Given ECEs have been noted to largely influence movement affordances in childcare settings,  ensuring they have the understanding, confidence, and motivation to facilitate physical activity opportunities in these settings is important. To our knowledge, this is the first study to examine the short-term effect of an e-Learning course in physical activity and sedentary behaviour on both pre- and in-service ECEs’ knowledge, self-efficacy, behavioural intention, and perceived behavioural control to support physical activity and minimize sedentary behaviour in childcare. After taking the course, both pre- and in-service ECEs demonstrated significant positive changes in their knowledge and self-efficacy regarding physical activity, sedentary behaviour, and outdoor play in childcare settings. Their intention and perceived control to promote healthy levels of physical activity and appropriate sedentary behaviour also increased following training. A number of these findings are discussed below.
As noted above, both pre- and in-service ECEs significantly increased their total knowledge of physical activity and sedentary behaviour. These improvements could largely be attributed to increased scores in the Guidelines and Important Definitions sections of the questionnaire. Of note, very few ECEs demonstrated an understanding of the physical activity and screen-viewing recommendations within the 24-Hour Movement Guidelines for the Early Years prior to taking the e-Learning course. This is consistent with previous work by Bruijns and colleagues,  which showed that less than 20% and 13% of ECEs (n = 83) correctly recalled physical activity and screen-viewing guidelines, respectively, prior to participating in training. More positively, findings from the present study showed that in-service ECEs’ guideline recollection approached 100% for some items following the e-Learning course, indicating that participants were able to learn this content effectively via e-Learning. Significant increases were also observed for the in-service ECEs who provided the correct responses for questions pertaining to physical literacy, active play, and muscle and bone-strengthening activities definitions. Our baseline finding related to physical literacy and subsequent improvements aligns with the findings of Foulkes and colleagues,  who found early care providers were not aware of the meaning of the term ‘physical literacy’. It is clear that ECEs need additional training in physical activity domains to both understand the importance of being active in a variety of ways and how to integrate active play experiences into early learning settings.
In addition to marked increases in pre- and in-service ECEs’ knowledge, the e-Learning course was also associated with a significant increase in ECEs’ self-efficacy. This finding speaks to the well-rounded nature of the e-Learning course, as previous professional learning studies with ECEs have typically focused only on children’s physical activity, [38,39,40] with sedentary behaviour often left out. By including sedentary behaviour content and placing focus on the importance of outdoor play in facilitating physical activity among children in childcare, the ECEs in our study appear to have gained confidence in these other domains as well. Similarly, Hassani et al.  measured Canadian ECEs’ (n = 1819) confidence following a professional learning intervention in healthy eating and physical activity (which also included content on sedentary behaviour), and found that ECEs demonstrated significant increases in both physical activity and sedentary behaviour-related confidence. As such, supporting ECEs’ self-efficacy development via professional learning is a useful tool that can increase the likelihood that they will incorporate movement-based programming, while satisfying their request for additional training in these domains.
Not only did ECEs show improvements in their knowledge and self-efficacy scores, but behavioural intention and perceived behavioural control relating to physical activity and sedentary behaviour also increased, consistent with previous literature . Bai and colleagues  implemented both a nature play and a fundamental movement skill professional learning intervention for Australian ECEs (n = 84 and n = 64, respectively), and observed significant increases in self-efficacy, intention, and perceived behavioural control for promoting physical activity. In accordance with the TPB,  when ECEs exhibit greater intention to promote active childcare settings and better ability to control their practices and programming, behaviour change is expected. The intersection of these psychosocial variables is likely to influence children’s physical activity levels in childcare,  which is important to consider when designing childcare-based intervention studies. As such, fostering ECEs’ own knowledge, confidence, intentions, and perceived control is an efficacious way to promote sustainable change in the childcare setting with respect to movement opportunities.
Research implications and future directions
The findings from this pilot study are important for public health researchers in the early years population. Specifically, the comprehensiveness of the e-Learning course itself, which included content on physical activity, sedentary behaviour, and outdoor and risky play, lends itself to be applicable to childcare providers both within and outside of Canada, as the course was not designed for a specific program or intervention, but rather to provide general training in these areas. The preliminary efficacy of the e-Learning course at increasing ECEs’ physical activity and sedentary behaviour-related knowledge, self-efficacy, behavioural intention, and perceived behavioural control is encouraging for the use of this training to address public health issues, such as physical inactivity in childcare settings, by ensuring ECEs understand how to and are confident in promoting healthy physical activity and sedentary behaviour in early learning environments. Moreover, the virtual nature of the course increases the potential for population-level reach, and only simple modifications would be needed to tailor it for other settings. Future research in this field should explore whether ECEs’ knowledge, self-efficacy, behavioural intention, and perceived behavioural control (uniquely or in combination) are important drivers of young children’s physical activity in the childcare setting.
Strengths and limitations
While this pilot study has many strengths including its diverse Canadian sample, inclusion of both pre- and in-service ECEs, and the high response rate within the context of online surveys, there are also limitations which must be highlighted. First, as this was a pilot study, findings should be interpreted with caution given there was no control group against which to compare intervention samples. Second, the small sample size of the pre-service ECEs, due to logistical issues with implementation in post-secondary settings during the COVID-19 pandemic, lacked the power needed to demonstrate complete intervention efficacy in this population. Further, the low retention of in-service ECEs (~ 40%), as compared to pre-service ECEs (~ 60%), is important to acknowledge, as in-service ECEs retained for analysis differed on select demographic variables from those lost to follow-up. While these differences in retention may have been attributed to the differential recruitment and implementation methods in these study populations, as well as the burden of the COVID-19 pandemic on in-service ECEs’ time to partake in professional learning, it is possible these differences may have impacted the study findings. Third, the knowledge questionnaire was not a validated instrument, as it was created based on the specific e-Learning course content which was unique to this study. As such, while face validity was achieved through expert review and consensus, measures of knowledge in this study may not be generalizable to other research with this population. Further, lack of sufficient cell sizes and item difficulty within the questionnaire limited the analyses that could be conducted with these data. Finally, given the self-reported nature of the online survey, social desirability bias may have been at play, as ECEs may have felt that more positive responses (i.e., rating themselves as more confident or intentional) were expected of someone in their profession. Despite these limitations, we found significance in a study that was underpowered to do so; as such, it is predicted that scale-up of this pilot study with a more robust sample and a comparison group is likely to demonstrate effectiveness within this population.