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Abstract Background Capacity building may play an important role in improving classroom teachers’ and early childhood educators’ (ECE) capacity to implement physical activity and FMS interventions. Capacity building is the development of knowledge, skills, and structures to improve the capability of individuals and organisations to achieve effective health promotion. This review aimed to determine the efficacy of capacity building interventions on teachers’ and ECEs’ perceived capabilities, knowledge, and attitudes relating to physical activity and fundamental movement skills. Methods An exhaustive literature search of six electronic databases was conducted. Controlled, single-group pre-post studies were included if they measured the effect of a capacity building intervention on in-service or pre-service classroom teachers’ (primary or secondary) or ECEs’ physical activity or fundamental skills related perceived capabilities, knowledge, or attitudes. The effects of interventions were synthesised using random effects meta-analysis. Subgroup analysis and meta-regression was conducted to determine if the effects differed based on study design, type of teacher (ECE vs. primary school), or teacher level (pre-service vs. in-service). Results A total of 22 studies reporting on 25 unique samples were included in the meta-analyses. Only studies reporting on ECEs and primary school teachers were identified. Interventions most commonly included training/professional development, resources and toolkits, communities of practice, mentorships, and ongoing support. Results showed that capacity building interventions significantly improved teachers’ and ECEs’ perceived capabilities (g = 0.614, 95% CI = 0.442, 0.786), knowledge (g = 0.792 95% CI = 0.459, 1.125), and attitudes (g = 0.376 95% CI = 0.181, 0.571). The effects did not differ significantly as a function of any of the moderators examined. Conclusion Findings from this review provide strong support that capacity building interventions are efficacious at improving teachers’ and ECEs’ perceived capabilities, knowledge, and attitudes related to promoting physical activity and teaching fundamental movement skills. Pre-service teachers and ECEs should be provided training in physical activity and fundamental movement skills as part of their degrees, and continual professional development and capacity building should be offered to in-service teachers and ECEs to promote physical activity and fundamental movement skills in children.

This study aimed to obtain consensus on physical activity (PA) and sedentary behaviour (SB) policy items for use in Canadian childcare settings. Purposeful sampling of Canadian experts in PA/SB (n = 19) and Early Childhood Education (ECE; n = 20) was used to form two distinct (i.e., PA/SB and ECE) panels for a 3-round Delphi study. In round 1, the PA/SB experts suggested their top 10 items for a Canadian childcare PA/SB policy. Policy items were then pooled to generate a list of 24 unique items. In round 2, experts in both panels rated the importance of the 24 policy items using a 7-point Likert scale (i.e., 1 = "Not at all important" to 7 = "Extremely important"). The ECE panel was also asked to report on the feasibility of the policy items using a 4-point Likert scale (i.e., 1 = "Not at all feasible" to 4 = "Very feasible"). Policy items that received an interquartile deviation (IQD) score of [less than or equal to] 1 (indicating consensus) and a median score of [greater than or equal to] 6 (indicating importance) in both panels were considered shared priorities. In round 3, members of both panels re-rated the importance of the policy items that did not achieve consensus among their respective panel in round 2 and were asked to order items based on importance. Descriptive statistics were used to assess feasibility of policy items, and differences in panel ratings were quantified using Mann Whitney U tests. Consensus was achieved for 23 policy items in the PA/SB panel and 17 items in the ECE panel. Overall, 15 shared priorities were identified (e.g., provide 120 min of outdoor time per day, sedentary behaviour should not be used as a punishment), and six policy items exhibited a statistical difference in ratings across panels. Members of the ECE panel indicated that the policy item, "children should be permitted to go outside whenever they want, for as long as they want" (M = 1.78; SD = 0.65) was lowest in terms of feasibility, and the policy item, "children should receive opportunities to engage in both unstructured and structured physical activity opportunities daily" (M = 3.89; SD = 0.32) was the most feasible for daily implementation. Findings from this study can inform the development of an expert-generated and feasibility-informed institutional PA/SB policy for use in Canadian childcare settings.

Abstract Background Childcare-based physical activity (PA) and sedentary behavior (SB) interventions have traditionally used in-person training to supplement early childhood educators’ (ECEs) knowledge and confidence to facilitate physically active programming for the children in their care. However, this method of delivery is resource-intensive and unable to reach a high number of ECEs. The purpose of the Training pre-service EArly CHildhood educators in PA (TEACH) pilot study was to test the implementation (e.g., fidelity, feasibility, acceptability) of an e-Learning course targeting PA and SB among a sample of pre-service (i.e., post-secondary students) and in-service (i.e., practicing) ECEs in Canada. Methods A pre-/post-study design was adopted for this pilot study, and implementation outcomes were assessed cross-sectionally at post-intervention. Pre-service ECEs were purposefully recruited from three Canadian colleges and in-service ECEs were recruited via social media. Upon completing the e-Learning course, process evaluation surveys (n = 32 pre-service and 121 in-service ECEs) and interviews (n = 3 pre-service and 8 in-service ECEs) were completed to gather ECEs’ perspectives on the e-Learning course. Fidelity was measured via e-Learning course metrics retrieved from the web platform. Descriptive statistics were calculated for quantitative data, and thematic analysis was conducted to analyze qualitative data. Results Moderate-to-high fidelity to the TEACH study e-Learning course was exhibited by pre-service (68%) and in-service (63%) ECEs. Participants reported that the course was highly acceptable, compatible, effective, feasible, and appropriate in complexity; however, some ECEs experienced technical difficulties with the e-Learning platform and noted a longer than anticipated course duration. The most enjoyed content for pre- and in-service ECEs focused on outdoor play (87.5% and 91.7%, respectively) and risky play (84.4% and 88.4%, respectively). Conclusions These findings demonstrate the value of e-Learning for professional development interventions for ECEs. Participant feedback will be used to make improvements to the TEACH e-Learning course to improve scalability of this training.

Abstract Background Early childhood educators (ECEs) are the primary daytime role models for many young children, and are responsible for facilitating physical activity (PA) opportunities and minimizing sedentary behaviour (SB) in childcare. However, they have reportedly received little related education in their pre-service training. The purpose of the Training pre-service EArly CHildhood educators in physical activity (TEACH) pilot study was to explore changes in pre- and in-service ECEs’ knowledge, self-efficacy, behavioural intention, and perceived behavioural control following the TEACH e-Learning course in PA and SB. Methods Pre-service ECEs were purposefully recruited from three Canadian colleges, while in-service ECEs were recruited via social media. A pre-post study design was used. ECEs completed two online surveys; one prior to, and one immediately following the completion of the TEACH e-Learning course (~ 5 h). Descriptive statistics were reported, and McNemar Chi-Square tests and paired samples t-tests were used to examine changes in ECEs’ question-specific, and total knowledge scores, respectively. Wilcoxon Signed Ranks tests were employed to examine changes in self-efficacy, behavioural intention, and perceived behavioural control. Results Both pre- (n = 32) and in-service (n = 121) ECEs significantly increased their total knowledge scores from pre- to post-course completion (p

Abstract Background The COVID-19 pandemic and associated public health measures have resulted in the closure of many physical activity-supporting facilities. This study examined Ontario parents’ and children’s perspectives of COVID-19’s impact on children’s physical activity behaviours, return to play/sport during COVID-19, as well as barriers/facilitators to getting active amid extended closures of physical activity venues. Methods Parents/guardians of children aged 12 years and under living in Ontario, Canada were invited to participate in an interview. 12 parent/guardian and 9 child interviews were conducted via Zoom between December 2020 – January 2021, were audio-recorded, and transcribed verbatim. Thematic content analysis was undertaken to identify pronounced themes. Results Themes for both parent and child interviews fell into one of three categories: 1) barriers and facilitators for getting children active amid COVID-19 closures of physical activity-supporting facilities; 2) changes in children’s activity levels; and, 3) perspectives on return to play/sport during and post-pandemic. Various subthemes were identified and varied between parents and children. The most common facilitator for dealing with children’s inactivity voiced by parents/guardians was getting active outdoors. Parents/guardians noted their willingness to have their children return to play/sport in the community once deemed safe by public health guidelines, and children’s willingness to return stemmed primarily from missing their friends and other important authority figures (e.g., coaches) and sporting events (e.g., tournaments). Conclusions Findings from this study could inform families of feasible and realistic strategies for increasing children’s physical activity during community closures, while also providing public health experts with information regarding what supports, or infrastructure might be needed during future lockdown periods and/or pandemics.

Abstract Background Early childhood educators (ECEs) play a critical role in promoting physical activity (PA) among preschoolers in childcare; thus, PA-related training for ECEs is essential. The Supporting PA in the Childcare Environment (SPACE) intervention incorporated: 1. shorter, more frequent outdoor play sessions; 2. provision of portable play equipment; and, PA training for ECEs. An extension of the SPACE intervention (the SPACE-Extension) incorporated only the shorter, more frequent outdoor play periods component of the original SPACE intervention. The purpose of this study was to explore the individual impact of these interventions on ECEs’ PA-related self-efficacy and knowledge. Methods ECEs from the SPACE (n = 83) and SPACE-Extension (n = 31) were administered surveys at all intervention time-points to assess: self-efficacy to engage preschoolers in PA (n = 6 items; scale 0 to 100); self-efficacy to implement the intervention (n = 6 items); and, knowledge of preschooler-specific PA and screen-viewing guidelines (n = 2 items). A linear mixed effects model was used to analyze the impact of each intervention on ECEs’ self-efficacy and knowledge and controlled for multiple comparison bias. Results The SPACE intervention significantly impacted ECEs’ self-efficacy to engage preschoolers in PA for 180 min/day (main effect), and when outdoor playtime was not an option (interaction effect). Further, the interaction model for ECEs’ knowledge of the total PA guideline for preschoolers approached significance when compared to the main effects model. Participants within the SPACE-Extension did not demonstrate any significant changes in self-efficacy or knowledge variables. Conclusions Findings from this study highlight the benefit of ECE training in PA with regard to fostering their PA-related self-efficacy and knowledge. Future research should explore the impact of PA training for ECEs uniquely in order to determine if this intervention component, alone, can produce meaningful changes in children’s PA behaviours at childcare.

Abstract Background Early childhood educators play a prominent role in promoting healthy activity behaviours in childcare. However, they have expressed that they lack the appropriate pre-service training to confidently lead physical activity (PA), and minimize sedentary behaviour (SB), in childcare. As such, the purpose of this Delphi study was to generate and reach agreement on content areas for inclusion in a PA and SB e-Learning module for Early Childhood Education (ECE) students. Methods Purposeful sampling of Canadian/international researchers was used to form two expert panels: a PA/SB expert panel (n = 26), and a Canadian ECE panel (n = 35). The PA/SB experts suggested their top 12 PA/SB topics for the module via online survey. These topics were then pooled to generate a list of 19 content areas. In a second online survey, both panels of experts rated the importance of each content area (0 = unimportant to 5 = very important). Mean ratings (M) were ranked separately for each panel, and then ratings were pooled to create an overall ranking of the 19 content areas. Inter-panel agreement of importance rankings was visually represented as a scatterplot and quantified using Spearman’s rho (r s ). Results The top-rated content area was Outdoor Play (M = 4.77 ± 0.64), followed by Benefits of PA in the Early Years (M = 4.75 ± 0.66), and Factors Influencing PA and SB in Childcare (M = 4.71 ± .74). Monitor PA and Sedentary Time Within Your Classroom had the lowest combined score (M = 3.77 ± 1.44). There was moderate-to strong inter-panel agreement for content area importance rankings (r s = 0.60, 95% CI: 0.20 to 0.83). The majority of the ECE expert panel considered this training important for ECE students (94.3%), aligning with ECE curriculum objectives (91.4%) and accreditation standards (78.8%), and complementary to the present ECE curriculum (88.6%). Conclusions Providing PA and SB training to ECE students is a proactive way to ensure healthy movement behaviours are prioritized in childcare programming. With the PA/SB expert-developed content areas, and endorsement by the ECE expert panel, implementing this training within ECE programs is a necessary next step.

Abstract Background Early experiences in physical activity (PA) are important to shape healthy movement behaviours long-term; as such, it is critical that PA is promoted from infancy, and that detrimental behaviours (e.g., prolonged sedentary time [ST]) are minimized. The purpose of this systematic review and meta-analysis was to examine infants’ and toddlers’ movement behaviours across daytime hours. Methods Seven online databases were searched for terms related to infants (

Abstract Background Early childhood educators greatly influence young children’s physical activity and screen-viewing behaviours in childcare. However, educators have requested additional training in physical activity programming, and one logical place to provide this education is during their pre-service schooling. This study explored the physical activity and screen-viewing-related knowledge, training, and self-efficacy of early childhood education (ECE) candidates across Canada, to determine their confidence and ability to facilitate physical activity opportunities and limit screen-viewing among young children in childcare. Methods Key program personnel at 61 (of 110) Canadian colleges/universities offering an ECE program agreed to participate in this cross-sectional study. An online survey (112 items; 9 domains), developed by experts using the Tailored Design Method, was administered via Qualtrics© to a sample of 1292 ECE candidates. Descriptive statistics, Mann-Whitney U-tests, and chi-square tests were used to report participant demographics and physical activity and screen-viewing-related knowledge (i.e., of physical activity and screen-viewing concepts), training (i.e., physical activity and screen-viewing courses/content received), and self-efficacy (i.e., to facilitate physical activity and limit screen-viewing in childcare) of candidates. Results ECE candidates exhibited the least amount of knowledge regarding the impact of screen-viewing on physiological outcomes (i.e., blood pressure) in young children. Further, only 32.2 and 26.7% of candidates reported completing physical activity or screen-viewing courses during their post-secondary training, respectively. Candidates who completed one or more physical activity or screen-viewing courses exhibited significantly greater (p

Abstract Background Many preschoolers spend a substantial portion of their day enrolled in centre-based childcare; the amounts of physical activity and sedentary time accumulated in this environment are critical to preschoolers’ ability to meet movement guidelines. The purpose of this systematic review was to provide a comprehensive overview of the objectively assessed physical activity and sedentary time of preschoolers in centre-based childcare (registration no. CRD42016033502). Methods Eight online databases were searched using terms related to physical activity, sedentary time, preschoolers and centre-based childcare. Published, peer-reviewed primary studies written in English that objectively assessed (via accelerometry) the physical activity and sedentary time of preschoolers (2-5 years) in centre-based childcare were included. Results Fifty-five studies (published 2004-2017) from 11 countries, representing 13,956 participants were included. Studies reported light physical activity (n=38) ranging from 2.94 to 29.96 mins/hr, moderate-to-vigorous physical activity (n=46) which ranged from 1.29 to 22.66 mins/hr, and total physical activity (n=42) ranging from 4.23 to 47.17 mins/hr. Sedentary time (n=47) ranged from 12.38 to 55.77 mins/hr. Conclusion Physical activity and sedentary time were highly varied and inconsistent between studies; therefore, it is difficult to determine preschoolers’ true amount of physical activity and sedentary time during childcare hours. Despite this variability, preschoolers were noted to participate in high rates of sedentary time in this setting. The lack of homogeneity is an important finding in and of itself as it highlights the lack of consistency in measuring, processing, and reporting paediatric physical activity data.

Abstract Background Early childhood educators play a critical role in promoting physical activity and reducing sedentary time in childcare centres. However, early childhood educators receive limited specialised pre- and in-service learning opportunities relating to these behaviours and may lack the capacity to effectively engage children in healthy movement behaviours. This study aimed to examine the efficacy of an e-Learning course on increasing early childhood educators’ physical activity and sedentary behaviour-related capacities. Methods A two-group parallel randomized controlled trial was conducted with early childhood educators in Canada (Mage = 41.78, 97% female). Participants randomized to the intervention group were asked to complete a physical activity and sedentary behaviour e-Learning course within a 4-week period. Participants randomized to the waitlist control condition were assigned to a waitlist to receive the intervention after the testing period. Participants reported on their self-efficacy, knowledge, intentions, and perceived behavioural control relating to physical activity and sedentary behaviours at baseline, post-intervention, and 3 months follow-up. Linear mixed effects models were estimated to determine difference in changes in outcomes from baseline to post-intervention, and follow-up. Results A total of 209 early childhood educators participated in the study (intervention n = 98; control n = 111). The TEACH e-Learning course was found to be efficacious at improving all of the examined outcomes, with standardized effect sizes ranging from d = 0.58 to d = 0.65 for self-efficacy outcomes, d = 0.66 to d = 1.20 for knowledge outcomes, d = 0.50 to d = 0.65 for intention outcomes, and d = 0.33 to d = 0.69 for perceived behavioural control outcomes post-intervention. The intervention effects were sustained at follow-up for all outcomes apart from perceived behavioural control to limit screen time. Additionally, the magnitude of the effect for knowledge outcomes decreased at follow-up, with standardized effect sizes ranging from d = 0.49 to d = 0.67. Conclusions The e-Learning course was highly successful at improving early childhood educators’ capacity pertaining to physical activity and sedentary behaviours. Providing training content through e-Learning may be an efficacious approach to providing continual professional learning opportunities relating to physical activity and sedentary time to early childhood educators on a large scale.

Abstract Background Parents/guardians can greatly influence their child’s movement behaviours (i.e., physical activity, sedentary behaviour, and sleep). Yet, they have reported to lack sufficient background knowledge to foster healthy movement habits, and little is known about specific educational gaps. The aim of this study was to explore the educational background and needs regarding promoting healthy movement behaviours in early childhood among parents/guardians living in Canada. Methods A cross-sectional study was conducted with parents/guardians living in Canada who had at least one child under the age of 5 years. Participants completed an online survey capturing their demographics, information they received about movement behaviours in early childhood during their prenatal/postnatal care or child’s pediatrician appointments, where they sourced information about these topics, content areas they would like more information on, and preferred format for delivery. Descriptive statistics and frequencies were calculated for all outcome variables and logistic regression was used to explore if sociodemographic variables were associated with receiving movement behaviour-related education across care types. Results Among the 576 parents/guardians who completed the survey, many reported no mention of any movement behaviour in their prenatal (49.4%), postnatal (29.6%), and pediatric care (37.2%). Physical activity was the most cited movement behaviour across care types, with 42.4%, 57.9%, and 54.8% of participants indicating this was discussed in their prenatal, postnatal, and pediatric care, respectively. Only 41.7% of parents/guardians reported asking their child’s pediatrician about movement behaviours, while most relied on social media (70.9%), internet websites/news articles (68.7%), and family/friends (67.6%). The most sought-after movement behaviour topics included incorporating movement into traditionally sedentary activities (68.8%) and activity ideas to break up sitting time (65.0%), and participants expressed preference to receive more information via social media (63.2%), an online resource package (47.8%), or email (46.6%). Conclusions Given the noted inconsistencies in education relating to movement behaviours in maternal and pediatric care, this study highlights the opportunity for greater integration of this type of education across care types. Ensuring all parents/guardians receive evidence-based and consistent guidance on their child’s movement behaviours will help ensure young children receive the best start to a healthy active life.