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Abstract Background A growing body of evidence suggest that the children’s physical activity (PA) level in early childhood education and care (ECEC) settings are insufficient. Since most children attend ECEC settings for many hours on most days of the week, and these institutions reach children across the socioeconomic spectrum, the ECEC settings may serve as an ideal avenue for increasing physical activity level, reduce sedentary time and enhance the overall health of young children. This paper investigates the effectiveness of the “Active Kindergarten – Active Children” study to increase children’s PA level and reduce sedentary time within the ECEC setting. Methods Accelerometers were used to asses PA and sedentary time. A total of 116 three to four-year olds took part in a randomised controlled trial in 11 ECEC settings. Participants were cluster-randomised, by ECEC setting, to either a 12 week staff-led and expert-supported intervention or a waiting list control group. Results The intervention group increased time spent in moderate- and vigorous intensity PA by 10 min/day (95% CI = 3, 18; P = 0.01), took 1909 more steps per day (95% CI = 1130, 2688; P < 0.01) and reduced sedentary time with 14 min/day (95% CI = − 27, − 1; P = 0.04) compared to the control group. The intervention group had a 2.4 higher odds (95% CI = 1.05, 5.7; P = 0.04) of meeting the PA recommendations compared to the control group at follow-up. Conclusions Our results show that a flexible staff-led and expert-supported multicomponent PA intervention can increase total PA level, moderate- and vigorous intensity PA and reduce time spent sedentary in three to four-year old children during their stay in ECEC settings. Trial registration The trial was retrospectively registered on September 19, 2020 and available online at ClinicalTrials.gov: No. NCT04555746 .

Abstract Background The CHEERS is a self-administered tool to measure gaps, weaknesses, and strengths of an early childhood education and care (ECEC) centre-based nutrition and physical activity environment. ECEC settings have the potential to profoundly influence early dietary and physical activity behaviours. Content validation of the CHEERS tool has been previously reported. The purpose of this study was to develop reliability and validity evidence for the CHEERS audit tool and the proposed subscales of food served, healthy eating environment, program planning, and physical activity environment in ECEC centre-based programs. Methods This cross-sectional study consisted of 2 phases: Phase 1 included inter-, intra-rater and Cronbach’s α. A subset of this sample was invited to participate in a second survey (Trial 2) for intra-rater assessment within 3 weeks of completing the first survey (Trial 1). Phase 2 included concurrent validity assessment between a nutrition expert and the ECEC director using within a one-week period. Results One hundred two directors and 85 educators (total of 187) returned the survey. Of these, there were 75 matched pairs for inter-rater reliability analysis providing a CHEERS ICC score of 0.59 and ICC scores ranging from 0.40 to 0.58 for the subscales. The ICC for intra-rater reliability of the CHEERS score was 0.81 for 40 participants completing the survey a second time and a range of 0.72 to 0.79 for the subscales. The CHEERS tool demonstrated very good internal consistency (α = 0.91) and α scores ranging from 0.73 to 0.79 for the subscales. In phase 2, concurrent validation was ICC = 0.65 (n = 30) CHEERS scores with a range of 0.42 to 0.69 for the subscales. Conclusions This study provides evidence of inter-, intra-rater reliability, internal consistency, and concurrent validity of an environmental assessment audit tool to assess the nutrition and physical activity environment of ECEC centre-based programs. The results demonstrate that the self-administered CHEERS instrument is stable overtime and between evaluators at the same ECEC centre. The scores obtained with CHEERS self-administered audit tool are reasonably accurate compared to an expert rater (dietitian) assessment. This study adds additional support to establishing the psychometric soundness of the CHEERS tool.

Background: A growing body of evidence suggest that the children's physical activity (PA) level in early childhood education and care (ECEC) settings are insufficient. Since most children attend ECEC settings for many hours on most days of the week, and these institutions reach children across the socioeconomic spectrum, the ECEC settings may serve as an ideal avenue for increasing physical activity level, reduce sedentary time and enhance the overall health of young children. This paper investigates the effectiveness of the "Active Kindergarten - Active Children" study to increase children's PA level and reduce sedentary time within the ECEC setting.Methods: Accelerometers were used to asses PA and sedentary time. A total of 116 three to four-year olds took part in a randomised controlled trial in 11 ECEC settings. Participants were cluster-randomised, by ECEC setting, to either a 12 week staff-led and expert-supported intervention or a waiting list control group.Results: The intervention group increased time spent in moderate- and vigorous intensity PA by 10 min/day (95% CI = 3, 18; P = 0.01), took 1909 more steps per day (95% CI = 1130, 2688; P < 0.01) and reduced sedentary time with 14 min/day (95% CI = - 27, - 1; P = 0.04) compared to the control group. The intervention group had a 2.4 higher odds (95% CI = 1.05, 5.7; P = 0.04) of meeting the PA recommendations compared to the control group at follow-up.Conclusions: Our results show that a flexible staff-led and expert-supported multicomponent PA intervention can increase total PA level, moderate- and vigorous intensity PA and reduce time spent sedentary in three to four-year old children during their stay in ECEC settings.Trial Registration: The trial was retrospectively registered on September 19, 2020 and available online at ClinicalTrials.gov: No. NCT04555746 . [ABSTRACT FROM AUTHOR]

Background: The CHEERS is a self-administered tool to measure gaps, weaknesses, and strengths of an early childhood education and care (ECEC) centre-based nutrition and physical activity environment. ECEC settings have the potential to profoundly influence early dietary and physical activity behaviours. Content validation of the CHEERS tool has been previously reported. The purpose of this study was to develop reliability and validity evidence for the CHEERS audit tool and the proposed subscales of food served, healthy eating environment, program planning, and physical activity environment in ECEC centre-based programs.Methods: This cross-sectional study consisted of 2 phases: Phase 1 included inter-, intra-rater and Cronbach's α. A subset of this sample was invited to participate in a second survey (Trial 2) for intra-rater assessment within 3 weeks of completing the first survey (Trial 1). Phase 2 included concurrent validity assessment between a nutrition expert and the ECEC director using within a one-week period.Results: One hundred two directors and 85 educators (total of 187) returned the survey. Of these, there were 75 matched pairs for inter-rater reliability analysis providing a CHEERS ICC score of 0.59 and ICC scores ranging from 0.40 to 0.58 for the subscales. The ICC for intra-rater reliability of the CHEERS score was 0.81 for 40 participants completing the survey a second time and a range of 0.72 to 0.79 for the subscales. The CHEERS tool demonstrated very good internal consistency (α = 0.91) and α scores ranging from 0.73 to 0.79 for the subscales. In phase 2, concurrent validation was ICC = 0.65 (n = 30) CHEERS scores with a range of 0.42 to 0.69 for the subscales.Conclusions: This study provides evidence of inter-, intra-rater reliability, internal consistency, and concurrent validity of an environmental assessment audit tool to assess the nutrition and physical activity environment of ECEC centre-based programs. The results demonstrate that the self-administered CHEERS instrument is stable overtime and between evaluators at the same ECEC centre. The scores obtained with CHEERS self-administered audit tool are reasonably accurate compared to an expert rater (dietitian) assessment. This study adds additional support to establishing the psychometric soundness of the CHEERS tool. [ABSTRACT FROM AUTHOR]

Abstract Background In Australia, 61.5 % of children aged 3–4 attend Early Childhood Education and Care (ECEC) programs. Children’s experiences within these programs vary widely and impact directly on educational wellbeing and social development. Research has shown that higher quality programs enhance children’s learning and developmental outcomes, foster social participation and have long-lasting effects on their productivity as adults. Quality matters, yet we do not know what components of ECEC result in a quality program. Effective Early Educational Experiences (E4Kids) is a 5-year longitudinal study designed to identify and assess the impact of mainstream ECEC programs and program components on children’s learning, development, social inclusion and well-being. E4Kids sets out to measure quality ECEC; identify components that add value and positively impact children’s outcomes; evaluate the effects of child, family, community and environment characteristics on programs; and provide evidence on how best to invest in ECEC. Methods/design E4Kids follows a sample of 2,494 children who have experienced a variety of approved care programs (long day care, kindergarten, family day care and occasional care), as well as 157 children who have not accessed such programs. Children are tracked to the first point of National Assessment Program – Literacy and Numeracy (NAPLAN) testing at Year 3. The study presents a multi-level design in which ECEC programs were sampled from two states – Queensland and Victoria – then randomly sampled from two greater metropolitan regions and two regional and remote locations. Parents, centre directors, educators and carers complete questionnaires to provide information on demographics and children’s progress. Data collected also include the make-up and organisation of ECEC programs and schools children attended. The quality of adult-child interactions is directly assessed using the Classroom Assessment Scoring System (CLASS) and direct testing of children’s cognitive abilities and achievements is undertaken over 3 years and linked with NAPLAN scores. Discussion Findings from the E4Kids study have the potential to influence the quality of ECEC available in Australia by providing up-to-date evidence on the impact of ECEC programs and program components to inform future policy decisions and research.

Background: In Australia, 61.5 % of children aged 3-4 attend Early Childhood Education and Care (ECEC) programs. Children's experiences within these programs vary widely and impact directly on educational wellbeing and social development. Research has shown that higher quality programs enhance children's learning and developmental outcomes, foster social participation and have long-lasting effects on their productivity as adults. Quality matters, yet we do not know what components of ECEC result in a quality program. Effective Early Educational Experiences (E4Kids) is a 5-year longitudinal study designed to identify and assess the impact of mainstream ECEC programs and program components on children's learning, development, social inclusion and well-being. E4Kids sets out to measure quality ECEC; identify components that add value and positively impact children's outcomes; evaluate the effects of child, family, community and environment characteristics on programs; and provide evidence on how best to invest in ECEC.Methods/design: E4Kids follows a sample of 2,494 children who have experienced a variety of approved care programs (long day care, kindergarten, family day care and occasional care), as well as 157 children who have not accessed such programs. Children are tracked to the first point of National Assessment Program - Literacy and Numeracy (NAPLAN) testing at Year 3. The study presents a multi-level design in which ECEC programs were sampled from two states - Queensland and Victoria - then randomly sampled from two greater metropolitan regions and two regional and remote locations. Parents, centre directors, educators and carers complete questionnaires to provide information on demographics and children's progress. Data collected also include the make-up and organisation of ECEC programs and schools children attended. The quality of adult-child interactions is directly assessed using the Classroom Assessment Scoring System (CLASS) and direct testing of children's cognitive abilities and achievements is undertaken over 3 years and linked with NAPLAN scores.Discussion: Findings from the E4Kids study have the potential to influence the quality of ECEC available in Australia by providing up-to-date evidence on the impact of ECEC programs and program components to inform future policy decisions and research. [ABSTRACT FROM AUTHOR]