Understanding physical activity and sedentary behaviour among preschool-aged children in Singapore: a mixed-methods approach

Abstract

ObjectivesThis study investigated physical activity (PA) and sedentary behaviour (SB) among preschool-aged children in Singapore and potential correlates at multiple levels of the socioecological model from in-school and out-of-school settings.DesignA cross-sectional study using a mixed-methods approach.ParticipantsParent–child dyads from six preschools in Singapore.MethodsPA and SB of children (n=72) were quantified using wrist-worn accelerometers for seven consecutive days. Three focus group discussions (FGDs) among 12 teachers explored diverse influences on children’s activities, and System for Observing Play and Leisure Activity in Youth (SOPLAY) assessed PA environment and children’s activity levels at preschools. Seventy-three parents completed questionnaires on home and neighbourhood factors influencing children’s PA and SB. Descriptive analyses of quantitative data and thematic analysis of FGDs were performed.ResultsBased on accelerometry, children (4.4±1.1 years) spent a median of 7.8 (IQR 6.4–9.0) hours/day in SB, and 0.5 (0.3–0.8) hours/day in moderate-to-vigorous physical activity (MVPA). MVPA was similar throughout the week, and SB was slightly higher on non-school days. In preschools, SOPLAY showed more children engaging in MVPA outdoors (34.0%) than indoors (7.7%), and absence of portable active play equipment. FGDs revealed issues that could restrict active time at preschool, including academic requirements of the central curriculum and its local implementation. The teachers had varying knowledge about PA guidelines and perceived that the children were sufficiently active. In out-of-school settings, parents reported that their children rarely used outdoor facilities for active play and spent little time in active travel. Few children (23.5%) participated in extracurricular sports, but most (94.5%) reported watching screens for 1.5 (0.5–3.0) hours/day.ConclusionMVPA was low and SB was high in preschool-aged children in an urban Asian setting. We identified diverse in-school and out-of-school correlates of PA and SB that should be taken into account in health promotion strategies.

The Role of Preschool Hours in Achieving Physical Activity Recommendations for Preschoolers

“…These low levels of school-day MVPA have also been observed in other studies. Segura-Martínez et al (2020) found that children had an average of 20 min of MVPA during the school day [ 32 ], while Chen et al (2020) observed a median 29 min [ 33 ]. For their part, Lu et al (2019) reported that children spent 6.6% of their day (both in and outside of school) in MVPA, and just 28% met the PA recommendations (32% of boys and 22% of girls) [ 18 ].…”

Children’s perceptions of factors influencing their physical activity: a focus group study on primary school children

“…However, similar to other studies, the most children perceived these concerns to be reasonable for their own protection (Brockman et al, 2011 ; Kirby et al, 2013 ; Thomson & Philo, 2004 ). It is interesting that safety concerns were being brought up by children as parents in a previous local study alluded that they felt their neighbourhood was safe for children to play in (B. Chen et al, 2020a ). Findings from our study suggest that parents’ perception of safety may not be limited to physical safety (e.g., road and traffic) but may include social safety (e.g., people) as well.…”

Parental perception and guideline awareness of children’s lifestyle behaviours at ages 5 to 14 in Singapore

“…Currently, most of the data we have on lifestyle behaviours of children in Singapore come from those of preschooler age (3-6 years) 1,3,12,[14][15][16] or younger (below 2 years). 2,17 Cross-sectional data in the preschooler age group have shown that time spent engaged in moderate to vigorous PA is low, while time spent in SB is high; 15 the duration of night-time sleep is significantly lower than recommended values. 16 At ages 2-3 years, 50% of children were already spending >2 hours/day on SVT, exceeding the recommended guidelines for this age group.…”

“…18 However, other Singapore studies have shown that engagement in PA was substantially lower when measured using heart rate monitoring data, with <15% of the primary school children 18,30 and none of the adolescents 19 meeting recommended PA guidelines. This trend of relatively low PA seems to begin as early as preschool; results from accelerometery data showed that children in Singapore aged 4.4 years spent only a median of 0.5 (interquartile range 0.3-0.8) hour/day on moderate to vigorous PA. 15 A large 12-country study (including 8 Western, 2 Asian and 2 African countries) using data from accelerometers reported that the overall adherence to moderate to vigorous PA guidelines in other Western and Asian countries in children of primary school age (9-11 years) was 44%. 31 The highest adherence was in Finland at 61%, and the lowest adherence was in China at 15%.…”