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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Psychol.</journal-id>
<journal-title>Frontiers in Psychology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Psychol.</abbrev-journal-title>
<issn pub-type="epub">1664-1078</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fpsyg.2023.1221566</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Psychology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Factors associated with implemented teacher-led movement and physical activity in early childhood education and care</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" id="_Hlk139962574" corresp="yes">
<name>
<surname>Sollerhed</surname>
<given-names>Ann-Christin</given-names>
</name>
<xref rid="c001" ref-type="corresp"><sup>&#x002A;</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/911467/overview"/>
</contrib>
</contrib-group>
<aff><institution>Faculty of Teacher Education, Kristianstad University</institution>, <addr-line>Kristianstad</addr-line>, <country>Sweden</country></aff>
<author-notes>
<fn fn-type="edited-by" id="fn0001">
<p>Edited by: Pedro Gil-Madrona, University of Castilla-La Mancha, Spain</p>
</fn>
<fn fn-type="edited-by" id="fn0002">
<p>Reviewed by: David Zamorano-Garc&#x00ED;a, University of Castilla-La Mancha, Spain; In&#x00EA;s Peixoto Silva, Instituto Polit&#x00E9;cnico de Viana do Castelo, Portugal; Mar&#x00ED;a Mart&#x00ED;nez L&#x00F3;pez, University of Castilla-La Mancha, Spain</p>
</fn>
<corresp id="c001">&#x002A;Correspondence: Ann-Christin Sollerhed, <email>ann-christin.sollerhed@hkr.se</email></corresp>
</author-notes>
<pub-date pub-type="epub">
<day>27</day>
<month>07</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="collection">
<year>2023</year>
</pub-date>
<volume>14</volume>
<elocation-id>1221566</elocation-id>
<history>
<date date-type="received">
<day>31</day>
<month>05</month>
<year>2023</year>
</date>
<date date-type="accepted">
<day>07</day>
<month>07</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2023 Sollerhed.</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Sollerhed</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>Movement and physical activity (MoPA) is critical for children&#x2019;s development and health. This study aimed to explore early childhood education and care (ECEC) educators&#x2019; reported frequency of implemented gross motor and physical activities (MoPA) among children in ECEC, as well as the educators&#x2019; reported personal physical activity (PA) levels in leisure time. A cross-sectional survey was performed in 68 preschools in southern Sweden. Data were obtained from questionnaires completed by 359 ECEC educators. The participation rate was 61%. About two thirds offered MoPA once a week or more seldom, while one quarter offered MoPA at least every other day. Educators who reported personal PA three times or more per week, offered MoPA for the children at least every other day to a higher extent (37%) compared to colleagues who reported personal PA once or twice a week (26%) or colleagues who reported that they were never or seldom active (18%) (<italic>p</italic>&#x2009;=&#x2009;0.034). The results from multiple logistic regression analysis showed that reported implemented MoPA among children in ECEC was significantly associated with the educators&#x2019; perceptions that free play improved children&#x2019;s gross motor skills (OR 2.7), the educators&#x2019; perceptions of needed curricular guidelines for MoPA (OR 2.1), the educators&#x2019; own leisure PA level (OR 2.0) and the educators&#x2019; perceptions that adequate gross motor skills were not learned at home (OR 0.4). Teacher-led MoPA occurs sparingly during the preschool day and the teachers believe that the children get sufficient MoPA in free play. The children are expected to develop their motor skills to a sufficient extent during the short moments of offered outdoor play. Teachers who are physically active in their leisure-time seem to offer gross motor training for the children to a higher extent than less active or inactive colleagues.</p>
</abstract>
<kwd-group>
<kwd>early childhood</kwd>
<kwd>motor skills</kwd>
<kwd>motor development</kwd>
<kwd>physical activity</kwd>
<kwd>teacher led activity</kwd>
<kwd>free play</kwd>
</kwd-group>
<counts>
<fig-count count="0"/>
<table-count count="4"/>
<equation-count count="0"/>
<ref-count count="61"/>
<page-count count="9"/>
<word-count count="7652"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Educational Psychology</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec1">
<label>1.</label>
<title>Introduction</title>
<p>The 21st century has seen steady growth in early childhood education and care (ECEC) to support parents with young children&#x2019;s education and care (<xref ref-type="bibr" rid="ref14">Cohen and Korintus, 2017</xref>), and ECEC is the first step into the formal education system (<xref ref-type="bibr" rid="ref6">Brostr&#x00F6;m et al., 2018</xref>). In 2021, 86% of children of preschool age (1&#x2013;5 years) in Sweden participated in ECEC. On average, children spent 31&#x2009;h a week in ECEC (<xref ref-type="bibr" rid="ref41">Skolverket, 2021</xref>).</p>
<p>As most children spend a large proportion of their waking hours in ECEC, the educators are important for promoting, teaching, and modeling children&#x2019;s physical activity (PA) (<xref ref-type="bibr" rid="ref29">Mavilidi et al., 2021</xref>), which in turn is important for children&#x2019;s motor development and to ensure they have the daily recommended PA. Early childhood development lays the foundation for a lifetime&#x2019;s mental and physical health, education, labor market productivity, and well-being (<xref ref-type="bibr" rid="ref40">Shonkoff, 2014</xref>; <xref ref-type="bibr" rid="ref37">Richter et al., 2020</xref>). PA offers significant physical health benefits in children, and prevents chronic diseases such as cardiovascular disease, diabetes, or osteoporosis later in life (<xref ref-type="bibr" rid="ref11">Carson et al., 2017</xref>). Moreover, there seems to be a significant association between PA and cognitive and academic performance in children. PA improve physical self-perceptions and enhance self-esteem, which seem to be mechanisms that affect cognitive and mental health in children (<xref ref-type="bibr" rid="ref27">Lubans et al., 2016</xref>). Activities with physical exertion (high intensity) seem to have the strongest effects on cognition, specifically on executive functions (<xref ref-type="bibr" rid="ref56">Vorkapic et al., 2021</xref>).</p>
<p>Participation in PA among children under the age of five has declined globally in recent years, while childhood obesity is, worryingly, increasing (<xref ref-type="bibr" rid="ref60">World Health Organization, 2019</xref>). The WHO recommends at least 180&#x2009;min of PA per day at any intensity level, including at least 60&#x2009;min of moderate-to-vigorous physical activity (MVPA), and reduced time sitting for children under the age of 5&#x2009;years (<xref ref-type="bibr" rid="ref60">World Health Organization, 2019</xref>). ECEC is regulated by governing documents for example in law and curriculum. The responsibility to organize pedagogical activities to promote the principles stated in the curriculum lies with the educators, yet specific pedagogical methods are not identified in the curriculum (<xref ref-type="bibr" rid="ref18">Einarsdottir et al., 2015</xref>). MoPA was found to have a low priority, to varying degrees, in the ECEC policies enacted by Nordic countries, and the guidance provided to educators and stakeholders therein was inexplicit (<xref ref-type="bibr" rid="ref47">Sollerhed et al., 2021</xref>), which may mean that educators do not implement MoPA for young children in ECEC.</p>
<p>Fundamental Movement Skills (FMS), defined as basic learned movement patterns, which include gross motor skills such as stability, locomotor skills, and object control (<xref ref-type="bibr" rid="ref2">Barnett Lai et al., 2016</xref>), are vital for motor development in children (<xref ref-type="bibr" rid="ref17">Eddy et al., 2019</xref>). The FMS can be regarded as building blocks for movement and are essential for learning more complex skills (<xref ref-type="bibr" rid="ref12">Clark and Metcalf, 2002</xref>), which in turn may lead to higher PA levels (<xref ref-type="bibr" rid="ref21">Hardy et al., 2010a</xref>; <xref ref-type="bibr" rid="ref26">Lubans et al., 2010</xref>), especially in MVPA (<xref ref-type="bibr" rid="ref59">Williams et al., 2008</xref>).</p>
<p>Various types of teachers&#x2019; strategies and qualifications to handle MoPA have been identified in studies as well as MoPA-related outcomes among children (<xref ref-type="bibr" rid="ref28">Mak et al., 2021</xref>). Teacher training in MoPA practice is essential to deliver adequate MoPA for children in ECEC (<xref ref-type="bibr" rid="ref54">Vanderloo et al., 2014</xref>; <xref ref-type="bibr" rid="ref29">Mavilidi et al., 2021</xref>). The ECEC educators meet children who are in a period of rapid brain development, growth, and motor development (<xref ref-type="bibr" rid="ref40">Shonkoff, 2014</xref>), a period when also healthy behaviors are established (<xref ref-type="bibr" rid="ref57">Ward et al., 2010</xref>). ECEC educators are agents who create conditions for children&#x2019;s learning in preschool practice (<xref ref-type="bibr" rid="ref16">Dalli et al., 2012</xref>). This includes the teaching of adequate MoPA, which is essential for MVPA levels (<xref ref-type="bibr" rid="ref2">Barnett Lai et al., 2016</xref>). Adequate teacher led programs have been shown to have the potential to improve motor skills in young children (<xref ref-type="bibr" rid="ref1">Adams et al., 2009</xref>; <xref ref-type="bibr" rid="ref22">Hardy et al., 2010b</xref>; <xref ref-type="bibr" rid="ref53">Van Cauwenberghe et al., 2013</xref>). An adequate education in teaching MoPA is important. Teacher training could positively influence perceptions and attitudes to increase the professional educator&#x2019;s perceived competence when implementing PE in ECEC (<xref ref-type="bibr" rid="ref43">Soini et al., 2021</xref>).</p>
<p>Parents often think that children are highly active in preschool, and thus offer few opportunities for MoPA at home (<xref ref-type="bibr" rid="ref34">Pate et al., 2008</xref>), but children were observed to be physically inactive during most of their time in ECEC, and physically active in MVPA only 2&#x2013;3% of the time (<xref ref-type="bibr" rid="ref34">Pate et al., 2008</xref>; <xref ref-type="bibr" rid="ref42">Soini et al., 2014</xref>). Sedentary time has been shown to be high in ECEC (<xref ref-type="bibr" rid="ref36">Reilly, 2010</xref>). Another study showed that mean MVPA in preschool children was about 16&#x2009;min per day. It takes at least twice that amount to achieve the positive effects of bone mineralization (<xref ref-type="bibr" rid="ref35">Raustorp et al., 2012</xref>).</p>
<p>The social and physical environment in ECEC has an important influence on children&#x2019;s MoPA (<xref ref-type="bibr" rid="ref7">Brown et al., 2009a</xref>). The educators are role models, and they need adequate competence in MoPA to provide opportunities for children to learn motor skills. Children&#x2019;s motor skills have been shown to lead to better immediate and long-term health and education outcomes (<xref ref-type="bibr" rid="ref40">Shonkoff, 2014</xref>). The educators&#x2019; behavior and attitudes are the least studied correlates when it comes to correlates of children&#x2019;s MoPA and/or sedentary behavior in ECEC (<xref ref-type="bibr" rid="ref51">Tonge et al., 2016</xref>).</p>
<p>Therefore, the aim of this study was to explore ECEC educators&#x2019; reported frequency of implemented gross motor and physical activities (MoPA) among children in ECEC during the preschool day, their opinions about learning situations for motor skills in ECEC, as well as the educators&#x2019; reported personal PA levels in leisure time. Additional aims were to explore the educators&#x2019; perceived competence level to teach MoPA and how they perceived the occurrence of guidelines for MoPA in the policy documents for ECEC.</p>
</sec>
<sec sec-type="methods|materials" id="sec2">
<label>2.</label>
<title>Methods and materials</title>
<sec id="sec3">
<label>2.1.</label>
<title>Participants</title>
<p>The study took place in 68 preschools in southern Sweden. The sample represented preschools from the countryside and mid-size municipalities. The preschool units consisted of both mixed and single age groups. On average, teacher-child ratios were 1:5 with ranges of 1:3 to 1:8. Three hundred fifty-nine in-service ECEC educators completed the self-report questionnaire (response rate 61%). The participants (aged 20&#x2013;65&#x2009;years old) worked as educators in ECEC and were either preschool teachers or day-care attendants. About half of all ECEC employees in Sweden are preschool teachers that have 3.5&#x2009;years of university training and the other half are day-care attendants who have upper-secondary qualifications (<xref ref-type="bibr" rid="ref38">Sandberg and Ottosson, 2010</xref>).</p>
</sec>
<sec id="sec4">
<label>2.2.</label>
<title>The survey</title>
<p>A questionnaire was distributed to individual ECEC educators to obtain statistically useful information about their experiences and perceptions about MoPA. A literature search did not show any previous studies related to MoPA in ECEC in Sweden and therefore the questions of the current questionnaire were developed by the research group specifically for the aim of this study. The questions in the questionnaire were developed from the perspective of content in the curriculum for ECEC, completed with questions about PA behavior that have been used in other studies (<xref ref-type="bibr" rid="ref44">Sollerhed, 2006</xref>). The questionnaire was piloted with 47 preservice teachers in ECTE outside the study before it was used in the actual survey. The questionnaire consisted of either multiple-choice questions or Likert scale questions. The questions were distributed in three parts: (1) Participants&#x2019; background information; (2) Participants&#x2019; experiences and perceptions of their own PA behavior; (3) Participants&#x2019; experiences and perceptions of MoPA in ECEC. Participants were asked to evaluate their experiences and perceptions of different activities and aspects in ECEC on a scale from 1&#x2009;=&#x2009;completely disagree to 4&#x2009;=&#x2009;completely agree. The teachers&#x2019; perception of children&#x2019;s MoPA at home was also investigated in a similar Likert scale question. The data collection was performed at each preschool and the participants filled in the survey on paper individually in connection to their working day.</p>
</sec>
<sec id="sec5">
<label>2.3.</label>
<title>Statistical analysis</title>
<p>SPSS Statistics version 28 software was used to carry out both descriptive and analytical statistics. Data were first analyzed using descriptive statistics with frequencies and percentages. Secondly, Chi-square tests were used to investigate any associations between the frequency of implemented gross motor teaching in the preschools and the independent variables of educators&#x2019; personal MVPA, perceived education level in MoPA, perceived competence to teach MoPA, perceptions of children&#x2019;s learned motor skills at home, at preschool and in free play, perceptions of the actual curriculum, wish for guidelines for MoPA, and enjoyment of teaching MoPA.</p>
<p>Finally, multiple logistic regression analysis was conducted to examine any association between the described independent variables and the likelihood of reported implemented gross motor teaching among children in the preschool. The rationale for using a logistic regression analysis is that it allows us to see the effects of variables after adjusting for other variables. This helps us to see and verify if the associations seen in the bivariate analysis are due to the influence of other variables. The method &#x201C;enter&#x201D; was used in the logistic regression analysis, which is a procedure for variable selection in which all independent variables are entered in a single step. The assumption of absence of multicollinearity was examined among the variables by calculating variance inflation factors (<xref ref-type="bibr" rid="ref31">Menard, 2010</xref>). The responses in dependent and independent variables were collapsed and dichotomized before the multiple logistic regression analyses. The coding and dichotomizing of response options are shown in <xref rid="tab1" ref-type="table">Table 1</xref>. The significance level was set at <italic>p</italic>&#x2009;&#x003C;&#x2009;0.05.</p>
<table-wrap position="float" id="tab1">
<label>Table 1</label>
<caption>
<p>Dichotomized variables included in the logistic regression with reported frequency of implemented gross motor skills training as the dependent variable.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top">Item</th>
<th align="left" valign="top">Response options</th>
<th align="left" valign="top">Dichotomization</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Reported personal PA<break/>&#x201C;How often do you exercise in your free time for at least half an hour so that you become short of breath and sweaty?&#x201D;</td>
<td align="left" valign="top">7 categories<break/>Never (1) &#x2192;&#x2009;&#x003E;&#x2009;4 times/week (7)</td>
<td align="left" valign="top">PA &#x2265;3 times/week (6&#x2013;7)<break/>PA 2 times or less/week (1&#x2013;5)</td>
</tr>
<tr>
<td align="left" valign="top">Adequate MoPA in free play<break/>&#x201C;Children learn adequate gross motor skills in free play.&#x201D;</td>
<td align="left" valign="top">4 categories<break/>Totally agree (1)&#x2009;&#x2192;&#x2009;Totally disagree (4)</td>
<td align="left" valign="top">Totally agree (1)<break/>Disagree to some extent or totally disagree (2&#x2013;4)</td>
</tr>
<tr>
<td align="left" valign="top">Adequate MoPA at home<break/>&#x201C;Children learn adequate gross motor skills at home.&#x201D;</td>
<td align="left" valign="top">4 categories<break/>Totally agree (1)&#x2009;&#x2192;&#x2009;Totally disagree (4)</td>
<td align="left" valign="top">Totally agree (1)<break/>Disagree to some extent or totally disagree (2&#x2013;4)</td>
</tr>
<tr>
<td align="left" valign="top">Adequate MoPA learning in ECEC<break/>&#x201C;Children learn adequate motor skills through organized teaching in preschool.&#x201D;</td>
<td align="left" valign="top">4 categories<break/>Totally agree (1)&#x2009;&#x2192;&#x2009;Totally disagree (4)</td>
<td align="left" valign="top">Totally agree (1)<break/>Disagree to some extent or totally disagree (2&#x2013;4)</td>
</tr>
<tr>
<td align="left" valign="top">Curriculum supportive for MoPA<break/>&#x201C;The curriculum provides sufficient support for gross motor training in preschool.&#x201D;</td>
<td align="left" valign="top">4 categories<break/>Totally agree (1)&#x2009;&#x2192;&#x2009;Totally disagree (4)</td>
<td align="left" valign="top">Totally agree (1)<break/>Disagree to some extent or totally disagree (2&#x2013;4)</td>
</tr>
<tr>
<td align="left" valign="top">Adequate competence for MoPA teaching<break/>&#x201C;I have adequate competence to lead and teach gross motor skills training.&#x201D;</td>
<td align="left" valign="top">4 categories<break/>Totally agree (1)&#x2009;&#x2192;&#x2009;Totally disagree (4)</td>
<td align="left" valign="top">Totally agree (1)<break/>Disagree to some extent or totally disagree (2&#x2013;4)</td>
</tr>
<tr>
<td align="left" valign="top">Adequate education for MoPA teaching<break/>&#x201C;I have an adequate education for work with gross motor skills teaching.&#x201D;</td>
<td align="left" valign="top">4 categories<break/>Totally agree (1)&#x2009;&#x2192;&#x2009;Totally disagree (4)</td>
<td align="left" valign="top">Totally agree (1)<break/>Disagree to some extent or totally disagree (2&#x2013;4)</td>
</tr>
<tr>
<td align="left" valign="top">Guidelines for MoPA in ECEC<break/>&#x201C;I am positive towards guidelines for adequate gross motor training for children in preschool.&#x201D;</td>
<td align="left" valign="top">4 categories<break/>Totally agree (1)&#x2009;&#x2192;&#x2009;Totally disagree (4)</td>
<td align="left" valign="top">Totally agree (1)<break/>Disagree to some extent or totally disagree (2&#x2013;4)</td>
</tr>
<tr>
<td align="left" valign="top">Enjoy teaching MoPA<break/>&#x201C;I enjoy and find pleasure in teaching children gross motor skills.&#x201D;</td>
<td align="left" valign="top">4 categories<break/>Totally agree (1)&#x2009;&#x2192;&#x2009;Totally disagree (4)</td>
<td align="left" valign="top">Totally agree (1)<break/>Disagree to some extent or totally disagree (2&#x2013;4)</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="sec6">
<label>2.4.</label>
<title>Ethical consideration</title>
<p>The study was conducted following the ethical principles for research involving human subjects, and all procedures were in accordance with the Declaration of Helsinki and the Swedish law on research ethics (SFS:2003:460). Ethical review application was approved by the Regional Ethical Review Committee in Lund (Dnr:2017/555). The participants were informed about the study, their voluntary status, and confidentiality, and informed written consent was obtained from all participants.</p>
</sec>
</sec>
<sec sec-type="results" id="sec7">
<label>3.</label>
<title>Results</title>
<p>As shown in <xref rid="tab2" ref-type="table">Table 2</xref>, about one quarter of the educators reported that they offered gross motor skills training for the children every other day or every day, while about two thirds of the educators reported that they offered gross motor training once a week or more seldom. About a fifth of the educators reported that they offered MVPA every other day or every day, while four fifths reported MVPA once a week or more seldom. The reported personal level of MVPA differed between the educators. About 30 percent of the educators reported MVPA very seldom or never, while about 40 percent reported regular MVPA once or twice a week and about 30 percent reported MVPA three or more times a week (<xref rid="tab2" ref-type="table">Table 2</xref>).</p>
<table-wrap position="float" id="tab2">
<label>Table 2</label>
<caption>
<p>Distribution of ECEC educators&#x2019; answers to questions and statements in the questionnaire.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top">Item</th>
<th align="left" valign="top">Options</th>
<th align="center" valign="top">Frequency <italic>n</italic> (%)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Planned gross motor training<break/>&#x201C;How often does planned teacher led gross motor training occur in your preschool?&#x201D;</td>
<td align="left" valign="top">Every day<break/>Every other day<break/>Once a week<break/>More seldom than once a week</td>
<td align="center" valign="top">57 (16.9)<break/>37 (10.9)<break/>185 (54.7)<break/>59 (17.5)</td>
</tr>
<tr>
<td align="left" valign="top">Planned MVPA<break/>&#x201C;How often does planned MVPA occur in your preschool?&#x201D;</td>
<td align="left" valign="top">Every day<break/>Every other day<break/>Once a week<break/>More seldom than once a week</td>
<td align="center" valign="top">39 (11.7)<break/>30 (9.0)<break/>160 (48.2)<break/>100 (30.1)</td>
</tr>
<tr>
<td align="left" valign="top">Spent time outdoor<break/>&#x201C;How often do the children spend time outdoors?&#x201D;</td>
<td align="left" valign="top">Every day<break/>Every other day<break/>Once a week<break/>More seldom than once a week</td>
<td align="center" valign="top">346 (98.9)<break/>2 (0.6)<break/>2 (0.6)<break/>-</td>
</tr>
<tr>
<td align="left" valign="top">Walking a little longer distance<break/>&#x201C;How often does the group of children walk a longer distance?&#x201D;</td>
<td align="left" valign="top">Every day<break/>Every other day<break/>Once a week<break/>More seldom than once a week</td>
<td align="center" valign="top">11 (3.2)<break/>38 (11.1)<break/>202 (59.2)<break/>90 (26.5)</td>
</tr>
<tr>
<td align="left" valign="top">Categories of staff members<break/>&#x201C;What is your highest education?&#x201D;</td>
<td align="left" valign="top">Day-care attendant<break/>Preschool teacher<break/>Other</td>
<td align="center" valign="top">107 (30.2)<break/>206 (58.2)<break/>41 (11.6)</td>
</tr>
<tr>
<td align="left" valign="top">Reported personal PA<break/>&#x201C;How often do you exercise in your free time for at least half an hour so that you become short of breath and sweaty?&#x201D;</td>
<td align="left" valign="top">Never<break/>A few times a year<break/>A few times a month<break/>Regularly once a week<break/>Regularly twice a week<break/>Regularly three times a week<break/>Regularly four times or more a week</td>
<td align="center" valign="top">10 (2.8)<break/>23 (6.4)<break/>66 (18.6)<break/>59 (16.5)<break/>84 (23.5)<break/>71 (19.9)<break/>44 (12.3)</td>
</tr>
<tr>
<td align="left" valign="top">Adequate MoPA in free play<break/>&#x201C;Children learn adequate gross motor skills in free play.&#x201D;</td>
<td align="left" valign="top">Totally agree<break/>Partially agree<break/>Partially disagree<break/>Totally disagree</td>
<td align="center" valign="top">218 (62.3)<break/>128 (36.6)<break/>2 (0.6)<break/>2 (0.6)</td>
</tr>
<tr>
<td align="left" valign="top">Adequate MoPA at home<break/>&#x201C;Children learn adequate gross motor skills at home.&#x201D;</td>
<td align="left" valign="top">Totally agree<break/>Partially agree<break/>Partially disagree<break/>Totally disagree</td>
<td align="center" valign="top">58 (17.7)<break/>214 (65.2)<break/>52 (15.9)<break/>4 (1.2)</td>
</tr>
<tr>
<td align="left" valign="top">Adequate MoPA learning in ECEC<break/>&#x201C;Children learn adequate motor skills through organized teaching in preschool.&#x201D;</td>
<td align="left" valign="top">Totally agree<break/>Partially agree<break/>Partially disagree<break/>Totally disagree</td>
<td align="center" valign="top">214 (61.3)<break/>127 (36.4)<break/>7 (2.0)<break/>1 (0.3)</td>
</tr>
<tr>
<td align="left" valign="top">Curriculum supportive for MoPA<break/>&#x201C;The curriculum provides sufficient support for gross motor training in preschool.&#x201D;</td>
<td align="left" valign="top">Totally agree<break/>Partially agree<break/>Partially disagree<break/>Totally disagree</td>
<td align="center" valign="top">99 (29.5)<break/>176 (52.4)<break/>51 (15.2)<break/>10 (3.0)</td>
</tr>
<tr>
<td align="left" valign="top">Adequate competence for MoPA teaching<break/>&#x201C;I have adequate competence to lead and teach gross motor skills training.&#x201D;</td>
<td align="left" valign="top">Totally agree<break/>Partially agree<break/>Partially disagree<break/>Totally disagree</td>
<td align="center" valign="top">223 (64.1)<break/>118 (33.9)<break/>6 (1.7)<break/>1 (0.3)</td>
</tr>
<tr>
<td align="left" valign="top">Adequate education for MoPA teaching<break/>&#x201C;I have an adequate education for work with gross motor skills teaching.&#x201D;</td>
<td align="left" valign="top">Totally agree<break/>Partially agree<break/>Partially disagree<break/>Totally disagree</td>
<td align="center" valign="top">90 (28.7)<break/>135 (43.0)<break/>72 (22.9)<break/>17 (5.4)</td>
</tr>
<tr>
<td align="left" valign="top">Guidelines for MoPA in ECEC<break/>&#x201C;I am positive towards guidelines for adequate gross motor training for children in preschool.&#x201D;</td>
<td align="left" valign="top">Totally agree<break/>Partially agree<break/>Partially disagree<break/>Totally disagree</td>
<td align="center" valign="top">189 (54.8)<break/>133 (38.6)<break/>19 (5.5)<break/>4 (1.2)</td>
</tr>
</tbody>
</table>
</table-wrap>
<p>The results of the bivariate analyses between reported implemented gross motor training in preschool and different variables are shown in <xref rid="tab3" ref-type="table">Table 3</xref>. The results showed significant associations between the educators&#x2019; reported personal MVPA in leisure time and the reported frequency of allocated gross motor training for the children in the preschool. The educators who reported MVPA three times or more per week, reported that they offered gross motor training for the children at least every other day to a higher extent (37%) compared to colleagues who reported personal MVPA once or twice a week (26%) or colleagues who reported they were never or seldom active (18%) (<italic>p</italic>&#x2009;=&#x2009;0.034). There was also a significant association between the educators&#x2019; opinion that children learn sufficient gross motor skills in free play and the reported frequency of allocated gross motor training (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.001) (<xref rid="tab3" ref-type="table">Table 3</xref>).</p>
<table-wrap position="float" id="tab3">
<label>Table 3</label>
<caption>
<p>Relationship between ECEC educators&#x2019; reported frequency of gross motor training in ECEC and reported personal PA, and opinions about MoPA.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th/>
<th align="center" valign="top">Gross motor training every day</th>
<th align="center" valign="top">Gross motor training every other day</th>
<th align="center" valign="top">Gross motor training once a week or more seldom</th>
<th align="center" valign="top"><italic>P</italic>-value&#x002A;</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top" colspan="5">Reported personal PA (%)</td>
</tr>
<tr>
<td align="left" valign="top">3 times or more/week</td>
<td align="center" valign="top">20.4</td>
<td align="center" valign="top">16.8</td>
<td align="center" valign="top">62.8</td>
<td align="center" valign="top"><bold>0.034</bold></td>
</tr>
<tr>
<td align="left" valign="top">1&#x2013;2 times/week</td>
<td align="center" valign="top">16.8</td>
<td align="center" valign="top">9.5</td>
<td align="center" valign="top">73.7</td>
<td/>
</tr>
<tr>
<td align="left" valign="top">Seldom or never</td>
<td align="center" valign="top">12.5</td>
<td align="center" valign="top">5.7</td>
<td align="center" valign="top">81.8</td>
<td/>
</tr>
<tr>
<td align="left" valign="top" colspan="5">Adequate MoPA in free play (%)</td>
</tr>
<tr>
<td align="left" valign="top">Agree</td>
<td align="center" valign="top">22.3</td>
<td align="center" valign="top">11.0</td>
<td align="center" valign="top">66.7</td>
<td align="center" valign="top"><bold>&#x003C;0.001</bold></td>
</tr>
<tr>
<td align="left" valign="top">Disagree</td>
<td align="center" valign="top">5.5</td>
<td align="center" valign="top">11.2</td>
<td align="center" valign="top">80.3</td>
<td/>
</tr>
<tr>
<td align="left" valign="top" colspan="5">Adequate MoPA at home (%)</td>
</tr>
<tr>
<td align="left" valign="top">Agree</td>
<td align="center" valign="top">14.0</td>
<td align="center" valign="top">7.0</td>
<td align="center" valign="top">78.9</td>
<td align="center" valign="top">0.597</td>
</tr>
<tr>
<td align="left" valign="top">Disagree</td>
<td align="center" valign="top">15.2</td>
<td align="center" valign="top">11.3</td>
<td align="center" valign="top">73.5</td>
<td/>
</tr>
<tr>
<td align="left" valign="top" colspan="5">Adequate MoPA learning in ECEC (%)</td>
</tr>
<tr>
<td align="left" valign="top">Agree</td>
<td align="center" valign="top">18.0</td>
<td align="center" valign="top">12.2</td>
<td align="center" valign="top">69.8</td>
<td align="center" valign="top">0.241</td>
</tr>
<tr>
<td align="left" valign="top">Disagree</td>
<td align="center" valign="top">12.5</td>
<td align="center" valign="top">9.4</td>
<td align="center" valign="top">78.1</td>
<td/>
</tr>
<tr>
<td align="left" valign="top" colspan="5">Adequate competence for MoPA teaching (%)</td>
</tr>
<tr>
<td align="left" valign="top">Agree</td>
<td align="center" valign="top">20.1</td>
<td align="center" valign="top">11.0</td>
<td align="center" valign="top">68.9</td>
<td align="center" valign="top">0.061</td>
</tr>
<tr>
<td align="left" valign="top">Disagree</td>
<td align="center" valign="top">10.4</td>
<td align="center" valign="top">9.6</td>
<td align="center" valign="top">80.0</td>
<td/>
</tr>
<tr>
<td align="left" valign="top" colspan="5">Adequate education for MoPA teaching (%)</td>
</tr>
<tr>
<td align="left" valign="top">Agree</td>
<td align="center" valign="top">18.0</td>
<td align="center" valign="top">11.2</td>
<td align="center" valign="top">70.8</td>
<td align="center" valign="top">0.721</td>
</tr>
<tr>
<td align="left" valign="top">Disagree</td>
<td align="center" valign="top">15.0</td>
<td align="center" valign="top">9.8</td>
<td align="center" valign="top">75.2</td>
<td/>
</tr>
<tr>
<td align="left" valign="top" colspan="5">Guidelines for MoPA in ECEC (%)</td>
</tr>
<tr>
<td align="left" valign="top">Agree</td>
<td align="center" valign="top">17.6</td>
<td align="center" valign="top">12.2</td>
<td align="center" valign="top">70.2</td>
<td align="center" valign="top">0.241</td>
</tr>
<tr>
<td align="left" valign="top">Disagree</td>
<td align="center" valign="top">14.2</td>
<td align="center" valign="top">8.8</td>
<td align="center" valign="top">77.0</td>
<td/>
</tr>
<tr>
<td align="left" valign="top" colspan="5">Enjoy teaching MoPA (%)</td>
</tr>
<tr>
<td align="left" valign="top">Agree</td>
<td align="center" valign="top">18.9</td>
<td align="center" valign="top">12.4</td>
<td align="center" valign="top">68.7</td>
<td align="center" valign="top">0.068</td>
</tr>
<tr>
<td align="left" valign="top">Disagree</td>
<td align="center" valign="top">12.2</td>
<td align="center" valign="top">6.8</td>
<td align="center" valign="top">81.0</td>
<td/>
</tr>
</tbody>
</table>
<table-wrap-foot>
<p><sup>&#x002A;</sup>Chi-square test. <italic>P</italic>-value in bold when significant.</p>
</table-wrap-foot>
</table-wrap>
<p>The results from the multiple logistic regression analysis showed that reported implemented gross motor training among children in the preschool was significantly associated with the educators&#x2019; perception that free play improved children&#x2019;s gross motor skills adequately (OR 2.7; CI 1.3&#x2013;5.5), the educators&#x2019; perceptions of needed guidelines for MoPA in the ECEC curriculum (OR 2.1; CI 1.1&#x2013;4.1), the educators&#x2019; reported personal leisure PA level (OR 2.0; CI 1.9&#x2013;3.8) and the educators&#x2019; perception that adequate gross motor skills were not learned at home (OR 0.4; CI 0.2&#x2013;0.9) (<xref rid="tab4" ref-type="table">Table 4</xref>).</p>
<table-wrap position="float" id="tab4">
<label>Table 4</label>
<caption>
<p>Variables associated with the educators&#x2019; reported gross motor teaching in a multiple logistic regression analysis (<italic>n</italic>&#x2009;=&#x2009;348&#x2013;359).</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top">Variable</th>
<th align="center" valign="top">
<italic>B</italic>
</th>
<th align="center" valign="top">SE</th>
<th align="center" valign="top">&#x03C7;<sup>2</sup></th>
<th align="center" valign="top">
<italic>P&#x002A;</italic>
</th>
<th align="center" valign="top">OR</th>
<th align="center" valign="top">95% CI</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Reported personal PA</td>
<td align="center" valign="top">0.709</td>
<td align="center" valign="top">0.318</td>
<td align="center" valign="top">4.958</td>
<td align="center" valign="top">
<bold>0.026</bold>
</td>
<td align="center" valign="top">2.03</td>
<td align="center" valign="top">1.089&#x2013;3.794</td>
</tr>
<tr>
<td align="left" valign="top">Adequate MoPA in free play</td>
<td align="center" valign="top">0.990</td>
<td align="center" valign="top">0.368</td>
<td align="center" valign="top">7.226</td>
<td align="center" valign="top">
<bold>0.007</bold>
</td>
<td align="center" valign="top">2.693</td>
<td align="center" valign="top">1.308&#x2013;5.544</td>
</tr>
<tr>
<td align="left" valign="top">Adequate MoPA at home</td>
<td align="center" valign="top">&#x2212;0.918</td>
<td align="center" valign="top">0.425</td>
<td align="center" valign="top">4.660</td>
<td align="center" valign="top">
<bold>0.031</bold>
</td>
<td align="center" valign="top">0.399</td>
<td align="center" valign="top">0.174&#x2013;0.919</td>
</tr>
<tr>
<td align="left" valign="top">Adequate MoPA learning in ECEC</td>
<td align="center" valign="top">0.396</td>
<td align="center" valign="top">0.342</td>
<td align="center" valign="top">1.339</td>
<td align="center" valign="top">0.247</td>
<td align="center" valign="top">1.486</td>
<td align="center" valign="top">0.760&#x2013;2.905</td>
</tr>
<tr>
<td align="left" valign="top">Curriculum supportive for MoPA</td>
<td align="center" valign="top">&#x2212;0.228</td>
<td align="center" valign="top">0.359</td>
<td align="center" valign="top">0.403</td>
<td align="center" valign="top">0.525</td>
<td align="center" valign="top">0.796</td>
<td align="center" valign="top">0.394&#x2013;1.608</td>
</tr>
<tr>
<td align="left" valign="top">Adequate competence for MoPA teaching</td>
<td align="center" valign="top">0.240</td>
<td align="center" valign="top">0.384</td>
<td align="center" valign="top">0.391</td>
<td align="center" valign="top">0.532</td>
<td align="center" valign="top">1.272</td>
<td align="center" valign="top">0.599&#x2013;2.700</td>
</tr>
<tr>
<td align="left" valign="top">Adequate education for MoPA teaching</td>
<td align="center" valign="top">&#x2212;0.017</td>
<td align="center" valign="top">0.350</td>
<td align="center" valign="top">0.002</td>
<td align="center" valign="top">0.962</td>
<td align="center" valign="top">0.983</td>
<td align="center" valign="top">0.496&#x2013;1.951</td>
</tr>
<tr>
<td align="left" valign="top">Guidelines for MoPA in ECEC</td>
<td align="center" valign="top">0.730</td>
<td align="center" valign="top">0.346</td>
<td align="center" valign="top">4.444</td>
<td align="center" valign="top">
<bold>0.035</bold>
</td>
<td align="center" valign="top">2.075</td>
<td align="center" valign="top">1.053&#x2013;4.091</td>
</tr>
<tr>
<td align="left" valign="top">Enjoy teaching MoPA</td>
<td align="center" valign="top">0.032</td>
<td align="center" valign="top">0.398</td>
<td align="center" valign="top">0.007</td>
<td align="center" valign="top">0.935</td>
<td align="center" valign="top">1.003</td>
<td align="center" valign="top">0.474&#x2013;2.252</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<p>&#x002A;<italic>P</italic>-value in bold when significant. <italic>&#x03C7;</italic><sup>2</sup>(8)&#x2009;=&#x2009;273.24, <italic>p</italic> &#x003C;&#x2009;0.001, Hosmer&#x2013;Lemeshow, <italic>p</italic> =&#x2009;0.414, Nagelkerke <italic>R</italic><sup>2</sup> =&#x2009;0.125. Variance Inflation Factors (VIFs) were calculated to detect the presence of multicollinearity between independent variables. All independent variables in the regression model have VIFs of 1.01&#x2013;1.06.</p>
</table-wrap-foot>
</table-wrap>
</sec>
<sec sec-type="discussions" id="sec8">
<label>4.</label>
<title>Discussion</title>
<p>The findings of our study among 359 ECEC educators, revealed that about two thirds of them reported that they offered organized MoPA sessions once a week or more seldom, while less than one fifth of the educators offered MoPA daily for the children. The question is why few occasions are offered in general. The answer seems to be multifactorial and complex. Other studies have shown different explanations for barriers to incorporating MoPA in ECEC. One explanation was shown to be the desire for educators to favor work for academic schooling over MoPA training (<xref ref-type="bibr" rid="ref36">Reilly, 2010</xref>). Another explanation could be the educators&#x2019; lack of competence to teach MoPA. It has been shown in other studies that it could be due to the educators&#x2019; personal attitudes and self-efficacy in MoPA-related issues (<xref ref-type="bibr" rid="ref33">Parks et al., 2007</xref>; <xref ref-type="bibr" rid="ref15">Copeland et al., 2012</xref>; <xref ref-type="bibr" rid="ref58">Webster et al., 2015</xref>), as well as insufficient pedagogical content knowledge to teach MoPA, fear of injury and their own low fitness levels (<xref ref-type="bibr" rid="ref46">Sollerhed, 2023</xref>). Educators&#x2019; insufficient understanding of the value and benefits of MoPA, which contribute to overall development, including cognitive and academic achievements (<xref ref-type="bibr" rid="ref25">Lu and Montague, 2016</xref>) also affects the implemented MoPA.</p>
<p>The playground and the outdoor environment, including spending time outdoors, are often pointed out as crucial for children&#x2019;s MoPA (<xref ref-type="bibr" rid="ref5">Bower et al., 2008</xref>), especially if the educators are asked about prerequisites for MoPA. The effects of educators&#x2019; underlying attitudes about MoPA and actions are seldom pointed out, especially not by the educators themselves. Individual educators make daily decisions about when and how MoPA should be integrated or denied for children in ECEC. The policy documents regulate ECEC activities and should guide educators in their work. MoPA was shown to be of low priority in the ECEC policies, and the governmental guidance provided to educators and stakeholders therein is inexplicit (<xref ref-type="bibr" rid="ref47">Sollerhed et al., 2021</xref>), which can increase the impact from the educator&#x2019;s attitudes, perceived competence and habitus. The importance of educators&#x2019; behaviors toward children&#x2019;s MoPA, including positive or negative prompts and modeling, has been shown to be vital (<xref ref-type="bibr" rid="ref8">Brown et al., 2009b</xref>).</p>
<p>In our study, it was shown that the educators&#x2019; statements that children learned motor skills sufficiently through free play in ECEC was associated with the reported level of implementation of MoPA. The educators can act either as facilitators for or barriers to children&#x2019;s motor development. This cannot be ignored from a public health perspective. Children spend a significant amount of their waking hours in ECEC, and educators are key players in shaping young children&#x2019;s active behavior, which is important not only for children&#x2019;s actual development but also for lifelong healthy behavior. According to the ECEC educators&#x2019; answers in the questionnaire, the likelihood for reported implemented MoPA at least every other day was almost three times higher when the educators perceived that the children learned motor skills in free play. It can thus be interpreted that the implemented MoPA was usually in the form of free play and not in the form of intentional teacher-led activity. Free play might offer efficient MoPA for the children, but it is not a guarantee. If the children have access to an enriching play area, they might choose to be physically active, and the free play might give the children the possibility to develop motor skills and endurance capacity. On the other hand, children can choose to do sedentary activities instead and exclude MoPA and learning motor skills in the free play period. In short, free play does not guarantee the effects of MoPA and therefore it is important to have adequately led MoPA sessions to ensure that all children get a chance to develop FMS. Besides general motor development, in terms of health, the importance of increased PA for influencing children&#x2019;s (0&#x2013;5&#x2009;years) adiposity, bone density and cardiometabolic factors must be emphasized (<xref ref-type="bibr" rid="ref50">Timmons et al., 2012</xref>).</p>
<p>Several studies have shown that children generally spend less than 50 percent of a free play period in ECEC participating in MoPA (<xref ref-type="bibr" rid="ref55">Verstraete et al., 2006</xref>), especially when the restrictions are comprehensive to exclude any risks. Structured and intentional MoPA sessions have been shown to substantially increase the total amount of children&#x2019;s PA in comparison with the amount in free play (<xref ref-type="bibr" rid="ref19">Frank et al., 2018</xref>), as well as to enhance the FMS (<xref ref-type="bibr" rid="ref2">Barnett Lai et al., 2016</xref>). The reason for the educators&#x2019; strong beliefs that children are highly active in MoPA in free play and their choice to often let the children have free play instead of various teacher-led MoPA is unclear, but is probably related to their perceived insufficient competence to lead and instruct MoPA (<xref ref-type="bibr" rid="ref46">Sollerhed, 2023</xref>), but may also be associated with indolence. In children&#x2019;s free play, the educators often take the position of an inactive supervisor (<xref ref-type="bibr" rid="ref48">Tandon et al., 2018</xref>), which might be perceived as a more convenient task compared to the position as an instructor with the responsibility to teach the children different techniques in MoPA. The educators may use free play perfunctorily and take the easiest way with the least energy-demanding effort for themselves. Adequate educator-led programs have the potential to improve motor skills in young children (<xref ref-type="bibr" rid="ref1">Adams et al., 2009</xref>; <xref ref-type="bibr" rid="ref22">Hardy et al., 2010b</xref>; <xref ref-type="bibr" rid="ref53">Van Cauwenberghe et al., 2013</xref>), which assumes that the educators are more actively participating in the activities and are not just supervising them. Also the intensity of PA among the children heightens during teacher led FMS practice, especially when involving locomotor skills (<xref ref-type="bibr" rid="ref13">Cliff et al., 2009</xref>; <xref ref-type="bibr" rid="ref23">Kain et al., 2018</xref>).</p>
<p>In free play, children are given access to certain areas in the environment with or without restrictions. The educators are the gatekeepers to available play areas and maintainers of restrictions. There is a strong belief that children should be kept as safe as possible, and the increasing focus on safety affects restrictions on children&#x2019;s freedom and possibility to develop motor skills in the play area. Outdoor play may offer great opportunities for children to use natural elements and may involve challenges, heights, and speed, including exploring the environment and taking risks.</p>
<p>As risky play is associated with injury it is highly limited with subsequent limited MoPA training (<xref ref-type="bibr" rid="ref10">Brussoni et al., 2012</xref>, <xref ref-type="bibr" rid="ref9">2015</xref>; <xref ref-type="bibr" rid="ref3">Bento and Dias, 2017</xref>). Risks of injury must be considered in ECEC, but the children&#x2019;s living conditions must not be de-risked to the extent that they do not learn to develop their own risk assessment, which is a normal part of childhood and development (<xref ref-type="bibr" rid="ref61">Wyver et al., 2010</xref>; <xref ref-type="bibr" rid="ref52">Tremblay et al., 2015</xref>). In ECEC, children are under adult supervision most of the time and the adults frequently decide what children are allowed to do and where they are allowed to play (<xref ref-type="bibr" rid="ref24">Kytt&#x00E4;, 2004</xref>). Thus, preschoolers are under the influence of the preferences and fears of the educators. Adult-imposed restrictions on risk-taking in free play and MoPA restrictions are often justified for safety reasons (<xref ref-type="bibr" rid="ref9">Brussoni et al., 2015</xref>), with children being banned from a variety of experiences of MoPA and from accessing forbidden areas (<xref ref-type="bibr" rid="ref49">Thomson, 2014</xref>). The reason behind heightened sensitivity to risk in children&#x2019;s play is a fundamental professional dilemma experienced by practitioners on a day-to-day basis. There is a dilemma in dealing with children&#x2019;s safety; on the one hand, it is important that the children do not suffer acute injuries, but on the other hand, it is important not to prevent the children&#x2019;s participation and exploration in MoPA, which can affect their motor and physical development negatively in the longer term. Thus, daily practice is fraught with conflicting priorities between safety and development imperatives. The educators should be encouraged to allow children to experience risk in their play by evaluating the developmental benefits of risk-taking and by having increased awareness of the value of risk-taking (<xref ref-type="bibr" rid="ref39">Sandseter, 2014</xref>). While the fear of injuries prevents MoPA in general, perceived lack of sufficient pedagogical content knowledge in MoPA prevents intentional MoPA sessions where FMS is trained (<xref ref-type="bibr" rid="ref45">Sollerhed, 2022</xref>).</p>
<p>In our study, a high percentage of the educators were convinced that the children learned adequate motor skills in free play in ECEC, while far fewer were convinced that children learned adequate motor skills at home. As children engage in free play both in the preschool context and at home this seems to be a paradox. The study cannot explain this discrepancy.</p>
<p>An association between the educator&#x2019;s reported personal PA level and the reported frequency of implemented MoPA for the children in ECEC was shown. The educators&#x2019; own interest in PA seems to be an important determinant of the possibility for children&#x2019;s MoPA in ECEC. About one third of the participating educators in our study reported that they were physically active in their leisure time. The likelihood that intentional MoPA would be implemented for the children in ECEC was doubled if the educator reported personal PA in their own leisure time. Educators&#x2019; beliefs and experiences of their own PA could thus be seen as a possible explanation for integrated MoPA among children. It is positive that these physically active educators implement MoPA sessions for the children in ECEC, but on the other hand, it could be questioned if the occurrence of MoPA among children is due to educators&#x2019; personal attitudes. Many teachers value MoPA but lack confidence to teach it. Teachers may believe in the benefits of PA, but would rather teach other subjects (<xref ref-type="bibr" rid="ref30">McBride et al., 2002</xref>; <xref ref-type="bibr" rid="ref32">Morgan and Hansen, 2008</xref>).</p>
<p>Interestingly, educators&#x2019; own experiences and perceptions about PA seem to be determinants for promotion and teaching of MoPA in children in ECEC, despite existing curriculum. The educators&#x2019; actions are not always performed in accordance with the curriculum, which is the governmental guidance provided to educators. Human behavior and actions are not performed in accordance with rules, but are often based on mental states, such as beliefs, attitudes, desires, goals and intentions (<xref ref-type="bibr" rid="ref20">Gibbs, 2001</xref>), and also in habitus and ingrained habits (<xref ref-type="bibr" rid="ref4">Bourdieu, 2017</xref>). MoPA should be legitimized and implemented from the perspective of children&#x2019;s development irrespective of educators&#x2019; own past experiences and habitus for PA. The educators&#x2019; wish for clearer guidelines for MoPA in the curriculum for ECEC was significantly associated with the reported implemented teacher led MoPA. The educators perceived that MoPA was insufficiently and vaguely mentioned in the curriculum, and they wished for more explicit guidance through the curriculum. MoPA was shown to be of low priority in the ECEC curricula (<xref ref-type="bibr" rid="ref47">Sollerhed et al., 2021</xref>), which strengthened the educators&#x2019; reflections.</p>
<p>The strengths of this study are worth mentioning, but also the limits. The study had a relatively large sample size, and the response rate was acceptable. However, a skewness in the positive direction could be noted. The survey may have attracted those educators interested in MoPA while those who felt resistance toward MoPA did not participate to the same level. Despite a sense of being skewed in a positive direction, the results showed that MoPA seems to occur sparingly in ECEC and seems to depend on the teachers&#x2019; benevolence and self-interest. The study was a cross-sectional survey and was unable to establish causality. As a literature search did not show any previous studies related to MoPA in ECEC in Sweden the questions in the questionnaire were developed by the research group, which can be seen as a weakness. The questions were developed on basis of the perspective of the content in the curriculum for ECEC, which could be seen as a strength. The PA was self-reported and not objectively measured, which is another limitation. The questions about reported PA have been used in several studies before and have shown to have acceptable validation. The questionnaire was piloted outside the study before it was used in the actual survey.</p>
</sec>
<sec sec-type="conclusions" id="sec9">
<label>5.</label>
<title>Conclusion</title>
<p>The teacher led MoPA seem to occur sparingly during the preschool day and the educators believe that the children get sufficient PA and develop adequately the gross motor skills in free play. The children are expected to develop their gross motor skills adequately during the short moments of offered outdoor play. Educators who report that they are physically active in PA three times or more per week in their leisure-time seem to offer gross motor training for the children to a higher extent than less active or inactive colleagues. Thus, educators&#x2019; own experiences and perceptions about PA seem to be determinants for promotion and teaching MoPA in ECEC.</p>
</sec>
<sec sec-type="data-availability" id="sec10">
<title>Data availability statement</title>
<p>The raw data supporting the conclusions of this article will be made available by the author upon request.</p>
</sec>
<sec id="sec11">
<title>Ethics statement</title>
<p>The studies involving human participants were reviewed and approved by Regional Ethical Review Committee in Lund (Dnr:2017/555). The participants provided their written informed consent to participate in this study.</p>
</sec>
<sec id="sec12">
<title>Author contributions</title>
<p>A-CS contributed to the design of the study. A-CS contributed to the data collection and interpretation of the data, drafted and revised the manuscript, provided final approval, and agreed to be accountable for all aspects of the work to ensure integrity and accuracy.</p>
</sec>
<sec sec-type="funding-information" id="sec13">
<title>Funding</title>
<p>This research was sponsored by the Gyllenstiernska Krapperup Foundation (KR 2021-0045) and The Research Platform for Collaboration for Learning, Faculty of Teacher Education at Kristianstad University.</p>
</sec>
<sec sec-type="COI-statement" id="sec14">
<title>Conflict of interest</title>
<p>The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="sec100" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
</body>
<back>
<ack>
<p>The author would like to thank the participants for participating in the study, as well as Hanna Hermansson and Emelie H&#x00E5;kansson for their help with the collection of the data. A special thank you to Jan-Eric Ekberg for cooperation.</p>
</ack>
<ref-list>
<title>References</title>
<ref id="ref1">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Adams</surname> <given-names>J.</given-names></name> <name><surname>Zask</surname> <given-names>A.</given-names></name> <name><surname>Dietrich</surname> <given-names>U.</given-names></name></person-group> (<year>2009</year>). <article-title>Tooty fruity vegie in preschools: an obesity prevention intervention in preschools targeting Children's movement skills and eating behaviours</article-title>. <source>Health Promot. J. Austr.</source> <volume>20</volume>, <fpage>112</fpage>&#x2013;<lpage>119</lpage>. doi: <pub-id pub-id-type="doi">10.1071/HE09112</pub-id>, PMID: <pub-id pub-id-type="pmid">19642959</pub-id></citation>
</ref>
<ref id="ref2">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Barnett Lai</surname> <given-names>S. K.</given-names></name> <name><surname>Veldman</surname> <given-names>S. L.</given-names></name> <name><surname>Hardy</surname> <given-names>L. L.</given-names></name> <name><surname>Cliff</surname> <given-names>D. P.</given-names></name> <name><surname>Morgan</surname> <given-names>P. J.</given-names></name> <name><surname>Zask</surname> <given-names>A.</given-names></name> <etal/></person-group>. (<year>2016</year>). <article-title>Correlates of gross motor competence in children and adolescents: a systematic review and meta-analysis</article-title>. <source>Sports Med.</source> <volume>46</volume>, <fpage>1663</fpage>&#x2013;<lpage>1688</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s40279-016-0495-z</pub-id>, PMID: <pub-id pub-id-type="pmid">26894274</pub-id></citation>
</ref>
<ref id="ref3">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bento</surname> <given-names>G.</given-names></name> <name><surname>Dias</surname> <given-names>G.</given-names></name></person-group> (<year>2017</year>). <article-title>The importance of outdoor play for young children's healthy development</article-title>. <source>Porto Biomed. J.</source> <volume>2</volume>, <fpage>157</fpage>&#x2013;<lpage>160</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.pbj.2017.03.003</pub-id>, PMID: <pub-id pub-id-type="pmid">32258612</pub-id></citation>
</ref>
<ref id="ref4">
<citation citation-type="book"><person-group person-group-type="author">
<name><surname>Bourdieu</surname> <given-names>P.</given-names></name>
</person-group> (<year>2017</year>). <source>Habitus: a sense of place</source> <publisher-name>Routledge</publisher-name>. e-Book ISBN 9781315253701</citation>
</ref>
<ref id="ref5">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bower</surname> <given-names>J. K.</given-names></name> <name><surname>Hales</surname> <given-names>D. P.</given-names></name> <name><surname>Tate</surname> <given-names>D. F.</given-names></name> <name><surname>Rubin</surname> <given-names>D. A.</given-names></name> <name><surname>Benjamin</surname> <given-names>S. E.</given-names></name> <name><surname>Ward</surname> <given-names>D. S.</given-names></name></person-group> (<year>2008</year>). <article-title>The childcare environment and children&#x2019;s physical activity</article-title>. <source>Am. J. Prev. Med.</source> <volume>34</volume>, <fpage>23</fpage>&#x2013;<lpage>29</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.amepre.2007.09.022</pub-id></citation>
</ref>
<ref id="ref6">
<citation citation-type="book"><person-group person-group-type="author"><name><surname>Brostr&#x00F6;m</surname> <given-names>S.</given-names></name> <name><surname>Einarsdottir</surname> <given-names>J.</given-names></name> <name><surname>Samuelsson</surname> <given-names>I. P.</given-names></name></person-group> (<year>2018</year>). <source>The Nordic perspective on early childhood education and care</source>. <publisher-loc>Nordrecht, Netherlands (NL)</publisher-loc>: <publisher-name>Springer</publisher-name>.</citation>
</ref>
<ref id="ref7">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Brown</surname> <given-names>W. H.</given-names></name> <name><surname>Googe</surname> <given-names>H. S.</given-names></name> <name><surname>Mciver</surname> <given-names>K. L.</given-names></name> <name><surname>Rathel</surname> <given-names>J. M.</given-names></name></person-group> (<year>2009a</year>). <article-title>Effects of teacher-encouraged physical activity on preschool playgrounds</article-title>. <source>J. Early Interv.</source> <volume>31</volume>, <fpage>126</fpage>&#x2013;<lpage>145</lpage>. doi: <pub-id pub-id-type="doi">10.1177/1053815109331858</pub-id></citation>
</ref>
<ref id="ref8">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Brown</surname> <given-names>W. H.</given-names></name> <name><surname>Pfeiffer</surname> <given-names>K. A.</given-names></name> <name><surname>Mciver</surname> <given-names>K. L.</given-names></name> <name><surname>Dowda</surname> <given-names>M.</given-names></name> <name><surname>Addy</surname> <given-names>C. L.</given-names></name> <name><surname>Pate</surname> <given-names>R. R.</given-names></name></person-group> (<year>2009b</year>). <article-title>Social and environmental factors associated with preschoolers&#x2019; nonsedentary physical activity</article-title>. <source>Child Dev.</source> <volume>80</volume>, <fpage>45</fpage>&#x2013;<lpage>58</lpage>. doi: <pub-id pub-id-type="doi">10.1111/j.1467-8624.2008.01245.x</pub-id>, PMID: <pub-id pub-id-type="pmid">19236392</pub-id></citation>
</ref>
<ref id="ref9">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Brussoni</surname> <given-names>M.</given-names></name> <name><surname>Gibbons</surname> <given-names>R.</given-names></name> <name><surname>Gray</surname> <given-names>C.</given-names></name> <name><surname>Ishikawa</surname> <given-names>T.</given-names></name> <name><surname>Sandseter</surname> <given-names>E. B. H.</given-names></name> <name><surname>Bienenstock</surname> <given-names>A.</given-names></name> <etal/></person-group>. (<year>2015</year>). <article-title>What is the relationship between risky outdoor play and health in children? A systematic review</article-title>. <source>Int. J. Environ. Res. Public Health</source> <volume>12</volume>, <fpage>6423</fpage>&#x2013;<lpage>6454</lpage>. doi: <pub-id pub-id-type="doi">10.3390/ijerph120606423</pub-id>, PMID: <pub-id pub-id-type="pmid">26062038</pub-id></citation>
</ref>
<ref id="ref10">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Brussoni</surname> <given-names>M.</given-names></name> <name><surname>Olsen</surname> <given-names>L. L.</given-names></name> <name><surname>Pike</surname> <given-names>I.</given-names></name> <name><surname>Sleet</surname> <given-names>D. A.</given-names></name></person-group> (<year>2012</year>). <article-title>Risky play and Children&#x2019;s safety: balancing priorities for optimal child development</article-title>. <source>Int. J. Environ. Res. Public Health</source> <volume>9</volume>, <fpage>3134</fpage>&#x2013;<lpage>3148</lpage>. doi: <pub-id pub-id-type="doi">10.3390/ijerph9093134</pub-id>, PMID: <pub-id pub-id-type="pmid">23202675</pub-id></citation>
</ref>
<ref id="ref11">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Carson</surname> <given-names>V.</given-names></name> <name><surname>Lee</surname> <given-names>E.-Y.</given-names></name> <name><surname>Hewitt</surname> <given-names>L.</given-names></name> <name><surname>Jennings</surname> <given-names>C.</given-names></name> <name><surname>Hunter</surname> <given-names>S.</given-names></name> <name><surname>Kuzik</surname> <given-names>N.</given-names></name> <etal/></person-group>. (<year>2017</year>). <article-title>Systematic review of the relationships between physical activity and health indicators in the early years (0-4 years)</article-title>. <source>BMC Public Health</source> <volume>17</volume>, <fpage>33</fpage>&#x2013;<lpage>63</lpage>. doi: <pub-id pub-id-type="doi">10.1186/s12889-017-4860-0</pub-id></citation>
</ref>
<ref id="ref12">
<citation citation-type="book"><person-group person-group-type="author"><name>
<surname>Clark</surname>
</name> <name><surname>Metcalf</surname> <given-names>J.</given-names></name></person-group> (<year>2002</year>). &#x201C;<article-title>The mountain of motor development: a metaphor</article-title>&#x201D; in <source>Motor development: Research and reviews</source>. eds. <person-group person-group-type="editor"><name><surname>Clark</surname> <given-names>I. N. J.</given-names></name> <name><surname>Humphrey</surname> <given-names>J.</given-names></name></person-group>, vol. <volume>2</volume> (<publisher-loc>Reston, US</publisher-loc>: <publisher-name>National Association Of Sport And Physical Education</publisher-name>), <fpage>163</fpage>&#x2013;<lpage>190</lpage>.</citation>
</ref>
<ref id="ref13">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Cliff</surname> <given-names>D. P.</given-names></name> <name><surname>Okely</surname> <given-names>A. D.</given-names></name> <name><surname>Smith</surname> <given-names>L. M.</given-names></name> <name><surname>Mckeen</surname> <given-names>K.</given-names></name></person-group> (<year>2009</year>). <article-title>Relationships between fundamental movement skills and objectively measured physical activity in preschool children</article-title>. <source>Pediatr. Exerc. Sci.</source> <volume>21</volume>, <fpage>436</fpage>&#x2013;<lpage>449</lpage>. doi: <pub-id pub-id-type="doi">10.1123/pes.21.4.436</pub-id>, PMID: <pub-id pub-id-type="pmid">20128363</pub-id></citation>
</ref>
<ref id="ref14">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Cohen</surname> <given-names>B. J.</given-names></name> <name><surname>Korintus</surname> <given-names>M.</given-names></name></person-group> (<year>2017</year>). <article-title>Making connections: reflections on over three decades of Eu initiatives in early childhood education and care (ECEC)</article-title>. <source>Early Years</source> <volume>37</volume>, <fpage>235</fpage>&#x2013;<lpage>249</lpage>. doi: <pub-id pub-id-type="doi">10.1080/09575146.2016.1181050</pub-id></citation>
</ref>
<ref id="ref15">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Copeland</surname> <given-names>K. A.</given-names></name> <name><surname>Kendeigh</surname> <given-names>C. A.</given-names></name> <name><surname>Saelens</surname> <given-names>B. E.</given-names></name> <name><surname>Kalkwarf</surname> <given-names>H. J.</given-names></name> <name><surname>Sherman</surname> <given-names>S. N.</given-names></name></person-group> (<year>2012</year>). <article-title>Physical activity in child-care centers: do teachers hold the key to the playground?</article-title> <source>Health Educ. Res.</source> <volume>27</volume>, <fpage>81</fpage>&#x2013;<lpage>100</lpage>. doi: <pub-id pub-id-type="doi">10.1093/her/cyr038</pub-id>, PMID: <pub-id pub-id-type="pmid">21804083</pub-id></citation>
</ref>
<ref id="ref16">
<citation citation-type="book"><person-group person-group-type="author"><name><surname>Dalli</surname> <given-names>C.</given-names></name> <name><surname>Miller</surname> <given-names>L.</given-names></name> <name><surname>Urban</surname> <given-names>M.</given-names></name></person-group> (<year>2012</year>). <source>Early childhood grows up: towards a critical ecology of the profession</source> <publisher-name>Springer</publisher-name>.</citation>
</ref>
<ref id="ref17">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Eddy</surname> <given-names>L. H.</given-names></name> <name><surname>Wood</surname> <given-names>M. L.</given-names></name> <name><surname>Shire</surname> <given-names>K. A.</given-names></name> <name><surname>Bingham</surname> <given-names>D. D.</given-names></name> <name><surname>Bonnick</surname> <given-names>E.</given-names></name> <name><surname>Creaser</surname> <given-names>A.</given-names></name> <etal/></person-group>. (<year>2019</year>). <article-title>A systematic review of randomized and case-controlled trials investigating the effectiveness of school-based motor skill interventions in 3-to 12-year-old children</article-title>. <source>Child Care Health Develop.</source> <volume>45</volume>, <fpage>773</fpage>&#x2013;<lpage>790</lpage>. doi: <pub-id pub-id-type="doi">10.1111/cch.12712</pub-id>, PMID: <pub-id pub-id-type="pmid">31329292</pub-id></citation>
</ref>
<ref id="ref18">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Einarsdottir</surname> <given-names>J.</given-names></name> <name><surname>Purola</surname> <given-names>A.-M.</given-names></name> <name><surname>Johansson</surname> <given-names>E. M.</given-names></name> <name><surname>Brostr&#x00F6;m</surname> <given-names>S.</given-names></name> <name><surname>Emilson</surname> <given-names>A.</given-names></name></person-group> (<year>2015</year>). <article-title>Democracy, caring and competence: values perspectives in Ecec curricula in the Nordic countries</article-title>. <source>Int. J. Early Years Educ.</source> <volume>23</volume>, <fpage>97</fpage>&#x2013;<lpage>114</lpage>. doi: <pub-id pub-id-type="doi">10.1080/09669760.2014.970521</pub-id></citation>
</ref>
<ref id="ref19">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Frank</surname> <given-names>M. L.</given-names></name> <name><surname>Flynn</surname> <given-names>A.</given-names></name> <name><surname>Farnell</surname> <given-names>G. S.</given-names></name> <name><surname>Barkley</surname> <given-names>J. E.</given-names></name></person-group> (<year>2018</year>). <article-title>The differences in physical activity levels in preschool children during free play recess and structured play recess</article-title>. <source>J. Exerc. Sci. Fitness</source> <volume>16</volume>, <fpage>37</fpage>&#x2013;<lpage>42</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jesf.2018.03.001</pub-id>, PMID: <pub-id pub-id-type="pmid">30662491</pub-id></citation>
</ref>
<ref id="ref20">
<citation citation-type="other"><person-group person-group-type="author">
<name><surname>Gibbs</surname> <given-names>Jr. R. W.</given-names></name>
</person-group> (<year>2001</year>). <article-title>Intentions as emergent products of social interactions</article-title>. In <source>Intentions and intentionality: Foundations of social cognition</source>. eds. <person-group person-group-type="editor"><name><surname>Malle</surname> <given-names>B. F.</given-names></name> <name><surname>Moses</surname> <given-names>L. J.</given-names></name> <name><surname>Baldwin</surname> <given-names>D. A.</given-names></name></person-group> pp <fpage>105</fpage>&#x2013;<lpage>22</lpage>.</citation>
</ref>
<ref id="ref21">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hardy</surname> <given-names>L. L.</given-names></name> <name><surname>King</surname> <given-names>L.</given-names></name> <name><surname>Farrell</surname> <given-names>L.</given-names></name> <name><surname>Macniven</surname> <given-names>R.</given-names></name> <name><surname>Howlett</surname> <given-names>S.</given-names></name></person-group> (<year>2010a</year>). <article-title>Fundamental movement skills among Australian preschool children</article-title>. <source>J. Sci. Med. Sport</source> <volume>13</volume>, <fpage>503</fpage>&#x2013;<lpage>508</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jsams.2009.05.010</pub-id>, PMID: <pub-id pub-id-type="pmid">19850520</pub-id></citation>
</ref>
<ref id="ref22">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hardy</surname> <given-names>L. L.</given-names></name> <name><surname>King</surname> <given-names>L.</given-names></name> <name><surname>Kelly</surname> <given-names>B.</given-names></name> <name><surname>Farrell</surname> <given-names>L.</given-names></name> <name><surname>Howlett</surname> <given-names>S.</given-names></name></person-group> (<year>2010b</year>). <article-title>Munch and move: evaluation of a preschool healthy eating and movement skill program</article-title>. <source>Int. J. Behav. Nutr. Phys. Act.</source> <volume>7</volume>, <fpage>1</fpage>&#x2013;<lpage>11</lpage>. doi: <pub-id pub-id-type="doi">10.1186/1479-5868-7-80</pub-id></citation>
</ref>
<ref id="ref23">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kain</surname> <given-names>J.</given-names></name> <name><surname>Leyton</surname> <given-names>B.</given-names></name> <name><surname>Soto-S&#x00E1;nchez</surname> <given-names>J.</given-names></name> <name><surname>Concha</surname> <given-names>F.</given-names></name></person-group> (<year>2018</year>). <article-title>In preschool children, physical activity during school time can significantly increase by intensifying locomotor activities during physical education classes</article-title>. <source>BMC. Res. Notes</source> <volume>11</volume>, <fpage>1</fpage>&#x2013;<lpage>5</lpage>. doi: <pub-id pub-id-type="doi">10.1186/s13104-018-3536-x</pub-id></citation>
</ref>
<ref id="ref24">
<citation citation-type="journal"><person-group person-group-type="author">
<name><surname>Kytt&#x00E4;</surname> <given-names>M.</given-names></name>
</person-group> (<year>2004</year>). <article-title>The extent of Children's independent mobility and the number of actualized affordances as criteria for child-friendly environments</article-title>. <source>J. Environ. Psychol.</source> <volume>24</volume>, <fpage>179</fpage>&#x2013;<lpage>198</lpage>. doi: <pub-id pub-id-type="doi">10.1016/S0272-4944(03)00073-2</pub-id></citation>
</ref>
<ref id="ref25">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lu</surname> <given-names>C.</given-names></name> <name><surname>Montague</surname> <given-names>B.</given-names></name></person-group> (<year>2016</year>). <article-title>Move to learn, learn to move: prioritizing physical activity in early childhood education programming</article-title>. <source>Early Childhood Educ. J.</source> <volume>44</volume>, <fpage>409</fpage>&#x2013;<lpage>417</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s10643-015-0730-5</pub-id></citation>
</ref>
<ref id="ref26">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lubans</surname> <given-names>D. R.</given-names></name> <name><surname>Morgan</surname> <given-names>P. J.</given-names></name> <name><surname>Cliff</surname> <given-names>D. P.</given-names></name> <name><surname>Barnett</surname> <given-names>L. M.</given-names></name> <name><surname>Okely</surname> <given-names>A. D.</given-names></name></person-group> (<year>2010</year>). <article-title>Fundamental movement skills in children and adolescents</article-title>. <source>Sports Med.</source> <volume>40</volume>, <fpage>1019</fpage>&#x2013;<lpage>1035</lpage>. doi: <pub-id pub-id-type="doi">10.2165/11536850-000000000-00000</pub-id></citation>
</ref>
<ref id="ref27">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lubans</surname> <given-names>D.</given-names></name> <name><surname>Richards</surname> <given-names>J.</given-names></name> <name><surname>Hillman</surname> <given-names>C.</given-names></name> <name><surname>Faulkner</surname> <given-names>G.</given-names></name> <name><surname>Beauchamp</surname> <given-names>M.</given-names></name> <name><surname>Nilsson</surname> <given-names>M.</given-names></name> <etal/></person-group>. (<year>2016</year>). <article-title>Physical activity for cognitive and mental health in youth: a systematic review of mechanisms</article-title>. <source>Pediatrics</source> <volume>138</volume>, <fpage>1</fpage>&#x2013;<lpage>13</lpage>. doi: <pub-id pub-id-type="doi">10.1542/peds.2016-1642</pub-id>, PMID: <pub-id pub-id-type="pmid">27542849</pub-id></citation>
</ref>
<ref id="ref28">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mak</surname> <given-names>T. C.</given-names></name> <name><surname>Chan</surname> <given-names>D. K.</given-names></name> <name><surname>Capio</surname> <given-names>C. M.</given-names></name></person-group> (<year>2021</year>). <article-title>Strategies for teachers to promote physical activity in early childhood education settings&#x2014;a scoping review</article-title>. <source>Int. J. Environ. Res. Public Health</source> <volume>18</volume>:<fpage>867</fpage>. doi: <pub-id pub-id-type="doi">10.3390/ijerph18030867</pub-id>, PMID: <pub-id pub-id-type="pmid">33498374</pub-id></citation>
</ref>
<ref id="ref29">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mavilidi</surname> <given-names>M. F.</given-names></name> <name><surname>Rigoutsos</surname> <given-names>S.</given-names></name> <name><surname>Venetsanou</surname> <given-names>F.</given-names></name></person-group> (<year>2021</year>). <article-title>Training early childhood educators to promote children's physical activity</article-title>. <source>Early Childhood Educ. J.</source> <volume>50</volume>, <fpage>785</fpage>&#x2013;<lpage>94</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s10643-021-01191-4</pub-id></citation>
</ref>
<ref id="ref30">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mcbride</surname> <given-names>R. E.</given-names></name> <name><surname>Xiang</surname> <given-names>P.</given-names></name> <name><surname>Wittenburg</surname> <given-names>D.</given-names></name> <name><surname>Shen</surname> <given-names>J.</given-names></name></person-group> (<year>2002</year>). <article-title>An analysis of preservice teachers' dispositions toward critical thinking: a cross-cultural perspective</article-title>. <source>Asia Pac. J. Teach. Educ.</source> <volume>30</volume>, <fpage>131</fpage>&#x2013;<lpage>140</lpage>. doi: <pub-id pub-id-type="doi">10.1080/13598660220135649</pub-id></citation>
</ref>
<ref id="ref31">
<citation citation-type="book"><person-group person-group-type="author">
<name><surname>Menard</surname> <given-names>S.</given-names></name>
</person-group> (<year>2010</year>). <source>Logistic regression: From introductory to advanced concepts and applications</source>. <publisher-loc>Los Angeles, US</publisher-loc>: <publisher-name>Sage</publisher-name>.</citation>
</ref>
<ref id="ref32">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Morgan</surname> <given-names>P. J.</given-names></name> <name><surname>Hansen</surname> <given-names>V.</given-names></name></person-group> (<year>2008</year>). <article-title>Physical education in primary schools: classroom Teachers' perceptions of benefits and outcomes</article-title>. <source>Health Educ. J.</source> <volume>67</volume>, <fpage>196</fpage>&#x2013;<lpage>207</lpage>. doi: <pub-id pub-id-type="doi">10.1177/0017896908094637</pub-id></citation>
</ref>
<ref id="ref33">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Parks</surname> <given-names>M.</given-names></name> <name><surname>Solmon</surname> <given-names>M.</given-names></name> <name><surname>Lee</surname> <given-names>A.</given-names></name></person-group> (<year>2007</year>). <article-title>Understanding classroom Teachers' perceptions of integrating physical activity: a collective efficacy perspective</article-title>. <source>J. Res. Child. Educ.</source> <volume>21</volume>, <fpage>316</fpage>&#x2013;<lpage>328</lpage>. doi: <pub-id pub-id-type="doi">10.1080/02568540709594597</pub-id></citation>
</ref>
<ref id="ref34">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Pate</surname> <given-names>R. R.</given-names></name> <name><surname>Mciver</surname> <given-names>K.</given-names></name> <name><surname>Dowda</surname> <given-names>M.</given-names></name> <name><surname>Brown</surname> <given-names>W. H.</given-names></name> <name><surname>Addy</surname> <given-names>C.</given-names></name></person-group> (<year>2008</year>). <article-title>Directly observed physical activity levels in preschool children</article-title>. <source>J. Sch. Health</source> <volume>78</volume>, <fpage>438</fpage>&#x2013;<lpage>444</lpage>. doi: <pub-id pub-id-type="doi">10.1111/j.1746-1561.2008.00327.x</pub-id>, PMID: <pub-id pub-id-type="pmid">18651931</pub-id></citation>
</ref>
<ref id="ref35">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Raustorp</surname> <given-names>A.</given-names></name> <name><surname>Pagels</surname> <given-names>P.</given-names></name> <name><surname>Boldemann</surname> <given-names>C.</given-names></name> <name><surname>Cosco</surname> <given-names>N.</given-names></name> <name><surname>S&#x00F6;derstr&#x00F6;m</surname> <given-names>M.</given-names></name> <name><surname>M&#x00E5;rtensson</surname> <given-names>F.</given-names></name></person-group> (<year>2012</year>). <article-title>Accelerometer measured level of physical activity indoors and outdoors during preschool time in Sweden and the United States</article-title>. <source>J. Phys. Act. Health</source> <volume>9</volume>, <fpage>801</fpage>&#x2013;<lpage>808</lpage>. doi: <pub-id pub-id-type="doi">10.1123/jpah.9.6.801</pub-id>, PMID: <pub-id pub-id-type="pmid">21952100</pub-id></citation>
</ref>
<ref id="ref36">
<citation citation-type="journal"><person-group person-group-type="author">
<name><surname>Reilly</surname> <given-names>J. J.</given-names></name>
</person-group> (<year>2010</year>). <article-title>Low levels of objectively measured physical activity in preschoolers in child care</article-title>. <source>Med. Sci. Sports Exerc.</source> <volume>42</volume>, <fpage>502</fpage>&#x2013;<lpage>507</lpage>. doi: <pub-id pub-id-type="doi">10.1249/MSS.0b013e3181cea100</pub-id></citation>
</ref>
<ref id="ref37">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Richter</surname> <given-names>L. M.</given-names></name> <name><surname>Cappa</surname> <given-names>C.</given-names></name> <name><surname>Issa</surname> <given-names>G.</given-names></name> <name><surname>Lu</surname> <given-names>C.</given-names></name> <name><surname>Petrowski</surname> <given-names>N.</given-names></name> <name><surname>Naicker</surname> <given-names>S. N.</given-names></name></person-group> (<year>2020</year>). <article-title>Data for action on early childhood development</article-title>. <source>Lancet</source> <volume>396</volume>, <fpage>1784</fpage>&#x2013;<lpage>1786</lpage>. doi: <pub-id pub-id-type="doi">10.1016/S0140-6736(20)32482-X</pub-id></citation>
</ref>
<ref id="ref38">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sandberg</surname> <given-names>A.</given-names></name> <name><surname>Ottosson</surname> <given-names>L.</given-names></name></person-group> (<year>2010</year>). <article-title>Pre-school teachers&#x2019;, other professionals&#x2019;, and parental concerns on cooperation in pre-school&#x2013;all around children in need of special support: the Swedish perspective</article-title>. <source>Int. J. Incl. Educ.</source> <volume>14</volume>, <fpage>741</fpage>&#x2013;<lpage>754</lpage>. doi: <pub-id pub-id-type="doi">10.1080/13603110802504606</pub-id></citation>
</ref>
<ref id="ref39">
<citation citation-type="journal"><person-group person-group-type="author">
<name><surname>Sandseter</surname> <given-names>E. B. H.</given-names></name>
</person-group> (<year>2014</year>). <article-title>Early childhood education and care practitioners' perceptions of children's risky play; examining the influence of personality and gender</article-title>. <source>Early Child Dev. Care</source> <volume>184</volume>, <fpage>434</fpage>&#x2013;<lpage>449</lpage>. doi: <pub-id pub-id-type="doi">10.1080/03004430.2013.794797</pub-id></citation>
</ref>
<ref id="ref40">
<citation citation-type="journal"><person-group person-group-type="author">
<name><surname>Shonkoff</surname> <given-names>J. P.</given-names></name>
</person-group> (<year>2014</year>). <article-title>Changing the narrative for early childhood investment</article-title>. <source>JAMA Pediatr.</source> <volume>168</volume>, <fpage>105</fpage>&#x2013;<lpage>106</lpage>. doi: <pub-id pub-id-type="doi">10.1001/jamapediatrics.2013.4212</pub-id>, PMID: <pub-id pub-id-type="pmid">24296870</pub-id></citation>
</ref>
<ref id="ref41">
<citation citation-type="other"><person-group person-group-type="author">
<collab id="coll1">Skolverket</collab>
</person-group>. (<year>2021</year>). <source>Statistik &#x00D6;ver Barn Och Personal I F&#x00F6;rskola 2021</source></citation>
</ref>
<ref id="ref42">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Soini</surname> <given-names>A.</given-names></name> <name><surname>Villberg</surname> <given-names>J.</given-names></name> <name><surname>S&#x00E4;&#x00E4;kslahti</surname> <given-names>A.</given-names></name> <name><surname>Gubbels</surname> <given-names>J.</given-names></name> <name><surname>Meht&#x00E4;l&#x00E4;</surname> <given-names>A.</given-names></name> <name><surname>Kettunen</surname> <given-names>T.</given-names></name> <etal/></person-group>. (<year>2014</year>). <article-title>Directly observed physical activity among 3-year-olds in Finnish childcare</article-title>. <source>Int. J. Early Childhood</source> <volume>46</volume>, <fpage>253</fpage>&#x2013;<lpage>269</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s13158-014-0111-z</pub-id></citation>
</ref>
<ref id="ref43">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Soini</surname> <given-names>A.</given-names></name> <name><surname>Watt</surname> <given-names>A.</given-names></name> <name><surname>S&#x00E4;&#x00E4;kslahti</surname> <given-names>A.</given-names></name></person-group> (<year>2021</year>). <article-title>Finnish pre-service teachers&#x2019; perceptions of perceived competence in early childhood physical education</article-title>. <source>Int. J. Environ. Res. Public Health</source> <volume>18</volume>:<fpage>6454</fpage>. doi: <pub-id pub-id-type="doi">10.3390/ijerph18126454</pub-id>, PMID: <pub-id pub-id-type="pmid">34203653</pub-id></citation>
</ref>
<ref id="ref44">
<citation citation-type="book"><person-group person-group-type="author">
<name><surname>Sollerhed</surname> <given-names>A.-C.</given-names></name>
</person-group> (<year>2006</year>). <source>Young today-adult tomorrow!: studies on physical status, physical activity, attitudes, and self-perception in children and adolescents</source>. <publisher-loc>Lund, Sweden</publisher-loc>: <publisher-name>Faculty Of Medicine, Lund University</publisher-name>.</citation>
</ref>
<ref id="ref45">
<citation citation-type="journal"><person-group person-group-type="author">
<name><surname>Sollerhed</surname> <given-names>A.-C.</given-names></name>
</person-group> (<year>2022</year>). <article-title>Perceived insufficient pedagogical content knowledge in teaching movement and physical activity. Experiences from an action-oriented study among educators in early childhood education and care</article-title>. <source>Front. Sports Active Living</source>:<fpage>4</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fspor.2022.1050311</pub-id></citation>
</ref>
<ref id="ref46">
<citation citation-type="journal"><person-group person-group-type="author">
<name><surname>Sollerhed</surname> <given-names>A.-C.</given-names></name>
</person-group> (<year>2023</year>). <article-title>Perceived insufficient pedagogical content knowledge in teaching movement and physical activity. Experiences from an action-oriented study among educators in early childhood education and care</article-title>. <source>Front. Sports Active Living</source> <volume>4</volume>:<fpage>514</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fspor.2022.1050311</pub-id></citation>
</ref>
<ref id="ref47">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sollerhed</surname> <given-names>A.-C.</given-names></name> <name><surname>Olesen</surname> <given-names>L. G.</given-names></name> <name><surname>Froberg</surname> <given-names>K.</given-names></name> <name><surname>Soini</surname> <given-names>A.</given-names></name> <name><surname>S&#x00E4;&#x00E4;kslahti</surname> <given-names>A.</given-names></name> <name><surname>Kristj&#x00E1;nsd&#x00F3;ttir</surname> <given-names>G.</given-names></name> <etal/></person-group>. (<year>2021</year>). <article-title>Movement and physical activity in early childhood education and care policies of five Nordic countries</article-title>. <source>Int. J. Environ. Res. Public Health</source> <volume>18</volume>:<fpage>13226</fpage>. doi: <pub-id pub-id-type="doi">10.3390/ijerph182413226</pub-id>, PMID: <pub-id pub-id-type="pmid">34948837</pub-id></citation>
</ref>
<ref id="ref48">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tandon</surname> <given-names>P. S.</given-names></name> <name><surname>Saelens</surname> <given-names>B. E.</given-names></name> <name><surname>Zhou</surname> <given-names>C.</given-names></name> <name><surname>Christakis</surname> <given-names>D. A.</given-names></name></person-group> (<year>2018</year>). <article-title>A comparison of preschoolers&#x2019; physical activity indoors versus outdoors at child care</article-title>. <source>Int. J. Environ. Res. Public Health</source> <volume>15</volume>:<fpage>2463</fpage>. doi: <pub-id pub-id-type="doi">10.3390/ijerph15112463</pub-id>, PMID: <pub-id pub-id-type="pmid">30400603</pub-id></citation>
</ref>
<ref id="ref49">
<citation citation-type="journal"><person-group person-group-type="author">
<name><surname>Thomson</surname> <given-names>S.</given-names></name>
</person-group> (<year>2014</year>). <article-title>'Adulterated play': an empirical discussion surrounding adults' involvement with children's play in the primary school playground</article-title>. <source>J. Playwork Pract.</source> <volume>1</volume>, <fpage>5</fpage>&#x2013;<lpage>21</lpage>. doi: <pub-id pub-id-type="doi">10.1332/205316214X13944535662152</pub-id></citation>
</ref>
<ref id="ref50">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Timmons</surname> <given-names>B. W.</given-names></name> <name><surname>Leblanc</surname> <given-names>A. G.</given-names></name> <name><surname>Carson</surname> <given-names>V.</given-names></name> <name><surname>Connor Gorber</surname> <given-names>S.</given-names></name> <name><surname>Dillman</surname> <given-names>C.</given-names></name> <name><surname>Janssen</surname> <given-names>I.</given-names></name> <etal/></person-group>. (<year>2012</year>). <article-title>Systematic review of physical activity and health in the early years (aged 0&#x2013;4 years)</article-title>. <source>Appl. Physiol. Nutr. Metab.</source> <volume>37</volume>, <fpage>773</fpage>&#x2013;<lpage>792</lpage>. doi: <pub-id pub-id-type="doi">10.1139/h2012-070</pub-id>, PMID: <pub-id pub-id-type="pmid">22765840</pub-id></citation>
</ref>
<ref id="ref51">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tonge</surname> <given-names>K. L.</given-names></name> <name><surname>Jones</surname> <given-names>R. A.</given-names></name> <name><surname>Okely</surname> <given-names>A. D.</given-names></name></person-group> (<year>2016</year>). <article-title>Correlates of Children's objectively measured physical activity and sedentary behavior in early childhood education and care services: a systematic review</article-title>. <source>Prev. Med.</source> <volume>89</volume>, <fpage>129</fpage>&#x2013;<lpage>139</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.ypmed.2016.05.019</pub-id>, PMID: <pub-id pub-id-type="pmid">27235604</pub-id></citation>
</ref>
<ref id="ref52">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tremblay</surname> <given-names>M. S.</given-names></name> <name><surname>Gray</surname> <given-names>C.</given-names></name> <name><surname>Babcock</surname> <given-names>S.</given-names></name> <name><surname>Barnes</surname> <given-names>J.</given-names></name> <name><surname>Costas Bradstreet</surname> <given-names>C.</given-names></name> <name><surname>Carr</surname> <given-names>D.</given-names></name> <etal/></person-group>. (<year>2015</year>). <article-title>Position statement on active outdoor play</article-title>. <source>Int. J. Environ. Res. Public Health</source> <volume>12</volume>, <fpage>6475</fpage>&#x2013;<lpage>6505</lpage>. doi: <pub-id pub-id-type="doi">10.3390/ijerph120606475</pub-id>, PMID: <pub-id pub-id-type="pmid">26062040</pub-id></citation>
</ref>
<ref id="ref53">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Van Cauwenberghe</surname> <given-names>E.</given-names></name> <name><surname>De Craemer</surname> <given-names>M.</given-names></name> <name><surname>De Decker</surname> <given-names>E.</given-names></name> <name><surname>De Bourdeaudhuij</surname> <given-names>I.</given-names></name> <name><surname>Cardon</surname> <given-names>G.</given-names></name></person-group> (<year>2013</year>). <article-title>The impact of a teacher-led structured physical activity session on preschoolers&#x2019; sedentary and physical activity levels</article-title>. <source>J. Sci. Med. Sport</source> <volume>16</volume>, <fpage>422</fpage>&#x2013;<lpage>426</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jsams.2012.11.883</pub-id>, PMID: <pub-id pub-id-type="pmid">23246443</pub-id></citation>
</ref>
<ref id="ref54">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Vanderloo</surname> <given-names>L. M.</given-names></name> <name><surname>Tucker</surname> <given-names>P.</given-names></name> <name><surname>Johnson</surname> <given-names>A. M.</given-names></name> <name><surname>Van Zandvoort</surname> <given-names>M. M.</given-names></name> <name><surname>Burke</surname> <given-names>S. M.</given-names></name> <name><surname>Irwin</surname> <given-names>J. D.</given-names></name></person-group> (<year>2014</year>). <article-title>The influence of centre-based childcare on preschoolers&#x2019; physical activity levels: a cross-sectional study</article-title>. <source>Int. J. Environ. Res. Public Health</source> <volume>11</volume>, <fpage>1794</fpage>&#x2013;<lpage>1802</lpage>. doi: <pub-id pub-id-type="doi">10.3390/ijerph110201794</pub-id>, PMID: <pub-id pub-id-type="pmid">24503975</pub-id></citation>
</ref>
<ref id="ref55">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Verstraete</surname> <given-names>S. J.</given-names></name> <name><surname>Cardon</surname> <given-names>G. M.</given-names></name> <name><surname>De Clercq</surname> <given-names>D. L.</given-names></name> <name><surname>De Bourdeaudhuij</surname> <given-names>I. M.</given-names></name></person-group> (<year>2006</year>). <article-title>Increasing children's physical activity levels during recess periods in elementary schools: the effects of providing game equipment</article-title>. <source>Eur. J. Pub. Health</source> <volume>16</volume>, <fpage>415</fpage>&#x2013;<lpage>419</lpage>. doi: <pub-id pub-id-type="doi">10.1093/eurpub/ckl008</pub-id>, PMID: <pub-id pub-id-type="pmid">16431866</pub-id></citation>
</ref>
<ref id="ref56">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Vorkapic</surname> <given-names>C. F.</given-names></name> <name><surname>Alves</surname> <given-names>H.</given-names></name> <name><surname>Araujo</surname> <given-names>L.</given-names></name> <name><surname>Borba-Pinheiro</surname> <given-names>C. J.</given-names></name> <name><surname>Coelho</surname> <given-names>R.</given-names></name> <name><surname>Fonseca</surname> <given-names>E.</given-names></name> <etal/></person-group>. (<year>2021</year>). <article-title>Does physical activity improve cognition and academic performance in children? A systematic review of randomized controlled trials</article-title>. <source>Neuropsychobiology</source>, <fpage>454</fpage>&#x2013;<lpage>82</lpage>. doi: <pub-id pub-id-type="doi">10.1159/000514682</pub-id></citation>
</ref>
<ref id="ref57">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ward</surname> <given-names>D. S.</given-names></name> <name><surname>Vaughn</surname> <given-names>A.</given-names></name> <name><surname>Mcwilliams</surname> <given-names>C.</given-names></name> <name><surname>Hales</surname> <given-names>D.</given-names></name></person-group> (<year>2010</year>). <article-title>Interventions for increasing physical activity at child care</article-title>. <source>Med. Sci. Sports Exerc.</source> <volume>42</volume>, <fpage>526</fpage>&#x2013;<lpage>534</lpage>. doi: <pub-id pub-id-type="doi">10.1249/MSS.0b013e3181cea406</pub-id></citation>
</ref>
<ref id="ref58">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Webster</surname> <given-names>C. A.</given-names></name> <name><surname>Buchan</surname> <given-names>H.</given-names></name> <name><surname>Perreault</surname> <given-names>M.</given-names></name> <name><surname>Doan</surname> <given-names>R.</given-names></name> <name><surname>Doutis</surname> <given-names>P.</given-names></name> <name><surname>Weaver</surname> <given-names>R. G.</given-names></name></person-group> (<year>2015</year>). <article-title>An exploratory study of elementary classroom teachers&#x2019; physical activity promotion from a social learning perspective</article-title>. <source>J. Teach. Phys. Educ.</source> <volume>34</volume>, <fpage>474</fpage>&#x2013;<lpage>495</lpage>. doi: <pub-id pub-id-type="doi">10.1123/jtpe.2014-0075</pub-id></citation>
</ref>
<ref id="ref59">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Williams</surname> <given-names>H. G.</given-names></name> <name><surname>Pfeiffer</surname> <given-names>K. A.</given-names></name> <name><surname>O'neill</surname> <given-names>J. R.</given-names></name> <name><surname>Dowda</surname> <given-names>M.</given-names></name> <name><surname>Mciver</surname> <given-names>K. L.</given-names></name> <name><surname>Brown</surname> <given-names>W. H.</given-names></name> <etal/></person-group>. (<year>2008</year>). <article-title>Motor skill performance and physical activity in preschool children</article-title>. <source>Obesity</source> <volume>16</volume>, <fpage>1421</fpage>&#x2013;<lpage>1426</lpage>. doi: <pub-id pub-id-type="doi">10.1038/oby.2008.214</pub-id></citation>
</ref>
<ref id="ref60">
<citation citation-type="book"><person-group person-group-type="author">
<collab id="coll2">World Health Organization</collab>
</person-group> (<year>2019</year>). <source>Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age: web annex: evidence profiles</source>. <publisher-loc>Geneva, CH</publisher-loc>: <publisher-name>World Health Organization</publisher-name>.</citation>
</ref>
<ref id="ref61">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wyver</surname> <given-names>S.</given-names></name> <name><surname>Tranter</surname> <given-names>P.</given-names></name> <name><surname>Naughton</surname> <given-names>G.</given-names></name> <name><surname>Little</surname> <given-names>H.</given-names></name> <name><surname>Sandseter</surname> <given-names>E. B. H.</given-names></name> <name><surname>Bundy</surname> <given-names>A.</given-names></name></person-group> (<year>2010</year>). <article-title>Ten ways to restrict Children's freedom to play: the problem of surplus safety</article-title>. <source>Contemp. Issues Early Child.</source> <volume>11</volume>, <fpage>263</fpage>&#x2013;<lpage>277</lpage>. doi: <pub-id pub-id-type="doi">10.2304/ciec.2010.11.3.263</pub-id></citation>
</ref>
</ref-list>
</back>
</article>