Evidence of the Potential Effectiveness of Centre-Based Childcare Policies and Practices on Child Diet and Physical Activity: Consolidating Evidence from Systematic Reviews of Intervention Trials and Observational Studies

The aims of this study are to synthesize the findings of systematic reviews to (1) determine whether centre-based childcare interventions are effective in improving child physical activity and diet and (2) identify promising modifiable centre policies and practices to improve child physical activity and diet. Four electronic databases were searched. The methodological quality of included reviews was assessed using the AMSTAR tool. For intervention effectiveness, reviews were categorized as ‘generally effective’ if more than two-thirds of primary studies demonstrated positive effects.

Database searches yielded 1164 unique citations of which 22 reviews were included. Three of 16 physical activity reviews, including one of the two higher quality reviews, and the largest and most recent review to date, reported that the interventions were generally effective in improving physical activity. One of nine nutrition reviews reported that interventions were generally effective at improving dietary intake. This review was of moderate quality and was the largest and most recent review of dietary outcomes in children in this setting. The most consistently reported policies and practices associated with improved child physical activity included those targeting the physical environment (playground markings, equipment, space), educator qualifications and training, and structured physical activities. Policies and practices associated with improved child diet included food availability and menu modification, positive peer modelling, and including parents.

There is increasing evidence from high-quality, recent systematic reviews that childcare-based interventions can be effective at improving child physical activity. Systematic review evidence regarding the effects of intervention on child diet is more equivocal.