authors.forename: Stewart
authors.initials: S
authors.lastname: Vella
authors.affiliation: Early Start Research Institute, School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia.|Early Start Research Institute, School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Howard
authors.affiliation: Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.|Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia.
authors.forename: Megan A
authors.initials: MA
authors.lastname: Kelly
authors.affiliation: School of Psychology University of New South Wales, Kensington, Australia.
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Angus
authors.affiliation: Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.|Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Wright
authors.affiliation: Early Start Research Institute, School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia.|Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.|Research Centre in Physical Activity, Health and leisure, Faculty of Sport, University of Porto, Porto, Portugal.
authors.forename: Rute
authors.initials: R
authors.lastname: Santos
authors.affiliation: Statistical Consulting Centre, School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia.
authors.forename: Marijka
authors.initials: M
authors.lastname: Batterham
authors.affiliation: Early Start Research Institute, School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.|Department of Education, University of Oxford, Oxford, UK.|Psychological Sciences, Birkbeck, University of London, London, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Melhuish
authors.affiliation: Early Start Research Institute, School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia.|Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Okely
authors.affiliation: Early Start Research Institute, School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia.
authors.forename: Marc
authors.initials: M
authors.lastname: de Rosnay
mesh_terms: D061725:Accelerometry; D050154:Adiposity; D002652:Child Behavior; D002657:Child Development; D000067576:Child Health; D002675:Child, Preschool; D002985:Clinical Protocols; D003071:Cognition; D003201:Computers; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D009517:New South Wales; D011446:Prospective Studies; D057185:Sedentary Behavior; D013690:Television
keywords: Active play; Cardiovascular; Early childhood; Electronic media; Emotion understanding; Executive function; Physical activity; Psychosocial; Screen time; Self-regulation; Theory of mind; Well-being