Evidence on the effectiveness of public policies for physical activity promotion in the early childcare education and care setting: A Systematic review

Background: Early childhood education and care (ECEC) is crucial for shaping physical activity (PA) behaviours due to the significant time children spend in this setting. In addition, research has shown that public policies can be an important means to create a healthy environment. This systematic review explores the effectiveness of public policies promoting PA in ECEC. Methods: Nine online databases (Scopus, Pubmed, Web of Science, SportDiscus, Cinahl, IBSS, ERIC, APA PsychINFO and Cochrane library) were searched in August 2023 for studies that examined public policies impacting children's PA behaviour or environments in ECEC. Data were extracted, and a quality assessment was performed using the Downs and Black checklist, and a narrative synthesis was applied. Results: A total of 11 articles met the inclusion criteria. The studies from the United States, Canada and Australia involved either the implementation of legally binding policies (n=6) or voluntary accreditation standards (n=5). Studies reported on the adher?ence of ECEC centres to policies, the effects on children's PA behaviour or changes in the environment using both device-based (e.g., accelerometer) and self-report (e.g., questionnaires and interviews) measures as well as observation. Reported adherence rates of childcare centres to new regulations ranged from 74% to 94%. Studies on policies that implemented PA into the curriculum required a mandatory PA time of at least 60min per day or implemented revised accreditation standards reported positive effects on the ECEC centres PA environment. Effects on the PA behaviour of children remained inconclusive, with studies reporting on both increased and decreased PA levels. Conclusion: Public policies have the potential to change the environment and positively influence PA behaviour in preschool children. However, due to the heterogenous methodological approaches in the identified studies, the findings of this review have certain limitations. Future research needs to further investigate the effectiveness of policy approaches to promote PA in early childhood settings.