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Effects of a cognitive-behaviorally based physical activity treatment for 4- and 5-year-old children attending US

James J Annesi¹, Alice E Smith, Gisèle A Tennant

¹YMCA of Metropolitan Atlanta, 100 Edgewood Avenue, NE, Suite 1100, Atlanta, GA, 30303, USA, jamesa@ymcaatlanta.org.

International Journal of Behavioral Medicine

|October 12, 2013

Insights

The Start For Life program increased physical activity and reduced body mass index (BMI) in preschoolers. This intervention shows promise for combating childhood obesity in early education settings.

Area of Science:

Pediatric obesity prevention
Early childhood education and physical activity
Behavioral interventions in preschools

Background:

Inadequate physical activity in young children is linked to excessive weight gain.
Preschools often have insufficient daily physical activity time for children.
Childhood obesity is a growing public health concern requiring effective interventions.

Purpose of the Study:

To evaluate the "Start For Life" program's effectiveness in increasing physical activity.
To determine if the "Start For Life" program reduces body mass index (BMI) in preschoolers.
To test a preschool-administered intervention based on social cognitive and self-efficacy theory.

Main Methods:

A 9-month randomized controlled trial comparing "Start For Life" (30 min/day) to usual care in preschools.
Accelerometer and BMI data collected from 17-20 children per class (mean age 4.4 years).
Intervention delivered by preschool teachers to primarily African-American children.

Main Results:

"Start For Life" significantly increased moderate-to-vigorous and vigorous physical activity (approx. 30 min/week more).
Sedentary time remained unaffected by the intervention.
A significant reduction in BMI was observed, particularly in overweight and obese children.

Conclusions:

The "Start For Life" intervention shows positive results compared to usual care for increasing physical activity and reducing BMI.
Further replication is needed to confirm generalizability, especially given the specific sample.
The program's practical application suggests potential for addressing preschooler overweight by boosting physical activity.

Read full analysis

Abstract

Background:

Inadequate volumes of physical activity may be associated with the increases in inappropriately high weight in children of 5 years of age and younger. Preschools have typically lacked sufficient time in daily physical activity.

Purpose:

A preschool-administered physical activity treatment based on social cognitive and self-efficacy theory (Start For Life) was tested for its association with increased physical activity and reduced body mass index (BMI).

Methods:

Data from accelerometer and BMI assessments over a 9-month preschool year (18 treatment and 8 control classes of 17 to 20 children each; mean age = 4.4 years) were used to contrast the behaviorally based treatment of 30 min per day with a usual care condition of the same duration. The sample was primarily African-American. Preschool teachers administered all processes.

Results:

The Start For Life treatment was associated with a significantly greater percentage of the preschool day in moderate-to-vigorous and vigorous physical activity (approximately 30 min per week more), with sedentary time unaffected. The treatment was also associated with a significant reduction in BMI, with effect sizes greatest in overweight and obese children.

Conclusions:

Although results were positive in contrast to usual care and other related interventions, the specific sample requires that the Start For Life treatment undergo sufficient replication to increase confidence in generalizability of the findings to others. Although reduction in sedentary time may require a different strategy, the practical application of the present treatment suggests possibilities for addressing overweight through increasing moderate-to-vigorous physical activity in preschool settings.

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