Physical Activity and Sleep, Knowledge and Perceptions of Child Movement Behaviours and Childcare Practices Among Home Providers: A Survey Study

BACKGROUND: Early childhood is an important phase for optimizing 24-h cycle behaviours (sleep, sedentary behaviour and physical activity) to support physical, social-emotional and cognitive health. While research often focuses on centre-based childcare, about 25% of US children under 5 attend home-based family childcare. Family childcare settings may face inequities in educational, financial, and resource support needed for health-related practices. Furthermore, limited studies have addressed daytime sleep health in such settings. Thus, the purpose of this cross-sectional study was to (1) identify physical activity and sleep behaviours of family childcare providers, (2) determine the provider knowledge and perceptions and childcare practices relating to children's 24-h movement behaviours and (3) explore relations between these factors. METHODS: Adult family childcare providers of western Massachusetts (N = 84, 85.7% female; age = 43.5 ± 10.8 years, 14.3% Hispanic) completed a semistructured online questionnaire. In addition to demographic and childcare practice information, quantitative sleep and movement behaviour variables included provider behaviours, provider knowledge and perceptions of child behaviours and childcare practices and policies. Open-text responses were analysed qualitatively. RESULTS: Most participants reported moderate physical activity levels and 'fairly good' sleep quality, although knowledge of child movement and sleep guidelines varied widely. Higher provider income, age and knowledge were significantly associated with more recommended practices for promoting nap sleep, screen time and physical activity in childcare settings. CONCLUSIONS: Gaps in knowledge and inconsistent practices suggest key opportunities for targeted interventions. Enhancing provider education and addressing environmental barriers may support the implementation of evidence-based strategies to promote healthy movement and sleep behaviours in these underresourced settings.