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An Intervention to Increase Physical Activity in Children: A Randomized Controlled Trial With 4-Year-Olds in
Russell R Pate1, William H Brown2, Karin A Pfeiffer3
1Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
Insights
Preschool physical activity interventions can increase children's moderate- to vigorous-intensity physical activity (MVPA). Training teachers to integrate movement throughout the day effectively boosted MVPA, especially for girls.
Area of Science:
- Pediatric health and wellness
- Early childhood education and physical activity
- Public health interventions
Background:
- Preschool-aged children often have limited physical activity during the school day.
- Low physical activity levels in early childhood are linked to long-term health issues.
- Preschool settings offer a critical opportunity to promote healthy habits.
Purpose of the Study:
- To determine if an ecologic physical activity intervention in preschools increases children's moderate- to vigorous-intensity physical activity (MVPA).
- To evaluate the intervention's effectiveness across different subgroups, including by sex.
- To assess the feasibility of integrating physical activity into existing preschool curricula.
Main Methods:
- A randomized controlled trial (RCT) was conducted with preschools as the unit of randomization.
- The intervention involved training preschool teachers to incorporate physical activity into structured lessons, recess, and daily routines.
- Child physical activity was measured using accelerometry, with data analyzed using mixed-effects models.
Main Results:
- Children in intervention preschools showed significantly higher MVPA (minutes/hour) compared to control groups.
- The intervention's positive effect on MVPA remained significant after adjusting for covariates like parent education and school day length.
- Sex-specific analysis revealed a significant increase in MVPA for girls but not for boys in the intervention group.
Conclusions:
- A flexible, ecologic physical activity intervention effectively increases MVPA in preschool children.
- Teacher training and adaptable strategies are key components for successful implementation.
- Targeted approaches may be needed to maximize physical activity benefits for all children, including boys.
Introduction:
A majority of preschool-aged children spend a significant portion of every weekday in a preschool or child care setting, where they typically participate in limited physical activity. This study determined if an ecologic physical activity intervention in preschools increases children's moderate- to vigorous-intensity physical activity (MVPA).
Design:
RCT, with preschool as the unit of randomization and analysis. Child physical activity was measured by accelerometry. Mixed model analysis of covariance with preschool as a random variable was used to test the effects of the intervention on physical activity in the total group and in sex-specific subgroups. Data were collected in 2008-2010 and analyzed in 2012-2014.
Setting/Participants:
Children in 4-year-olds' classrooms in 16 preschools, pair matched and assigned to intervention or control groups.
Intervention:
The intervention focused on increasing children's physical activity by changing instructional practices. Researchers trained preschool teachers to engage children in physical activity during (1) structured, teacher-led physical activity opportunities in the classroom; (2) structured and unstructured physical activity opportunities at recess; and (3) physical activity integrated into pre-academic lessons. Research staff encouraged teachers to adapt the intervention to their classrooms.
Main Outcome Measures:
Minutes/hour of MVPA during the preschool day.
Results:
In an analytic sample of 379 children (188 intervention, 191 control), those in the intervention schools engaged in significantly more MVPA than children in control schools (7.4 and 6.6 minutes/hour, respectively). This difference remained significant after adjusting for parent education and length of the school day (half versus full day). In the sex-specific analyses, the difference was significant for girls (6.8 vs 6.1 minutes/hour of MVPA, respectively) but not for boys (7.9 vs 7.2 minutes/hour, respectively).
Conclusions:
A flexible ecologic physical activity intervention that trains teachers to provide children with opportunities to be active throughout the school day increased MVPA in preschool children.
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