Physical Activity During the Early Years: A Systematic Review of Correlates and Determinants

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Context

Being physically active during the early years (age 0–6 years) is vital for healthy development. Identifying correlates and determinants of physical activity (PA) is crucial to guide effective interventions. This systematic review synthesized studies investigating potential correlates and determinants of PA during the early years, accounting for different types of PA assessment.

Evidence acquisition

Nine electronic databases were searched from inception year (1900) until September 2014; data were analyzed/interpreted in April 2015. The following inclusion criteria were used: written in English, published in peer-reviewed journals, participants not in statutory/school education, and an observational design investigating associations between an exposure/variable, and a quantitative measure of PA. Correlates/determinants of total, moderate to vigorous, and light PA were reported using an ecologic model.

Evidence synthesis

Of 22,045 identified studies, 130 were included. All took place in high-income countries and few (6%) were of high quality. Correlates of total PA were sex (male, ++); parental PA (+); parental support (+); and time outdoors (+). Determinants of total PA were sex (+) and time spent playing with parents (+). The only correlate of moderate to vigorous PA was sex (male, ++). No determinants of moderate to vigorous or light PA were found. PA correlates/determinants were relatively consistent between objective and subjective PA measures.

Conclusions

Numerous studies investigated potential correlates and determinants of PA, but overall quality was low. A small number of demographic/biological and social/cultural factors were associated with PA. There is a need for high-quality studies exploring correlates/determinants across all domains of the ecologic model.

Section snippets

Context

Physical activity (PA) is a key influence upon health across the life course.1, 2, 3, 4 The “early years” is an umbrella term for an age range that encompasses infants (0–2 years), toddlers (2–4 years), and preschoolers (4–6 years).5 During this period, PA is reported to be associated with multiple health outcomes.5 Evidence suggests PA levels track from early to later childhood,6 and into adulthood,7 so establishing optimal levels of this health-related behavior early in life is crucial.8, 9

Search Strategy

The search and review process followed guidance from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.33 A systematic literature search was conducted within nine electronic databases: Web of Science, SCOPUS, SPORTDiscus, PubMed, Cochrane, ProQuest, PsycINFO, Embase, and CINAHL. Each database was searched from the year of inception (i.e., the earliest was Web of Science, 1900) until September 2014. Data extraction and interpretation took place between November 2014 and

Review Process

Figure 1 outlines the flow of articles through the review. A total of 22,045 articles were identified and screened; 19,385 were excluded based on the title (mostly because of their sample’s age falling outside the inclusion criteria), and a further 1,733 were identified as duplicates and excluded. Of the remaining 927 abstracts, 490 were excluded. Four hundred thirty-seven full articles were screened and 332 excluded, leaving 105 articles. A further 25 articles were included from hand searching

Discussion

This systematic review identified a large number of observational studies that examined the correlates and determinants of PA in the early years. Few studies were of high quality and the numbers of identified correlates and determinants were small. All correlates and determinants found for each of the PA intensities (TPA, MVPA, and LPA) were either demographic and biological variables, social and cultural variables, or physical environment variables. Boys were found to participate in more TPA,

Conclusions

Although a large body of research investigating potential correlates/determinants of PA in the early years has been published, few studies are of high quality. Studies included in this review focused predominantly on demographic/biological and social/cultural correlates and determinants. Future research should focus on:

  • 1

    improved reporting of measurement methods so study quality can be accurately assessed;

  • 2

    longitudinal/prospective studies to assess temporal associations (determinants);

  • 3

    additional

Acknowledgments

DDB and SEB’s involvement in this publication was funded by the National Institute for Health Research (NIHR). This study is part of the Healthy Children, Healthy Families Theme of the NIHR Collaborations for Leadership in Applied Health Research and Care Yorkshire and Humber. The views expressed in this publication are those of the authors and not necessarily those of the National Health Service, NIHR, or the Department of Health.

TH is funded by a National Health and Medical Research Council

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