Results
track/path
In total, 190 ECE centers were contacted, 101 ECE centers completed phone screening, and ultimately four ECE centers participated (two ECE centers/group). The ECE centers that did not enroll were unwilling to participate (n = 4), did not offer full-time enrollment (n = 2), did not have enough preschoolers (< 20) enrolled (n = 39), and 56 ECE centers did not have adequate concrete space to paint at least three stencils within their ECE center.The four centers that enrolled included two Head Start centers, one church-affiliated center, and one hospital-affiliated center. One Head Start was randomly assigned to each condition. The centers averaged 184 children enrolled ages zero to five (range: 90–300) and 104 in the target age range of three to five year olds (range: 30–180). Directors reported 100% of children received state funding for meals in three of the four centers, with the fourth center reporting no state funding for meals. All four centers reported being in operation for 10 years or more and being active participants in the state star (i.e., quality) rating system for ECE centers. Two of the four centers also participated in additional accreditation, with one in each condition.During the baseline interview, directors of all four centers reported providing at least two hours of free play each day and at least 60 min of active play time per day. Two directors reported allowing “no more than 15 minutes at a time” of continuous seated time each day and two allowed “15–30 minutes but only 1 occasion” per day. All four center directors reported providing “multiple play areas, open space for running, and a track/path for wheeled toys” with “good” or “lots of” variety both indoors and outdoors. Two of the four centers offered structured programs/field trips for PA and three offered community organizations who came to the center to provide PA. All four directors reported not withholding active play time for misbehavior. Directors reported providing one or two trainings per year for teachers and one or two trainings per year for parents on PA education, and all four directors reported having a written PA policy. There were no appreciable differences in the directors’ responses to questions at the end of the study period.For the child-specific measurements that required parental consent, parents of 55 preschoolers returned consent forms, which included 33 preschoolers at intervention ECE centers and 22 preschoolers at wait-list control ECE centers. Of the 55 who completed consent forms, 54 completed baseline assessments, and 51 (n = 32 intervention, n = 19 control) completed follow-up assessments that occurred six to eight weeks after baseline assessments. The study took place between December 2018 – June 2019.
Baseline demographics of participants by group
As shown in Table 