Barriers to and Facilitators of the Implementation of Environmental Recommendations to Encourage Physical Activity in Center-Based Childcare Services: A Systematic Review

Abstract

Background: Identifying factors influencing the implementation of evidence-based environmental recommendations to promote physical activity in childcare services is required to develop effective implementation strategies. This systematic review aimed to: (1) identify barriers and facilitators reported by center-based childcare services impacting the implementation of environmental recommendations to increase physical activity among children, (2) synthesize these factors according to the 14 domains of the “Theoretical Domains Framework,” and (3) report any associations between service or provider characteristics and the reported implementation of such recommendations. Methods: Electronic searches were conducted in 6 scientific databases (eg, MEDLINE) and Google Scholar to identify studies reporting data from childcare staff or other stakeholders responsible for childcare operations. Included studies were based on childcare settings and published in English. From 2164 identified citations, 19 articles met the inclusion criteria (11 qualitative, 4 quantitative, and 4 mixed methods). Results: Across all articles, the majority of factors impacting implementation fell into the “environmental context and resources” domain (eg, time, equipment, and space; n = 19) and the “social influences” domain (eg, support from parents, colleagues, supervisors; n = 11). Conclusion: The current review provides guidance to improve the implementation of environmental recommendations in childcare services by addressing environmental, resource, and social barriers.

Cooperative planning in childcare centers to improve physical activity: a qualitative investigation of directors’ perspectives

“…time) or social influences (e.g. support from parents) ( Razak et al , 2019 ). The authors used the theoretical domains framework, which focuses on behavior change, to categorize the barriers and facilitators ( Cane et al , 2012 ).…”

“…Different strategies and interventions for PA promotion have been developed and tested in this setting, and a growing number of best practice guidelines and PA recommendations exist for childcare centers ( Finch et al , 2016 ; Wolfenden et al , 2020 ; Jackson et al , 2021 ). However, there is a lack of evidence to inform the successful implementation of evidence-based policies, practices and programs in childcare centers ( Larson et al , 2011 ; Finch et al , 2016 ; Jones et al , 2017 ; Razak et al , 2019 ; Wolfenden et al , 2020 ). Implementation can be defined as ‘a process whereby specific strategies are used to facilitate the adoption of evidence-based interventions and change practice patterns within a specific setting’ ( Wolfenden et al , 2016 ).…”

A randomised controlled trial of an implementation strategy delivered at scale to increase outdoor free play opportunities in early childhood education and care (ECEC) services: a study protocol for the get outside get active (GOGA) trial

“…This framework was used to enable comprehensive barriers assessment to inform intervention development [ 38 ]. Barriers to service provision of outdoor free play opportunities were first identified via: i) a systematic review of barriers and facilitators to the implementation of physical activity policies in ECEC [ 39 ]; b) quantitative survey with ECEC services to assess key barriers and enablers to providing more outdoor free play opportunities [ 20 ]; and c) consultation with Service Managers and Educators from five ECEC services about the key barriers to implementation. The barriers identified from this process are described in Table 1 .…”

The impact of an e-newsletter or animated video to disseminate outdoor free-play information in relation to COVID-19 Guidelines in New South Wales Early Childhood Education and Care services: a randomised controlled trial

“…the modality in which the message is communicated; e.g. e-newsletter or animated video) (29). Additionally, the 'Interactive System Framework' recommends the use of two components as part of a dissemination strategy, including; i) developing messages and materials customised to the target audience; and ii) distribution of messages and materials through channels of optimum reach (18).…”