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Over the last 4 decades, physical activity researchers have invested heavily in determining "what works" to promote healthy behaviors in schools. Single and multicomponent school-based interventions that target physical education, active transportation, and/or classroom activity breaks effectively increased physical activity among children and youth. Yet, few of these interventions are ever scaled-up and implemented under real-world conditions and in diverse populations. To achieve population-level health benefits, there is a need to design school-based health-promoting interventions for scalability and to consider key aspects of the scale-up process. In this opinion piece, we aim to identify challenges and advance knowledge and action toward scaling-up school-based physical activity interventions. We highlight the key roles of planning for scale-up at the outset, scale-up pathways, trust among partners and program support, program adaptation, evaluation of scale-up, and barriers and facilitators to scaling-up. We draw upon our experience scaling-up effective school-based interventions and provide a solid foundation from which others can work toward bridging the implementation-to-scale-up gap. [ABSTRACT FROM AUTHOR]

Educators strongly influence young children's behaviors, and their perspectives regarding physical activity (PA) and screen-viewing (SV) may influence their provision in childcare. This study gathered early childhood education (ECE) candidates' perspectives regarding: (1) the importance of their role(s) in promoting PA/reducing SV; (2) how their ECE program and personal PA may influence these perspectives; and (3) their interest in PA/SV training. An online survey was completed by 1,292 ECE candidates from 61 programs. Descriptive statistics and chi-square tests explored these perspectives by PA/SV courses taken and by meeting the Canadian adult PA guideline. ECE candidates with PA-related training reported higher perceived importance (n=2 items; p<0.05*) and personal responsibility (n=4 items; p<0.05) for items related to teaching PA, compared to those without training. SV training was not reported to influence their perspectives. Candidates who reported meeting the PA guideline reported higher importance (n=3 items; p<0.05) and personal responsibility (n=3 items; p<0.05) for items related to promoting PA, than those not meeting the guidelines. Most candidates (77.5%-93.3%) showed interest in further PA/SV training. Findings underscore the benefit of PA-related training, and personal PA habits, with regard to positively influencing ECE candidates' values and perceptions of their role in promoting PA in childcare.

Children and youth in contemporary western society spend less time outdoors compared to previous generations. Increased use of technology, lack of green space, and concerns for risk and safety have contributed to a generation of children spending too much time indoors. A disconnection between children and nature has occurred. Our team conducted a research synthesis review of several empirically defined non-traditional literacies (physical literacy, media literacy, health literacy, nutrition literacy, and ecological literacy) to identify common components used to conceptualize, define, and describe a new nature-based literacy. Findings included four common components: (a) Motivation, (b) Knowledge, (c) Competence, and (d) Confidence. Operationalizing nature-based literacy into a set of capability domains are described as a practical way of re-engaging children and youth with the natural world. Recommendations for future research and practice are shared. [ABSTRACT FROM AUTHOR]

Background: Given the significance of motor competence (MC) for healthy development and as a cornerstone for lifelong physical activity (PA), it is crucial to understand the manifold factors that are associated with MC. Thus, the aim of the present study was to investigate correlates of children's MC and their fundamental movement skills (FMS) within their daily life from a comprehensive biopsychosocial-ecological perspective. Methods: This is a cross-sectional sub-study of the 'Physical Literacy for Communities (PL4C)' WAVES cohort study conducted in the West Vancouver School District, Canada. Motor competence was assessed using the PLAYfun tool including overall MC score and five FMS category scores, namely, running, locomotor skills, upper and lower body control and balance skills. By means of structural equation modeling (SEM), direct associationswith MC and with the specific FMS categories addressing physical activity behavior, self-perceived physical literacy, parenting, and school ground design were investigated. Results: A total of 355 children with a mean age of 7.5 years and 111.1 min of MVPA per day participated. The group comprised 51% boys and 47% girls from 14 elementary schools. Most children were at an emerging MC-level (71%), while those at a competent MC-level exhibited significantly more daily minutes of MVPA (123 versus 109, p = 0.001). Additionally, they played outdoors more frequently and engaged in more instructor-led PA. The results revealed that logistical support from parents had not only a direct positive association with overall MC, both for girls and boys, but also with most of the FMS categories. However, the correlates of MC varied between genders and showed different patterns across the five FMS categories. While time spent in sports or coach-/instructor-led physical activities had a significant SEM generated direct effect only for boys' MC and for locomotor, upper body object control and balance, the aesthetic design of the school grounds was only associated with girls' MC and those same three FMS categories. Multivariate SEM could explain 26% of variance for girls' MC and 30% for boys'. Conclusions: This exploratory baseline assessment revealed parental logistical support as an important correlate of MC, irrespective of gender. There were distinct gender patterns across biopsychosocial-ecological correlates influencing MC and FMS. Despite the heterogeneity of the results, our findings indicate a potential role of school ground design in supporting the development of children's MC, especially for girls. Key Points: • The influence of biopsychosocial-ecological correlates on motor competence (MC) varied based on gender and the specific fundamental movement skill (FMS) categories. • While parental logistical support demonstrated a positive direct association with both genders' MC and most of the FMS categories, coach-led physical activities appeared to enhance only boys'. • The positive direct association of outdoor play on boys' MC and of school ground aesthetics on girls' MC might suggest the role of the physical environment in MC development. [ABSTRACT FROM AUTHOR]

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 FROM AUTHOR]

With an increasing number of children attending regular early childhood education and care (ECEC), this setting presents an opportunity to develop physical activity habits and movement skills of children. These behaviours play an important role in the development and well-being of children. In 2017, an Active Play Standard was introduced in British Columbia, Canada, to mandate practices related to physical activity, screen time and movement skill development in licensed ECEC. A capacity-building initiative including training and online resources was released alongside these guidelines to support implementation. The purpose of this study was to qualitatively examine the barriers and facilitators ECEC practitioners faced in implementing the standard, and to explore the role of the capacity-building initiative. Data were collected via semi-structured telephone interviews with educators (n = 23). Data were coded using thematic analysis and sorted into three major themes influencing provision of physical activity opportunities: attributes and impact of the Active Play standard and capacity-building workshop, characteristics of providers and characteristics of ECEC settings. Future studies should consider targeting factors including organizational culture and climate, and provider capacity to provide physical activity and fundamental movement skill programming, and support for facility level policies and collaborative planning processes that create a positive physical activity culture. [ABSTRACT FROM AUTHOR]

The family setting can be an opportunistic environment for parents and children to engage in physical activity (PA) together; however, there is still much to learn from families about their participation in family PA interventions. The findings presented in this paper are from an analysis of exit interviews with families (parents and children) who participated in a randomized controlled trial which explored planning as a strategy to increase PA. A rigorous inductive and deductive coding reliability thematic analysis taking a constructive realist perspective was used to code the interviews and determine themes. The major themes were benefits to family PA, barriers to family PA, and perspectives on research participation. Families identified many benefits to family PA including bonding and enjoyment. Barriers to family PA included complex family schedules and family differences. Important concerns with accelerometers, as well as perspectives on planning as a strategy and secondary fitness measurements were shared by families with respect to their research participation. Parents' awareness of their influence on their children's PA was noteworthy in this study. Planning was also perceived by the majority of families as beneficial, despite also voicing ongoing challenges with logistics. These findings support researchers who have previously suggested leveraging family-based tools and supports for enhanced PA engagement and adherence. Participants' perceptions of weight-related benefits and secondary fitness measures may have both distracted and detracted from family PA uptake and potential maintenance. Future research could benefit from family system approaches, targeted protocols and more seamless technology to better engage families. Registered Trial: clinicaltrials.gov # NCT01882192 Highlights: This study included the perspectives of children and parents together to provide greater insight. Planning as a strategy was most frequently perceived as helpful. Participants identified many benefits, such as family bonding, enjoyment, and educational benefits. Perceived barriers included family scheduling logistics, lack of time, and family differences. Complex impacts related to weight and accelerometer monitoring, and fitness testing were found. [ABSTRACT FROM AUTHOR]

Background: The Early Intervention Program (EIP) was a 10-week, blended, in-person and online lifestyle intervention for families with children who were off the healthy weight trajectory. The engagement pattern and the dose response of EIP have not been examined. Objective: The aims of this paper are to examine families' engagement patterns with the EIP and to evaluate the dose-response relationship between EIP engagement patterns and physical activity and healthy eating--related outcomes at 10 weeks. Methods: Families with children (8-12 years old) who are off the healthy weight trajectory (child BMI ≥85th percentile for age and sex) were recruited. Pre- and postintervention questionnaires assessed child lifestyle behaviors, parental support behaviors, family lifestyle habits, as well as parental physical activity and healthy-eating identity. Hierarchical cluster analysis of both in-person and online components was used to classify engagement patterns. Regression analysis assessed differences in outcomes by engagement groups. Results: Two distinct clusters of engagement groups were identified (N=66), which were in-person (IP; n=40, 61%) and in-person + online (IP+; n=26, 39%) engagement. Relative to the IP group at week 10, IP+ showed a greater child moderate-to-vigorous physical activity level (1.53, SD 0.56; P=.008), child physical activity confidence (1.04, SD 0.37; P=.007), parental support for child physical activity (5.54, SD 2.57; P=.04) and healthy eating (2.43, SD 1.16; P=.04), family habits for physical activity (3.02, SD 1.50; P=.049) and healthy eating (3.95, SD 1.84; P=.04), and parental identity for physical activity (2.82, SD 1.19; P=.02). Conclusions: The online EIP portal complemented the in-person sessions. Additional engagement with the portal was associated with greater improvements in child physical activity and parental support behaviors, habits, and identity for physical activity. [ABSTRACT FROM AUTHOR]

Educators strongly influence young children's behaviors, and their perspectives regarding physical activity (PA) and screen-viewing (SV) may influence their provision in childcare. This study gathered early childhood education (ECE) candidates' perspectives regarding: 1. the importance of their role(s) in promoting PA/reducing SV; 2. how their ECE program and personal PA may influence these perspectives; and, 3. their interest in PA/SV training. An online survey was completed by 1,292 ECE candidates from 61 programs. Descriptive statistics and chi-square tests explored these perspectives by PA/SV courses taken and by meeting the Canadian adult PA guideline. ECE candidates with PA-related training reported higher perceived importance (n= 2 items; p<.05*) and personal responsibility (n= 4 items; p<.05) for items related to teaching PA, compared to those without training. SV training was not reported to influence their perspectives. Candidates who reported meeting the PA guideline reported higher importance (n= 3 items; p<.05) and personal responsibility (n= 3 items; p<.05) for items related to promoting PA, than those not meeting the guidelines. Most candidates (77.5%-93.3%) showed interest in further PA/SV training. Findings underscore the benefit of PA-related training, and personal PA habits, with regard to positively influencing ECE candidates' values and perceptions of their role in promoting PA in childcare. [ABSTRACT FROM AUTHOR]

This study examined the associations of parental movement behaviors (MBs; sleep, stationary time, light-intensity physical activity [LPA], and moderate- to vigorous-intensity physical activity [MVPA]) and parent–child proximity with preschool-aged children's MBs. Parent–child MBs and proximity were assessed with Bluetooth-enabled accelerometers. Parent–child proximity behaviors were categorized as follows: no proximity (NP), proximity and matching parent–child MBs (Co), and proximity and mismatching parent–child MBs (Close). Lastly, proximity MBs were categorized specific to children's MBs (e.g. NP-MVPA, Co-MVPA, and Close-MVPA). Compositional analyses were conducted. Children (n = 89) were mostly boys (69.7%) with a mean age of 4.6 ± 0.7 years. Parent MBs were not associated with children's MBs. Reallocating 1% of the proximity behavior composition to Close resulted in +2.45 minutes/day of children's LPA. Reallocating 1% of the proximity-MVPA composition to NP-MVPA resulted in +1.61 minutes/day of children's MVPA. Parent–child proximity may be a modifiable correlate of children's physical activity. Future research should measure the whole family. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to examine the dissemination of the healthy eating component of Appetite to Play at scale using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework., Design: The Appetite to Play capacity-building intervention is a set of evidence-informed implementation strategies aimed at enhancing the adoption of recommended practices for promoting healthy eating and active play in early years settings. The evaluation was pragmatic, employing both quantitative (surveys) and qualitative (interviews) data collection., Setting: The Appetite to Play intervention was delivered through in-person community-based workshops, virtual workshops, asynchronous e-learning and online resources., Participants: We received completed surveys from 1670 in-person workshop participants (96 % female), and twenty-three (all female) survey respondents also participated in a telephone interview. Approximately two-thirds of all participant groups were certified early childhood educators., Results: Results indicated that Appetite to Play had high reach (25 867 individual website visits, 195 workshops delivered), effectiveness (significant increases in care provider's knowledge, confidence ( P < 0·05) and high post-intervention intention to implement), adoption (11 % of educators in BC trained) and implementation (good alignment with implementation strategies and current practices), with a significant maintenance plan to support the intervention's future success., Conclusions: An evidence-based capacity-building intervention with an emphasis on training and provision of practical online resources can improve early years providers' knowledge, confidence and intention to implement recommended practices that promote healthy eating. Further research is needed to determine the impact on child-level outcomes and how parents can be supported in contributing to positive food environments.

Emerging evidence suggests that the accuracy of a child's perceived physical competence (PPC) impacts participation in physical activity. We examined differences in active physical recreation (APR) participation based on clusters of high and low motor competence and perceptions from grades 3-5. Participants were a longitudinal sample ( n = 155; 85 girls) of grade three, four, and five children. Fundamental motor skills (FMSs) were assessed using the TGMD-2, perceptions were assessed using the Self-Perception Profile for Children, and APR was measured using the Children's Assessment of Participation and Enjoyment. K-means cluster analysis was used to create four clusters per grade based on participants' FMSs and PPC z -scores. Differences in FMSs, PPC, and APR with cluster group as a factor were examined using a series of factorial ANOVAs. In each grade, participants in the high-high cluster participated in significantly more APR than those in the low-low cluster ( p = 0.002 in grades three and four; p < 0.001 in grade five). Among the less accurate clusters (e.g., low FMSs with high PPC) was a trend toward positive FMSs growth among the children with higher perceptions. Results show that combinations of FMSs and PPC influence patterns of engagement or disengagement in active physical recreation persistently across middle childhood.