Kristen A. Copeland of Cincinnati Children's Hospital Medical Center and colleagues said the study involved nine focus groups with 49 child care providers -- 55 percent African-American -- assembled from 34 centers from the inner-city, suburban, Head Start and Montessori in Cincinnati.
Three researchers independently analyzed verbatim transcripts for themes.
The study, published in the journal Pediatrics, identified three main barriers to children's physical activity in child care -- injury concerns, financial and a focus on academics.
Stricter licensing codes intended to reduce children's playground injuries have resulted in playgrounds less physically challenging and interesting, while at the same time, some parents, who also fear injury, request staff to restrict playground participation for their children, Copeland said.
Copeland also said since child care centers operate on limited income their ability to install abundant playground equipment is also limited.
Meanwhile, child care providers also felt pressure from state mandates and parents to focus on academics at the expense of physical activity.
"Societal priorities for young children -- safety and school readiness -- may be hindering children's physical development," study authors said in a statement.
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