This was the first study to employ the Delphi method to generate physical activity and sedentary behaviour content to be included in training for ECE students. The use of two field-specific expert panels to offer their insights on this training provided a unique perspective on module content development, and their general consensus on important rankings of the content areas provides helpful direction regarding areas of foci for the e-Learning module. A number of important findings from this study are discussed below.
Six content areas proposed by the experts focused on giving ECE students necessary background information on physical activity and sedentary behaviour, ranging from definitions and benefits/risks of these behaviours to guidelines and current prevalence rates. These content areas are essential to include, as ECE students have noted the lack of physical activity and sedentary behaviour-specific training in their program.(15) Bruijns et al. (2019) surveyed 1,292 ECE students, and while the majority of students reported that their courses covered gross motor development (86.6%), few covered concepts such as physical literacy (46.2%), screen-viewing (47.3%), or sedentary behaviour (41.5%).(15) Without a proper introduction to these concepts and their importance to consider when programming, it is unlikely that ECE students will be receptive to strategies to promote physical activity and minimize sedentary time.(22) As evidenced by Bruijns et al. (under review), ECE students felt it was more important and their responsibility to teach physical activity-related skills (such as fitness activities, locomotor skills, and play skills) in childcare if they reported receiving training in physical activity.(22) As such, if ECE students are introduced to these concepts during their pre-service schooling, it is likely that they will promote healthy movement behaviours among the children they care for upon entering the ECE profession.
Physical activity/sedentary behaviour experts also suggested including training related to factors that influence young children’s physical activity and sedentary behaviour in the childcare environment, with specific attention paid to outdoor and risky play (receiving heightened attention in the ECE field as of late.(35) This review of correlates is critical within the module, as it will highlight to ECE students the varying aspects of the childcare environment, and educator behaviours, that act as facilitators/barriers to children’s physical activity and that influence their sedentary behaviours.(13,36) Stemming from the review of correlates, eight additional content areas suggested by the panel related to providing ECE students with practical strategies on how to promote physical activity and minimize sedentary time in their classroom (noted as important within childcare educator training interventions). (26,37) In addition, two content areas focused on helpful resources and training, and practical video example activities, to further aid ECE students in this respect. The focus of the content suggested for the module on these strategies and resources is encouraging, as educators have reported they lack the appropriate training on how to lead skill-based physical activities in childcare.(38) Further, early childhood educator training interventions have noted the benefit of this type of practical support in scaffolding educators’ physical activity-related self-efficacy,(27) and both increasing physical activity(39) and decreasing sedentary time(26) among children in their care. Offering video examples may teach ECE students how to engage children in physical activity, and promises to support their self-efficacy in this pursuit via vicarious reinforcement and modeling.(40)
While both expert panels expressed their views of the importance of all proposed content areas for the e-Learning module, the top-rated content areas (i.e., Outdoor Play, Benefits of Physical Activity in the Early Years, Factors Influencing Physical Activity and Sedentary Behaviour in Childcare) were logical. Considering outdoor time is a required component of all childcare in Canada, coupled with the knowledge that children accumulate the majority of their daily MVPA outdoors while attending childcare,(41) the high prioritization of Outdoor Play by both expert panels is reassuring and important to educate ECE students about. The introductory content area regarding benefits of physical activity stresses the need to provide ECE students with solid foundational knowledge of physical activity and sedentary behaviour. Further, overviewing the factors influencing children’s movement behaviours in the childcare environment was considered very important. Specifically, early childhood educator behaviours, known to influence children’s movement behaviours in childcare,(42) was highlighted as critical for targeted education. Taken together, the top-rated content areas represent topics in need of focus within training interventions for early childhood educators, and are pertinent to include in the e-Learning module for ECE students.
The moderate-to-strong inter-panel agreement, both in terms of content area mean score and rank-order, demonstrates general consensus regarding the importance of each topic for inclusion within the module. While select content areas were rated higher by one panel than the other (e.g., Creation of Physical Activity/Screen-Viewing Policies was favoured by the physical activity/sedentary behaviour experts, and Risky Play was favoured by the ECE experts), most content areas were similarly rated and ranked by both panels. Given the overarching goal of the TEACH study is to implement this e-Learning module in ECE post-secondary programs, it is critical that the content created for the module is pertinent to the ECE field. It is reassuring, then, that the large majority of ECE experts rated this training module as both in line with objectives of, and of added benefit to, the current post-secondary ECE curriculum. Hnatiuk and colleagues(43) stress the importance of tailoring early years physical activity interventions to community needs (in this case, lack of physical activity and sedentary behaviour training in the present ECE curriculum). With the overwhelming support of the ECE expert panel (nearly 100% of ECE experts reported this training was important for ECE students to receive), the creation of the e-Learning module using the content areas generated from this Delphi study is likely to be well-received by ECE programs within Canadian post-secondary institutions.
Research Implications and Future Directions
This research study has a number of important implications. First, the results of this study will be used to generate a physical activity and sedentary behaviour e-Learning course that is tailored specifically to ECE students, the first study globally to focus this training within early childhood educators’ pre-service education. Having educators who are well-trained in physical activity and sedentary behaviour will ensure children in childcare are provided sufficient movement opportunities daily, which is vital for their healthy development. Second, the recruitment of top international experts in the field to generate the content for the module ensures that this training covers the most important and relevant information for ECE students to promote healthy movement behaviours in childcare-based professions upon graduation. In addition, having a diverse panel of ECE experts review the content proposed by the physical activity/sedentary behaviour panel confirmed the applicability of this training to ECE, and will ease its receptivity by post-secondary ECE programs.
The implementation of the e-Learning course across Canada will shed light on whether this training is successful in ECE programs in multiple locations. In Canada, ECE curricula and professional accreditation standards are governed at the provincial/territorial level; as such, testing the effectiveness of this educational tool nationwide will determine the versatility of the e-Learning course to be implemented in multiple educational environments. If successful, the e-Learning course can be adapted (e.g., changing country-specific movement guidelines) for use in other countries, which would maximize the reach and global public health impact of this training. Given the global call for physical activity and sedentary behaviour training to be made available within early childhood educators’ pre-service schooling,(20,29,44) international collaborations are warranted to support this initiative.
Although this study has many strengths, including a high online survey response rate (53% for physical activity experts, 58% for ECE experts) and the use of the Delphi technique with two field-specific expert panels, it is not without limitations. First, the purposeful sampling method may have introduced selection bias. While efforts were made by the research team to overcome this bias (e.g., ensuring sufficient recruitment of international/provincial experts, allowing participants to suggest researchers to recruit), the selection of experts by the research team may have included experts with similar ideals and values regarding the importance of this training in ECE; this may limit the generalizability of the findings. Second, despite the anonymous nature of the online surveys, participants may have been subject to social desirability bias, as they may have felt that higher importance ratings were ‘expected’ of someone in their profession. Third, as is the case in any Delphi study, data gathered were based upon availability and the subjective opinion and expertise of participants.