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Effectiveness of early care and education center-based interventions for improving cardiovascular fitness in early childhood: A systematic review and meta-analysis.

ABSTRACT: This systematic review and meta-analysis examined the literature on early care and education center (ECEC)-based physical activity interventions to identify ecologic environmental factors that improve cardiovascular fitness (CVF) in preschool-aged children. Data sources included PubMed, Web of Science, Cochrane Library Trials, CINHAL, Science Direct, PsychINFO and SPORTDiscus. Peer-reviewed publications of studies that met the following criteria were eligible for inclusion: (1) mean age of participants between two and a half and five and a half years old enrolled in a pre-primary school; (2) randomized controlled trials or quasi-experimental interventions with a control group; (3) interventions occurring before, during, or immediately after school; (4) use of an objective measure or field-based estimate of CVF; (5) enrolled apparently healthy children. In June of 2018, titles (n?=?1197) were reviewed for inclusion into the study and 74 abstracts/full texts were assessed for eligibility. Ten articles met all eligibility criteria and were included in the final review. A random effects meta-analysis suggested a moderate-to-large effect size for ECEC-based interventions to increase CVF (g?=?0.75; 95%CI [0.40-1.11]). Interventions that included three or more ecologic environments (g?=?0.79 [0.34-1.25]) were more effective than interventions occurring at the individual level (g?=?0.67 [0.12-1.22]). Study quality was moderate, and (mean?±?SD) 17.9?±?4.3 (63.9%) of 28 checklist items were reported. Preliminary evidence suggests that ECEC-based interventions to increase CVF are highly effective at improving preschool children's exercise test scores. Although ECEC-based interventions show promise, the small number of studies included in this review limits confidence in these findings. Review registered at PROSPERO CRD42018099115.

SUBMITTER: Szeszulski J

PROVIDER: S-EPMC6598036 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Effectiveness of early care and education center-based interventions for improving cardiovascular fitness in early childhood: A systematic review and meta-analysis.

Szeszulski Jacob J Lorenzo Elizabeth E Shaibi Gabriel Q GQ Buman Matthew P MP Vega-López Sonia S Hooker Steven P SP Lee Rebecca E RE

Preventive medicine reports 20190608

This systematic review and meta-analysis examined the literature on early care and education center (ECEC)-based physical activity interventions to identify ecologic environmental factors that improve cardiovascular fitness (CVF) in preschool-aged children. Data sources included PubMed, Web of Science, Cochrane Library Trials, CINHAL, Science Direct, PsychINFO and SPORTDiscus. Peer-reviewed publications of studies that met the following criteria were eligible for inclusion: (1) mean age of parti ...[more]

PMID: 31297309

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Project description:INTRODUCTION:Diet during infancy and early childhood can have implications on child growth, health, and developmental trajectories. Yet, poor dietary habits are common in young children, who often consume diets that are not aligned with dietary recommendations. Early childhood education and care (ECEC) is a recommended setting to deliver healthy eating interventions as they offer existing infrastructure and access to a large number of children. This protocol aims to describe the methods of a systematic review to assess the effectiveness of healthy eating interventions conducted within the ECEC setting to improve child diet. METHODS AND ANALYSIS:Eight electronic databases including Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, EMBASE, CINAHL Complete, PsycINFO, ERIC, SCOPUS, and SPORTDiscus will be searched from conception to March 2020. Randomised controlled trials (RCT) of dietary interventions targeting children aged up to 6?years conducted within the ECEC setting (including pre-schools, kindergartens, long day care, and family day care) will be included in the review. The primary review outcome is any measure of child dietary intake. Secondary outcomes include (i) child anthropometrics, (ii) child cognition, (iii) child mental health, (iv) child quality of life, (v) the absolute cost or cost-effectiveness of included interventions, and (vi) any reported adverse effects. Study inclusion, data extraction, and risk of bias assessments will be performed independently by two reviewers. Meta-analyses will be performed if adequate data is available, else review findings will be described narratively. DISCUSSION:This systematic review seeks to synthesise the effectiveness of healthy eating interventions conducted within the ECEC setting for improving child diet. This review will also seek to describe the effect of ECEC-based healthy eating interventions on a variety of important secondary outcomes (adverse events and cost-effectiveness) that will enhance the public health policy and practice relevance of review findings. SYSTEMATIC REVIEW REGISTRATION:PROSPERO [ID CRD42020153188 ].

Project description:BACKGROUND:The United Nation's Sustainable Development Goals encompass lifelong learning from birth to youth to adulthood (Goal 4) and economic opportunities for young people (Goal 8). The targets include improving access to quality early childhood care and education (ECCE) as well as learning and training opportunities for adolescents and youth. Cross-generational models for young children and youth may offer opportunities to address the interconnections between goals and targets for the next generation. We investigated whether an ECCE programme for young children (3.5-6.5 years) delivered by female youth (18-24 years) in rural Pakistan would be effective on children's school readiness. METHODS:In partnership with the National Commission for Human Development in Pakistan, we implemented the 'Youth Leaders for Early Childhood Assuring Children are Prepared for School' (LEAPS) programme to train female youth to deliver ECCE. The effectiveness of the LEAPS programme on children's school readiness was evaluated in a cluster-randomised controlled trial. We randomly allocated five clusters (villages) to receive the intervention (n = 170 children) and five clusters to control (n = 170 children). Children's school readiness was assessed after nine months of intervention exposure using the International Development and Early Learning Assessment tool. Analyses was by intention-to-treat. The trial is registered with ClinicalTrials.gov, number NCT02645162. FINDINGS:At endline, the intervention group had significantly higher school readiness scores (n = 166, mean percentage score 59.4, 95% CI 52.7 to 66.2) compared with the control group (n = 168, mean percentage score 45.5, 95% CI 38.8 to 52.3). The effect size (Cohen's d) was 0.3. CONCLUSION:Trained female youth delivered an ECCE programme that was effective in benefitting young children's school readiness. The cross-generational model is a promising approach to support early child development; however, further evaluation of the model is needed to assess the specific benefits to youth including their skills and economic development.

Project description:ImportanceEducational attainment is an underrecognized factor associated with racial disparities in cardiovascular disease (CVD) risk. Early childhood programs providing comprehensive family services can promote educational and socioeconomic success, but few, if any, studies of large-scale programs have assessed their associations with midlife CVD risk and mediating factors.ObjectiveTo examine the association between an early childhood program providing multisystemic services from ages 3 to 9 years with midlife CVD risk and whether years of education mediate these associations.Design, setting, and participantsUsing a matched-group, quasi-experimental design, a cohort of Black and Hispanic children in the Chicago Longitudinal Study enrolled in an established early childhood program from 1983 to 1989 or the usual services were followed up for 30 years after the end of the intervention. A midlife survey on well-being was administered when the participants were aged 37 years. Analyses were conducted from September 1, 2020, to October 15, 2020.InterventionThe Child-Parent Center (CPC) Education Program provides school-based educational enrichment and comprehensive family services for 6 years, from ages 3 to 9 years (preschool to third grade [P-3]).Main outcomes and measuresGeneral and hard Framingham Risk Scores (FRSs) were calculated from self-reported physical health and behavior profiles in the midlife Chicago Longitudinal Study survey. Years of education completed at age 34 years were measured primarily from administrative records.ResultsThere were 1539 participants in the original sample (1430 Black participants [92.9%]; 108 Hispanic participants [7.0%]; 1 White participant [0.1%]); 1104 of 1401 participants (78.8%) in the tracked sample completed a midlife survey on well-being by age 37 years, and 1060 participants had data available for analysis (mean [SD] age, 34.9 [1.4] years; 565 women [53.3%]), including 523 participants who grew up in high-poverty contexts. After adjusting for 17 baseline attributes and differential attrition via propensity score weighting, CPC preschool was associated with significantly lower general FRS (marginal coefficient, -2.2 percentage points [% hereafter]; 95% CI -0.7% to -3.6%; P = .004) and hard FRS (marginal coefficient, -1.6%; 95% CI -0.5% to -2.6%; P = .004), for a 20% reduction in cardiovascular disease risk. The program group was also less likely to have high-risk FRS status, including being in the top quartile of hard FRS (marginal coefficient, -7.2%; 95% CI, -0.3% to -11.6%; P = .02). Those who participated for 4 to 6 years (CPC P-3) had lower general FRS than those who participated for fewer years, but the difference was not significant (marginal coefficient, -1.2%; 95% CI, -2.5% to 0.2%; P = .09); longer participation was associated with placement in the median or higher risk category for general FRS (marginal coefficient, -7.9%; 95% CI -0.7% to -12.4%; P = .007) and hard FRS (marginal coefficient, -9.0%; 95% CI -0.6% to -11.4%; P = .02). Years of education completed by age 34 years accounted for up to 23% of the observed group differences for FRSs, including CPC preschool (general FRS, from -2.16% to -1.66%; difference = -0.5%) and P-3 (general FRS, from -1.16% to -0.71%; difference = -0.45%).Conclusions and relevanceIn this quasi-experimental design study, a comprehensive early childhood program for a community cohort at high risk of disparities was associated with lower CVD risk later in life. Corroborating previous research, years of education through college matriculation accounted for a sizable percentage of this association. Early childhood enrichment may contribute to CVD prevention.

Project description:ImportanceSocial-emotional competence in early childhood influences long-term mental health and well-being. Interest in the potential to improve child health and educational outcomes through social and emotional learning (SEL) programs in early childhood education and care (ECEC) settings is increasing.ObjectiveTo conduct a systematic review and meta-analysis of studies examining the social, emotional, and early learning outcomes associated with universal curriculum-based SEL programs delivered to children aged 2 to 6 years in center-based ECEC settings.Data sourcesKeyword searches of Education Resources Information Center (ERIC), MEDLINE Complete, PsycINFO, and Proquest Dissertations and Theses Global databases were conducted to identify all relevant studies published from January 1, 1995, through December 31, 2017.Study selectionStudies included in this review examined universal curriculum-based SEL intervention delivered to children aged 2 to 6 years in a center-based ECEC setting. All assessed individual-level social and/or emotional skill after the SEL intervention and used an experimental or quasi-experimental design (ie, studies that did not or were not able to randomly allocate participants to intervention and control groups) with a control group.Data extraction and synthesisA total of 13 035 records were screened, of which 362 were identified for full-text review. A systematic literature review was conducted on 79 studies. Multilevel random-effects meta-analyses were conducted on 63 eligible studies from October 2 through 18, 2018.Main outcomes and measuresSocial competence, emotional competence, behavioral self-regulation, behavior and emotional challenges, and early learning outcomes.ResultsThis review identified 79 unique experimental or quasi-experimental studies evaluating the effect of SEL interventions on preschooler outcomes, including a total of 18 292 unique participants. Sixty-three studies were included in this meta-analysis. Compared with control participants, children in intervention conditions showed significant improvement in social competence (Cohen d [SE], 0.30; [0.06]; 95% CI, 0.18-0.42; P < .001), emotional competence (Cohen d [SE], 0.54 [0.16]; 95% CI, 0.22-0.86; P < .001), behavioral self-regulation (Cohen d [SE], 0.28 [0.09]; 95% CI, 0.11-0.46; P < .001), and early learning skills (Cohen d [SE], 0.18 [0.08]; 95% CI, 0.02-0.33; P = .03) and reduced behavioral and emotional challenges (Cohen d [SE], 0.19 [0.04]; 95% CI, 0.11-0.28; P < .001). Several variables appeared to moderate program outcomes, including intervention leader, type of assessment, informant, child age, and study quality.Conclusions and relevanceAccording to results of this study, social and emotional learning programs appeared to deliver at a relatively low intensity may be an effective way to increase social competence, emotional competence, behavioral self-regulation, and early learning outcomes and reduce behavioral and emotional difficulties in children aged 2 to 6 years. Social and emotional learning programs appear to be particularly successful at increasing emotional knowledge, understanding, and regulation.

Project description:Early motor skills underpin the more complex and specialized movements required for physical activity. Therefore, the design of interventions that enhance higher levels of early motor skills may encourage subsequent participation in physical activity. To do so, it is necessary to determine the influence of certain factors (some of which appear very early) on early motor skills. The objective of this study was to examine the influence of some very early environmental variables (delivery mode, feeding type during the first 4 months of life) and some biological variables (sex and age in months) on preschool motor skills, considered both globally and specifically. The sample was composed by 43 preschool students aged 5-6 years. The participant's parents completed an ad hoc questionnaire, reporting on delivery mode, feeding type, sex, and age in months. The children's motor skills were assessed using observational methodology in the school setting, while the children participated in their regular motor skills sessions. A Nomothetic/Punctual/Multidimensional observational design was used. Results revealed that certain preschool motor skills were specifically influenced by delivery mode, feeding type, sex, and age. Children born by vaginal delivery showed higher scores than children born via C-section in throwing (p = 0.000; d = 0.63); total control of objects (p = 0.004; d = 0.97); total gross motor skills (p = 0.005; d = 0.95); and total motor skills (p = 0.002; d = 1.04). Children who were exclusively breastfed outperformed those who were formula-fed in throwing (p = 0.016; d = 0.75); visual-motor integration (p = 0.005; d = 0.94); total control of objects (p = 0.002; d = 1.02); total gross motor skills (p = 0.023; d = 0.82); and total motor skills (p = 0.042; d = 0.74). Boys outperformed girls in throwing (p = 0.041; d = 0.74) and total control of objects (p = 0.024; d = 0.63); while the opposite occurred in static balance (p = 0.000; d = 1.2); visual-motor coordination (p = 0.020; d = 0.79); and total fine motor skills (p = 0.032; d = 0.72). Older children (aged 69-74 months) obtained higher scores than younger ones (aged 63-68 months) in dynamic balance (p = 0.030; d = 0.66); visual-motor integration (p = 0.034; d = 0.63); and total balance (p = 0.013; d = 0.75). Implications for early childhood care and education are discussed since this is a critical period for motor skill development and learning.

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Effectiveness of early care and education center-based interventions for improving cardiovascular fitness in early childhood: A systematic review and meta-analysis.

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Effectiveness of early care and education center-based interventions for improving cardiovascular fitness in early childhood: A systematic review and meta-analysis.

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