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Understanding physical activity and sedentary behaviour among preschool-aged children in Singapore: a mixed-methods
Bozhi Chen1, Clarice N Waters2, Thomas Compier3
1Saw Swee Hock School of Public Health, National University Singapore, Singapore.
Insights
Preschoolers in Singapore have low moderate-to-vigorous physical activity (MVPA) and high sedentary behaviour (SB). Health promotion strategies must address in-school and out-of-school factors influencing children's activity levels.
Area of Science:
- Pediatrics
- Public Health
- Behavioral Science
Background:
- Sedentary behaviour (SB) and physical activity (PA) patterns established in early childhood significantly impact long-term health.
- Understanding the socioecological correlates of PA and SB in preschool-aged children is crucial for developing effective interventions.
- Preschool-aged children in urban Asian settings may face unique environmental and societal influences on their activity levels.
Purpose of the Study:
- To investigate physical activity (PA) and sedentary behaviour (SB) in Singaporean preschool-aged children.
- To identify potential correlates of PA and SB across multiple socioecological levels, encompassing both in-school and out-of-school settings.
Main Methods:
- A mixed-methods approach combining accelerometry, focus group discussions (FGDs) with teachers, and parent questionnaires.
- Objective measurement of children's PA and SB using wrist-worn accelerometers for seven days.
- Qualitative exploration of environmental and psychosocial factors influencing activity through teacher FGDs and parent surveys.
Main Results:
- Children (4.4±1.1 years) exhibited low moderate-to-vigorous physical activity (MVPA) (0.5 hours/day) and high SB (7.8 hours/day), with higher SB on non-school days.
- Preschool environments showed more MVPA outdoors (34.0%) than indoors (7.7%), with a lack of active play equipment and curriculum constraints impacting activity.
- Out-of-school factors included limited use of outdoor facilities, minimal active travel, low sports participation (23.5%), and high screen time (94.5% watched screens for 1.5 hours/day).
Conclusions:
- Preschool-aged children in this urban Asian setting demonstrate insufficient MVPA and excessive SB.
- Diverse in-school (e.g., curriculum demands, indoor/outdoor activity balance) and out-of-school (e.g., screen time, facility access) factors are associated with children's PA and SB.
- Targeted health promotion strategies are needed to address these multi-level correlates and improve children's activity patterns.
Objectives:
This study investigated physical activity (PA) and sedentary behaviour (SB) among preschool-aged children in Singapore and potential correlates at multiple levels of the socioecological model from in-school and out-of-school settings.
Design:
A cross-sectional study using a mixed-methods approach.
Participants:
Parent-child dyads from six preschools in Singapore.
Methods:
PA and SB of children (n=72) were quantified using wrist-worn accelerometers for seven consecutive days. Three focus group discussions (FGDs) among 12 teachers explored diverse influences on children's activities, and System for Observing Play and Leisure Activity in Youth (SOPLAY) assessed PA environment and children's activity levels at preschools. Seventy-three parents completed questionnaires on home and neighbourhood factors influencing children's PA and SB. Descriptive analyses of quantitative data and thematic analysis of FGDs were performed.
Results:
Based on accelerometry, children (4.4±1.1 years) spent a median of 7.8 (IQR 6.4-9.0) hours/day in SB, and 0.5 (0.3-0.8) hours/day in moderate-to-vigorous physical activity (MVPA). MVPA was similar throughout the week, and SB was slightly higher on non-school days. In preschools, SOPLAY showed more children engaging in MVPA outdoors (34.0%) than indoors (7.7%), and absence of portable active play equipment. FGDs revealed issues that could restrict active time at preschool, including academic requirements of the central curriculum and its local implementation. The teachers had varying knowledge about PA guidelines and perceived that the children were sufficiently active. In out-of-school settings, parents reported that their children rarely used outdoor facilities for active play and spent little time in active travel. Few children (23.5%) participated in extracurricular sports, but most (94.5%) reported watching screens for 1.5 (0.5-3.0) hours/day.
Conclusion:
MVPA was low and SB was high in preschool-aged children in an urban Asian setting. We identified diverse in-school and out-of-school correlates of PA and SB that should be taken into account in health promotion strategies.
