Skip to Content

Arnold School of Public Health

  • Children Playing

South Carolina child care centers improve practices aimed at increasing children’s physical activity while in care

December 7, 2016 | Erin Bluvas, 

A study led by Arnold School researchers* has found that South Carolina has made modest improvements in increasing children’s physical activity at child care centers after a 2012 policy on the public health issue took effect. The research, which was funded by the Robert Wood Johnson Foundation (grant 69551) and published in the American Journal of Public Health, compared South Carolina to North Carolina—a state that has not made recent policy changes related to physical activity for children (ages 3-5) while at child care centers.

With this study, the researchers aimed to evaluate the effect of the ABC Grow Healthy Standards that were adopted by South Carolina to improve the quantity and quality of physical activity opportunities for children in child care. The standards are a mandatory component of the state’s child care enhancement program and were prompted by the strategies recommended by The National Academies of Science, Engineering, and Medicine’s Institute of Medicine (now known as the Health and Medicine Division) in 2011 to promote physical activity in child care settings. Prior to this study, only a few states have implemented regulations that align with these recommended strategies.

The present study looked at physical activity practices in 34 South Carolina and 30 North Carolina child care centers before and after the policy took effect in 2012. The researchers looked at eight standards applied to children ages 3-5 years old, such as creating and consistently implementing a written physical activity policy, providing 90 to 120 minutes of daily active outdoor play, and requiring teachers to attend physical activity training at least once per year.

“This study tells us that state-level policies can improve practices in child care centers to promote young children’s physical activities, but additional steps must be taken to move beyond modest improvements,” says Jennifer O’Neill, clinical assistant professor of exercise science and lead author on the study. “More training is needed for teachers to fully meet the physical activity standards, particularly in the area of promoting strategies that encourage physical activity in young children.”

Examples include staff joining children in play, encouraging children to be active, and having enough portable play equipment for all children. The authors especially emphasize the importance of providing daily outdoor time. “It is not enough to have outdoor time on the schedule,” says O’Neill. “Outdoor play must be provided daily, and if the weather is inclement, then appropriate opportunities for indoor activities should be provided.”

With 25 percent of U.S. children ages 2-5 years classified as overweight or obese, this public health issue has long-term implications and will continue to grow if not addressed. “Sixty-five percent of young children attend structured child care in the U.S., so child care centers are an important setting for obesity prevention,” adds O’Neill. “Future research should determine how to help teachers and directors fully implement the physical activity standards and determine whether the standards increase physical activity levels of children in care.”

*Co-authors include Jennifer O’Neill (Exercise Science), Marsha Dowda (Exercise Science), Sara Benjamin Neelon (Johns Hopkins University), Brian Neelon (Medical University of South Carolina), and Russell Pate (Exercise Science)

Challenge the conventional. Create the exceptional. No Limits.