Increasing physical activity in pre-school aged children: systematic review, individual participant meta-analysis and intervention pilot

The project will use epidemiology, systematic review and qualitative methods to explore the associations between physical activity and pre-school environments to design an intervention to increase physical activity. This project will be unique in using the special resource of the MRC Epidemiology Unit's International Children's Accelerometry Database (ICAD) to investigate physical activity of pre-school children in 5 countries. I will collaborate with the Universities of Loughborough, Cambridge and those providing ICAD data. Further, I will use observation of the environment and practices of staff in 12 nurseries and accelerometer data for 116 children aged 2-4 from the NAP SACC UK RCT. The research questions and methods will be: 1. How does the time spent in sedentary, light and moderate vigorous physical activity (MVPA) differ by country, SES, gender, age, setting and time of day in pre-school children? Method: individual- participant meta-analysis of accelerometer data of ~900 children aged 2-4-year-old children in ICAD and the NAP SACC UK trial. 2. What factors are associated with the time spent in sedentary, light and MVPA among pre-school children in pre-school settings and at home? Method: systematic review and meta-analysis of observational studies on the predictors of physical activity in 2-4-year-olds. 3. What are the barriers and facilitators of changing factors associated with sedentary time and physical activity? How can these be facilitated or overcome? Methods: In-depth interviews with staff in 20 pre-school settings (parents, day nurseries, school nurseries, pre-schools and child minders). In-depth interviews with staff in 10 Local Authorities responsible for promoting physical activity. 4. What intervention design has the support of pre-school professionals and physical activity professionals for physical activity in pre-school settings? Method: Delphi development of intervention design.