Children’s physical activity level and sedentary behavior in Norwegian early childhood education and care: effects of a staff-led cluster-randomized controlled trial
Abstract Background: A growing body of evidence suggests that children’s physical activity (PA) level in early childhood education and care (ECEC) settings is 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, ECEC settings may serve as an ideal avenue for increasing PA level, reducing sedentary time and enhancing the overall health of young children. This paper investigates the effectiveness of the “Active Kindergarten – Active Children” study in increasing children’s PA level and reducing sedentary time within the ECEC setting. Methods: Accelerometers were used to assess PA and sedentary time. A total of 116 three- to four-year-olds took part in a randomized controlled trial in 11 ECEC settings. The participants were cluster-randomized, 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 by 14 min/day (95% CI = -27, -1; P=0.04) compared to the control group. The intervention group was 2.4 times more likely (95% CI = 1.05, 5.7; P = 0.04) to meet the PA recommendations than the control group at follow-up. Conclusions: Our results show that a flexible staff-led and expert-supported multi-component PA intervention can increase the total PA level and moderate- and vigorous-intensity PA and reduce sedentary time in three- to four-year-old children during their stay in ECEC settings.