- Title
- Improving the effectiveness and implementation of physical activity interventions delivered in childcare
- Creator
- Finch, Meghan
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2017
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background Aims and Methods: Internationally and in Australia low levels of physical activity are associated with the most prevalent causes of mortality and morbidity. Further, adequate physical activity in early childhood is associated with a number of health benefits. Despite this, many preschool age children are not meeting physical activity guidelines. Childcare services provide an opportune setting in which interventions to address inadequate physical activity levels among young children can be delivered. The population impact of childcare-based physical activity interventions is suggested to be a function of their effectiveness in increasing physical activity levels of children, and the number of childcare services that implement effective interventions (reach). To determine the extent to which population impact can be achieved, the first broad aim of the thesis is to: Identify effective interventions that can feasibly be delivered in the context and resources of routine childcare service delivery. This aim will be addressed through the conduct of three studies with the following aims: 1. To describe associations between childcare policies and practices and physical activity levels of children aged three to five attending childcare in an Australian context. ; 2. To systematcally review evidence regarding the impact of childcare based physical activity interventions overall, and according to intervention and trial design characteristics including trials of interventions that were conducted in pragmatic or non-pragmatic contexts. ; 3. To assess the effectiveness of a pragmatic staff delivered physical activity intervention delivered in childcare. In the context of limited or no knowledge regarding the effectiveness of interventions aiming to support routine implementation of evidence-based physical activity promoting policies and practices by childcare settings (reach), the second aim of the thesis was to: 4. Assess the effectiveness of a population-based intervention in increasing the implementation of physical activity promoting policies and practices by childcare. Results: In regard to the first aim, findings from the cross-sectional study assessing childcare physical activity practices and service environmental and organisational characteristics showed a number of significant associations between children’s activity and childcare policies and practices. The systematic review, found that childcare physical activity intervention effectiveness varied according to intervention and trial design characteristics and that there was evidence suggesting pragmatic trials may be ineffective. Further, in a pragmatic a cluster randomised controlled trial, the thesis found no improvement in child physical activity following receipt of a pragmatic staff delivered physical activity intervention. In regard to the second aim, the large quasi-experimental study conducted with 392 childcare services in New South Wales (NSW), Australia found significantly greater increases in the proportion of services implementing two of eight targeted physical activity practices relative to the comparison region. Specifically the services in the experimental group were more likely to implement a physical activity policy (including the policy referring to placing limits on small screen recreation) and have staff trained in physical activity. Conclusion: This thesis provides new evidence to inform the both the future effectiveness of pragmatic physical activity interventions delivered in childcare and the routine implementation of evidence- based physical activity promoting policies and practices. Firstly, the findings indicate that there is a need to address the limitations of pragmatic interventions aimed at increasing children’s physical activity in the childcare setting. Secondly, the findings suggest that additional evidence is required to improve the effectiveness of strategies aiming to improve implementation of evidence-based physical activity promoting policies and practices by childcare services.
- Subject
- childcare; activity; interventions; implementation; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1347456
- Identifier
- uon:30045
- Rights
- Copyright 2017 Meghan Finch
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 25 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 340 KB | Adobe Acrobat PDF | View Details Download |