Elsevier

Journal of Pediatric Health Care

Volume 19, Issue 4, July–August 2005, Pages 253-258
Journal of Pediatric Health Care

Patient Education
Health promotion strategies to encourage physical activity in infants, toddlers, and preschoolers

https://doi.org/10.1016/j.pedhc.2005.05.002Get rights and content

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Background

Over the last two to three decades, the number of overweight children and adolescents in the United States has reached epidemic proportions, creating a significant public health problem. These children are at risk for developing immediate physical and psychological health problems, as well as the chronic comorbid conditions that affect obese adults (Eissa & Gunner 2004, Williams 2003). Research also has shown that children are unlikely to outgrow their overweight status through linear growth as

Why prevention?

The primary response by health care professionals to the obesity epidemic has been to treat the overweight child in an effort to reduce the child's risk of developing complications. This approach, like weight management programs for adults, has had limited success (Klish & Goodrick, 2003). Thus, the focus now has shifted from the management of overweight children to prevention of overweight (Klish & Goodrick 2003, Williams 2003). The goal is to develop health promotion strategies that emphasize

Contributing factors

Environmental risk factors associated with limited physical activity include: restricting children to infant seats, strollers, and small play spaces for long periods of time; television or video viewing for more than two hours per day; and lack of at least one hour of moderate physical activity per day (Dennison & Boyer 2004, National Association for Sport and Physical Education 2002). Barriers to physical activity include: 1) parental concern for safety in neighborhoods, 2) parental work

Guidelines and anticipatory guidance

Parents perceive the cost of weight management programs, equipment, and activities to be a significant barrier to increased family activity. However, the authors suggest the use of the guidelines developed by the National Association for Sport and Physical Education (BOX 1, BOX 2, BOX 3, BOX 4) as the framework to develop the following practical, inexpensive physical activity strategies (Figure). These strategies create an environment that fosters a parent's ability to support a growing child's

Parent guidelines: Birth—12 months (Box 2)

Infants and toddlers experiment with bodily sensations and motor movements with objects and people, a type of activity called sensorimotor play (Phillips, 1969). Infants need opportunities that will encourage large motor activity and increase mastery over body movements. Physical activity in a safe setting, particularly with encouragement from a parent or caretaker, allows time to acquire crucial skills for motor development and lays the foundation for critical neuronal connections (NASPE, 2002

Parent guidelines for toddlers: 12 months—36 months (Box 3)

Building on sensorimotor play, toddlers begin to understand the world in more symbolic terms (Phillips, 1969). They begin to perceive the function of objects and enjoy mimicking family activities. For instance, at this age they understand that they may use a baby bottle to feed a doll. Young children continue to expand their world and refine motor skills and movement (Dowshen & Walter, 2001). Toddlers often play side-by-side with peers in parallel play; however, solitary play is equally

Parent guidelines for preschoolers: 3 years—5 years (Box 4)

Preschoolers are ready to engage in the world of symbolic play where they substitute one object for another (Phillips, 1969). A preschooler may use a paper towel tube as a musical instrument or an empty box as a drum. In this process, 4-year-old to 5-year-old children infuse play with their experiences with family members and their immediate world. Children often play “school” or “house” with peers or friends, share play with parents or find solitary activities for brief periods (Dowshen &

Conclusion

Lifestyle changes and modern conveniences insidiously have created a more sedentary population. These sedentary changes affect children, starting with the infant, and have been linked to the surge of overweight children, adolescents and adults (National Association for Sport and Physical Education 2002, Neumark-Sztainer 2003). Once overweight is established, attempts at weight reduction are most often modestly successful for only a short time (Reilly & McDowell, 2002). The focus has shifted now

Acknowledgment

The authors would like to thank Robert J. Yetman, MD, for his assistance in the preparation of this article.

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Section Editor

Mary Margaret Gottesman, PhD, RN, CPNP

Ohio State University College of Nursing

Columbus, Ohio

1

Kathy B. Gunner is Pediatric Nurse Practitioner, Parkview Pediatric Clinic, Houston, Texas; and Assistant Professor of Pediatrics—Clinical, University of Texas, School of Nursing, Houston.

2

Paige M. Atkinson is Assistant Professor of Pediatrics—Clinical, University of Texas School of Nursing, Houston.

3

Julieana Nichols is Assistant Professor, Department of Pediatrics, University of Texas School of Medicine, Houston.

4

Mona A. Eissa is Assistant Professor, Department of Pediatrics, University of Texas School of Medicine, Houston.

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