Activity Promotion Interventions Research Articles

Assessing the Internal and External Validity of Mobile Health Physical Activity Promotion Interventions: A Systematic Literature Review Using the RE-AIM Framework

BackgroundMobile health (mHealth) interventions are effective in promoting physical activity (PA); however, the degree to which external validity indicators are reported is unclear.ObjectiveThe purpose of this systematic review was to use the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework to determine the extent to which mHealth intervention research for promoting PA reports on factors that inform generalizability across settings and populations and to provide recommendations for investigators planning to conduct this type of research.MethodsTwenty articles reflecting 15 trials published between 2000 and 2012 were identified through a systematic review process (ie, queries of three online databases and reference lists of eligible articles) and met inclusion criteria (ie, implementation of mobile technologies, target physical activity, and provide original data). Two researchers coded each article using a validated RE-AIM data extraction tool (reach, efficacy/effectiveness, adoption, implementation, maintenance). Two members of the study team independently abstracted information from each article (inter-rater reliability >90%) and group meetings were used to gain consensus on discrepancies.ResultsThe majority of studies were randomized controlled trials (n=14). The average reporting across RE-AIM indicators varied by dimension (reach=53.3%, 2.67/5; effectiveness/efficacy=60.0%, 2.4/4; adoption=11.1%, 0.7/6; implementation=24.4%, 0.7/3; maintenance=0%, 0/3). While most studies described changes in the primary outcome (effectiveness), few addressed the representativeness of participants (reach) or settings (adoption) and few reported on issues related to maintenance and degree of implementation fidelity.ConclusionsThis review suggests that more focus is needed on research designs that highlight and report on both internal and external validity indicators. Specific recommendations are provided to encourage future mHealth interventionists and investigators to report on representativeness, settings, delivery agents for planned interventions, the extent to which protocol is delivered as intended, and maintenance of effects at the individual or organizational level.

Adapting health promotion interventions to meet the needs of ethnic minority groups: mixed-methods evidence synthesis.

There is now a considerable body of evidence revealing that a number of ethnic minority groups in the UK and other economically developed countries experience disproportionate levels of morbidity and mortality compared with the majority white European-origin population. Across these countries, health-promoting approaches are increasingly viewed as the long-term strategies most likely to prove clinically effective and cost-effective for preventing disease and improving health outcomes in those with established disease. To identify, appraise and interpret research on the approaches employed to maximise the cross-cultural appropriateness and effectiveness of health promotion interventions for smoking cessation, increasing physical activity and improving healthy eating for African-, Chinese- and South Asian-origin populations. Two national conferences; seven databases of UK guidelines and international systematic reviews of health promotion interventions aimed at the general population, including the Clinical Evidence, National Institute for Health and Clinical Excellence and Scottish Intercollegiate Guidelines Network databases (1950-2009); 11 databases of research on adapted health promotion interventions for ethnic minority populations, including BIOSIS, EMBASE and MEDLINE (1950-2009); and in-depth qualitative interviews with a purposive sample of researchers and health promoters. Theoretically based, mixed-methods, phased programme of research that involved user engagement, systematic reviews and qualitative interviews, which were integrated through a realist synthesis. Following a launch conference, two reviewers independently identified and extracted data from guidelines and systematic reviews on the effectiveness of interventions for the general population and any guidance offered in relation to how to interpret this evidence for ethnic minority populations. Data were thematically analysed. Reviewers then independently identified and critically appraised studies of adapted interventions and summarised data to assess feasibility, acceptability, equity, clinical effectiveness and cost-effectiveness. Interviews were transcribed, coded and thematically analysed. The quantitative and qualitative data were then synthesised using a realist framework to understand better how adapted interventions work and to assess implementation considerations and prioritise future research. Our preliminary findings were refined through discussion and debate at an end-of-study national user engagement conference. Initial user engagement emphasised the importance of extending this work beyond individual-centred behavioural interventions to also include examination of community- and ecological-level interventions; however, individual-centred behavioural approaches dominated the 15 relevant guidelines and 111 systematic reviews we identified. The most consistent evidence of effectiveness was for pharmacological interventions for smoking cessation. This body of work, however, provided scant evidence on the effectiveness of these interventions for ethnic minority groups. We identified 173 reports of adapted health promotion interventions, the majority of which focused on US-based African Americans. This body of evidence was used to develop a 46-item Typology of Adaptation and a Programme Theory of Adapted Health Promotion Interventions. Only nine empirical studies directly compared the effectiveness of culturally adapted interventions with standard health promotion interventions, these failing to yield any consistent evidence; no studies reported on cost-effectiveness. The 26 qualitative interviews highlighted the need to extend thinking on ethnicity from conventional dimensions to more contextual considerations. The realist synthesis enabled the production of a decision-making tool (RESET) to support future research. The lack of robust evidence of effectiveness for physical activity and healthy-eating interventions in the general population identified at the outset limited the comparative synthesis work we could undertake in the latter phases. Furthermore, the majority of studies undertaking an adapted intervention were conducted within African American populations; this raises important questions about the generalisability of findings to, for example, a UK context and other ethnic minority groups. Lastly, given our focus on three health areas and three populations, we have inevitably excluded many studies of adapted interventions for other health topics and other ethnic minority populations. There is currently a lack of evidence on how best to deliver smoking cessation, physical activity and healthy eating-related health promotion interventions to ethnic minority populations. Although culturally adapting interventions can increase salience, acceptability and uptake, there is as yet insufficient evidence on the clinical effectiveness or cost-effectiveness of these adapted approaches. More head-to-head comparisons of adapted compared with standard interventions are warranted. The Typology of Adaptation, Programme Theory of Adapted Health Promotion Interventions and RESET tool should help researchers to develop more considered approaches to adapting interventions than has hitherto been the case. The National Institute for Health Research Health Technology Assessment programme.

Gender, weight status and socioeconomic differences in psychosocial correlates of physical activity in schoolchildren

This study sought to assess differences in attraction to physical activity, perceived physical competence and parental socialization influences across gender, body mass index and socioeconomic status in Portuguese children. Cross-sectional study. 683 children, aged 8-10 years, from elementary schools were participants. Attraction to physical activity, perceived physical competence, parental socialization influences and socioeconomic status were assessed via standardized questionnaires. The prevalence of overweight and obesity was calculated using body mass index, based on the international cut-off points. MANOVA and ANOVA models were conducted. Boys reported greater enjoyment of games and sports participation than did girls. Boys and normal-weight children perceived themselves as being more successful and physically competent than did girls and obese children. Normal-weight girls enjoyed participation in vigorous physical activity more than did overweight and obese girls. Obese children felt less accepted by their peers in games and sports than did normal-weight and overweight children. High and medium socioeconomic status children perceived physical activity participation as of greater importance than did low-socioeconomic status children. High-socioeconomic status girls reported greater liking of the exertional aspects of physical activity compared to low socioeconomic status girls. High socioeconomic status children were more likely to perceive their parents as positive role models and perceived that they had greater enjoyment of physical activity than did lower socioeconomic status children. These results suggest that physical activity promotion interventions should focus on girls, obese children and lower socioeconomic status children as these individuals tend to have lower levels of attraction to physical activity, lower perceived physical competence and less parent physical activity support, which puts them at greater risk of being physically inactive.

Mental health and somatic symptom severity are associated with reduced physical activity among US Iraq and Afghanistan veterans

ObjectiveEnsuring that Iraq and Afghanistan veterans engage in adequate physical activity is essential to prevent metabolic and cardiovascular diseases, and promote psychological well-being. Identifying factors associated with physical activity in this population will yield areas for targeted interventions aimed at increasing activity. MethodCorrelates of meeting physical activity recommendations (≥150min/week of moderate-to-vigorous physical activity [MVPA]) were examined in Iraq/Afghanistan veterans assessed at intake to VA Puget Sound Healthcare System's post-deployment health clinic (May, 2005–August, 2009; N=266). ResultsThe majority were male (94.3%) and Caucasian (70.7%), with an average age of 29.8 (SD=7.3) years. Participants engaged in a median of 180 weekly MVPA minutes. Among those meeting (59%) and not meeting (41%) recommendations, median weekly MVPA minutes were 540 and 0, respectively. In multivariate regression models, higher levels of depression (p=.042) and somatic (p=.018) symptom severity were associated with significantly decreased odds of meeting physical activity recommendations. ConclusionOverall, physical activity engagement among Iraq/Afghanistan veteran VA patients was above the level specified in national recommendations. Those with higher depressive and somatic symptoms were less likely to meet physical activity recommendations and may benefit from targeted physical activity promotion interventions.

Masculine Identity and It's Potential Influence on Physical Activity in Older African American Men

PURPOSE: The purpose of this study was to gain a greater understanding of midlife and older African American (AA) men's perception of masculinity and its potential influence on health-related behavior to help inform the development of a gender-specific physical activity (PA) promotion intervention. METHODS: Participants were 49 AA men ages 45-88 years. In-depth interviews ascertained the participants' perspectives on masculinity, how masculine identity varied by age and race, and how it influenced PA and other health-related behaviors. Taped interviews were transcribed and organized in NVivo for analysis. Common themes were identified by multiple research staff. RESULTS: Most often cited attributes of someone considered "manly' included a leader of a family/household, provider, strong work ethic, and masculine physique. The men commonly used terms such as responsible, principled, man of God, macho, and strong to describe the typical man. Participants' age was not associated with the responses, but men who reported lower levels of PA were more likely to state that the typical man was responsible, and possessed athleticism, wisdom, principles, and sexual prowess. These same men, however, were less likely to indicate that the typical man was a hard worker. The men reported potential negative and positive influences of masculinity on health including avoiding health care services/doctors and being a good example to children/others, respectively. Themes associated with how masculinity changes with age were acceptance of diminished health and physical function and being more health conscience. Negative factors associated with how masculinity is influenced by AA race included stress, racism, and lack of trust in physicians, balanced by perseverance. CONCLUSION: The AA men in this study mostly reflected traditional views of masculinity, as well as perceptions associated with their life priorities (e.g., provider, father, husband, and role model), aging (e.g., lower functional capacity), and being AA (e.g., stress). This qualitative research yielded insightful information that can be used to tailor recruitment, intervention, and retention strategies to enhance PA and health promotion among midlife and older AA men, particularly those exhibiting lower levels of PA. Supported by NIA/NIH Grant #R21AG028674.

Predictors of Physical Activity in Adults With Type 2 Diabetes

To determine demographic, medical, social cognitive, and environmental predictors of aerobic physical activity and resistance training in a population sample of adults with type 2 diabetes. Two hundred forty-four (244) participants completed questionnaires with a 3-month follow-up. Multiple and logistic regression models examined predictors of aerobic activity and resistance training. Several factors were associated with higher levels of both aerobic physical activity and resistance training; self-efficacy was the strongest predictor for both modes of activity. The findings can guide physical activity promotion interventions and programs for this population, profiling those who are least active.

Physical Activity and Nutrition Health Promotion Interventions: What is Working for People With Intellectual Disabilities?

A scoping review of studies on physical activity and nutrition health promotion interventions for individuals with intellectual disabilities was conducted. Searches included MEDLINE, PsycINFO, and CINAHL databases from 1986 through July 2006. The final number included 11 articles comprising 12 studies. Generally, this review indicated some evidence for fitness and psychosocial benefits of community-based physical activity and exercise programs for adults with intellectual disabilities. When combined with a more comprehensive health behavior education program incorporating exercise and nutrition information, some evidence exists for reductions in weight.

Does tailoring on additional theoretical constructs enhance the efficacy of a print-based physical activity promotion intervention?

To enhance a previously efficacious individually tailored physical activity (PA) promotion intervention by adding theoretical constructs to the tailored feedback. We randomly assigned 248 healthy, underactive (moderate to vigorous physical activity [MVPA] min/week < 90) adults (mean age = 48.8 years, SD = 10.0) to receive either (a) a theoretically tailored (based on 5 constructs from the transtheoretical model and social-cognitive theory [SCT]) print-based PA promotion intervention (print) or (b) the same theoretically tailored print-based PA promotion intervention plus enhanced tailoring addressing 5 additional SCT constructs (enhanced print). The 7-day physical activity recall administered at baseline, Month 6, and Month 12, with outcomes operationalized as percentage achieving 150 min/week of MVPA. When controlling for covariates, there was a nonsignificant trend in favor of the enhanced print condition reflecting 46% and 50% greater odds of achieving 150 min/week of MVPA at Month 6 and Month 12, respectively. Enhanced tailoring based on additional theoretical constructs may result in marginal improvements in physical activity outcomes.

Worksite Physical Activity Interventions and Obesity: A Review of European Studies (the HOPE Project)

Objective: Our aim was to review the effectiveness of physical activity promotion interventions in the worksite setting in Europe in order to identify those studies that had measured obesity-related outcomes and to evaluate how external validity of the findings had been assessed. Methods: We conducted a review of studies conducted in Europe, published up to December 2009. We assessed levels of evidence regarding effectiveness and analysed external validity using the RE-AIM framework. Results: Studies included (n = 33) were divided in 6 intervention categories. Moderate evidence of effectiveness was found for physical fitness outcomes with exercise training interventions and for physical activity outcomes with active commuting interventions. There was no or inconclusive evidence for obesity-related outcomes for all intervention categories. For external validity, elements receiving the least attention (<20%) were representativeness of participants, setting-level inclusion/exclusion criteria and representativeness, characteristics regarding intervention staff, implementation of intervention, costs, long-term effects and programme sustainability. Conclusions: Active commuting and exercise training appear as promising approaches to promote physical activity or fitness in the workplace. The effect of interventions on obesity-related outcomes remains to be further investigated. There is a need to better report elements of generalizability and dissemination for translation into practice of worksite physical activity interventions.

Enjoyment of exercise moderates the impact of a school-based physical activity intervention

BackgroundA school-based physical activity intervention designed to encourage adolescent girls to be more active was more effective for some participants than for others. We examined whether baseline enjoyment of exercise moderated response to the intervention.MethodsAdolescent girls with a low level of baseline activity who participated in a controlled trial of an intervention to promote increased physical activity participation (n = 122) self-reported their enjoyment of exercise and physical activity participation at baseline, mid-way through the intervention, and at the end of the 9-month intervention period. At all three time points, participants also underwent assessments of cardiovascular fitness (VO2peak) and body composition (percent body fat). Repeated measures analysis of variance examined the relationship of baseline enjoyment to change in physical activity, cardiovascular fitness, body composition and enjoyment of exercise.ResultsA significant three-way interaction between time, baseline enjoyment, and group assignment (p < .01) showed that baseline enjoyment moderated the effect of the intervention on vigorous activity. Within the intervention group, girls with low enjoyment of exercise at baseline increased vigorous activity from pre-to post-intervention, and girls with high baseline enjoyment of exercise showed no pre-post change in vigorous activity. No differences emerged in the comparison group between low-and high-enjoyment girls.ConclusionAdolescent girls responded differently to a physical activity promotion intervention depending on their baseline levels of exercise enjoyment. Girls with low enjoyment of exercise may benefit most from a physical-education based intervention to increase physical activity that targets identified barriers to physical activity among low-active adolescent girls.

Systematic Development of the YouRAction program, a computer-tailored physical activity promotion intervention for Dutch adolescents, targeting personal motivations and environmental opportunities.

BackgroundIncreasing physical activity (PA) among adolescents is an important health promotion goal. PA has numerous positive health effects, but the majority of Dutch adolescents do not meet PA requirements. The present paper describes the systematic development of a theory-based computer-tailored intervention, YouRAction, which targets individual and environmental factors determining PA among adolescents.DesignThe intervention development was guided by the Intervention Mapping protocol, in order to define clear program objectives, theoretical methods and practical strategies, ensure systematic program planning and pilot-testing, and anticipate on implementation and evaluation. Two versions of YouRAction were developed: one that targets individual determinants and an extended version that also provides feedback on opportunities to be active in the neighbourhood. Key determinants that were targeted included: knowledge and awareness, attitudes, self-efficacy and subjective norms. The extended version also addressed perceived availability of neighbourhood PA facilities. Both versions aimed to increase levels of moderate-to-vigorous PA among adolescents. The intervention structure was based on self-regulation theory, comprising of five steps in the process of successful goal pursuit. Monitoring of PA behaviour and behavioural and normative feedback were used to increase awareness of PA behaviour; motivation was enhanced by targeting self-efficacy and attitudes, by means of various interactive strategies, such as web movies; the perceived environment was targeted by visualizing opportunities to be active in an interactive geographical map of the home environment; in the goal setting phase, the adolescents were guided in setting a goal and developing an action plan to achieve this goal; in the phase of active goal pursuit adolescents try to achieve their goal and in the evaluation phase the achievements are evaluated. Based on the results of the evaluation adolescents could revise their goal or choose another behaviour to focus on. The intervention is delivered in a classroom setting in three lessons. YouRAction will be evaluated in a cluster-randomized trial, with classes as unit of randomization. Evaluation will focus on PA outcomes, cognitive mediators/moderators and process measures.DiscussionThe planned development of YouRAction resulted in two computer-tailored interventions aimed at the promotion of PA in a Dutch secondary school setting.Trial registrationNTR1923

Obesity increase among low SES Australian schoolchildren between 2000 and 2006: time for preventive interventions to target children from low income schools?

To examine change from 2000 to 2006 in obesity and overweight by gender, school year and school socioeconomic status (SES) in a national sample of students from Australia. Survey of students aged 6-18 years from the same 32 schools in 2000 (N = 3,819) and 2006 (N = 5,524) with measured height and weight. All analyses were adjusted for the cluster survey design. Main outcome measures were height, weight, Z-score distribution of BMI, overweight and obesity [International Obesity Task Force (IOTF) cut-offs], school SES. Obesity and overweight were similar to previous Australian findings with 5.2% and 6.1% obese in 2000 and 2006, respectively, and 16.3 and 19.0% overweight. Significant increase in obesity was observed in students from low SES schools which increased from 5.8 to 8.6% (P < 0.05) compared to 5.5 to 6.3% (P = 0.32) in middle SES and 3.3 to 4.2% (P = 0.92) in high SES schools. Obesity increased significantly among children in low SES schools and preventive efforts should urgently and carefully target preventive efforts to assist schools, families and communities which are socially and economically, disadvantaged using culturally appropriate physical activity and nutrition promotion interventions.

The Effects Of A Multi-level Physical Activity And Health Promotion Intervention On A Group Of Females In The Worksite Setting

The Effects Of A Multi-level Physical Activity And Health Promotion Intervention On A Group Of Females In The Worksite Setting

Physical Activity Promotion Among Underserved Adolescents: “Make It Fun, Easy, and Popular”

There is a paucity of studies regarding noncurricular physical activity promotion interventions among adolescents, and even less such research pertaining to underserved youth. This article describes the development and implementation of a noncurricular, school-based physical activity promotion program designed for a multiethnic, underserved population of adolescents. The program's impact on leisure-time physical activity (LTPA) and on physical activity enjoyment (PAE) is also presented. The 16-week program, named FunAction, utilizes social marketing principles. Control (n = 90) and intervention (n = 131) students are assessed pre- and postintervention for levels of LTPA and PAE. Results indicate that although the program did not contribute to an increase in LTPA or PAE among intervention group students, participation in the program was elevated. This study offers preliminary evidence that noncurricular physical activity promotion programs that apply social marketing principles can be effective in engaging multiethnic, underserved adolescents in physical activity.

Aerobic Walking among Adults with Intellectual Disabilities: Implications for Health Promotion Programs

Research has indicated that adults with intellectual disabilities (ID) do not participate in sufficient volume or intensity of physical activity for many health benefits. In addition, little is known about the context in which physical activity occurs for this population on which to build health promotion interventions. This study used time-stamped pedometers to measure aerobic physical activity behavior of 131 adults with mild to moderate ID living in community-based supported living group settings. Participants wore a pedometer for seven consecutive days. A qualitative study of supported living agency stakeholders was performed to interpret the results in the context of intervention planning within the agency setting. Open-ended interviews of eight agency administrators and staff were combined with results of two focus groups of adults with ID (n=12). The participants accrued 6508 ± 3296 steps/day. Controlling for age, participants with mild ID were more active than participants with moderate ID (F=7.03, p<.01). While 14.1% accumulated 10,000 steps/day, only 1.5% achieved 30 minutes of aerobic physical activity in 10-minute bouts on 5 days of the week. Qualitative study results revealed that an intervention should emphasize self-determination and allow for individual needs, abilities, and interests. Interviews also revealed several barriers to program implementation, including resource barriers related to agency financial support structures. Very few adults with ID met public health guidelines for physical activity, indicating a need for physical activity promotion interventions. Study results indicated stakeholder perceived need and interest for such programs, but structural resources are considered a primary barrier to successful implementation.

The Active plus protocol: systematic development of two theory- and evidence-based tailored physical activity interventions for the over-fifties

BackgroundLimited data are available on the development, implementation and evaluation processes of physical activity promotion programmes among older adults. More integrative insights into interventions describing the planned systematic development, implementation and evaluation are needed.Methods and designThe purpose of this study is to give an integrative insight into the development of the Active plus programme applying the six-step Intervention Mapping protocol. The Active plus programme consisted of two theory- and evidence-based tailored physical activity promotion interventions, both comprising three tailored letters delivered over four months and aimed at raising awareness of insufficient physical activity, and stimulating physical activity initiation and maintenance among the over-fifties.The first intervention, the basic tailored intervention, provided tailored letters that intervened on the psychosocial determinants of physical activity. The second intervention, the intervention plus, provided the same tailored information but additionally provided tailored information about physical activity opportunities in the specific environment in which the older adults lived. This environment-based component also provided access to a forum and e-buddy system on a website. A plan for implementation and evaluation is also described.DiscussionThe planned development of the Active plus programme resulted in two theory- and evidence-based tailored physical activity interventions targeted at the over-fifties.Trial RegistrationDutch Trial Register NTR 920

Low discretionary time as a barrier to physical activity and intervention uptake.

To determine whether self-reported discretionary time was associated with physical activity and uptake of a physical activity promotion intervention in a multi-ethnic urban sample. We examined the association of self-reported discretionary time with hours/week of leisure-time physical activity at baseline and physical activity intervention uptake. Low levels of discretionary time were significantly (P<0.01) associated with fewer hours/week (beta=-0.78, 95%CI=-1.34, -0.22) of physical activity at baseline. Discretionary time was not associated with physical activity intervention uptake. Lack of discretionary time may serve as barrier to physical activity, but its importance on intervention uptake is less clear.

Interventions to Increase Walking Behavior

Walking is the most prevalent and preferred method of physical activity for both work and leisure purposes, thus making it a prime target for physical activity promotion interventions. We identified 14 randomized controlled trials, which tested interventions specifically targeting and assessing walking behavior. Results show that among self-selected samples, intensive interventions can increase walking behavior relative to controls. Brief telephone prompts appear to be as effective as more substantial telephone counseling. Although more research is needed, individual studies support prescriptions to walk 5-7 versus 3-5 d.wk and at a moderate (vs vigorous) intensity pace, with no differences in total walking minutes when single or multiple daily walking bouts are prescribed. Mediated interventions delivering physical activity promotion materials through non-face-to-face channels may be ideal for delivering walking promotion interventions and have shown efficacy in promoting overall physical activity, especially when theory-based and individually tailored. Mass media campaigns targeting broader audiences, including those who may not intend to increase their physical activity, have been successful at increasing knowledge and awareness about physical activity but are often too diffuse to successfully impact individual behavior change. Incorporating individually tailored programs into broader mass media campaigns may be an important next step, and the Internet could be a useful vehicle.

Underlying mechanisms of improving physical activity behavior after rehabilitation

Regular physical activity is beneficial for the health and functioning of people with a disability. Effective components of successful physical activity promotion interventions should be identified and disseminated. To study the underlying mechanisms of the combined sport stimulation program "Rehabilitation & Sports" (R&S) and daily physical activity promotion program "Active after Rehabilitation" (AaR). Subjects in four rehabilitation centers received R&S + AaR (n = 284). Subjects in six control centers (n = 603) received usual care. Physical activity and its determinants were assessed with questionnaires at seven weeks before and nine weeks and one year after rehabilitation. Variables that were determinants of the intervention-induced improvement in physical activity behavior at both follow-up measurements were attitude, the perceived benefits "improved health and reduced risk of disease," "better feeling about oneself," and "improved fitness," and the barrier "limited environmental possibilities." The percentage change in the intervention coefficient caused by these determinants ranged from -35.3% to -16.3% and from -28.4% to -11.3% at nine weeks and one year after rehabilitation, respectively. Personalized tailored counseling interventions can improve physical activity behavior in people with a disability by targeting both personal and environmental determinants of physical activity behavior.

Project Play: Preschool Lessons for Active Youngsters

PURPOSE: To test efficacy of a newly developed physical activity promotion curriculum on motor skill development and levels of PA during time spent at an early childhood center. METHODS: Thirty eight preschool-aged children (3-5 yrs) enrolled in a Midwest childhood development center participated in the study. Half (n=19) of the children were randomly assigned to a 12 week physical activity program conducted 4 days per week by a master teacher in three morning classes of no more than 8 students per class. PA levels were assessed using MTI Actigraphs during the time spent at the center for at least three days in one week prior to and after the intervention. Minutes of Moderate and Vigorous PA were determined using 400 and 700 cts per 15s epoch respectively. Motor skills were assessed using the Test of Gross Motor Development - 2. Locomotor, object control, standard scores and Gross Motor Quotient were determined pre- and post-intervention in all subjects. Group and Test comparisons were made using a twoway ANOVA with repeated measures. RESULTS: 34 children (18 treatment, 16 control) completed the study. Due to lack of sufficient data only 23 children were included in the pre-post PA comparisons. There was a significant interaction between group (treatment vs. control) and time (pre-post) for minutes of MVPA (F = 5.424 (1, 21), p = 0.03) and VPA (F = 6.372 (1, 21), p = 0.02). In the intervention group (n=12), mean (SD) MVPA increased 51.7 (23.7) to 59.8 (18.2) minutes while the control (n=11) decreased 75.1 (20.9) to 62.7 (21.3) minutes. Mean (SD) VPA increased 23.7 (12.1) to 29.9 (12.4) and decreased 35.5 (10.0) to 29.7 (12.1) for intervention and control groups respectively. A total of 31 children (15 intervention, 16 control) completed the pre-post motor skill assessment. There were no significant interactions between group and test in locomotor, object control, or GMQ. While the raw locomotor and object control scores increase between tests (p=0.01and p=0.008), no significant effect of group nor test was evident on standard scores and GMQ. CONCLUSIONS: The physical activity program was effective in increasing PA levels on average and preventing a reduction of PA levels measured in the control. However this physical activity promotion intervention was not effective in improving the gross motor skills of the children over control.