学龄前儿童上学日幼儿园内外身体活动特征及相关因素

Physical activity patterns and influencing factors of preschooler in and outside of kindergarten during weekdays

目的评估学龄前儿童幼儿园内外身体活动特征及其相关因素,为未来针对性促进不同类型幼儿的身体活动提供参考。方法2016年4月—2022年12月,选取上海亲子队列于3~6岁时期随访的706名学龄前儿童,在园期间儿童配戴加速度计测量身体活动,并使用家长问卷调查儿童园外的身体活动及屏幕时间。采用限制性立方样条分析儿童园内及园外中高强度身体活动(MVPA)的关系,聚类分析得到儿童上学日活动类型;采用多分类Logistic回归分析儿童上学日活动类型的影响因素。结果学龄前儿童上学日园内MVPA时间为(40.83±15.71)min/d,园外MVPA为30(15,53)min/d;限制性立方样条分析显示,园、内外MVPA呈倒“U”形关系。聚类分析将儿童分为每日MVPA偏低但园内较活跃(196名,27.8%)、每日MVPA尚可但园外屏幕时间较多(97名,13.7%)、每日MVPA达标且园外相对活跃(96名,13.6%)以及每日MVPA偏低且园内外相对不活跃(317名,44.9%)。多分类Logistic回归分析结果显示,以每日MVPA达标且园外相对活跃作为参照组,2岁时屏幕时间>60 min/d的儿童更可能为每日MVPA尚可但园外屏幕时间较多(OR=3.84,95%CI=1.16~12.74);男生相比女生有更低的可能为每日MVPA偏低且园内外相对不活跃(OR=0.33,95%CI=0.16~0.70);社区周边活动设施不充足的儿童更可能为每日MVPA偏低且园内外相对不活跃(OR=2.20,95%CI=1.05~4.63)(P值均<0.05)。结论不同儿童的园内外身体活动及园外屏幕时间的行为模式有较大差异,2岁时屏幕时间以及社区周边运动设施是影响学龄前儿童上学日活动类型的影响因素,应联合家校对不同类型儿童实施个性化干预方案。

Objective To evaluate the characteristics and related factors of physical activities both inside and outside the kindergarten among preschool children,so as to provide a reference for promoting targeted physical activities among different types of children in the future.Methods From April 2016 to December 2022,706 preschool children aged 3 to 6 years from the Shanghai parent-child cohort followed up.Accelerometers were used to measure their physical activities during kindergarten hours,and a parent questionnaire was employed to assess their physical activities and screen time outside the kindergarten.Restrictive cubic spline analysis was used to examine the relationship between moderate to vigorous physical activities(MVPA)inside and outside the kindergarten.Cluster analysis was performed to identify physical activity patterns among children,and multinomial Logistic regression analysis was conducted to explore the influencing factors of these physical activity patterns.Results On weekdays,preschooler accumulated an average of(40.83±15.71)minutes of MVPA inside the kindergarten and 30(15,53)minutes outside daily.Restricted cubic spline analysis revealed an inverted U-shaped relationship between MVPA inside and outside the kindergarten.Cluster analysis identified four groups:low daily MVPA but active inside(196,27.8%),moderate daily MVPA but high screen time outside(97,13.7%),adequate daily MVPA and relatively active outside(96,13.6%),and low daily MVPA and relatively inactive both inside and outside(317,44.9%).Compared to the reference group of adequate daily MVPA and relatively active outside,children with screen time exceeding 60 minutes at 2 years old were more likely to belong to the group with adequate daily MVPA but more screen time outside(OR=3.84,95%CI=1.16-12.74,P<0.05).Boys had a lower likelihood of being in the group with low daily MVPA and relatively inactive both inside and outside(OR=0.33,95%CI=0.16-0.70,P<0.05).Children from neighborhoods with insufficient sport facilities were more likely to be in the low daily MVPA and relatively inactive group(OR=2.20,95%CI=1.05-4.63,P<0.05).Conclusions Behavior patterns of physical activity and screen time for both inside and outside the kindergarten vary greatly among different children.Screen time at the age of 2 and the sports facilities around the commuinty are key factors influencing the physical activity pattern.It is recommended to implement personalized intervention plans in collaboration with schools and families for different types of children.