Hands-on childcare garden intervention: A randomized controlled trial to assess effects on fruit and vegetable identification, liking, and consumption among children aged 3-5 years in North Carolina.

Gardening at childcare centers may have a potent influence on young children's learning about fruits and vegetables and their development of healthy dietary behaviors. This randomized controlled trial examined the effect of a garden intervention on fruit and vegetable (FV) identification, FV liking, and FV consumption among 3-5-year-old children enrolled in childcare centers in Wake County, North Carolina, USA. Eligible childcare centers (serving primarily low-income families) were randomly selected and then randomly assigned to one of three groups: (1) intervention; (2) waitlist-control that served as a control in year 1 and received the intervention in year 2; or (3) no-intervention control. From the 15 participating childcare centers, 285 children aged 3-5 years were consented by their parents or guardians to participate. The intervention comprised six standardized, raised, mulched garden beds, planted with warm-season annual vegetables and fruits, and perennial fruits. A Gardening Activity Guide describing 12 age-appropriate, sequential gardening activities was distributed for teachers to lead hands-on gardening activities during the growing season. Data were gathered between Spring 2018 and Fall 2019. FV identification and liking were measured using an age-appropriate tablet-enabled protocol. FV consumption was measured by weighing each child's fruit and vegetable snack tray before and after tasting sessions. Compared to children receiving no-intervention, children who received the garden intervention showed a greater increase in accurate identification of both fruits and vegetables as well as consumption of both fruit and vegetables during the tasting sessions. Consistent with prior research, the effects on fruit consumption were greater than on vegetable consumption. There was no significant effect of the garden intervention on children's FV liking. Garden interventions implemented early in life foster learning about FV and promote healthy eating. Early exposure to gardening may yield a return on investment throughout the lifecourse, impacting healthy diet and associated health outcomes, which are particularly important within disadvantaged communities where children's health is challenged by a host of risk factors. Clinical Trials Registration #NCT04864574 (clinicaltrials.gov).

Childcare outdoor renovation as a built environment health promotion strategy: evaluating the preventing obesity by design intervention.

PURPOSE: To evaluate the effectiveness of Preventing Obesity by Design (POD), a childcare center outdoor renovation intervention. DESIGN: Pre-post intervention evaluation. SETTING: North Carolina licensed childcare centers (N = 27). SUBJECTS: Preschool children. INTERVENTION: Outdoor renovation, teacher training. MEASURES: Behavior mapping, Preschool Outdoor Environment Measurement Scale (POEMS), center director interview. ANALYSIS: Descriptive statistics, ordinary least squares and logistic regressions calculated to assess levels of association between environmental change, children's physical activity (PA), social behaviors, and environmental quality. Qualitative interview data analyzed to help understand intervention impact. RESULTS: Behavior mapping showed that site layout attributes, such as the form (i.e., "single loop" and "double loop") of pathways (functioning as circulation routes and wheeled toy settings), are associated with higher levels of PA. Teacher interaction was associated with decreased children's PA. Absence of teacher or lack of child/child interaction was associated with increased PA. POEMS assessment of environmental quality was higher after renovation. POEMS domains (Physical Space and Teacher/Caregiver Roles) were positively associated with PA. After renovation, 68% of center directors reported positive changes in children's behavior and 40% mentioned edible plant installations as greatest success. CONCLUSION: Built environment renovation of childcare center outdoors, including looped pathways installation, coupled with teacher training, may support increased PA. Renovation, including food gardens, may be a key to success for preschool health promotion and support change in childcare policy.

Park-based physical activity among children and adolescents.

BACKGROUND: Availability of parks is associated with higher levels of physical activity among children and adolescents. Few studies examine actual park use and park-based physical activity in these populations. PURPOSE: This study examined associations among individual, park, and neighborhood environmental characteristics and children's and adolescent's park-based physical activity. METHODS: Data were collected in 2007 on 2712 children in 20 randomly selected parks in Durham NC. The System for Observing Play and Recreation in Communities (SOPARC) provided measures of physical activity. Hierarchic regression analysis assessed associations among individual, park, and neighborhood environmental characteristics and children's park-based physical activity. Data were analyzed in 2010. RESULTS: Of the 2712 children observed, 34.2% and 13.2% were engaged in walking or vigorous physical activity. Environmental features of parks were associated with activity levels whereas neighborhood characteristics were not. Physical activity was negatively associated with gender (girls) (p=0.003); presence of a parent (p<0.0001); presence of nonparental adult (p=0.006); and an interaction involving the 0-5 years age group and style of play (p=0.017). Higher level of physical activity was associated with presence of other active children (p<0.0001); courts (e.g., basketball); and an interaction between number of recreation facilities and formal activities (p=0.004). CONCLUSIONS: These social factors and design features should be considered in order to stimulate higher levels of park-based physical activity among children and adolescents.

Behavior mapping: a method for linking preschool physical activity and outdoor design.

UNLABELLED: The preschool that children attend has been shown to be a significant but variable predictor of physical activity of 3- to 5-yr-olds, whereas the time outdoors has been found to be a strong correlate of physical activity. Researchers speculate that variations in preschool physical activity may be attributed to variations in preschool policies and practices, including the form and content of outdoor physical environments. However, assessment methods linking them to physical activity are limited. Improved understanding of links between environment and activity could be used to influence childcare policy, which is highly regulated, usually at state level, to create outdoor environments more conducive to children's informal play and physical activity. The purpose of this article was to introduce behavior mapping as a direct observation method on the basis of the theories of behavior setting and affordance and to demonstrate its sensitivity to gathering physical activity and associated environmental data at a sufficiently detailed level to affect built environment design policy. METHODS: Behavior mapping data, including outdoor environmental characteristics and children's physical activity levels, were obtained in two preschool centers at the Research Triangle region, NC. RESULTS: Physical activity levels at the two centers varied across different types of behavior settings, including pathways, play structures, and open areas. The same type of setting with different attributes, such as circular versus straight pathways, and open areas with different ground surfaces, such as asphalt, compacted soil, woodchips, and sand, attracted different levels of physical activity. CONCLUSIONS: Behavior mapping provides a promising method for objectively measuring relationships between physical behavior settings and directly associated activity levels.