Abstract
BackgroundThe implementation of physical activity interventions in centre-based childcare services has been recommended to improve child health. This study aims to evaluate the efficacy of scheduling multiple periods of outdoor free play in increasing the time children spend in moderate-to-vigorous physical activity (MVPA) during childcare.MethodsThe study will employ a between group cluster randomised controlled trial design. Fourteen childcare services in the Hunter New England region of New South Wales, Australia, who currently implement a single session of free outdoor play between their core operational hours of 9 am to 3 pm will be recruited into the trial. Childcare services will be randomised to an intervention or a no intervention control group. Childcare services in the intervention group will be supported by an early childhood education specialist to provide three periods of outdoor free play for children between the hours of 9 am to 3 pm. Each period of outdoor free play will be at least 15 min in duration but must equate to their total usual duration of outdoor play. Services in the control group will continue to implement a single period of outdoor play. The primary trial outcome is minutes of time children spend in MVPA whilst in care assessed objectively via accelerometer over 5 days. Outcome assessment will occur at baseline and 3 months post baseline. Generalised Linear Mixed Models (GLMM) under an intention to treat framework will be used to compare differences between groups in the primary trial outcome at follow-up. Sensitivity analysis will be conducted to test assumptions of missing data. Per protocol analysis will be performed using services that implemented the intervention as intended and subgroup analysis undertaken by gender and baseline physical activity levels of children.DiscussionThe study tests a simple ecological intervention that has the potential to increase child physical activity in care.Trial registrationAustralian New Zealand Clinical Trials Registry 12616000347460. Prospectively registered 17th March 2016.
Highlights
The implementation of physical activity interventions in centre-based childcare services has been recommended to improve child health
A number of characteristics of centre-based childcare services suggest that they represent an ideal setting for interventions to improve physical activity in young children
Intervention efficacy will be determined by comparing differences between groups in the minutes children spend in moderate-to-vigorous physical activity (MVPA) per day at childcare
Summary
The implementation of physical activity interventions in centre-based childcare services has been recommended to improve child health. Physical activity in early childhood has immediate beneficial effects on blood pressure, lipid profile, motor skill and bone development [2,3,4] with greatest benefit accruing at moderate-to-vigorous intensity [3, 4]. Despite these benefits, research in Australia and internationally has demonstrated that most children aged 2 to 6 years do not engage in physical activity consistent with current national guidelines [5, 6]. Childcare service staff believe in the importance of children being physically active as a part of their professional responsibility and are amenable to interventions to support improvements in child activity [9]
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