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The Effect of a Teacher-Guided and -Led Indoor Preschool Physical Activity Intervention: A Feasibility Study

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Title: The Effect of a Teacher-Guided and -Led Indoor Preschool Physical Activity Intervention: A Feasibility Study
Language: English
Authors: Carroll, Alexandra V., Spring, Katherine E., Wadsworth, Danielle D.
Source: Early Childhood Education Journal. Dec 2022 50(8):1475-1483.
Availability: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
Peer Reviewed: Y
Page Count: 9
Publication Date: 2022
Document Type: Journal Articles
Reports - Research
Education Level: Early Childhood Education
Preschool Education
Descriptors: Preschool Teachers, Physical Activities, Intervention, Feasibility Studies, Low Income Students, Preschool Children, Planning
DOI: 10.1007/s10643-021-01274-2
ISSN: 1082-3301
1573-1707
Abstract: Preschoolers are not meeting physical activity recommendations and are spending an extensive amount of their day sedentary. Interventions targeting teacher-led strategies can benefit children's physical activity levels the most. The purpose of this feasibility study was to examine the effects of an indoor teacher-guided and -led preschool physical activity intervention in low-income schools. Sixty-six preschoolers and twelve preschool teachers participated in this study. Intact classrooms were randomly assigned to either an intervention or control group. A 2 x 3 mixed ANOVA was used to test changes by group and time. Follow-up measurements included Post-hoc analysis. There was a significant group by time interaction in children's moderate-to-vigorous physical activity (MVPA) levels during indoor time (p = 0.036) and a significant effect on time in children's MVPA levels during outdoor time (p = 0.002). Teacher's identified that when planned, physical activity opportunities are easy to implement during indoor time. Moreover, teachers indicated that they enjoyed providing physical activity opportunities into the classroom setting and the children enjoyed participating in the activities implemented. Teachers identified implementation barriers could be correlated with decreased levels of children's physical activity. Our findings show that a teacher-guided and -led indoor preschool physical activity intervention is a feasible approach that can acutely increase children's MVPA levels.
Abstractor: As Provided
Entry Date: 2022
Accession Number: EJ1353737
Database: ERIC
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  Value: <anid>AN0159972220;5mx01dec.22;2022Nov03.02:12;v2.2.500</anid> <title id="AN0159972220-1">The Effect of a Teacher-Guided and -Led Indoor Preschool Physical Activity Intervention: A Feasibility Study </title> <p>Preschoolers are not meeting physical activity recommendations and are spending an extensive amount of their day sedentary. Interventions targeting teacher-led strategies can benefit children's physical activity levels the most. The purpose of this feasibility study was to examine the effects of an indoor teacher-guided and -led preschool physical activity intervention in low-income schools. Sixty-six preschoolers and twelve preschool teachers participated in this study. Intact classrooms were randomly assigned to either an intervention or control group. A 2 × 3 mixed ANOVA was used to test changes by group and time. Follow-up measurements included Post-hoc analysis. There was a significant group by time interaction in children's moderate-to-vigorous physical activity (MVPA) levels during indoor time (p = 0.036) and a significant effect on time in children's MVPA levels during outdoor time (p = 0.002). Teacher's identified that when planned, physical activity opportunities are easy to implement during indoor time. Moreover, teachers indicated that they enjoyed providing physical activity opportunities into the classroom setting and the children enjoyed participating in the activities implemented. Teachers identified implementation barriers could be correlated with decreased levels of children's physical activity. Our findings show that a teacher-guided and -led indoor preschool physical activity intervention is a feasible approach that can acutely increase children's MVPA levels.</p> <p>Keywords: Childcare; Pre-k; Movement; Implementation</p> <hd id="AN0159972220-2">Introduction</hd> <p>Current United States physical activity recommendations stipulate that preschool-aged children should engage in physical activity throughout the day, with a variety of activity types that are encouraged at different intensities (U.S. Department of Health and Human Services, [<reflink idref="bib39" id="ref1">39</reflink>]). The benefits of physical activity and the risks of physical inactivity are well-documented for this population (Centers for Disease Control & Prevention, [<reflink idref="bib9" id="ref2">9</reflink>]; Centers for Disease Control & Prevention, [<reflink idref="bib10" id="ref3">10</reflink>]; Janssen & LeBlanc, [<reflink idref="bib21" id="ref4">21</reflink>]; Kirk et al., [<reflink idref="bib25" id="ref5">25</reflink>]; Lee et al., [<reflink idref="bib26" id="ref6">26</reflink>]; Lees & Hopkins, [<reflink idref="bib27" id="ref7">27</reflink>]; Schneifer & Lounsbery, [<reflink idref="bib35" id="ref8">35</reflink>]; Stodden et al., [<reflink idref="bib36" id="ref9">36</reflink>]; U.S. Department of Health and Human Services, [<reflink idref="bib39" id="ref10">39</reflink>]). However, the majority of preschool-aged children (ages three to five years) do not meet age specific physical activity recommendations (Dowda et al., [<reflink idref="bib15" id="ref11">15</reflink>]; Jurakic & Pedisie, [<reflink idref="bib23" id="ref12">23</reflink>]; Pate et al., [<reflink idref="bib32" id="ref13">32</reflink>]; Raustorp et al., [<reflink idref="bib34" id="ref14">34</reflink>]; Tucker, [<reflink idref="bib38" id="ref15">38</reflink>]) and spend a substantial amount of their day in sedentary behavior (Byun et al., [<reflink idref="bib7" id="ref16">7</reflink>]; Tandon et al., [<reflink idref="bib37" id="ref17">37</reflink>]). While preschool-aged children in the United States as a whole show low levels of physical activity and high levels of sedentary behavior, minority children living in low-income rural communities and attending low-socioeconomic status (SES) schools are typically at an even greater risk of low physical activity levels and high levels of sedentary behavior (Carlson et al., [<reflink idref="bib8" id="ref18">8</reflink>]; Gibson et al., [<reflink idref="bib17" id="ref19">17</reflink>]; Nelson et al., [<reflink idref="bib30" id="ref20">30</reflink>]). Current evidence suggests this age group is more receptive to physical activity related behavior change compared to older children (Natale et al., [<reflink idref="bib29" id="ref21">29</reflink>]). Thus, the best prevention and promotion opportunities may be during these early learning years to establish new behaviors, such as physical activity (Henderson et al., [<reflink idref="bib19" id="ref22">19</reflink>]).</p> <p>Around 60% of preschool-aged children attend preschool, where they generally spend anywhere from four to ten hours per day (U.S. Department of Health and Human Services, [<reflink idref="bib39" id="ref23">39</reflink>]). Preschools are an important environmental setting that play a major role in contributing daily physical activity opportunities and facilitating the participation of preschoolers (Copple & Bredekamp, [<reflink idref="bib13" id="ref24">13</reflink>]; Pate et al., [<reflink idref="bib33" id="ref25">33</reflink>]). Preschools can play a significant role in children's daily physical activity opportunities and participation, yet aside from recess, physical activity is often not recognized as integral to the curriculum because preschools often see this time as taking away from instructional time (Brown et al., [<reflink idref="bib5" id="ref26">5</reflink>]).</p> <p>The little activity preschoolers are participating in is generally correlated with outdoor unstructured playtime (recess) (Baranowski et al., [<reflink idref="bib4" id="ref27">4</reflink>]; Brown et al., [<reflink idref="bib5" id="ref28">5</reflink>]; Tucker, [<reflink idref="bib38" id="ref29">38</reflink>]) which only accounts for 8% of their preschool day (Tandon et al., [<reflink idref="bib37" id="ref30">37</reflink>]), leaving a very large portion of their day indoors and sedentary. While most preschools provide children with some daily physical activity opportunities, including recess, few provide planned, structured activity (Hinkley et al., [<reflink idref="bib20" id="ref31">20</reflink>]), which can be a viable strategy to increase children's physical activity levels and decrease sedentary behavior (Annesi et al., [<reflink idref="bib2" id="ref32">2</reflink>]; Jones et al., [<reflink idref="bib22" id="ref33">22</reflink>]; Tandon et al., [<reflink idref="bib37" id="ref34">37</reflink>]; Webster et al., [<reflink idref="bib41" id="ref35">41</reflink>]; Williams et al., [<reflink idref="bib42" id="ref36">42</reflink>]). Structured physical activity is an activity that is planned and intentionally directed by an adult in order to contribute to a child's basic motor development and enjoyment of movement (Alabama Department of Public Health, [<reflink idref="bib1" id="ref37">1</reflink>]).</p> <p>Teachers are considered the primary gatekeepers to physical activity during the preschool day, due to their high involvement in the decision-making process regarding children's physical activity opportunities (Copeland et al., [<reflink idref="bib12" id="ref38">12</reflink>]). Moreover, preschool teachers are important role models (Cheung, [<reflink idref="bib11" id="ref39">11</reflink>]) that can highly influence children's physical activity behaviors (Fossdal et al., [<reflink idref="bib16" id="ref40">16</reflink>]; Kahan et al., [<reflink idref="bib24" id="ref41">24</reflink>]; Pate et al., [<reflink idref="bib31" id="ref42">31</reflink>]; Van Cauwenberghe et al., [<reflink idref="bib40" id="ref43">40</reflink>]). Although teachers hold the responsibility to provide age-appropriate opportunities, education and encouragement, with regard to physical activity (Brown et al., [<reflink idref="bib5" id="ref44">5</reflink>]; Copeland et al., [<reflink idref="bib12" id="ref45">12</reflink>]; U.S. Department of Health and Human Services, [<reflink idref="bib39" id="ref46">39</reflink>]), they rarely do so within the preschool setting (Brown et al., [<reflink idref="bib5" id="ref47">5</reflink>]; Tandon et al., [<reflink idref="bib37" id="ref48">37</reflink>]).</p> <p>Research suggests that preschool physical activity interventions that target teacher-led strategies can have the highest beneficial outcomes for children's physical activity levels (Gordon et al., [<reflink idref="bib18" id="ref49">18</reflink>]; Pate et al., [<reflink idref="bib31" id="ref50">31</reflink>]; Webster et al., [<reflink idref="bib41" id="ref51">41</reflink>]). The low levels of physical activity coupled with the lack of teacher's encouragement, leadership, and provision of physical activity highlights the need for teacher involvement to improve preschoolers' physical activity levels and create active classroom environments. By having one member of the research team conversing with and instructing teachers to create active classroom environments can assist teachers in offering children more physical activity opportunities during the preschool day. Therefore, communicating strategic teacher-guided (i.e., the teacher's ideas and plan) and -led (i.e., the teachers implement their ideas and plan) physical activities during indoor classroom time, with a goal of children becoming more active, is needed in the preschool setting in order to help maximize children's physical activity opportunities and levels. The purpose of this study was to examine the effects of a teacher-guided and -led preschool physical activity intervention in low-income schools during indoor classroom time. Because previous research suggests that preschool physical activity interventions with teacher-led strategies have the highest physical activity outcomes (Gordon et al., [<reflink idref="bib18" id="ref52">18</reflink>]; Pate et al., [<reflink idref="bib31" id="ref53">31</reflink>]; Webster et al., [<reflink idref="bib41" id="ref54">41</reflink>]) we hypothesize children in the intervention group will experience a greater increase in physical activity levels compared to children in the control group.</p> <hd id="AN0159972220-3">Methods</hd> <p></p> <hd id="AN0159972220-4">Participants and Setting</hd> <p>Seventy-one (34 males, 37 females) preschool-aged children attending a Head Start center in the Southeastern United States participated in this study. In addition, 12 (six head, six assistant) preschool teachers employed by this center also participated in this study. This federally funded center specifically serves diverse and disadvantaged children and families living in low-income housing surrounding rural communities. Preschool hours were from 8:00 am to 12:30 pm, Monday through Friday. Daily schedules included arrival/breakfast (8:00–8:45 am), curriculum instruction (8:30- 12:00 am) including morning, small and large group, work time, and read aloud, an allotted outdoor play time (8:30–11:30 am), lunch (11:30 am–12:00 pm), and dismissal (12:30 pm).</p> <p>For the purposes of this study, curriculum instruction and outdoor time are explained in more detail. Morning, small and large group all involve curriculum instruction within the preschool day and last around 20-min per day, per group. Morning group always occurs right after breakfast when the entire classroom comes together to prepare for the preschool day through child initiated and teacher directed activities (i.e., by discussing the day's planned events, weather, listening to music, singing songs, etc.) Small group consists of teacher planned activities for children in small groups to learn, develop, and practice developmentally appropriate activities (i.e., problem solving, experimenting with materials, trying new skills, etc.). Large group is a time that incorporates interactive activities with the aim to build community for the entire classroom (i.e., movement and music, storytelling, etc.). Work time consists of a four-part sequence that includes planning, work, clean-up, and recall and lasts around 80 min of the preschool day. For work time, there are center activities that children can choose to play at throughout the classroom (blocks, creative arts, dramatic play, reading, writing, etc.). During work time children plan which center they would like to play at during work time (planning), engage in the planned center (work), work together with other children to clean-up (clean-up), and review with peer and teachers what they did and learned during work time (recall). Read aloud is a time where teachers read a story to children for around 15 min. Outside time is an allotted 45-min that children and teachers spend outside on the playground.</p> <p>Approval from the University's Institutional Review Board for Research Involving Human Subjects and child and teacher informed consent was received prior to this study. Letters for child consent were sent home in weekly folders for parents/guardians to complete for child participants and returned to classroom teachers. Teacher consent forms were provided to the teachers and collected once complete. Six classrooms were randomly assigned to either the intervention (three classrooms) or control (three classrooms).</p> <hd id="AN0159972220-5">Procedures</hd> <p>This study was conducted in late Spring of 2019 and lasted three consecutive weeks in duration; stemming from a recent meta-analysis that found some of the greatest effects for moderate-to-vigorous physical activity (MVPA) in preschoolers were identified for interventions that were less than four weeks in duration (Gordon et al., [<reflink idref="bib18" id="ref55">18</reflink>]). Teachers in the intervention group were asked a series of questions (Fig. 1) related to the physical activities they were planning to incorporate during their indoor classroom time on Thursdays prior to implementation of the intervention. Each week following, teachers were asked a series of follow-up questions related to the previous week's physical activity and planned physical activity for the following week (Fig. 2). In order to maintain consistency in the interviews, one member of the research team conducted the interviews and the same set of questions were asked each week.</p> <p>Graph: Fig. 1 Teacher indoor physical activity questions</p> <p>Graph: Fig. 2 Teacher indoor physical activity follow-up questions</p> <p>Children in both the control and intervention group wore accelerometers (ActiGraph GT3X) on their right hip using a Velcro belt, during the preschool day two times per week (Tuesdays and Thursdays) over three consecutive weeks. Researchers applied and removed the children's accelerometers, that were calibrated and programmed to collect data from 8:30 am to 11:30 am for all six sessions. Physical activity data were separated into indoor and outdoor time based on researchers' time stamped notes.</p> <hd id="AN0159972220-6">Intervention</hd> <p>The control group consisted of three classrooms participating in their typical preschool day and did not involve a discussion with teachers regarding the inclusion of physical activity during indoor time. All classes consisted of two teachers. The lead teacher earned an Associate degree in early childhood education that is required by the state for a lead teacher. The secondary teachers varied in training as some were enrolled in the associate degree program and some were not. The intervention's week-by-week breakdown can be seen in Fig. 3. The intervention group consisted of three classrooms in which teachers were asked a series of questions on a weekly basis (for three consecutive weeks) with a goal of the researcher obtaining teachers' physical activity ideas and perceived indoor implementation opportunities at the preschool. This information was obtained from teachers in order to allow teachers to have high autonomy to implement their own physical activity ideas into the preschool day and to determine if brief interviews could help facilitate this process. Physical activity and exercise were defined by the state's requirement of active play throughout the day and emphasis was placed on encouraging MVPA. Teachers were then instructed to implement their indoor physical activity ideas the following week and provided a copy of their planned weekly indoor physical activity ideas to increase teachers content retention. Teachers were asked another series of follow-up questions pertaining to the indoor activities they were instructed to implement the week prior. All interviews were conducted on Thursdays at the classroom teacher's convenience and answers were noted by the researcher.</p> <p>Graph: Fig. 3 Week-by-week intervention protocol</p> <hd id="AN0159972220-7">Measures</hd> <p></p> <hd id="AN0159972220-8">Demographics and Anthropometrics</hd> <p>Children's date of birth, sex, and race were provided by parents on the parental informed consent form. Children's height and weight were measured in a secluded setting within the preschool. Height was measured to the nearest 0.25 cm using a portable stadiometer and weight was measured to the nearest 0.10 kg using a precision electronic scale.</p> <hd id="AN0159972220-9">Physical Activity</hd> <p>Physical activity data were separated into indoor and outdoor time and collected two days per week (Tuesdays and Thursdays) during the preschool day over three consecutive weeks via accelerometry (ActiGraph GT3X). Accelerometers were worn on participants' right hip and attached with a Velcro belt. Children's accelerometer data were programmed, collected, and stored in 15-s intervals (epochs), which is recommended for preschool children (Bailey et al., [<reflink idref="bib3" id="ref56">3</reflink>]). Moreover, children's accelerometer activity intensity was quantified using Butte et al. ([<reflink idref="bib6" id="ref57">6</reflink>]) cut-points, developed specifically for preschool-aged children. The reliability of the Actigraph accelerometer for preschoolers, reported by previous studies, is 0.90–0.94 (Costa et al., [<reflink idref="bib14" id="ref58">14</reflink>]). Based on the accelerometer cut points, data were divided into two activity categories: light MVPA. Due to potential participant accelerometer wear time differences, the percent of time spent in light and MVPA for both indoor and outdoor time, was averaged for the week.</p> <hd id="AN0159972220-10">Data Analysis</hd> <p>All data were analyzed using statistical software (SPSS: Version 26) with a level of significance <emph>p</emph> < 0.05. A 2 × 3 mixed ANOVA examined intervention effects on group (control and intervention) and time (week 1, week 2, and week 3). If an interaction or main effect was found, Bonferroni Post-Hoc analysis were used to determine point of significance.</p> <hd id="AN0159972220-11">Results</hd> <p>Five children did not wear the monitor during the intervention and were removed from the analysis. Final analysis included sixty-six children (31 control; 35 intervention). The control group was primarily composed of males (58%), while the intervention group was primarily composed of females (63%). The majority (77%) of child participants were African American. Children's demographic variables for groups are presented in Table 1. Teacher subjects included twelve teachers (six control; six intervention) that were all female. Teacher demographic variables for group are presented in Table 2.</p> <p>Table 1 Child participant demographics</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Variable</p></th><th align="left" colspan="2"><p>Group</p></th></tr><tr><th align="left" /><th align="left"><p>Control (n = 31)</p></th><th align="left"><p>Intervention (n = 35)</p></th></tr></thead><tbody><tr><td align="left"><p>Sex</p></td><td align="left" /><td align="left" /></tr><tr><td align="left"><p> Female</p></td><td char="." align="char"><p>18</p></td><td char="." align="char"><p>22</p></td></tr><tr><td align="left"><p> Male</p></td><td char="." align="char"><p>13</p></td><td char="." align="char"><p>13</p></td></tr><tr><td align="left"><p>Race</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> African American</p></td><td char="." align="char"><p>25</p></td><td char="." align="char"><p>26</p></td></tr><tr><td align="left"><p> Hispanic/Latino</p></td><td char="." align="char"><p>4</p></td><td char="." align="char"><p>3</p></td></tr><tr><td align="left"><p> Caucasian</p></td><td char="." align="char"><p>1</p></td><td char="." align="char"><p>2</p></td></tr><tr><td align="left"><p> Other</p></td><td char="." align="char"><p>1</p></td><td char="." align="char"><p>4</p></td></tr></tbody></table> </ephtml> </p> <p>Table 2 Teacher participant demographics</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Variable</p></th><th align="left" colspan="2"><p>Group</p></th></tr><tr><th align="left" /><th align="left"><p>Control (n = 6)</p></th><th align="left"><p>Intervention (n = 6)</p></th></tr></thead><tbody><tr><td align="left"><p>Sex</p></td><td align="left" /><td align="left" /></tr><tr><td align="left"><p> Female</p></td><td align="left"><p>6</p></td><td align="left"><p>6</p></td></tr><tr><td align="left"><p> Male</p></td><td align="left"><p>0</p></td><td align="left"><p>0</p></td></tr><tr><td align="left"><p>Race</p></td><td align="left" /><td align="left" /></tr><tr><td align="left"><p> African American</p></td><td align="left"><p>5</p></td><td align="left"><p>4</p></td></tr><tr><td align="left"><p> Hispanic/Latino</p></td><td align="left"><p>1</p></td><td align="left"><p>1</p></td></tr><tr><td align="left"><p> Caucasian</p></td><td align="left"><p>0</p></td><td align="left"><p>1</p></td></tr><tr><td align="left"><p> Other</p></td><td align="left"><p>0</p></td><td align="left"><p>0</p></td></tr></tbody></table> </ephtml> </p> <p>The interview data collection notes revealed that, when asked during the intervention period, teachers in the intervention group often (78%) indicted that they did not know what classroom content was being covered in the upcoming week. All teachers in this group identified various physical activities they felt could be incorporated into their indoor lesson content each week of the study. The most common indoor time that teachers chose to incorporate these activities were during group (i.e., morning, small and large group) (90%), transition (90%), and reading (56%) time. Each week teachers indicated that they implemented the majority of the activities they planned on incorporating during the specified indoor time that week. Every teacher found that incorporating physical activity into indoor time was easy to implement, especially when planned, and seemed to benefit children's focus in the classroom. In addition, all teachers identified that they, as well as the children, enjoyed the implementation of indoor physical activity and that the activities worked well in their classrooms. Implementation difficulties were identified in week two due to field trips, and in week three due to elevated teacher absence attributable to the flu.</p> <p>A 2 × 3 mixed ANOVA was used to determine whether the teacher intervention had an effect on children's indoor and outdoor physical activity levels across a three-week duration, compared to children in the control group. All assumptions of homogeneity were met except for MVPA during outdoor time where the Green-house Geiser effect was used. Moreover, all assumptions for sphericity were met.</p> <p>The effects of within-subjects factors can be found in Table 3. There was not a significant group by time interaction in children's light physical activity levels during indoor or outdoor time, nor was there an effect on time. There was a significant group by time interaction in children's MVPA levels during indoor time. About 8% of the variance in children's MVPA levels indoors was explained by the group by time interaction (η<sups>2</sups> = 0.078). Moreover, there was a significant effect of time on children's MVPA levels during outdoor time; however, there was not a significant group by time interaction. About 15% of the variance in MVPA levels outdoors was explained by time (η<sups>2</sups> = 0.147).</p> <p>Table 3 Tests of within-subjects contrasts</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Measure</p></th><th align="left"><p>Source</p></th><th align="left"><p>F</p></th><th align="left"><p>η<sup>2</sup></p></th><th align="left"><p><italic>p</italic></p></th></tr></thead><tbody><tr><td align="left"><p>Indoor time</p></td><td align="left" /><td align="left" /><td align="left" /><td align="left" /></tr><tr><td align="left" rowspan="2"><p> Light physical activity</p></td><td align="left"><p>Time</p></td><td char="." align="char"><p>0.999</p></td><td char="." align="char"><p>0.024</p></td><td char="." align="char"><p>0.373</p></td></tr><tr><td align="left"><p>Group * Time</p></td><td char="." align="char"><p>0.560</p></td><td char="." align="char"><p>0.013</p></td><td char="." align="char"><p>0.574</p></td></tr><tr><td align="left" rowspan="2"><p> MVPA</p></td><td align="left"><p>Time</p></td><td char="." align="char"><p>0.122</p></td><td char="." align="char"><p>0.003</p></td><td char="." align="char"><p>0.885</p></td></tr><tr><td align="left"><p>Group * Time</p></td><td char="." align="char"><p>3.449</p></td><td char="." align="char"><p>0.078</p></td><td char="." align="char"><p><bold>0.036</bold></p></td></tr><tr><td align="left"><p>Outdoor time</p></td><td align="left" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left" rowspan="2"><p> Light physical activity</p></td><td align="left"><p>Time</p></td><td char="." align="char"><p>0.057</p></td><td char="." align="char"><p>0.001</p></td><td char="." align="char"><p>0.944</p></td></tr><tr><td align="left"><p>Group * Time</p></td><td char="." align="char"><p>0.322</p></td><td char="." align="char"><p>0.008</p></td><td char="." align="char"><p>0.726</p></td></tr><tr><td align="left" rowspan="2"><p> MVPA</p></td><td align="left"><p>Time</p></td><td char="." align="char"><p>6.883</p></td><td char="." align="char"><p>0.147</p></td><td char="." align="char"><p><bold>0.002</bold></p></td></tr><tr><td align="left"><p>Group * Time</p></td><td char="." align="char"><p>0.389</p></td><td char="." align="char"><p>0.010</p></td><td char="." align="char"><p>0.679</p></td></tr></tbody></table> </ephtml> </p> <p>Level of significance is <emph>p</emph> < 0.05. Significant <emph>p</emph>-values are bolded within this table</p> <p>In order to determine where our significant differences occurred, we used the Bonferroni Post-Hoc test. We found that the significant group-by-time interaction seen in children's MVPA levels during indoor time occurred in week 2 (<emph>p</emph> = 0.45). In addition, the significant effect on time seen in children's MVPA levels during outdoor time occurred in week 3 (<emph>p</emph> = 0.022). See Fig. 4 for descriptive statistics.</p> <p>Graph: Fig. 4 Descriptive statistics. Top: Percentage of means in light (right) and MVPA (right) for weeks 1, 2, and 3 by group (control and intervention) for indoor time. Bottom: Percentage of means in light (left) and MVPA (right) for weeks 1, 2, and 3 by group (control and intervention) for outdoor time</p> <hd id="AN0159972220-12">Discussion</hd> <p>This feasibility study examined the effects of a teacher-guided and -led indoor physical activity intervention on preschooler's physical activity levels. Our hypothesis was partially supported in that children in the intervention group experienced a greater increase in physical activity levels compared to children in the control group in MVPA during indoor time early on in the intervention (week 2). While there was a steady decline seen in children's MVPA during outdoor time for both groups, the intervention group decreased less, particularly at week 3. The decline in week 3 for both groups could be attributed to teacher absences during this time due to the flu, however, the less of a decline in children's indoor physical activity seen in the intervention group could have been due to teachers having had a plan to incorporate indoor physical activity during this week. Therefore, as teachers in the intervention group identified, incorporating physical activity into indoor time is easier to implement when planned.</p> <p>Our findings showed that a teacher-guided and -led intervention can increase MVPA levels during indoor time, which is in agreement with Pate et al. ([<reflink idref="bib31" id="ref59">31</reflink>]) as well as Annesi, Smith and Tenant ([<reflink idref="bib2" id="ref60">2</reflink>]) who's studies suggest that preschoolers' MVPA levels can be increased by modifying teachers' instructional practices. Although, our intervention was initially successful in week 2, there was a decrease in indoor physical activity from week 2 to week 3. These data changes may be associated with intervention implementation difficulties teachers in the intervention group faced due to field trips (week 2), and teacher absences due to the flu (week 3). Although teachers seem to have the ability to plan and implement indoor physical activity opportunities within the preschool setting, as well as identify an ease when planned and beneficial outcomes in children's behavior, teachers perceived implementation difficulties may take precedence over application, as there was a decrease seen in indoor physical activity only during the weeks that teachers identified barriers to incorporating these physical activities.</p> <p>While MVPA during outdoor time decreased for both groups, there was less of a decline seen in week 3 for the intervention group. Moreover, although there was a continual decrease in children's MVPA levels during outdoor time seen in both groups at week 1 and week 2, it was significantly larger at week 3 for the control group. While the intervention's goal was to increase preschoolers MVPA levels during indoor time, this change had an effect on reducing the declines seen during outdoor MVPA.</p> <p>Our feasibility study found that teacher-guided and -led intervention acutely changed physical activity in the first two weeks, but not long-term which aligns with the findings of Gordon et al. ([<reflink idref="bib18" id="ref61">18</reflink>]) as well as Metcalf et al. ([<reflink idref="bib28" id="ref62">28</reflink>]) which suggest that preschool physical activity interventions see the greatest effects early on in the intervention, have small-moderate increases in children's physical activity, and lack longitudinal success. Clearly further research is necessary on how to provide sustainable physical activity interventions for this population. However, our findings can directly benefit early childhood educators as well as researchers implementing preschool physical activity interventions as they found that teacher strategies that involve minimal changes (i.e., teachers planning to implement physical activities into their indoor preschool time) can have an effect on increasing preschoolers MVPA levels.</p> <hd id="AN0159972220-13">Conclusions</hd> <p>In conclusion, a teacher-guided and -led preschool physical activity intervention is a feasible approach to acutely benefit children's MVPA during indoor time, however, future research needs to be done in order to determine how to make this type of intervention effective long-term. Although teachers identified that physical activity is easy to incorporate during indoor time at school when planned, changes in weekly routine continue to be a barrier that hinders their intended implementation. Therefore, there is a need for future research to explore ways that will assist preschool teachers in overcoming perceived physical activity implementation barriers when changes in their weekly routines occur. In the current study, children in the intervention group showed less of a decline in MVPA during outdoor time compared to children in the control group. These findings indicate that structured physical activity provides additional opportunities to be physically active during the school day that can compensate for various obstacles that may reduce or impact unstructured play time. There are several aims which should be considered for future research direction. Firstly, future research should aim to gain more insight on how indoor physical activity participation effects outdoor physical activity participation at the preschool setting. This study demonstrates how simple changes in preschool teachers' indoor instructional practices can immediately benefit children's MVPA levels; however, it would be beneficial to include a measurement of teacher physical activity in future studies. Additionally, in order to identify which strategies elicit higher levels of physical activity during indoor time, future research could benefit from examining individual measures of teacher implementation strategies that influence children's physical activity levels during indoor time (i.e., modeling verses verbal prompting). Direct observation strategies could be helpful for related future studies to determine whether physical activity opportunities were being implemented during indoor time as opposed to relying on teacher's self-report.</p> <p>While our feasibility study adds to the body of literature, it is not without limitations. The intervention was implemented at one Head Start center where the population was primarily low-income African American children, which limits the results of this study for other geographic regions and races. In addition, our study relied on teacher self-report to determine whether the intervention was being implemented during indoor time, this is a limitation due to reliability and validity issues are often associated with self-report. Furthermore, our study did not include a baseline measure for either group in order to determine physical activity levels prior to the intervention implementation. Finally, while the literature suggests that preschool physical activity interventions lasting less than four weeks tend to have the greatest impact on children's physical activity levels (Gordon et al., [<reflink idref="bib18" id="ref63">18</reflink>]), a longer duration to assess sustainability is necessary.</p> <hd id="AN0159972220-14">Acknowledgements</hd> <p>The authors would like to acknowledge the teachers, participants, and parents for their contribution and their time devoted to the study. This study was developed without external funding support. All contributing authors declare no conflicts of interest.</p> <hd id="AN0159972220-15">Funding</hd> <p>No funding was received for conducting this study.</p> <hd id="AN0159972220-16">Data Availability</hd> <p>The datasets and coding generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.</p> <hd id="AN0159972220-17">Declarations</hd> <p></p> <hd id="AN0159972220-18">Conflict of interest</hd> <p>My coauthors and I declare that we do not have any conflicts of interest/competing interests to disclose.</p> <hd id="AN0159972220-19">Ethical Approval</hd> <p>American Psychological Associations ethical principles were followed in the conduct of the study, and we received approval from the University's institutional review board.</p> <hd id="AN0159972220-20">Informed Consent</hd> <p>Informed consent was obtained from all individual participants included in the study. Legal guardians and participants signed informed consent regarding publishing their data.</p> <hd id="AN0159972220-21">Consent for Publication</hd> <p>All authors have been personally and actively involved in the preparation of this research for publication. All authors read and approved the final manuscript.</p> <hd id="AN0159972220-22">Publisher's Note</hd> <p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p> <ref id="AN0159972220-23"> <title> References </title> <blist> <bibl id="bib1" idref="ref37" type="bt">1</bibl> <bibtext> Alabama Department of Public Health. (2014). Building a healthy start module 2: Promoting physical activity for infants and toddlers in early childhood settings. 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  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Preschool+Teachers%22">Preschool Teachers</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Activities%22">Physical Activities</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Feasibility+Studies%22">Feasibility Studies</searchLink><br /><searchLink fieldCode="DE" term="%22Low+Income+Students%22">Low Income Students</searchLink><br /><searchLink fieldCode="DE" term="%22Preschool+Children%22">Preschool Children</searchLink><br /><searchLink fieldCode="DE" term="%22Planning%22">Planning</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1007/s10643-021-01274-2
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1082-3301<br />1573-1707
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Preschoolers are not meeting physical activity recommendations and are spending an extensive amount of their day sedentary. Interventions targeting teacher-led strategies can benefit children's physical activity levels the most. The purpose of this feasibility study was to examine the effects of an indoor teacher-guided and -led preschool physical activity intervention in low-income schools. Sixty-six preschoolers and twelve preschool teachers participated in this study. Intact classrooms were randomly assigned to either an intervention or control group. A 2 x 3 mixed ANOVA was used to test changes by group and time. Follow-up measurements included Post-hoc analysis. There was a significant group by time interaction in children's moderate-to-vigorous physical activity (MVPA) levels during indoor time (p = 0.036) and a significant effect on time in children's MVPA levels during outdoor time (p = 0.002). Teacher's identified that when planned, physical activity opportunities are easy to implement during indoor time. Moreover, teachers indicated that they enjoyed providing physical activity opportunities into the classroom setting and the children enjoyed participating in the activities implemented. Teachers identified implementation barriers could be correlated with decreased levels of children's physical activity. Our findings show that a teacher-guided and -led indoor preschool physical activity intervention is a feasible approach that can acutely increase children's MVPA levels.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2022
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1353737
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1353737
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1007/s10643-021-01274-2
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 9
        StartPage: 1475
    Subjects:
      – SubjectFull: Preschool Teachers
        Type: general
      – SubjectFull: Physical Activities
        Type: general
      – SubjectFull: Intervention
        Type: general
      – SubjectFull: Feasibility Studies
        Type: general
      – SubjectFull: Low Income Students
        Type: general
      – SubjectFull: Preschool Children
        Type: general
      – SubjectFull: Planning
        Type: general
    Titles:
      – TitleFull: The Effect of a Teacher-Guided and -Led Indoor Preschool Physical Activity Intervention: A Feasibility Study
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Carroll, Alexandra V.
      – PersonEntity:
          Name:
            NameFull: Spring, Katherine E.
      – PersonEntity:
          Name:
            NameFull: Wadsworth, Danielle D.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 12
              Type: published
              Y: 2022
          Identifiers:
            – Type: issn-print
              Value: 1082-3301
            – Type: issn-electronic
              Value: 1573-1707
          Numbering:
            – Type: volume
              Value: 50
            – Type: issue
              Value: 8
          Titles:
            – TitleFull: Early Childhood Education Journal
              Type: main
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