Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Melinda Irwin

Second Advisor

Marney White



Background: Prior to the development of the Activity Begins in Childhood (ABC) Trial, no cluster-randomized control trial has investigated the effectiveness of a physical activity intervention with daycare providers in Canada.

Rationale: Educating daycare providers about the importance of improving their preschooler’s gross motor skills, physical activity, and reducing sedentary time in their daycare environments is an important step toward diminishing the rates of childhood obesity and overweight across Canada.

Method: A total of N = 15 daycare centers were enrolled in the ABC trial and equally randomized to: Intervention 1, Intervention 2, or a Comparison Group. Intervention providers attended two 3-hour workshops, bi-monthly booster sessions, and obtained a physical activity guidebook. Changes in the daycare environment were assessed using the Environmental Policy Assessment & Observation (EPAO) instrument. Data collections occurred at baseline, 3-months, and 6-months. Higher scores on EPAO subscales and the total EPAO –Physical Activity (PA) component indicated higher quality daycare environments. Changes in total EPAO –PA scores and all eight EPAO subscales, total physical activity minutes, and positive staff statements were assessed over time between groups.

Results: No significant differences were found between groups at 6-months for mean total EPAO-PA scores. At 6 months, Intervention 2 descriptively had the highest mean EPAO-PA score. “Staff Behaviors and Physical Activity” subscale scores were significantly higher in the Intervention 2 group than the Control group at 6 months. More positive staff prompts were observed for Intervention 2 as compared to both groups at 6 months.

Conclusions: The Activity Begins in Childhood (ABC) intervention with daycare providers using the EPAO suggests that improvements in staff behaviors and the overall daycare environment are feasible. Future research should explore the validation of a more comprehensive tool to assess the daycare environment.


This is an Open Access Thesis.

Open Access

This Article is Open Access