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Effect of a governmentally-led physical activity program on motor skills in young children attending child care centers: a cluster randomized controlled trial.

ABSTRACT: To assess the effect of a governmentally-led center based child care physical activity program (Youp'là Bouge) on child motor skills.We conducted a single blinded cluster randomized controlled trial in 58 Swiss child care centers. Centers were randomly selected and 1:1 assigned to a control or intervention group. The intervention lasted from September 2009 to June 2010 and included training of the educators, adaptation of the child care built environment, parental involvement and daily physical activity. Motor skill was the primary outcome and body mass index (BMI), physical activity and quality of life secondary outcomes. The intervention implementation was also assessed.At baseline, 648 children present on the motor test day were included (age 3.3?±?0.6, BMI 16.3?±?1.3 kg/m2, 13.2% overweight, 49% girls) and 313 received the intervention. Relative to children in the control group (n?=?201), children in the intervention group (n?=?187) showed no significant increase in motor skills (delta of mean change (95% confidence interval: -0.2 (-0.8 to 0.3), p?=?0.43) or in any of the secondary outcomes. Not all child care centers implemented all the intervention components. Within the intervention group, several predictors were positively associated with trial outcomes: (1) free-access to a movement space and parental information session for motor skills (2) highly motivated and trained educators for BMI (3) free-access to a movement space and purchase of mobile equipment for physical activity (all p?

SUBMITTER: Bonvin A

PROVIDER: S-EPMC3724593 | biostudies-literature | 2013 Jul

REPOSITORIES: biostudies-literature

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Effect of a governmentally-led physical activity program on motor skills in young children attending child care centers: a cluster randomized controlled trial.

Bonvin Antoine A Barral Jérôme J Kakebeeke Tanja H TH Kriemler Susi S Longchamp Anouk A Schindler Christian C Marques-Vidal Pedro P Puder Jardena J JJ

The international journal of behavioral nutrition and physical activity 20130708

<h4>Objective</h4>To assess the effect of a governmentally-led center based child care physical activity program (Youp'là Bouge) on child motor skills.<h4>Patients and methods</h4>We conducted a single blinded cluster randomized controlled trial in 58 Swiss child care centers. Centers were randomly selected and 1:1 assigned to a control or intervention group. The intervention lasted from September 2009 to June 2010 and included training of the educators, adaptation of the child care built enviro ...[more]

PMID: 23835207

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Project description:BACKGROUND:North Carolina Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) resources improve child body mass index (BMI) when the resources are introduced by nurses to child care providers, and offered with workshops and incentives. In San Francisco, public health and child care agencies partnered to adapt NAP SACC resources into an annual "Healthy Apple" quality improvement program (HAP). METHODS:This cluster randomized controlled trial pilot-tested integration of the HAP with bi-annual public health screenings by nurses. All child care centers that participated in Child Care Health Program (CCHP) screenings in San Francisco in 2011-2012 were offered routine services plus HAP in 2012-2013 (CCHP?+?HAP, n?=?19) or routine services with delayed HAP in 2014-2015 (CCHP?+?HAP Delayed, n?=?24). Intention-to-treat analyses (robust SE or mixed models) used 4 years of screening data from 12 to 17 CCHP?+?HAP and 17 to 20 CCHP?+?HAP Delayed centers, regarding 791 to 945 children ages 2 to 5y, annually. Year-specific, child level models tested if children in CCHP?+?HAP centers had greater relative odds of exposure to 3 index best practices and smaller Autumn-to-Spring changes in BMI percentile and z-score than children in CCHP?+?HAP Delayed centers, controlling for age, sex, and Autumn status. Multi-year, child care center level models tested if HAP support modified year-to-year changes (2013-2014 and 2014-2015 vs 2011-2012) in child care center annual mean Autumn-to-Spring BMI changes. RESULTS:In 2011-2012, the CCHP?+?HAP and CCHP?+?HAP Delayed centers had similar index practices (<15% of children were exposed to a physical activity curriculum, staff joining in active play, and drinking water pitchers) and annual BMI changes. In 2013-2014: 60% of children in CCHP?+?HAP centers were exposed to the 3 index practices vs 19% in CCHP?+?HAP Delayed centers; Mean (SE) child BMI percentile (-2.6 (0.9), p?=?0.003) and z-score (-0.08 (0.03), p?=?0.007) decreased more in CCHP?+?HAP vs CCHP?+?HAP Delayed centers. In 2014-2015, after all centers were offered HAP, the index practices and BMI changes were improved for all centers vs 2011-2012. CONCLUSIONS:Integration of the HAP with existing public health nursing services was associated with significantly more children exposed to best practices and improvement in child BMI change. The results warrant continued integration of HAP into local public health infrastructure. TRIAL REGISTRATION:ISRCTN18857356 (24/04/2015) Retrospectively registered.

Project description:BackgroundOver the last decades, a decline in motor skills and in physical activity and an increase in obesity has been observed in children. However, there is a lack of data in young children. We tested if differences in motor skills and in physical activity according to weight or gender were already present in 2- to 4-year-old children.MethodsFifty-eight child care centers in the French part of Switzerland were randomly selected for the Youp'là bouge study. Motor skills were assessed by an obstacle course including 5 motor skills, derived from the Zurich Neuromotor Assessment test. Physical activity was measured with accelerometers (GT1M, Actigraph, Florida, USA) using age-adapted cut-offs. Weight status was assessed using the International Obesity Task Force criteria (healthy weight vs overweight) for body mass index (BMI).ResultsOf the 529 children (49% girls, 3.4 ± 0.6 years, BMI 16.2 ± 1.2 kg/m2), 13% were overweight. There were no significant weight status-related differences in the single skills of the obstacle course, but there was a trend (p = 0.059) for a lower performance of overweight children in the overall motor skills score. No significant weight status-related differences in child care-based physical activity were observed. No gender-related differences were found in the overall motor skills score, but boys performed better than girls in 2 of the 5 motor skills (p ≤ 0.04). Total physical activity as well as time spent in moderate-vigorous and in vigorous activity during child care were 12-25% higher and sedentary activity 5% lower in boys compared to girls (all p < 0.01).ConclusionsAt this early age, there were no significant weight status- or gender-related differences in global motor skills. However, in accordance to data in older children, child care-based physical activity was higher in boys compared to girls. These results are important to consider when establishing physical activity recommendations or targeting health promotion interventions in young children.

Project description:BackgroundPromoting health-enhancing and sustainable physical activity levels across childhood and adolescence contribute to positive health outcomes as an adult. This study will aim to: a) examine the immediate (pre- to post-intervention) and sustained (1-year post-intervention follow-up) effects of the Children's Health Activity Motor Program-Afterschool Program (CHAMP-ASP) on physical activity, motor competence, and perceived motor competence relative to the comparison ASP, b) examine the immediate and sustained effects of CHAMP-ASP on secondary health outcomes, specifically health-related physical fitness (i.e., cardiorespiratory fitness, muscular strength, percent body fat) and weight status compared to children in the comparison ASP, and c) determine if perceived motor competence mediates the effect of CHAMP-ASP on moderate-to-vigorous physical activity.MethodsThis multicenter cluster randomized trial will be implemented by ASP staff and will be conducted in ASPs located in two city-based cohorts: East Lansing/Lansing and Ann Arbor/Ypsilanti, Michigan. Children (N = 264) who are K-2 graders will participate 35 min/day X 3 days/week for 19 weeks (1995 min) in their afterschool movement program (i.e., CHAMP-ASP vs. comparison). The research team will train ASP staff to implement the program, which will be delivered within the existing ASP offering. Measures of physical activity (accelerometer), motor competence (process and product measures of fundamental motor skills), health-related fitness, perceived motor competence, and anthropometry will be collected pre-, immediately post-, and one-year post-intervention. Random-effects models will be used to assess the clustered longitudinal effect of the intervention on outcome measures.DiscussionThe long-term goal is to provide a sustainable, ecologically-relevant, and evidence-based program during the early elementary years that can be delivered by ASP staff, is health-enhancing, and increases physical activity in children. Findings hold the potential to help shape public health and educational policies and interventions that support healthy development and active living during the early years.Trial registrationClinicalTrials.gov Identifier NCT05342701 .Ethics and disseminationEthical approval was obtained through the Health Sciences and Behavioral Sciences IRB, University of Michigan (HUM00208311). The CHAMP-ASP study is funded by the National Institutes of Health. Findings will be disseminated via print, online media, dissemination events, and practitioner and/or research journals.

Dataset Information

Effect of a governmentally-led physical activity program on motor skills in young children attending child care centers: a cluster randomized controlled trial.

Publications

Effect of a governmentally-led physical activity program on motor skills in young children attending child care centers: a cluster randomized controlled trial.

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