Which Meso-Level Characteristics of Early Childhood Education and Care Centers Are Associated with Health, Health Behavior, and Well-Being of Young Children? Findings of a Scoping Review

Abstract

Characteristics of early childhood education and care (ECEC) centers might be relevant for children’s health. This scoping review aims to provide an overview of the association between meso-level characteristics (MLCs) of ECEC centers with children’s health, health behavior, and wellbeing. Five databases were searched for quantitative and qualitative research articles published in English or German since 1 January 2000 on health, health behavior, and wellbeing of children aged 0 to 6 years considering MLCs of ECEC centers. Two authors screened 10,396 potentially eligible manuscripts and identified 117 papers, including 3077 examinations of the association between MLCs and children’s health indicators (Kappas > 0.91). Five categories of MLCs were identified: (1) structural characteristics, (2) equipment/furnishings, (3) location, (4) facilities/environment, (5) culture/activities/policies/practices, and 6) staff. Only very few studies found an association of MLCs with body weight/obesity, and general health and wellbeing. Especially physical activity and mental health were related to MLCs. In general, the location (rural vs. urban, neighborhood status) seemed to be a relevant health aspect. MLCs of ECEC centers appeared relevant for child health indicators to different degrees. Future research should focus on these associations, in detail, to identify concrete ECEC indicators that can support health promotion in early childhood.

Moderating or mediating effects of family characteristics on socioeconomic inequalities in child health in high-income countries – a scoping review

“…One limitation is that despite a large number of children attending day care facilities, this review focuses exclusively on the mediating and moderating effects of the family as the most important social environment in early childhood. The findings presented here should, therefore, be supplemented by reviews of cooperating research groups [ 68 ] on the effects of further relevant social environments, such as kindergartens [ 69 ] and schools [ 70 ], and by reviews examining late childhood and adolescence [ 29 ].…”

Associations of individual factors and early childhood education and care (ECEC) centres characteristics with preschoolers’ BMI in Germany

“…Research into the age composition of groups has shown that a wider range of ages might be beneficial regarding children’s learning and development [ 33 ]. It is also known that meso level characteristics of facilities are related to children's health; for example, because they might have an influence on children's physical activity behaviour [ 17 ]. Research results have shown that children moved more and spend less time sitting if the ECEC centre has created a movement-friendly environment [ 34 ].…”

“…Research results have shown that children moved more and spend less time sitting if the ECEC centre has created a movement-friendly environment [ 34 ]. Especially movable and fixed play equipment, a sedentary environment, the physical activity training, and the physical activity education have been found to influence physical activity behaviour [ 17 ]. In our study, larger groups are significantly associated with a lower BMI.…”

“…A recent scoping review identified the location of ECEC centres as a relevant factor for health behaviour, health and well-being of young children [ 17 ]. A closer look at the health outcomes revealed that location was particularly frequently found to be related to nutrition, physical activity, sedentary behaviour, physical health, development and mental health, but not with further factors like body weight and obesity.…”

“…ECEC centres are considered as socialization instances, since – for example – health behaviours such as nutrition and exercise are learned and established in this phase of life and contribute to individual health behaviour in the further course of life [ 16 ]. However, existing research on preschool children's health predominantly focuses on the individual level, and a recent review has shown that the number of studies considering meso level characteristics of ECEC centres (i.e., institutional structures) and their association with health, and health behaviours is limited and only very few studies additionally consider the individual SEP [ 17 ]. However, there is a reason to assume that the compositional (i.e., aggregated information about the children) and contextual (i.e., structural conditions of an institution) characteristics of ECEC centres at the meso level might add to the explanation of health differences in children [ 13 , 17 ].…”