Linda’s Blog

Linda Baston-Pitt, PurpleBee CEO, shares her thoughts, insights and advice

Active Movement – A behavioural programme for health 

 

Click here to see the published article in the EYE Magazine.

Introduction  – Active interest

Ensuring the positive well-being of the children in any early years’ organisation should be viewed as a necessity not a luxury. However well-being is a difficult concept to understand and can mean different things to different people. Felicity Huppert gives one of the best descriptions ‘well-being is a positive and sustainable condition that allows individuals, groups or nations to thrive and flourish.  Well-being….requires an integrated approach, one that embraces mind, body, society, and the environment. Understanding how individuals and communities can be helped to thrive and flourish could be of great benefit to our citizens, our educators and our leaders ‘

In 2007 The World Health Organisation highlighted the power of an early influence on health and social well-being commenting  “investment in early childhood is the most powerful investment a country can make, with returns over the life course many times the amount of the original investment”.  The proposition being that the early learning of positive behaviours and attitudes that contribute to well-being have significant value in later life, benefitting both the individual and society as a whole.

However the growing concern, amongst parents, organisations and the media, about the health and well-being of our children continues to rise. Much of this concern is based round the rise of obesity in children, and the associated lack of physical activity in their everyday lives (Gallagher, 2014, Holm, J. et al. 2011, Statham & Chase, 2010). There is little doubt that a healthy diet and regular physical activity are crucial for a healthy childhood and emerging evidence suggests that sedentary behaviour in the early years is associated with overweight and obesity (NHS 2010), as well as lower cognitive development (Hawkins and Law 2006).

While according to an all-party parliamentary group on health patterns for healthy families “Obesity is a family affair and it starts early……over 90% of excess weight gained by girls and over 70% gained by boys is acquired before school age” (APPG, 2014).

With parents, politicians and the media united in their commitment to encourage physical activity and redress obesity, it is not surprising that well-being remains high on the agenda and will do so post-election.

Children’s well-being is clearly integral to nursery provision.  The benefits of health and happiness are beyond question and we all seek to promote an early year’s environment that influences positive behaviours in both childhood and adulthood.

The project between Active Movement™ and the Old School House Nursery (OSHN) aims to both identify and reduce non-sedentary behaviours within the nursery using this unique behavioural change intervention, evaluated by the Mosaic Approach to collect evidence and support children’s participation in the process.

Aims and Objectives

 

In defining the programme, four main objectives were set:

  • To work in partnership with an early years setting to establish non-sedentary behaviour for children
  • To test a process of setting activity and communication tailored to the mobility and understanding of each year group (via a campaign using two characters, Stan and Sid)
  • To involve children under five, parents and practitioners, to improve their long term well-being.
  • Extending and adapting the Mosaic Approach in order to educate adults and children as to the benefits of non-sedentary behaviour, and how its integration within daily practices can bring to both adults and children’s a lifetime of well-being.

This pilot project was carried out over eight weeks, in November and December 2014. The Active Movement™ programme has been successfully used in a number of office-based businesses, and aims to embed movement into every day routines to benefit individual’s long term health and well-being. The project with the OSHDN is the first time the Active Movement™ programme has been adapted for use in an early years’ setting, with a similar project running simultaneously at a primary school. The programme is co-designed by Dr. Mike Loosemore, a leading authority in Exercise Medicine, and is centred round long-term behavioural change. “Active Movement has been designed to integrate simple actions and non-sedentary behaviour into everyday lives……….the focus on small steps to achieve major gains makes the programme achievable by, and therefore accessible to, everyone.” (Loosemore & Savage, 2014).

The Old School House Nursery is a national award winning day nursery near Cambridge, which has achieved an ‘outstanding’ in all areas rating from Ofsted. The setting offers full day care to children from 6 weeks to pre-school age, and holiday care for 4-11 year olds. The project was run with the full backing of the settings management team, staff and parents, and children were supported and involved using the well-established Mosaic Approach. The setting staff were following an eight week Active Movement™ programme where the children in the setting were introduced to posters and messages on Active Movement™ alongside two characters, Sid and Stan. The characters were depicted on posters displayed round the setting and on stickers, featuring for added memorability and understanding a phonetic link between Sid sitting down and Stan standing up.

The findings in this article are from evidence collected from the children, and from the staff who were looking after the children.

Findings

 

The raw data collected from the setting included the 8 week schedule for the programme, thirteen child observations, and weekly reflections from the setting staff on how Active Movement™ is affecting both themselves and the children in their care.

Observations and comments from the children relating to the characters of Sid and Stan were taken during a tour of the nursery and a magic carpet activity (part of the Mosaic Approach). The use of a variety of sources to gather information can help to provide triangulated evidence for a small research project such as this. The OSHN has used the Mosaic Approach to ensure data is sourced in a variety of ways, including observations, discussions, photographs and children’s work. Robert-Holmes (2005) suggests the Mosaic Approach uses multiple methods to empower children through participation.

The process starts with the gathering of evidence including drawings and maps by the children, photographs the children have taken and observations and discussions conducted with the child, their parents and key workers at the setting. The Mosaic is made up of many components with the child at the centre of it. Observation is just one piece of the mosaic; field notes, narrative observations used to inform discussions, diary studies, observation of pre-verbal children’s body language, expressions and noises are all used in conjunction with other pieces of the mosaic to see the whole picture (Clark & Moss, 2001).

Stage two involves collating all the information, interpreting it and reflecting on the evidence, which has been gathered. This information then enables the researcher to gain insight into the child’s activities and interests, and act accordingly. The Mosaic Approach appears to be inclusive and is not dependent on the child’s developmental stage or verbal communication skills, this was particularly valuable in this project as the children involved were so young.

School Room environment

 

Initially, staff identified a list of activities and areas in the school room environment, and divided these into sitting, standing or areas to do both in. The sitting areas identified included snack/meal times, playing on the computer, reading books and sitting on vehicles such as trikes and cars. The standing areas included washing hands, the puppet show and light box area, putting on coats, dancing, games such as football, and playing in the forest garden. Most regular activities were recognised as being suitable for both standing and sitting, for example home/role play, writing and numeracy areas, puzzles, construction and small world toys, art and messy play, musical instruments and singing, the sand pit, mud kitchen and den building, and planning/recall and news times.

Child observations

 

Of the 13 observations taken during the programme seven were of male children and six of female children, all were aged between 13 and 45 months at the time of the observations. These took place at different times of the setting day, during the third week of the eight week programme. All observations were conducted either inside the child’s usual room or in their garden area. The observations were carried out by senior staff in the setting, and were between 30-65 minutes long. Each observation focused on one child playing within their peer group, some of the observations were of the same child.

Stan and Sid tour around nursery

 

A small group of children did a tour round the nursery with an adult, looking for posters of Sid and Stan. The children decided the route they took, and the adult wrote down their comments when they found the posters. The messages from the character posters about the health and wellbeing benefits of standing and moving appeared to be followed and understood by the children doing the tour (a mix of boys and girls aged from 3-4 yrs old). Comments demonstrating this included:

“standing makes our bodies work”, we like Stan, he is tall and has long strong arms”, “we will be good like Stan and healthy because we stand”, we sit for lunch but we play and run”, “if you don’t move you ache”, and “mummies and daddies like to stand and walk”.

It is clear from the children’s comments that they do not view Sid in a negative way. For example at the snack table one child said “we can only be like Sid at the snack table”, another said “Sid and Stan can play together in the art area”. In the forest garden one child commented “Sid can sit with us in the log circle”, another said “we need to be like Stan and Sid in the number area”.

This is an important consideration in the early years, as young children have a developmental need for rest. There are also safety and developmental reasons for children to sit down for some activities.

Magic Carpet Activity

 

A member of staff took photographs of different areas of the nursery setting, alongside photographs of the children playing in these areas. These contained images of the children displaying both sedentary and non-sedentary behaviours during a variety of activities which identified and supported the children’s recognition of, and engagement with, the characters of Sid and Stan.

The photographs were spread on the carpet and used as a point of discussion, after which the children placed stickers on each picture. The children were each asked to decide whether the area and/or activity shown should have a sticker of Stan, a sticker of Sid, or a sticker of both Stan and Sid.

The children were a mixed gender group of three year olds, and all the children joined in with the activity. Each child was able to identify the area and activity in the photograph, the other children in the picture, and identify and place the stickers of Sid and Stan.

Their comments demonstrated their recognition and engagement with Sid and Stan, for example one child said “he’d stand, he’s Sid, he could stand up, and play… both….he could be Stan and Sid, we do both”.  At the end of the activity each child was asked what activity they would like to do next, and whether they would be a Sid or Stan whilst doing the activity. Each child was able to do this and comments from the children included;

“Sid, sitting down in the role play area”, “Stan, in the light box area cause I’m Stan” and “Sid in the snack area”.

At the end of the activity three of the seven children were going to be a ‘Stan’ and four were going to be ‘Sid’, demonstrating that the children identified equally with both characters.

Active learning reflections/observations

 

These were carried out by staff in the four rooms throughout the programme, for each of the eight weeks (32 in total). The four rooms included the baby room upstairs (0-1 year olds), the baby room downstairs (1-2 year olds), the nursery room (2-3 year olds), and the school room (3-5 year olds).

The staff reflections provided evidence of how the characters of Sid and Stan had been integrated, and evidence of the children’s recognition and engagement with the characters. For example during the first week of the programme in the baby room one of the pre-verbal babies pointed to the characters and babbled, while another slightly older baby said the characters names when the adult pointed to them. In the nursery room one child kissed the poster of Sid and said “I like him”, when the adult said “I like Stan”, the child said “I do too” , whilst in the garden an adult asked a child looking at the posters what they were doing and the child responded “sitting on a chair and standing, and Stan is best”

“The children continue to recognise Stan and Sid, regularly commenting and questioning about the characters spontaneously. The children particularly reacted well to the new poster in the room, especially the ‘Sid stood up today’. The children were questioning where he had gone and celebrated that he had stood and was no longer sitting on the chair. Many children also showed the new poster to parents when being collected at the end of the day” Adult reflecting on Week 3 of the project.

These reflections demonstrated that the characters appear to have a positive influence on children of all ages, with staff in each room observing interaction between the children and the posters of Sid and Stan. For example babies approached and stroked the posters, and offered them toys. They evidenced how staff adapted challenges and goal from the programme to suit the developmental needs of the children in their care, for example one of the challenges was to walk round with an upset child. This worked well for the baby room, but staff in the nursery room adapted this to holding hands and walking to another area as they don’t carry the older children

Examples of how messages about the benefits of the Active Movement™ programme were influencing those around the staff and children were demonstrated when one practitioner reflected on how a parent told her their child had reminded her and her husband that they could walk and talk.

There is also some evidence in the reflections that the project is improving /increasing non sedentary behaviour with some of the children. In week 7 staff commented that “one child in the group regularly chooses to stand at times he would normally sit, e.g. at planning times when the rest of the group are seated. When chairs aren’t provided at table top activities-my group are generally more accepting that we are standing and don’t request chairs.”

Towards the end of the eight week programme staff decided to incorporate the characters of Sid and Stan further into the planning for Christmas activities. Ideas included baking Stan gingerbread men, Stan’s birthday dance party (songs and games), Stan’s birthday role play (picnic using role play food, pretending to bake him a cake etc.), and practicing writing Christmas cards to Stan and Sid.

These demonstrated how easily the programmes messages and aims could be adapted and incorporated into everyday planning and routines.

Adult observations/quotes

 

Comments from the staff demonstrated their engagement with their own Active Movement™ programme, and how it had influenced their behaviour both within the setting and in their non-work lives. Comments from adults participating in the eight week programme included:

“while at the concerts I was aware of the need to stand all the way through rather than sitting”, “I like the news articles and reports regularly presented by Active Movement™ as reassurance, it’s a gentle reminder all the time”, “when I went shopping at the weekend I was telling my friend about the benefits of standing and being a Stan-all the way round I referred to myself as Stan” and “I hadn’t realised the impact of standing until I had seen all the facts”.

This positive engagement from staff with the messages of increasing health and well-being benefits from non-sedentary behaviour should also have a positive impact on the positive role model they project to the children in their care.

Discussion

 

The projects’ main aims and objectives were to work in partnership with an early years setting to establish non-sedentary behaviours in children; for the children to move from recognition of the characters (initially Stan and Sid) and what they represent, to advocacy in everyday actions; to involve children under five, and parents and adults working with them, to improve their well-being; to extend and adapt the Mosaic Approach in order to educate adults and children to the benefits of non-sedentary behaviour; and how its integration within daily practices can bring to both adults and children’s a lifetime of well-being.. These objectives seem to have been largely met, within the boundaries of a relatively small scale research project.

Active Movement™ and the Old School House Nursery worked closely together, with key staff liaising regularly by email and phone, and scheduled face-to-face meetings taking place. The data in this report clearly demonstrates the children’s recognition of Sid and Stan, and their engagement with the characters in their everyday routines. Comments and reflections from staff and children show their understanding of the benefits of non-sedentary behaviours on their well-being, and the Mosaic Approach seems to have adapted well to accommodate and provide evidence for the eight week programme.

Staff have adjusted daily activities and routines to support key messages about the benefits of non-sedentary behaviour, using the characters to encourage and embed these. The children’s tour of the nursery and magic carpet activity clearly demonstrated their empathy with the characters of Sid and Stan, with some of their comments showing that the children viewed them as peers who could be part of their setting and join their play. This engagement with the characters of Sid and Stan appeared to support the children’s understanding of the health benefits of being non-sedentary, and enthused them to stand and move more.

The increased awareness of their own and children’s well-being is clear from staff reflections and comments. The short- and long-term benefits of this increased awareness for the setting, staff and children should not be underestimated. Role modelling is a vital part of a nursery practitioner’s job, and if staff feel positive about their own well-being they will communicate this to the children in their care, and feel better equipped to carry out their role with energy and enthusiasm. Their involvement in the programme via their own bespoke Active Movement™ programme made their assimilation with the concept and its integration that much more intense.

An increased awareness of the child’s well-being, their energy and activity levels and general emotional and physical well-being, could also help identify any concerns for the child earlier and lead to more targeted early support for families. Raising awareness and expectations of both the  well-being of staff and children, indicates benefits for health, self-esteem, peer and social engagement, and a sense of advocacy and achievement.

Some of the barriers the staff identified when attempting to carry out their weekly challenges are unique to early years’ settings, and these could easily be adapted to accommodate differing circumstances. For example social needs and safety considerations may make it impossible for neither staff nor children to be standing or moving during feeding/refreshment times (indeed Sid advocates this as ‘good’ sitting time.)  The flexibility of the Active Movement™programme enables staff to compensate with alternative planning for children and staff to be active during the setting day, so offsetting these issues.

Conclusion

Though the evaluation was relatively limited, the effect on children and staff has been encouraging.  Young children have become aware that activity is an important part of their lives and recognise its benefits. The cross-pollination of the characters from ‘activity’ to ‘health’ also throws up enormous possibilities such as the areas of nutrition and personal safety.

In the meantime, the programme continues to evolve within the OSHN and is stretching into primary and secondary schools with greater participation and increased educational content. Its huge potential for building the physical, social, emotional and mental capabilities for all children both in the short-term and for a lifetime is only possible because it has started from a place that few have considered before.

Report written by Juliet Porter, in conjunction with Linda Baston-Pitt  Dr. Mike Loosemore and Peter Savage.

References

 All Party Parliamentary Group (APPG). (2014). Health patterns for healthy families: removing the hurdles to a healthy family: a report by the all-party parliamentary group on a fit and healthy childhood

 Clark, A & Moss, P. (2001). Listening to Young Children The Mosaic Approach. National Children’s Bureau and Joseph Rowntree Foundation.

Gallagher, J. (2014). Obese lose up to eight years of life. Available at http://www.bbc.uk.co.uk/news/health-30327777. Accessed 5.12.14.

Hawkins, S. S. and C. Law (2006). “A review of risk factors for overweight in preschool children: A policy perspective.” International Journal of Pediatric Obesity 1(4): 195-209.

Holm, J. et al. (2011). Chronic care treatment of obese children and adolescents. International Journal of Paediatric Obesity, 2011; 6:188-196.

Loosemore, M. & Savage, P. (2014). An introduction to Active Movement™. www.activemovement.co.uk . Unpublished.

NHS Statistics on Obesity, physical activity and diet in England (2010). The NHS information Centre, Lifestyle Statistics accessed online

Roberts-Holmes, G. (2005). Doing your early years research project a step by step guide. London: Paul Chapman Publishing.

Statham, J. & Chase, E. (2010) Childhood Wellbeing: A brief overview. Childhood Wellbeing Research Centre. Briefing Paper 1 (August 2010). IOE London, Loughborough University, PSSRU University of Kent.

World Health Organisation. (2007). Early Child Development: A Powerful Equalizer: Final Report. Final Report for the World Health Organization’s Commission on the Social Determinants of Health. Prepared by Lori G. Irwin, Arjumand Siddiqi, and Dr. Clyde Hertzman. June 2007. Available at: http://www.who.int/social_determinants/resources/ecd_kn_report_07_2007.Accessed 12/12/2014

Share this article

 

About the Author:

Linda has been a passionate advocate for health and wellbeing in Early Years throughout her career. Known for her cross-disciplinary and collaborative approach, Linda is a well-known speaker at national and international conferences. Linda is CEO of PurpleBee, and co-founder of the PANCo qualification.