Background
FMS
FMS
Few children ages three to five years meet the World Health Organization (WHO) recommendations of at least 180 min/day of physical activity (PA), of which at least 60 min are moderate-to-vigorous physical activity (MVPA), and limit sedentary time, typically measured as one hour of sedentary screen-time [To improve preschooler PA and FMS and to reduce time spent sedentary, it is important to consider where preschoolers spend their waking hours. Maximizing time spent in MVPA during outdoor activities is a key strategy, particularly outdoor play at formalized early childhood education (ECE) centers which are attended by 80% of preschoolers in the United States [A combination of environmental and capacity-building interventions may overcome limitations in teacher capacity and translate to more PA over the long-term. Adding colorful markings (e.g., hopscotch, foursquare) to existing outdoor play settings and open spaces may provide a low-cost, feasible way to increase children’s PA outdoors while also providing teachers with structured opportunities to help children build motor skill proficiency. These markings can be easily applied and implemented in outdoor play settings, since they use existing open space (e.g., concrete or other hard surface), have a low-cost for application, and can be sustained when using long-lasting materials (e.g., spray paint). These “painted playgrounds” have resulted in an increase in MVPA in elementary age children in outdoor play sessions [Stencils are a viable option to promote PA and FMS in this age range as they can facilitate higher intensity PA and locomotor skills (e.g., jump, hop, skip), through activities like hopscotch or jumping between places [