BackgroundChild care centers influence physical activity levels among children, yet little is known about the specific aspects of the environment that support generous amounts of activity. The purpose of this study was to examine the practices, and environmental aspects of the child care center that are associated with children’s moderate and vigorous physical activity.MethodsThirty-five child care centers serving 389 3 to 5 year old children were assessed for: 1) environmental characteristics of the center; and 2) staff practices related to child physical activity. Children’s physical activity was measured using accelerometers over a single day in child care.ResultsFourteen percent (an average of 9 minutes per waking hour) were spent in moderate to vigorous physical activity (MVPA). The strongest environmental predictors of MVPA were: time spent in outdoor play, suitability of indoor play space, and teacher encouragement of (but not participation in) indoor play.ConclusionsIn order to reach the U.S. recommended 120 minutes of physical activity per day, significant changes will need to occur in the child care setting, including increased time outdoors and more opportunities for indoor physical activity.

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Child care centers generally comply with current CACFP regulations, but do not provide lunches consistent with the 2011 IOM recommendations for saturated fat, protein, fiber, and sodium. Decreased use of beef and cheese and increased provision of whole grains, fruits, and vegetables are recommended.

Background Licensed childcare centers, represent an opportunity to positively influence children's health behaviors. Valid and easy-to-use measures of the childcare environment are needed to assess the impact of environmental change on health. Objective To develop and validate a self-administered survey to assess the nutrition and physical activity environment of child care centers, and to identify domains which may be evaluated adequately through self-report. Design A survey was developed to assess four areas related to nutrition and physical activity: center policies, practices related to the social environment, physical environment, and nutrition quality. Development involved review of literature, existing measures, and regulations/standards; and collaboration with a working group. The survey was piloted and feedback sought from expert consultants. It was administered statewide and validated against a menu rating tool, a center director interview, and a direct observation tool developed for this study. Participants/Setting Participating sites were drawn from CACFP-participating licensed Connecting childcare centers serving 13 or greater 3 to 5 year olds. Survey responses from 146 center directors were included, as were 62 center menus, and director interviews and observational data from 33 sites. Primary Outcomes/Statistical Analyses Criterion validity of the survey was assessed through percent agreement with mirroring items in the additional measures. Healthy and unhealthy food scores were calculated for menu and survey tools, and Pearson correlations computed. Results Percent agreement with criterion outcomes ranged from 39 to 97%, with 61% of items achieving agreement at or above 80%. Agreement was highest for nutrition and policy domains, and lowest for physical activity and barriers to promoting health. Correlations between food scores across measures were moderate. Conclusions The self-report survey demonstrated adequate criterion validity; recommendations are made for improving validity of low-agreement items and for the use of more labor-intensive evaluation procedures for domains not adequately assessed through self-report.

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