Increasing physical activity among young children from disadvantaged communities: study protocol of a group randomised controlled effectiveness trial.

Rebecca M Stanley,Steven J Howard,Ngiare Brown,Paul Chandler,Donna Berthelsen,Jo Salmon,Trina Hinkley,Rachel A Jones,Xanne Janssen,John J Reilly,Karen J Mickle,Fay Gowers,Stewart G Trost,Dylan P Cliff,Anthony D Okely,Marijka Batterham,Penny Cross,Simon Eckermann

doi:10.1186/s12889-016-3743-0

Abstract

BackgroundParticipation in regular physical activity (PA) during the early years helps children achieve healthy body weight and can substantially improve motor development, bone health, psychosocial health and cognitive development. Despite common assumptions that young children are naturally active, evidence shows that they are insufficiently active for health and developmental benefits. Exploring strategies to increase physical activity in young children is a public health and research priority.Methods Jump Start is a multi-component, multi-setting PA and gross motor skill intervention for young children aged 3–5 years in disadvantaged areas of New South Wales, Australia. The intervention will be evaluated using a two-arm, parallel group, randomised cluster trial. The Jump Start protocol was based on Social Cognitive Theory and includes five components: a structured gross motor skill lesson (Jump In); unstructured outdoor PA and gross motor skill time (Jump Out); energy breaks (Jump Up); activities connecting movement to learning experiences (Jump Through); and a home-based family component to promote PA and gross motor skill (Jump Home). Early childhood education and care centres will be demographically matched and randomised to Jump Start (intervention) or usual practice (comparison) group. The intervention group receive Jump Start professional development, program resources, monthly newsletters and ongoing intervention support. Outcomes include change in total PA (accelerometers) within centre hours, gross motor skill development (Test of Gross Motor Development-2), weight status (body mass index), bone strength (Sunlight MiniOmni Ultrasound Bone Sonometer), self-regulation (Heads-Toes-Knees-Shoulders, executive function tasks, and proxy-report Temperament and Approaches to learning scales), and educator and parent self-efficacy. Extensive quantitative and qualitative process evaluation and a cost-effectiveness evaluation will be conducted.DiscussionThe Jump Start intervention is a unique program to address low levels of PA and gross motor skill proficiency, and support healthy lifestyle behaviours among young children in disadvantaged communities. If shown to be efficacious, the Jump Start approach can be expected to have implications for early childhood education and care policies and practices, and ultimately a positive effect on the health and development across the life course.Trial registrationAustralian and New Zealand Clinical Trials Registry No: ACTRN12614000597695, first received: June 5, 2014.

Highlights

Participation in regular physical activity (PA) during the early years helps children achieve healthy body weight and can substantially improve motor development, bone health, psychosocial health and cognitive development
The development of the Jump Start intervention was informed by formative research, involving two Early Childhood Education and Care (ECEC) parent organisations and ECEC educators employed by those organisations
This paper presents the study protocols for the Jump Start intervention

Summary

Methods

Study design The Jump Start study is a two-arm, parallel group, cluster randomised controlled trial (RCT) using a nested-cohort design [33] (Fig. 1). For increasing the value that educators place on gross motor skills and physical activity in young children in their Centre, a strategy would be to show educators how the Jump Start intervention links to important compliance and curriculum documents such as the Early Years Learning Framework and National Quality Standard [19, 48]. Demographic variables include children’s date of birth, sex, Aboriginal or Torres Strait Islander (ATSI) status, and Cultural and Linguistic Diversity (CALD); parent/ caregivers’ age, sex, postcode, marital status, education status, employment status, gross annual income, ATSI status, CALD and family structure; and educators’ age, sex, qualifications, years of experience (in ECEC and in the participating centre), and level of training and experience in physical activity and motor skill development. Standard summary measures for cost-effectiveness analysis, including net benefit curves, cost-effectiveness acceptability curves, and expected net loss curves and frontiers will be presented to best inform societal decision makers of the net benefit of the intervention and value of future research [65, 66]

Discussion

Background

Findings