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Efficacy of a free-play intervention to increase physical activity during childcare: a randomized controlled trial
Luke Wolfenden1,2,3,4, Jannah Jones1,2,3,4, Ben Parmenter2
1Hunter New England Population Health, Wallsend, NSW, Australia.
Insights
Childcare free-play access did not significantly increase moderate to vigorous physical activity (MVPA). Future interventions should address multiple environmental factors to boost child physical activity.
Area of Science:
- Pediatrics
- Public Health
- Behavioral Science
Background:
- Childhood physical activity is crucial for development and long-term health.
- Childcare settings are key environments for influencing children's physical activity levels.
- Current interventions often focus on structured activities, with less emphasis on free-play opportunities.
Purpose of the Study:
- To evaluate the effectiveness of a childcare intervention promoting unrestricted outdoor free-play.
- To determine if increased access to outdoor free-play enhances child physical activity and cognition.
Main Methods:
- A randomized controlled trial involving 231 children across six childcare services.
- Intervention group: unrestricted outdoor free-play access during non-structured times.
- Control group: usual scheduled outdoor play; physical activity measured by accelerometry.
Main Results:
- No significant differences were found in moderate to vigorous physical activity (MVPA) between groups.
- Proportion of wear time in MVPA and total physical activity also showed no significant group differences.
- Child cognition measures did not differ significantly between the intervention and control groups.
Conclusions:
- Unrestricted outdoor free-play in childcare alone may not be sufficient to increase child physical activity.
- Comprehensive interventions targeting both childcare and home environments show greater potential.
- Further research is needed to identify optimal strategies for promoting physical activity in early childhood settings.
Abstract:
The primary aim of this study was to assess the efficacy of a childcare-based intervention in increasing child physical activity by allowing children unrestricted access to outdoor areas for free-play when structured activity is not taking place. A randomized controlled trial was conducted in six childcare services. Intervention services provided children unrestricted access outdoors for active free-play, while control services provided their usual scheduled periods of outdoor play. Consent was obtained from 231 children. Child moderate to vigorous activity (MVPA), the primary trial outcome, was assessed via accelerometer at baseline and 3 months post baseline. Intervention effects were examined using Generalised Linear Mixed Models. Controlling for child age, gender and baseline outcome measure, at follow-up there were no significant differences between groups in minutes of MVPA in-care (mean difference: 4.85; 95% CI: -3.96, 13.66; P = 0.28), proportion of wear time in-care spent in MVPA (mean difference: 1.52%; 95% CI: -0.50, 3.53; P = 0.14) or total physical activity in-care (mean difference in counts per minute: 23.18; 95% CI: -4.26, 50.61; P = 0.10), nor on measures of child cognition (P = 0.45-0.91). It was concluded that interventions addressing multiple aspects of the childcare and home environment might provide the greatest potential to improve child physical activity.
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