Impact of Policies on Physical Activity and Screen Time Practices in 50 Child-Care Centers in North Carolina

Background: This study assessed physical activity and screen time policies in child-care centers and their associations with physical activity and screen time practices and preschool children's (3-5 years old) physical activity. Methods: Data were from 50 child-care centers in North Carolina. Center directors reported on the presence/absence of written policies. Trained research assistants observed physical activity and screen time practices in at least 1 preschool classroom across 3 to 4 days. Children (N = 544) wore accelerometers to provide an objective measure of physical activity. Results: Physical activity and screen time policies varied across centers. Observational data showed 82.7 min/d of active play opportunities were provided to children. Screen time provided did not exceed 30 min/d/child at 98% of centers. Accelerometer data showed children spent 38 min/d in moderate-to-vigorous physical activity and 206 mind in sedentary activity. Policies about staff supervision of media use were negatively associated with screen time (P < .05). Contrary to expectation, policies about physical activity were associated with less time in physical activity. Conclusions: Clear strategies are needed for translating physical activity policies to practice. Further research is needed to evaluate the quality of physical activity policies, their impact on practice, and ease of operationalization.