Childhood Obesity
Conditions
Brief summary
Painted Playgrounds Aim 1: Observation will examine the physical environment of licensed childcare centers before and after painting stencil activities (hopscotch, foursquare, fun trails, etc.) on playgrounds. The stencils are a promising intervention to help decrease obesity and sedentary behaviors in preschool aged children because they are cost-effective and easily scalable. Observations will be held at follow-ups by video recording during recess and using a modified behavioral observation method, called SOPLAY. Surveys will be administered to childcare center directors to report further on their physical activity environment and how much they are interacting with the stencils.
Detailed description
Preschool is a critical period during which children develop fundamental motor skills, build confidence in their movement, and start a physical activity trajectory that follows through adolescence and beyond. Unfortunately, few sustainable interventions have succeeded in increasing preschool children's physical activity, and subsequently children are developing obesity at alarming rates. A simple, low-cost strategy is the addition of colorful markings (i.e. hopscotch, foursquare, fun trails) to existing playgrounds or open spaces. These painted playgrounds have been shown to be effective to increase physical activity in older school-aged children but remain understudied in preschool children. The proposed project will examine the physical activity environment of licensed childcare centers before and after the implementation of a promising (cost-effective, easily scalable) playground stenciling intervention. The project aim will be achieved through a prospective observational epidemiological approach before and after a stenciling intervention is implemented. Among 4 childcare centers licensed in East Baton Rouge Parish (EBR), the investigators will first observe the playground environment to assess the equipment, space, ground material, etc. to provide a baseline measure of the physical activity environment prior to stenciling and ensure that intervention and control centers have similar playground environments. A modified behavioral observation method, the System for Observing Play and Leisure Activity in Youth (SOPLAY), will be used during recess to identify changes in physical activity after the stencils are added and which stencils are generating the biggest changes in physical activity. Surveys will be administered to center directors to further understand the physical activity environment (i.e. policies, additional PA support, etc.) in each center. This project will examine how a promising (cost-effective, easily scalable) playground stenciling intervention changes the physical activity landscape of childcare centers in order to provide evidence for the need for dissemination to numerous childcare centers across Louisiana. Ultimately, this pilot may launch an innovative strategy that has the potential to disrupt negative trends in obesity and sedentary behavior among Louisiana preschoolers.
Interventions
None listed
Sponsors
Blue Cross Blue Shield
Pennington Biomedical Research Center
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Licensed by DOE as a Class A or Class B childcare center * Current childcare enrollment of at least 20 children between the ages of 3-6 years * Has a playground/play area with adequate space for stenciling
Exclusion criteria
* Childcare center and/or childcare center director are unwilling to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Children's Physical Activity Levels During Recess | Children will be examined at follow up (6-8 weeks after receiving the stencils) | The investigators will observe the number of children participating in physical activity during recess before and after the implementation of a playground stenciling intervention to asses for change. The observation will be performed using a modified version of the System for Observing Play and Leisure Activity in Youth (SOPLAY). SOPLAY is an observational tool designed to assess physical activity levels & environmental conditions in settings where youth are engaged in play and leisure. SOPLAY is typically used to capture data on physical activity levels, the type of activity, and environmental factors that may influence youth activity. SOPLAY does not produce a single cumulative score but instead provides a detailed record of activity levels and environmental conditions. The data is typically analyzed to assess patterns, identify factors that promote or inhibit physical activity, and guide interventions to improve youth physical activity engagement. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Childcare Center Physical Activity Environment | Baseline | Childcare center directors will complete a survey assessing the physical activity environment (e.g. policies for outdoor play and screen time, available equipment, teacher engagement in physical activity, etc.) of their childcare center. |
| Satisfaction With Playground Stencils | 6-8 weeks after receiving the playground stencils. | Intervention Childcare center directors will complete a survey to measure their satisfaction and perceptions of teacher's satisfaction with the playground stencils. |
| Childcare Center Resources for Physical Activity | Baseline | Project staff will evaluate the availability of resources (i.e. playground space, equipment, etc.) at each childcare center. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Children Enrolled in Participating Child Care Centers - Control All childcare centers enrolled to Aim 1 will be observed. The physical activity environment will be examined before and after the implementation of playground stencils; control group DID receive stencils. The demographic data listed represents the 19 children in the control group | 19 |
| Children Enrolled in Participating Child Care Centers - Intervention All childcare centers enrolled to Aim 1 will be observed. The physical activity environment will be examined before and after the implementation of playground stencils; intervention group did NOT receive stencils. The demographic data listed represents the 32 children in the intervention group | 32 |
| Total | 51 |
Baseline characteristics
| Characteristic | Children Enrolled in Participating Child Care Centers - Control | Children Enrolled in Participating Child Care Centers - Intervention | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 19 Participants | 32 Participants | 51 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 12 Participants | 23 Participants | 35 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants | 2 Participants | 3 Participants |
| Race (NIH/OMB) White | 6 Participants | 7 Participants | 13 Participants |
| Sex: Female, Male Female | 12 Participants | 17 Participants | 29 Participants |
| Sex: Female, Male Male | 7 Participants | 15 Participants | 22 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 19 | 0 / 32 |
| other Total, other adverse events | 0 / 19 | 0 / 32 |
| serious Total, serious adverse events | 0 / 19 | 0 / 32 |
Outcome results
Primary
Change in Children's Physical Activity Levels During Recess
The investigators will observe the number of children participating in physical activity during recess before and after the implementation of a playground stenciling intervention to asses for change. The observation will be performed using a modified version of the System for Observing Play and Leisure Activity in Youth (SOPLAY). SOPLAY is an observational tool designed to assess physical activity levels & environmental conditions in settings where youth are engaged in play and leisure. SOPLAY is typically used to capture data on physical activity levels, the type of activity, and environmental factors that may influence youth activity. SOPLAY does not produce a single cumulative score but instead provides a detailed record of activity levels and environmental conditions. The data is typically analyzed to assess patterns, identify factors that promote or inhibit physical activity, and guide interventions to improve youth physical activity engagement.
Time frame: Children will be examined at follow up (6-8 weeks after receiving the stencils)
Population: A total number of 45 children were observed playing in either the intervention or control playgrounds. When the numbers listed below does not match with the over number of participants analyzed (51), that means the children not represented DID NOT use the stencils at their center. Reminder that the participants listed below are children who were students at the 4 sites within this aim.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Children Enrolled in Participating Child Care Centers - Control | Change in Children's Physical Activity Levels During Recess | Moderate physical activity | 3.5 count of participants | Standard Deviation 3.6 |
| Children Enrolled in Participating Child Care Centers - Control | Change in Children's Physical Activity Levels During Recess | Moderate-to-Vigorous Physical Activity | 6.2 count of participants | Standard Deviation 4.1 |
| Children Enrolled in Participating Child Care Centers - Control | Change in Children's Physical Activity Levels During Recess | Vigorous PA | 2.6 count of participants | Standard Deviation 1.2 |
| Children Enrolled in Participating Child Care Centers - Control | Change in Children's Physical Activity Levels During Recess | Sedentary Behavior | -8.5 count of participants | Standard Deviation 6.8 |
| Children Enrolled in Participating Child Care Centers - Control | Change in Children's Physical Activity Levels During Recess | Light physical activity | 2.3 count of participants | Standard Deviation 3.3 |
| Children Enrolled in Participating Child Care Centers - Intervention | Change in Children's Physical Activity Levels During Recess | Sedentary Behavior | -5.6 count of participants | Standard Deviation 6.1 |
| Children Enrolled in Participating Child Care Centers - Intervention | Change in Children's Physical Activity Levels During Recess | Light physical activity | 4.3 count of participants | Standard Deviation 2.9 |
| Children Enrolled in Participating Child Care Centers - Intervention | Change in Children's Physical Activity Levels During Recess | Moderate physical activity | 0.5 count of participants | Standard Deviation 3.2 |
| Children Enrolled in Participating Child Care Centers - Intervention | Change in Children's Physical Activity Levels During Recess | Vigorous PA | .9 count of participants | Standard Deviation 1.1 |
| Children Enrolled in Participating Child Care Centers - Intervention | Change in Children's Physical Activity Levels During Recess | Moderate-to-Vigorous Physical Activity | 1.4 count of participants | Standard Deviation 3.7 |
Secondary
Childcare Center Physical Activity Environment
Childcare center directors will complete a survey assessing the physical activity environment (e.g. policies for outdoor play and screen time, available equipment, teacher engagement in physical activity, etc.) of their childcare center.
Time frame: Baseline
Population: 4 sites were selected to participate in this study thus 4 directors completed the survey for this aim; directors were not considered to be enrolled in the study. These 4 centers are where the 51 preschoolers attend school and where the stencils were painted; child participants were not included in this analysis.
| Arm | Measure | Group | Category | Value (COUNT_OF_UNITS) |
|---|---|---|---|---|
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Does your center offered structured programs children to be physically active? | Yes | 2 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Does your center offered structured programs children to be physically active? | No | 2 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Do any community organizations support or provide physical activity programs at the center? | Yes | 3 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Do any community organizations support or provide physical activity programs at the center? | No | 1 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Active play time is provided to all preschool children more than 120 minutes each day. | Yes | 4 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Active play time is provided to all preschool children more than 120 minutes each day. | No | 0 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Preschool children are expected to remain seated for no more than 15 minutes at a time. | Yes | 2 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Preschool children are expected to remain seated for no more than 15 minutes at a time. | No | 2 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Indoor gross motor play area for preschool children consists of space for all activities. | Yes | 1 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Indoor gross motor play area for preschool children consists of space for all activities. | No | 3 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Outdoor play areas consist of multiple play areas, open space, and a track/path for wheeled toys. | Yes | 4 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Outdoor play areas consist of multiple play areas, open space, and a track/path for wheeled toys. | No | 0 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Portable play equipment consists of lots of variety for children to use at the same time. | Yes | 1 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Portable play equipment consists of lots of variety for children to use at the same time. | No | 3 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Providers are offered training opportunities in physical activity at 2 or more times per year. | Yes | 2 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Physical Activity Environment | Providers are offered training opportunities in physical activity at 2 or more times per year. | No | 2 childcare centers |
Secondary
Childcare Center Resources for Physical Activity
Project staff will evaluate the availability of resources (i.e. playground space, equipment, etc.) at each childcare center.
Time frame: Baseline
Population: 4 sites were selected to participate in this study; 2 were in the intervention group \& 2 were in the control group. These 4 centers are where the 51 preschoolers attend school and where the stencils were painted. The 2 directors from the intervention group only are included in the analysis population.
| Arm | Measure | Group | Category | Value (COUNT_OF_UNITS) |
|---|---|---|---|---|
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Resources for Physical Activity | Was Portable Play Equipment Present? | Yes | 1 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Resources for Physical Activity | Was Portable Play Equipment Present? | No | 1 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Resources for Physical Activity | Was Fixed Play Equipment Present? | Yes | 2 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Childcare Center Resources for Physical Activity | Was Fixed Play Equipment Present? | No | 0 childcare centers |
Secondary
Satisfaction With Playground Stencils
Intervention Childcare center directors will complete a survey to measure their satisfaction and perceptions of teacher's satisfaction with the playground stencils.
Time frame: 6-8 weeks after receiving the playground stencils.
Population: 4 sites were selected to participate in this study; 2 were in the intervention group \& 2 were in the control group. These 4 centers are where the 51 preschoolers attend school and where the stencils were painted. The 2 directors from the intervention group only are included in the analysis population.
| Arm | Measure | Group | Category | Value (COUNT_OF_UNITS) |
|---|---|---|---|---|
| Children Enrolled in Participating Child Care Centers - Control | Satisfaction With Playground Stencils | Do providers use the playground to teach academic concepts through movement? | Yes | 2 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Satisfaction With Playground Stencils | Do providers use the playground to teach academic concepts through movement? | No | 0 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Satisfaction With Playground Stencils | If yes, are stencils used? | Yes | 1 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Satisfaction With Playground Stencils | If yes, are stencils used? | No | 1 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Satisfaction With Playground Stencils | Have you seen any change in students' physical activity since the playground stencils were painted? | Yes | 1 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Satisfaction With Playground Stencils | Have you seen any change in students' physical activity since the playground stencils were painted? | No | 1 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Satisfaction With Playground Stencils | Are playground stencils used to infuse physical activity into the day outside of recess? | Yes | 0 childcare centers |
| Children Enrolled in Participating Child Care Centers - Control | Satisfaction With Playground Stencils | Are playground stencils used to infuse physical activity into the day outside of recess? | No | 2 childcare centers |