Happy new year! We’re resuming publication with a story that is probably close to your heart right now: what makes an exercise or physical activity program really ‘stick’ so it goes beyond a new year’s resolution and becomes a daily part of your life. In this case, we’re talking about children’s programs and Amplify editor Bec Lloyd interviewed research leader Dr Jill Hnatiuk about some very practical findings out of an academic review.
the ‘realist’ approach was a missing link in reviews of physical activity programs
Do physical activity programs at your service feel more like special occasions than lifelong habits?
Are you worried about your whole program relying on the enthusiasm of a single educator? Have you tried and failed to get parents supporting children’s interests in more vigorous activities? Do interesting physical activity opportunities turn out not to suit your service’s environment or culture?
It can be difficult to find good evidence for what makes or breaks a physical activity program for young children. However, a new ‘realist’ review of more than 30 early years physical activity programs says one or more of these ingredients appears to be vital if you want your activity program to become a normal part of life at your service.
- Tailoring. More successful programs responded to local environments, cultures, and the knowledge of directors and educators. One-size-fits-all programs were less effective than programs that allowed and supported tailoring to individual services.
- Hands-on training for educators. The research review showed programs were more effective if educators received hands-on (or feet-on!) training in physical activities. Inductions and workshops where educators increased their knowledge through practice was a factor successfully implemented programs.
- Routine. Physical activity sessions structured to become part of the children’s daily routine were more likely to create permanent changes in activity levels. This could take many forms, such as a dance session every morning before snack time, or an afternoon movement game.
Another important ingredient for long term success in children’s activity programs was to focus on changing parents’ or educators’ habits and measuring those changes so the adults also understood how their behaviour affects the activity of children in their care.
How do we know?
Melbourne researchers undertook a comprehensive analysis of current research and developed these recommendations for preschool and childcare industry workers and policymakers aiming to increase physical activity in young children aged 0-5years old.
Published recently in Obesity Reviews, the study is the first to examine both traditional systematic reviews and meta-analysis with ‘realist’ reviews, that help to show what is effective to help increase children’s level of physical activity.
Amplify spoke with Dr Jill Hnatiuk from the Institute for Physical Activity and Nutrition at Deakin University about the outcomes of the review and what it means for early childhood education services.
we looked not just at whether a program was more or less effective, but what tangible actions made it succeed
Why early years activity?
With a background in health promotion, Dr Hnatiuk, didn’t initially focus on the early years but came to study the birth-five years age group via a growing interest in preventative health for chronic diseases like type 2 diabetes.
“When you talk to older people experiencing type 2 diabetes they often share that the habits they have now have been with them for a long time,” she said.
“It made me think much more about what could be done in the earliest years, which took me to research about brain development and the economic arguments for quality early childhood education programs.”
Moving to Australia from Canada for her PhD studies in 2015, Dr Hnatiuk also met a researcher working on the Melbourne InFANT Program, another connection to improving health outcomes from the very beginning of life.
Why get ‘real’?
Dr Hnatiuk says the ‘realist’ approach was a missing link in reviews of physical activity programs.
“My background in health promotion meant that the practical side of a ‘realist’ review appealed to me. It means we looked not just at whether a program was more or less effective, but what tangible actions made it succeed,” she said.
One of the report’s co-authors, Helen Brown, had experience in ‘realist’ synthesis and the research team believes this is one of the first reviews in the world to look at early childhood physical activity programs this way.
tailoring should be a crucial component for researchers and practitioners to consider even before they develop or implement any physical activity initiative
What does the research review mean?
Essentially, the study will contribute to improving future research and future evaluations, which ultimately will improve future programs being funded and implemented in early childhood services around the world.
Dr Hnatiuk said the study provides crucial insights about effective early childhood physical activity strategies:
“We found that the most effective programs were those tailored to provide ongoing support to the early childhood educators as they deliver the program, as well as modifying materials to suit the parents and children involved to increase their participation. This might include considerations for cultural practices, or to suit the local community.
“In fact, tailoring should be a crucial component for researchers and practitioners to consider even before they develop or implement any physical activity initiative within any early childhood setting.”
She said it was also important that structured physical activity sessions can be easily incorporated into daily routines for children.
“Finding ways to help increase educators’ knowledge, such as hands-on workshops where they can practice running physical activities for children, can be effective at increasing children’s physical activity,” she said.
overall there was a small, but significant, positive effect for children’s moderate or vigorous intensity physical activity (MVPA)
Positive outcomes for children
Dr Hnatiuk said this review of the growing body of research in early childhood physical activity found that overall there was a small, but significant, positive effect for children’s moderate or vigorous intensity physical activity (MVPA).
“This is critical as we know that many young children aren’t active enough by the start of primary school,” she said.
“Early childhood is an important time to establish healthy behaviour patterns that, with the right support, will hopefully continue into middle childhood and even early adulthood.”
[programs that] focus on changing parent or educator practices are the most effective…
Don’t forget the grown-ups
Educators and parents are generally aware of the influence their own behaviour can have on children. Taking that learning through to physical activity might sound obvious, yet including adults isn’t a universal feature of programs targeting children in their early years.
“We found that physical activity programs in children’s services that focus on changing parent or educator practices are the most effective way to affect change in children’s physical activity levels,” Dr Hnatiuk said.
“It is also important to measure changes in the parents’ or providers’ behaviours, to help explain the impact of those behaviours on children’s physical activity.”
Read the full study here (log in required): https://onlinelibrary.wiley.com/doi/abs/10.1111/obr.12763
Or contact Dr Jill Hnatiuk directly to find out more and request a copy of the paper here: Jill.firstname.lastname@example.org
Dr Jill Hnatiuk
Institute for Physical Activity and Nutrition (IPAN) Deakin University
Dr Jill Hnatiuk completed her Bachelor of Kinesiology – Exercise and Sport Science and Master of Science degrees at the University of Manitoba (Winnipeg, Canada), and in 2015 was awarded her PhD from Deakin University (Melbourne, Australia).
Jill’s research interests focus on understanding and promoting physical activity in young children and their families. Using a behavioural epidemiology framework, her research can be summarized into three main areas: (1) Examining the levels and patterns of physical activity undertaken in infants, toddlers and preschoolers and how these change over time; (2) Investigating the role of the family and community in shaping young children’s physical activity behaviours; and (3) Identifying and applying approaches to promoting physical activity for young children and their families in the home and community environments.
Jill’s research has been used to inform public health recommendations, government parenting websites, VCE curriculum material, early learning centre legislation and professional development workshops for early childhood educators, community leaders and families.