Abstract
BackgroundDaily physical activity is critical during the early years of life for facilitating children’s health and development. A large proportion of preschool children do not achieve the recommended 3 h of daily physical activity. Early childhood education and care (ECEC) services are a key setting to intervene to increase physical activity. There is a significant need for ECEC specific physical activity policy, including clearer guidelines on the amount of physical activity children should do during care, and strategies for implementation of these guidelines.MethodsThis study is a pragmatic cluster randomised trial to evaluate the effectiveness of the Play Active physical activity policy intervention to improve early childhood education and care educator’s physical activity-related practices. The central component of Play Active is an evidence-informed physical activity policy template which includes 25 practices to support nine age-specific recommendations on the amount of physical activity and sedentary time, including screen time, young children should do while in care. There are six implementation support strategies to facilitate physical activity policy implementation: (i) personalise policy (services select at least five of the 25 practices to focus on initially); (ii) policy review and approval; (iii) a resource guide; (iv) a brief assessment tool for monitoring children’s energetic play; (v) professional development; and (vi) Project Officer implementation support (phone calls). A total of 60 early childhood education and care services will be recruited from metropolitan Perth, Western Australia. After baseline assessment, services will be randomly allocated to either intervention or wait-listed comparison conditions. Primary (educator-reported frequency and amount of daily time provided for children’s physical activity, sedentary and screen time) and secondary (educator physical activity-related practices, self-efficacy, motivation, attitudes and beliefs, social support, and supportive physical environment) outcomes will be assessed at baseline and post-intervention, after intervention services have had a minimum 3 months of policy implementation within their service.DiscussionThe Play Active trial will rigorously evaluate a novel physical activity policy intervention with implementation support that promotes positive physical activity behaviours in educators and children attending ECEC. If effective, the program could be adapted, scaled-up and delivered in ECEC services nationally.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12620001206910 (date of registration 13/11/2020).
Highlights
Physical activity is critical during the early years of life for facilitating children’s health and development
Systematic reviews of intervention studies implementing physical activity policies, practices or programmes within Early childhood education and care (ECEC) services indicate little evidence of benefit on young children’s physical activity [6]. This is due to lack of efficacy that the intervention improves children’s physical activity, lack of implementation supports, implementation barriers, the intervention not being conducive to real-word conditions and the insufficient use of evidence-based behaviour change frameworks [6]
This paper describes the protocol of a pragmatic cluster randomised trial to evaluate the effectiveness of the Play Active physical activity policy intervention on increasing the frequency and amount of time each day ECEC educators provide for young children’s physical activity, sedentary and screen time
Summary
Study design and setting This pragmatic cluster randomised trial design involves 60 ECEC services in Perth metropolitan and Peel regions of Western Australia. Primary outcomes Change in educator physical activity practices related to the frequency or amount of time provided each day for physical activity, sedentary and screen time of young children in care will be assessed using established items drawn from existing validated instruments (e.g., Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC) [31] and Environment and Policy Assessment and Observation (EPAO) – Self Report tool [32]), which have been modified for the Australian ECEC context [27] and found to have acceptable test-retest reliability [33]. Uptake of the implementation support strategies (reach) will be measured using multiple methods These include project management logs to see if the policy template is returned for review; website data from partners (Nature Play WA and KIDDO) to assess the uptake of professional development by educators as well as selfreport items in the educator post-intervention survey. Results will be reported according to Consolidated Standard of Reporting Trials guidelines [26]
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