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Feasibility, Acceptability and Process Evaluation of a Physical Activity Intervention in Toddler aged Children: The TAP-A-LONG Study

Recent literature has suggested the importance of physical activity in early childhood such as during the toddler years (12 months - 3 years.) Despite this, most toddlers are not physically active. There is a need to determine the types of physical activity programs that would interest toddlers within the settings they spend a significant amount of time in (e.g., childcare center). Currently, data on the feasibility, implementation, and process evaluation of physical activity interventions in toddler age children attending childcare centers is lacking within the literature. Therefore, the purpose of the Toddler Activity Pilot (TAP-A-LONG) study was to examine the feasibility and acceptability of a four day per week, 10-week physical activity program in toddler aged children during the childcare day. Process evaluation data was collected daily during the entire 10-week study using a semi-structured questionnaire. Once per week on a randomly selected day, toddlers’ physical activity was assessed with accelerometers during the 10-minute intervention session or gross-motor playtime for the treatment and control group, respectively. Accelerometers were also worn for the duration of the full day during baseline, midpoint, and post. Participants were male (58%), white (46%), and lived in a household with married parents (58%). Toddlers’ average age was 25.0 ± 4.2 months. A total of 69.4% of the toddler population was recruited to participate in the study amongst the three participating centers (TAP = 37; CON = 13). During the 10-minute intervention session, toddlers in the treatment group spent 60.4 ± 22.0%, 28.7 ± 15.7%, and 10.9 ± 10.6% of time in sedentary (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA), respectively. While control center spent 55.7 ± 18.8%, 35.9 ± 15.1, and 8.4 ± 8.0% in SED, LPA, and MVPA, respectively. For program quality, 76.7% and 62.0% of researcher and provider led intervention sessions were delivered clearly (i.e., directions were understandable to toddlers), respectively. The majority of intervention sessions held toddlers’ attention (60% of toddlers participated in at least half of the intervention). Overall, the high acceptability of our TAP-A-LONG intervention highlights the usefulness of physical activity interventions within the childcare setting.